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Back to basics

Veterinarians today are able to provide better and more advanced medical care for pets than ever before, but the cost of that care makes it out of reach for many owners. The growing gap between underserved pet owners and veterinary service providers has consequences for overall pet health.


Dr. Jeffrey F. Powers, owner of two veterinary clinics in northern Michigan, says he's always been bothered by the fact that a large swath of animals don't receive adequate care or see a veterinarian. (Photo by Central Michigan University student Allison Sadro)

Citation: American Journal of Veterinary Research 78, 1; 10.2460/ajvr.78.1.4

Fifty-six percent of U.S. households owned a pet as of year-end 2011, according to the 2012 edition of the U.S. Pet Ownership & Demographics Sourcebook published by the AVMA. Results also showed that 44.9 percent of cat owners did not take their cat or cats to a veterinarian in 2011, up from 36.3 percent in 2006. Among dog owners, 18.7 percent did not take their dog or dogs to a veterinarian during 2011, up from 17.3 percent in 2006. Further, 21.5 percent of cat owners and 29.3 percent of dog owners who did not visit a veterinarian said they could not afford it.

Dr. Michael Blackwell, chief veterinary officer for the Humane Society of the United States, says while veterinarians have done a great job serving the needs of most of the public, “We have a large sector of the American population who frankly are poor and can't afford private care. Some veterinarians say if you can't afford them, you shouldn't have pets. The fact is, pets are in these homes and need care as we speak. It's there, and it has to be dealt with. The model the profession built—this robust private veterinary industry, in all of its glory—is not a panacea. It is not complete in its ability to address the needs of all animals.”

Dr. Blackwell is part of the Access to Veterinary Care Coalition, a group that is advocating for shelters and nonprofit clinics to supplement and complement the veterinary industry by addressing unmet needs. Meanwhile, small animal practitioners in low-income areas say they're learning to adjust to their clients’ financial constraints while still providing an adequate level of care and maintaining profitability.

Dr. Jeffrey F. Powers owns two veterinary clinics in a low- to moderate-income area in northern Michigan. He believes that charging less for some services not only enables more clients to agree to veterinary care but also attracts more clients in general, increasing caseload and income overall. At his clinics, Dr. Powers offers prepayment plans and works with local nonprofits that are willing to help pay for part or all of the cost of services for in-need clients.

In the Knoxville, Tennessee, area, Dr. Sam Meisler has taken basic care to another level. “We shaved off the radiographs, surgery, and skill level of the support staff and hospital so everything else can be offered cheaper,” says Dr. Meisler, who likens his PetWellClinics to Walgreens Take Care clinics.

He doesn't always require heartworm testing, as he sees the cost as a barrier to owners seeking care. Going one step further, Dr. Meisler doesn't require an examination prior to vaccination.

Price sensitivity is something all veterinarians need to understand and pay attention to, not just those in low-income areas, according to Michael Dicks, PhD, director of the AVMA Veterinary Economics Division. He wrote in the essay “Supply and Demand” this past May that low-cost care providers, including spay-neuter and nonprofit clinics, enter the market and establish themselves because they can, even in areas where clients can afford higher prices. That's why veterinarians must understand what services they can provide to maximize the health and wellness of pets and be willing to provide that set of services at prices each segment of the local population is able and willing to pay, Dr. Dicks wrote.

Condensed from Dec. 1, 2016, JAVMA News

Ready for the real world

In 2012, the Cummings School of Veterinary Medicine at Tufts University and Worcester Technical High School in Worcester, Massachusetts, did something unprecedented. Together, they opened a small animal hospital on the trade school campus where students from both institutions could receive on-the-job training by providing subsidized veterinary care to underserved pet owners throughout the Worcester area.

There was no model for Tufts at Tech Community Veterinary Clinic, located a little more than 6 miles from the veterinary school in North Grafton, Massachusetts. Fourth-year Cummings veterinary students spend three weeks at the clinic as part of their primary care rotation, managing a mix of basic and urgent-care cases while under the mentorship of veterinary staff and volunteers. Discussions with clients about diagnoses, treatment options, and service costs are left entirely to students.


Fourth-year veterinary student Bryan Greenberg prepares a patient for a rabies vaccination with help from Tufts at Tech Community Veterinary Clinic director Dr. Greg Wolfus.

Citation: American Journal of Veterinary Research 78, 1; 10.2460/ajvr.78.1.4

Scheduling appointments, taking patient histories, and supporting the veterinary students in all they do are the juniors and seniors at Worcester Technical High School who are working toward graduating with a diploma and as approved veterinary assistants.

Part of the Tufts at Tech paradigm is to reverse the trend among new veterinary graduates who feel unprepared to work in a small animal primary care setting. Veterinary student Kelly McMullin, who was nearing the end of her second week at Tufts at Tech, explained, “On day one, we're told to be doctors, and that's very much not the experience I've had in my other clinical rotations.”

Images of the day-to-day operations at Tufts at Tech Community Veterinary Clinic are available at the JAVMA News photo galleries, http://jav.ma/tuftsattech.

Condensed from Dec. 15, 2016, JAVMA News

Report: Market for veterinarians has been robust

The national market for veterinarians remained robust in 2015 for a second straight year, according to the 2016 AVMA Report on the Market for Veterinarians. Per the report, “The single largest source of this improvement has been the growth in the U.S. economy.”

The AVMA released the report Oct. 26 as the third of four economic reports for 2016. The reports are available at http://jav.ma/2016markets for free download by AVMA members or for purchase by others as a series.

The 2016 AVMA Report on the Market for Veterinarians covers veterinarians’ employment, unemployment, and underemployment; income and the net present value of the veterinary degree; and data available on possible causes of negative well-being: debt, job/career satisfaction and income, expenditure patterns, burnout scores, and health.

Key findings of the report include the following:

  • • The market for veterinarians has witnessed the second straight year of low unemployment and increasing mean salaries.

  • • The applicant-to-jobs ratio decreased to one or less in 2015.

  • • In 2015, veterinary unemployment remained below the national mean and was not significantly different from 2014.

  • • Veterinary underemployment was again negative in 2015, with more veterinarians indicating they wish to work fewer hours for less compensation than those who wish to work additional hours for more compensation.

  • • The net present value of the veterinary degree has been declining since the earliest data were available in 2010. The primary reason for this decline is the increasing “opportunity costs”: Starting salaries for bachelor's degree holders grew 19 percent over this period, whereas starting salaries for veterinary degree holders grew about 5.5 percent.

Condensed from Dec. 15, 2016, JAVMA News

NIFA awards $2.3 million to relieve veterinary shortages

The Department of Agriculture's National Institute of Food and Agriculture on Oct. 17, 2016, announced 12 awards totaling $2.3 million to help relieve shortages of veterinary services through education, extension, training, and support for new or existing veterinary practices in designated rural areas.

The fiscal year 2016 competitive grants are funded through the new Veterinary Services Grant Program authorized by the 2014 Farm Bill.

“The new Veterinary Services Grant Program will enable training and retention initiatives to support veterinarians and veterinary technicians so they can continue to provide quality services in rural areas,” said NIFA Director Sonny Ramaswamy. “It also supports the expansion of existing veterinary educational programs and facilities, including mobile services.”

Veterinary Service Grants fund work by universities, veterinary associations, and state, local, or tribal agencies. Funds may also be used to support the establishment or expansion of veterinary services in eligible rural areas.

The AVMA was instrumental in pushing Congress to authorize and fund the program. AVMA CEO Janet Donlin said, “These grants are the outcome of AVMA's sustained advocacy efforts over the past eight years.”

Fiscal year 2016 grantees are as follows: the American Association of Bovine Practitioners ($224,136); Colorado State University ($238,251); the University of Georgia ($236,243); Kansas State University ($239,656); the University of Minnesota ($238,346); Betsy the Vet Inc., Hardin, Montana ($124,462); Lewistown Veterinary Service, Lewistown, Montana ($116,036); Town and Country Veterinary Clinic, Auburn, Nebraska ($124,760); Utah State University ($236,619); the University of Wisconsin-Madison ($237,327); the Wisconsin VMA ($238,429); and Squared Circle Veterinary, Evanston, Wyoming ($104,000).

Condensed from Dec. 1, 2016, JAVMA News

Free training offered in suicide prevention

On Nov. 19, 2016, the AVMA launched a training program to help members identify and aid individuals who may be at risk for suicide, as part of its ongoing well-being initiative.

QPR, which stands for question, persuade, and refer, is a method that can be used to recognize the warning signs of someone in crisis. Through this 90-minute, self-guided online program, individuals will also learn how to establish a dialogue and assist those in crisis to seek professional help. It is not intended to replace professional assistance.

In partnership with the AVMA PLIT and AVMA Life, the Association is opening up a limited number of free registrations for AVMA and Student AVMA members. Participants have access to their QPR Institute accounts for up to three years. The launch date coincided with National Survivors of Suicide Loss Day.

“This pilot program demonstrates the AVMA's commitment to moving forward in helping our profession become more healthy,” said Dr. Marci Kirk, AVMA assistant director for recent graduate initiatives.

The idea for offering QPR training first came about during the veterinary profession wellness roundtable, held this past March in Schaumburg, Illinois, and convened by the AVMA. The 35 participants talked about major causes of wellness issues among veterinarians, strategies to promote wellness among veterinary professionals, barriers to implementing wellness programs, and tactics to overcoming these barriers. In addition, one of the priorities that roundtable participants highlighted was exploring the creation of more support communities for veterinarians.

Condensed from Dec. 1, 2016, JAVMA News

Education council schedules site visits

The AVMA Council on Education has scheduled site visits to 11 schools and colleges of veterinary medicine for 2017.

Comprehensive site visits are planned for the Oklahoma State University Center for Veterinary Health Sciences, March 19–23; the Kansas State University College of Veterinary Medicine, April 2–6; the University of Prince Edward Island Atlantic Veterinary College, Sept. 17–21; the University of Saskatchewan Western College of Veterinary Medicine, Oct. 1–5; Washington State University College of Veterinary Medicine, Oct. 8–14; Iowa State University College of Veterinary Medicine, Oct. 29-Nov. 2; and Cornell University College of Veterinary Medicine, Nov. 5–9.

Focused site visits are planned for the University of Illinois College of Veterinary Medicine, Jan. 22–25; the Lincoln Memorial University College of Veterinary Medicine, Jan. 22–25; and the University of Alaska Fairbanks College of Natural Science and Mathematics Department of Veterinary Medicine collaborative program, Feb. 26-March 2.

A consultative site visit is scheduled for the University of Nottingham School of Veterinary Medicine and Science in the U.K., Dec. 3–7.

A comprehensive site visit is planned for the University of Pennsylvania School of Veterinary Medicine, Dec. 4–8. A consultative site visit is scheduled for the University of Cambridge Department of Veterinary Medicine in the U.K., Nov. 6–10.

The council welcomes written comments on these plans or the programs to be evaluated. Comments should be addressed to Dr. Karen Martens Brandt, Director, Education and Research Division, AVMA, 1931 N. Meacham Road, Suite 100, Schaumburg, IL 60173.

Comments must be signed by the person submitting them to be considered.

From Jan. 1, 2017, JAVMA News

AVMA, pediatrics academy collaborate toward one health

The AVMA and American Academy of Pediatrics adopted a joint statement, “The Value of Professional Collaboration in Protecting the Health of People and Animals,” on Nov. 3, 2016, in honor of the inaugural One Health Day. The statement outlines potential opportunities for collaboration that would benefit patients, families, and communities.

According to the introduction: “Humans and animals have much in common. They share issues of health and disease and co-exist in common environments. Advancing technologies and science-based evidence are increasing awareness, knowledge, and understanding of these interdependencies, further supporting the concept of ‘One Health.'”

Representatives from the AVMA and AAP met at AVMA headquarters in Schaumburg, Illinois, to discuss opportunities for collaboration. The professionals found that both groups are increasingly focused on the benefits of healthy lifestyles and environments, with an emphasis on preventive care for improved physical and mental health of patients.

Potential opportunities for collaboration between the AVMA and AAP include participation in cross-disciplinary campaigns and projects designed to share information with veterinarians and physicians as well as the public. The joint statement identifies the following potential areas for collaboration:

  • • Healthy pets as members of healthy households.

  • • Health of people as tied to the safety and quality of the food they consume.

  • • Zoonotic disease.

  • • Animals in the service of people.

  • • Environments and lifestyle choices impacting people and animals.

  • • Responsible use of antimicrobials and antimicrobial resistance.

  • • Professional wellness.

The complete text of the joint statement is available at http://jav.ma/onehealthstatement.

Condensed from Dec. 15, 2016, JAVMA News

Nominations open for Excellence in Veterinary Medicine Awards

The AVMA is accepting nominations for the following Excellence in Veterinary Medicine Awards: The AVMA Award, AVMA Meritorious Service Award, AVMA Advocacy Award, AVMA Animal Welfare Award, AVMA Clinical Research Award, AVMA Humane Award, AVMA Lifetime Excellence in Research Award, AVMA Public Service Award, AVMA XIIth International Veterinary Congress Prize, AVMF/AKC Career Achievement Award in Canine Research, and AVMF/Winn Excellence in Feline Research Award.

The deadline is Feb. 15 for award nominations. Award information and nomination forms are available by visiting www.avma.org/awards, emailing avma-awards@avma.org, or calling 800-248-2862.

Condensed from Dec. 1, 2016, JAVMA News

Report: Similar rises in human, pet health care expenses

Household pet health care expenses have risen in patterns similar to those seen in human health care, despite any influences of insurance coverage and public sector reimbursement on the former, according to recent economic analysis.

The nonprofit National Bureau of Economic Research published the report, “Is American pet health care (also) uniquely inefficient?” in September 2016. Its title is based on a 2008 Journal of Economic Perspectives article, “Is American health care uniquely inefficient?”

The authors of September's article—Liran Einav, PhD, and Atul Gupta of Stanford University's Department of Economics and Amy Finkelstein, PhD, of the Massachusetts Institute of Technology's Department of Economics—wrote that human health care expenses in the U.S. are higher and rising more quickly than expenses in other developed countries, without being associated with better outcomes. The rise has been attributed to insurance that shields patients from costs of their decisions and government reimbursement that provides little incentive for efficiency, the report states. Similar changes in pet health spending indicate other factors are influencing the demand for and supply of health care, it states.

“It should give us pause before attributing the large and rising healthcare costs in the US solely to the prevalence of insurance and government involvement,” the report states. “The similar growth patterns in US human and pet healthcare may also suggest that technological change in human healthcare may have spillover effects on related sectors, including perhaps pet healthcare or human care in other countries.”

The report is available at www.nber.org/papers/w22669.

Condensed from Dec. 1, 2016, JAVMA News

Two free wellness webinars available for AVMA members

AVMA Life and the Pet Poison Helpline are offering two free wellness webinars for AVMA members. Leading the webinars is Elizabeth Strand, PhD, director of the Veterinary Social Work program at the University of Tennessee College of Veterinary Medicine.

The first webinar, “Adverse Childhood Experiences, Moral Stress, and Veterinary Mental Health,” was held Dec. 8, 2016, and is archived. The second webinar, “Neural-integration and the Reversal of Poor Wellbeing in Veterinary Medicine,” will be from noon to 1 p.m. Central time on Jan. 26. Details are at http://jav.ma/wellnessCE.

Each webinar is approved for one hour of credit from the Registry of Approved Continuing Education. The webinars will be archived via links from the AVMA Life and Pet Poison Helpline home pages, www.avmalife.org and www.petpoisonhelpline.com.

From Dec. 15, 2016, JAVMA News

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