R. Scott Nolen
When the Executive Summary of the latest economic study of the entire US veterinary profession was released during the AVMA Annual Convention last year, a primary goal of the three commissioning associations was that the issues raised in the summary would generate nationwide discussion.
The summary conclusions derived from "The Current and Future Market for Veterinarians and Veterinary Medical Services in the United States" describe a profession of competent, independent individuals who, however, earn comparatively less than other medical professionals.
A source of the inequity identified by the market study is that veterinarians often are deficient in skills necessary for economic success; they may also tend to undervalue their abilities and downplay their role in society.
Despite the substantial potential to increase demand for veterinary services, if dramatic changes aren't made soon, the summary forecasts a poor economic future.
Coverage of the summary in the veterinary press and its discussion during the AVMA Veterinary Leadership Conference and House of Delegates Informational Assembly in January indicate that the associations are making headway in bringing these issues to the forefront of veterinary dialogue.
Dr. David P. Madsen directs an AASP concern about the market study to the AVMA/AAHA/AAVMC Joint Steering Committee.
Yet the coalition that commissioned the market study — the AVMA, American Animal Hospital Association, and Association of American Veterinary Medical Colleges — recognizes that, although a buzz has begun among associations and within academe, more veterinarians need to know about the study and its implications.
During the leadership conference, held Jan 7-9 in Chicago, two informational sessions about the market study were hosted by the AVMA/AAHA/AAVMC Joint Steering Committee.
A history of the study and a review of its conclusions were presented, as was an update on the National Commission on Veterinary Economic Issues. The steering committee, which will also be the board of directors for the commission, fielded questions from a diverse spectrum of veterinary interests. In their presentations both days, the committee revisited and expanded on issues raised in the summary.
For the most part, the leadership's questions and comments acknowledged a need for change in veterinary business practices and supported the study. Dr. Kenneth J. Rotondo, New York alternate delegate, said, "I think it's the best [money] the AVMA's ever spent."
Speaking on behalf of the steering committee, chair Dr. James E. Nave, 1999-2000 AVMA president-elect, underscored the importance of a national dialogue. "Such communication and open discussion is vital. It transforms the market study into a working document. It is the input of veterinarians that will drive the change in the economic state [of the profession]."
Some members of the House of Delegates commented on the apparent lack of awareness among private practitioners and veterinary students about the study.
Since its publication in the JAVMA (July 15, 1999, pages 161-183), the Executive Summary has prompted several veterinary colleges to hold faculty retreats examining how better to prepare their graduates for the business world (see JAVMA, Jan 1, 2000).
Dr. Joseph H. Kinnarney, AVMA vice president, told the delegates during the informational assembly of the HOD that, as liaison to veterinary students, he makes the study an integral part of his presentation to student chapters. "I can assure you that when I [visit] the schools, if they didn't know about the market study before, they do by the time I leave," he said.
There are plans for the national commission, which held its first meeting in late January, to host a series of national forums across the country to discuss the study and veterinary economics in general. These will afford veterinarians an opportunity to help shape the commission's initiatives. In addition to the commission's up-and-coming Web site, JAVMA and AAHA's Trends will devote pages to national commission activities.
It was announced that the not-for-profit commission has received $150,000 annually for five years. Bayer Animal Health and Veterinary Pet Insurance each have paid $75,000, in addition to a one year pledge of $50,000 from Pfizer Animal Health. Corporate and grant sources throughout the animal health industry continue to be developed, Dr. Nave said, to ensure the commission's financial independence.
The question and answer times at the conference also allowed for the steering committee to clarify what the study is and is not, and what direction the profession needs to take.
Representatives from the AASP and AABP voiced their concerns about the study's inclusion of the food animal industry and the perceived fallout for food animal veterinarians.
Dr. David P. Madsen, AASP alternate delegate, said his association was under the impression that the market study would examine only companion animal practices. Because formal input from the food animal associations was not incorporated into the study "the conclusions represent a summary of data that are flawed by their age, by their source, and by their relevancy," he said.
Further, Dr. James A. Jarrett, AABP alternate delegate, worries that the study will discourage veterinary colleges from funding food animal education programs, thus affecting the "quality and quantity" of veterinarians provided to the animal agriculture industry. "Our concern is how this information is used, and how it may impact veterinary education."
AVMA executive vice president Dr. Bruce W. Little noted that some confusion may have resulted because two studies were commissioned at about the same time. The market study, which is not species specific but a comprehensive review of all markets in the veterinary profession, was commissioned in 1998 around the time the Brakke Management and Behavior Study was commissioned. The Brakke study, Dr. Little said, specifically examines companion animal practice issues and has not been released.
Dr. Nave referenced a letter he sent to the food animal associations seated in the HOD in which he explains that the conclusions were not influenced by the joint steering committee, but are those of the research organization, KPMG LLP Economic Consulting Services.
In the letter Dr. Nave further states he was unaware of any veterinary colleges using the market study to scale down food animal courses. Although not a member of the HOD, Dr. Peter Eyre, dean of the Virginia-Maryland Regional College of Veterinary Medicine, was allowed to comment during the meeting. Dr. Eyre averred that he was also unaware of any downsizing of food animal medicine programs.
Dr. Lonnie J. King, dean of Michigan State University College of Veterinary Medicine, advised against jumping to conclusions based on the Executive Summary, but to read the entire study. "I think the right questions are: is this accurate information, is the analysis correct, and what are the implications, and then what should we do about them?"
The print and CD-ROM versions of the 700-page market study are currently available for purchase, with an abridged version scheduled for release later this month. Details will follow.
Questions about an oversupply of veterinarians and the economic impact of women in the profession were raised during the conference, as they have been since the Executive Summary's release. AAHA executive director Dr. John W. Albers said that, despite the apparent scarcity of practitioners, as evidenced in the JAVMA's classified ad section, in purely economic terms, the demand for veterinary services will not match the supply in the years ahead.
One factor is that most animal care is delivered through a highly inefficient system. A common example is a small community may be home to several independent practices, each with its own costly equipment. (Such a model in human medicine in relatively unheard of today). A consequence is that competition, compounded by already low service prices, holds prices and income down.
Dr. Albers clarified that the profession's economic problems are not the fault of women; nevertheless, gender issues have to be examined. Differences in income and business practices exist between men and women in nearly all professions, and veterinarians in the next 15 years will be predominantly women.
It is these kinds of issues, he explained, that the national commission will address through task forces and with the input of veterinarians, associations, and colleges.
"We must improve the economic base of the profession in order to ensure that veterinary medicine meets the needs of society in the future," Dr. Albers said.