Strong action taken to strengthen veterinary economics

As your AVMA President, I’m thrilled to be the first to tell you about recent AVMA Executive Board actions directed at strengthening the economic foundation of our profession.

Today, the Executive Board approved an Economic Vision Statement that will drive a national economic strategy. The vision statement is “Veterinary medicine is a personally and financially rewarding profession.”

To work toward this vision, the Executive Board also approved a number of related recommendations, including:

  • Establishing a Veterinary Economic Strategy Committee, composed of AVMA members, to advise and recommend strategies to the Executive Board on economic issues;
  • Creating a veterinary economics division at the AVMA;
  • Setting aside a $5 million National Economics Strategy Reserve Fund to fund tactical plans and programs consistent with the national strategy;
  • Authorizing the continuation of the Economics Vision Steering Committee (of which I’m proud to say I’m a member) to provide additional guidance and oversee the development of alliances and partnerships with stakeholder groups to support economic programs; and
  • Developing an economics communications plan including, but not limited to, a web presence, to disseminate information and resources regarding economic issues.

We know the challenges you’re facing and we know that economic viability and growth are top-of-mind for you. We also know there are no quick fixes and no “magic bullets” for the problem, and we need your help to achieve this vision. If you’re interested in serving on the Veterinary Economic Strategy Committee, watch the AVMA@Work blog and newsletter and/or sign up for the AVMA volunteer/leadership opportunities email alerts in our Email Subscription Center. In addition, feel free to comment below on the specific issues you’re facing or any other input you’d like to provide.

20 thoughts on “Strong action taken to strengthen veterinary economics

  1. I agree with Dr. MacKay. As pointed out by Dr. Pion on VIN, all of the web sites for veterinary colleges quote the AVMA as the source for information about a “projected shortfall” of veterinarians. Students think they will have many job offers, lots of employment opportunities, and great pay when they graduate. Many are shocked when they find it no longer true. TODAY AVMA could take steps to update and correct this information.

    Thank you, Dr. Carlson for your willingness to tackle the issue and keep the lines of communication open.

  2. Dr. Carlson,
    Here the first order of business for the economic group…fight the EPA with the ridiculous, business killing, economic destroying, government control regulations. Now hay is being considered a pollutant??? How devastating will this be for our farmers, in turn our veterinarians, in turn our food supply? Stop this madness. I also recommend you read the book “Restoring A Broken America” by Dr. Michael Coffman. You will begin to understand what the US govt is doing through Executive Order effectively bypassing Congress and imposing regulations which are destroying the economy and in effect our country.

    R-CALF says EPA declares hay a pollutant
    John Maday, Managing Editor | Updated: September 2, 2011

    In a news release this week, R-CALF USA says the Environmental Protection Agency has, in effect, declared hay a pollutant, potentially requiring farmers and ranchers to store it in pollution containment zones.
    The issue stems from a compliance order from EPA’s Region 7 charging Callicrate Feeding Company with environmental violations. The Region 7 office outlined the alleged violations in an August 22 news release. Following is the information provided regarding the Callicrate operation in the release:
    “A.J. Jones, d/b/a Callicrate Feeding Company, St. Francis, Kan. – An inspection in February 2011 identified significant NPDES permit violations, including failure to maintain adequate wastewater storage capacity, failure to meet Nutrient Management Plan requirements, failure to conduct operations within areas that are controlled in a manner capable of preventing pollution, and failure to maintain adequate records. The order requires the operation to comply with all terms of the Clean Water Act and its NPDES permit, and to coordinate with the Kansas Department of Health and Environment on its compliance. The order requires the operation to comply with the terms of its Nutrient Management Plan, including sampling and recordkeeping requirements. The feedlot has a permitted capacity of 12,000 cattle and was confining approximately 3,219 cattle at the time of the inspection.”
    According to the R-CALF release, Mike Callicrate, after presenting information on country of origin labeling at R-CALF’s annual convention last week, was asked whether the EPA has declared hay a pollutant. He indicated that in his case at least, they have. “Now that EPA has declared hay a pollutant, every farmer and rancher that stores hay, or that leaves a broken hay bale in the field is potentially violating EPA rules and subject to an EPA enforcement action,” Callicrate said. “How far are we going to let this agency go before we stand up and do something about it?”
    Much of release moves from the hay issue to broader complaints against concentration in the packing and feeding sectors, including implications that packers are conspiring to drive small feeders out of business. The title of the release, “EPA declares hay a pollutant in effort to antagonize small and mid-sized U.S. cattle feeders,” and additional statements in the release, suggest EPA is singling out certain feeding operations for enforcement actions. “I believe the EPA’s enforcement action is a premeditated effort by EPA to partner with the beef packers to finish the job the beef packer’s couldn’t do alone,” says Callicrate. “Along with my feedlot, the EPA has filed enforcement actions against five other smaller feedlots, including one with only 400 cattle.”
    The idea that the EPA has joined a conspiracy with packers against small cattle feeders seems a bit of a stretch, but the hay-storage issue certainly raises concerns. The information provided in the EPA news release uses a fairly broad accusation of “significant NPDES permit violations,” but does not mention anything about hay storage. Drovers/CattleNetwork has contacted EPA’s Region 7 for more information on specific charges in the case. We’ll let you know what we find out.

  3. As someone at the far end of a veterinary career, I believe the profession can and will be an exciting place to be, but will need this large project to take root quickly. I do not recall a time since the removal of the horse as the primary source of veterinary income that has/is as serious. More study and delayed action are not going to work in the short or long term. Adjusting the supply of practitioners (not veterinarians) needs to be a primary subject. As someone that as private practice ownership (30 years), academia (4 years) and industry (13 years) and now am involved in consulting, the sudden dramatic increase in practitioners in the companion animal marketplace along with (I believe) too many no/low value practices is and will cause extreme hardship and likely an overall decline in the viability of this business model. I applaud the proposed efforts but suggest that things today need to change in the vocabulary of the organized profession.
    AVMA briefs continues to publish erroneous, poorly researched newspaper articles like the one end of last week which stated:
    Veterinary Education
    According to the American Veterinary Medical Association, more than 61,500 veterinarians were working in private practice last year. The demand for veterinarians has been increasing steadily over the past few years because pets are very popular. More than 43 million households in the U.S. own a dog and more than 37 million own a cat.
    The road to becoming a veterinarian is rigorous. Students must complete 4 years of undergraduate education, then another 4 years at an accredited college of veterinary medicine. Many also go on for a one-year internship. To practice, veterinarians must meet state licensing requirements and pass a national board examination. Median salary for a veterinarian in private practice is $97,000.
    The Need for Specialty Veterinary Care
    Animals are susceptible to many of the same diseases and conditions as their human owners. While most veterinarians are capable of taking care of the routine ailments, sometimes proper diagnosis and treatment takes specialty care. Veterinary specialists have at least an extra three years of training in a specific area of veterinary medicine.
    Meg Sleeper, V.M.D., Clinical Veterinary Cardiologist with the University of Pennsylvania School of Veterinary Medicine in Philadelphia, PA, says most owners who need specialized pet care are referred by their primary veterinarian (similar to the way people are referred to specialists by their primary health care provider). Currently, the American College of Veterinary Medicine recognizes 21 veterinary specialty organizations. The organizations with the most members are the American College of Veterinary Internal Medicine, American College of Veterinary Pathologists and the American College of Veterinary Surgeons.
    In the U.S. 10,200 veterinarians have board certification from a veterinary specialty organization. It may be hard to locate a nearby specialty vet. However, a primary veterinarian may be able to consult with a specialist via the internet or telephone to provide better diagnosis and care for a pet.

    This unedited and in my opinion wrong headed article in the AVMA website could suggest to the members and the public that the issues here are reality. I would suggest all such articles be answered both in the papers where they are published and in the AVMA brief section to allow members some idea of what reality should be.

  4. @CL Chevis
    Thank you for these comments, CL. You have voiced more good ideas for us to consider as we put together a national strategy for this economic dilemma that intends to approach it from many sides simultaneously. There is no doubt a veterinary medical practice is expensive to maintain (I owned one for 15 yrs), especially with the standard of care rising and continually increasing client expectations. Your comments are good ones and will be noted in this process. It isn’t just the general economy that is the challenge. Use of veterinary medical services has been in decline long before the economy tanked in 2008. The cost of attaining a DVM degree has risen much faster than the compensation for having that degree. In addition to these many suggested tactics, we need to look at how to increase the demand and value of vet med services to the public sectors. We have to identify jobs and opportunities for DVMs that have not yet been considered traditionally. It is a big country and world with lots of potential for work by DVMs, esp if we can broaden the public’s view of the scope of the significant contributions we make to their every day lives they don’t even know about. How can we contribute on a much larger scale to global issues of hunger and disease control? Finally, I don’t think we are looking to model pet health insurance after the human model. Right now, it is modeled after property insurance as it should be as long as animals remain property. Thank you again for your thoughts on this. You can be sure legislative strategy will be part of the plan.

  5. First of all, I find that setting up more committees ends up in spending more money than it is worth. $5 Million seems like way too much money. AVMA could decrease the number of committees and decrease our dues. Part of the problem is the immense overhead veterinarians have to carry. When I owned a practice, overhead was close to 70%. This is way too high. There are too many regulations which increase manpower, overhead and equipment. It doesn’t matter how many economic committees you set up, if the economy is bad, then all business will suffer. Reports of the committees will only reflect what we already know- the economy is bad. The best service this committee could do is to get government both state and federal out of our lives. All effort should be put into stopping regulation like the prescription law that the feds are trying to pass. The economic committee can also fight to decrease the influence of pharmaceuticals. How many of you have noticed that expiration dates on medications are getting shorter, meaning we have to replace meds sooner, which means more money for the pharmaceuticals? How many of you older vets know efficacy is much longer. Do independent research to challenge the expiration dates.
    As far as the comment about pet insurance- not only NO but HELL NO. Insurance companies is the reason the human health field is in the mess it is now along with federal regulations. Pet insurance will destroy veterinary medicine.

  6. @Greg Nutt
    Greg, here’s your answer from AVMA leadership:
    Thanks for your question. It couldn’t be more timely. The AVMA recently approved a new strategic plan that will carry us through 2015. In the plan we acknowledge the fact that there does appear to be an imbalance of veterinarians in the workforce. As a result and with the coming of a new Economics Division here at headquarters, we’ll be taking an in-depth look at that situation and developing solutions to effectively balance the needs of society with the supply of veterinarians. Thanks for asking!

  7. @Greg Nutt
    Thanks, Greg, for the good question. Dr. Carlson is at a meeting through Friday PM and asked the AVMA staff to address this. I’m in the process of getting an answer to your question and will get back to you asap. Thanks!

  8. Dr. Carlson,

    What is the AVMA’s official stance on the supply of veterinarians in the workforce? What is your opinion, based on the body of research that we have now to draw from?

    Knowing this would be extremely helpful.

    Thank you
    Greg Nutt

  9. Again, I greatly appreciate the dialogue here. The personal stories of difficulty relating to our economic situation only highlight and bring to life the importance of this initiative to take priority. I still believe this is the greatest profession ever, and would hate to see people lose their passion and dreams for its mission to animals and society, but we have to increase the value society places on the level of education we have and the service we provide. I worry there will be those caught in the time segment of high debt and financial hardship before we can achieve our goals, but we need your help to do so. Thank you for being an AVMA member and I hope we will all participate in the strategy to improve this situation.

  10. I am a 2010 graduate making 68,000 a year. When I tell people that, they are like “that is great why are you complaining, you make more than I do.” Then I explain to them that after taxes and paying all of my bills (including a $1400 dollar a month student loan payment), I am just barely getting by each month. I always seem to make it by the skin of my teeth, but at some point I would like to start saving for retirement, have a college fund for my baby, buy a house, etc… The problem is, that for the area of the country I live in, this is pretty much the max salary for an associate so I don’t know where the extra money is going to come from. Sure I could buy a practice (which may or may not be profitable given the terrible economy), but my debt to income ratio is too high for a bank to feel comfortable lending to me (I have asked). I guess in 30 years when I am 59, and my $200,000 (vet school only) in student loans are payed off I can start saving for retirement then, but something tells me that I will not have enough time, unless I plan on working until I am 80. I guess what I am trying to say is vet school cost entirely too much for what you make coming out as a general practitioner. The math simply does not add up. I realize that universities are businesses and they need to make money too, but at some point there has to be a cap or people are going to start defaulting on their loans if they haven’t already. Tuition at my school doubled during my 4 years. I feel sorry for the incoming 1st years.

  11. Dr. Harrison,
    My thoughts and prayers go out to you. I think you are one of many veterinarians struggling with a very difficult job market. Your story is a heart wrenching example of the importance of the issues facing the profession. I see you are located in MD– too bad. There is a position open in Kentucky working for the US Army as a civilian veterinarian. You might want to check on to see if any other openings are close to you. Best of luck, hang in there.

  12. Implement legislation that puts OTC antibiotics and modified live vaccines back into the veterinary office.

    Keeps the nations food supply safer (less residue issues) and improves the health and safety of livestock and companion animals.

  13. To the AVMA Economic Strategy Committee:
    I am facing the crisis of my life. I am a small animal single, female veterinarian with 19 years of experience. I will be 58 in a week. I dreamed of being a veterinarian starting at age 16, when I took biology and realized that this, combined with my love of animals, presented an obvious career. I didn’t get the chance when I first got out of college, not having gotten the grades. I took a job as a histology technician and worked my way up until 11 years later, at the top of my field, I was appointed the Education Coordinator for the first school of histotechnology in the U.S. at an ivy league university hospital. I worked during the day and repeated undergraduate classwork at night, to improve my GPA. I then quit my job and attended graduate school for two years to improve my C.V. When I was admitted to vet school at age 34, it was a dream come true and the fulfillment of 15 years of effort. I was not as smart as most of my classmates, but I wasn’t a quitter- two classmates, both friends, did quit: the first, after year 1, the other, after year 3. I finished in the bottom quarter of my class with a GPA of 3.0. I didn’t worry. I knew grades were not a predictor of success in the work world.
    What I didn’t know was that, at age 57, after working with a veterinary practice for more than 6 years, I was issued a letter of termination with no explanation and told I was being let go. Managers waited to see that I packed all my belongings into my car in the hour that followed and I drove away totally unprepared to face what I am now. It has been 5 months of hell. During that time I have mailed out over 50 resumes- most locally, and some to nearby states- moving would be very very difficult for me because I have a house that is in very poor shape and needs about $60,000 worth of work, and I have 8 cats, with ongoing housesoiling challenges. No one in their right mind would rent to me. I have only had 3 interviews in this time, two offering relief work, one day a month or “as needed”,and the third, a 20 hour a week position for $30,000 and no benefits. None of these has resulted in work. In the majority of cases, there has been no acknowlegement of receiving my resume, and no response to follow up inquiries. I recently even applied for a vet tech job at the National Zoo (local for me). I was told my application score was not high enough to be in the competitive range.
    I feel very very frightened. Before the recession, I feel my credentials (experience) would have given me an advantage over other vets with less experience. Now it is a handicap, as most practices assume you will expect to be paid more for your experience. I have had to include the assurance in my cover letters that I will consider any reasonable salary offer, to allow me to compete with younger applicants. I have even considered the possibility that I’ll have to abandon my profession, the career I have spent my whole life working to have, at great cost, in order to survive financially. I have 7 more months of unemployment and then that’s gone. I had a ten year plan which included paying off my mortgage in another 6 years, and setting enough aside to pay for a new roof on my house, and a new car. My roof is 19 years old and my car is 16 years old. I hoped to continue working as long as my health would permit, and if health problems developed to try to work part time at least. I have a nice amount set aside for retirement, which would have meant I could afford long term health care insurance this year. Not any more. If I can’t find another job, all of my retirement security which I have worked so hard to create, will vanish.
    The thought I try so hard to suppress, is that it was my bad luck to have gotten into vet school, to have achieved my life long goal. I thought it was going to provide the income and security I would need as an unmarried woman. I thought it would far exceed histotechnology as a secure line of work. Now I am thinking I made a big mistake leaving histotechnology, which would have provided me with a job forever, with good benefits. Histotechnologists are employed in research and in all major human hospitals, and are an essential part of the laboratory that supports anatomic pathology. They will never be paid with discretionary income. And because the field is regulated by the American Society of Clinical Patholoists, they are certified by means of a standardized exam, and all have the same credential based on what exam they take.
    Sadly, I can’t even go back to that field, because I let my certifications lapse when I graduated from vet school. I saw no reason to maintain them.
    My heart is broken. For myself, I am in a life crisis that may result in living out my retirment years in poverty. I am also heartbroken for the profession. It is not the calling I dreamed of, all those years ago. I gave up so much and worked so hard to follow my dream, and now I have nothing to show for it.
    I know that the hospital where I worked last has not replaced me with a full time veterinarian. They are using a relief veterinarian who works part time. I didn’t kill a patient or commit malpractice or steal. I just got in the way of the Bottom Line. God help me.

  14. Once again, I appreciate the skepticism and the magnitude of this economic challenge, however I greatly appreciate the discussion of ideas to bring forward as we all begin to collect the ideas that will go into the pot to help forumulate how we hit this issue from all sides. The shelters do provide a lot of the initial care before adoption. On one hand, I see that as responsible health care for the animal because without it, I was seeing a lot of very sick newly adopted pets. What we need to do is work with the shelters to be sure they promote good health care and relationships with a veterinarian in the future.

    Second, certainly pet health care insurance may indeed be part of the solution. And third, knowledgeable practice management is also imperative. Good medicine is good business. We are collecting your input and again, if interested in serving on the Veterinary Economic Strategy Committee, watch the AVMA website for the forthcoming nomination process.

  15. There has been this same call to arms about the economics of Veterinary Practice since I’ve been out of school, proudly Purdue ’85. There is the subscription magazine Vet. Econ.,this has not helped. There is DVM magzine, this has not helped. There have been countless call to arms to give complete care including worming, Heart Worm prevention, dental cleanings and geriatric blood work, this has not helped. And Frankly I find these articles a bit insulting. If you got through vet School and don’t know to do these things, then you should be turned out of the profession. This is basic medicine 101. But alluding to it in countless articles has not helped. We all need to admit this.

    My perceptions of why we are in this “low pay” situation are three fold. First the shelters and the do gooders are providing much of our preventative care for free or low cost. Usually a shelter animal has all it needs when adopted. The low or no cost leaves a disconnect and some anger when the client comes to the practice the next year and finds the cost of “regular vet care” to be astronomic (to them) and they label us as money grubbers and feel that we do not have the animals welfare in mind compared to shelters and other animal low cost services. We have to come to terms with this. It creates a huge loss of income.I do not know how to overcome this issue. Articles I have read just say we need to increase our fees for other things to offset the loss in income. Thus burning more of a hole in pet owner’s pockets. If we complain to the shelters, then they will paint us black. I do feel that a committee needs to think out a strategy here, where it counts.

    WE need to get people to buy pet insurance policies that include preventative care. Teaching clients that if the insurance company will pay for preventive care, so as to help the pet and lower their cost, should help the client to want preventive care.

    Finally, Vets need to get consultants into their practices for a year or two, to gain the business knowledge required to be successful. Having the vet in the back and the wife in the front and call that management is foolish. A single course in economics in vet school just doesn’t cut it and there is no room for more time. So the course should center on how a consultant can help your bottom line, rather then the course I had which covered:micro economics, macro economics and stocks. That was a waste of time. Students need to be taught what a client average is, how the owner or partner looks at you as an economic entity and teach you what you can do for the bottom line. Vet students have already had a disconnect between the cost of their education and the loans they need to pay back. The courses should show a typical new grad income and then list all the realistic expenses they are likely to have. Hopefully this would prompt them to mix their love of animals to generating income.

    I hope this has ruffled a few feathers, raised a few guard hairs and kicked a pail of boot wash over.

    Dave Kestenman

  16. We need to agressively embrace this issue. As a profession, I believe we have under valued our services for decades. It’s time for veterinarians to erradicate our own beliefs that we are “less than” other health care professions .

  17. Although I applaud this effort it is also prudent to address the crux of the problem, we are graduation more veterinarians per year than there are jobs to support them.

  18. This is an exciting and comprehensive initiative.

    Kudos to AVMA for taking bold steps to rise to the economic challenges that face our profession.