Redefining veterinary medicine

PORTLAND, ORE. — The alarms are sounding again to increase the number of veterinarians in the United States.

Table 1 Keeping pace with the population

Demand is simply outpacing supply, according to some academic and practice leaders at the 2008 Pet Healthcare Industry Summit.

The meeting, sponsored by Banfield, The Pet Hospital, brought together 150 leaders from veterinary organizations, animal-health companies and others to discuss problems and potential solutions facing the veterinary profession.

Shortages of veterinarians continue to plague market expansion. It ranks as one of the most serious issues facing the veterinary market, says John Payne, Banfield's president and CEO. The shortage certainly has potential ramifications for Banfield's network, which now numbers 725 practices and continues to grow.

John Albers, executive director of the American Animal Hospital Association (AAHA), believes the supply issue needs to be studied carefully, especially in light of the current economy.

It's a complex problem, Albers says, that needs to be examined by region and market segment.

Opinions about the need for more veterinarians in the United States are just as diverse as the problems the shortage is believed to be causing. Close to 75 percent of practitioners responding to a DVM Newsmagazine poll in late 2007 didn't believe there is need for more small-animal practitioners.

Academia and some practice leaders see the issue very differently.

The topic was spurred by veterinary academia's Foresight Report last year, which called on veterinary schools to increase output of veterinarians to fulfill current unmet needs and pave the way for future expansion.

While companion-animal practice is netting about 80 percent of current graduates, many other areas within the profession continue to evolve. That will put more pressure on filling companion-animal vacancies, says Scott Campbell, DVM and Banfield's chairman of the board.

There also is a population of pet owners currently underserved. The profession should focus on expanding access to veterinary care, keeping costs affordable and increasing veterinary visits, which will work to improve the health of the pet population. All of that will fuel a need for more practitioners in companion-animal medicine, not to mention the many other segments of the market, Campbell says.

Dr. Marguerite Pappaioanou, DVM, MPVM, PhD, Dipl. ACVPM and executive director of the Association of American Veterinary Medical Colleges (AAVMC), explains that the need for veterinarians in many sectors is expanding.

The profession has not kept pace with population growth, she says, pointing to the many areas it touches, including:

• Companion-animal medicine

• Food-animal medicine, including disease prevention and control, diagnostics and international trade

• Wildlife, zoo veterinary medicine

• Public health

• Biomedical research

• Pathology

• Lab-animal medicine

• Environmental health

• Emergency response

• Industry

While the U.S. population continues to grow, number of veterinarians have remained relatively flat. The same is true for the numbers of veterinary schools in the United States and Canada, Pappaioanou adds.

Applications to veterinary colleges, on the other hand, have remained strong, she says.

For veterinary education, the Foresight Report spawned the North American Veterinary Medical Educational Consortium, a group that will host a series of meetings about these topics next year. The goals:

• Create agreement on societal needs and core competencies for DVM/VMD graduates.

• Explore different educational models to meet the need.

• Address the relationship between licensure, curriculum and accreditation.

• Create a strategic plan for veterinary education.

The challenges for veterinary education, Pappaioanou says, are many. There have been significant changes within society, environment, technology, disease emergence, human-animal bond and agriculture.

It's difficult to provide the requirements to meet all of these needs within a four-year program.

The next phase of reform for veterinary education will focus on creating Centers of Excellence within veterinary institutions.

The concept will drive new alliances and cooperation among the schools. To make it happen, officials need to look seriously at the role of accreditation and limited licensure.

Mark L. Cushing, partner in Tonkon Torp LLP, offered an overview of the Veterinary Shortage National Task Force, which identified these major problems:

• Veterinary shortages in all segments

• Educational costs too high

• New graduates not prepared for practice

• Recent graduates working fewer hours/days/years

• Medical knowledge exploding

• Veterinary teaching hospitals evolving to sub-specialty practices.

What's needed, Cushing says, is for licensing boards, accredition bodies, colleges, associations, practices and industry to work together to solve the problems facing the market.

In 2030, 4.8 billion people will live in urban areas on this planet, which is about 60 percent of our population. This will include the largest concentration of pets in our history, says Joseph T. Bielitzki, DVM, MS and COO of LensAR Inc. The medical issues and challenges that poses for veterinarians are multifactorial — from emerging new diseases to public health.

Veterinary medicine needs to redefine itself, Bielitzki says, and recognize that change is inevitable.

"Big problems are also big opportunities," Payne adds. "It will take collaboration to solve them."