Eagle Post: too many vets?

Thomas Donnelly, BVSc DipVP DipACLAM reports from the US.

You may have seen the US Veterinary Workforce Study published by the American Veterinary Medical Association (AVMA) recently, or read the reports in Veterinary Record (May 2013, Vol 172, Issue 18) that suggest the supply of veterinarians in the USA may be exceeding demand for their services. Although specific to the US, as concerns are also being expressed about a likely oversupply of vets in Australia, the findings are of great interest.

The findings support a February 24 story in the New York Times entitled “High debt and falling demand trap new vets.” The story described a 30-year old vet, Hayley Schafer working in Gilbert, Arizona with $312,000 owing in student loans and depicts a profession bogged down by exorbitant educational costs, a looming oversupply of practitioners and the public’s declining demand for pet health care. Comments on Veterinary Information Network (VIN) reached fever pitch garnering more than 400 posts. Specifically, the results suggest that approximately 12.5 per cent of veterinary services in the US went unused in 2012 and that demand for veterinary services was sufficient to employ only 78,950 of the 90,200 vets currently working in clinical and non-clinical settings. The AVMA further suggested that excess capacity is likely to persist for the near future, even if US veterinary colleges were to limit expansion in enrolment. The study predicts the excess capacity will range from 11-14 per cent annually until 2025. Overcapacity is greatest in equine practice (23 per cent), followed by small animal (18 per cent), food animal (15 per cent) and mixed practice (13 per cent).

Many US veterinarians are already angry with the AVMA for recently accrediting Ross University in the Caribbean, which graduates over 300 veterinarians per year, and the National Autonomous University of Mexico. At present, there are 28 AVMA accredited schools in the US and 11 in other countries (including three in Australia and one in New Zealand). Another two new veterinary schools – Midwestern University in Arizona and Lincoln Memorial University in Tennessee – remain on track to open in 2014.

However, the AVMA has stated that the study does not show 11,500 vets can’t find work, but rather most do not feel their capacity to provide services is being used to the full. It also points out that overcapacity is present in every industry and is necessary to meet surges in demand. These comments did not endear the AVMA to already disgruntled members.

The problem is a boom in supply (i.e. vets) and a decline in demand (i.e., veterinary services). Class sizes have been rising at nearly every school, in some cases by as much as 20 per cent in recent years. Moreover, the cost of vet school has far outpaced the rate of inflation rising to a median of $63,000 per year for out-of-state tuition, fees and living expenses – this is up 35 per cent in the last decade. Mean educational debt for the 90 per cent of veterinary graduates borrowing to fund their education was greater than $150,000 in 2012; and 47 per cent of those polled had amassed debt in excess of that. These figures would seem less alarming if vets made more money. But starting salaries have sunk by 13 per cent during the same 10-year period to $45,575 a year. In tangible terms, that means new veterinarians face monthly student loan bills the size of mortgage payments and salaries barely large enough to cover them.

One good thing has come of the study – with the profession’s uncertain future on a national stage, leaders are uniting in the view that problems exist and must be addressed to maintain the profession’s viability. The AVMA issued an open letter to its 80,000-plus members. Universities went full swing into damage control as academic leaders have faced direct questions from students and alumni. Veterinary colleges at Oregon State University, the University of Minnesota and The Ohio State University hosted meetings to try to quell fear among students, many of whom already are steeped in educational debt. At the University of California, Davis School of Veterinary Medicine, Dean Michael Lairmore posted a statement on the school website titled “DVM — a valuable investment.” Ross University, a Caribbean-based veterinary school heavily featured in the Times article for its high tuition costs (and the only for-profit veterinary school in North America), also issued a public response. It blamed the decline in demand for veterinary services on the “weak economic climate” but said that a full turnaround is expected.

While acknowledging a problem exists, it is another to decide what to do about it. Suggestions in the workforce report include developing better ways of measuring demand for veterinary services, developing ‘early warning’ indicators of imbalances between supply and demand for veterinarians, and finding ways of increasing demand for veterinary services. The AVMA has made a number of recommendations on the collection of more economic and employment data, investigating the need and demand for veterinary services, and looking at ways of boosting demand. The Association of American Veterinary Colleges suggested that ‘market forces are the ultimate determinants of capacity and demand’ and that ‘periods of stress and friction are not unusual as professions work through supply and demand cycles’.

Certainly, the anaemic US economy has left millions of younger working Americans, not only veterinarians, struggling to get ahead. Economists are recognising the added millstone of student loan debt, which recently exceeded $1 trillion in total. The Federal Reserve Bank of New York found that 30-year-olds with student loans were now less likely to have debts like home mortgages than 30-year-olds without student loans — even though most of those with student loans are better educated and can expect to earn more money over their lifetimes. The weak US economy and tight credit standards remain the main culprits preventing young people just establishing themselves from making major purchases. But millions now face putting a substantial share of their take-home pay toward past debts rather than present needs. A poor job market is compounding the problem: the educational debt burden of many so-called millennials has sharply increased even as they are being forced to get by on significantly less income than the previous generation — a decline of about 15 per cent in real terms since 2000, with much of that drop coming from the recession.

Optimists are saying there are signs that the US economy is recovering and pointing out that people in possession of a veterinary degree are uniquely equipped to tackle some of society’s most pressing problems. The AAVMC — a membership body representing accredited veterinary schools has said its overarching goal is to make sure that efforts to prepare new generations of veterinarians “remain in strategic alignment with the needs and expectations of the society we serve.” Emphasis is being placed on thinking beyond traditional roles, encouraging veterinarians to carve out new roles for themselves in response to changing requirements. Certainly, given the challenges currently facing the planet, and as the report “workforce Needs in Veterinary Medicine” from the US National Academy of Sciences pointed out in 2012, their expertise could usefully be applied in more areas (www.tinyurl.com/m9r2tjs)

The US is not Australia, and the conditions surrounding veterinary education and labor force requirements differ. Nonetheless, the debate being had in the US could be useful here especially with seven vet schools in Australia graduating about 1000 veterinarians per year from 2012. Australia now has 360 veterinarians per one million people, which 30 per cent higher than the US.