Getting Technical columnist Sandy Walsh is a veterinary practice management consultant, speaker and adviser. She is an instructor for Patterson Veterinary Management University and continues to work in a small animal practice. She has over 35 years of experience in the veterinary field and brings her in-the-trenches experience directly to readers.Read Articles Written by Sandy Walsh
One of the challenges we face in practices nationwide is a shortage of veterinarians. According to JAVMA News, nearly 20% of U.S. veterinarians are set to retire within the next 10 years. For the last decade, the number of veterinarians has risen by roughly 2.2% a year. So, the question is: Can we keep up with and meet the constant demand for veterinary services? And is increasing the number of veterinarians the answer? While adding veterinarians is essential, perhaps we need to look deeper at credentialed technicians within the practice.
A recent study conducted by the National Association of Veterinary Technicians in America revealed interesting but troubling data.
- Only 51% of technicians were satisfied with their job.
- 24% have more than one job.
- 56% changed jobs in the first five years, and nearly half of those technicians left the profession.
When we explore a bit, we find many reasons for these trends. The primary reasons are a negative practice culture, lack of leadership, physical and emotional demands, and chronic low wages. This is a common dynamic, so it’s not surprising that technicians are leaving the profession in droves.
A Mixture of Titles
The Bureau of Labor Statistics in 2017 counted 103,430 veterinary technicians in the United States. Of those identified, 92% worked in veterinary practices and 8% in other areas of veterinary medicine. What wasn’t clear was how many of them were credentialed.
First, what is a credential? Here is where the confusion begins. The credential differs from state to state and is one of these:
- Registered veterinary technician (RVT)
- Licensed veterinary technician (LVT)
- Certified veterinary technician (CVT)
- Licensed veterinary medical technician (LVMT)
Add to this the fact that a handful of states do not require any certification or oversight of technicians. To confuse things further, in states where certification exists, the veterinary medical boards and practice acts differ in what they permit credentialed technicians to do.
Consumers are confused as well, which is a primary reason NAVTA has taken on the Veterinary Nurse Initiative, a campaign to standardize the designation and bring awareness to the role of the veterinary technician. Rather than states using different designations, the common title registered veterinary nurse (RVN) would be adopted. Terminology, practice acts, policies and procedures would be standardized.
As for veterinary assistants, they serve an important role in helping veterinarians and technicians. Their position within the profession has not been minimized. Approved veterinary assistant programs need to be evaluated and enhanced, which hopefully will lead to more assistants becoming credentialed.
You might be thinking, “This is all very interesting, but why should I care and how does it affect me and my practice?” Take an honest look at what goes on in your practice each day. Veterinarians are the only ones who can generate active revenue; we can’t do it without them. Technicians and the rest of the support team generate passive revenue, and we can’t do it without them either. When we talk about leveraging, it’s about the right person doing the right thing at the right time.
Active vs. Passive
So, who’s doing the work in your practice? Let’s take a look.
Active revenue produced only by veterinarians
- Diagnosis and prognosis
- Initiating treatment
- Performing surgery
- Prescribing medication
Passive revenue produced by support team
- Patient care and nursing
- Diagnostics (imaging and laboratory)
- Surgical assisting and anesthesia
- Dental cleanings (extractions in some states)
- Ancillary services and sales
When veterinarians do the work of qualified credentialed technicians, you have a problem. Efficiency is challenged, job satisfaction is low, and optimal revenue isn’t realized. Yet this is happening in practices every day. The financial aspect is staggering.
Consider this table from Synergie Consulting regarding a simple task done every day in veterinary practices: an IV catheter placement.
When all operational costs are considered, the per-minute cost of a veterinarian’s time is a significant factor in maximizing where that time is spent. The data represents those costs and the lost revenue potential when a veterinarian does a qualified technician’s job.
Placing a catheter is just one common task. Imagine the lost revenue opportunity if the veterinarian also draws blood or takes radiographs? Our fee schedules should be well thought out and based on the actual cost of the support team performing non-veterinarian tasks. Freeing up veterinarians’ time so they can devote their energy to appropriate tasks is a direct result of leveraging the team.
Credentialed technicians have the education and training necessary to achieve higher productivity and an even stronger skill set, especially among those who earn the VTS (veterinary technician specialist) designation.
A team that is leveraged effectively provides better patient and client care and improved communication. The result is a more engaged team, higher job satisfaction, less turnover and increased revenue.
If you are part of a team that isn’t utilizing your skills, figure out why. If it’s an issue of veterinarian trust (or lack of), ask for further training and the opportunity to perform so that the doctors will be comfortable with your skills and abilities. If the right people are on the team and have been properly trained, the trust level will be there and the veterinarians will embrace leveraging. Their time can then be devoted to responsibilities that only veterinarians can fulfill.
The Numbers Don’t Lie
A challenge in the practice will continue to be maintaining adequate staffing levels. So, does another associate veterinarian need to join the team or will you benefit more by adding experienced technicians? As we strive for the perfect team, consider where it makes the most sense to add employees. Speaking at AVMA Economic Summit in October 2019, Frederic Ouedraogo, Ph.D., shared some of his research.
Here’s what he reported:
- Bringing in another veterinarian resulted in an average increase of 6.3% in practice revenue.
- Adding another credentialed veterinary technician delivered an 18.3% increase in practice revenue.
Let’s look at it in dollars. The American Veterinary Medical Association’s biennial economic survey in 2008 found that for each credentialed veterinary technician employed, the practice generated $161,493 more in gross revenue. In today’s dollars, adjusting for inflation, it’s closer to $220,000.
The numbers don’t lie. The conclusion was that the revenue increase was a direct result of veterinarians devoting their time to generating active revenue and allowing credentialed technicians to do their jobs.
The right person doing the right thing at the right time. Leverage, leverage, leverage. Take the necessary steps in your practice to make it a reality for your team. This is clearly the equation for practice success.