Specialists wanted

The very institutions that have cultivated veterinary specialists may be doomed because of the increasing demand for their graduates and, worse yet, their instructors.

Dr. Guy Pidgeon

"The future of some specialties may be compromised because a number of faculty have left academia for the private sector. Ultimately, this may jeopardize university-based training programs, which have provided the vast majority of residency positions to date," says Dr. Guy Pidgeon, chair of the board of ACVIM.

Compounding matters, if universities are no longer able to post competitive numbers of future specialists, those tenured in academia may be looking at a postponed retirement.

"There's some fear that the number being produced in the various training programs is not enough to even replace those who are retiring let alone the backlog that is out there," says Pidgeon, dipl. ACVIM and president and CEO of The Animal Medical Center in New York city.

Dr. Sonya G. Gordon

The lack of replacements directly relates to the increase in the number of small animal referral hospitals, not necessarily the number of those being trained, says Dr. Robert Schneider, dipl. ACVS and president of the American College of Veterinary Surgeons.

"Those practices have definitely caused a drain on the numbers of people who would normally be in a university, but eventually we (have) to get to a point where there won't be such an expanding number, in my opinion, of new small animal hospitals being developed. It's been so lucrative for them," says Schneider, on the faculty of Washington State University.

In private practice, Pidgeon concurs that specialists have enjoyed a "seller's market" across the country for some time.

"How long that can continue, you'd assume there's some maximum number of specialty practices before you start to saturate. But if you follow the wires, there's always somebody looking for any specialty you list," he says.

Pidgeon says he would give up the "key to the city" just to recruit a radiologist to the Big Apple. It's been over a year, and he's had no takers. Likewise for Dr. Marsha Carruthers, board-certified dermatologist in Akron, Ohio, whose referral hospital could desperately use a cardiologist and neurologist.

Table 1: Veterinary Specialists

"Everybody in the country is looking for them," she says.

Reason for demand

Washington-based Dr. Sandy Wright, dipl. ACVIM, says the increased demand, which may be a precursor to a future shortage, directly correlates with owner awareness.

"It's a feeding frenzy on the part of veterinarians' and pet owners' awareness that is increasing the demand for specialists," Wright says.

Dr. Sonya Gale Gordon, cardiologist at Texas A&M University, adds that today's clients are "very savvy."

"They know that if they have a heart problem, they see a cardiologist. They come to expect that with their other family members - their furry ones. Maybe the idea of a shortage is really just that the need is expanding and the training programs haven't met the numbers yet," Gordon says.

While no national organizations have tracked whether a potential shortage of specialists is on the horizon, the demand definitely impinges on a university's ability to turn out enough specialists of all sorts, says Washington, D.C.-based Dr. Robert Rosenthal, dipl. ACVIM (oncology). Several years ago, he and his colleagues were approached by an unnamed organization that wanted to brand specialty medicine. They conducted a survey showing only 2 percent of people in the United States were aware of veterinary specialists.

"Part of their pitch was to say if we raise our awareness to 4 or 6 percent, just think you might be two times as busy. We all sat in that room thinking, we don't want to be 2 or 3 times as busy. We want more people who can do the job," says Rosenthal.

Training resources limited

Is training additional residents the answer? Possibly, but probably not financially feasible, says Wright, public relations chair for ACVIM.

"All training is dictated by the budget of the schools, so that is somewhat limited," she says. "They can only graduate so many specialists a year because they can only fund so many positions."

Dr. Dan Brogdon, board-certified ophthalmologist in Florida agrees, "It's easy to say we need to train more. But we're not going to dilute the training programs just so that we can get 10 residents in."

Pay more

Instead, Dr. Robert Pechman, dipl. ACVR, of Louisiana State University, says universities are advised to assess how to keep specialists if they plan to compete with private practice. He says universities are far more vulnerable than they realize. As an example, an unnamed veterinary school in recent years went from having four to zero radiologists on board.

"The administration had been dilly-dallying for several years and suddenly they were in a crisis," Pechman says. "They spent a lot more money than was necessary but they brought in great people, good equipment and now they're back."

Pechman says that universities, in order to hire any specialist, are going to have to hire them at what private practices are paying. "They're going to have a hard time until they understand these people command high salaries and you're going to have to pay them to compete," he says.

External options

Emerging in the midst of the universities' dilemma is what Pidgeon calls "hybrid programs" where larger private referral centers partner with universities to jointly train their own residents.

"Certainly as some of these huge practices get better established with a broader breadth of people in place, they can conduct very good training programs, Pidgeon says. "At issue is when the mentor is in a for-profit environment, can they afford or will they take the several hours per week in rounds and discussion and journal groups, which are important to a resident's training, when that's cutting the bottom line."

Eventually, Pidgeon says such a plan could lead to a majority of training being done in the private sector versus public institutions.