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Two out of three is bad

We have technology and wellness care down pat. So then, why are we so slow to empower veterinary nurses? They are capable of so much more. Doctors, it’s your move.

Two out of three is bad
Throughout the remainder of the pandemic and beyond, let’s work harder to empower, utilize and honor veterinary nurses.

Meat Loaf the singer released his “Bat Out of Hell” signature album, the music of my youth, in 1977. (I know I’m old.) On the album was the power ballad “Two Out of Three Ain’t Bad,” a great song and a sentiment I typically share. In the case of the pandemic, however, two out of three ain’t so good. I’ve seen two significant changes for the better and a third that remains in need of changing.

I’ve made the case before that our profession would benefit by making three significant changes:

  • Embrace technology.
  • Prioritize preventive care.
  • Empower veterinary nurses.

During COVID-19, we took nice strides toward driving change on the first two items but moved little on the third. Two out three is not good enough.

A New Beginning

As I write this article, we’re barely emerging from the major disruption brought about by COVID-19. As the title of this column, “Creative Disruption,” implies, I am a fan of internally driven change and disruption in creation of a new and better profession. Sadly, the COVID-19 external disruption was often destructive. My heart goes out to those impacted.

So, how can we best move forward during a time in which veterinary consumer behavior has been forever changed? We’re at the point where our nation better understands the physical and emotional benefits of puppy breath and kitten purrs. Witness the record number of pet adoptions. The support, stability and unconditional love that results from including four-legged members in our families is at the top of my mind. Let’s not return to the old ways of practice. Let’s learn from COVID-19 and embrace a new and better normal.

Those of you who’ve read my column know that I am an incurable optimist. Our profession is so fortunate. Pet numbers are up, pet spending is up, the bond has never been stronger, shelters are emptying, respect for veterinary professionals remains high, pet lifespans are growing, we’re again proving that we are recession-resistant, PetGen (millennials and Gen Zers) are crazy for pets, and wellness care is growing. What’s not to like?

Well, think about this:

  • Half of the pets in the United States won’t see a veterinarian this year.
  • Burnout, compassion fatigue, mental health challenges and suicide continue to plague our ranks.
  • Our current business model often fails to meet the needs of PetGen.
  • While we’re recession-resistant, we are clearly vulnerable to outside disruption.

The 3 Keys

How do we best address these deficiencies? My answer remains technology, preventive care and veterinary technicians/nurses. We moved the ball way up the hill on two out of three. Technology in support of better pet care is a big winner post-COVID, as is the necessity of preventive care. What we failed to do was further empower veterinary nurses. In that respect, a good crisis is being wasted. Let’s go a little deeper.

1. Good disruption: Embracing technology in support of the connection between the veterinary team and pet owner.

I’m confident that we’ve conducted more telemedicine consults over the last several months than in the entire history of the profession. Telemedicine has made enormous strides in proving its value. Additionally, e-commerce platforms have further demonstrated their value in home delivery, cloud-based PIMS that allow work from anywhere have further shown their worth, and marketing platforms that facilitate multiple, digital client communication modalities have provided a tremendous lift. These are all big wins for pets, clients and veterinary professionals.

Society, state boards (except in California), pet families and our profession have a new appreciation for the role of technology in quality practice. We should see more and more state boards follow the leadership of the American Association of Veterinary State Boards and move toward permanently recognizing the value of telehealth as one more tool to help pets and families. Millennials and Gen Zers have been waiting for us. Let’s hang on to our use of technology in support of better pet health care and client communication post-COVID.

2. Good disruption: Recognition of the importance of preventive care.

Because veterinary care is an officially designated essential service, our society and profession have rediscovered the importance of prevention. We remained open for business because of the critical role we play in both human and animal health. The safeguarding of both two-legged and four-legged animal health has been elevated. One need only think back to Hurricane Katrina to remember what happens when pet health is not prioritized.

As pets and families sheltered in place during COVID, we were reminded of the importance of immunizations, parasite and behavior care, dental health, and nutrition. Governors offices, state boards, veterinary professionals and pet families have gained a deeper understanding of the importance of proactive preventive care.

Ironically, by safeguarding the wellness of our nation’s pets, we’re also safeguarding the well-being of our profession. A side effect of proactive preventive care for pets is a decrease in reactive, stressful, often unfunded emergent care, which leads to veterinarian and staff stress, burnout, compassion fatigue and worse. Let’s never lose sight of the importance of preventive care.

3. Little disruption: Veterinary technician/nurse utilization.

Perhaps it’s just me, but I’ve not seen much change in embracing the power of the veterinary nurse over the term of the pandemic. I thought I would. That is not to say that veterinary nurses didn’t step up. They did! As usual, they provided the energy, compassion, intellect and drive to help us through the crisis, but they could have done so much more if we just let them.

Veterinary nurse appointments, veterinary nurse virtual teleconsults, microchipping, rabies vaccinations, simple extractions, catheter placements, skin and gingival suturing — the list goes on and on. The state boards I follow didn’t further empower veterinary nurses to perform more procedures during the crisis. I didn’t hear veterinary medical associations tout the value of veterinary nurses. Veterinarians didn’t appear to utilize nurses to the top of their license, and society sadly didn’t benefit from the amazing skills these underappreciated members of our health care team can provide. Why is that? I wish I knew. We’re letting a good crisis go to waste. We’ve squandered an opportunity to further elevate the importance of the veterinary nurse.

Way back in 2008, an American Veterinary Medical Association economic survey revealed that on average, for every licensed veterinary nurse a practice employed, the practice generated an additional $161,493 in gross revenue. With non-credentialed veterinary staff, no significant revenue improvement was seen.

It’s not too late. Throughout the remainder of the pandemic and beyond, let’s work harder to empower, utilize and honor veterinary nurses, our vital health care partners. We all win — pets, pet families, veterinarians, teams, nurses and our practices’ financial health.

Techs and Tech

To move from a doctor-focused sick-care model to a team-based well-care model we need both techs (veterinary nurses) and tech(nology). We’ve proven over the course of COVID that we can better utilize technology and focus on preventive care, but why aren’t we further empowering technician/nurses?

Doctors, you have only four jobs: diagnose, prescribe, perform surgery and build relationships with your community. Anything else can be delegated. Honor your veterinary nurse team, delegate, appreciate, respect and utilize. Doctors, trust your professional staff. Nurses, push your veterinarians. You’ve proved your value again during the pandemic.

I see the current state of veterinary practice as “doctors delivering sick care.” We’re moving toward a state of “team-delivered, technology-enabled well care powered by veterinary nurses.”

I’m pleased to see our profession’s renewed respect for preventive care and for our (finally) embracing technology. Where’s the love for veterinary technicians? We can do better.

Meat Loaf sang, “… we can talk all night, but that ain’t getting us nowhere.” Let’s not just talk. Let’s not let a crisis go to waste. Honor your veterinary nurses. Together we’ll emerge from COVID-19 stronger than ever.

Two out of three ain’t bad? I’m gonna have to disagree with Meat Loaf on that one.

Creative Disruption columnist Dr. Bob Lester is chief medical officer of WellHaven Pet Health and a founding member of Banfield Pet Hospital and the Lincoln Memorial University College of Veterinary Medicine. He serves as vice president of the North American Veterinary Community.