AVMA House of Delegates
VIN News Service photo
Veterinarians at a recent AVMA House of Delegates meeting in Philadelphia reflected on a profession in the grips of a workforce crisis. "We're respected by the public, we have an obligation to take care of our patients, but what I’m hearing is we don't have the manpower to do that," said Dr. Cathy Lund of Providence, Rhode Island.
A large emergency and specialty clinic in Southern California has eliminated overnight hours due to staffing difficulties. While the need for middle-of-the-night care still exists, the practice's five veterinarians couldn't provide it anymore, being overworked during the day performing routine surgeries that the area's general practitioners don't want to do or are too busy for, according to Dr. Diane Craig, the hospital's owner.
The turn of events leaves Craig bewildered.
"So I'm wondering, as a profession, how we shifted from veterinarians who wanted to do surgery and who were interested in keeping their clients to veterinarians that just say, 'Go there ... and they'll take care of you,' " she said to colleagues at a recent meeting of the American Veterinary Medical Association.
Craig's experience and question illustrate a phenomenon troubling the veterinary profession across the country: Staff shortages mixed with an uptick in patients has stretched many practices so thin that they're limiting services or sending away sick animals.
The labor market has been tight across many sectors but is tighter than average for veterinary practice. The unemployment rate is telling: For veterinarians, it is 0.5%, compared with 3.7% for the U.S. overall, according to U.S. Bureau of Labor Statistics.
On the plus side, robust demand for veterinarians is fueling pay that averaged $136,837 across all demographics, up from $118,460 last year, according to the AVMA 2022 Census of Veterinarians.
Veterinarians in industry command the greatest salaries, making an average of $193,196, followed by food animal practitioners at $152,441 and companion animal doctors at $140,348. New graduates are earning more, too, averaging $111,242 a year — up nearly 30% since 2019 — plus bonuses and moving allowances, the AVMA reports.
Debt-to-income ratio said to improve
Rising wages for the profession's newest members mean that new graduate student debt finally has reached a manageable level — at least on paper. According to Bridgette Bain, former senior economist for the AVMA, the mean debt-to-income ratio for new veterinarians is at 1.4-to-1 for the first time in nearly two decades. In 2020, by comparison, the mean debt-to-income ratio was 2-to-1.
A ratio of 1.4-to-1 means that the borrower's debt is 1.4 times that of their annual income. That proportion has been a stated goal for the profession since leaders held a Fix the Debt summit in 2016. (The general rule of thumb on debt is to not exceed a year's income, or a ratio of 1-to-1.)
The debt figure used to achieve the 1.4-to-1 ratio comes with caveats. It is the mean debt of all students nearing graduation in spring 2022 who responded to the AVMA survey, including those students who did not borrow to finance their educations.
"We're seeing this trend emerging, where a greater proportion of tuition and fees are covered by parents or family members, and a smaller proportion of tuition and fees are covered by educational loans," Bain said, speaking at the AVMA Veterinary Business and Economic forum this fall, prior to her departure from the association.
Other caveats about the debt figure are that it does not include money owed for undergraduate education or the debt of graduates from programs in the Caribbean, where the student body is predominantly American.
The mean figure also masks the fact that a sizable proportion of graduates leave school with very high debt: The survey found that 38% owed $200,000 or more for their veterinary degree. Within that group, 13% owed greater than $300,000.
At the other end of the spectrum, 10% had a debt of less than $100,000, while 18% paid their tuition outright without borrowing.
"The debt levels really vary across the class ..." Bain observed.
'A sense of burnout'
While better pay is good news for the profession, it doesn't appear that rising salaries are ameliorating the workforce crunch, at least not immediately. Data from the AVMA's Veterinary Career Center show that job openings have doubled in the past 18 months; and between May 2021 and May 2022, 64% of openings posted for veterinarians and veterinary technicians went unfilled.
And a thin workforce breeds unhappiness among those who remain on the job. As employers struggle to fill openings, more pressure is put on the rest of the veterinary team, which "is no doubt contributing to a sense of burnout," Bain observed.
Dr. Kate Boatright is a case in point. A veterinary consultant based in Pennsylvania, Boatright alluded to her career turn during a gathering this summer of the AVMA House of Delegates, for which she is an alternate delegate representing the Pennsylvania Veterinary Medical Association.
"I was in emergency for several years and got burned out," said Boatright, a 2013 graduate of the University of Pennsylvania School of Veterinary Medicine. "As a younger veterinarian, I work part time now. I have a lot of other things in my life that I do. I wonder if, in addition to our ethical duty to recognize illness in pets ... we also have a duty to support the well-being of the veterinary profession."
Systemic issues around the veterinary workforce go deeper than supply and demand. Some issues existed before the onset of the Covid-19 pandemic in 2020, including underutilization and attrition of veterinary technicians and a lack of veterinarians in rural and public practice. Others factors are more recent, such as the pandemic boom in adoptions of dogs and cats and increased attention by society to pet care.
Shift in fortunes coming?
While the dominant narrative is that veterinary practice is understaffed and overburdened, signs point to a looming market correction, said Sheri Gilmartin, a veterinary technician who is vice president of sales and marketing at VetSuccess. "We are looking at a changing economy," she said at the business and economic forum.
VetSuccess is an analytics company that's partnered with the AVMA since 2021 to monitor the veterinary economy. Gilmartin presented data collected on 5,000 practices across the country, including more than 30 corporate groups. She said reported practice revenue was up 6.4% between Sept. 1, 2021, and Sept. 15, 2022.
However, the number of visits — defined as any appointment for food, prescriptions or care — is in decline. "We get to January 2022, and we see negative growth in every month with the exception of February," Gilmartin said.
Whether the decline in visits represents lower demand or something else is unclear. Gilmartin surmised that the data might be skewed by busy practices that put limits on volume.
"I heard that some practices aren't accepting new clients," she said, "so that could be contributing."
As Dr. Cathy Lund sees it, the situation is a crisis. The owner of a feline practice in Providence, Rhode Island, since 1999, Lund said in an interview: "As people in the profession choose not to see pet owners or turn people away because of the stresses on themselves and their staff, I really worry that our profession will lose something special. The public trust and respect us because we care.
"I see folks who've tried 10-plus practices before they've found someone who will see them," she said. "This just doesn't feel right and is going to chip away at our core values."