11 Apr Credentialed Veterinary Technician Underutilization: How Do We Move Forward?
It’s a Process! Keep Going!
Chantal Faraudo, CVT, CVPP
OVTAA Board Director
Having skilled credentialed veterinary technicians on veterinary teams is an essential part of building an efficient and healthy practice. Utilizing the skills of the credentialed technician to the fullest extent is critical for the credentialed technician’s job satisfaction, the practice’s bottom line and healthy work culture. Credentialed veterinary technicians are qualified and trained to do many skills and tasks in a practice so veterinarians can leverage their time within the practice, generating additional revenue. Freeing up the veterinarian to be able to focus on diagnosing, prognosing, prescribing and performing surgery helps the patients, clients, veterinary team and the practice. The clients look to credentialed techs to educate, improve compliance, provide follow-ups via phone, perform rechecks and offer compassionate nursing care and advocacy for their pets. Clients want the increased communication opportunity with regards to their pet’s status, treatments and care, in addition to what the veterinarian provides. And the patients, depend on credentialed technicians to give them compassionate high-quality care delivered by educated and skilled state licensed professionals.
Today we are experiencing ever increasing pet ownership and high demand for accessible, high-quality veterinary care. The only way to meet this demand is to attract and retain qualified individuals who have the training and skills to deliver that high-quality care. I am in no way suggesting that non-certified assistants aren’t extremely important. Every practice needs assistants in addition to credentialed staff to function at the highest level possible. Non-credentialed staff may be cheaper to employ but will not contribute to the bottom line of the practice at the same level as a credentialed technician.
Credentialed veterinary technician underutilization has been a frustration, and one of the reasons for job dissatisfaction for decades, for credentialed technicians. With a multitude of surveys conducted by NAVTA, state veterinary technician associations, corporately owned practices and others, the message from these surveys tell us that credentialed techs feel underutilized and experience barriers to advancement in their job positions, leading them to feel disrespected, and that their work and value feels meaningless. These factors, along with historically low pay and toxic work cultures, has driven many credentialed veterinary technicians to find different places to work or leave the profession all together. Throw a pandemic into the mix and we have the makings of a perfect storm for credentialed techs leaving the profession
A study in JAVMA, Vol 236, No. 8, April 15, 2010 showed results of regression analysis that it is possible for a typical veterinarian’s gross income to increase by $93,311 for every credentialed veterinary technician per veterinarian in the practice. The increased revenue generated by appropriately utilized credentialed technicians is well beyond a certified veterinary technician’s salary. When the workload is shared amongst staff members, everyone’s sense of worth and value improves.1
Credentialed veterinary technicians have dealt with a systems organizational issue for years. Technicians do not have their own governing board like human nurses. We are governed by state veterinary boards across the country. We attend AVMA accredited programs to earn our degrees and we work directly with and for veterinarians. We are not allowed to be members of the AVMA, even though the AVMA represents all of the veterinary profession and has great influence and power over the technician profession. Technicians need the support and advocacy of veterinarians to help us stay in the profession. Veterinary Schools could help by teaching students about team structure, where veterinary students understand and recognize the qualifications of credentialed veterinary technicians and what a tremendous asset and partner they are to them. By utilizing technician’s skills fully, they can focus on diagnosing, prognosing, prescribing medication and treatments and performing surgery.
Sadly, still in the year 2022 veterinary technicians continue an uphill battle with the antiquated attitudes of some veterinarians attending the AVMA Leadership Conference in January. A veterinarian delegate from Alabama proposed and tried to advocate for the inclusion of credentialed veterinary technicians as members of the AVMA by making the point that, “The idea is not to undermine great partners … or to employ a tactic with the goal of increasing membership or dues revenue,” she said, but to discuss “opportunities to potentially be more inclusive and to consider how these opportunities could advance the profession and the veterinary health care team.” While some delegates agreed with her opinion, many expressed opposition. 2
The proposal on the table would have allowed credentialed veterinary technicians to join the AVMA as affiliate/associate members, allowing them to have access to some of the excellent benefits enjoyed by veterinarians. What an amazing recognition this would have been for the technician profession, being offered the chance to have access to career services, powerful purchasing solutions for those states that allow credentialed techs to own practices, insurance and retirement products, online continuing education access to professional publications, wellbeing resources, career resources for new graduates and experienced technicians, clinical and policy resources, cyberbullying and crisis management help, events and networking, financial resources, practice management guidance, savings for AVMA members, policy participation, marketing and client service tools, industry research access, scholarships and grants, volunteer opportunities domestically and internationally and most importantly it would have made veterinary technicians feel respected, valued and included as professional partners.
Instead of being held in high esteem for all we bring to the table, one delegate from Utah sited the classic tale of the “Camel in the Tent” https://www.bedtimeshortstories.com/the-arab-and-the-camel as to why it should be voted down. And… the proposal was voted down.
This is one more blow for credentialed veterinary technicians, most who graduated from AVMA accredited veterinary technology programs, who continue to ask for, and strive for professional recognition and inclusion. The AVMA doesn’t work solely on behalf of veterinarians, it works on behalf of the entire profession. Other professional associations like the American Bar Association, offers membership at a reduced cost for paralegals and economists. The American Optometric Association provides something similar for “associate professionals.” The purpose of credentialed veterinary technicians is not to compete with veterinarians, it is to work alongside them to care and advocate for animals and to educate and show compassion to their owners. Bottom line, credentialed veterinary technicians want to fully utilize the skills they have been trained and educated to do and they want to be respected as professionals.
How can veterinarians help?
The following are a few suggestions on how to fully utilize credentialed veterinary technicians in a veterinary practice and tap into credentialed veterinary technician’s diverse skillsets.
1. Evaluate what staff you have and look for ways to capitalize on the use of your credentialed technician’s advanced skills. Some credentialed technicians have specialty training in pain management, anesthesia, behavior, ultrasound, dentistry, assisting in surgery and the list goes on. Credentialed technicians are capable of doing an extensive selection of clinical skills. Talk with your credentialed techs and ask them if they are being fully utilized. Ask them to tell you what they are capable of doing. Ask them if they have skills that aren’t being utilized. Ask them if their days are filled with tasks that don’t require technician training. Bring other associate veterinarians to the table and let them give their thoughts on tasks that could be delegated to credentialed techs.Make these conversations honest, open and candid. If you ask them, they will give you the information you seek. There may be a revelation that your team needs and wants more training in a certain area. Maybe they need a mentor to hone a skill? Maybe you need to think about hiring more staff? These open, honest conversations send the message to your credentialed techs that you value and trust their autonomy and ability to make independent decisions within their scope of practice and that you respect them. Credentialed techs can bring insight into many situations and issues that you may not even realize the practice had. When you empower your credentialed technicians and staff to identify problems and give them the resources and tools to help fix the problems, that means everything to them. It says I trust you. I value you and your ideas. It sends the message that they make a difference.
2. Read your state’s practice act to understand what is legally allowed in your state in regards to what a certified veterinary technician can and can’t do. Then, step back and evaluate whether the credentialed technicians in your practice are being allowed to do everything they are capable of and qualified to do. https://www.oregon.gov/ovmeb/Pages/practice-act.aspx
The Washington State Veterinary Medical Association and the Washington State Association of Veterinary Technicians created a Guide to Animal Health Care Tasks and Supervision Levels for Licensed Veterinary Technicians, Unregistered Assistants, and Registered Veterinary Medication Clerks (https://www.wsavt.org/documents/Guide-to-Animal–Health-Care-Tasks-and-Supervision-Levels.pdf to help clarify specific tasks that can be performed by Licensed veterinary technicians and with what level of supervision is required.
OVTAA is working toward creating a similar guide for Oregon Certified Veterinary Technicians in order to begin achieving title protection for Oregon Certified Veterinary Technicians.
If you have a team of credentialed technicians already functioning at a high level and utilizing their skills fully, ask them what they would like to learn. Every technician has tasks they love to do and get great satisfaction from doing them. Find out what these areas are and provide them some additional training by bringing in a specialist in that area to teach them or invest in a hands-on conference where they can participate in labs and lectures. Encourage credentialed technicians to explore specialty training in an area that will strengthen the practice’s capabilities and if able, possibly contribute to the cost of their training. NAVTA supports an ever-increasing number of veterinary technician specialties (VTS) in clinical medicine. If your practice is involved in lab animal medicine the American Association of Laboratory Animal Science has 3 levels of certification in the laboratory animal field: ALAT (Assistant Lab Animal Technician), LAT (Lab Animal Technician), and LATG (Lab Animal Technologist). The Veterinary Hospital Management Association offers certification to become a certified veterinary practice manager (CVPM). International Veterinary Academy of Pain Management (IVAPM) offers a certification in pain management to credentialed technicians and veterinarians. Rehabilitation is another option for technician advancement. There are 2 certifications for technicians: Certified Canine Rehabilitation Assistant (CCRA) and Certified Canine Rehabilitation Technician (CCRT). The RECOVER Initiative offers certification in RECOVER CPR BLS and ALS. Credentialed technicians can also get a certification in ultrasonography.
3 . When technicians see that they have encouragement and support to grow in their job and education they feel like they are appreciated and valued for what they bring to the team and practice.
4. The power of recognition and respect
Recognition can be an excellent demonstration of respect, and it can be a powerful motivator. Recognizing technician’s contributions during the workday or shift helps build morale and a strong team. Making sure that staff members are respected for the titles they have earned is important. CVT’s are educated and highly skilled members of the team and have earned a degree and passed the Veterinary Technician National Exam. Credentialed veterinary technicians have spent time and money investing in their training and education. They are proud of their accomplishments and to have the earned the right to add the title of credentialed veterinary technician to their name. When non-certified team members are referred to as one in the same as the credentialed staff member, it devalues all the hard work, study and money invested in earning their credential. Veterinary Technicians are fighting for title protection across the US. This has nothing to do with non-credentialed staff member’s value and worth, all members of the team are essential and valuable. But the credentialed veterinary technicians title should not be disrespected by allowing, non-credentialed staff to call themselves veterinary technicians or CVT’s. Veterinarian’s can help by having all staff wear their correct titles and referred to as those titles, particularly in the presence of clients. The AVMA has a written policy for veterinary technology and the value it brings to the profession. https://www.avma.org/resources-tools/avma-policies/avma-policy-veterinary-technology
The current state of the veterinary technician profession is contributing to the frustration, burnout, high turnover and leaving the profession all together, for credentialed veterinary technicians who are constantly having to compete for jobs and salaries with non-credentialed individuals.
Why aren’t credentialed veterinary technicians being fully utilized? It’s a good question with a complicated answer. The contributing factors all have to do with personalities, training, practice culture, liability and a desire or lack thereof, to want to change. Veterinary technicians in surveys have identified the following as the reasons for underutilization. 1) The veterinarian can perform the task faster or better or the veterinary technician doesn’t have the skill or knowledge to perform a task. Credentialed veterinary technicians are taught an extensive array of skills with in-depth education as to why and how they are performing a task and need an opportunity to practice and hone those skills so they become expertly proficient at them. Having a veterinarian drawing blood, intubating and inducing patients, setting IV catheters, etc. and performing other nursing tasks is an inefficient use of their time and backs up the workflow of the practice. If a credentialed technician doesn’t have the skill to do a task, find time to do it with them and teach them. Eventually, as their skill develops they will be proficient on their own and the veterinarian can delegate so they can-do higher-level tasks.
There aren’t enough veterinary technicians to delegate tasks to. There is a national shortage of veterinary technicians, for many of the reasons that are identified in this article. If veterinary technicians are in short supply, consider hiring veterinary assistants to work in a supportive role to veterinary technicians to improve the efficiency of the team, instead of hiring non-credentialed veterinary assistants to do the same tasks as the credentialed veterinary technicians. When this happens, you have your credentialed staff competing with non-credentialed staff to do the same tasks, while tasks that are equally as important to get done but don’t require as much skill, go undone or are ignored. This point causes a considerable amount of discontent among credentialed veterinary technicians, contributing to their growing dissatisfaction with their role and value, and ultimately leaving the profession all together. 3) There is not enough time to train staff. As the saying goes, “the expert in anything was once a beginner.” Carving out a regular schedule for training of existing staff, new hires and new graduates will pay any practice back a 100-fold in the long run. Using experienced credentialed veterinary technicians to onboard, train and mentor new staff is extremely valuable. Creating “Training Coordinator” positions with-in the staff, helps the trainer and the new staff member grow. When new graduates are thrown into the fray without training and mentorship, they often flounder, lose confidence and leave. When existing, experienced staff stagnate in their job roles, they disengage and ultimately leave as well. When you invest in people, they will invest in you.
What can credentialed veterinary technicians do promote their knowledge, skills and value?
Advocate for yourself. Get yourself organized and create a portfolio of your college degrees, your veterinary technician license, proof of passage of the VTNE, your professional resume, any advanced certifications you hold. Include a copy or synopsis of your syllabi from your veterinary technology program including if the program was an AVMA accredited program and a list of courses you took. List the places you completed your clinical rotations and the skills you performed. List continuing education courses you have completed and emphasize wet-labs you may have completed like urinary catheter placement in female dogs, regional and local blocks placement, advanced catheter placement, sacrococcygeal blocks in blocked cats, dental blocks, etc. Depending on your experience this could be an extensive list. Don’t forget to include your math calculation skills including calculating CRI’s, laboratory skills, basically anything that will help someone understand what you know, what you are capable of performing and even skills you aspire to learn. You can make it as comprehensive as you want, some even include pictures and videos. A professional, organized presentation can make a very positive impression and help people to learn something about you.
Be proactive when advocating for yourself. Schedule a time to meet with your veterinarian to share your portfolio. Promote your strengths and accomplishments are and the value you can bring to the practice.
Contact your State Veterinary Medical Board and read the Veterinary Practice Act. Make sure you understand what you legally can and cannot do according to your state practice act. Depending on what the practice act in your state allows, it can make the discussion about increased veterinary technician utilization easier if everyone is on the same page.
Always represent yourself as a professional. Present yourself with a professional image by dressing in clean, untattered clothes/scrubs and shoes. Find out what the dress code policy at your work place is and adhere to it. Show pride in your work and try to exceed expectations. Be productive at work and be known for your punctuality. Show initiative by asking for more projects, assignments or responsibilities if you feel you have time. Be eager to learn from others and be willing to share your knowledge. Be organized, efficient with tasks and follow through to completion. Be a good communicator with your veterinarians, leadership, co-workers, online and with clients. Set goals for yourself and prioritize your tasks. If you finish your tasks, jump in and help others on the team to complete theirs. Be open, honest and show integrity. Be accountable for your work and actions and be ethical, always. When challenges come your way, be resilient with a positive attitude. When problems do arise, take a minute to brainstorm and find a possible solution before going to your supervisor. Be self-aware, watch your language and work collaboratively with others. Over time, your professionalism will be noticed and will lead you toward success. Be specific about what skill or tasks you would like to be able to do. When you do get the opportunity to perform new or additional skills, be open to coaching and feedback. If you are unsure about anything you are doing, ask questions for clarification. Change takes time. Trust takes time to develop. Try to be patient. Change doesn’t happen overnight. It’s a process. Keep going.
References
https://avmajournals.avma.org/view/journals/javma/236/8/javma.236.issue-8.xml
VIN News January 11, 2022- https://news.vin.com/default.aspx?pid=210&Id=10685148&fbclid=IwAR2J3P6l_nwifD9Y6VisC4z5xpLvou7zovvzfW0EOPRKspdT3JnBpdjuVpc
U.S. Bureau of Labor and Statistics Occupational Outlook Handbook
https://www.bls.gov/ooh/healthcare/veterinary-technologists-and-technicians.htm
Impacting Veterinary Utilization in Practice- https://vtutilization.com
Ethical and Professional Utilization of the Credentialed Veterinary Technician and Assistant- https://www.avma.org/resources-tools/practice-management/utilizing-veterinary-technicians-improve-practice-success
Today’s Veterinary Nurse Focus on Utilization- https://todaysveterinarynurse.com/articles/a-focus-on-utilization/
NAVTA 2016 Demographic Survey Results- https://cdn.ymaws.com/navta.site-ym.com/resource/resmgr/docs/2016_demographic_results.pdf
Prime issue for veterinary technicians: Underutilization- https://www.avma.org/javma-news/2018-11-15/prime-issue-veterinary-technicians-underutilization
Ethical and Professional Utilization of the Credentialed Veterinary Technician and Assistant- https://aaep.org/sites/default/files/2021-03/Ethical_and_Professional_Utilization_of_the_Credentialed_Veterinary_Technician_and_Assistant.pdf