Raised in a small town, I’m always amazed at the Southern California freeway system. I recently visited my daughter in Los Angeles and counted the lanes: six, eight, 10, 12. Where I grew up, two lanes were the norm. L.A. requires all those lanes to deal with the heavy volume of traffic. That got me thinking about congestion in the veterinary profession. Follow me as I run this metaphor off the road.
Our profession has well-built lanes — mostly paved and with a few potholes. However, we could deal with the ever-increasing traffic volume if we constructed additional lanes or widened a few. Building new lanes and improving existing ones would provide more fulfilling careers for veterinary professionals and improve access to care.
Which lanes make up my veterinary superhighway? How about these 10?
1. Approved Veterinary Assistants (AVAs)
This lane, reserved for a critical and sometimes overlooked role in every hospital, is underused. We are blessed with many great veterinary assistants, but few are certified, and the training generally happens on the job. Wouldn’t our practices and assistants’ careers benefit from certification? A Google search shows more than 50 assistant programs (four online) approved by the National Association of Veterinary Technicians in America. Several state VMAs offer free AVA certification as a benefit of membership. Being an approved veterinary assistant is an excellent on-ramp to a career in veterinary medicine.
2. Credentialed Veterinary Technicians
Veterinary technicians with associate degrees are the beating heart of our profession, but this lane is vastly underutilized. I sang the praises of and challenges for credentialed veterinary technicians in earlier columns. If we trust and fully utilize these exceptional professionals, we retain them, help more pets, improve productivity and enhance the quality of care.
3. Credentialed Veterinary Technologists
This lane, intended for holders of a four-year bachelor’s degree, isn’t traveled as much. To my knowledge, there is no distinction between two-year credentialed technicians and four-year credentialed technologists in state practice acts or everyday clinical practice. The value of a bachelor’s degree and the depth of training and preparation are unarguable. These professionals provide the added knowledge and skills to help pets and practices even more. According to the American Veterinary Medical Association, we have 28 bachelor-level veterinary technologist programs. How can we better promote and tap into this underappreciated resource?
4. Veterinary Professional Associate (VPA)
This new lane opened for credentialed technicians with bachelor’s degrees who aspire to become midlevel practitioners. The first cohort has graduated with a master of veterinary clinical care degree from Lincoln Memorial University. A VPA accrediting body has been identified, credentialing exams are in the works, and practice act inclusion will follow. Nurse practitioners and physician assistants entered human medicine to initial fear-based objections. Imagine human medicine without them today. Happily, more institutions are working to add master-level VPA programs.
5. Veterinary Technician Specialists
In their usual “get it done” approach to every obstacle, certified veterinary technicians didn’t wait for legislators, state boards, academic institutions or accrediting bodies. They saw a need and filled it. We’re up to 16 NAVTA-affiliated specialty academies. Our profession has acknowledged and supported the value of veterinary technician specialists and the road they built.
6. Telehealth Providers
This lane, driven by veterinarians and certified technicians, has been remarkably busy the past few years. One could view telehealth as a roundabout directing clients and patients to the proper lane and improving access to care. It holds added potential when virtual veterinarian-client-patient relationships become commonplace.
7. General Practitioners
General practitioners are the hub around which the rest of the profession revolves. Their lane is in the center but is nearing capacity. Thirty-three U.S. veterinary schools are graduating predominantly general practitioners, with another dozen in the pipeline (yippee!). Full disclosure: I am a proud GP.
One more thought for my primary care colleagues: Don’t be afraid to extend your scope of practice. We can do more — pyometras, enucleations, enterotomies, gastropexy, cystotomies. Refer where appropriate but be open to offering more.
8. ABVP Diplomates
These members of the American Board of Veterinary Practitioners possess advanced, species-specific, broad-range specialization. Since 1978, the ABVP has recognized the need for species specialization, providing another critical lane. We need more of these board-certified practitioners.
9. Alternative Specialists
A narrow area of specialization shouldn’t require an internship and residency. Going back to school is often a non-starter for veterinarians a few years after graduation. I know many non-boarded colleagues who function as a middle ground between GPs and board specialists. These professionals excel in areas such as orthopedics, behavior, dentistry, imaging and reproduction. They offer an alternative for clients who might not have the financial means to visit a boarded specialist. This alternative road provides a career path for clinicians with a passion and desire to gain competency in a limited subject area. Increasingly, these providers serve as a relief valve for overwhelmed board-certified specialists. Couldn’t we offer a microcredential, advanced certification or ABVP-like path to formal recognition and regulation? I’m encouraged by a new AVMA task force that aims to address the specialist shortage in academia. Additionally, let’s create a lane recognizing discipline-specific advanced care providers.
10. Board-Certified Specialists
I was reminded that veterinary specialization was introduced in the 1970s. Presently, 22 AVMA-recognized veterinary specialty organizations oversee 46 AVMA-recognized specialties. Over 16,500 veterinarians have been awarded diplomate status and play a crucial role in private practice and academia. As a GP, I’m grateful to have daily access to the deep knowledge and skills of the specialty community. Unfortunately, this lane is unlikely to meet the growing need.
Roadwork Ahead
We’ll get where we’re going faster and more efficiently if we open a few more lanes, fix the on-ramps and fill the potholes. Today’s veterinary highway can be much smoother.
Swiss philosopher Henri Frederic Amile said, “The best path through life is a highway.” While our career is not our life (a fact I sometimes forget), imagine if our profession traveled on a superhighway. How many more pets and clients could we help, and how many more careers could be fulfilled?
Together, let’s build out the veterinary superhighway. Our future is bright. What roads will you travel?
ON THE FRONT LINE
As I wrote this column, I realized I neglected to mention the front of the hospital, arguably the most important part of the team. Clients might not find the appropriate roads without the hard work and skills of receptionists, our profession’s traffic controllers. I was thrilled to see the launch of the North American Association of Veterinary Receptionists. Kudos to its founders and all receptionists. You have my thanks.