A census of veterinarians prepared by the AVMA raises concerns that demographic factors could exacerbate shortages in the profession and declines in practice ownership.
The AVMA Veterinary Economics Division conducted an analysis of the AVMA membership database that identified 113,394 veterinarians living in the United States in 2018, of which 72.4% were AVMA members and 27.6% were not. Results of the analysis appear in this issue of the JAVMA.
Millennials, born between 1981 and 1996, now represent 39% of veterinarians. Baby boomers represent 33%, and members of Generation X represent 25%. Women represent 61.7% of veterinarians, continuing a long-term gender shift.
Most veterinarians age 75 or younger, 83.9%, work in private clinical practice. The AVMA analysis found that, among veterinarians who identified themselves as being practice owners or associates, 42% were owners in 2018, down from 47% in 2008. Younger veterinarians and female veterinarians were less likely to be practice owners.
The analysis found substantial increases from 2008-18 in the number of veterinarians in emergency and critical care medicine and in referral or specialty practice.
According to the census report, "Mean age at the time of graduation has increased since 1975, raising concerns that career length for veterinarians may be decreasing, potentially exacerbating veterinarian shortages." Also according to the report, "Worryingly, a large number of board-certified veterinarians are nearing retirement within the next 15 years, which may increase the shortage of board-certified veterinarians unless there is a substantial increase in the number of younger veterinarians pursuing board certification."
The big picture
The motivation behind the demographic analysis was to provide information that would help policymakers improve their workforce planning and address issues such as veterinarian shortages and high educational debt among veterinarians, said Frederic B. Ouedraogo, PhD, lead author on the report and assistant director of economics in the AVMA Veterinary Economics Division. Other professions conduct similar analyses, such as a 2016 census identifying 953,695 actively licensed physicians in the United States.
In 2018, the U.S. population of veterinarians who were 65 years old or younger was 102,000, a 30% increase from 2007. More than 3,000 veterinarians graduated from the 30 U.S. veterinary colleges in 2018, and approximately 750 U.S. citizens graduate from foreign veterinary colleges every year.
"Most states had a ratio of 1,000 to 1,500 housing units for every 1 veterinarian," according to the census report. "States with the lowest number of housing units per veterinarian were mainly located in the West Central and Mountain Regions."
Out of all veterinarians, 21.3% percent identified themselves as practice owners in 2018, and 29.3% identified themselves as associates.
Dr. Ouedraogo said the profession is seeing a decline in practice ownership, particularly among younger veterinarians. He attributed the decline to a combination of market consolidation and educational debt.
"For veterinarians who identified as practice owners or associates, 14.5% of those ≤ 39 years of age indicated in 2008 that they owned a practice, but only 9.0% did in 2018," according to the census report. For ages 40-49, the percentage decreased from 43.8% to 27.5%.
Among owners and associates, about 62.1% of male veterinarians and 29.7% of female veterinarians were owners in 2008, compared with 59.3% of male veterinarians and 29.3% of female veterinarians in 2018. Men made up roughly half of all veterinarians in 2008, decreasing to 38.2% in 2018.
Age at graduation
The mean age at graduation from veterinary college was 25 in 1975 and rose until about the year 2000, for unknown reasons, before plateauing at 28 or 29. Dr. Ouedraogo is still analyzing retirement age, but shorter career lengths could exacerbate veterinarian shortages and complicate the problem of educational debt.
If a veterinarian graduates at 24 or 25 with a certain amount of student debt to repay, Dr. Ouedraogo said, the debt will be easier to repay than for a veterinarian who graduates at 30 with the same amount to repay.
Data from the Association of American Veterinary Medical Colleges indicate a somewhat different pattern in the age of veterinary students, said Lisa M. Greenhill, EdD, AAVMC senior director for institutional research and diversity.
"There was a period in which the mean graduate age was rising and approached 30 years of age; however, that was about 20 years ago," she said. "We have seen a drop from that number with a continued slow decline during the last decade."
According to AAVMC data, the mean age of first-year veterinary students was 22.4 in 1975, increased to 24.9 in 1995, and decreased to 23.3 in 2018.
Specialists, emergency and critical care
Among veterinarians age 75 or younger, the number in emergency and critical care—both specialists and nonspecialists—increased 133.5% from 2008-13 and 63.3% from 2013-18, while the number in all types of referral or specialty practice increased 98.4% from 2008-13 and 49.1% from 2013-18.
"In economics, we usually say that demand creates its supply, so I guess that it's because now we're seeing more people who want specific care for their pets that we observe this rising pattern for critical care and specialty medicine," Dr. Ouedraogo said.
"In 2008, approximately 20% of board-certified veterinarians were between 50 and 54 years old," according to the census report. "In 2018, approximately 24% of board-certified veterinarians were ≥ 60 years old, most likely representing the same veterinarians in the 50- to 54-year-old cohort in 2008. Compared with 2008, higher percentages of veterinarians in their 30s to mid-40s were board certified in 2018."
Dr. Ouedraogo said the problem that the profession could be facing is that the replacement rate won't keep up.
"We have seen articles recently or heard from hiring firms describing the difficulty hiring some specialists, which suggests that the demand is still growing," said Dr. Ed Murphey, an assistant director of the AVMA Education and Research Division and staff consultant for the AVMA American Board of Veterinary Specialties.
Anecdotally, at least, Dr. Murphey said, veterinary colleges are having a hard time hiring some specialists, notoriously radiologists. He said, "This can have a large impact by reducing the number of individuals training future specialists in that field."
The census report and ABVS data alike indicate that emergency and critical care is the specialty with the largest percentage increase in board-certified veterinarians. The census report found that the number increased 31.7% from 2008-13 and 62.8% from 2013-18, while the ABVS data indicate that the number increased 163% from 2008-18.
All the veterinarians
Dr. Ouedraogo is working on a study to predict the number of veterinarians necessary to meet demand in coming years for various categories, such as companion animal medicine. He is nearly done with a study about when and why veterinarians shift from full-time to part-time work.
While the AVMA membership database is missing data, Dr. Ouedraogo said, the AVMA does keep track of all the veterinarians in the country.
"It's not a sample; we have the population of the U.S.," he said. "So we can really do a lot of good study with it, and we are only ones who can really pretend to know all the population of veterinarians in the U.S."
Related JAVMA content:
Ripple effects of Megastudy still being felt (July 15, 2019)
Veterinary association created to counter corporate influence (May 1, 2019)
Hiring crunch (April 1, 2019)
Efforts evolve on how to address educational debt (March 15, 2019)
ER docs shortage turns critical (March 1, 2019)
Market for veterinarians still going strong (Dec. 15, 2018)
The corporatization of veterinary medicine (Dec. 1, 2018)
Specialists in short supply (Oct. 15, 2018)