No veterinary workforce shortage, study finds

Four years after originally promised, a panel convened under the auspices of the National Academies of Science has released its report on the current and future workforce needs of the veterinary profession. Its conclusion? While there's no shortage of veterinarians in the profession now, there is a significant imbalance in the types of veterinary medicine being practiced. What's more, if these imbalances aren't corrected, the profession is headed for economic disaster.

"The committee is concerned that an unsustainable economic future is confronting the profession and calls for veterinary organizations, academe, industry, government and nongovernment organizations to proceed strategically and with urgency," the study committee says in the report.

The study was instigated after legislation introduced in Congress in 2005, the Veterinary Workforce Expansion Act, called for an increase in the number of veterinarians. The bill was predicated on the assumption that there would be a shortfall of 15,000 to 20,000 veterinarians by 2024 and that, as a result, the nation was ill-equipped to address concerns related to bioterrorism, zoonotic disease and other public health and safety issues.

The bill did not pass, but in 2007, the American Veterinary Medical Association (AVMA), the American Association of Veterinary Medical Colleges (AAVMC) and other organizations commissioned the National Research Council, part of the National Academies of Science, to investigate these assumptions in more detail.

Originally the investigation was supposed to take 18 months. But, says Alan Kelly, BSc, BVSc, PhD, chairman of the committee and dean emeritus at the University of Pennsylvania School of Veterinary Medicine, complications arising from the economic recession, along with a lack of reliable data on segments of the veterinary profession—compounded by a rigorous review process involving all 13 committee members—stretched out the process into a more-than-five-year undertaking.

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In the meantime, the question has continued to plague the profession: Is there truly a shortage of veterinarians in the United States? Some groups say yes, including U.S. veterinary schools, which have increased their enrollment steadily over the past several years. In addition, new veterinary schools have been created in the United States and foreign veterinary schools have been accredited by the AVMA.

Other groups say no, there is no shortage, including the American Association of Bovine Practitioners (AABP). The AABP issued a report in 2011 stating that parts of rural America are underserved by veterinarians not because of a shortage of willing practitioners but because it simply isn't possible for large animal veterinarians to make a viable living in these areas.

And the report from the group tasked with providing a definitive answer and laying the debate to rest kept getting delayed, and delayed—and delayed again.

Finally, on May 30, the committee released its report, titled "Workforce Needs in Veterinary Medicine." In answer to the question "Is there a shortage of veterinarians?" the report gives a clear answer: no.

"True personnel shortages are indicated when salaries rise sharply in an attempt to attract qualified candidates," the report says. "That is not occurring in any sector of veterinary medicine, except industry," which requires a PhD or other highly specialized training.

However, that's a highly qualified "no," as the rest of the report goes on to explain in 298 pages' worth of analysis and detail. Here are the report's key findings and recommendations:

• Although there is no overall shortage of veterinarians, there are unfilled positions in some sectors of veterinary medicine. These sectors inclue industry and scientific research, which require advanced training, and the public sector (epidemiology, food safety, wildlife and ecosystem health and public health), where salaries are lower than average and recruitment efforts fail to reach veterinarians who might be looking for jobs. The report recommends more extensive partnerships between veterinary schools and animal health corporations and also encourages state and local governments to reexamine how they recruit and pay veterinarians.

The report also implies that veterinary schools—which are increasing their class sizes as well as growing in number—focus too heavily on companion animal medicine. "The demand for a veterinary education among U.S. citizens remains high, yet the economic reality regarding student educational costs in relation to modest practice incomes is worrisome," the report states. "Companion animal medicine has come to dominate the curriculum and resources of veterinary schools, sometimes to the detriment of other fields of veterinary medicine." The report urges organizations such as the AVMA, AAHA and AAVMC to address this imbalance accordingly.

• The decline in veterinary school funding has jeopardized the profession's ability to meet society's needs. Specifically, the report indicates, state budget cuts have hurt scientific research efforts. "Veterinary medicine has made immense contributions to human well-being but is losing the breadth of its intellectual base," the report reads. "The trend jeopardizes the vigor of veterinary medicine, threatens the profession's future and urgently requires a change in direction."

In addition to recommitting to scientific investigation and recruiting students and faculty to research careers, veterinary schools need to seek alternative sources of funding, the report states—for example, from the National Institutes of Health (NIH). "The total NIH funding of the nation's 28 veterinary schools and colleges in 2010 was about $280 million—less than the NIH funding for any one of the nation's top medical schools." This despite ample opportunity for cross-disciplinary biomedical investigation that has direct implications for human health, such as cancer research.

• The cost of veterinary education is at a "crisis point." With the ratio of student debt to starting salaries at greater than 2 to 1, people will eventually wake up to the grim reality of this paltry return on investment, and the quality of veterinary school applicants will decline, the report predicts. Veterinary schools will need to seek other sources of funding besides tuition increases, make a better case for the value of veterinary services to state and federal governments (which, again, requires a recommitment to scientific research that's in the public interest) and examine alternative teaching methods that reduce costs (such as webinars and partnering with private specialty practices instead of maintaining teaching hospitals).

One potential piece of the solution suggested by the report is to encourage more students to apply for admission to veterinary school after two years of undergraduate training, similar to how many pharmacy schools and overseas veterinary schools operate. Earlier admission would decrease the student debt load and help graduates begin earning income earlier. "In Britain we go straight from high school to vet school," says committee chairman Kelly. "I've never understood why in North America students need an additional four years."

• The veterinary profession is losing its presence in food animal production and care. Food animal medicine has failed to adapt to the changes in the livestock and poultry industries, the report asserts. Rather than providing traditional veterinary care focused on individual animals, food animal veterinarians need to be trained to manage herd health and increase producers' productivity.

"Large producers who dominate the livestock industries seek veterinarians who are ... committed to food animal practice, who can understand production systems, can read farm records and can use them to make decisions aimed at increasing herd health, productivity and the overall profitability of the farming operation," the report says. "It is these services producers seek and for which they are willing to pay."

In rural areas where there are too few farms that are too widely dispersed to make veterinary practice finacially feasible, the profession should look to the human health model of utilizing nurse practitioners and other paraprofessionals in underserved areas, the report recommends.

"The AVMA and other professional associations will need to enter a dialogue with officials to modify state practice acts to permit credentialed veterinary technicians to administer livestock-health services, provided that they are subject to collaborative oversight (and constant communication) with licensed practitioners who may be in distant locations," the report says. "Veterinary technicians and other paraprofessionals working with food animal veterinarians in this way have the potential to provide affordable, high-quality care to rural America, and their role should be expanded."

• Global food issues will dominate the 21st century, and the veterinary profession must be equipped to manage these challenges. With the world's population currently at 7 billion and well on its way to 9 billion by 2050, the report says, "it is increasingly clear that agricultural science, veterinary medicine and other disciplines must work together to deliver sufficient, safe food to sustain the world's growing population."

Currently the rising demand for animal protein in developing, rapidly urbanizing areas of the world is being met by increasing numbers of low-producing animals, a trend that is "environmentally destructive and unsustainable," the report states. One example is ranchers in Argentina clear-cutting the rain forest to create grazing pasture for their cattle.

As an alternative, the veterinary profession should partner with other disciplines and organizations to increase the efficiency of livestock and poultry production so that yields are higher and numbers are lower. Plus, veterinarians need to understand animal health hazards and control infectious disease outbreaks that endanger public health. All of this, the report says, calls for an expansion of the One Health initiative beyond infectious diseases into management of food safety and sustainability.

"Society tends to view veterinary medicine through the narrow lens of companion animal medicine," the report reads. "The profession has not done enough to expand recognition of its immense responsibilities in addressing global food security and resilience. Tackling the multiple dimensions of One Health and sustainable food security will require a new, broader definition of veterinary medicine, of its foundational competencies and the focus that veterinary research must take."

Andrew McCabe, DVM, MPH, JD, executive director of the AAVMC, says he is pleased with how closely the report aligns with the North American Veterinary Medical Education Consortium (NAVMEC) "Roadmap for Veterinary Medical Education in the 21st Century" in calling for changes to veterinary education.

"This report confirms our initial thoughts that there are sectors of unmet need and shortages in certain key disciplines: biomedical research, public health and global medicine," McCabe says. "There are certainly areas of unmet need. If we fail to meet those, we risk losing relevance in society."