Are we trying to solve the wrong problem?

Are there too few veterinarians? A simple question. But finding the answer is anything but easy. Let’s unpack this by first looking at some data I found surfing the interwebs.

?'Surveys of the profession suggest that around 15?000 (US) veterinarians will resign from their current employer each year and, approximately 10% of them will leave the profession.'

The U.S. class of 2022 graduated more than 3,000 veterinary students. Welcoming them to a profession where they are spoilt for choice when it comes to choosing their first job. Typically, an estimated 2,000 or so boomer (2.6%) veterinarians retire each year. But the Covid – 19 pandemic seemed to have accelerated that somewhat. Then there are those who leave clinical practice due to reasons other than retirement, also most likely accelerated by the pandemic. Surveys of the profession suggest that around 15?000 (US) veterinarians will resign from their current employer each year and, approximately 10% of them will leave the profession. Overall, the number of veterinarians working in private practice in the US today is just shy of 76,000, two-thirds of whom exclusively treat companion animals. Statistically, the ‘average’ US veterinarian is younger than 44 and female.

'However, the situation in the UK has been exacerbated quite considerably by Brexit..'?

Across the pond in the United Kingdom, around 1,000 veterinary students joined the profession this year. However, more than 10% of these graduates are overseas students unlikely to remain in the UK. The number of veterinarians currently employed in the UK is just under 28,000, 52% of whom are in small animal private practice. Looking at data published by the Royal College of Veterinary Surgeons (RCVS), 634 (2.3%) veterinarians changed their registration status from practising to non-practising in 2021, down from the record high 851 who did so in 2020. However, the situation in the UK has been exacerbated quite considerably by Brexit as well as the pressures brought on by the pandemic and the surge in pet ownership. Here the total number of veterinary surgeons joining the UK-Practising category minus the number who have left has fallen drastically since 2019, from 1180 to 269. Statistically, the ‘average’ UK veterinarian today is younger than 41 and female.

?'Animal Health Economics suggests the US will have a shortage of 15,000 veterinarians come 2030.'

As it stands, the nett number (the number joining minus the number leaving) of veterinarians joining the profession now falls short of the number of job vacancies in both the US and the UK. In fact, anecdotal data suggest this to be true for Canada, many of the countries in the EU, South Africa, Australia and New Zealand. Back in March this year, Mars Veterinary Health posted on their blog that their economists are predicting a jaw-dropping 33% increase in pet healthcare service spending over the next 10 years. What’s more, a report published by Animal Health Economics suggests the US will have a shortage of 15,000 veterinarians come 2030. That is despite the potential increase in veterinary graduates during this time.

But, a mere 9 years ago, an article with the headline ‘Too Many Indebted Veterinary Grads Chase Too Few Jobs’ appeared in Veterinary Practice News. In his opening lines, the author wrote: ‘In the year 2023, veterinary medicine will appear very different from the way it is now. I have felt for some time that we are training too many veterinarians for the number of available job openings.’ This article followed the publication of the AVMA Workforce Study in April of the same year in which a 12.5 per cent excess capacity in the profession was reported and, predicted could continue until 2025. Fair dues to the professor, his prediction for 2023 seems to have been spot-on! Veterinary medicine does appear to be very different from the way it was then. For one, practices are closing their doors today not because they are struggling to attract and retain clients, but because they are struggling to attract and retain staff.

The problem with forecasts like these is that they use data from the past to predict the future using models that, like all models, are usually wrong. There is a limit to how much past data can tell you about the future. Not a single model predicted a global pandemic ostensibly followed by a global recession, nor the profound impact Millennials and Gen-Z are having on the world and the workplace. No economist in the ‘animal health space’ predicted that veterinarians will demand working more sociable hours whilst pet owners will be referred to as ‘pet parents’ who demand higher standards of care for their ‘fur babies'.

'Because they focussed all their attention on getting rid of the poo rather than the horse.'?

But there is one further, maybe more significant problem with these forecasts: The unintended consequences of solving the wrong problem. Let me explain with this famous example dating back to the end of the 19th and start of the 20th century. In those days, the horse was tractor, truck, ATV, Land Rover and Range Rover. Large cities were dependent on horses for the transport of both people and goods. Thousands of horses! The problem of course was that all these horses produced huge amounts of manure. And the streets of nineteenth-century cities like London and New York were covered in it. Urban planners thought the mounting manure problem to be insurmountable. Writing for the Times in 1894, one reporter estimated that every street in London would be buried under nine feet of manure within five decades. Delegates from around the globe gathered in New York in 1898 at the first International Urban Planning Conference, convened to solve the Great Horse Manure Crisis. Although scheduled for 10 days, the conference was allegedly abandoned after three because no solution could be found. Why? Because they focussed all their attention on getting rid of the poo rather than the horse. By 1912, the seemingly insurmountable “Great Horse Manure Crisis of 1894” had been resolved. Thanks to Gottlieb Daimler and Henry Ford, horses had been replaced by motorised vehicles as the main source of transport of people and goods in cities all around the world.

In his penultimate sentence the author of ‘Too Many Indebted Veterinary Grads Chase Too Few Jobs’ questioned how ‘a scientifically trained profession [could] keep ignoring the facts of too many graduates chasing too few jobs with an ever-increasing debt burden’. Suggesting, as he did, that the veterinarians ‘should think about the ethics of encouraging young people to join a profession in which only a few will ever have financial freedom.’ Like many others at the time, it seems, he was only focusing on solving the wrong problem of too many veterinary graduates and too few jobs. The ‘scientifically trained profession’ as is often the case, got their predictions of the future spectacularly wrong. Imagine the profession today were his advice followed back then. Wouldn’t a better approach have been to ask what the profession needed to do to create more jobs and pay better wages?

Are there too few veterinarians? Is that the problem that needs solving and is opening more vet schools the solution? In the latest issue of Today’s Veterinary Business Bob Lester (I’m a huge fan btw!) concludes that: ‘The workforce shortage will continue to be the rate-limiting factor in our profession’s growth and ability to meet the needs of society.’ He posits (among others) opening more vet schools, increasing the numbers of students in each cohort and the number of annual intakes too (Ross University offers ‘3 flexible start dates’ for their AVMA accredited DVM program). Bob Murtaugh, DVM, MS proposes ‘doubling our veterinary school and graduate totals’ to be on par with the vet school to population ratio in Canada. Sure, but that will only solve the problem years from now.

?'The veterinary profession, to be sure, is failing in its role as an employer.'

The veterinary profession, to be sure, is failing in its role as an employer. Data published by the AVMA suggest the churn rate for veterinary doctors is twice that of medical doctors. Moreover, within five years after graduating, only one in three of our once optimistic and enthusiastic young colleagues would recommend becoming a veterinary surgeon and between 30% and 40% are contemplating leaving the profession altogether. A sad state of affairs really. More vet schools, bigger classes and more cohorts won’t fix that I’m afraid.

So, what are we to do?

Maybe we should:

• Bring veterinary workplace culture into the 21st century by investing time, effort and money in the team’s professional development and their financial, physical, and emotional wellbeing. Providing a distinctively great place to work will not only have a positive effect on staff turnover in our practices, but also have a positive effect on the number of veterinary professionals leaving the profession.
• Expand the scope of practice for veterinary nurses/technicians, enable them to work at the top of what is allowed by the relevant regulatory bodies and paying them well.
• Employ animal care / veterinary assistants and cleaners to free vet nurses/technicians to do what only they can do.
• Employ managers (and allow them to manage) and admin staff to support them.
• Improve efficiency by utilising technology. Clinical records on paper, kept in manilla file jackets belong in past, as does not operating an appointment system.
• Get rid of problem team members (yes, you read that right).
• Take time to employ the right people.
• Get rid of problem clients (yes, you read that right too).

Are there too few veterinarians? Probably. Is that the problem that needs solving and is opening more vet schools the solution? Maybe. Or we may read a newsletter in 2030 lamenting how there are too many veterinarians and too few jobs! But there are many things we can do now that will go a long way towards solving the veterinary workforce problem much quicker and at a fraction of the cost of opening more vet schools and doubling class sizes. Let’s first solve the problem of too many highly skilled talented people leaving the profession.?

I’ll leave you with this quote from Bob Lester with which I wholeheartedly concur: ‘My boomer generation’s legacy of work first, life second will thankfully be replaced by subsequent generations’ wisdom in putting life first, work second.’

Over to you.

To the 1343 subscribers, thanks for reading!

PS: Please feel free to share, copy and paste, or plagiarize my newsletter!

Links to three of my favourite Bob Lester DVM articles well worth reading:

https://todaysveterinarybusiness.com/employees-great-renegotiation/

https://todaysveterinarybusiness.com/technicians-and-technology/

https://todaysveterinarybusiness.com/a-shared-journey/

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