Looking Back…but Moving Forward

As the staff consultant to the AVMA Task Force on Governance and Membership Participation, I’m posting this on their behalf.

It’s AVMA’s 150th birthday this year and as we reflect on our rich heritage, it’s also time to think ahead to the future. Right now, following the suggestion of AVMA’s 20/20 Commission and a 2011 resolution of the House of Delegates, the AVMA Task Force on Governance and Membership Participation has been working hard to develop a new way to structure AVMA’s governance where each and every member can make contributions to its future.  Please check out the Governance Task Force website, review the Governance Dialog script,  and provide your comments and feedback.  They are important to us – AVMA is your association and it needs to work for you.  We need your help to develop a new governance structure that will carry us into the next 150 years.

AVMA members have a number of ways to provide feedback:

  • Submit your comments and/or the feedback form, preferably by February 28, 2013, via email to avmagovernance@avma.org; fax it to 202.842.4360; or mail it to Governance Task Force, c/o Dr. Mark Lutschaunig, AVMA Governmental Relations Division, 1910 Sunderland Place, NW, Washington, DC 20036-1642.
  • Join the discussion on NOAH, the AVMA’s members-only online discussion forum.
  • Post your comment on this blog entry. Please note that your comment will be accessible to members and the public.

19 thoughts on “Looking Back…but Moving Forward

  1. I suggest that all DVM’s, current and potential Pre-Vet students, and Vet Techs read today’s article in The New York Times (High Debt and Falling Demand Traps New Vets). URL: http://www.nytimes.com/2013/02/24/business/high-debt-and-falling-demand-trap-net-vet.
    The article says nothing new to practicing veterinarians but may be a shocker to students, potential students, new graduates, and the consuming public. It, starkly, points to the lack of reality held in the body of the AVMA “leadership” and the lack of current control over accreditation and or formation of new veterinary schools. Like our Socialistic economy in the US, the growing number of underemployed and financially stressed veterinarians coupled with an attitude of ever increasing output of graduates will end in a flooded market, questionable practice integrity, and an overall attrition of professional skills. Certainly, these newbie’s will have no AVMA GHLIT to rely on for their health needs and, little do they know, no professional guidance and support. There has got to be something better that the way we are doing things regarding our professional organization, AVMA.

    • I appreciate the many comments and perspectives here, however I need to address some of these very serious concerns mentioned below. First, I have been a member of the AVMA since my graduation in 1978. I felt this organization was so important to my success as a practicing veterinarian and to this profession that I became actively involved to make a difference. Pleasing 84,000 very diverse members can be challenging, but I assure you, the member veterinarians who volunteer their time and the AVMA’s 140 staff members in your 12 AVMA divisions work VERY hard (many times over weekends) to provide us members with tremendous benefits, many of which are sometimes not as visible as others. Having traveled the country and world representing veterinary medicine in the United States these past two years as your President-Elect and President (2010-2012), you can be assured we are the most organized, productive, and respected organization in the world in many ways. That said, let me address some of these issues:

      1. AVMA Governance – A recent membership survey shows 43% of our members are less than 15 years out of veterinary medical school. They are members of a new era with high speed technology communications and they want involvement in their association now, not years from now. AVMA needs to re-evaluate its current cumbersome, expensive, and somewhat sluggish and even exclusive at times governance structure so it is truly trustworthy, nimble in its decision-making, and knowledge-based in order to retain its credibility and relevance with its members and those making decisions that affect veterinary medicine, both from within and outside this profession. Old style governance will not work in the 21st century. A new more efficient and more meaningful structure for our members is imperative. We are simply in the process of looking at what would meet these imperative goals, goals specifically identified by our own members. Many of our members in leadership positions are “older” members (it seems to take years in our current model to have a seat at a face-to-face table). The younger members in this 43% are looking for ways to have a voice now, and they are extremely motivated. They don’t want to wait for someone to move out of the way or retire so they can have influence on the profession they will be working in for the next 40 years. Our governance must evolve to accommodate current times and the next generation of members or we will become archaic and irrelevant. Negativity, without ideas or participation, gets us nowhere. Let’s put all our heads together.

      2. The Loss of our AVMA Health Insurance Plan – The AVMA GHLIT Insurance Trust did not give up the health insurance program easily. As soon as the The Affordable Care Act was passed by Congress and signed into law by the President on March 23, 2010, we knew we had a BIG fight on our hands to retain the health care portion of the insurance program. The AVMA GHLIT hired expert lobbyists in health care policy to try to get an exception for bona fide association health care plans like ours that benefits over 17,000 AVMA members and their families. The AVMA has been fighting for those members diligently for two years while we awaited the Supreme Court ruling on its constitutionality. On June 28, 2012 the Supreme Court rendered a final decision to uphold the health care law. It is not AVMA’s fault ObamaCare would potentially terminate 56 dedicated years of medical coverage for our members. I can vouch for the fact AVMA fought long and hard to retain that program, and we were actually making great progress, when the underwriter for the program, New York Life, made the decision last November not to continue coverage for bona fide association health care plans in general. It was very disappointing. AVMA searched creative other options, but none could be found to equal what we had just lost. The AVMA GHLIT made a prompt and readily communicated decision to inform members of the situation that became insurmountable under the new rules for healthcare. The AVMA GHLIT has worked and is working tirelessly to help each affected AVMA member make a transition to new coverage to meet each member’s needs for their particular situation. The private exchange program arrangement is an excellent resource to help provide that assistance.

      3. Number of Veterinarians and Increasing Schools and Class Sizes – AVMA is very well aware of the economic challenges facing our members right now. That is why we created an Economics Division with a Veterinary Economics Strategy Committee to advise our Executive Board. That is why we have one of the best organizations in the world (IHS Global Insight) assisting us with a true and accurate picture of the current status and potential future status of the veterinary workforce in the United States. The report is due in late spring. The AVMA does not and cannot control the number of veterinary graduates that our public or private education institutions choose to admit to their veterinary medical programs. The AVMA Council on Education only accredits the programs for quality and sustainability to be sure the students get the education promised and the public is assured graduates from the program have entry level competency in veterinary medicine. As long as the school provides adequate faculty, clinical resources, and physical infrastructure to accommodate the needs of their student body and sustain successful outcome assessments, they can accept as many “customers” for their educational program as choose to pay for it. Much of that determination is made in Standard 11, Outcomes Assessment. It is a very rigorous process. I know. I served on the AVMA Council on Education representing private clinical practice. I know the process, the rigors, the complexity, and the accountability very well. It is the hardest working entity in the profession, all volunteering their time and expertise to assure we have the best veterinary medical educational programs in the world and that our degree from an AVMA COE accredited college represents a very high standard. Every process can be improved and the accreditation process itself is held strongly accountable by the US Department of Education. It continues to evolve and improve its own process in order to meet those very stringent requirements.

      Our next generation of veterinarians will have challenges, but they very readily recognize the value and reward of their chosen profession for animals, people, and society. They are VERY excited about veterinary medicine. Let’s make sure they ALL have a voice in AVMA’s governance in one way or another because it is their association too. We can always do better! I am happy to continue this dialogue, preferably on governance in this section.

      • Cry me a river of regret, and I will not be holding my breath for meaningful change expect more than platitudes from the AVMA. Also, don’t forget the other side of the coin! We senior practioners make up nearly 60% of the veterinarian; it is not just the young folks that want meaningful change.

          • I would like to have seen and to see forethought, foresight, and immediate action on finding alternatives for the Health Care Insurance, dealing with the Federal Trade Commission and it heavy handed implementation of the Red Flag Rules, deal with the FDA on drug shortages and inspections of generic manufacturers that have resulted in loss of drugs or massive price increases, increased awareness of the economics of practice and influence in avoiding further flooding of the ranks of young graduates with little hope of jobs or practices, drawing up the gusset and reposition itself and a leadership body for the Profession with great influence or control on the quality and quantity of professional educational intuitions formed, how their faculty are formed, and the quality their graduates for a start. I have practiced for 39 years and have seen the AVMA decline steadily as a meaningful body truly representing the needs and interests of the Veterinary Profession. If we don’t do it through the AVMA or some other professional body we will have allowed the gross dilution of our profession and truly have become the “Boiled Frogs”.

          • All very specific suggestions, but not necessarily relating to meaningful changes in AVMA Governance. Let me address each one of your suggestions.
            1. Health insurance – I think I gave a pretty good summary to that item, and whether you believe it or not, the AVMA GHLIT CEO and Trustees worked long and hard on it, and truly made the best out of a situation out of their control. If we could have motivated all members, especially the members directly affected by the Executive and Judicial Branches’ decisions on the Affordable Health Care Act, to contact their legislators en masse to ask that bona fide association heatlh care plans be included in the AHCA, that may have had an even greater impact (and we did urge them all to do so). All I can do is assure you this was a very high priority item for three years for the Trustees (many general practitioners like yourself) and lots of research was done to try to find suitable alternative options.

            2.The Red Flag Rule – Your AVMA Governmental Relations Division is much of the reason veterinarians are exempted from the Red Flag Rule. See https://www.avma.org/News/JAVMANews/Pages/110201f.aspx.

            3. Drug Shortages – The AVMA works very closely with the FDA. In fact, our Council on Biologic and Therapeutic Agents and Clinical Practitioners Advisory Committee both communicate with the FDA on issues affecting drug availability. This article at https://www.avma.org/News/JAVMANews/Pages/101115a.aspx might give you more insight.

            I would also suggest calling a member or members of these entities to express your concerns. The description and member roster for the Council are located at https://www.avma.org/About/Governance/Councils/Pages/Council-on-Biologic-and-Therapeutic-Agents-Entity-Description.aspx and https://www.avma.org/About/Governance/Leadership/Documents/cobta-roster.pdf respectively.

            The Clinical Practitioners Advisory Committee entity description and member roster are located at https://www.avma.org/About/Governance/Councils/Pages/Clinical-Practitioners-Advisory-Committee-Entity-Description.aspx and https://www.avma.org/About/Governance/Leadership/Documents/cpac-roster.pdf respectively. The CPAC has drug availability issues specifically stated in its charge. They would love to hear from you.

            4. Economics of the Veterinary Profession – AVMA has had this on its priority list since making it the number one priority in its update Strategic Plan for 2012-2015. We have established a Veterinary Economics Strategy Committee (all brilliant people), an entire new Veterinary Economics Division, regular meetings with the AAVMC and Deans of the veterinary medical colleges on this issue including discussions on NAVMEC core competencies, financial resources, and practice readiness solutions, have a world class workforce study commissioned by IHS Global Insight to have actual current and future data on veterinary workforce issues to discuss with AAVMC, and are a founding member of the Partners for Preventive Pet Healthcare consortium with practical tools for practitioners and a forthcoming public outreach campaign. The report from IHS Global Insight late this spring should give us specific data from which to further define our actions. We have an Advisory Committee to IHS Global Insight which includes a veterinary college Dean to better assure the study results are credible to all parties.
            This was all done in the last two years. We are working hard on making sure veterinary medicine remains a “personally and financially rewarding profession” as specifically committed to in our economic vision statement.

            5. Education standards for accreditation – The AVMA COE has been continually sanctioned by the US Department of Education and the Council for Higher Education Accreditation since its inception. Those are the two highest and most rigorous bodies with which accrediting bodies are held accountable. The COE accreditation process is the gold standard in the world. That doesn’t mean it is perfect, but having sat on the Council for several years, I understand the process well, and it is constantly re-evaluating how it can improve, just like it requires of the veterinary medical schools. What don’t you like about it and why?

            I have been in private clinical practice for 34 years, and an owner of an AAHA practice I built myself for 15 years until recently. I have been directly involved in AVMA leadership since 1996 and, believe me, it is a world class organization. I really do appreciate your comments and even frustration, but we are transitioning through some challenging times. AVMA has evolved immensely for the better. Our dues are a better buy than many other professional associations in regard to members to staff ratios and productivity. We get A LOT of work done.

            You obviously give a lot of thought to these issues. Getting back to the theme of this thread, what would you like to see us do to improve governance and function?

          • As you engage CYA and toot your Horn at the AVMA, here are some ideas;
            I found out about the “then” required compliance with Red Flag Rules in 2007 and the information was never conveyed by the AVMA. I complied and great time and expense in 2008-09. Now you cackle because in 2011 Veterinarians Medicine became exempt!!!! Funny thing, when you guys get you but in a vice this is the first time I have heard of the exception from the AVMA!!! I don’t know that I could trust the AVMA single blurb on the matter is true and there was no documentation of source given in your articles and links. Who says that we are exempt and by what action of the FTC or Congress?

            Now let’s consider the Affordable Health Care Act and the 2.5% tax on dual use medications and equipment from the Obamacare Tax. What have you done to let veterinarians know, to exempt veterinarians, and to warn the public???? Here is the information that might be helpful to any practioner: http://miami.cbslocal.com/2013/03/11/obamacare-may-bite-you-at-the-vets-office/

            So far as medical costs, are you being pro-active in determining why the FDA is gutting the generic and proprietary drug industry with inspections and requirements on old stand-by drugs that result in the loss of the product, reduction in the number of producers, and multiple times the cost of the drugs when they return to the market. Have you done anything or let us rank and file know how our efforts and money is being spent to help protect our growing overhead costs.

            On the economics of Veterinary Medicine, WHAT PART OF OVERSUPPLY DO YOU NOT UNDERSTAND? For the economy there are too many pet animal practioners, too few food animal practioners, and an abundance of graduates who want 8-5, no emergency, all technology/no practical knowledge practice, or part time engagement. The system of selection needs to be altered to consider those low B average students that will actually practice a full practice lifetime rather than A+ students who will never get feces on their hands or shoes.

            Get real AVMA. You have become too PC, too organized around your own executive staff and their pay, and too little involved with the needs of your practioners/constituents. A few tootings of your horn and timely articles now is too little too late.

  2. Regardless of what the AVMA says, there is no shortage of veterinarians. In fact, new graduates are finding their employment opportunities limited. The AVMA has made it easier for foreign graduates to take jobs away from these new graduates. Isn’t it interesting that this was driven by corporate veterinary medicine when the AVMA is supposed to protect and advocate for its membership. Where is the leadership of the AVMA on issues such as cities overriding state practice acts and standing up to animal rights activists. If I have a problem, I am more likely to turn to my state association. The AVMA appears to be an inept bureaucracy.

  3. The AVMA needs to stop caving to Animal Rights Pressure and focus on the science behind the medicine. Also, the dues are way too high for what members get–it is terrible.

  4. Well it is about time that the AVMA recognised that it is top-heavy, ineffective, and in existence to maintain its own existence not that of the constituent veterinarians!!! I would hope that in your governance choices you can choose somebody that had sense enough to lance an abscess then collect a fee. The AVMA and we veterinarians had better get busy before we are all taken down by the lunacy that has occurred over the past 40 years at the AVMA!!!!
    • Chicken Little Report
    • Cow towing to the FTC
    • Abandonment of Ethics
    • Renewed cry of manpower shortage when veterinary practices a going broke
    • Cost of education beyond the investment/benefit ratio that would allow practice
    • Selection of students by grades rather than ability to practice or remain in practice to develop an experiential knowledge base
    o This was the last straw for me.
    o I truly question why I am a member at current!

    L. B. Windley DVM, EdS, EdD (GA 74)

  5. After reading the proposed new structure, I am concerned that regional interests are not being considered in any of the committee structures. This will allow all 11 appointees/electees on each committee to come from one area rather than representing the entire constituency. I agree that the current structure is unweildy, at best, and needs to be remodeled, but there should be at least one forum out of the three where regional representation is included. The AVMA should represent everyone and lobby for the entire constituency rather than local pockets.

    Thank you for addressing the changing demographics of the profession. That is a huge step forward.

  6. Honestly, I’m so ticked off by how the whole health insurance thing was handled, I’m planning on quitting the AVMA as soon as this year’s membership expires. I didn’t appreciate the big premium hike which was almost immediately followed with a December letter telling us that we would lose our health insurance. I have three small children to take care of. If the AVMA-GHLIT was considering that, then its members should have been told as early as possible and given every opportunity to find other coverage. The way it was handled was inconsiderate and unprofessional. I also don’t appreciate not receiving a reply when I wrote why I was upset. You guys are out of your minds if you think I’m going to send you another dime.

    • Group health insurance is what I see as the major benefit to being an AVMA member. I am extremely disappointed by the action taken by the AVMA. I understand that there are many barriers with the current health insurance situation. As a former board member of a non-profit, what I would see as a major purpose of the AVMA Board is to speak for the interests of the members. The way the health insurance situation has been handled seems to reflect a complete lack of governance by the board and apparent lack of good policy. As an equine veterinian, I no longer see benefit to AVMA membership without group health insurance. Maybe there is a better option out there, and I am in the process of investigating.

  7. Thanks for your work on this health insurance thing. I’ve always been happy with the coverage provided by AVMA-GHLIT and would like more than anything else to stay under the umbrella offered

  8. I was shocked to read in the recent AVMA journal that $80,000 was approved to develop a new LOGO. Are you kidding me? At a time when veterinarians are picking and choosing which professional dues they can afford to pay, this is a kick in the teeth. It seems excessive and leaves me with a bad taste in my mouth about the AVMA.

    Kirsten Franke, DVM

    • Relevance and value to it’s membership are always the main criteria for the existence and viability of any organization. Does the AVMA leadership really feel they are meeting the needs of it’s members? I would say they are not based on allocating an unjustifiable amount of money for a new LOGO; seemingly seldom taking substantive stands on current issues that are front and center in the public forum, out of control Veterinary College populations that have resulted in significant declines in the compensation and demand for new grads, and informing members of an impending discontinuance of important health insurance coverage with out first doing the “homework” to provide possible options for meeting the associations membership needs in this area. Most of my colleagues that have coverage through MONY AVMA group plan read the letter to convey; “well folks, your’e on your own after 2013”. I can appreciate the need for vision for another 150 years, but our organization will not make it another decade if it doesn’t take it one year at a time and forget the “symbolism over substance” approach. We already have much to much of that coming from our national political leadership.

      Wm. Collins, DVM

      • Drs. Franke and Collins, I fully agree. This is an excellent example of the AVMA’s misdirection and irrelevance in our current economy, practice environment, and professional lives. Smoke and mirrors, duck and dive, just to look like something meaningful is being done are the order of the day. The practices and paradigms at the “home office” and suited non practioners there remind me of our current Administration and Congresspersons in D.C. as well as the corrupt Union bosses in their husbandry of our funds and confidences.