The Case for Veterinary Nurse Practitioners

We covered what a veterinary nurse practitioner’s role may include, as well as some of the most commonly heard pros and cons of adding this new role to the profession.

This week, we’re covering some additional pros and cons for discussion, as well as practical considerations for when and how this change may occur in vet med.

Read on to learn more…

Veterinary Technician Utilization and Career Growth 

It’s no secret that veterinary technicians are often underutilized and that their pay is often not up to the standards of their professional education and the crucial role that they play at a veterinary practice.

Many technicians note there is a “ceiling” for them in clinical practice—in terms of reaching new levels of professional satisfaction and an income that truly reflects their knowledge and hard work. 

As such, many vet techs leave the clinical side of the work they love in order to pursue management, teaching, or even an entirely new start in human medicine or another field. 

Many argue that a veterinary nurse practitioner option would help more techs stay in the field and be appropriately compensated while continuing to grow professionally.

On the other hand, many have pointed out that it may make more sense to fully utilize vet techs (and pay them a higher compensation) prior to creating a new role. 

In other words, if we don’t fix the current problems vet techs are facing, would those issues just be perpetuated in a new role?

Less of a Role for Veterinary Technicians

Those who don’t support the veterinary nurse practitioner movement point out that once this new role is created, there may be less of a need for traditional vet techs. 

These wonderful staff members may begin to feel underutilized, underappreciated, and underpaid next to their new nurse practitioner coworkers—since nurse practitioners would still be able to perform all the tasks a vet tech could.

Veterinarians Fully Utilizing Their Education versus Daily Routine Appointments

While a nurse practitioner role may help vet techs see their full professional potential, some argue it will carry the same benefit for veterinarians. 

If a vet’s time is freed up from repetitive daily wellness and minor issues appointments, they may be freer to pursue their own professional interests, such as dentistry, surgery, acupuncture, complicated internal medicine cases, or anything else they enjoy. 

Of course, many vets do enjoy daily interactions with clients for more routine appointments, so this may depend on personal preference.

And some worry that the loss of those daily, routine interactions could hurt their relationships with clients in the long-term—that they would only see clients when their pet is seriously ill, without a prior relationship.

Preventing Burnout Within the Profession

Many veterinarians and veterinary professionals have suffered from burnout and mental health concerns related to their careers. 

Some state that a veterinary nurse practitioner role can help the profession as a whole in this regard—by taking some of the extraordinary workloads off of veterinarians and delivering better workflow to the whole practice.

Also, allowing skilled veterinary professionals to receive fair compensation and derive more professional satisfaction could help with job satisfaction for the whole team, not just vets.

Consumer Expectations and Preferences

It’s been pointed out that veterinary medicine, in general, is slow to update to new technology and consumer preferences.

Some argue that veterinary nurse practitioners may be expected by pet owners in the near future, since that’s what people are used to for their own health care.

While many veterinarians and practice owners expect clients to stick to the practice’s way of doing things, history in many other industries has shown us that customers eventually do turn elsewhere when businesses fail to adapt to the times.

Distribution of Veterinary Services

Whether there is a national surplus or shortage of veterinarians, some parts of the country have faced a vet shortage in either climate—especially rural areas.

For this reason, some rural practitioners have voiced their support of the veterinary nurse practitioner, as it may be a way to distribute some of their caseloads even when they can’t find a DVM to hire.

Others argue that while nurse practitioners would be more affordable than a DVM, they would still be too expensive for some rural practices—and that these practices would be hurt in the long run because there would be fewer traditional vet techs overall for them to hire.

Liability

One serious concern to answer is who is legally responsible if a medical error occurs while a patient is under the care of a veterinary nurse practitioner?

If the veterinarian is liable, as is the case when an error occurs by a vet tech, this may make veterinarians reluctant to delegate.

When and How Could the Role of Veterinary Nurse Practitioner Be Created?

While there is much discussion about this topic right now, it could take quite a while for any serious changes to be made toward the creation of this new role.

Some of the roadblocks include the need for major changes to education and credentialing. 

Currently, many vet techs have an associate degree—which is much shorter than the length of time required to become a veterinarian. Supporters of the nurse practitioner role envision the degree being the equivalent of a master’s degree, so the education would be much more extensive.

Additional considerations include accreditation of any educational programs, as well as standardization for credentialing, continuing education, etc.

Also, there’s the matter of what the state laws allow vet techs to do at a veterinary practice. These laws would have to be changed, and that could take years and be very expensive.

What’s Next?

It’s been suggested that more data is needed to know if the nurse practitioner is really sustainable for the long-term (and not just a short-term need during the pandemic), and that it may take many years for this new role to be created.

On the other hand, at least one university is in the process of creating a master’s degree targeted to veterinary technicians.

There is certainly some appeal to the collaborative environment envisioned by supporters, with a healthier workload distribution to all employees while allowing the practice to provide high-quality care to more pets and bring in more revenue.

But while there may be benefits, it’s certainly necessary to continue discussing any potential downsides so that there is a realistic idea of how this new potential role could affect the profession as a whole.

Additional great sources of information include a recent podcast from Dr. Andy Roark

(https://drandyroark.com/vet-nurse-practitioners/ ),

and an article from VIN News Service (https://news.vin.com/default.aspx?pid=210&Id=10484775 ).

Written by: Dr. Tammy Powell, DVM

Does the Profession Need a Veterinary Nurse Practitioner?

A hotly debated topic in veterinary medicine right now is whether there is a need for a midlevel practitioner—a position comparable to a nurse practitioner or physician’s assistant on the human side of medicine. 

So, what are the arguments for and against this potential new veterinary career track? And what would be required for the role of veterinary nurse practitioner to be created?

This is what will discuss today, in the first part of a two-part series on midlevel practitioners in veterinary medicine…

What Is a Veterinary Nurse Practitioner?

A midlevel practitioner is someone whose scope of practice would be beyond that of a veterinary technician or nurse, but less than that of a veterinarian.

This idea has been floating around for at least a decade, if not longer. But the recent veterinarian and vet staff shortage during the pandemic may have spurred to the forefront of many vet professionals’ minds.

Right now, veterinary technicians are able to perform many of the tasks necessary for patient care. The exception is any part of the scope of practice that is limited to vets—diagnosing, prognosing, prescribing, and performing surgeries.

Creating a veterinary nurse practitioner would mean allowing these vet professionals to take on some of these roles that are currently restricted to veterinarians. 

Examples may include taking on wellness visits, diagnosing and prescribing treatment for minor ailments (ear infections, etc.), refilling chronic medications after checking bloodwork or performing minor surgeries such as uncomplicated dental extractions.

Of course, many tasks—including most surgeries and management of more in-depth medical cases—would continue to be reserved for licensed DVMs… 

The goal of this new role would be to take some of the routine daily tasks off the veterinarian’s hands, to free up the veterinarian and allow the practice to provide care to more patients.

What Are the Arguments For and Against Creating Veterinary Nurse Practitioners?

There are strong cases being made both for and against this new position within veterinary medicine. Here are some of the key points of the debate…

Access to Care 

Right now—as demand for veterinary care increased during the pandemic, while a shortage in vets and vet team members has left many practices struggling to keep up with that demand—many pet owners report challenges in receiving care for their pets. 

Clients are having difficulty scheduling appointments, often having to wait weeks to months for a wellness visit. And some practices have limited how many new clients they can see. 

Proponents of the veterinary nurse practitioner envision the role freeing up time for the vet, so that the practice can see more patients and clients. 

On the other hand, some state that a decision that could permanently affect the future of the profession shouldn’t be made because of circumstances that could be short-term.

In other words, is the increased demand for pet care during the pandemic going to stick around? Is it enough to fuel and support the new role of the veterinary nurse practitioners in the long term?

Availability of Jobs for Veterinarians

Right now, there is a veterinarian shortage. But not so many years ago, many complained of a surplus, which made veterinarians’ jobs harder to find with less competitive salaries.

Detractors of the veterinary nurse practitioner movement worry that in another few years, we could again be facing a surplus of vets. After all, ups and downs are natural in any industry.

Should that occur at any point in the future, there is a serious concern that veterinarians could be out of work because practices (especially corporate practices) may prefer to hire lower-salary nurse practitioners rather than DVMs.

Since nurse practitioners in human medicine have the right to open their own practice, there is also a potential concern of competition for veterinarians who are practice owners.

Cost of Care 

Even before staffing shortages occurred, the cost of care has been another hotly debated topic in veterinary medicine for many years. This is another important facet of access to care since many pet owners are unable to afford quality veterinary care. 

Some state that by providing a midlevel practitioner, a veterinary practice can expand its reach to more clients by offering affordable services (since a veterinary nurse practitioner would be paid less than a veterinarian), especially for wellness and minor ailments.

Supporters argue it would be the best of both worlds. In addition to the ability to offer affordable services, the new system would also increase the practice’s bottom line and provide fair compensation to all employees (since having a nurse practitioner would allow a practice to see a lot more patients per day and thus bring in more revenue). 

Also, the availability of nurse practitioners may decrease the need to hire relief vets for too many shifts, decreasing the practice’s overall operating costs. Of course, for relief vets, this would be a disadvantage.

Stay Tuned for More…

To cover this topic more in-depth, we’ll address more pros, cons, and considerations in next week’s article. 

In the meantime, hopefully, this has provided some food for thought. 

Whether the profession moves forward with creating a nurse practitioner role or not, the issue has opened discussions on many important topics currently facing the field of veterinary medicine. And those discussions are important to always improve, adapt, and to find solutions to keep the profession healthy and sustainable.

Written by: Dr. Tammy Powell, DVM