Are new measures being proposed in Colorado the answer to the state’s veterinary care problem?
Barbara Crimond | Jun 30, 2024 | Comments 0
A pair of measures, assuming they make it to the November ballot, could be the solution to solving Colorado’s shortage of veterinary care and improve access in rural communities, proponents say. The measures, which are both backed by Denver’s Dumb Friends League seek to increase veterinary telehealth services and create a new job title within veterinary clinics that would require a Master’s degree, instead of a Doctor of Veterinary Medicine degree.
Ballot initiative 144: Veterinary Telehealth
The first initiative seeks to overturn some of the provisions laid out in this session’s House Bill 1048, which was signed into law. That law mandates that veterinarians must conduct an in-office visit with a pet before offering telehealth services for that pet in the future. Dumb Friends League President and CEO Apryl Steele, a veterinarian, says ballot initiative 144 would remove the requirement for veterinarians to see a pet in an office before conducting telehealth consultations. “When 40% of visits are resolved over telehealth, and when people physically can’t get in because they live in veterinary deserts or they’re in rural areas of Colorado and they need help for their pets, to deny them the ability to get this care is not being appropriate for the animals’ needs or the people’s needs,” she said. “Not every medical condition can be addressed by telemedicine,” she said. ” Just like in human medicine, veterinary telehealth is only used in specific instances. Common issues that veterinarians can evaluate via telehealth include skin issues, upper respiratory disease, behavior problems, and intestinal issues.
Telehealth has evolved significantly due to COVID-19. ” In some cases it can even be a better way to evaluate a condition than an in-office visit, Steele said. “For lameness and limping, vets can actually see the animal walk in their normal environment, which is actually better than what you can do in a clinic, because they never walk normally in a clinic,” she said. “For behavior issues, they can watch the behavior situation, see if there’s a trigger and notice things that an owner can’t notice.”
While an in-office visit may sometimes be necessary after a virtual evaluation, allowing the initial appointment to be conducted virtually saves a trip to the vet for the 40% of pet owners whose issues are resolved through telehealth. “With telehealth, the initial steps would all be the same,” explained Steele. “If the animal didn’t improve, then they would say, ‘hey, you need to go be seen. This is not a typical situation and we need to do further diagnostics.’ So those things still would follow that same pattern.”
In opposition to the initiative, Representative Karen McCormick, a veterinarian who sponsored HB 1048, in a column in The Denver Post, defended HB1048 and argued against initiative 144, stating that the in-person requirement ensures telehealth is used as a supplement, not a replacement, for hands-on animal care. She and other critics worry that removing this requirement could lead to improper diagnoses and treatments, posing a danger to pets. They also express concerns about potential “pill mills” for human drugs if veterinarians are allowed to prescribe medication virtually.
Ballot initiative 145: Establish qualifications and registration for a veterinary professional associate
The initiative introduces the role of a veterinary professional associate, a position that will require a Master’s degree in veterinary clinical care or something similar. Similar to a physician’s assistant or nurse practitioner in human medicine, veterinary professional associates would have more training and duties than veterinary technicians, who hold bachelor’s degrees, but less than Doctors of Veterinary Medicine, who typically complete at least eight years of schooling. Colorado State University is on track to become the first school in the nation to offer a Master’s in veterinary clinical care, which will be a five-semester program. Lincoln Memorial University in Tennessee offers a similar program that’s only two and-a-half semesters; they have said they will adjust their program to align with CSU’s if it is approved. “There are veterinary schools and policymakers across the country watching what Colorado does with this, because they see the need,” Steele said, adding that CSU is facing “bullying” from veterinary trade associations, but she believes they will hold their ground and are expecting their first class of students to start in fall of 2025.
While trade associations generally disprove of the measure, Steele said she has spoken to a number of vet techs who have expressed interest in becoming a veterinary professional associate. “We’re hearing from them all the time about wanting to pursue this and be able to stay in the field that they love,” she said.
Opponents of 145, including Rep. McCormick, are concerned that animals will suffer because they will be cared for by individuals with lesser qualifications than Doctors of Veterinary Medicine. “This proposed role lacks the extensive clinical experience and verified competency required of registered veterinary technicians and veterinary technician specialists,” said the Colorado Association of Certified Veterinary Technicians. “The focus should be on utilizing existing veterinary professionals effectively rather than creating new roles.” Opponents like vet tech association also argue that the measure is redundant; this session’s House Bill 1047 already expanded the scope of practice for veterinary technicians to include procedures like dental extractions, suture removal, and reproductive ultrasounds.
The country is facing a critical shortage of veterinarians as pet ownership reaches record highs. According to a study conducted by the American Association of Veterinary Medical Colleges, over 75 million cats and dogs will go without veterinary care if no solution is found by 2030. “Even people that have existing relationships can’t get a timely vet appointment,” Steele said. “Emergency hospitals are shutting off accepting new patients at least on a weekly basis across the state. Emergency clinics are shutting down; there’s no emergency veterinary care in Pueblo anymore at all because they just can’t hire people So it’s super challenging and people are feeling that pain.” According to Steele, the pet owners seem to be overwhelmingly in favor of the measure. She said polling has shown 80% support for the measure and only 8% opposition. Both measures must receive just under 125,000 signatures by the end of July to qualify for the November ballot.
Article comprised of news published by ColoradoPolitics.com and The Denver Post
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ADDENDUM TO ARTICLE:
I sent the article to the two veterinarians I know best: my daughter, Jessica Christine, DVM, who practices in Columbus Ohio and Jeff Sarek, DVM, one of our personal veterinarians here in Colorado to get their thoughts.
Dr. Christine said “I have mixed feelings about adding in a new degree. I certainly see both sides to the argument of not enough veterinarians, short-lived careers for vet techs and too many pets/too much demand for our current structure”. She went on to say that she feels there are bigger systemic issues that adding a new degree won’t address, such as the huge financial burden of veterinary school and the difficulty with getting into those programs. “When we look at human medicine vs. veterinary medicine, there are hundreds times more schools and therefore opportunities for people to graduate with a degree”. She said she’s seen more clinics provide “rankings” for their technicians such as “Level 1, Level 2” etc, which typically mean the technician has more qualifying skills and therefore receives a higher pay grade. “In a way, adding a Masters Degree program or certification is attempting the same thing on a more official level. Either way, I’m very interested to see what Colorado does with this”. Regarding telemedicine, she said she feels there is some degree of flexibility needed in what would be allowed without an in-person visit and that she has hesitations about new clients being allowed to start with telemedicine. “There are a lot of things we are able to discuss with clients but may need follow-up with lab work: diarrhea, ear/skin infections, minor wounds or injuries, etc”. She said her clinic already does this to some degree with existing clients who they can’t fit in immediately. “Granted, we TRY to get these pets in in-person first but I think this would be a great case for telemedicine. The same is true with behavioral issues. Seeing pets in the home or having owners give us a ‘tour’ of the home may help us spot issues they may not be aware of”.
Dr. Sarek told me “In regards to the telemedicine and telehealth appointments, I do agree that telehealth has its place in veterinary medicine. I feel there are certain measures of things that can be simply addressed via a virtual consult. For example, skin issues, looking at a mass or sometimes even looking at a fecal sample (for things like intestinal worms) are simple things that can be addressed through telehealth visits”. He went on to say “I do think veterinarians and their staff do need to get compensated appropriately for these types of visits, however”. He told me that he has clients reaching out to him on social media asking for advice (a situation that my daughter also encounters) and that it weighs on them as vets, especially when it comes to their work/life balance. He stated that he feels that there is an appropriate place for telehealth but that most often, visits still need to be in-person visits because issues are so much more easily addressed when the veterinarian can see them first-hand. He is all in favor of a new degree being created. “Seeing firsthand the shortage of vets present, especially in rural areas is sad. Vet techs nationwide are being stretched as far as they can, and so are vets”. He mentioned that many of the tasks which would normally be handled by the already-overburdened techs won’t get done unless he does them personally, which in turn causes him to work through lunch breaks or stay very late into the evening working to catch up. “With a new position of ‘veterinary professional’ or whatever title is chosen, it will take a large weight off veterinarians’ and veterinary technicians’ shoulders. There are many things a ‘veterinary professional’ could handle that won’t overwhelm the veterinarian’s schedule”. He went on to say that the veterinary field is suffering badly because of technician and doctor burnout, contributing to the veterinarian suicide rate being as high as it is. “We give so much until we can no longer give”.
By: Barbara Crimond
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