April 24, 2013
AVMA workforce study nixes notion of veterinary shortage
Report calls on practitioners to increase public's demand for services
By: Jennifer Fiala
For The VIN News Service
There is no oversupply of veterinarians in the United States.
Rather, what the veterinary profession is experiencing is “excess capacity” — a problem that could turn around if veterinarians find a way to increase the public’s demand for their services.
That’s the gist of a study released Tuesday by the American Veterinary Medical Association (AVMA) titled "2013 U.S. Veterinary Workforce Study: Modeling Capacity Utilization." The study states that there’s an overall 12.5 percent excess-capacity in the profession.
Focus on small animal practitioners alone, and excess capacity rises to 18 percent. For equine veterinarians, excess capacity is calculated at 23 percent. Both trends could continue through the next decade, the study says.
What is excess capacity? It’s an economics term that defines when production falls below what a worker is able to produce. Michael Dicks, the AVMA’s newly hired economist and head of its Economics Division, explained the term on Tuesday during a press conference:
“If the average veterinarian is at work 50 hours a week but providing services 40 hours a week,” that’s excess capacity. He later added, “It’s not a matter of too many veterinarians, but a matter of a lot of veterinarians not running their practices at full capacity.”
Indicators of excess capacity in veterinary medicine, Dicks said, include short wait times in clinical practices, increased difficulty for new veterinarians to find work and falling incomes.
The AVMA’s study never references the term “oversupply.” It’s not a measurable term used by economists and found in economics literature, Dicks explained.
Practitioners, however, have been using the term for years to interpret why they feel exceedingly crunched by competition. Growing numbers of new graduates entering the profession coupled with seemingly stagnant demands for services has created a cutthroat environment for practitioners, some insist.
Rising tuition, six-figure student debt loads and the nation’s economic downturn have added to profession’s economic stress.
That anxiety prompted the AVMA in 2011 to commission a workforce advisory group to look at economic issues in the profession and ways to maintain the profession’s health and viability. Shortly after, the AVMA agreed to conduct a workforce study with hopes of learning more about the current and future supply of veterinarians and their services.
But the AVMA’s 97-page study — put together with the help of analysts from IHS Healthcare & Pharma and researchers at the Center for Health Workforce Studies — focuses less on supply and more on demand in the profession. Officials cited a lack of data on the supply of veterinarians, including a reliable system for tracking practitioners post graduation.
“The reality is the colleges lose track of students almost immediately after they graduate … and the AVMA has self-reported data,” AVMA President Dr. Doug Aspros said during the press conference. “It’s nowhere near as good as we would like to have.”
Demand, it seems, is easier to map and articulate.
The study counts 90,200 veterinarians in 2012 in the United States but calculates demand for just 78,950 of them. By 2025, demand for veterinarians is expected to rise by 12 percent to total 88,100 practitioners, the study says.
That doesn’t mean veterinarians are unemployed, but that they’re underemployed, the study says. (Data from the Association of American Veterinary Medical Colleges reveals that 98 percent of 2012 graduates found employment in veterinary medicine via a job in private practice, an internship or residency six months post graduation.)
“This really is an excess capacity problem,” said Dr. Link Welborn, chairman of the AVMA Workforce Advisory Group, which played a role in the study’s development. “If we were able to enhance the demand for veterinary services … we would solve a lot of that problem. “
Welborn recommends that practitioners focus on wellness and preventative care, perhaps joining the American Veterinary Medical Foundation-sponsored Partners for Healthy Pets campaign.
Aspros suggests that veterinarians become financially savvy. “Our profession needs to be more professional on the business side and figure out how to do that.”
Influencing numbers of veterinarians in the workforce by refusing to accredit new veterinary colleges or proposing that they freeze or reduce class sizes is not something the AVMA is willing to do.
“As a professional association, the AVMA must not and will not interfere with market forces,” stated the workforce advisory group in a review of the study's findings.
Sharon Granskog, an AVMA communications official, said during the press conference that “hindering people going into a certain area of livelihood … that’s something that would not be legal.”
The legal issues Granskog referred to were not referenced. Aspros agreed that it is inherently wrong to dial back on class sizes or veterinary colleges in an effort to sway the market.
“Our role is to provide information to policymakers," he said during the press conference. "We can’t, as an organization in the United States, use our heavy hand to alter the marketplace to our advantage."
Besides, curbing the number of new graduates entering the profession would do little to change things, AVMA officials stated.
“Given the high debt load of new students and stagnant incomes seen in recent years among veterinarians, it is unlikely veterinarians will reduce average work hours or retire earlier than current or historical patterns,” the study says.
Other study findings include:
Excess capacity ranging from 11 percent to 14 percent (from 9,300 to 12,300 full-time equivalents) is expected to persist each year from 2012 through 2025.
The projected mean annual growth in numbers of U.S. citizens expected to graduate from veterinary schools located inside and outside the United States is 4.5 percent.
The effects of the overall U.S. economy on the demand for veterinary services are unclear. The relationship between consumers’ disposable income and the demand for veterinary services is not well understood.
On average, veterinarians in clinical practice are working overtime (>40 hours/week) despite excess capacity in clinical practice employment sectors. The paradoxical situation of veterinarians working overtime when there’s excess capacity has developed, to some extent, because clinical practices have extended their hours and availability.
A maldistribution of veterinarians exists geographically and across employment sectors. There appears to be a sufficient supply of food animal veterinarians, yet need exists in some, mostly rural, areas. However, the ability of these areas to support a veterinarian is in question.
A perception exists that there are too many veterinarians and too many veterinary practices. Conversely, some believe that the veterinary market is not oversaturated.
The number of new veterinary college graduates entering the U.S. market during the next decade is unknown, but estimates based on North American Veterinary Licensing Exam data are that approximately 3,457 graduates from accredited and non-accredited veterinary colleges completed their education in 2012. By 2016, that number could increase by as much as 4 percent.
Market monitoring system
What’s also come out of the study is a realization that many of organized veterinary medicine’s methods for measuring the profession’s health and mapping trends are inadequate in their methodology and scope.
To help fix the problem, the AVMA has developed proprietary software called the Veterinary Workforce Simulation Model to aid its Economics Division in producing new, reliable and statistically accurate information pertaining to supply and demand issues impacting the profession.
“The improved ability to collect, measure, track and analyze this data will help fill long-existing gaps in important information that affected this study and others in the past,” the AVMA said in a press release.
Organizations such as the Association of American Veterinary Medical Colleges (AAVMC) applaud the AVMA’s efforts.
“We don’t see anything alarming or terribly unexpected,” AAVMC Executive Director Dr. Andrew Maccabe said of the study’s findings. “What I think we do see is a more rigorous approach to studying the problem, and they’ve identified a number of areas where there’s a lack of data. We’re committed to working with the AVMA to get a better handle on the information.”
Editor's note: The article's title was changed from its original to better reflect the AVMA's departure from a once widely espoused idea that there is a deep deficit of veterinarians in the United States.
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.
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