Too many veterinarians? AVMA panel tackles hot topic


Too many veterinarians? AVMA panel tackles hot topic

Experts argue whether oversupply issues will push the veterinary profession to the brink.
Aug 18, 2014
By staff

The room was full, and no one was quite sure what would happen next. Philosophies were varied. Opinions were impassioned. Whispered exchanges were heated.  

Such was the atmosphere at the American Veterinary Medical Association (AVMA) plenary session “Veterinary Oversupply: Issues and Ethics” on July 28 during the AVMA’s annual convention in Denver.

Featuring pillars of the profession and a panoply of perspectives, the panel was moderated by Alice Villalobos, DVM, president emeritus of the Society for Veterinary Medical Ethics. According to some speakers, the veterinary profession is in or near acute crisis, with its constituents facing poverty and despair in a few short years. Others theorized that the expanding number of veterinarians is just what the profession needs to serve society’s needs as pet ownership and population numbers soar in the near future.

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Dennis McCurnin, DVM, MS, DACVS
Louisiana State School of Veterinary Medicine

Key points
> In 2005, the AAVMC predicted a 15,000-veterinarian shortage by 2025. In 2013, the AVMA reported an excess capacity of 12.5 percent in the profession. Why can’t we interpret the data correctly?

> No one can control a university’s decision to open a veterinary school and therefore the number of schools in existence. We are approaching 4,000 graduates per year now.

> Since the loss of state support for higher education, veterinary schools are just trying to survive. They are doing this by increasing tuition and increasing class sizes, all while the pet population is decreasing.

> The mean starting salary for veterinarians is $67,156. The debt load is $162,113. This means the debt-to-salary ratio is 2.4, when it should be 1.

> Physicians’ starting debt-to-income ratio is 1; dentists’ is 1.7; attorneys’ is 1.7. However, only 50 percent of JDs find work in the legal profession. That’s veterinarians in a few years.

> A look at dental history: In 1986, seven dental schools closed because the applicant pool dried up. The schools changed the curriculum to emphasize preventive and cosmetic services, and the profession recovered. Insurance was a big part of that success.

> Solutions involve increasing demand for services and practice profitability, but there are no easy fixes. We are all struggling with the answers.

James Wilson, DVM, JD
Priority Veterinary Management Consultants

Key points
> Here’s a fictional news report for 2018: Average veterinary debt has reached $236,000, 38.6 percent of veterinary school applicants are not qualified, three schools have closed, 9.5 percent of recent grads are in default on their loans, and the veterinary suicide rate has increased. These stats are fictitious, but they underscore the sense of alarm we should be feeling.

> The student debt trend is unsustainable, and we need to reduce the amount veterinary students borrow. The University of Indiana provides detailed financial information before students take on additional debt. Could others do likewise?

> The profession is seeing rapid enrollment growth as schools desperately seek more money. There is also rapid expansion of U.S. students graduating from overseas in the Caribbean, Canada and elsewhere. The total debt today’s veterinary students carry is $2.5 billion.

> John Bogel, author of Clash of Cultures, reports that our society is in an out-of-control educational spending bubble. Schools set tuition based on the money available for educational loans to graduate students. And we’re looking at a massive train wreck in 20 to 25 years.

Mark Cushing, JD
Animal Policy Institute, Tonkon Torp Attorneys

Key points
> The “oversupply” of veterinarians is only alleged. We’re asking the wrong questions, sending the wrong message and looking at the wrong facts.

> Ninety-eight percent of graduates have jobs six months after leaving school, so we don’t have oversupply.

> The real issue is that more than half of pets in the United States receive no veterinary care at all.

> Do we really want the government telling people, “It’s nice you want to go to veterinary school, but what we really need right now are plumbers. Here’s your loan package for that”?

> Scaring undergrads is not a long-term, viable strategy. We need to share the good news, too.

> What does the public think when they see our headlines? They think veterinarians want more money.

> Dire predictions are usually wrong. When a veterinary college in Mexico was seeking accreditation, people predicted an influx of Mexican veterinarians into the U.S. At the time there were eight per year. Now there are six.

> Population growth projections point to tens of millions of new pets coming onto the scene in coming years.

> The key is to focus on demand rather than oversupply.The key will be innovation in how we get pet owners into veterinary practices, what we deliver and how we deliver it. We don’t spend enough time on innovation.

Paul Pion, DVM, DACVIM
Veterinary Information Network (VIN)

Key points
> Our responsibility is to leave the profession as good as or better than it was when we received it.

> We are failing to have an open and honest debate on this issue, instead acting like children yelling on a playground. Transparency is missing. The AVMA’s legal team is squashing every open discussion.

> We do need to tell students the whole story; we need the best and brightest to join the profession.

> We do need to do better with PR and marketing to increase the demand for veterinary services.

> But it’s unrealistic to say that 50 percent of pets not seeing a veterinarian is the solution. We are a luxury; human medicine is not.

> We’re not telling students not to be veterinarians; we’re making sure they know what they’re getting into. I tell students that all of this will work out because it has to. They’ll find a way because they have to.

> I’m tired of people being silent publically; I’m tired of people saying there is nothing they can do. We have a problem, like it or not, and we have to address it. There is no single or quick solution.

> We should be ashamed of how we have approached, debated and handled this issue.

An Obvious But Continually Overlooked Solution

Dennis McCurnin has wisely, albeit briefly, pointed out that "insurance was a big part of the success" of the recovery of the dental profession.  In fact, the U.S. Department of Labor has reported that in 2013, the mean annual incomes were $164,570 for dentists and $96,140 for veterinarians.  With only 4-6% of pets currently protected by medical insurance versus approximately 50% of dental patients, it has to be obvious that a dependence on the discretionary income of pet owners by our profession is a huge factor in the growing overcapacity problem.

Would a broader use of pet health insurance reduce the percentage of pets that never see a veterinarian?  Probably not! Would insurance allow pet owners who are strongly bonded with their pets to afford medical care and avoid economic euthanasia? Definitely yes!  Would increasing the size of the revenue pie assist in solving the overcapacity problem?  Yes! Yet, indifference, fear of managed care, and a long history of bad insurance experiences have all suppressed a serious discussion of the potential of this obvious solution.

A valuable tool has been available to our profession for a very long time.  Unfortunately, the courage to explore and evaluate the tool has been sadly lacking.