Editor's Note: DVM Newsmagazine asked six thought-leaders to talk about five of the most pressing issues facing the veterinary profession at CVC East in Baltimore. During the succeeding months, each of the issues introduced at the DVM Newsmaker's Summit will be presented for publication. This month, the panel takes on specialization and its impact on the delivery of veterinary care and veterinary education. Drs. Joan Hendricks and Gary Block introduced issues surrounding specialization.

About the panelists:

Dr. Bonnie Beaver, Texas A&M University, former president of the American Veterinary Medical Association.

Dr. Joan Hendricks, dean of the University of Pennsylvania School of Veterinary Medicine.

Dr. Lonnie King, director of strategic innovation for the Centers for Disease Control and Prevention; former dean of the Michigan State University College of Veterinary Medicine.

Dr. David Lane, practitioner and consultant in Cardondale, Ill.

Moderator Kerry M. Richard, attorney with Tobin, O'Connor, Ewing and Richard in Washington, D.C.

Dr. Jack O. Walther, practitioner in Lamoille, Nev., and former AVMA president.

Dr. Joan Hendricks

We struggle in training veterinarians to treat all species and all specialties. The general public of course recognizes that it is difficult to be a veterinarian because you have to be able to treat every species. We all know it is kind of true, but kind of not. The bigger challenge is that everyone expects a veterinarian to be able to do brain surgery, endocrine testing, advanced behavioral modification as well as run an excellent business, step-up and provide leadership, manage their staffs and have superb communication skills.

We are not training people to do all of those things.

Our trainers are generally specialists within an area like surgery or internal medicine. It's been stated that we aren't training people broadly to do what's needed in family or general practice. About half of our students do expect to go on for further training of some kind either in clinical specialization, gain a PhD or increasingly MPH or its equivalent. What about the half who fully expect in fours years, lacking the additional four years of training that an MD would have, to walk out the door, hit the ground and be a completely competent family practitioner.

If we truly want that to happen, I think what we are going to need to change the way we train. We could have a national system where some schools are designated as spots for the four years maybe with a possibility of additional training through CE, and we focus more on business management, communication skills, maybe marketing and maybe knowing when to refer.

Other schools could allow for tracking toward advanced training in preventive care. It hasn't been something that we all thought through nationally, but it is something I think we're beginning to recognize.

A great boon to all of us is the public interest in seeking specialized care for their pets essentially outpace the supply of even of specialists. Many of our specialties are driven by people's demand, like critical care. We hear the requests: "Why don't you do dialysis?" or "My grandmother has it, why don't you have my pet on a ventilator?" And I cannot tell you what a surprise this was that the public was pressing and willing to bare the costs that we're charging them. Sometimes the costs are in five figures with full information about the low possibility of a good outcome.