Covid-19 pandemic magnifies workforce crisis in veterinary field
By Alec Snyder, CNN
Madison Vollbracht says she burned out after five years working as a veterinary technician.
Her work was already grueling before the Covid-19 pandemic — staff shortages, long hours, little pay and no overtime.
But the pandemic sparked a dramatic increase in pet adoptions, “Covid puppies and kittens,” as Vollbracht calls them, as well as a rise in inquiries about pet care, which greatly increased the workload.
Also, the mandatory lockdowns forced many people out of work, which meant some owners could no longer afford care for their pets, and in some cases, had to surrender or euthanize them.
The effects of the pandemic took a toll on Vollbracht. The vet tech says she “had more anxiety and depression than joy from the job,” even after changing clinics.
“There were a couple of days where everything was dying,” she says. “And it was around Christmastime. It was my first Christmas working emergency and it also happened (during) the pandemic and I had only discharged one patient that day. Everything else had been euthanized. And that was my, ‘I’m kind of done with this’ day. I euthanized 16 patients that day.”
That holiday season in 2020, she realized she’d had enough, and is now a veterinary assistant instructor at the Pima Medical Institute.
Approximately half of all vet techs burn out of the profession within their first five years and 35% of them burn out altogether.
Rise in adoptions strain veterinary clinics
Inquiries about pet adoptions increased 70% between March 2020 and March 2021, according to Petfinder.com spokeswoman Lorie Westhoff. And an ASPCA survey released in May 2021 shows that 90% of dogs and 85% of cats adopted during the pandemic were kept by their owners.
Millennials and Gen Zers are also adopting pets at higher rates than their predecessors, says Mark Cushing, a founding partner and the CEO of the Animal Policy Group. Because baby boomers are adopting fewer pets as they grow older, millennials and Gen Z adults now make up half of all pet owners, he says.
“Millennials, last year where they had or got one dog, they got two or had one dog and thought a cat might be fun,” he says. “People who are into it, they know how much fun it is and want to have a playmate for their pet when they go back to work.”
While an increase in pet adoptions is generally a good thing, it also means that veterinarians and vet techs have to see more patients, field more calls from pet owners, which sometimes result in delayed visits and care. Dr. Douglas Kratt, president of the American Veterinary Medical Association, tells CNN that a recent AVMA survey found that the average number of patients a veterinarian saw per hour was 25% lower in 2020 than in prior years, which means clients are waiting longer before their animals can be seen.
“This has also resulted in an increase in client wait times — our current data indicate an average 20-minute wait in 2020, up from 11 minutes in 2019,” Kratt says. “While the amount of time it takes to see each patient has increased, total veterinary visits in the United States do not appear to have gone up — according to national data compiled by the AVMA and VetSuccess, the number of veterinary visits in the United States was about the same in 2020 as compared with 2019.”
That number has remained about the same not because fewer people are trying to see their veterinarians; rather, it’s because there aren’t enough veterinarians to meet client demand. Dr. Karl Jandrey, associate dean for Admissions and Student Programs at the University of California, Davis, who also practices as an emergency critical care specialist, says that people working from home means they’re seeing problems with their pets that they wouldn’t have normally notice, leading to more calls with concern. It also means the shortage of veterinarians and vet techs has led to a need to stop taking new clients and squeezing others in.
“(You go from) not having enough prior — veterinarians and technicians — to even worse during the pandemic, where everyone else has to work harder and more,” he says. “Instead of having your average emergency shift, one patient every half-hour, you now have four every hour you’re trying to deliver care to. Something’s gotta give, right?”
Where are all the vet techs?
Andrew Maccabe, CEO of the American Association of Veterinary Medical Colleges, says that applications to graduate veterinary medicine programs increased by 19% this past cycle compared to the previous year. But for veterinary technicians, the promise of an enriching career is not as apparent, despite only requiring two years of schooling, and even less in some states.
Jennifer Serling, president-elect of the Association of Veterinary Technician Educators, tells CNN that 35% of all vet techs eventually “burn out,” while Cushing says that half of them leave the profession within five years. Vet tech educational retention is also down about five to 10%, Serling says, which she believes is “directly related to the pandemic.”
Cushing says that inadequate pay often leads vet techs to leave the profession. On average, he says, veterinary technicians are paid $32,000 a year, which is “close to the poverty level” in some parts of the country. That can be as much as half the starting salary of a registered nurse in human medicine, Serling adds.
Vollbracht tells CNN her highest pay as a vet tech “started with a $16” per hour and there were times when there were more veterinarians in her clinic’s emergency room floor than vet techs themselves.
“What started my burnout was really the money aspect and always being constrained with what we can do treatment-wise based on owners’ financial situations,” she says. “(I would go over) treatment plans and estimates with owners but (was) being constantly told ‘no’ or being belittled and berated for requiring such costs, in advance or at all, for certain things to be done and then not being able to do those things because they couldn’t be afforded.”
In addition to being underpaid, vet techs are also underutilized. Cushing says that half of vet technicians’ learned skills are often ignored, leading to decreased morale as veterinarians’ working dynamics with vet techs can be less delegated and collaborative than those in human hospitals and clinics.
“I’ll say publicly, if you chronically underpay someone, they’ll be looking to leave,” he says.
“If you’re trained to do it all and only do half, and you’re told by a veterinarian, ‘I’ll do the rest,’ you create a morale issue that is systemic across the profession.”
Serling points out that vet techs, unlike RNs and physician assistants, are responsible for providing care to “multiple species that can’t talk and tell us what’s wrong.” Unlike a hospital or a doctor’s office, which has specialty nurses and assistants for everything, veterinary technicians are required to do it all, and then some.
“We have the same training as an RN,” she says. “It’s not just the same things as them but anesthesia, radiology, (etc.). We do a lot of the human components of medicine combined into multiple species, so utilizing us fully is a huge plus to the practice (of veterinary medicine).”
That ubiquitous involvement in end-of-life care, which is more specialized in human medicine, also takes its toll.
“It’s both a blessing and a curse in that we can end our patients’ suffering with euthanasia but that does weigh heavily on the individuals and can be incredibly mentally taxing,” Serling says. “Early on, we get into this because it is a labor of love, not one we’ll get rich at doing. You love your patients, love animals and want to help them. When you get that emotionally attached and driven into this field, that can also be mentally taxing as well.”
Serling also points out that pet insurance is often not used, meaning that the expenses that hospitals and health care practices can largely bill to insurance companies have to be absorbed by the veterinary clinics, if not billed to the clients themselves.
“Until we’re able to charge appropriately for the services we’re providing, it’s going to be difficult for clinics and some vets (to afford their expenses),” she says. “Veterinarian salaries and the cost of all that, even that is significantly less than their MD counterparts. There’s a lot of catch-up to do so we’re earning what we deserve.”
How the field is trying to adapt
Maccabe says that one of the biggest causes for the perception, or reality, of a workforce shortage, is the inefficiencies caused by the pandemic. Covid-19 infection control procedures have slowed the ability of veterinarians and their health care teams to handle caseloads, and in a field that has long relied on direct, in-person care, it has caused extended waits on top of the added influx of pets.
On the educational side, Maccabe says that many virtual programs offering models and simulations for students to practice on have eased the burden the pandemic has placed on training future veterinarians. So, what are veterinary clinics doing? Some of them have adopted telehealth policies for visits in order to alleviate the burden caused by waiting for in-person care.
“With video conferencing available, even when people were taking their animals to clinics, they oftentimes had to drop the animal off, get a phone call or video call to see what the vet saw, right?” he says. “(For) how much of that did the animal need to be transported, whereas some could have been done at home? So that’s where I think every crisis like (the pandemic) drives innovation.”
Cushing says that veterinary medicine is a conservative field and that, on the whole, vets “don’t welcome change.” He says the field is about 25 years behind human medicine in terms of delegation of tasks and proper use of staff.
Some schools, such as Lincoln Memorial University, are starting to institute a middle ground master’s degree, akin to a nurse practitioner, that would allow for positive movement up the ladder. Cushing says it would help vet techs who may still not want to attend or can’t afford the schooling required to obtain a veterinary medicine degree to advance their careers.
The rewards aren’t just financial for veterinary professionals. Private equity firms are investing more money into veterinary clinics, Cushing says, after seeing how lucrative the field is. In order for them to feel like they can get a proper return on their investments, they want to see additional outlets to prevent the staff they’re invested in from burning out.
Serling says some of the improvements can take place in how clients approach their visits with veterinary staff.
“I think that owners do need to understand there are some incredible wait times right now,” she says. “It can be difficult to get appointments. Usually, surgeries can be scheduled within a couple of weeks, so two months out is very unusual.”
Generally speaking, though, Serling says revenue remains high enough that there should be enough money to go around to pay vet techs a higher salary.
“I think an increase in pay is the number one thing and I think technician utilization is the other,” she says. “I think training veterinarians to utilize us and our education (is key). There’s an AVMA study that says for every credentialed technician, they bring about a $90,000 to $100,000 increase in revenue per year. So utilizing us to the best of our ability (would change things).”
Maccabe says that despite the stresses of the pandemic, he believes necessary changes and progress in the field are on the horizon.
“I’m very optimistic about the future,” he says. “I think that as challenging as this last year and a half has been, not just for our community but society in general, … it has driven some changes to have a long-lasting impact to improve quality of teaching, care, and access in a way that might have been delayed or postponed for many years if not for this pandemic.”
