Donlin talks about the proposed midlevel practitioner position, telemedicine, and more
R. Scott Nolen
The profession is now seeing demand for veterinary services begin to normalize, according to nationwide data. “That means clinic visits, new patients, and new clients appear to be gradually returning to prepandemic levels with evidence of growth in demand that is more in line with what we have seen in the past,” said Dr. Janet Donlin, AVMA CEO.
She recently spoke during the KC Animal Health Corridor’s 18th annual Animal Health Summit (AHS), held August 26-27 in Kansas City, Missouri. She was part of a panel of veterinary leaders invited by summit host KC Animal Health Corridor to speak about trends within veterinary medicine. Her co-panelists were Drs. Karen Felsted, founder of PantheraT Veterinary Management Consulting; Carolyn Henry, professor and former dean of the University of Missouri College of Veterinary Medicine; and Matt Peuser, owner of Advanced Veterinary Care of Olathe, Kansas.
Acknowledging that some areas of the profession are experiencing workforce shortfalls, she said some of the short-term solutions the AVMA has identified can help address these situations, including focusing on retaining staff, incorporating innovative technology into practice, and effectively engaging the full skill sets of all team members, especially veterinary technicians, veterinary technologists, and veterinary technician specialists.
Erroneous estimates for the number of companion animal veterinarians needed in 2030 “substantially” overestimate demand and underestimate supply, Dr. Donlin told the audience. These estimates, she said, are based on faulty math and are being used to justify proposed long-term changes to the profession that, in AVMA’s opinion, threaten animal health and safety.
Proposals include introducing a midlevel position (MLP) and dangerously relaxing VCPR requirements under the guise of expanding access to care.
“We believe that introducing a midlevel position is unnecessary, would be detrimental to the quality of care animals receive, and presents risks for food safety and public health,” Dr. Donlin said. “The addition of a midlevel position would mean someone who is not a veterinarian could be diagnosing, doing surgery, prescribing, and that is very worrisome. It’s also important to understand the concerns on the food animal side. The misdiagnosis or slow diagnosis of a life-threatening public health disease could cost billions of dollars or harm public health, so you’ve got to be careful.
“Claims of crisis-level shortages have some legislators in several states considering making dramatic changes to how the profession is regulated, even to the point of comments being made suggesting doing away with licensure altogether.”
AVMA’s position is that rather than creating a new, unneeded midlevel position, the profession should increase the number of veterinary technicians, veterinary technologists, and veterinary technician specialists, leverage them to the top of their degrees, and provide the pay and recognition they deserve.
Telemedicine and VCPR
Asked about the AVMA’s support for an in-person examination to establish a VCPR, Dr. Donlin responded that, “the AVMA really believes in telemedicine, and has for years,” adding that it is essential to have a previously established in-person VCPR.
“We firmly believe that an in-person exam establishing the VCPR is essential because you need to have your hands on and do the physical exam and also have the capability of doing diagnostics if necessary.”
Animal owners are not always able to accurately describe the clinical signs they are seeing their animals exhibit. Animals will instinctively hide signs of illness and pain, making a professional evaluation even more important. The in-person examination also allows the veterinarian to obtain appropriate diagnostic specimens.
For animals that don’t regularly see a veterinarian, a complete in-person examination is a vital component of basic or preventative veterinary care, Dr. Donlin added. Once a veterinarian has established that in-person relationship with the animal, telemedicine can provide numerous advantages for patients, veterinary teams, and clients throughout the duration of the animal’s care, she said.
Direct-to-consumer (DTC) veterinary telemedicine has been on the rise since the pandemic, according to Dr. Donlin. As a result, the AVMA is concerned that some DTC companies appear to be product sales-oriented rather than care-oriented, meaning that their focus is 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. They are 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, she said.
“For all these reasons,” Dr. Donlin said, “the AVMA opposes any legislative efforts to eliminate the need for an in-person visit to establish the VCPR.”