Creative Disruption columnist Dr. Bob Lester is the chief medical officer at WellHaven Pet Health, a former practice owner and a founding member of Banfield Pet Hospital and the Lincoln Memorial University College of Veterinary Medicine. He serves on the boards of Pet Peace of Mind, WellHaven Pet Health and the Lincoln Memorial veterinary college. He is the immediate past president of the North American Veterinary Community.Read Articles Written by Bob Lester
The demand for veterinary services is growing and the supply of veterinary professionals is not, which is both a blessing and a curse. A blessing for millions of new pet owners who benefit from a fur baby’s unconditional love. A curse in figuring out how best our profession can deal with the growing need for veterinary care. Those of you misguided enough to have read my recent columns know that the workforce shortage, in my estimation, is among the most pressing issues facing our profession. We have a fundamental mismatch in which the demand for services outpaces our ability to attract, select, develop and retain an adequate supply of great team members.
The consequences of this imbalance include the risk that non-veterinary professionals will provide veterinary services, that we won’t deliver necessary care, and that we will overwork our teams and colleagues. The barriers to care continue to grow. Ultimately, we risk the health of pets and ourselves.
Techs and Tech
The solution, in part, lies in embracing techs and tech. By that, I mean veterinary technicians/nurses and technology in support of better medicine and better relationships with pet owners and each of us.
Team-based health care delivery supported by technology will go a long way in solving our dilemma. The solution is not to work harder — we can’t work any harder — but work differently. Other health care professions have done a better job of delivering team-based health care. Look at the ratio of doctors to licensed support staff in similar professions. Your physician averages about five empowered, well-compensated licensed professionals for every MD, and your dentist about three. For every veterinarian, on average, is one veterinary nurse. That’s sad. Think back to your last physician or dentist appointment. How much time did you spend with the doctor’s team?
As for technology, think texting, cloud-based PIMS, telemedicine, teletriage, artificial intelligence, client apps, e-commerce, bots, clinical decision-making support … the list goes on. Our dominant workforce and consumers are now millennials. They insist that our profession move into the 21st century. With an assist from technology, we can maintain and improve the deep client-doctor relationships for which our profession is known. Technology is an opportunity and a tool, not a threat. Telephones and paper appointment books will soon join the Walkman and typewriter somewhere deep in the attic.
Tony Stark, DVM
Veterinary professionals are superheroes. The COVID-19 pandemic proved that once again. But let’s take the analogy a little further. Think of Tony Stark as a veterinarian. All by himself, without his Ironman suit (technology) and his Avenger colleagues (health care team), he does a fair job of problem-solving, diagnosing and treating issues. With his suit and team, he can save the world. Just as Tony Stark can do more, accomplish more and occasionally leave work on time, so can we by embracing our team and utilizing technology.
How best to address the shortage of veterinary professionals? I see three categories of prospective additions to our teams.
1. Non-credentialed employees
COVID severely impaired our ability to recruit these critical team members. Generous unemployment benefits, the necessity to care for families, school closures, illness and the fear of contracting COVID complicated hiring efforts. Much of this will pass through more immunizations, the resumption of in-person school, reduced fear and more unemployed people returning to the workplace. Fingers crossed.
I don’t have a short-term solution for finding more veterinarians, but a midterm answer is clear: Lobby veterinary college deans and the Council on Education to increase class sizes. Perhaps add a second incoming class each year. In addition to helping solve the veterinarian shortfall, scaling up class sizes should reduce tuition. (Econ 101: Scaling results in cost advantages. The greater the output, the lower the per-unit cost.) Simply put, more students, lower tuition. A win-win.
The primary customer of academia is the society it serves and the workplace it supplies. Society and the workplace have made clear that we are desperate for more graduated veterinarians. One need look no further than the one-plus-month waits to book a veterinary appointment and to American Veterinary Medical Association data indicating that 45% of clinics have 1.8 vacant veterinarian positions that they struggle to fill for 10 months. Fact: Society needs more veterinarians! The old COE objections to raising class sizes included the potential of compromising the educational experience due to a lack of chairs, lecture space and microscope numbers, and the limited caseloads in tertiary-care referral hospitals. Those objections are no longer relevant because of virtual teaching modalities and distributed clinical education.
But wait! We have a reason for optimism as new veterinary schools come online. Texas Tech University, Long Island University and the University of Arizona will soon add great veterinarians to our ranks.
3. Veterinary technicians/nurses
The issue here is less about the supply of graduates and more about retention. After all, we have over 200 accredited veterinary technician schools. Veterinary nurses leave our profession, on average, after only seven years. How do we stop these amazing individuals from resigning? The answer is to empower, honor and compensate them fairly. Let’s grow the career span from seven years to 27 and beyond. We can do it. Start a conversation today with your techs/nurses and doctors.
Pets, Pets, Pets
According to the American Pet Products Association, 12.6 million new pets entered pandemic households from March to December 2020. Anecdotally, WellHaven Pet Health hospitals are seeing record numbers of new pets thus far in 2021. Idexx Laboratories reported net pet population growth of 6%, up from the normal 1%. Additionally, surveyed single-pet households indicated that they are likely to adopt another pet when they return to the office so that their single pet will have company.
The much-feared return of pandemic pets to animal shelters as society reopens is proving to be unfounded. Giving up pets is unthinkable to new pet owners. Have you met millennials with new pets? Did anyone think they were going to abandon their fur babies? The bond has never been stronger. The increased demand for veterinary services is here to stay.
Dr. Stark and His Avengers
By adopting a team health care delivery model supported by technology, we can help more pets and maybe get home on time. (Call me a crazy optimist.)
More than ever, veterinary professionals provide a critical need to society by promoting the magic bond between pets and people. In this polarized time of red versus blue and urban versus rural, we all agree on the value of pets. Pets unite us, connect us and bring us together.
When confronted with enormous world-threatening challenges, what does Tony Stark do? He reaches out to his team and dons his suit. As veterinary superheroes, we can learn from Tony.
BEHIND THE MASK
In reality (or fantasy), Tony “Ironman” Stark earned doctorates in physics and electrical engineering. His Marvel Entertainment biography says nothing about an interest in veterinary medicine.