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 president-elect of the North American Veterinary Community.Read Articles Written by Bob Lester
Pet numbers are up, pet lifespans are up, pet spending is up, the family-pet bond is up, veterinary fees are up, compensation is up, student debt is up, barriers to care are up, applications to veterinary school are up, efficiency through technology utilization is up, team-based health care delivery is up, and new models of care are up.
What’s not up? The number of veterinary professionals. We have a fundamental supply-and-demand mismatch in which the need for our services outpaces our ability to attract, select, develop and retain an adequate supply of great team members. We’re in a workforce crisis.
We all can share stories of having to delay needed pet care for days and sometimes weeks. Of clinics that reluctantly cut hours or closed due to a lack of staff or doctors. Of saying “no” to pets in need. It’s all so hard and goes against our oath. The consequences of the workforce crisis include the risk of losing business to nonveterinary professionals, not delivering necessary care and overworking our teams. Ultimately, we risk our health and that of the pets we swear to care for. More veterinary professionals are needed.
While we have much to celebrate, we must acknowledge the rocks under our roller skates. The biggest of these are:
- The well-being of our colleagues.
- The lack of diversity, equity and belonging.
- The ever-increasing cost of a university education.
- The growing barriers to pet care.
- The workforce crisis.
But good news! Solutions exist. Today, let’s talk about fixing the workforce crisis.
The Power of AND
I see four roads for overcoming the workforce crisis. Each is marginally effective, but together they can move us to an even stronger profession, one in which pets get their needed care and we get home on time. The roads are better team-based health care delivery AND embrace technology AND graduate more veterinarians AND, most important, prioritize the wellness of the entire team ahead of pets and clients. The power of AND will get us there. Let’s dig a little deeper into each of the four.
First, we must take care of ourselves and our team members. Our employees deserve to be respected, listened to, compensated appropriately and empowered. We can create safe workplace cultures in which asking for help is not just OK but also encouraged. A place where well-being tools are readily available, where time away is abundant and supported, and where relief help provides relief to team members. A place where compensation and benefits are fair and provide for a good living, where flexible schedules are the norm, where lifelong learning is promoted and where life comes before work. We’ve got to take care of ourselves and our teams today so that they can be here tomorrow.
Team-Based Health Care Delivery
Second, we can’t work any harder, but we can work better together. Other health care professions have experienced the power of team-based health care delivery. Look at the ratio of doctors to licensed support staff in other professions and the number of midlevel providers. Your physician averages about five empowered and well-compensated licensed professionals, and your dentist about three. For every veterinarian, on average, is one veterinary technician/nurse and few roles between the two-year technician and the eight-year DVM/VMD. That’s silly.
Think back to your last physician or dentist appointment. How much time did you spend with the doctor? Did you see a midlevel provider? Was your care appropriate? Mine was. Why doesn’t veterinary medicine have midlevel providers? They’re coming.
Doctors, trust your team members. Delegate, appreciate and compensate them. The retention of everyone is important, especially the veterinary technicians/nurses. Challenge them and watch them grow.
Third on my list are texting, cloud-based practice management software systems, telemedicine, teletriage, artificial intelligence, e-commerce, client communication apps, bots and clinical decision-making support. Our dominant workforce and consumer are Gen Zers and millennials. They insist that our profession move into the 21st century. Technology can help us maintain and improve the deep client-doctor relationships for which our profession is known. Technology is an opportunity, not a threat. It’s another tool that will improve access to care. And — heads up! — a virtual VCPR is inevitable. Embrace it.
Lastly, and as obvious as this might sound, we need more veterinarians. The U.S. Bureau of Labor Statistics, the investment community, analysts, the American Pet Products Association and other observers are unanimous in forecasting the growing need for veterinary services. Morgan Stanley predicts the pet space to nearly triple, to $275 billion a year, by 2030, with veterinary care the fastest-growing segment. Triple? Wow!
Calling Out the AVMA
I was disappointed to read a Journal of the American Veterinary Medical Association article (“Are We in a Veterinary Workforce Crisis?”) that demonstrated my trade association is challenging the crisis. As a decades-long member, volunteer and admirer of the AVMA, I’m confused. I struggle to understand certain stances taken by the AVMA on issues of critical importance to our changing and growing profession and society. An association that works in support of our profession and whose vision includes “meeting the needs of society” believes that “adding veterinarians to the companion animal sector is unlikely to address the profession’s current workforce issues” and that “temporary cyclical economic factors are influencing demand.” Really?
Filling an open veterinary position takes 10 months on average. Two out of three postings don’t get an applicant. There are north of 18 open doctor positions for every applicant. A few minutes at a clinic’s front desk will confirm a client’s difficulty in scheduling an appointment. The evidence of a workforce crisis seems overwhelming. How does questioning it serve the needs of society and our profession?
Further, the AVMA claims to believe in team-based health care delivery but denies membership to all veterinary professionals except DVMs/VMDs. It believes in telehealth but doesn’t trust its members to determine when and how to establish a VCPR. It challenges the need for trialing a midlevel provider. I struggle to understand how limiting membership, the failure to trust members’ judgment and a reluctance to acknowledge the existence of a crisis help our profession. I remain a committed member, but I’m confused and disappointed.
So, how do we graduate more veterinarians? Fortunately, applicant numbers are setting records. Let’s look at increasing incoming class sizes, doubling cohorts to two classes a year, reducing the time to graduation — check out three-year programs like the University of Arizona’s — embracing virtual teaching modalities and adopting hybrid distributed clinical-year models. All will allow us to accommodate more students without sacrificing educational quality.
Scaling up class sizes and embracing the efficiencies of virtual modalities can lead to a tuition reduction. Simply put, more students, lower tuition. A win-win. More graduates to meet the growing demand for veterinary care, graduates with less debt, and improvements in well-being for future graduates.
Let’s Get to Work
By embracing all those solutions, we can help more pets and can get home on time. I know it’s a lot, but much is underway. We can do it. We must do it.
Seeing what’s wrong in our profession is easy and seeing what’s right is harder. Let’s not lose sight of what’s right. Our profession has never been needed more. Can we deal with success? Yes, we can.
Now is the time to lobby for more graduates, embrace team-based health care, fully utilize technology and put our wellness first. There’s never been a better time to be a veterinary professional. We are on the way up. Way up!
DID YOU KNOW?
One selling point of the University of Arizona College of Veterinary Medicine, which enrolled its first class in August 2020, is the speed at which students earn their DVM degree. “Our three-year, nine-semester, continuous program provides the necessary structure and breaks to help increase graduation rates and enable students to earn salaries sooner than their peers,” the college website states. “Students will receive the same amount of didactic teaching but in a more condensed strategic model.”