In the face of unparalleled change and uncertainty, the American Veterinary Medical Association (AVMA) needs to become more transparent, inclusive, influential and driven to support the profession's future, including the economic vitality of its members.

All of this should happen by the year 2020, along with a host of other changes that involve broadening the association's global perspective, taking action in a more democratized manner and achieving a new level of social responsibility.

These action items and others are laid out in the AVMA 20/20 Vision Commission report, released to the public on Thursday. The final report — a first of its kind for the AVMA — is more than a year in the making and comes at a time when the veterinary profession faces major challenges that include skyrocketing student indebtedness, increased competition and socioeconomic changes that are threatening the professional health of U.S. veterinarians, 83 percent of whom are AVMA members. 

It is not yet clear how the AVMA's leadership plans to put the Vision Commission report into action, but a need to do so is evident, according to the document.

"The veterinary profession and the AVMA are being challenged to reconcile a fundamental shift of the profession from one that has traditionally prided itself on its strong independence, to now, integrating itself into a new interdependency that calls into question how AVMA works, operates, what it does and who are its future partners and members," the report's executive summary states.

The AVMA Executive Board established the AVMA 20/20 Vision Commission in January 2010, and challenged the group to create a "progressive vision" for the near future of the association, looking six to 10 years out, along with goals for how to get there.

Some of the commission's 11 members are influential leaders in the academic and government circles while others are tied to conventional general practice. The group's chair is Dr. Lonnie King, dean of The Ohio State University's veterinary program and one-time director of the National Center for Zoonotic, Vector-Borne and Enteric Diseases at the Centers for Disease Control and Prevention.   

He and others on the commission could not be reached immediately to discuss the 11 "dimensions" laid out in the report, which represent critical areas of change and action intended for the AVMA. The report suggests the AVMA must accomplish the following overarching goals by 2020 in an effort to transform the association over the next decade:

• Achieve a new level of social responsibility and help meet societal needs;
• Become more influential by being externally focused, spanning boundaries and sparking a new public awareness of the profession’s contributions to society;
• Help drive improved economic performance and long-term financial stability for the entire profession;
• Balance its relationships with an increasingly complex and more diverse profession and group of stakeholders as the convener/facilitator leader to address critical issues;
• Become global in perspective and actions;
• Retain and gain new members by creating personalized services and portals that provide products and information continuously for AVMA members and the public;
• Reflect the changing demographic, ethnic and generational differences of society and actively engage more women in leadership roles;
• Leverage and adopt remarkable advances in technology that improve communications, education, connectivity and engagement;
• Govern, operate and make decisions and policies in a transparent, inclusive and more democratized manner;
• Create a special culture that is collaborative, customer-focused, forward-leaning, innovative, nimble and inclusive;
• Ensure it has the capacity to be knowledge-based, proactive and responsive on critical issues.

Beyond the 11 "dimensions," much of the 32-page report hones in on broad, nebulous concepts before it gets into meaty detail concerning the changes proposed and why they're necessary. One paragraph lays out all that threatens to upend veterinary medicine as it's existed for decades:

"We in veterinary medicine now face a group of strategic inflection points that are certain to change our thinking and actions. The points include: emerging infectious and zoonotic diseases; antimicrobial resistance; food safety and security; global food systems; loss of biodiversity and animal species; animal welfare; information technology; greater consumer information and activism; globalization; specialization of veterinary practice; and the delivery and changing models of veterinary medical education. There has never been another time in history when the profession has faced so many significant inflection points that potentially will alter our thinking and actions."

Organizations go through life cycles, the report explains, where they grow, evolve and transform; successful organizations can create new futures. "An organization that cannot re-imagine its deepest sense of what it is, what is does and how it operates will be rendered obsolete."

Forces influencing change at the AVMA include:

• generational and gender issues;
• fragmentation of the profession into specialties and special interests;
• economic and financial realities experienced by the veterinary workforce;
• time and financial constraints of members;
• technological advances for communication;
• the need to be well informed and proactive;
• culture;
• dynamics of AVMA's governance, systems and processes;
• a building desire of members for personalized services and products; and
• diversity among members and leaders.

The AVMA's 81,500 veterinarians are mostly Caucasian, sparking concerns that profession does not mirror society in terms of race and ethnicity. In a section on diversity, the report calls for the AVMA to address this considering that minorities are the fastest growing population segment in the United States and expected to become the majority by 2030.

"The diversity of the veterinary profession has made too little progress," the report states. "There is growing concern that the profession is not serving, nor will it get an opportunity to serve, and caring for pets and animals owned by minority clients. Thus, it is obvious that the profession’s impact could be proportionately reduced and its image and public trust tarnished."

The Vision Commission also outlines a need for the AVMA to further address student debt and the lack of veterinarians in underserved communities. By 2020, the report calls for the AVMA to play a "major" role in securing economic profitability for veterinarians in all professional segments.

As the profession is battered by the nation's economic downturn and rising student debt, the report focuses on a projected migration away from the veterinary profession. "The level of income for veterinarians compared with other professions is alarmingly low," the report states. "... the pool of applicants to attend colleges of veterinary medicine has leveled off over that last 4 to 5 years; yet, applicants to other professional colleges have continued to increase."

To maintain its relevance, the AVMA is being asked to develop a strategy for re-branding by getting out on the global circuit and reinventing new roles and relationships with state and federal agencies as well as academicians and those in other health sciences. The AVMA must be the expert on surveillance, standard setting, animal welfare, food safety, biodiversity and other critical societal issues, the report states.

Relationships within the veterinary profession also are touched on by the report. "While AVMA should enhance and build new relationships outside the profession, it also needs to strengthen relationships internally. Difficult and potentially divisive issues are more and more likely to occur among special interest groups under the AVMA umbrella of members."

Those special interest groups could extend overseas, where the AVMA is expected to carry influence and create opportunities. "Because of the reputation of U.S. veterinarians and our veterinary medical and veterinary science educational institutions, AVMA has a competitive advantage to exert new global clout and assume a stronger international presence and leadership."

In terms of representing its members, the report calls for the AVMA to extend membership opportunities to the lay public, so they can get involved and be engaged. The proposed membership category is called "Friends of the AVMA."

"As the AVMA needs to consider its national representation and brand, greater attention should be paid to expanding membership to associated groups such as veterinary technicians and the public," the report states.

However, just among veterinarians, challenges already exist to maintaining a cohesive force in the face of conflicting views and perspectives. According to a survey by the Vision Commission, some members feel disconnected from the AVMA while others feel it's overly bureaucratic, sparking concerns that the value of the group's membership is waning.

"Moreover, the current economic downturn, lack of diversity, greater scrutiny and questions of value (especially from younger members), controversial issues and positions, dominance of membership by private practitioners, potential dividers such as large versus companion animals, growth of CE outside AVMA venues, corporate chain practices and the potential for spin-off groups to offer greater value have created a very different environment of more uncertainty and ambiguity," the report states.

The AVMA must also face a generational and gender shift to attract and retain women, considering that less than 20 percent of today's graduates are men. In addition, millennial-generation workers soon are expected to dominate the profession.

To engage to the younger sect, the report calls for the AVMA to create a 10-year technology plan. And in terms of governance, the Vision Commission fears that the AVMA's volunteer system will not be compatible to the next generation of members and the growing number of women in the profession.

"Survey results and interviews suggest that some women and younger members feel disenfranchised based on their concern that the Association has a strong bias toward constituency-based participation," the report states. "... 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. The governance also underpins the association’s culture, which also needs to be reconsidered if the governance is adjusted and is connected to the next dimension."

Thus, AVMA governance needs to be more transparent and horizontal by nature — changes that could take place via technology (though specifics on that are unclear). And all of this calls for a shift in the organization's culture.

"Every profession has its defining moments where talented individuals and leaders will influence the course of events for generations to come," the report concludes. "The adoption and implementation of this vision and recommendations represents such a moment."