New, old challenges beg for radical change in veterinary profession

Nearly eight months into the pandemic, it almost feels as though we’re living in an alternate reality, says Matthew J. Salois, PhD, AVMA chief economist.

Social distancing. Virtual schools and offices. Rampant unemployment in a shaky economy. Racial reckoning in a polarized society. And more than 200,000 lives lost to COVID-19 here in the U.S. alone, he said.

But, as Winston Churchill once said, never let a crisis go to waste. To make that happen, Dr. Salois said, you have to ask yourself what can be done better.

“We have to do better because we have to get through the alternative reality of COVID. Because at some point, we need to return to our original reality. The reality that was before this one. Why?” he asked. “The challenges that existed before the pandemic, they’re still there, and we can’t forget about them because while we remain in an alternate reality, our original reality is not getting taken care of.”

Change is a constant in everything we do, Dr. Salois said during his keynote address on the first day of the annual AVMA Economic Summit, held virtually Oct. 26-28. To remain adaptable, people need to have principles that allow them to respond to the changes coming at them. He explained the summit was not about providing rules and instructions for how to solve economic challenges, but instead was focused on outlining principles on the meeting’s theme of transformation through collaboration.

In his talk, Dr. Salois discussed three realities confronting veterinarians that must be addressed to create a more economically sustainable profession.

The first reality: Nearly a third of the nation’s pets don’t see a veterinarian at least once a year. That’s over $7 billion worth of veterinary care not being delivered to animals.

“And this is on top of the reality that you deal with every day, which is that two-thirds of pet owners you see may not be in compliance” with recommendations for care, Dr. Salois said.

Surveys of pet owners who don’t regularly see a veterinarian suggest two underlying issues. Either these owners don’t see the value, or they don’t think they can afford veterinary care.

“If we’re honest with ourselves, the cost of veterinary care isn’t always the most transparent, at least not up until the point of sale, and the benefit isn’t always clear to the owner, either. We need to fix our value proposition and make abundantly clear the value of veterinary care and do something about the ever-rising prices, especially when the perceived benefit may not be rising in tandem.”

The second reality: Most practices struggle with inefficiency.

That’s according to data from AVMA surveys of practice owners, which collect information on inputs, such as the number of clinic staff members or examination rooms, and outputs, such as the number of patients seen in a week and revenue generated. That information is then analyzed by the AVMA economics team and used to provide insights into the efficiency of the profession.

Dr. Salois said 15%-25% of clinics fall into the highly efficient range—or 90-100 on a 100-point scale—followed by another 15%-25% in the medium efficiency range of 70-89. That leaves 50%-70% of practices falling in the low to very low range of efficiency.

“We have to fix this. So many things can influence this: positive leadership; better leveraging of staff, especially veterinary technicians; smarter inventory management; financial standardization and the AAHA (American Animal Hospital Association) chart of accounts; and better pricing strategies,” Dr. Salois said.

The third reality: Only one-third of veterinarians would recommend joining the profession to others. That’s according to the executive summary of the Merck Animal Health Veterinarian Wellbeing Study II, published this past June (J Am Vet Med Assoc 2020;256:1237-1244).

Dr. Salois said while the veterinary profession is in the midst of an era of exciting momentum and change, with the advent of new technologies and innovations to deliver better care to pets while providing more value and convenience to pet owners, the profession is also coping with substantial challenges that seem daunting and insurmountable. These include burnout and compassion fatigue, crushing educational debt and financial insecurity, gender pay inequality, the lack of racial diversity, and the prevalence of suicide and psychological distress.

Dr. Salois told a story about how redwood tree roots are very shallow, often only 5 or 6 feet deep. But they make up for it in spread, sometimes extending up to 100 feet out from the trunk. They thrive in thick groves, where the roots can intertwine and even fuse together, which helps them hold each other up and withstand the forces of nature.

“If we are going to grow and nurture this profession into what we want it to be, if we are going to weather the storms of life, if we are going to become all that we can become, we can’t do it alone,” Dr. Salois said. “We have to be dedicated to each other. There is no rulebook for this. There is not a set of instructions on how to transform yourself or build more meaningful collaborations.”

“This is not to say we aren’t doing things—we are doing good things, important things. But a lot of the things being done are too comfortable to have the real impact we want and need,” Dr. Salois said.

What’s needed are open, transparent, and honest conversations about these issues, especially at meetings and conferences, he said, as well as trying something different.

“Something bold, maybe even something risky. Something we never would have done before. The more radical, the better. Because if the input isn’t radical, then neither will be the outcome,” Dr. Salois said. “Our profession is too important not to have that.”