The veterinary profession is at a crossroads, facing a surge of proposed changes — expanding veterinary schools, introducing midlevel practitioners and removing the physical exam requirement for the veterinarian-client-patient relationship. These reforms are positioned as solutions to workforce shortages and access issues.
Advocates argue that these changes are urgently needed, often dismissing concerns as obstructionist or nostalgic. But change for its own sake is not progress. True progress strengthens patient care, upholds standards and delivers lasting benefits — not quick fixes with long-term consequences.
Spinning the Revolving Door: The Push for More Vet Schools
Expanding veterinary schools is frequently presented as the answer to workforce challenges. But this approach ignores why so many veterinarians are cycling in and out of jobs. Rather than solving the root causes, we’ve created a revolving door — veterinarians accept employment only to be spun back out due to burnout, debt, heavy workloads and insufficient support.
This churn drains veterinary practices of stability and continuity. The profession isn’t short on talent; it’s short on sustainable environments where talent can thrive.
A meaningful solution must address both recruitment and retention. For example:
- Improve work-life balance and mental health support.
- Reduce student debt so new grads can afford to stay in practice.
- Invest in workflow improvements that enhance efficiency without lowering standards.
Turnover in veterinary medicine exceeds that of other health care sectors, costing billions in lost productivity. Until we fix the conditions that push veterinarians away, producing more graduates will only spin the door faster.
Midlevel Practitioners: A Risky Shortcut
Veterinarians are trained to diagnose and treat a wide range of species, each with distinct needs. Allowing midlevel practitioners with significantly less education to perform diagnostics, prescribe medications or conduct surgeries introduces a dangerous margin for error — from misdiagnoses to malpractice, often with veterinarians bearing the liability.
The proposed Veterinary Professional Associate program at Colorado State University exemplifies this concern, with limited clinical experience and over 60% of the coursework online. Similarly, Lincoln Memorial University’s master of veterinary clinical care program is 100% online and can be completed in only three semesters. Each program’s graduates would be authorized to perform procedures like spays, neuters and dental extractions. These are not risk-free tasks. In fact, adverse events related to spays and neuters comprise most of the malpractice claims submitted to the AVMA PLIT.
Some justify midlevel roles by pointing to human health care. But the U.S. system is a poor model. We spend 18% of our gross domestic product on health care — almost double that of peer countries — yet we rank lower in life expectancy and have the highest rate of preventable deaths. Emulating an inefficient, overburdened system is not a path to progress.
Further complicating the issue, market forces are expanding the supply of veterinarians. Several new schools are graduating their first classes, with more than a dozen in the accreditation pipeline. Meanwhile, affordability of care is worsening, patient visits are declining, and AI-driven productivity gains are growing. Soon, small animal practice might have more veterinarians than needed.
Adding midlevel practitioners into the mix could reduce earnings potential for everyone — veterinarians, credentialed veterinary technicians and midlevels themselves — making it harder to repay educational debt or earn a living wage. Instead, the veterinary profession should maximize the training and utilization of credentialed veterinary technicians to increase capacity without compromising care.
Telemedicine: The Physical Exam Still Matters
Telemedicine offers real value for follow-ups, triage and client education. But removing the physical exam requirement from the VCPR is risky. Unlike human patients, animals can’t describe their symptoms. They rely on veterinarians to observe and assess through hands-on exams.
Eliminating the physical exam opens the door to delayed diagnoses, misinterpretations and worse outcomes. While virtual care has its place, it cannot replace the cornerstone of veterinary medicine: the comprehensive physical exam.
Even more troubling is the rise of online pill mills — platforms issuing prescriptions without proper veterinary oversight. Without a physical exam, the risk of overprescribing, medication misuse and declining standards increases significantly. These platforms also undercut local practices, diverting revenue from in-person care toward poorly regulated, convenience-driven services.
Telemedicine should complement, not compromise, high-quality veterinary care. Removing the physical exam requirement doesn’t improve access, it undermines safety and weakens professional integrity.
Learning from Icarus: A Cautionary Tale
In Greek mythology, Daedalus gave his son, Icarus, wings made of wax and feathers and warned him not to fly too close to the sun. But overcome with ambition, Icarus soared too high. The sun melted his wings, and he fell into the sea.
Veterinary medicine faces its own Icarus moment. The rush to expand schools, delegate surgery to undertrained midlevels or drop essential exams from the VCPR threatens to dismantle the safeguards that uphold quality care. These sweeping changes might appear innovative, but ambition without caution leads to poor outcomes, not progress.
The revolving door continues to spin, yet we remain focused on pushing more people through it. We chase short-term relief without solving the long-term issues of burnout, debt and poor retention. We risk flying too high and too fast, ignoring the very factors that keep the profession grounded and safe.
Instead of repeating Icarus’s mistake, we must take a more measured path, one that strengthens the profession, protects patients and ensures veterinarians can thrive.
Navigating Change With Purpose
The desire for change is not misguided. It’s commendable. The people advocating for these changes are not adversaries; they’re seeking solutions to very real challenges. But good intentions must be paired with sound judgment. Right now, too many of these proposals fail to balance urgency with risk.
We need profession-wide conversations — grounded in evidence and experience — that guide thoughtful, well-considered reform. Not all change is progress. But all progress requires care, vision and a firm grip on what truly matters.
The path forward should focus on sustainable, high-impact solutions such as:
- Retain veterinarians by addressing burnout and work-life balance.
- Streamline workflows without sacrificing medical standards.
- Fully leverage credentialed veterinary technicians to expand care capacity.
- Embrace technology and automation to enhance, not replace, medical excellence.
Change should strengthen, not weaken, the profession. If we want to safeguard the future of veterinary medicine, we must be deliberate and united in our pursuit of progress that elevates care, not erodes it.
A TRENDY TOPIC
Drs. Matthew Salois and Gail Golab addressed the question “Are we in a veterinary workforce crisis?” in a 2021 JAVMA News article. Read it at bit.ly/4cp8Y3L.