Vote NO to Proposition 129
The idea of a mid-level practitioner in veterinary medicine has been tossed around for several years. With my decade of experience in the profession, I struggle to see where a mid-level practitioner like the proposed Veterinary Professional Associate (PVA) would improve access to veterinary medical care. I am against Proposition 129 and will be voting NO.
Here are some bullet points - but I have a more complete explanation below:
1) This proposition is driven by corporate entities who are looking to hire cut-price providers who are inadequately trained for a better profit margin.
2) Because of the incomplete/inadequate training of this position, I fear pets will suffer. They will be misdiagnosed and treated inappropriately (their cases will be mismanaged). Ultimately the patient will be worse off and it will be more work to go back and fix everything.
3) This does not address the underlying issue that the United States needs more fully licensed, full-time, and independent veterinarians. And we need them in rural areas most of all (livestock/production, equine, and small animals).
4) Having a mid-level practitioner will diminish the hard-won role of Registered Veterinary Technician (RVT) and choke out the already tried and tested credentialing process of Veterinary Technician Specialists (VTS). These are programs that provide great relief to veterinarians - increasing the quality of patient care and allows a provider to serve a greater number of patients. (See more below)
5) These positions are subject to working under veterinary supervision meaning they cannot practice on their own and they cannot practice outside of the state of Colorado. These individuals will have spent ~$80,000 to get a master's degree that they can’t leave the state with. This may put a student in a vast amount of debt without adequate employment opportunities.
Explanation:
The dynamics of the veterinary healthcare industry is changing and has rapidly changed since COVID. The debt-to-income ratio for graduating veterinarians has never been good (meaning new vets have a lot of student debt ~$250-320K compared to their starting salaries) and it is unfortunately getting worse.
Now, corporate entities are buying up privately owned veterinary practices and offering higher starting salaries to new graduates and these new graduates are taking these positions as a way to pay off massive debt. These corporate positions tend to be in urban areas. Thus newly graduated veterinarians are not coming to rural areas and there aren’t as many opportunities to buy a practice.
The United States has a massive need for veterinarians. Our community feels that need even more in our rural areas. Several schools are doing their best to educate the next wave of veterinary professionals by increasing class sizes and opening new schools (Utah and Arizona both have new schools and Texas has just opened their second one).
Proposition 129 is a smoke and mirrors pseudo solution to a real problem. Having a mid-level practitioner to practice under a veterinarian doesn’t help if there aren’t enough veterinarians to hire them.
The proposed PVA (programs of which are not set up yet - and unknown on how soon they will be running) will obtain a master’s degree (two-year degree) after their bachelor's degree (4-year degree). The PVAs are intended to see patients and act independently with a truncated education but the ultimate responsibility falls to the supervising veterinarian. These PVAs are not intended to perform surgery out of school but there is already talk of doing online training to perform surgeries. This can’t alleviate a veterinarians plate or allow them the ability to expand services to more patients when they are constantly having to review a PVAs actions.
So we are looking at having a 6-year trained PVA compared to an 8-year trained veterinarian. I cannot imagine why a motivated student would choose to go to school for two fewer years and give up their autonomy for their entire career. Someone who will act independently in the exam room and surgical suite but be subordinate to a supervising licensed veterinarian.
In addition, there is already so much to learn in veterinary medicine. It is impossible to learn what is needed in the four years we are trained. It is becoming much more common to do a postgraduate internship (rotating through different specialties and emergency practice) before entering practice. How can we create a competent provider (PVA) with only two years of training (in my mind the 4-year bachelor’s program is academic and science-based but does not help you to become a provider).
My worries are that things will be missed. Things will be misdiagnosed. Things will be treated incorrectly. And the loved pets will be the ones suffering for it.
Now the other side of the coin is that, I believe, this proposal will diminish the role of Registered Veterinary Technician (RVT). The title of RVT became a protected term as of last year. The state of Colorado has limited the term ‘technician’ to a person who has gone through all of the regulatory agencies and passed the credentialing process to use the title RVT. Anybody who is not an RVT cannot refer to themselves as a technician - the correct term would be: assistant, veterinary assistant, or certified veterinary assistant (CVA) if they have the proper certification.
Traditionally an RVT is a 2.5 year associate's degree (four semesters + 1 semester clinical internship). They are registered with the state of Colorado and have a defined role and scope of practice. An RVT who has been in practice for 5-6 years and has enough experience in a specific role can become a Veterinary Technician Specialist (VTS). I have worked with so many VTSs in vet school and during my internship. These individuals are a wealth of experience and knowledge. Some VTS categories include Dentistry, Anesthesia, Critical Care, Internal Medicine, and Clinical Practice (Large Animal/Production, exotic, and Canine/Feline practice).
As a whole - our RVTs are underutilized and our VTSs are drastically underutilized - essentially an untapped resource of highly dedicated and knowledgeable individuals.
I think it is a mistake to create an entirely new position (untested, undeveloped, unknown) that doesn’t solve the problem of the veterinary shortage. And then continue to ignore programs (RVT and VTS) that remain underutilized and undervalued. These programs and credentialing processes are established (already up and running) and are tested (we have had VTS in vet med for decades). I think we should raise these dedicated individuals instead of squash them down by adding unnecessary and incompletely trained providers.
Sincerely,
William T. Brock, DVM, DABVP (Canine/Feline Practice) and Vibrant Pet Animal Hospital Team
The idea of a mid-level practitioner in veterinary medicine has been tossed around for several years. With my decade of experience in the profession, I struggle to see where a mid-level practitioner like the proposed Veterinary Professional Associate (PVA) would improve access to veterinary medical care. I am against Proposition 129 and will be voting NO.
Here are some bullet points - but I have a more complete explanation below:
1) This proposition is driven by corporate entities who are looking to hire cut-price providers who are inadequately trained for a better profit margin.
2) Because of the incomplete/inadequate training of this position, I fear pets will suffer. They will be misdiagnosed and treated inappropriately (their cases will be mismanaged). Ultimately the patient will be worse off and it will be more work to go back and fix everything.
3) This does not address the underlying issue that the United States needs more fully licensed, full-time, and independent veterinarians. And we need them in rural areas most of all (livestock/production, equine, and small animals).
4) Having a mid-level practitioner will diminish the hard-won role of Registered Veterinary Technician (RVT) and choke out the already tried and tested credentialing process of Veterinary Technician Specialists (VTS). These are programs that provide great relief to veterinarians - increasing the quality of patient care and allows a provider to serve a greater number of patients. (See more below)
5) These positions are subject to working under veterinary supervision meaning they cannot practice on their own and they cannot practice outside of the state of Colorado. These individuals will have spent ~$80,000 to get a master's degree that they can’t leave the state with. This may put a student in a vast amount of debt without adequate employment opportunities.
Explanation:
The dynamics of the veterinary healthcare industry is changing and has rapidly changed since COVID. The debt-to-income ratio for graduating veterinarians has never been good (meaning new vets have a lot of student debt ~$250-320K compared to their starting salaries) and it is unfortunately getting worse.
Now, corporate entities are buying up privately owned veterinary practices and offering higher starting salaries to new graduates and these new graduates are taking these positions as a way to pay off massive debt. These corporate positions tend to be in urban areas. Thus newly graduated veterinarians are not coming to rural areas and there aren’t as many opportunities to buy a practice.
The United States has a massive need for veterinarians. Our community feels that need even more in our rural areas. Several schools are doing their best to educate the next wave of veterinary professionals by increasing class sizes and opening new schools (Utah and Arizona both have new schools and Texas has just opened their second one).
Proposition 129 is a smoke and mirrors pseudo solution to a real problem. Having a mid-level practitioner to practice under a veterinarian doesn’t help if there aren’t enough veterinarians to hire them.
The proposed PVA (programs of which are not set up yet - and unknown on how soon they will be running) will obtain a master’s degree (two-year degree) after their bachelor's degree (4-year degree). The PVAs are intended to see patients and act independently with a truncated education but the ultimate responsibility falls to the supervising veterinarian. These PVAs are not intended to perform surgery out of school but there is already talk of doing online training to perform surgeries. This can’t alleviate a veterinarians plate or allow them the ability to expand services to more patients when they are constantly having to review a PVAs actions.
So we are looking at having a 6-year trained PVA compared to an 8-year trained veterinarian. I cannot imagine why a motivated student would choose to go to school for two fewer years and give up their autonomy for their entire career. Someone who will act independently in the exam room and surgical suite but be subordinate to a supervising licensed veterinarian.
In addition, there is already so much to learn in veterinary medicine. It is impossible to learn what is needed in the four years we are trained. It is becoming much more common to do a postgraduate internship (rotating through different specialties and emergency practice) before entering practice. How can we create a competent provider (PVA) with only two years of training (in my mind the 4-year bachelor’s program is academic and science-based but does not help you to become a provider).
My worries are that things will be missed. Things will be misdiagnosed. Things will be treated incorrectly. And the loved pets will be the ones suffering for it.
Now the other side of the coin is that, I believe, this proposal will diminish the role of Registered Veterinary Technician (RVT). The title of RVT became a protected term as of last year. The state of Colorado has limited the term ‘technician’ to a person who has gone through all of the regulatory agencies and passed the credentialing process to use the title RVT. Anybody who is not an RVT cannot refer to themselves as a technician - the correct term would be: assistant, veterinary assistant, or certified veterinary assistant (CVA) if they have the proper certification.
Traditionally an RVT is a 2.5 year associate's degree (four semesters + 1 semester clinical internship). They are registered with the state of Colorado and have a defined role and scope of practice. An RVT who has been in practice for 5-6 years and has enough experience in a specific role can become a Veterinary Technician Specialist (VTS). I have worked with so many VTSs in vet school and during my internship. These individuals are a wealth of experience and knowledge. Some VTS categories include Dentistry, Anesthesia, Critical Care, Internal Medicine, and Clinical Practice (Large Animal/Production, exotic, and Canine/Feline practice).
As a whole - our RVTs are underutilized and our VTSs are drastically underutilized - essentially an untapped resource of highly dedicated and knowledgeable individuals.
I think it is a mistake to create an entirely new position (untested, undeveloped, unknown) that doesn’t solve the problem of the veterinary shortage. And then continue to ignore programs (RVT and VTS) that remain underutilized and undervalued. These programs and credentialing processes are established (already up and running) and are tested (we have had VTS in vet med for decades). I think we should raise these dedicated individuals instead of squash them down by adding unnecessary and incompletely trained providers.
Sincerely,
William T. Brock, DVM, DABVP (Canine/Feline Practice) and Vibrant Pet Animal Hospital Team
Please click the images below to learn more about proposition 129
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