California to debate future RVT role

SACRAMENTO, CALIF.—Registered veterinary technicians (RVTs) in California want state veterinary medical board officials to expand their licenses to include minor surgeries, such as cat and dog neuters, in the name of career advancement.

On Jan. 20, the California Veterinary Medical Board (CVMB) will begin to discuss a proposal brought by the California Registered Veterinary Technician Committee (RVTC), which states veterinarians underutilize and subsequently underpay RVTs.

Role play: California officials are set to argue how much medical freedom to give registered veterinary technicians in an effort to stave off high attrition numbers. Like his colleagues, RVT Chad King (above) seeks prospects for advancement and compensation.

Because the plea involves a regulatory issue, CVMB has the final word on whether or not changes are permitted. In most of the country, RVTs are regulated and credentialed by the states.

CVMB President Dr. Mike Kerfoot says the motion is "very preliminary."

"We are looking at expanding the role of RVTs in California; that's true," he says. "But it's just one of those things where you know it will be a long, drawn-out procedure."

RVT complaints

The process began in October, when an RVTC task force presented the veterinary medical board with national survey statistics showing low salary as the biggest complaint among RVTs, likely contributing to high turnover among veterinary practices. Lack of professional recognition, burnout and lack of advancement also ranked as concerns. Additionally, 35 percent to 40 percent of the survey's respondents expressed low job satisfaction, and more than 50 percent did not expect to remain in the profession.

RVTC Vice Chairwoman Nancy Erlich says the problem stems from veterinarians failing to use RVTs in ways that generates income for the practice. State regulations permit RVTs to perform four basic tasks under the direct supervision of a veterinarian, including dental extractions, application of casts and splints, suturing of existing skin incisions and anesthesia induction by inhalation or intravenous injection.

Those duties haven't changed for 22 years, Erlich says.

"We haven't added any new job tasks for RVTs in California since 1982," she says. "The rules need to be changed."

New approach

RVTC proposes the profession treat RVTs much like human medicine views physician assistants (PAs), and its October appeal to CVMB included a list of new duties recommended for RVTs (see Table 1). "In most states, including California, PAs with the appropriate training can perform a physical examination, make an assessment and diagnosis, initiate treatment, write prescriptions and do surgery," the proposal states. "In California, this profession also requires a Delegation of Services Agreement between the supervising physician and the PA. The supervising physician must also accept responsibility for the supervision of the PA."

Lack of uniformity

That's not a risk many practitioners would take, says Dr. Jon Klingborg, president of the California Veterinary Medical Association.

"There's such a diversity in terms of the abilities among graduates of technician programs," he says. "I don't see how veterinarians could protect themselves from poorly trained technicians."

While all registered veterinary technicians must pass a standardized exam for licensure, the American Veterinary Medical Association's (AVMA) Council on Education accredits just 10 of California's 12 RVT programs.

"We can't be sure what kind of education veterinary technicians are getting," Klingborg says. "Not to mention, physicians' assistants go through a lot more training than what's even required by AVMA."

According to the RVTC document, PAs were established in the mid 1960s to address the shortage of primary-care physicians and now complete approximately 26 months of training before sitting for licensure. By comparison, accredited RVT training is a two-year program consisting of 60 educational units of classroom instruction, Erlich says.

"We have been discussing adding job tasks for RVTs for many years," she says. "Surveys have shown that the most-successful practices utilize RVTs to their maximum legal potential. For some reason, this concept has not gotten through to most veterinarians."