The new year is upon us. Though 2,009 is just another number, the ‘turning of the clock’ always provides exciting new incentives to reassess the state of any given process. In this case, the process in question is the evolution of the veterinary industry.
There’s no doubt that veterinary medicine is rapidly evolving relative to almost every other medical field. The resulting change is disconcerting to most veterinarians—myself included—but the prospects for change are exciting and challenging nonetheless.
In general, I see an upswell in positives currently immersed in a sea of negatives. My profession is clearly in for another rollercoaster year. Here are this year’s ten biggest issues in veterinary medicine, per my predictions:
1-The cost of veterinary education
There’s no mistaking it. When new graduates are leaping into their careers with an average of $100K to $200K in debt, the entire industry reels. Back when I graduated there were just a few of us shouldering this high level of indebtedness. Now it’s the median.
What it means is…more stress on young vets, more specialists, fewer practice owners (who can afford it?), the rise of corporate medicine, a larger separation between the “have” and “have not” veterinarians, somewhat higher salaries and, ultimately, bigger vet bills.
2-Veterinary drug and product supply choices
This is the fastest growing segment of the pet sector. In fact, it’s high up there among the fastest growing industries in the US—second to the likes of the consumer electronics market. That’s great news for all of us when it comes to newer and better drugs for pets and increased product choices.
But newer drugs and products also means there’s going to be more to pay for. And, consequently, where you buy these drugs and products is changing. When you’re using more of this stuff, saving a few bucks a month by buying your arthritis meds and flea products elsewhere is bound to be the upshot.
Doing so, however, will alter the economics of the average vet hospital. Recognize that the price of veterinary services will likely rise as more of our clients eschew the convenience of buying at the vet’s in favor of saving some bucks where they can.
Currently, we effectively subsidize the cost of veterinary services with the income we make on products. When that income takes a hit, something’s going to have to give somewhere. Expect this change to begin taking serious effect in 2009.
3-The decline of the ‘old guard’
As new veterinarians and their issues enter the industry and older veterinarians retire, leadership will eventually change hands at the highest levels of the American Veterinary Medical Association (AVMA). Instead of rich practice management and industrial agriculture taking center stage, I believe the larger economic issues of access to care, insurance, animal welfare, and balancing the needs of individual veterinarians with huge debt loads will rise to the forefront.
4-Milking wellness and a new breed of general veterinary practice
We all know about the rise of the veterinary specialty market. More of you are seeing surgeons, internists, cardiologists and ophthalmologists than ever before. But smart vets know that the more they refer their big money cases to specialists the more they lose income. Should that mean that the next major abdominal surgery be tackled ‘in-house’? No, of course not. But it does mean that general practice veterinarians will be brushing up and offering a better brand of service to their clients.
This year I predict most of you will be seeing a higher quality of veterinary offerings across the board. From mandatory IV catheters on every anesthetic procedure to more comprehensive labwork, you're in for it.
5-Corporate inroads into veterinary medicine
It’s inevitable. More of you will patronize large corporation-owned hospitals because fewer vets can afford to buy their own practices. Some will take on the cookie-cutter Banfield style of practice (which has it’s own set of pros and cons) while others will look more like your regular vet’s place with a corporate backbone behind the scenes.
6-Cancer therapies
Good news! More pet owners are willing to treat their pets’ cancer than ever before. That means more cancer therapies will become available. I’m betting that 2009 will see even more cancer patients receiving treatment for their condition. From radiation (like my Sophie Sue received for her brain tumor) to vaccines (like the melanoma vax) and chemotherapy (with increasingly safe and effective protocols), this is the future of vet medicine. Embrace it!
7-Less invasive approaches
Consider my leech approach for ear hematomas. While the jury’s out on its efficacy just yet (stay tuned), veterinarians are increasingly looking to less invasive ways to accomplish what we used to do with cold hard steel. Interventional radiology, ovariectomies and laparoscopic surgery are just a few of the ways in which we hope to spare our patients the pain and risk of more traditional approaches.
8-Pet health insurance
Every year we see more policies being written to help protect pet owners from taking huge hits on their increasingly hefty pet health expenditures. Is this the year you’ll sign up for one of those plans?
9-The rise of animal welfare
Here’s a biggie. 2008 saw broad-based changes in the AVMA’s way of tackling the animal welfare issue. The HSUS spawned its HSVMA as a response to the AVMA’s historically slack take on ear cropping, tail docking, factory farming and other hot button issues. I predict 2009 to bring more of the same welcome changes in policy as increasing numbers of veterinarians clamor for them.
10-Broad-based changes in population control measures
2008 was crazy with issues related to spaying and neutering pets. From mandatory spay/neuter laws to a multi-million dollar bounty offered on the head of a non-surgical sterilization technique, can 2009’s controversial offerings be far behind?
OK, now it's your turn. What are your hopes and predictions for the new year?
Add Comment45 Comments
I see 2009 just a bit differently:
1. I see prices stablizing or perhaps slightly decreasing in some areas. I know that in 4/09, I will face a substantial decrease in pay to follow previous 2 yr. decreases. My income id directly affected by "volume", it is a fact that many industries & businesses have lost "volume".
2. I predict that most clinics/staff will focus very heavily on client satisfaction and quality patient care vs. volume based income
3. I predict that education will also suffer with volume of students unable to afford heaping debt. And with it, lower expectations to education or career = high income or job stability
4. I predict a change in access to home-based clinics with expanding hours availability
5. I predict much, much lower tolerance for fraudulent or bad care and more clients becoming outspoken for reform in the legislative, judicial, and public media systems.
6. I do not predict interest in pet insurance, because the economy and people's ability to take on a "new" debt is prohibitive--- no matter how beneficial.
7.Although new procedures, treatments, and drugs will enter the market, I believe there will be a reluctance or perhaps "distrust" in clamoring demand. This may be based on all the drug & treatment fallicies in human care that have become known to cause harm.
8. I do agree with the changing of the "guard" (AVMA) on the horizon and in general, a going back to honest, ethical business practices, along with some businesses failing.
9.In short, I completely agree that '09 is going to be an interesting year with many positives to come out of very tough economic times and a sincere belief that material things are going to take a back seat to what is really the most important in life.
10. Some will embrace, some will resent, some will fight tooth & nail to keep status quo, but everyone will feel some or many effects!!
Barbara A. Albright, USPS 22yr. employee
Pocket's Story from NH January 4th, 2009 12:01:50 PM
Another side effect of the massive debt vs relatively moderate pay that I've experienced is that more people are comfortable criticizing my choice of career. We all experience people asking us why we don't want to be "real" dcotors, but now I have people telling me (not completely unreasonably) that $57,000 per year in loans is ridiculous and not worth it for a career that pays $60,000 a year starting. I won't let that criticism affect my career choice, of course, but it does get a little wearing to have to explain why I want to take on huge amounts of debt to people who think that all I'll do is express anal glands and give vaccines all day.
I know a number of people pushed into human med from vet med by parents who thought vet med was a waste of time, money, and energy, and I think as tuition climbs we'll see more and more of that. I'd hate to see vet med become a career only attainable by those who can afford tuition out of pocket.
Megan January 4th, 2009 01:00:42 PM
On the plus side I'm hoping to see some changes in vet education around the issues of 1)nutrition and 2)caring for the elderly pet. On the minus side, I think along with the corporate vet practice we'll see vets being treated as being 'just employees' by these large corporations. Which means more tunrover, less continuity of care, less loyalty to a particular vet practice. And that's not good for vets or pets.
2CatMom January 4th, 2009 01:09:57 PM
2CatMom: Yeah, that's one of my critiques of corporate practice...the vet as mere tool model. Standardization of protocols is important to maintain a reasonably high level of care but I hate to see the art and curiosity go out the window with it. e.g., I'd bet the average vet at Banfield won't be able to get his/her corporate boss to OK leech therapy, for example.
Dr. Patty Khuly January 4th, 2009 02:30:56 PM
I have to agree with Barbara here.
I don't see 2009 as a time to increase pricing in the vet market. With the economy crashing and people losing jobs, I see "extra" things getting cut way back. And while I personally don't equate dining out with vet expenses, many people do look at things in excess of the yearly visit as extras.
Not a good time for expansion on any level I don't think.
I do see more and more people switching to human pharmacies and online pharmacies to save money though. That 300% mark up is just too much to swallow.
LorriM http://lorrim-fip.blogspot.com/ January 4th, 2009 10:34:40 PM
Re: "the larger economic issues of access to care, insurance, animal welfare, and balancing the needs of individual veterinarians with huge debt loads . . . " et al How odd. I still don't see anything about standards or quality improvement here. Sigh. When will that be one of the central focuses?
Stefani January 4th, 2009 10:41:45 PM
I'm not sure if i "see" it happening, but I'm hoping for a rise in awareness and use of good quality pet foods. Particularly brands that recognize the fact that cats and dogs are carnivores, not cornivores. Heh I heard the term "cornivore" somewhere and i love it, its a great jab at how big brands seem to see our pets.
Tatyana January 5th, 2009 12:02:59 AM
Stefani, I believe improvements in quality of care and standards will be consumer driven. I would love to AAHA become more visible so that the average pet owner would know exactly what accredidation really means. That is the best model we have right now. When enough pet owners demand a higher standard, the industry as a whole will respond. We will always have superstar Vets and bottom feeder Vets (who will never change), hopefully the ones in the middle will gravitate torwards the superstars.
Hobson January 5th, 2009 06:15:38 PM
Stefani: I do see veterinarians circling the wagons on the quality issue. It's simply that this isn't a legislative issue and the AVMA doesn't come into it--which was the focus of that section of the post. I do believe that higher quality care is more of a focus with the younger set. For those of us who came out of vet school with modern pet medicine in full swing, that's inevitably going to be the case.
Not that some older practitioners don't seriously keep up (one of my bosses is 65 and he's a beutiful example of that), but it's true that those who graduated not planning to ultrasound, refer to specialists and commit to excellent dentistry, for example, may be holding the profession up.
I agree with Hobson on the AAHA issue. That's the best example we have so far of a standard-setting body within the profession. However, I hate to think that improvements in quality are all consumer-driven. I'd like to believe that the 'superstars' bring up the bottom, but I can't help thinking (when I hear stories like yours) that, as a profession, we're only as good as our lowest common denominators.
Dr. Patty Khuly January 6th, 2009 08:50:49 AM
Thank you, Dr. K and Hobson.
Re: "I would love to AAHA become more visible so that the average pet owner would know exactly what accredidation really means."
My nightmare experience was at an AAHA place. While it may be the only "standards" that exist, it's really NOT reassuring to know that a place can maintain its AAHA membership even though:
1. They do not have one single solitary licensed technician on staff;
2. They leave patients alone with unqualified, unlicensed, unsupervised staff, and apparently have no procedures in place to review what pets will be there over the weekend and to ensure that the weekend staff are qualified to care for their specific medical conditions.
I specifically was reassured into going to that place in part because of the AAHA tape that runs in your ear -- telling you that AAHA membership means that the practice is held to a higher standard in patient care. I literally bought that s*&t.
My pet would have been safer home alone than at the AAHA hospital I entrusted him to, even if that meant he went a weekend without insulin.
You would have to work pretty hard to make me believe AAHA has any worth whatsoever. All they did in response to my complaint was require the business to come up with some protocol for medication administration -- but I bet it was entirely made up and bogus. Unless you are observing them, doing spot audits, etc. you are just rubberstamping a snowjob.
Dr. Khuly, I'm counting on you SuperStars to bring up the bottom, so I hope you are right. Frankly, we consumers can just make a lot of noise, but we lack the power to change anything in your profession. Can we take our business elsewhere? Sure. Can we reward a practice for standards we appreciate by giving them our business and singing their praises? Absolutely. But we can't do anything to raise "standard of care" only those of you on the inside can do that.
Stefani January 6th, 2009 03:55:42 PM
Stefani, I would probably feel the same about AAHA if I were in your shoes, you had an awful experience. Neither certification, liscensing or accretidation guarantee quality, whether it is a Vet, Technician or facility, but it does increase the odds. One problem with liscensed technicians is that there are not enough of them for everyone to have them in our clinics. Smaller clinics such as mine have a hard time attracting liscensed techs. In 26 years I have never had a liscensed tech apply for a job when I have advertised locally or regionally. My county only has 12,000 people and one stoplight (no mall, Walmart, theater et) so it is not easy getting a young person to move here. Fortunately one of my 2 techs is taking an online tech course and will be liscensed in a few months. That is the best I can do. The responsibilty for all that happens comes down to me so I make sure that anything I delegate is done by someone that I have trained adequately. I trust my 2 techs as much as I would trust anyone, liscensed or not. I know my clinic's limitations and I try to refer when I cannot provide optimum care. Most clients decline and say "just do the best you can". I get dismayed when I here stories like yours, I wish they would make me king for a year and I would clean up the profession. Sad thing about it is that many of these poor clinics are quite popular either because their prices are so low or the owner is a silver tongued devil. It is quite frustrating at times to compete against these vets. For example, in the neighboring county, the low cost vet ($50 spays) was arrested on drug charges (hydrocodone and viagra) in a well publicized case, but people from my area still flock to him.
Hobson January 6th, 2009 08:19:43 PM
Thank you Hobson. I appreciate that. Please be king for a day.
As for prices low or silver tongued devil, the place I had the bad experience at -- their prices weren't low. I wouldn't have called the vet a silver tongued devil either. How they managed to make a "Best of" list around the time this happened always baffled me -- but they weren't on it anymore the next year. Still, it goes to prove your point -- we clients don't know how to discern quality, and I also rue the fact that vets who are very conscientious, which you sound like you are, have to compete with them.
FWIW, the practice I go to now is AAHA cert, but that doesn't matter to me. What DOES matter is a) they use only licensed technicians. b) they combine clinic with 24 hour practice under one roof; c) the vet I go to there, as best I can tell, has good ethics -- she wrote an opinion for me on an aspect of care to use in my vet board complaint (Toonces used to be her patient before I moved from the neighborhood and ended up at the bad place) d) I have gone over their protocols with them, and I don't know what else I could ask for, e) my friends in rescue say the are the best, have said that consistently for years. So now I drive all the way back there, obviously, wish I'd never left when I moved across state lines.
How they have all licensed techs is that they have engaged in partnership with the very well regarded AVMA accredited vet tech program about a half hour away, and they also provide tuition benefits for vet assistants who work there to enroll in the program as long as they commit to a certain number of years as employees. I've never heard of another practice doing this and I wish they would.
I know the distance thing is not as highly regarded as classroom, but some of the programs are supposed to be strong when combined with clinical practicum. What is your opinion of the program your tech is enrolled in?
Stefani January 6th, 2009 08:42:40 PM
I generally agree classroom learning is probably superior. The clinical portion is conducted at my clinic and is the normal course of her duties. I do think the coursework has allowed her to better understand what is going on at a deeper level. I have the same arrangement regarding her tuition, she has to work for 3 years after she graduates or she reimburses me.
Hobson January 7th, 2009 08:16:53 AM
Stefani:We have an excellent distance learning program available to us here. It's not 100% online so our student techs have to travel to St. Petersburg, FL (4 hours away) for a year to finish it up but their distance learning curriculum is great from the materials I've seen.
Our local tech program is very new and consequently not the highest quality but it's getting better every year. Sadly, there's talk of shutting it down due to funding.
Ultimately, we have the same problem Hobson does: very few certified/licensed techs available. The only ones who have the bucks (and the challenging cases) to lure them down to Miami are the specialty hospitals. Yet even these places are hurting for licensed techs.
It is improving, though. I predict the next ten years will bring a great many licensed techs into the market.
Dr. Patty Khuly January 7th, 2009 09:01:54 AM
Dr. Khuly, that would be a very welcome development.
Believe it or not, in I live in a Maryland suburb of D.C. and there are practically NO vet techs in Maryland, especially here in the DC suburbs (there is a vet tech program in the Baltimore burbs but practices closer to DC tend not to have licensed techs, I might as well live in the boonies.) Ironically, just over the river, in the Virginia suburbs of DC where I used to live before I so unwisely moved, the situation is much better. That's why I drive back over the river now.
For a while, in the wake of what happened to Toonces, I tried to help promote and encourage the establishment of a vet tech program here in our Maryland locale. After a few months of trying (and a former vet board member working on this too) I basically learned that the local VMA said they'd hire LVTs if they were around, but they had no interest in doing anything proactive to try to increase the supply. They are fine with things the way they are, it seems. Not only did we NOT succeed in getting a vet tech program established, but the ONE veterinary ASSISTANT (not LVT) training program at the community college was also killed due to lack of enrollment. I guess potential students weren't motivated to pay $700+ a semester for a 2-semester program to train them to do something they a) could get hired to do with no training at all; and b) will be paid little more than minimum wage for, in any case.
I give up. I'm just driving to VA.
Stefani January 7th, 2009 12:53:41 PM
Stefani: $700 a semester for a 2 sem. program?? You've got to be kidding, how cheap can a educational/training program get? To fill positions all over the country?? What happened to the thinking of a stepping stone for furthering a particular career?
I just don't get it anymore, my age has obviously put me in the "I remember when....category"
Going out on a limb, I met a vivacious young student enrolled in the (now-called) Great Bay CC vet tech program POST-Pocket. She quit after a short internship, learning that the school/clinic was not working in the best interest of animals....but the $$$.
I can't help but have my reservations regarding "that" program, hearing that plus my personal abhorrent experience.
Hobson, you are king for a few days, I'd go to YOUR clinic in a hearbeat!
Barb A./New Hampshire
Pocket's Story from NH January 13th, 2009 12:32:03 PM
I'm surprised to see that you didn't mention the standardization of veterinary technician credentialing in your top ten for 2009.
Faith January 13th, 2009 07:02:06 PM
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