Tech Talk: Is there really a veterinary technician shortage? A profession in crisis

Editor’s Note: Welcome to Tech Talk, a bimonthly column by NAVTA president Ed Carlson. Future columns will explore possible explanations for the veterinary technician shortage, underutilization, and improper use of veterinary technicians and assistants, along with potential strategies to address these issues. If you have questions or ideas for future columns, please comment below. Ed Carlson is the current 2021 NAVTA President; he was also the recipient of the NAVTA 2019 Technician of the Year award. Is there really a shortage of veterinary technicians? According to the U.S Department of Labor, the number of veterinary technicians/technologists employed is 91,297.1 Is this an accurate number of credentialed veterinary technicians? Are all of these individuals graduates of an accredited veterinary technology college program? Unfortunately, no statistics are provided for the number of veterinary assistants employed or other individuals working in a veterinary technician capacity. Given these numbers are of individuals self-reporting as veterinary technicians, it is doubtful it represents only credentialed veterinary technicians. So, does this make a difference? Ongoing issues with the profession The veterinary technician profession continues to grapple with such issues as lack of job satisfaction, low wages, lack of professional respect, limited career advancement, and veterinary technician underutilization. Results from multiple surveys conducted over the past 30 years support these trends Through grant funding, NAVTA (an association formed to represent veterinary technicians on the issues affecting their careers) has conducted several surveys to obtain a more complete picture from veterinary technicians about their jobs, employment, continuing education opportunities, and suggestions for improving the veterinary technician profession. The first national survey regarding the profession of veterinary technologists was conducted in 1991—30 years after the first veterinary technician college program was offered at SUNY/Delhi. (See below, “A short history of veterinary technology.”) Of those who responded, 88 percent strongly agreed or agreed that veterinary technicians are extremely underpaid resulting in individuals leaving the profession with 95 percent indicating the general public does not understand the role of the veterinary technician. According to responses to the 1992 NAVTA survey, the four greatest concerns of veterinary technicians include: low salary (88 percent of respondents agreed with the statement: “veterinary technicians are so underpaid that the feasibility of staying in the profession is declining”); lack of career advancement, lack of employment benefits, lack of professional recognition, noting specifically that “the variety of terminology used across the country to identify veterinary technicians contributes to this.”3 “Inadequate compensation and ineffective utilization begins at the top when veterinarians perform both their duties and those better delegated to technicians. The cycle continues with the technician performing technical tasks and those of the assistant,” wrote R. David Brunner, DVM.4 NAVTA saw the issue as so alarming that it made headlines on the cover of the June 1995 NAVTA News as “Profession in Crisis, Veterinary Technicians Caught in a Vicious Circle.”5 It is of great concern these same issues continue. The 2016 NAVTA Demographic Survey reported that “the top 6 most significant problems that face individuals as credentialed veterinary technicians include low income, burnout, lack of recognition and career advancement, the underutilization of skills, and the competition with on-the-job trained technicians.”6 This survey also revealed most veterinary technicians work 30-40 hours per week (43 percenm), followed by 40-50 hours per week (37.6 percent). Full-time veterinary technicians reported a salary between $15-$20 per hour (44 percent); part-time technicians reported earning $14-$16 per hour (29 percent). Therefore, even veterinary technicians paid at the top of this reported pay scale live only slightly above the poverty line.7 Creating a task force To address the ongoing issues with the profession of veterinary technology, the AVMA Task Force on Veterinary Technician Utilization was formed in May 2019. The task force consisted of 10 voting members, nominated by the organizations they represented and appointed by the AVMA Board of Directors. They include: A credentialed veterinary technician A veterinary technician member of the NAVTA Committee on Veterinary Technician Specialties (CVTS) A NAVTA executive board member A veterinarian representing the Association of Veterinary Technician Educators Representative (AVTE) One veterinarian member and one veterinary technician member of the Committee on Veterinary Technician Education and Activities (CVTEA) A veterinarian member of the Council on Veterinary Service (CoVS) A representative of the Veterinary Hospital Managers Association A veterinary technician representing the American Association of Veterinary State Boards Veterinary Technician National Exam (VTNE) Committee Representative One at-large member veterinarian practitioner The voting members serving on the task force were all either AVMA or NAVTA members. The task force also consisted of nonvoting members, four AVMA consultants, three external consultants, an AVMA House of Delegates liaison, and an AVMA board of directors’ liaison. The task force was directed “to develop a plan to improve veterinary technician utilization while recognizing the profession’s challenges of financial and career sustainability, effective task delegation, and the wellbeing of both the veterinary technician and the practice.”7 The task force provided a 22-page report to the AVMA board at the end of December 2019. The report has not been made available to the public as of February 2021, however, a summary of the task force recommendations was published in the Journal of the American Veterinary Medical Association (JAVMA) January 2020 issue. A short history of veterinary technology Before any formal educational programs, individuals providing medical care for animals, like most, if not all medical professions (human and animal), began with experiential learning.6 Often, trial and error, experimentation, and apprenticeship-type learning, was eventually followed by formal education. The U.S. Air Force developed an animal technician-training program for enlisted Air Force members in 1951. The first civilian educational program was established by the State University of New York at Delhi in 1961. In 1972, the American Veterinary Medical Association (AVMA) Council of Education established the first accreditation procedures for animal technician programs. In 1973, Michigan State University and Nebraska Technical College were the first animal technician educational programs to receive accreditation by the AVMA. In 1981, the North American Veterinary Technician Association (AVTA) was formed to represent all veterinary technicians. The name has since changed to the National Association of Veterinary Technicians in America (NAVTA), an organization that works closely with the AVMA to protect, support, and promote the profession of veterinary technology. However, it wasn’t until 1989 that the AVMA officially approved the term “veterinary technician.” Following the July 1989 action of the House of Delegate at the Annual Meeting of the AVMA, which changed the nomenclature from that of “animal technician” to “veterinary technician,” and in recognition of the advancements and changes in the scope of function and activities of technicians in the multi-faceted fields of veterinary medicine, and at the direction of the AVMA/NAVTA Liaison Committee, the following was approved as the official AVMA policy on veterinary technology: “The AVMA recognizes the able assistance of the veterinary technician as an integral and valuable component of veterinary medicine in the United States and urges the utilization of veterinary technicians whenever possible in veterinary research, regulatory and health care activities. “Veterinary technology” is the science and art of providing professional support service to veterinarians in the practice of their profession. A “veterinary technician” is a person who has graduated from a two- or three-year AVMA-accredited program in veterinary technology. A “veterinary technologist” is a graduate of a four-year AVMA-accredited program and who holds a baccalaureate degree from such study.” A license to practice became required over time for all other medical professions (i.e., doctors, nurses, dentists, dental hygienists, physical therapists, etc.), all requiring a college degree, plus the successfully passing of a state and/or national exam to obtain a legally required license. However, there is no legal requirement in some states to work in a veterinary technician’s capacity. In some states, a license is required to be referred to as a veterinary technician’ a Registered Veterinary Technician (RVT), a Licensed Veterinary Technician (LVT), as a Licensed Veterinary Medical Technician (LVMT), or as a Certified Veterinary Technician (CVT). In those states that mandate such a requirement, anyone, with or without education, training, or experience, may legally perform all the same tasks, duties, and medical procedures as those with a credential. Some of the important highlights of the task force recommendations include: Education The AVMA should conduct a census of credentialed veterinary technician staff at AVMA Council on Education-accredited veterinary colleges. The COE, in consultation with the CVTEA, should establish a requirement for the use of credentialed veterinary technicians in veterinary teaching hospitals at COE-accredited veterinary colleges. The COE should encourage COE-accredited veterinary colleges to develop or host accredited programs in veterinary technology in consultation with the CVTEA. The AVMA and COE should utilize and promote the use of consistent and correct nomenclature throughout promotional and educational materials, demographic studies, and accreditation documents to clarify that a “veterinary technician” is a graduate of a CVTEA-accredited program in veterinary technology who has passed the Veterinary Technician National Exam and any relevant state examination required to obtain and maintain credentialing as a veterinary technician. The AVMA should produce and promote educational products targeted at veterinarians that highlight the value credentialed veterinary technicians bring to practice, including increased profitability and practice efficiency, and that demonstrate how increased utilization of credentialed veterinary technicians can be implemented in practice. The AVMA should launch an ongoing public relations campaign to educate the public on the education required to become a credentialed veterinary technician, the credentialed veterinary technician’s role on the veterinary health care team, and the continuing education required to legally maintain the credential and provide high-quality patient care. The AVMA should create a “seat at the table” that fully acknowledges the model of the veterinary health care team by adding credentialed veterinary technician members to the AVMA House of Delegates and additional volunteer entities. The AVMA should mirror NAVTA associate memberships available to veterinarians by establishing an AVMA associate membership available to credentialed veterinary technicians. Licensing and regulation The AVMA, in collaboration with NAVTA and the American Association of Veterinary State Boards, should revise and align model practice acts and rules to define, recognize, and regulate the practice of veterinary technology. The AVMA should create written information and presentations to educate state veterinary boards, state VMAs, and state veterinary technician associations, and actively encourage all states to adopt credentialing requirements for veterinary technicians that include scope of practice and title protection. The AVMA should encourage states to eliminate alternative routes to credentialing, so-called “grandfather” clauses, from state practice acts. Economics The AVMA should partner with NAVTA and other leaders in veterinary technology to survey credentialed veterinary technicians annually or biennially using intentional terminology and clear descriptors to measure demographics, compensation, and utilization. The AVMA should conduct a study similar to the one conducted by the Ontario Association of Veterinary Technicians (OAVT) to demonstrate the value that well-utilized credentialed veterinary technicians add to practice income. The AVMA should evaluate the effect traditional benchmarks have on compensation of credentialed veterinary technicians and consider leading the discussion on establishing new metrics, key performance indicators, and benchmarks for practice management. The AVMA should examine other health professions for comparable practice models—(e.g., dental hygienists, nurse practitioners, and physician’s assistants)—and use that information to help drive improved utilization of credentialed veterinary technicians. The AVMA should expand surveys and investigations to include other categories of careers for credentialed veterinary technicians in areas such as equine medicine, production medicine, education, specialty practice, and consultation. Availability and attrition The AVMA should conduct a nationwide survey of veterinarians, using intentional terminology and clear descriptors, to determine how many credentialed veterinary technicians versus veterinary assistants are employed in various practice types. The AVMA should use existing and newly acquired data on the demographics of credentialed veterinary technicians to evaluate supply-and-demand issues. The AVMA should conduct a survey of credentialed veterinary technicians who have left veterinary medicine to determine why they left, how long they stayed, and what steps could be taken to decrease the rate of attrition. Wellness The AVMA should provide support for ongoing research on mental health issues for credentialed veterinary technicians and other members of the support team, such as veterinary assistants and customer service representatives. The AVMA should encourage inclusion and implementation of the AVMA Model Program for Wellness at the state level. The AVMA should collaborate with and support the NAVTA Wellbeing Task Force, collaborate with and support NAVTA in the creation of the Student Chapters of the National Association of Veterinary Technicians in America Wellbeing Committee, and encourage a partnership between the SCNAVTA Wellbeing Committee and Student AVMA Wellbeing Committee. The AVMA should expand the AVMA Wellbeing Summit to include issues specific to credentialed veterinary technicians and other support staff members. Community The AVMA should convene a summit with key stakeholders to assess the efficacy of efforts to improve utilization of veterinary technicians, aid planning for future efforts, and chart a path to optimize the model of the veterinary health care team. What brought the AVMA Task Force to these recommendations? Did the they get it right? What are other potential contributing factors and possible solutions? Future articles in this series will explore these and other questions, including examining the inconsistency in credentialing requirements and how this may be a root cause of the shortage the profession is experiencing today. Ed Carlson, CVT, VTS (nutrition) is the 2021 NAVTA President and has served on multiple NAVTA committees. He is also the Director of Technician Learning and Development for Ethos Veterinary Health and VetBloom. Ed is the President of the Massachusetts Veterinary Technician Association and the Treasurer of the New Hampshire Veterinary Technician Association. He obtained a VTS (Nutrition) in 2014 and lectures frequently at local, regional, and national veterinary conferences on a variety of nutrition topics. Ed was also the recipient of the NAVTA 2019 Technician of the Year award. Columnists’ opinions do not necessarily reflect those of VPN Plus+. REFERENCES U.S. Dept. of Labor. Employment and Earnings by Occupation. Veterinary technologists and technicians. https://www.dol.gov/agencies/wb/data/occupations (visited January 25, 2021). Navarre, A. P. and Decker, C.A. (1992). NAVTA News, 6(3). Increase your Salary by Utilization, Vet Technician, May 1993. R. David Brunner, DVM, How to Leverage Your Staff for Proficiency and Profitability, AVMA 1995 Convention Proceedings. 15-31,1995 NAVTA News, June 1995, Volume 9, No. 2. Task for Recommends Solutions for Technician Utilization. (January 2020). J of the American Veterinary Medical Association (JAVMA) News, https://www.avma.org/javma-news/task-force-recommends-solutions-technician-utilization (visited January 27, 2021). Task for Recommends Solutions for Technician Utilization. (January 2020). Journal of the American Veterinary Medical Association (JAVMA) News, https://www.avma.org/javma-news/task-force-recommends-solutions-technician-utilization (visited January 27, 2021).

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