Addressing the Veterinarian Shortage
Lee Lenkoff
Introduction
The 2021 American Veterinary Medical Association (AVMA) Veterinarian and Practice Owners Survey revealed that “44% of private veterinary practitioners reported they are thinking of exiting veterinary medicine before retirement.” [1] Why? The hours are long and unpredictable, as emergencies do not always wait for convenient hours. Each appointment brings the possibility of heartbreak with poor diagnoses and, at its worse, having to put an animal down whose quality of life cannot be improved. The mental health effects from these tragedies have been linked to suicides in the profession. [2] And this is by no means an all-inclusive list of reasons.
The possible mass exodus of veterinarians from the profession has the potential for devastating ramifications. If key problems are not solved in the industry, many animals will be left without quality care. Preventative medicine will not be as easily accessible, leaving populations vulnerable to disease outbreaks. And even where veterinary care is available, it may only be accessible to those with enough money to afford it.
Reasons Behind the Shortage
This issue starts at the beginning. The veterinary school admissions process is a notoriously difficult one. Most veterinary schools in the United States use the Veterinary Medical College Application Service (VCMAS). [3] Through this service, prospective students submit transcripts, GRE scores, letters of recommendation, and personal statements. [4] Veterinary schools also prefer applicants that have previous experience working in the field, with some recommending at least 1,000 hours. [5] And, even for those applicants that can check off all of these boxes (and more), the seats available are limited. In 2021, there were 10,834 veterinary school applications, according to the American Association of Veterinary Medical Colleges (AAVMC). [6] Compared to the 4,571 seats available, qualified applicants are turned down every year. [7]
For those successful in the admissions process, the costs of veterinary school pose yet another challenge. Non-resident tuition and fees at AAVMC Colleges of Veterinary Medicine ranged from $32,800 to $73,796 in 2022. [8] Those that are able to pursue this education in their state of residency are not much better off, where tuition and fees ranged from $19,616 to $64,930 in 2022. [9] At the end of their programs, class of 2021 veterinary school graduates faced an average debt of $178,541. [10] To put that into perspective, the Bureau of Labor Statistics reported the 2021 average annual pay for veterinarians to be $109,920 in May 2021. [11]
Problems that contribute to the shortage continue to manifest after veterinary school. Veterinarians often experience compassion fatigue. Compassion fatigue can be defined as “the emotional burden that occurs as the result of continued and excessive exposure to traumatic events that patients and families experience.” [12] Veterinarians are constantly trying to treat patients that cannot verbalize what is wrong like humans do. While the success stories are sweet, veterinarians have to face the inevitable of being the one to put animals down. Euthanasia, even when it is the best option, is a major source of stress in the profession. [13]
Resolutions
There have been initiatives taken to help address the high costs of veterinary school being a barrier to the profession. For example, the National Institute of Food and Agriculture (NIFA) “solicit[s] nominations for veterinary shortage situations from all State Animal Health Officials” through their Veterinary Medicine Loan Repayment Program (VMLRP). [14] This program “helps qualified veterinarians offset a significant portion of the debt incurred in pursuit of their veterinary medicine degrees in return for their service in certain high-priority veterinary shortage situations.” [15] The VMLRP has been particularly helpful in rural areas, where recruiting and retaining veterinarians is particularly difficult. The VMLRP accepts nominations from all areas of practice but gives priority to food animal medicine shortages. [16]
The American Association of Equine Practitioners (AAEP) created the Commission on Equine Veterinary Sustainability to address the veterinary shortage specifically within the equine industry. [17] The five focus areas of the Commission on Equine Veterinary Sustainability are: “compensation, strategies for effective emergency coverage, veterinary practice culture, internships, and supporting the growth and development of the equine veterinary student.” [18] Given that this initiative was just announced in July 2022, its effects on the equine industry have not yet been fully manifested.
The mental health crisis in the veterinarian industry has not received enough attention to properly address it. The Veterinary Mental Health Initiative (VHMI) was created in 2021 and is considered “the first and only program in US to specifically address the mental health crisis in the veterinary profession.” [19] This is simply not enough to address this issue, given the startling statistics available. For example, a 2019 study found that “female and male veterinarians were 3.5 and 2.5 times as likely to die by suicide, respectively, compared with the general population.” [20]
Perhaps the most unique resolution to the veterinarian shortage is telemedicine. Telemedicine for animals experienced a surge during the COVID-19 pandemic. [21] There is legal debate as to this practice, as laws in many states prohibit it due to the belief that it is near difficult to impossible to properly establish the “veterinarian-client-patient relationship” (VCPR). [22] While there has been some shift in the courts to allow more telemedicine practice by veterinarians, it is still widely regarded as inferior to in-person visits. [23]
Conclusion
The veterinarian profession is not for the faint of heart. There are simply not resources to aide our present and future veterinarians. The support for this vital profession must start at the beginning with their education and continue throughout their careers. If we do not continue to create more resources for veterinarians and explore innovative forms of treatment, our animals will be the ones paying the price.
About the Author
Lee Lenkoff is a first-year member on Volume 14. Lee graduated from the University of Louisville with a degree in Equine Administration and a minor in Entrepreneurship and is now in the JD/MBA Dual-Degree Program at Brandeis. Her goal is to combine business, law, and equine into a career, hopefully by working in the equine industry after graduating law school, such as for a racing commission or in-house counsel. In her free time, Lee likes horseback riding, going to the gym, hanging out with friends, family, and her two cats Half-Stache and Otis.
References
[1] R. Scott Nolen, Practice inefficiencies compound veterinary stress, JAVMAnews (Dec. 1, 2011), https://www.avma.org/javma-news/2021-12-01/practice-inefficiencies-compound-veterinary-stress#:~:text=%E2%80%9CThe%20most%20intriguing%20fact%2C%E2%80%9D,%25)%20as%20their%20top%20reasons.%E2%80%9D.
[2] See Debbie L. Stoewen, Suicide in veterinary medicine: Let’s talk about it, 56 Can Vet J. 89 (2015).
[3] Vet School Acceptance Rates in 2022, BeMo Academic Consulting, https://bemoacademicconsulting.com/blog/veterinary-school-acceptance-rates#:~:text=Average%20vet%20school%20acceptance%20rates,all%20vying%20for%20those%20seats (last updated Oct. 19, 2022).
[4] BeMo Academic Consulting, supra note 3.
[5] Why the majority of veterinary school applicants are denied, Veterinarian EDU, https://www.veterinarianedu.org/2017/03/why-the-majority-of-veterinary-school-applicants-are-denied/.
[6] Public Data, American Association of Veterinary Medical Colleges, https://www.aavmc.org/about-aavmc/public-data/.
[7] Id.
[8] Id.
[9] Id.
[10] Id.
[11] Occupational Employment and Wage Statistics, U.S. Bureau of Labor Statistics, https://www.bls.gov/oes/current/oes291131.htm#(2) (last updated Mar. 31, 2022).
[12] Brenda L. Lovell & Raymond T. Lee, Burnout and health promotion in veterinary medicine, 54 Can Vet J. 790 (2013).
[13] See Harold A. Herzog Jr., Tamara L. Vore and John C. New Jr., Conversations with Veterinary Students: Attitudes, Ethics, and Animals, 3 Anthrozoös 181 (1989).
[14] Veterinary Shortage Situations, United States Department of Agriculture, https://www.nifa.usda.gov/grants/programs/veterinary-medicine-loan-repayment-program/vmlrp-shortage-situations (last visited Nov. 11, 2022).
[15] VMLRP General Information, United States Department of Agriculture, https://www.nifa.usda.gov/grants/programs/veterinary-medicine-loan-repayment-program/vmlrp-general-information (last visited Nov. 11, 2022).
[16] United States Department of Agriculture, supra note 14.
[17] AAEP Creates Commission to Alleviate Equine Veterinarian Shortage, American Association of Equine Practitioners, https://aaep.org/news/aaep-creates-commission-alleviate-equine-veterinarian-shortage (last visited Nov. 11, 2022).
[18] Id.
[19] Tony McReynolds, A free, mental-health resource for veterinary staff, American Animal Hospital Association (Mar. 8, 2022), https://www.aaha.org/publications/newstat/articles/2022-03/a-free-mental-health-resource-for-veterinary-staff/.
[20] Katie O’Connor, Caring for Carers: Veterinarians Struggle With MH Issues (Aug. 22, 2022), https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2022.09.7.7.
[21] Camille Declementi et al., Column: Animal Law: In the Cards: Betting on Veterinary Telemedicine Legal Reform, 96 Fla. Bar J. 52 (2022).
[22] Id.
[23] See Id.