The veterinary industry is being hit by a trio of challenges in the areas of workforce, workflow and well-being — making positive progress feel elusive. Matt Salois, Ph.D., applies a data-driven mindset to help veterinary practices understand and navigate our current climate. The former Chief Economist with the American Veterinary Medical Association and current President of Veterinary Management Groups, Salois is charged with enhancing the economic and cultural success of more than 2,000 veterinary member practices.
Matt Salois believes the veterinary industry stands at a pivot point.
“Without question, there are many economic challenges confronting veterinary professionals and pet owners everywhere,” Salois observes. An economist by training, Salois sees a trio of intersecting forces at play:
- A veterinary workforce challenge stemming from high turnover, declining labor force participation, and increased competition for talent resulting from rising demand for veterinary services.
- A veterinary workflow challenge rooted in entrenched barriers to efficiency that the pandemic only made worse, further complicating the workforce challenge.
- A veterinary well-being challenge arising from long hours, mounting stress, and burnout resulting in declining career satisfaction for many veterinarians and other veterinary professionals.
“And yet, there is also a long runway of opportunity to truly support one another and help each other be stronger and weather the storms we are all collectively trying to navigate,” he maintains.
Making sense of the path forward begins with a data-driven understanding of the current state of the industry.
The pet-care demand rollercoaster
On a macroeconomic level, the pandemic’s economic shock was closely followed by a “roller coaster of economic activity,” Salois explains. “I think if we look at demand, we have to ask ourselves: Where is the dust going to settle exactly? We are starting to see that the epic highs of 2021 were never going to last at that level forever.”
Veterinary services went through an intense period of rising demand. The average number of appointments rose 4.5 percent from 2019 to 2020, and 6.5 percent from January to June 2021, according to research Salois and a co-author cited in the Journal of the American Veterinary Medical Association.
That whipsaw of rising demand is being followed now by what Salois describes as “normalization” or a steady return to pre-pandemic levels. Many practices are now faced with declining visits and softening revenue growth. Meanwhile, some practices are still seeing strong gains, demonstrating how national averages can belie individual practice experiences.
“I think we’ve all read an article on labor shortages and the talent challenges there, and again, not to dismiss demand, increased demand does create an increased demand for workers and labor, but it’s much more complex than that,” he maintains.
Practices continue to feel stretched and stressed out for reasons beyond volatility in demand for veterinary services. Veterinarians are leaving the labor force, reports the 2021 AVMA Veterinarian and Practice Owners Survey, showing a decline in labor force participation among DVMs in the last 2 years. Moreover, nearly half — 44 percent — of veterinary practitioners have considered abandoning veterinary medicine entirely.
“A big swath of workers are simply saying, “I’m not going to work in this environment,'” Salois notes. “So that really creates a significant issue when you’re trying to hire staff. And we also have seen quitting go through the roof, which creates its own challenges.”
Veterinary medicine has one of the highest turnover rates in all of healthcare, according to the AVMA. At 20 percent, the average turnover for DVMs is twice that of MDs in private practice. For veterinary technicians, turnover soars to nearly 50 percent, surpassing turnover rates for RNs. The reality is that turnover is even higher for many practices.
“If you have a high turnover, in addition to the open roles you might be recruiting for, you’re also trying to plug the drain of staff leaving your practice and having to re-hire those positions, so that creates significant labor friction,” Salois explains.
Barriers to veterinary practice efficiency
At the same time, lingering pandemic-related barriers to efficiency and productivity “wreak havoc on staff’s ability to deliver veterinary care, effectively reducing the number of patients they’re able to see in a given day,” Salois adds.
Although veterinary practitioners are working more hours, many report feeling like they can’t catch up. In a 2021 survey by Covetrus, 94 percent of veterinarians said they struggle to find the time to get everything done.
It’s a recipe for burnout, Salois says. “When you’re burned out, no one can do their jobs as effectively as they really want to because they’re coping with those challenges of feeling completely exhausted.”
The result is a snowball effect of “pain points inside and outside veterinary medicine,” he continues. “We have a labor situation that’s not going away any time soon, barriers to productivity and efficiency making work harder for everybody, matched with burnout, declining well-being, and on and on.”
Still, with an eye to the future, Salois maintains that great challenges also yield great opportunities for transformational change.
“I think our biggest challenges within veterinary medicine represent the biggest opportunities for us, Covetrus, Veterinary Management Groups, other organizations and companies dedicated to supporting veterinarians and veterinary professionals to adapt and deliver support to veterinary teams — and help them support, bring value back to their clients and deliver the best medicine to patients,” he maintains.
Finding a path forward
When Salois reimagines today’s challenges as opportunities, he draws on three intersecting themes: workforce, workflow and well-being.
“With workforce and staffing, it’s how do we address the staff shortages combined with the high turnover and the workflow efficiency productivity challenges? What can we do to save time and increase productivity — to make it easier to be a veterinarian or a veterinary professional and deliver care?”
Between 2017 and 2021, at least 60 percent of surveyed practices experienced severe inefficiency problems, according to research cited by the AVMA.
To gain efficiency, Salois encourages veterinary practitioners to identify and remove workflow bottlenecks — whether that involves new technology or more streamlined processes.
For example, taking payments over the phone might not seem inefficient, Salois says, “but just think about someone giving a credit card number and they get to that ninth digit, and they mess it up. Then they often must repeat the whole credit card number, right?”
He continues, “Suddenly, something that’s a three-second transaction just turned into 45 seconds, and you multiply that across thousands of patients — it adds up.”
And that’s just one example of how a small disruption can create significant inefficiencies when added up. There are a lot more – and more significant – disruptions to producing veterinary care that raise significant barriers to efficiency. Even worse, these barriers make it harder for veterinary professionals to do their jobs, often leaving them burned out.
Step-wise approach
Although change can feel daunting, Salois says a mindset shift and adoption of incremental advances can create a positive feedback loop. Improvements in one area then spill into another area of the practice, creating a step-wise cycle of transformation.
“By focusing on efficiency,” he explains, “we address workflows and how we leverage our staff and leverage technology, so we get a workflow dividend. And then we get a workforce dividend in the sense that we might not need as many people as we think we need, because the ones we do have are now better able and better equipped to do their jobs.”
He continues, “If we can lean on efficiency as a priority, we can address some of these barriers to productivity and well-being issues. And, as an added benefit, we can hopefully make it more economical to deliver veterinary care affordably for our clients and for our patients.”
Salois believes veterinary medicine today is primed for change, both in the broader industry and at the practice level.
“We have challenges, there is no doubt, and we can’t sugar coat that,” he says. “But I have never seen a bigger opportunity to make a positive difference and help reshape veterinary medicine for the better.”
Four-step solution
For veterinary practices looking to address workforce, workflow and well-being challenges, Salois suggests a step-wise approach that draws on the work of Emeritus Professor John Kotter of Harvard Business School. To begin:
- Establish a sense of urgency
Commit to near-term change. “We’re past that point in veterinarian medicine where we’ve talked about these issues of workforce, workflow and well-being,” he says. Now, it’s time for the veterinary community to embrace positive change with a sense of urgency.
- Develop a vision and strategy
Sketch out a vision for a positive path forward. Harness a sense of urgency, Salois says, and build a coalition of support around it. “Then communicate across your practice around the changes that you want to make and the strategy for making those changes happen,” he adds.
- Notch short-term wins
“Never try to eat the whole pie in one bite, you eat it bite by bite,” Salois offers as an analogy. Similarly, when rolling out changes in your clinic, focus on short-term wins to fuel “a sense of urgency and a sense of support because you’re seeing success happen real-time,” he says.
- Realign your work culture
And last, nurture “a culture of new approaches and continuous improvement,” he advises.”You do that in your practice, and we can do that as a whole profession,” he maintains. “But like anything, there’s a process to it. There are tools and resources to guide business leaders and others on leading change in their practices, or in their companies.”
For more insights from Salois, listen to his recent interview on the Covetrus Connected Care podcast: https://software.covetrus.com/veterinary-insights/blog/podcast/covetrus-connected-care/