How do you eat an elephant like veterinary student debt?

How do you eat an elephant like veterinary student debt?

Answer: One bite at a time, of course, says AVMA's new chief economist Dr. Matthew Salois—but be sure to share the task with colleagues from other disciplines.
May 11, 2018

As an economist, the best advice I ever received was to be “more than just an economist.” As strange as that may sound at first, it’s proven to be true. In its own right, economics is a valuable discipline, but across all areas of science we’re seeing a more interdisciplinary approach. By collaborating with veterinarians and other professionals spanning the animal health spectrum, economists can apply new and different lenses and philosophies to economic-based problems, gleaning better insights and informing better solutions.Veterinary student debt--the elephant in the room--is just one major challenge the veterinary profession is facing. (

At the AVMA, we are focused on the veterinary community’s core challenges: new graduate debt, depressed starting salaries and lingering gender pay gaps, to name a few. Beyond those traditional challenges are income-related obstacles such as practice performance and profitability, a gap in client compliance and the need for continued innovation in products and services to grow demand.   

These are big issues with complex solutions. But by taking a holistic view, by mingling and intersecting disciplines, we can move beyond identifying problems and begin to formulate practical steps for improvement. Grounded in the right data and information, tools such as communication, education and innovation can be leveraged to drive demand for veterinary services. We can begin to identify specific actions every veterinarian can adopt and implement to drive small, positive change. And that means over time we will begin to turn the tide toward improved practice economics—both at the clinic level and professionwide.

As I have stepped into my current role as AVMA’s chief economist, my approach is to focus on short-run wins while pursuing long-run change, asking first and foremost: what can be influenced in the short run? What can we do now, in the near term, to help improve the profession one step at a time? Because as we all know, we’re not going to change the debt problem overnight. But with an integrated approach, bringing multiple disciplines to the table to tackle a specific challenge, we can help improve the veterinarian’s life today. And that, over time, will change the profession.

In the five years since its inception, the AVMA economics team has built an incredible foundation to understand the dynamics of veterinary economics. As we enter the next phase of converting that knowledge into tangible tools, I look forward to bringing those actionable insights to you.

Dr. Matthew Salois worked in private industry, government and academia before joining the AVMA in 2018 as director of veterinary economics. Most recently, he served as director of global scientific affairs and policy at Elanco Animal Health, supervising a team of scientists in veterinary medicine, human medicine, animal welfare, economics and sustainability. Before joining Elanco, Dr. Salois was chief economist with the Florida Department of Citrus. He earned his PhD in food and resource economics from the University of Florida.

Student Debt and other "symptoms"

The big challenge for AVMA economist Salois is to think like a veterinarian. A veterinarian is trained NOT to treat symptoms (problems) but to study symptoms to arrive at a diagnosis. Once the diagnosis (inadequate revenue) and etiology is determined, a treatment plan can be devised to solve the medical problem.

Attempting to “take a bite” out of student debt, low starting salaries, high veterinary nurse turnover, and economic euthanasia is the same as treating symptoms. It’s like getting the cart before the proverbial horse!

The common PROBLEM is that companion animal medicine is dependent on the discretionary cash of clients to pay for patient medical expenses. Because the cost of veterinary care is increasing faster than the ability of pet owners to pay, the symptoms are intensifying and the patient is suffering even more.

I recently talked with a practice manager who rightfully boasts that 41% of his practice patients are insured. He says the many benefits to the practice are enormous! This practice has developed a treatment plan and taken a substantial bite out of the problem. I know of other veterinarians who have abandoned traditional 3rd-party billing. Instead, they have enlisted the aid of a billing service to assess the credit worthiness of individual clients and to manage the billing internally. By keeping monthly billing “in-house”, these practices have reduced expenses, added substantial monthly revenue, and taken another bite out of the problem! Other veterinarians who have established charitable funds to assist worthy pet owners have enlisted yet another very compassionate way to take a bite out of the problem.

Here is a suggestion for Dr. Salois: Research why the mean salaries for physicians and dentists are so much higher than the salaries for veterinarians. After all, these three medical professions have similar educational requirements. Also, graduates in all three professions have similar medical skills. Like a veterinarian, evaluate the symptoms, make a diagnosis, determine the etiology, and THEN prescribe a series of bite at a time!

Kent A. Kruse, DVM