The debate on midlevel practitioners in veterinary medicine is heating up
The veterinary industry is facing significant challenges as demand for pet care in underserved areas rises and the availability of licensed veterinarians struggles to keep pace.
In response to accessibility challenges, some advocates have proposed creating midlevel veterinary practitioner roles, similar to nurse practitioners or physician assistants in human healthcare. Proponents argue these roles could expand access to veterinary care, particularly in underserved areas, by handling routine cases and easing the workload on licensed veterinarians.
However, not everyone is in favor of this approach. The American Animal Hospital Association (AAHA) has taken a firm stance against midlevel practitioners, citing potential risks to patient safety, regulatory complexities, and negative implications for credentialed veterinary technicians.
For veterinary professionals, the impact of this proposed role could vary.
How could midlevel roles affect your team's responsibilities, job security, and patient outcomes?
What does it mean for maintaining the standard of care that clients expect and pets deserve?
Do you know where you stand on the issue yet?
What are midlevel veterinary practitioners?
Midlevel veterinary practitioners are a proposed role aimed at bridging the gap between credentialed veterinary technicians and fully licensed veterinarians. Similar to nurse practitioners and physician assistants in human medicine, they would be trained to handle specific medical responsibilities under the supervision of a licensed veterinarian. Advocates believe midlevel practitioners could help address localized shortages of veterinary care providers, allowing clinics to see more patients and improve service accessibility in areas where veterinary resources are limited.
The scope of responsibilities for midlevel practitioners would likely include diagnosing common conditions, developing treatment plans, and performing minor surgical procedures. However, unlike veterinarians, these practitioners would not undergo the extensive education and training required for veterinary licensure.
This difference in training is at the heart of AAHA's concerns, raising questions about how these roles would be regulated and how their inclusion might impact the overall standard of care in veterinary practices.
Why the role is being considered in veterinary medicine
The push for midlevel veterinary practitioners is driven by several challenges facing the industry.
Workforce shortages
Demand for veterinary services is outpacing the number of licensed veterinarians available. This imbalance leaves many clinics stretched thin, resulting in longer wait times and overworked staff.
Access to care in underserved areas
Rural and underserved communities face a significant lack of veterinary care, which can delay treatment and impact animal health. Advocates believe midlevel practitioners could provide basic care and fill critical gaps where full-time veterinarians are scarce.
Easing the workload
By handling routine cases and procedures, midlevel practitioners could free licensed veterinarians to focus on more complex cases, potentially improving the overall efficiency of clinics.
Proponents argue that these roles could bring tangible benefits, such as:
Reduced wait times for appointments
Increased appointment capacity
Improved client satisfaction
However, while the idea aims to solve these pressing problems, it comes with potential trade-offs that need careful evaluation, which is why the AAHA is voicing its concern.
AAHA's concerns with midlevel practitioners
The American Animal Hospital Association (AAHA) outlined clear reasons for opposing the introduction of midlevel veterinary practitioners. Its primary concerns center around patient safety, regulatory issues, and the potential devaluation of existing veterinary roles.
Patient safety and quality of care
The AAHA emphasizes that midlevel practitioners would not receive the same comprehensive education and training as licensed veterinarians. This discrepancy could lead to:
Misdiagnoses or inappropriate treatment plans
Increased risk of surgical errors
Higher liability for practices if mistakes occur under the supervision of licensed veterinarians
Regulatory and licensing complications
Implementing midlevel roles introduces a complex layer of regulatory challenges. The AAHA highlights:
Potential delays in emergency care due to ambiguous role definitions
The absence of a standardized licensing framework
Uncertainty around prescriptive authority and competency checks
Impact on credentialed veterinary technicians
One of the most significant concerns is how midlevel roles could affect credentialed technicians. The AAHA points out that:
Retention issues could worsen as career paths become less clear
Technicians could see reduced recognition and compensation
In its statement, the AAHA stressed that the best way to increase the capacity for care is to invest in enhancing the roles of credentialed veterinary technicians in a team-based approach.
Its position aligns with organizations such as the American Veterinary Medical Association and the American Association of Bovine Practitioners, who also share similar concerns.
Impacts on vet practices -
potential benefits and risks
The introduction of midlevel veterinary practitioners could have significant implications for vet practices, both positive and negative. Understanding these impacts helps clinic owners and staff prepare for what changes might mean in their day-to-day operations.
Potential benefits:
With midlevel practitioners handling routine cases, vet practices could see more patients, reducing wait times and improving client satisfaction.
By delegating less complex procedures to midlevel staff, veterinarians might be able to focus more on high-priority or complex cases.
For clinics in underserved or rural areas, midlevel roles could provide a more feasible staffing solution, ensuring that pets receive timely treatment
Risks and challenges:
Practices would need to navigate the legal and professional responsibility of overseeing midlevel practitioners, which could increase liability.
Without the extensive training that veterinarians undergo, midlevel practitioners may not have the skill set to manage unexpected complications or nuanced cases, which could compromise care standards.
Vet practices may need to adjust protocols, training, and workflow to integrate midlevel practitioners effectively, which could be time-consuming and costly.
There’s a risk of creating role confusion, especially among credentialed veterinary technicians, who may find their responsibilities overlapping with midlevel practitioners, potentially leading to job dissatisfaction and retention challenges.
While the potential benefits aim to address capacity and accessibility issues, the risks raise important questions about how such changes could affect the quality of care, staff dynamics, and practice operations.
How the AAHA believes credentialed veterinary technicians can fill the role
Credentialed veterinary technicians help deliver high-quality patient care and support the efficiency of veterinary practices. Their roles are multifaceted and often extend beyond basic support functions, encompassing:
Monitoring patients during procedures
Assisting with diagnostics
Client communication and education
Despite their critical contributions, credentialed technicians often face challenges such as limited recognition and constrained career advancement. AAHA argues that investing in their development through better training, compensation, and expanded responsibilities could address capacity concerns more effectively than introducing midlevel practitioners.
Why supporting credentialed technicians is a smart strategy, according to the AAH
Increased job satisfaction
Providing opportunities for growth and recognition can lead to higher retention rates and a more motivated workforce.
Enhanced patient care
A team that fully leverages the expertise of credentialed technicians can deliver more comprehensive and effective care.
Stronger team dynamics
Clearly defined roles that recognize technicians' contributions help foster better collaboration and reduce confusion within the practice.
AAHA and other organizations advocate for strengthening the defined role of credentialed technicians as a sustainable way to expand care capacity without the potential pitfalls of midlevel practitioners.
Broader industry implications and alternative solutions
The debate around midlevel veterinary practitioners reflects broader challenges in the veterinary field. Workforce shortages, high demand for care, and limited access in underserved areas are all issues pushing the industry to find new ways to meet client needs without compromising care standards.
Key industry challenges include…
The demand for services is outpacing the supply of licensed veterinarians, leading to overburdened staff and longer wait times.
Rural and less-served regions often struggle with inadequate access to timely veterinary treatment, affecting animal health outcomes.
High workloads contribute to burnout, affecting job satisfaction and retention among veterinary professionals.
While midlevel practitioners have been proposed as a solution, AAHA and other organizations believe there are alternative paths that could address these issues more effectively:
Potential alternative solutions include…
1. Telemedicine expansion. Leveraging technology to consult with clients remotely can help reach more patients and reduce clinic strain.
2. Advanced training for technicians. Enhancing the roles of credentialed technicians with specialized training and responsibilities could help meet the demand without the regulatory and quality concerns linked to midlevel practitioners.
3. Incentives for rural practice. Financial incentives or loan repayment programs could encourage veterinarians to work in underserved areas, improving care access where it’s most needed.
4. Improved clinic efficiency. Implementing better scheduling, task management systems, and support tools could optimize practice operations, allowing existing teams to handle more cases effectively.
Balanced perspectives from industry organizations
The debate over midlevel veterinary practitioners has garnered attention from several influential organizations, each weighing in with differing perspectives on the potential impacts on veterinary care and practice dynamics.
Organizations opposing midlevel roles
American Animal Hospital Association (AAHA)
AAHA has taken a firm stance against the midlevel role, citing concerns about patient safety, regulatory complexities, and the impact on credentialed veterinary technicians. The association argues that the risks of undertrained practitioners compromising care quality outweigh the potential benefits.
American Veterinary Medical Association (AVMA)
The AVMA supports AAHA’s position, emphasizing that any new role in veterinary care must meet rigorous training and licensing standards. They express concern that midlevel practitioners without comprehensive oversight could lead to increased liability for supervising veterinarians and potential harm to patient care.
Organizations supporting or open to midlevel roles
National Association of Veterinary Technicians in America (NAVTA)
NAVTA has expressed openness to the concept of midlevel practitioners, suggesting that if implemented with a robust training framework and clear regulatory guidelines, such roles could help address the industry’s workforce shortage. NAVTA emphasizes the need for collaboration in defining the scope and educational requirements to maintain high standards of care.
Veterinary associations focused on access to care
Some regional veterinary groups, particularly those working in rural and underserved areas, have shown support for exploring midlevel roles as a means to bridge care gaps. These organizations argue that with the proper structure, midlevel practitioners could extend care to areas struggling with limited veterinary resources, thereby improving animal health outcomes.
Despite differing opinions, most organizations agree that…
Patient safety is paramount. Any role must ensure the quality of care meets current standards and that animal health is not compromised.
Regulatory clarity is needed. Clear guidelines around licensing, oversight, and scope of practice are crucial for any new role to function effectively without causing confusion or added liability.
Support for credentialed technicians. There is consensus that strengthening the role and career path of credentialed veterinary technicians is a necessary and effective strategy to enhance practice capacity and care quality.
Understanding the official positions helps veterinary professionals and practice owners evaluate how the potential introduction of midlevel practitioners could impact their clinics. While the debate continues, it’s clear that any shift in the structure of veterinary teams must be handled with a balance of innovation, regulation, and respect for the roles already in place.
Sources
AAHA | AAHA opposes mid-level practitioner role in veterinary medicine
AMVA | Opposing midlevel practitioner proposals
Today’s Veterinary Business | AAHA Opposes Midlevel Practitioner Role
AMVA | Veterinary groups say “No” to midlevel practitioner position
Colorado Public Radio News | Proposition 129: Establish position of Veterinary Professional Associates, explained