Legislators are revising veterinary practice acts to allow laypeople to perform animal care services such as equine dentistry.
Voters are hearing polarizing debates over animal welfare legislation and ballot initiatives.
Farmers who are rarely paying for veterinary services are lamenting when veterinarians decline to open businesses in their area.
About 80 volunteer leaders and staff members from state veterinary associations and the AVMA shared experiences and concerns related to these and other topics at the third AVMA State Public Policy Symposium, Nov. 7-8, 2009, in Tampa, Fla. And they discussed the need to engage elected leaders and the public to help shape public policy and legislation.
Ralph Johnson, executive director of the Colorado VMA, leads discussion on regulated and
nonregulated animal therapies in a session on nonveterinarian animal care providers at the
AVMA State Public Policy Symposium Nov. 8 in Tampa, Fla.
"It's going to take the whole profession in order to be effective in the legislative process and in order for veterinary medicine to remain and continue to be one of the world's most highly respected professions," Dr. Larry R. Corry, AVMA president, said in opening comments for the symposium.
Bill Heller, a state representative in Florida, encouraged leaders in veterinary medicine to build relationships with their elected officials and learn about their interests. Changing a single word in legislation can impact the veterinary profession, Heller said, adding that it is important to educate legislators on complex issues.
Philip Hinkle, former mayor of Haines City, Fla., and the executive director of the Florida VMA, said elected officials want constituents to be involved with government, and developing a strong relationship and rapport pays off.
Dr. W. Ron DeHaven, AVMA CEO, said veterinarians need to be leading advocates at the local, state, national, and international levels.
"So inherently, that means that if we were going to succeed in that goal, we need to do so through partnerships, and there's no way that we can be effective in advocating for the profession without having a synergistic relationship with a lot of partners, and none more important than our colleagues at the state associations," Dr. DeHaven said.
The profession is increasingly seeing state regulations and legislation with national implications as well as national legislation that impacts the states. Dr. DeHaven said dialogue on current issues helps members maximize their impact and become more successful in advocating on issues that affect veterinarians.
Ballots, bills, and court cases
In a session about livestock housing and animal welfare, Jack Advent, executive director of the Ohio VMA, talked about the possible impact of a ballot initiative that Ohio voters passed in November 2009 creating a largely politically appointed expert panel with the power to determine animal welfare standards. Advent also discussed the possibility that another ballot initiative in 2010 could outlaw some forms of animal housing.
Dr. Gail C. Golab, director of the AVMA Animal Welfare Division, said a federal legislator from Ohio recently expressed a desire for a logical, trustworthy voice in the middle to whom he could turn during welfare debates. She said veterinary associations and welfare-savvy veterinarians can provide that rational middle ground for legislators.
Arguments against animal welfare legislation often focus on decreased food safety and increased food prices, but Dr. Golab said those arguments do not directly answer the questions being put to voters. Voters are not being asked to make decisions on food safety, and they are not immediately focusing on economics.
Dr. Golab said that, as important as those issues are, "The question they want you to answer is: 'What's going on with that animal?' And tell me why that animal is being well-cared for in the situation it's in right now."
Dr. Arnold L. Goldman, president of the Connecticut Veterinary Medical Foundation, said after the session that it was helpful to learn that the veterinary profession in other states faces similar challenges regarding animal welfare legislation, and it was instructive to learn how other states approach those challenges. He said the profession must focus on putting overall animal welfare first and, in doing so, they will do what is best for society and animals.
Dr. Drew L. Allen, immediate past president of the Utah VMA and the association's state legislative committee chairman, said he appreciated that the animal welfare session included a discussion of whether veterinarians should focus attention on the animals and leave economics to producers.
Another session focused on possible challenges from courthouses, rather than statehouses, and what the profession is doing to prevent harm to practitioners.
Chris Copeland, executive director of the Texas VMA, said few courts in the U.S. have allowed animal owners to claim noneconomic damages, and legislation to allow recovery of such damages has so far failed. But as some attorneys continue pushing in courts for such damages, the AVMA Legal Outreach Program is giving law students, veterinary students, and practicing attorneys information on the negative, unintended consequences of awarding such damages.
Rural practice needs
Symposium attendees also discussed how to create financial incentives for veterinarians to start practices in rural areas or take over practices of retiring veterinarians as well as funding options for such incentives. Potential hurdles include the tendency among some producers to rarely use veterinary services outside of emergencies, laypeople cutting into potential work for rural veterinarians, and concerns over whether it is helpful to provide financial relief to recent graduates who may not have the business experience to start practices in unfamiliar areas.
Dr. Calvin R. White, president-elect of the Oklahoma VMA, said it is problematic that legislators are encouraging veterinarians to start rural practices at the same time they revise state practice acts to allow laypersons to take over certain aspects of veterinary medicine, such as equine dentistry.
Dr. DeHaven said he thinks veterinarians three to five years out of college could be ideal candidates to open rural practices, as they may have the experience needed to open their own clinics. However, Dr. Stephen Shores, Florida's alternate delegate to the AVMA and a Florida VMA past president, said it is easier to convince state lawmakers to fund tuition relief than new practices for existing veterinarians.
Discussion addressing the current and potential impact of allowing nonveterinarians to provide animal care focused on lay animal dentists, chiropractors, physical therapists, acupuncturists, massage therapists, reproductive medicine workers, and aquatic animal medicine workers.
Participants raised concerns that nonveterinarians could harm animals or, as in cases involving large animals, people; defraud clients; worsen the shortage of rural veterinarians; and reduce state authorities' disciplinary powers.
Hinkle said he expects that chiropractors who start receiving income for animal patients, for example, will want to expand their services into animal care.
He also said some veterinarians in his state were reluctant to offer equine dental services, which led to an increase the number of lay equine dentists. More veterinarians wanted to offer the services after the economy softened.
Hinkle warned that, once veterinarians surrender a portion of veterinary practice to other regulated professions or nonregulated individuals, they will never again be the only individuals allowed to provide that service. Organized veterinary medicine should do everything possible to ensure the safety and well-being of animals and to ensure that veterinary practices are restricted under state practice acts to qualified individuals, he said.
Dr. White said the 2009 arrest of a rodeo star who was practicing equine dentistry caused an uproar among horse owners in Oklahoma. Legislators received a deluge of calls from people praising the arrested man, while few veterinarians spoke out in opposition to allowing him to continue practicing animal dentistry.
Dr. Douglas G. Aspros, vice chair of the AVMA Executive Board, also noted that physicians and dentists may be willing to perform procedures at zoos for free because it's interesting work and "kind of a lark" for them. That may compromise care that should come from properly trained veterinarians, he said. Some physicians and the director of a large zoo in New York unsuccessfully argued for the passage of a bill introduced last year that would have allowed physicians to take over care of nonhuman primates.
Dr. Clark K. Fobian, AVMA Executive Board member representing District VII, said it appears that lay practitioners generally enjoy positive public perception. He states it is not unusual to see an article in a county newspaper about a chiropractor helping a person's dog walk again, and said the profession needs to address the lack of accountability of nonveterinarian practitioners.
Dr. Aspros added that, if a state permits only veterinarians to perform a medical procedure on animals and the procedure is in demand by the public, some veterinarians must be willing and able to perform that procedure.
Dr. Fobian said there is a societal expectation that professions continually evolve and progress to incorporate additional services. He thinks the public may see future expansion of nonveterinarian practitioners into veterinary medicine as natural growth.
The attendees indicated that, in addressing the issue of regulated professions and nonregulated individuals providing services, the profession can educate the public and elected officials, examine the demand for animal care services offered by nonveterinarians compared with the supply of veterinarians, identify requirements for liability insurance, and determine whether states can fine or otherwise penalize unauthorized service providers.