Shrinking caseload ignites $5 million initiative

Schaumburg, Ill. — The American Veterinary Medical Association (AVMA) committed $5 million toward a new campaign to improve the economics of the veterinary profession.

"The impetus behind it certainly has been what we've all been hearing and reading about what's been going on in the profession," says Dr. Theodore J. Cohn, a partner at University Hills Animal Hospital in Denver and chair of the AVMA Executive Board. "Indeed there is a real situation and problem as far as the economics of the profession."

Discussions about business trends in the veterinary profession are nothing new for the Executive Board, but talks ramped up in April when the Economic Vision Steering Committee, chaired by Cohn, was formed. By August, the Executive Board had the start of a plan.

Over the next five years, the Executive Board will put $5 million into the Strategic Economics Initiative. The initiative will include establishing a Veterinary Economic Strategy Committee to advise the Executive Board on economic strategies. The open-nomination committee is meant to include veterinarians as well as leaders in business and economics, Cohn says.

The initiative will also support the creation of a new Veterinary Economics Division within AVMA, allow the Economic Vision Steering Committee to continue to provide guidance on economic strategies, and include the development of an economics communication strategy that will circulate new information and resources throughout the profession.

"There's not any one thing (the Executive Board) expects to come from it. The overall goal is to certainly improve the financial viability of the profession," Cohn says. "There are so many different things that are happening, so many different challenges we're facing, and we've got to start somewhere. This is the first step down that road."

AVMA has long heard about problems with rising education costs and student debt, coupled with decreasing visits, inadequate salaries and poor client compliance. The problem won't be solved overnight, or maybe not even in a year or two, cautions AVMA President René A. Carlson.

"It was very obvious the economy was stressing everybody out. It's been talked about for as long as 30 years," Carlson says. "It's a number of things that brought it to the forefront ... How can we begin to address this huge elephant in the room?"

Presently, it's a challenge to view veterinary medicine as a financially rewarding profession, Carlson says. She worries about a new generation of veterinarians saddled by debt before a solution can be found.

"We have the best education system in the world, hands-down. However, I don't think the current cost of the education and our education models can be sustained," Carlson says. "We just have to really start being much more visible about what we do and start looking at job opportunities for veterinarians that are outside the traditional model of companion-animal practice.

"As president of AVMA, this is one of the reasons I really wanted to be involved at this particular time," she adds. "I am almost fearful for the profession, and society, if we don't get this taken care of ... I think our members are ready to invest the finances to really give this a lot of attention."

The initiative will first support the Executive Board's efforts to study the issues, according to Cohn. Questions to be answered include: Is there really a workforce imbalance? What are the causes? What is keeping clients away from practices? What drives clients to a particular practice?

The initiative will reach out to organizations and experts to form partnerships and try to involve the entire profession by launching focus groups and collaborative summits across the country over the next year, he says.

"This is an economic strategy that I think is important to the entire profession, not just AVMA," Cohn says.

The root of the problem, he believes, is a perception of a lack of value on the part of the public when it comes to veterinary medicine. From a practice perspective, that perceptionresults in decreasing client visits and poor compliance, which leads to decreased profitability and the inability of practice owners to offer associate veterinarians salaries commensurate with their experience. Then, those associates are put in a position where they have difficulty paying down mountains of student debt. Veterinary medicine begins to look less and less attractive to students. Applicant pools start to shrink.

"Over time, what's going to happen is the profession is going to be seen as a less-than-optimal profession," he says. "We're going to fail to attract the best and the brightest, and it just kind of snowballs from there."

Legislators need to put more value on veterinary medicine in terms of funding for learning and research at veterinary colleges, but first the veterinary profession must get to the root of the economic problem. Veterinarians need to become better business people, learn to market their practices better, and become more efficient.

"The Bayer-Brakke study shows us that client visits started dropping a good 10 years ago or more. What is it that has created this situation in clients' minds that they don't value visits to the veterinarian the way they used to? What has changed in their psyche that means they can go to the Internet for advice rather than talk to their veterinarian?" he asks. "If it's on the Internet, it must be right. It's the same lack of critical thinking by the public that sometimes I think students get into. Teaching the public to think critically about these issues is going to be a huge challenge for us."

Carlson talks of three pieces she recently came across in the media—a television broadcast about the world's cutest dog ... with bad breath, an interview with a young 9/11 survivor who wants to be a veterinarian when she grows up but doesn't know how she can do that and teach, and a magazine article about an elephant sanctuary that cared for an elephant with a spear through its foot.

All three pieces could have featured comments from veterinarians but did not. There was just one sentence in the article about the elephant, saying a veterinarian removed the spear and the elephant was fine.

"Where's the attention for this enormous talent?" she asks.

"Those three things are just crying out for us to not be silent. We have to become a much more visible and vocal profession," Carlson says.

But veterinarians are reluctant to promote their profession loudly, she says. No one is more qualified to speak about a topic so many people love—animals—yet few veterinarians are willing to take on the role.

"We just have to start telling people what we do. Nobody is more passionate or talented or broadly educated to deal with all these issues," Carlson says. The traditional image of the veterinarian needs to be updated for a global world through social media and Internet campaigns, with consistent, grass-roots efforts.

"I think there's a lot of creative ideas we can approach to make people more aware," she says. "We've done all of that, but in little pieces."

At some point in the initiative, there will be a public education campaign, and Cohn says there will be room for all the groups invested in the profession to get involved.

"This is just really the start of something. I don't feel like we've accomplished anything significant yet," Cohn says. "We've taken the first step in committing ourselves to do something for this profession from an economic perspective ... but we're going to need a lot of help."

The association plans to assemble the new Veterinary Economic Strategy Committee by the end of October so that the committee can begin work at the start of the new year, Cohn says.