In less than a week, delegates of the American Veterinary Medical Association’s (AVMA) House will meet in St. Louis and consider their relevance, or lack thereof, as a group making policy and representing the interests of 81,500 veterinarians in the United States.     

Such scrutiny is being prompted by the New Jersey Veterinary Medical Association’s (NJVMA) unprecedented decision to renounce its House representation. With longtime delegate Dr. Robert Gordon retiring and the state’s alternate, Dr. Mark Helfat, moving to the Executive Board, New Jersey’s veterinary leadership plans to leave its AVMA delegate seats vacant.

The House of Delegates is a federation of 68 state, territorial and allied veterinary medical groups charged with driving AVMA policy. The group’s 136 members meet just twice annually — in January and July — leaving the AVMA’s 16-member Executive Board, a policy and administrative body, to take over in the interim. This has led some to question whether the House is needed. Additionally, the fact that House meetings are heavy with pomp and circumstance has left some to muse whether it functions more as a social group than a working entity.     

“The NJVMA Executive Board decided to not fill the positions at this time, as it has questions regarding the role and relevance that the (House of Delegates) has in the 21st century,” writes NJVMA Executive Director Rick Alampi in a letter sent last month to AVMA leaders. The letter requests that the AVMA evaluate, via cost-benefit analysis, the House’s value as a governing tool.         

In an interview with the VIN News Service, Alampi adds: “We’re making a statement acknowledging that the House is a neutered entity. Things just move too fast now to have a governing structure that makes policy but meets twice a year."

Based on AVMA figures from the past three years, it costs, on average, $325,793 to produce both annual House meetings. While the January meeting takes place near AVMA headquarters in Chicago, costs tied to the House session held in conjunction with the AVMA Annual Convention in July vary depending on the meeting's location.    

The AVMA budgeted $224,000 to cover House expenses for the July 14-15 meeting in St. Louis.    

Gordon, who is attending his final House meeting in St. Louis, is expected to introduce from the House floor a resolution calling for the cost-benefit analysis that New Jersey seeks. Because the resolution comes after the deadline to submit it, two-thirds of the House must agree to bring the resolution forward before any debate can ensue.    

Even if the resolution passes, it exists as a mere recommendation. The decision to put the request into action is up to the Executive Board.  

Gordon, who was not consulted on New Jersey’s decision, supports taking a hard look at the House’s viability.

"I agree with the premise," he says. "And New Jersey has never shied away from controversy.”     

New Jersey’s choice to abstain from the House of Delegates has “really opened a can of worms,” says Dr. George Bishop, the delegate representing California. He hinted that other last-minute resolutions might be in the works, building off of New Jersey’s bid for introspection in the House. A thorough examination of AVMA’s entire system of governance might be necessary, he says.     

Dr. Stewart “Chip” Beckett, AVMA delegate for Connecticut, isn’t shocked by New Jersey’s withdrawal from the House. He laments that the group’s meetings are weighed down by formality, speeches and reports. The “real work” of debating resolutions, he says, is reserved for three hours at the end of a two-day session.     

“I love getting together with the House from a social standpoint, but that’s not why we’re here,” he says. To get his point across, Beckett represents one of several states seeking to amend the AVMA Bylaws to curb the Executive Board’s authority to create policy without a final sign-off from delegates.

A quiet power struggle between the AVMA House of Delegates and its Executive Board has existed for decades. The conflict got louder last November, when the Executive Board neglected to consult the House before altering the Veterinarian’s Oath to add animal welfare language.    

Given that the Veterinarian's Oath is recited each year by thousands of new graduates, delegates considered the slight to be particularly offensive.

“We’re the buffer between 81,000 members and the administration,” Beckett says. “I think the House needs to be relevant or disbanded. I don’t want to be talking about how the sky is falling, but I think New Jersey is making a legitimate statement.”    

Helfat, New Jersey's alternate delegate, is on his way to a six-year term on the Executive Board. He believes the House has a role to play within the AVMA but supports taking a hard look at how the group functions.      

“It comes down to whether we’re wasting our time,” he says. “You’ve got to wonder: Is New Jersey the only state thinking about this?”    

It’s obvious that’s not the case. Questions as to whether the House remains a viable arm of the AVMA first surfaced in a major way in 2006, when AVMA legal counsel Jed Mandel stood before the House of Delegates and stated that, following an association audit, the nation’s largest trade association for veterinarians could legally and efficiently run its operations without a delegation.     

The bottom line on Mandel’s message: If created today, the AVMA would not be comprised of two policy-making bodies. Rather, the Executive Board would function without a House of Delegates to streamline the AVMA’s governing operations. The assessment has been echoed by a number of AVMA leaders since then.     

An Executive Board member who spoke on condition of anonymity due to the sensitive nature of the topic put it this way: “Ask us privately, and most of us think we can do without a House of Delegates. But we’re in a difficult position to state that publicly.”      

Any move to eliminate the House in favor of operating with just the Executive Board might be greeted with contempt by a growing number of AVMA members who report feeling as though they are not being heard by the association’s leadership.     

“That’s the problem with just getting rid of the House,” California’s Bishop says. “You’ll have a smaller group of people making all of the decisions.”     

According to one AVMA-sanctioned study, that might not be a good idea.     

In April, the AVMA 20/20 Vision Commission report hinted that an overhaul of the association’s governance infrastructure might be necessary, mainly to foster greater democracy and transparency. The report explores the merits of constituency-based representation versus competency-based representation. The House is constituency based, made up of delegates and alternates from each state and a handful of allied organizations.     

“Competency-based governance is necessary for credibility and favors participants that are most knowledgeable and fair. On the other hand, constituency-based governance helps to ensure that broad perspectives and multiple special interests are part of policy development and decision-making," the report says.     

Coincidentally, the switch from geographic representation to a competency-based system is exemplified by the NJVMA, which recently whittled its 18-member Executive Board down to five. Nowadays, the smaller group meets more often to steer the direction of the NJVMA.     

“We wanted the best people we could get, and that doesn’t necessarily mean you have board members from all corners,” Alampi says. “At our last meeting, we got more done in two hours than the old board would have gotten done in two years.”     

That doesn’t mean unrepresented areas of New Jersey are forsaken, Alampi adds. “The people we get on the board are smart enough to know that if they have a question about bovine medicine, let’s say, they’ll put some bovine practitioners together to get their input.”     

Whether the AVMA ultimately will follow New Jersey’s example of leaner government is unclear. According to the AVMA 20/20 Vision Commission, it's vital that the association explore change:      

“There is a distinct and likely possibility that the (current) governance system will not be compatible or conducive to the next generation of members …,” the report states.

Why? Because some AVMA members — especially women and younger veterinarians — feel disenfranchised, the report states. The time and financial commitment required of volunteers who make up the AVMA’s House, Executive Board or any of its 23 committees and six councils prove to be too onerous for many. As a result, the AVMA’s governing bodies are mostly comprised of older male volunteers who are in a position to take time away from their families and practices. That sharply contrasts the makeup of America’s newest generation of veterinarians, considering that more than 80 percent are women.     

“The substantial time it takes to serve on councils, and especially the Executive Board, may be biased in favor of those who can financially make this commitment and/or who are in the later stage of their careers,” the report says. “…There is concern that the governance process is leading to a significant disconnection between those who serve and those choosing not to get involved in the current organizational hierarchy.”    

That disconnection has been aired on message boards of the Veterinary Information Network (VIN), the nation’s largest online community for the profession. In response to veterinarians’ complaints, the VIN Foundation, the benevolent arm of VIN, put together the One Member, One Vote campaign. It was unveiled during last year’s AVMA Convention in Atlanta, where it met a mixed reception.    

(VIN is the parent company of the VIN News Service.)     

The concept behind One Member, One Vote is to enhance democracy within the AVMA. For example, veterinarians have expressed concern about the AVMA’s ties to a private health insurance company company and efforts to extend U.S. accreditation internationally.      

On paper, the AVMA’s governance structure is open to any veterinarian who wants to volunteer (the AVMA counts more than 80 percent of all U.S. veterinarians as members). The reality, critics say, is that the current system is highly politicized and vulnerable to personal agendas.     

In a VIN survey published last year on perceptions of the AVMA, nearly 59 percent of 2,934 veterinarians who responded rated as "fair" or "poor" the AVMA’s efforts to understand and address issues important to them. Fifty-six percent of the respondents rated the AVMA’s communication with its membership the same way.     

Dr. Paul Pion, president and co-founder of VIN as well as an advocate of the One Member, One Vote campaign, says his idea of a better-designed democracy within the AVMA is built on the ability of its members to cast ballots on major issues affecting veterinary medicine.     

“It’s not reasonable to ask 81,000 people to vote on every small issue, that’s true,” he says. “But if the House feels disenfranchised, the membership must feel like it has no voice. There’s a need to rebuild the AVMA and what it stands for.”