Q&A: Colorado legislator, veterinarian sees veterinary technicians as solution to workforce issues, not midlevel practitioner position

Colorado Rep. Karen McCormick

As a consequence of the COVID-19 pandemic, the veterinary profession has experienced a substantial fluctuation in visits from clients. Veterinary visits spiked in the early 2020s, when people were at home with their pets, had more opportunity to notice their health issues, and had more disposable income to spend on them as a result of the government's introduction of $5 trillion in stimulus money into the economy. The result was a tight veterinary labor market or "shortage."

More recently, there's been a slowdown in demand for veterinary services, according to the Veterinary Industry Tracker, with a 2.5% reduction in companion animal visits, year over year, compared with October 2023. At the same time, as a result of expansions in existing veterinary programs and the establishment of multiple new veterinary colleges-13 currently in various stages of development-there's a potential for a nearly 40% increase in new veterinarian graduates by the late 2020s and early 2030s.

While the veterinary labor market remains tight in some sectors of the veterinary profession (e.g., rural practice, academia, and some veterinary specialties), on a national scale, an ongoing general shortage of veterinary practitioners seems highly unlikely. In fact, some data suggest that the growth in supply of veterinarians is likely to outpace growth in the pet population, and potentially veterinary services spending, through 2035.

Yet, proponents of a ballot measure in Colorado who seek to create a new midlevel practitioner (MLP) of veterinary medicine claim that doing so is necessary to alleviate a generalized shortage of veterinarians.

Colorado Proposition 129 will ask voters whether the state should establish the position of veterinary professional associate (VPA). The VPA's duties would overlap those of a veterinarian and veterinary technician. Working under the supervision of a licensed veterinarian, they would be able to diagnose, prognose, and recommend treatment plans, including performing surgery.

Colorado voters will have their say on November 5. In the meantime, efforts are underway to educate the public on the potential implications of the ballot measure.

Colorado Rep. Karen McCormick, who is a veterinarian from Longmont, spoke with AVMA News about her thoughts on the ballot measure and why she believes leveraging credentialed veterinary technicians (CrVTs) and veterinary technician specialists (VTSs) is a much better way to support the effectiveness and sustainability of the veterinary workforce.

The following responses have been lightly edited for length and clarity.

Q. Is someone with a master's degree qualified to diagnose, prescribe, and do surgery?

A. The master's degree program being proposed has not gone through accreditation, nor is there any national exam or credentialing of it graduates. Therefore, I have to assume no. Doing surgery without a veterinary license or extensive training-and with most (of the master's degree) training being online-they're going to be woefully undertrained and unprepared to do any kind of surgery.

Also, we know there is a huge barrier to prescriptive authority with federal law. The Food and Drug Administration unequivocally says that only a licensed veterinarian can prescribe anything; it doesn't matter if it's onlabel or extralabel.

There's a good reason for the FDA to have these rules and regulations. The biggest reason is the protection of public health.

I find it hard to believe someone with only a master's degree and such limited hands-on training would be confident and competent to do surgery.

Q. Some people have suggested that MLPs could operate under protocols created by veterinarians. What's wrong with that?

A. When you picture what's happening in practice, you can imagine that the desire to follow the protocol may overcome or overwhelm what you're seeing and thinking about the animal that's in front of you. You might need a different course of action or additional thinking. Following a protocol sounds good, perhaps as a talking point, but in practice-when you think about how often a protocol can actually be followed without any changes to meet the needs of a particular patient-it's going to be a rare event.

The injustice ends up being to the animal and person who is financially responsible for the animal because they may or may not get what the animal truly needs. The pressure will be on to follow the protocol because that's all the MLP is allowed to do, whether it's the right thing to do or not. Any deviation from the protocol would require a veterinarian to step in.

In order for someone to be able to follow a protocol, they would need to be tethered to a veterinarian. In a way, to me it doubles the work for the veterinarian because you're having to trust that the person has enough knowledge and training to come to you with enough information, and if they want to deviate from the protocol, you have to ask questions. Who is cheated? The animal and the person.

Q. Some of the top complaints veterinary medical boards receive regarding veterinarians have to do with surgeries, so why have surgery done by less qualified people?

A. Surgeries and communication are among the top drivers for board complaints. We've all seen the proposed curriculum: a person would graduate with three semesters of online training, one semester in person, and an internship somewhere, which are not all standardized or equivalent.

There's no attempt to go through an accreditation process for the curriculum, so there's no collaborative conversation on what the courses will be, the training level-none of that has happened. This basically, to me, is a position that is being formed in a vacuum without important voices needed to know whether it's been done right or not. That's a big disservice to the public but even bigger to the animals, which is why we took the oath we took.

Q. Do you have concerns about the potential negative impacts an MLP program might have on existing educational programs awarding doctoral degrees in veterinary medicine?

A. Quite a few, actually. Number one, this is an incredible disservice and slap in the face to veterinary technicians and veterinary technician specialists. They are critical members of the veterinarian-led team. They are the folks with training, experience, and leadership skills who do and can fill the role of what this proposed VPA is being suggested to do.

We need more VTSs. A great opportunity is being lost here to increase our workforce in a way that allows more people to apply and achieve that credential. Right now, it's a self-driven program that's pretty intense. For most of the veterinary technician specialties, becoming a VTS requires graduating from an accredited program, a national examination, and continuing education requirements.

We don't have enough VTSs. In our state, there are only 60 to 70. If we work together to build up this profession that already exists, that will go a long way to alleviating the challenges we're facing. Creating a new profession that doesn't have the input of all that are in the profession right now is a big negative.

Plus, veterinary programs are already struggling to find faculty. I do hear from (Colorado State University College of Veterinary Medicine & Biomedical Sciences) that they don't have all the faculty they truly need right now, but they want to start a new program?

Q. What about the argument that creating this new position would help alleviate a veterinary shortage?

A. The veterinary shortage is a talking point behind this push. I think what really is behind the push is big corporate money trying to find innovative ways to grow the bottom line. The only group the VPA would benefit are large corporations trying to find ways to see more patients, get customers, and somehow lower their cost of doing business.

I don't see it as a benefit to anybody else. I don't see it helping a veterinary shortage at all. It's a barrier between the veterinarian and patients because one veterinarian supervising two to four people puts the veterinarian farther from the patients and dilutes the accuracy of the treatment. It doesn't cause clients to spend any less money, and they might not get an accurate diagnosis and medication right off the bat.

Q. What would help the veterinary profession in Colorado right now then?

A. Legislation we passed earlier this year was completely focused on increasing access to care while protecting the health and welfare of animals and making sure client and consumer protection issues were addressed.

One law is about defining, expanding, and promoting the use of veterinary telehealth in a way that is legal, helpful, and really allows veterinary clinics and practices to use teletechnologies in a way that benefits everyone involved and can save time and money when appropriate.

The other law is about expanding the veterinary technician's scope of practice with input from food animal producers, our animal shelters, our small animal veterinarians, and our RVTs and VTSs to do things that we know RVTs and VTSs are trained and competent to do.

This will help veterinary teams to use their full scope of expertise and to stretch the veterinary practice act in ways that makes sense where RVTs and VTSs are able to do more in the field of dentistry, wound care, and surgical assistance.

There's lots in that legislation that will pretty much fill any perceived gap between veterinarians and VTSs. It also acknowledges that RVTs and VTSs deserve to be recognized for skill sets they have.

We need to do everything we can to hang on to this workforce we have and develop them and compensate them for what they contribute to the veterinary team and the patients they treat. That way they can have higher job satisfaction and advance in their careers.

As someone mentioned back when we were having discussions two years ago, if veterinary teams are truly not composed of each and every person working to the full scope of training and competency, having another position in an inefficient model does not help at all and would potentially increase inefficiencies. That is not the answer. We have the answer and that is what we're all working toward: Increasing the number and skills of veterinary technicians in the profession and leveraging everybody so we're all humming along at the full speed.

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