N.H. commission mulls allowing technicians to practice medicine

Group explores elevated licensure to ease rural vet shortage

October 15, 2008 (published)
By Jennifer Fiala

Lancaster, N.H. — A state legislative commission plans to convene next week to discuss the feasibility of granting “super technicians” the authority to provide large-animal veterinary care in underserved rural areas of New Hampshire.

If the idea comes to fruition, the reclassification of highly trained technicians to a level that some consider on par with physician assistants or nurse practitioners would be the first of its kind in the United States.

Established by law on June 11, the commission is charged with studying the viability of creating the classification of animal-care worker, most likely highly trained technicians who can provide basic veterinary medical care and act in emergency situations under the direct or indirect supervision of a licensed DVM. A full report is due to Gov. John Lynch by Nov. 1, although rumors circulate that there are calls for a deadline extension.

The New Hampshire Veterinary Medical Association reports no position on the initiative at press time, but Dr. Clifford McGinnis, a retired state veterinarian who sits on the commission, questions the practicality of the project. Specialized training that leads to variable licensure will prove a lot more complicated than officials realize, he predicts, requiring new regulatory and testing bodies, a practice act, enforcement measures and an upgraded education program for technicians.  

“If they want to shell out a super technician who can be a veterinarian, I have to ask, ‘What do they plan to let this technician do? How are they going to have someone go out and make a diagnosis and, not being a veterinarian, use drugs?’” McGinnis says. “We already know what the problem is: People need a veterinarian for emergencies and there isn’t one. But it boggles my mind to think we’re going to resolve this problem with some technicians.”

Harsh reality

Originators of the project, including bill author Sen. Jackie Cilley, did not return interview requests by press time. Yet a recent study by Tufts University’s Cummings School of Veterinary Medicine confirms DVM deficiencies in New England, projecting 1,036 veterinarian vacancies within the next six years.

Many of those jobs will be for rural veterinarians in areas like Colebrook, N.H., where horse owner Carol Couture longs for a full-time DVM. Right now, she suspects a mare is pregnant, but no one is available to check. And when her 32-year-old horse went down last year, she was forced to call a local farmer to shoot it in the head.

“I think having your animal suffering with its head in your lap and nothing you can do is about the worst thing. I would welcome just about anyone who could help in a situation like that,” she says.

McGinnis suggests that owners alleviate their problems by trailing large animals to emergency clinics or general veterinary practices, a situation he often witnessed during his 20-plus years in practice.

“People learned to live with this problem 40 years ago when I went to school. I think they will now, too,” he says.

But Couture says transporting large animals often is impractical. Besides, the Vermont veterinarian she occasionally trucked her animals to reports he’s cutting back his practice.

Dying breed?

That’s Dr. Steven Sanford. At age 56, degenerative arthritis is slowing the mixed-animal veterinarian, yet he can’t find anyone to take over his business.

“I could put an ad out that says three-person large-animal practice, turn-key operation with the word ‘free’ in large print, and no one would show up to take it. I can’t give this place away because no one wants the responsibility and the work. That’s it in a nutshell,” he says.

Sanford, who still works 60 hours a week, says he feels a tremendous responsibility to clients who will have no one to turn to once he retires. The problem: He can’t get recent graduates who shun farm calls and long hours, to stay more than a year, reflecting a generational mindset that he claims lacks America’s “blue-collar work ethic.”

“New graduates don’t have an interest in dairy. They’re not the types of individuals who are going to return to rural areas and satisfy the need,” Sanford says. “That’s because it’s much more manageable to have a life with better pay and hours by working in small-animal medicine.”

Like McGinnis, Sanford, too, questions the logistics of elevating the status of technicians to practice any level of veterinary medicine.

“No one has lived the life of the veterinary shortage more than me,” he says. “I’m the last of a dying breed.”

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