Workforce: What is best for safe, quality animal care?

Discussing the risks of a midlevel position and virtual VCPR

The past few years have been extremely challenging for veterinary practices and teams. We saw an increase in client demand early in the COVID pandemic, and practices have had team members leave at all levels, at least temporarily.

While we continue to face workforce challenges, veterinary patient demand is beginning to return to a pre-pandemic norm. As individuals and as a profession, we're in favor of solutions that ensure our practices are able to provide quality care for patients now and long into the future.

So what are the right answers?

The pandemic: An outlier, not the norm

First off, it's important to note that pandemic data is an outlier, not a baseline. Despite its continuing repercussions, it wouldn't be wise to make long-term decisions based on what happened in the midst of COVID-19.

The most effective short-term solutions to lingering workforce challenges focus on three primary strategies:

  • Retaining current team members—especially veterinary technicians, veterinary technologists, and veterinary technician specialists—and leveraging them to the top of their degrees
  • Utilizing technology to drive innovation and quality care
  • Leveraging tools to increase practice efficiency

Related to the first of these, the AVMA also supports the expansion of veterinary technology programs; title protection and licensing; appropriate credentialling, and improved recognition and leveraging, of veterinary technicians; and enhanced pay and benefits.

Scrutinizing a proposed midlevel position

Unfortunately, some estimates circulating for the number of companion animal veterinarians needed in the profession substantially overestimate demand and underestimate supply. These erroneous numbers are being used to justify proposed long-term changes to the profession that can jeopardize animal health and welfare, patient safety, and public health. This includes inappropriately expanding the scope of practice of non-veterinarians under the guise of expanding access to care.

In some cases, claims of crisis-level shortages are causing stakeholders to consider pursuing dramatic changes to how the profession is regulated, even to the point of trying to amend the veterinary practice acts in all 50 states.

It's critically important to use accurate data for long-term planning. By 2030, the number of veterinarians providing services for companion animals is projected to grow by more than 20%. On top of that, there are 15 new and proposed veterinary schools in various stages of development, which will lead to increased workforce capacity of veterinarians.

Rather than creating a new midlevel position for which there is no demand, no validated third-party test to ensure competency of candidates, and no accreditation, we can more efficiently leverage veterinary technicians, veterinary technologists, and veterinary technician specialists to the top of their degrees, and provide the pay and recognition they deserve.

The AVMA wants the right long-term solutions—solutions that will not compromise or undermine safe, quality medical care for animals or public health.

Telemedicine and the VCPR

Proper use of telemedicine can improve effectiveness and efficiency in delivering veterinary care, and the AVMA provides a suite of resources that empower veterinary practices to implement it.

The veterinary profession has been using telemedicine successfully for a very long time, largely because it has been done within a veterinarian-client-patient relationship (VCPR) established with an in-person exam.

The AVMA strongly believes that veterinary telemedicine must only be conducted after a VCPR has been established in person, except in emergencies until the patient can be seen by a veterinarian. The in-person visit gives the veterinarian information about the animal's physical condition and allows the veterinarian to obtain appropriate diagnostic specimens. Both are important for a prompt and accurate diagnosis, particularly because animals may not show obvious signs of disease and cannot speak.

A wrong diagnosis and/or treatment plan results in prolonged illness and suffering, and also increases costs for the animal's owner.

Some direct-to-consumer companies appear to be sales-oriented rather than care-oriented, focused on delivering their preferred set of drugs and medical products instead of comprehensively evaluating patients and delivering best-suited care. Some of these companies are actively pursuing state legislative and regulatory changes that would allow a VCPR to be established electronically—lobbying for a virtual VCPR because, it appears, their business model is only sustainable and more profitable in an operating environment that allows a VCPR to be established electronically.

The AVMA opposes any legislative efforts to eliminate the need for an in-person visit to establish the VCPR. The in-person VCPR requirement is in the best interest of animals and is fundamental to quality care.