The mid-level practitioner…what is it, and how could it impact veterinary medicine in Colorado? For over a year, CVMA has been asking these questions to see whether a new veterinary professional could positively impact the delivery of veterinary medicine in Colorado.
This article is the first in a series exploring the concept of the mid-level practitioner and examining what may make sense for Colorado. The goal of this series is to assess the issue from an unbiased view, solely looking at the information available from all voices in the conversation.
Advocacy is always the number one job at CVMA, and the mid-level practitioner issue is no different; CVMA has worked long and hard behind the scenes to ask the hard questions and ensure the voices of members have been represented during the stakeholder process. This series on the mid-level practitioner demonstrates CVMA’s commitment to representing member input on key issues impacting veterinary medicine in Colorado.
Why a series?
Much of the advocacy work CVMA does is behind the scenes, in the form of written briefs for legislative issues, in stakeholder meetings, after-hours calls, and in hours spent researching and tracking key issues. However, CVMA members don’t always get to see the “behind-the-scenes homework” CVMA engages in daily. This series seeks to educate members about CVMA’s work on the concept of the mid-level practitioner, and to demonstrate how CVMA responds to member input and works on behalf of members regarding key issues in Colorado.
CVMA survey to members
From January 28 through February 7, 2022, CVMA surveyed members regarding a proposal for a mid-level practitioner (also referred to as a veterinary professional associate) in Colorado. CVMA received an overwhelming number of responses from veterinarians in Colorado, with 440 survey responses received in just a few days.
Click here to read the information that was shared with survey respondents about the mid-level practitioner concept.
Reactions to the proposal were strong, with the majority of respondents expressing concern about a mid-level practitioner in Colorado. Key quantitative results included:
- 60% of respondents did not believe a mid-level practitioner would positively benefit the profession; 35% of respondents did believe a mid-level practitioner would positively benefit the profession
- 57% of respondents did not believe a mid-level practitioner would positively benefit their practice; 31% of respondents did believe a mid-level practitioner would positively benefit their practice
- 59% of employers indicated they would not hire a mid-level practitioner to work in their practice; 27% of employers indicated they would hire a mid-level practitioner
The survey also asked Colorado veterinarians about any concerns they had. CVMA surveys typically have a fairly low response rate; however, this survey produced hundreds of responses from Colorado veterinarians. While there were responses on both sides of the issue, the overwhelming majority of responses raised concerns about the proposal. From the number of responses received and the emotional tenor of those responses, it was clear that Colorado veterinarians had questions and wide-ranging concerns about the concept of a mid-level practitioner.
Key concerns cited by members included:
- Surgery: Colorado veterinarians were concerned about a mid-level practitioner’s ability to successfully perform surgery with limited schooling.
- Liability: Colorado veterinarians reported concerns about mid-level practitioners adding to the liability burden of a veterinarian. Many Colorado veterinarians indicated they were not willing to take on additional liability for more workers due to concerns regarding competency, and said that mid-level practitioners would need to have their own liability coverage.
- Veterinary technicians: Many Colorado veterinarians identified veterinary technicians as an underutilized group of veterinary professionals, and suggested that existing technicians be permitted to expand their responsibilities rather than create an entirely new level of veterinary professional.
Based on the feedback received from members, the CVMA Board of Directors concluded that more information was essential to further examine the issue and to get more information about how a mid-level practitioner would feasibly work…and to determine whether it is the right solution to veterinary care in Colorado today.
Mid-Level Professional Stakeholder Working Group
In February 2022, State Representative Karen McCormick (also a DVM) informed an interested group of her desire to convene a working group to “fully stakehold” the concept. In June 2022, Rep. McCormick convened a working group of approximately 35 stakeholders to examine the issues broadly related to access to veterinary care in Colorado, including whether a mid-level professional might be a potential solution for these problems.
CVMA appointed nine members to a CVMA Task Force that provided input to the working group.
The group met for 90-minute sessions biweekly beginning in June and will continue meeting in December 2022. A robust lineup of experts was invited to present on topics concerning veterinary care and the mid-level practitioner as a potential solution. Eleven meetings have been held to-date, covering topics such as:
- “Considering the Veterinary Mid-level Professional: Where We Are Today” — presented by Dr. Gail Golab, chief veterinary officer of the American Veterinary Medical Association
- “Veterinary Technician Specialists” — presented by Ed Carlson CVT, VTS and Lorelei D’Avolio, chair of NAVTA Committee on Veterinary Technician Specialties
- “Veterinary Workforce Analysis” – presented by Dr. James Lloyd, former dean of the University of Florida College of Veterinary Medicine
- “The Mid-level Practitioner and Access to Veterinary Care” – presented by Dr. Apryl Steele, Denver Dumb Friends League
- “Proposal for a Professional Science Master’s Degree in Veterinary Clinical Care” – presented by Dr. Wayne Jensen, Colorado State University
- “Master of Veterinary Clinical Care: A New Veterinary Advanced Care Provider” – presented by Dr. Stacy Anderson, dean of Lincoln Memorial University College of Veterinary Medicine
- “The Economics of Veterinary Medicine” – presented by Drs. Clint Neill and Bridgette Bain, AVMA veterinary economists
- “CVT Utilization Models in Practice” – presented by Dr. Austin Graham
- “AVMA Liability Insurance” – presented by Dr. Kent McClure, American Veterinary Medical Association
- “Programmatic Accreditation” – presented by Dr. Karen Brandt, American Veterinary Medical Association
- “Stakeholder Discussion” – hosted by Rep. Karen McCormick
Because CVMA’s chief role is to represent the concerns of its members, CVMA representatives to the working group made sure to raise the questions cited by members in the 2022 survey.
As evidenced by the range of topics discussed during the stakeholder meetings, the mid-level practitioner issue is complex and multi-faceted, with many considerations at play: There is no cut and dry answer to veterinary care in Colorado that can be applied with a broad stroke.
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In the next article in this series, CVMA will invite guest authors Dr. Wayne Jensen and Dr. Apryl Steele to share the full proposal for a mid-level practitioner.
Have questions or comments? Click here to submit them! CVMA will host a member town hall in January during which submitted questions will be addressed.
