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Abstract

OBJECTIVE

To determine whether career choice and starting salary of new DVM graduates in the US were associated with their educational debt accrued during veterinary school.

SAMPLE

Up to 48,527 fourth-year students at US veterinary schools who responded to the AVMA Senior Survey in 2001 through 2021 and accepted a full-time position or advanced education opportunity.

PROCEDURES

To determine whether career choice was associated with educational debt, multiple linear regression was performed, controlling for graduation year, gender, age, marital status, having children, tuition level, and school location. The correlation between educational debt and starting salary was also determined.

RESULTS

On average, mean educational debt increased by $6,110 each successive year. A mean of 60.5% of respondents accepted positions in private practice (public practice, 3.3%; advanced education, 36.2%). Respondents choosing public practice had a mean of $24,913 less debt than those choosing advanced education, controlling for other factors. Respondents choosing public practice also had less debt than those choosing private practice, but debt did not differ significantly between private practice and advanced education. The correlation between educational debt and starting salary was significant but low (r = 0.177).

CLINICAL RELEVANCE

Findings suggested that the amount of debt incurred during veterinary school was associated with new veterinarians’ career paths. Notably, graduates with higher debt levels appeared to seek higher paying jobs or clinical training that might lead to higher paying jobs, leaving public practice—a field in which critical needs have been identified—underrepresented despite the availability of loan forgiveness programs and other incentives.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective

To estimate the effects of practice ownership on wellbeing of US private practice veterinarians.

Sample

1,217 practice owners and 1,414 associate veterinarians (ie, nonowners) who participated in the 2021 AVMA Census of Veterinarians and Practice Owners Survey.

Procedures

A professional quality of life instrument was used to measure compassion satisfaction (CS; a positive attribute), burnout (BO), and secondary traumatic stress (STS) in practice owners and nonowners both as scores and as score categories (low, moderate, and high CS, BO, and STS). For hypothesis tests, propensity score matching was used, with owners (n = 595) matched to nonowners (595) on several demographic and employment factors.

Results

Owners had significantly (P < .001) higher CS scores (mean ± SE, 34.1 ± 0.3) and lower BO scores (26.1 ± 0.3) than nonowners (32.8 ± 0.3 and 26.9 ± 0.3, respectively), but STS scores were comparable between groups (27.4 ± 0.3 and 27.5 ± 0.3; P = .55). The prevalence of low CS scores and high BO scores was significantly (P < .001) higher for nonowners versus owners (53.8% vs 42.7% and 51.6% vs 46.4%, respectively). Both owners and nonowners had a high prevalence of high STS scores (81.8% and 83.2%, respectively; P = .53).

Clinical Relevance

Results suggested that practice ownership confers a benefit to private practice veterinarians in terms of CS and BO, but not STS. The prevalence of poor CS, BO, and STS scores was higher than reported previously for 2016 to 2018, suggesting an impact of the COVID-19 pandemic. The high prevalence of high STS scores in both groups warrants attention and action to protect the welfare of the veterinary workforce and support optimal patient care.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine the contributions of veterinarians and support staff to revenue and veterinarian productivity (ie, number of patients seen/full-time–equivalent veterinarian/wk) in private mixed and companion animal practices in the US and identify staff-to-veterinarian labor ratios (SVLRs) that maximized these 2 practice outputs.

SAMPLE

409 owners of mixed and companion animal practices who participated in the 2020 AVMA Practice Owner Survey.

PROCEDURES

Data regarding owner demographics, practice characteristics, labor (defined as mean total hours worked/wk), and gross revenue in 2019 were obtained from participating practices. Multivariable ordinary least-squares regression was used to identify factors associated with revenue and productivity as well as the SVLRs at which revenue and productivity were maximized.

RESULTS

For each 10% increase in total veterinarian hours worked per week, revenue increased by a mean of approximately 9%. A 1-unit increase in total number of technician hours used to support 1 hour of veterinarian work was associated with a 20.5% increase in revenue but with no change in productivity. The same increase in total number of nonmedical staff hours was associated with a 17.0% increase in revenue and 14.4% increase in productivity. In terms of revenue, the optimal SVLRs for veterinary technicians and nonmedical staff were 9:1 and 8:1, respectively. In terms of productivity, the optimal SVLR for nonmedical staff was 10:1.

CLINICAL RELEVANCE

Findings confirmed the important role of nonveterinarian staff in revenue and veterinarian productivity in mixed animal and companion animal practices and may be useful for making evidence-based staffing decisions.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To characterize and compare fourth-year students of US veterinary schools graduating with and without related educational debt (ie, DVM debt) from 2001 through 2020.

SAMPLE

45,756 fourth-year veterinary students who participated in the annual AVMA Senior Survey from 2001 through 2020.

PROCEDURES

Survey data were summarized for variables hypothesized to be associated with DVM debt. Multivariable modeling was used to investigate associations between these variables and the likelihood of graduating with DVM debt.

RESULTS

Mean DVM debt increased fairly steadily from $56,824 in 2001 (n = 1,587) to $157,146 in 2020 (2,859). Of 45,756 students, 6,129 (13.4%) had no DVM debt. Attending Tuskegee University and having children (both men and women) were associated with an increased likelihood of DVM debt. Attending certain other veterinary schools and more recent survey year were associated with a decreased likelihood. For 2020, the likelihood of DVM debt decreased with increasing percentage of tuition paid by family and increased with increasing percentage of tuition paid by educational loans, being a woman with children, and increasing total cost of attendance. No association was found with state cost of living index or per capita income.

CLINICAL RELEVANCE

Results suggested a growing rift between US veterinary students who cannot afford tuition and fees without accumulating financially concerning levels of debt and those who have the financial ability or family situation to fully fund veterinary school. Efforts should be undertaken to recruit across socioeconomic statuses and provide meaningful scholarships to students with greatest financial needs to support diversity, equity, and inclusion in veterinary medicine.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To identify more effective language strategies for helping pet owners appreciate the value and importance of preventive veterinary care and encouraging more regular visits.

SAMPLE

15 pet owners representing a mix of demographic and other characteristics.

PROCEDURES

This qualitative study began with a communication and research audit, followed by interviews with subject matter experts, development of language stimuli (messages about the importance of veterinary care and encouraging pet owners to prioritize wellness visits), three 2-hour online focus group sessions with study participants (4 to 6/group) to test and discuss the language stimuli, and 1-hour one-on-one interviews with 5 of these participants to measure emotional responses to optimized stimuli.

RESULTS

Language stimuli testing showed that simply telling pet owners how veterinary care is valuable does not work. What did work was focusing on the pet owner’s relationship with their pet, tying preventive care into the animal’s overall health and happiness, and emphasizing a veterinarian’s experience versus their qualifications. Personalized recommendations were perceived as most valuable to owners. Addressing cost head-on, demonstrating understanding, empowering pet owners to ask questions, and providing payment options were identified as strategies that could help owners see they can afford routine care now.

CLINICAL RELEVANCE

Results suggested that by focusing on experience, relationships, and personalized care, veterinarians can address pet owners’ concerns while promoting the importance of preventive care, including regular checkups. Additional research is needed to evaluate the impact of this language on pet owner perceptions, behaviors, and outcomes in clinical settings.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate technical efficiency of US companion animal practices.

SAMPLE

60 independently owned companion animal practices selected from the 2022 AVMA Veterinary Practice Owners Survey.

PROCEDURES

A ratio of the weighted sum of outputs to weighted sum of inputs was computed for each practice (ie, decision-making unit [DMU]). Inputs included labor (hours worked) and capital (fixed costs and number of exam rooms). Outputs (or production) included annual gross revenue, number of patients seen per year, and number of appointment slots per full-time–equivalent (FTE) veterinarian per year. Data envelopment analysis was used to optimize the ratio and estimate relative efficiency (RE) scores.

RESULTS

25 (42%) practices were classified as having high efficiency (RE = 1 or 100% efficient), 26 (43%) as having moderate efficiency (RE > 0.7 but < 1.0), and 9 (15%) as having low efficiency (RE ≤ 0.7). Mean RE scores for moderate- and low-efficiency practices were 0.83 and 0.66, meaning they could have reached their current production levels with 17% or 34% less resources. Per the model, if all 60 practices were 100% efficient on the RE scale, 22 fewer FTE veterinarians, 47 fewer FTE veterinary technicians and assistants, and 43 fewer FTE nonmedical staff would be needed overall.

CLINICAL RELEVANCE

These preliminary findings suggested that efforts to optimize efficiency could allow companion animal practices to meet demands for their services without necessarily needing to hire more staff. Such efforts might include engaging support staff to their full potential and implementing automated processes. Additional research is needed to identify routines or workflows that distinguish high-efficiency practices from others.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine prevalences of low compassion satisfaction (CS), high burnout (BO), and high secondary traumatic stress (STS) scores among full-time US veterinarians and estimate effects of selected demographic, employment-related, and education-related factors on those scores.

SAMPLE

5,020 full-time veterinarians who participated in the 2016, 2017, and 2018 AVMA Census of Veterinarians surveys.

PROCEDURES

Data were obtained from census surveys regarding demographic, employment-related, and education-related factors, and scores assigned to items from a professional quality-of-life instrument designed to measure CS and compassion fatigue (ie, BO and STS) were compared between and among various demographic and employment groups.

RESULTS

Overall, 35.5% of veterinarians were classified as having low CS scores, 50.2% as having high BO scores, and 58.9% as having high STS scores. Controlling for other variables, high educational debt was associated with low CS, high BO, and high STS scores. Veterinarians who spent ≥ 75% of their time working with dogs or cats had higher BO and STS scores than did those who spent < 25% of their time. Veterinarians with more experience and higher annual incomes had higher CS scores and lower BO and STS scores. Women had higher BO and STS scores than did men, but no gender differences were observed in CS scores.

CONCLUSIONS AND CLINICAL RELEVANCE

Several variables were identified that may put veterinarians at higher risk than others for compassion fatigue and low CS. These findings may be useful in the development of resources and targeted initiatives to support and defend veterinarian well-being.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To examine potential associations between periodontal disease (PD) and the risk of development of chronic azotemic kidney disease (CKD) among cats and determine whether the risk of CKD increases with severity of PD.

DESIGN Retrospective cohort study.

ANIMALS 169, 242 cats.

PROCEDURES Cats were evaluated ≥ 3 times at any of 829 hospitals from January 1, 2002, through June 30, 2013. Cats with an initial diagnosis of PD of any stage (n = 56,414) were frequency matched with cats that had no history or evidence of PD (112,828) by age and year of study entry. Data on signalment, PD, and other conditions potentially related to CKD were extracted from electronic medical records. Cox proportional hazards modeling was used to estimate the association of PD with CKD after controlling for covariates.

RESULTS PD was associated with increased risk of CKD; risk was highest for cats with stage 3 or 4 PD. Risk of CKD increased with age. Purebred cats had greater risk of CKD than mixed-breed cats. General anesthesia within the year before study exit and diagnosis of cystitis at any point prior to study exit (including prior to study entry) were each associated with increased CKD risk. Diagnosis of diabetes mellitus or hepatic lipidosis at any point prior to study exit was associated with decreased CKD risk.

CONCLUSIONS AND CLINICAL RELEVANCE The findings supported the benefit of maintaining good oral health and can be useful to veterinarians for educating owners on the importance of preventing PD in cats.

Full access
in Journal of the American Veterinary Medical Association