Veterinary school project in Buffalo is dead

Proposed new vet school in Buffalo dead

Hooray!  Well, maybe... Screen_Shot_2013-07-14_at_1.58.58_PM.png

Saturday I got an email from another veterinarian declaring victory at the demise of the  proposal for a new vet school in Buffalo.   I think it was officially called the Kaleida proposal, as it would have been a redevelopment of the old Millard Filmore hospital owned by Kaleida Health.  I pointed out several ways he relied on anecdotal evidence instead of hard numbers in deciding this was a victory.

He admitted it, and that he knew the danger of relying on anecdotes, but then sniped at me for being ‘oh so right’ for pointing it out.  That's ok.  He’s been a little stressed this past year; he bought an aging, neglected practice and has been busting his (insert body part of your choice) to revitalize it. He gave me an update:

up 50% in June and, if all goes as the first 1/3 of the month, it looks like we could be up 90% in July

See?  Good things happen when you manage by hard numbers. It's not about being right.  It's about doing things right- because doing things right makes good things happen.

Sometimes that takes looking at the hard numbers, like with the Buffalo deal.  The current numbers we have (which aren't very hard, as we all know) show we have an oversupply.  Not an overcapacity, not an underdemand- those are both magical thinking terms that keep economists happily employed* but don't describe the real world behaviour of real world people.  In the real world ...

...we've got too damn many vets.  

And we will have for the next 10-15 years no matter whether we open new schools or not.

Losing easy access to loan money is the only thing I see that will drop enrollments enough to really reduce the bodycount of new vets flinging themselves at the profession every year.   Now, any meaningful student loan reform or higher education cost controls are a year or two away, and will take a year or two to be implemented. Until then, odds are at least the same number as now will enroll every year.  Maybe more. So there'll be guaranteed overproduction for four to six years after the point at which meaningful reforms are enacted.  So that's 2+2+6=10 years of overproduction.

Basing attitudes and actions on a desire to decrease the body count now is well intentioned and satisfying but unlikely to make a difference in the damage. Kinda like steroids in shock; might make them, and you, feel better but doesn’t decrease the number dying.

What will decrease enrollment is large scale loss of easy student loan money. When student loan reform comes- and it is coming- there will be significant drops in enrollment.   While I have not looked at the overall budget for each school and its parent university, I have looked at the total amount of tuition revenue for each school.  We're talking major money. Millions. Much too much for strapped universities to absorb in these lean times.

Now, some schools may be in precarious enough position that even small decreases in enrollment cause their universities to start shutting them down.  Like I said, I have not examined each school's and parent university's budget.  Even so, one school here or there won't be enough to address the oversupply. Jim Stowe estimates it'll take closing four of the seven schools in Australia to deal with supply demand mismatch there.  That translates into 18 schools here.  

The oversupply was only minimally caused by the increasing number of graduates.  It was mostly caused by a shift in how people want to spend their money.  The market will no longer support the number of private practitioners we already have, much less more, and far fewer if they insist on practicing the same way they always have.  Will there be churn that will absorb some of the production? Sure. Intuitively, many marginal participants in the veterinary professional labor force- part timers, floaters, relief vets, medically stagnant associates, financially unsuccessful owners- should be leaving.  Anecdotally.. well, we all know the risks of reliance on anecdotal evidence.  

If programs are to survive decreasing or uncertain tuition revenue they are going to have to drop their fixed costs or find other ways to generate revenue. New schools offer the promise of doing both, as in the Buffalo proposal.

One fixed cost a new school automatically cuts is supporting pensions and health insurance of retired employees.  New schools don't have retired employees.  Granted, whether an established school is supporting any retirees depends on how it's parent university is structured financially, and it may not apply at all to some schools- or even significantly at any school.  Anybody know?

Another fixed cost a new school can drop (that established schools can't) is the construction, maintenance, operation and staffing of an academic teaching hospital.  This is the approach taken by Western and Calgary.  Anybody wanna argue the distributive model can't turn out good vets?  Didn't think so.  

Another way to drop fixed costs is to share a teaching hospital across multiple schools. This is something the schools have always done on a small scale via externships or a large scale in the case of the Caribbean schools contracting clinical space at schools with teaching hospitals. This is another element I was watching in Buffalo, and one of the elements called for in NAVMEC. The contracting approach is being taken by the new "+2" programs in Alaska and Utah; one is contracting with CSU, the other with WSU.

Buffalo was, and the new schools in Harrogate TN and Glendale AZ are, planning on sharing resources beyond just a hospital; and not just with other vet programs but also with vet tech programs and other health professions programs.  So this approach can drop not only fixed costs of instructional space, but also operational costs of administrative infrastructure and instructional personnel.  Who teaches what to whom is a difficult thing to change at best at an established school; faculty don't even like teaching the *same* thing to more of the *same* students.  They're griping about having to teach bigger classes now.  Can you imagine the outcry if you told them they had to teach that many more, and change what they teach to accommodate students aimed at vet tech, public health, nursing, medicine, biomedical engineering...


So those are some reasons why new schools are inherently capable of being more cost competitive than established schools.  And like it or not a program has to cash flow.  No money, no mission.  

What about generating other revenue as tuition becomes harder to come by?

Well, there's federal grant money for research- always a very competitive market and getting more so as programs in all the STEM fields feel the same squeeze. There's industry research funding, also incredibly competitive and more so as companies trim and reorganize budgets to position themselves for post-recession success. There's intellectual property income- but that sort of an income stream doesn't happen overnight.

Schools increasingly are turning to service revenue to make up their shortfalls; we all hate that because in the ruling zero sum vision of vet med, we feel it is taking money from area veterinarians.  We used to not feel that way, because the university offered experimental, advanced and specialized treatment that our clients couldn't get from us. Now there's a referral hospital with flouroscopy half an hour from Purdue.  And art in the lobby, rather than a life sized poster of the AVMA CEO.

There's donations. This holds some interesting possibilities, and is another element I was looking at in the Buffalo deal.  The nonprofit segment of the industry has exploded in the past ten years for a reason.  Consumers want to support this model. Why are we fighting our own market?  Yeah, a few of the traditional schools have some sort of non-profit effort; Davis has long had a clinic for the homeless where students and faculty can volunteer, Tufts partnered with the vo-tech program at a local high school on the poor side of town to start a subsidized clinic for the people nobody wants as clients anyway.

But what we need- and Buffalo offered, with the involvement of an SPCA- is integration of schools with the non-profit movement on a systemic level, because that's where the veterinary health care delivery model has gone.  We are an information economy now, not a services economy.  The shelter will do the spays and neuters and vaccines for the pets they adopt out- and vets will design their intake, anesthesia and treatment protocols.  Vets will write blogs that explain, explore and celebrate the bond, consult with pet owners on general health questions via paid internet websites, research ways to minimize the public health and environmental impact of feral cat populations, speak to civic groups about establishing networks that accommodate the pets of domestic abuse sufferers.

We need to be preparing vet students to do those sorts of things.  Yes, that means partnering with national organizations like the ASPCA, the (shudder) HSUS, Banfield Pet Charities. Establishing partnerships at the program level controls and limits the impact any individual organization can have. Better than funded lectures in shelter medicine and funded residencies in animal welfare where schools are merely acting as pimps, turning their students over to some corporation for a price- which is what the traditional schools are doing now.

And this is the ultimate reason I don't object to new schools.  Because we need different schools.   And I don't know that traditional programs geared toward producing hands on service providers can change enough, fast enough.  New schools will not affect overproduction- screwed is screwed and degree doesn't matter.  New schools will not affect established schools as far as competition for applicants, which provide their major source of funding; if competition for state funding or donations pushes a school over the edge, it needs to go and we should help it along. This profession knows all about euthanasia.

New schools look to be better suited to cope with the rapidly changing regulatory, financial and philosophical market.  It's called evolution.  I don't think fighting it is a winning strategy for the veterinary species as a whole.

*My personal preference of terminology is supply- demand mismatch. Of course, I’m neither an economist, nor employed, nor happy. Fairly dismal, actually.  Of course, economics is the dismal science. Welcome to why I drink.

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Showing 12 reactions

commented 2017-04-05 06:29:12 -0400 · Flag
The distinction between the top ingenious technologies to recognize before getting a self cleaning.
commented 2017-04-05 06:28:20 -0400 · Flag
See the distinction between the top ingenious technologies to recognize before getting a self cleaning can that.
commented 2013-07-19 16:40:08 -0400 · Flag
Well actually the schools ARE well served by the tuition rates-especially those with a distributive model because they are making the MOST money.As I said I think that the distributive model will not persevere simply because economically the loss is much less if a university closes a distributive model than if it shuts down a teaching hospital.
I actually dont have a huge problem with the distributive model per se except that it has only benefitted the university.
I think a distributive model that adequately and with good supervision and monitoring (which is NOT currently happening) could be a way forward, but if it doesnt reduce tuition it wont survive the downturn.
The colleges that figure out a way to provide education cheaper will survive.Just like vet practices.Some of the badly managed ones have already bitten the dust.The ones that have better fiscal management have survived.How easy would it be if we had an endless supply of clients with no money problems? Thats what the schools are facing.And how many of us would be looking to improve our efficiency in this climate.Probably none of us.
BUT the gravy train is going to end and probably soon.Is it not better to prepare now?
We cant compare ourselves to medicine and engineering.The job markets and educations are totally different.There is only one species of human and you dont need large herds of TVs to surround the engineering school for it to do well. It is also accepted that a new graduate engineer or MD is not much use until they have had lots of additional training.

If a distributive model can reduce tuition costs significantly I wil be its biggest champion.I dont think it matters very much how they are trained. We must not neglect clinical research however so there will always be a role for a teaching hospital based system.

We need the Walmart approach to teaching.Pare back all ther administrative BS to reduce costs, share resources, and engage the local veterinary community.

There is a difference between herding together and stampeding.When you herd together only the weaklings get picked off.When you stampede there is a lot of collateral damage to the herd and it is indiscriminate.Some of the healthy buffalo get trampled as well as the weaker ones.Not a great strategy.
You stampede when you have no other option.
So if you want a long term strategy to help keep your herd healthy you will avoid a stampede at all cost.

Of course we have such poor leadership that a stampede is probably what will happen to us and after the dust has settled AVMA will yell “watch out”.
commented 2013-07-17 15:32:34 -0400 · Flag
Scott, I think Carl spoke my mind on schools pretty well (good job, Carl). Only I would include Ross and Western as schools that do as good a job educating as any other. I think they all need to do a better job getting more cases into students’ hands, and getting students into more settings- research labs, wildlife medicine, regulatory medicine, epidemiology.

Like Carl, my primary observation about the schools is that they are not financially sustainable. Like Carl, I think we’re going to lose a lot of them. There will be schools that simply will not be able to change enough fast enough. By change I mean figure out a way to get away from reliance on unlimited tuition. That has to be done in a way that benefits the public, the animal and the client, and then the veterinarian. They market doesn’t exist to serve providers. Providers exist to serve the market. Right now no one is well served by the structure of the veterinary educational system, Scott. Not limited to the schools- it’s the whole system. The schools alone didn’t cause this and they cannot solve it by themselves, anymore than the AVMA, or corporates, or nonprofits, or private practice. Heads up, Carl? Distributive model is extensively used in medical education, and engineering. Another headsup? Herding together works best against certain types of threats. Stampede is actually more effective at the herd level when taken by surprise or threatened by multiple predators.

Food for thought to go with that drink…
commented 2013-07-17 14:03:56 -0400 · Flag
Hi Scott,
I think as far as education goes the schools are all doing OK.I have mentored students from just aobut every school, inclding some eurpoean schools over 22 years and frankly I dont see a huge difference in the level of knowledge.I believe where the schools are not doing a good job is in making the education more affordable.Obviously there is currently NO incentive for them to do so.I think only when federal loan money dries up we will see the innovation and creativity necessary for a more efficient teaching model.
Schools do need to adapt to not only the changing education requirements of the students, but also to bring the cost down enough to make the investment in a veterinary degree worthwhile.

The lack of state funding makes sense to me.After all large animal medicine has changed so much and it seems wrong for states to subsidize the education of primarily small animal vets.

I was involved in the last NAVMEC meeting as a board member of the VINfoundation . There were some interesting ideas thrown out regarding developing centers of excellence to concentrate resources and talent and prevent duplication of teaching opportunities.

I dont think that vet schools or Deans are bad.They are in business and need to make money.

I would not want to be a Dean.They are between a rock and a hard place.

However, that doesnt give them a free pass in my mind.They need to stand up to the university.Increasing enrollment and tuition is a short term patch to their fiscal problems that will have serious consequences on the students, the profession and the schools long term survival.

In stead of cloak and dagger deals like Buffalo or the nasty legal debacle that was OSU how about the schools engaging with the profession as a whole.
We have a collective intelligence that is not being used.I am sure there are innovative solutions to our problems-We just need to;

1.Admit there is a problem (no more BS about not enough vets)
2.Stop things getting worse in the short term
3.Come up with some long term solutions that involve ALL facets of the profession working together toward common goals.

1.make the return of investment on veterinary degree worthwhile
2. Make sure that vets in practice can make a decent living
3.Ensure an efficient and robust education model that has alumni and private practitioner support.
4. Be willing to change our ideas based on changes in our industry-but ensure that our changes do not harm any other part of our profession.

Things are going to change.look at the history of the dental and legal profession.The same thing is going to happen to vet schools and it may be quite soon.What triggered the closing of dental schools was publicity about the poor job market in the NY Times.

Since NY Times just published such an article about vet med how long before enrollment tanks? Ross was advertizing for open spaces in may of 2013.

So the Deans have the ammo to fight the “grab the money while you can” lobbying.
They can say-hey the job market is getting pretty bad pretty quickly.The education load is making a veterinary degree not worth its investment.’
Time to innovate.partner with private specialty hospitals, get students out into clinical practices sooner, trim the courses, consider consolidation of schools and pooling of resources.

If its going to happen anyway why adopt a race to the top approach and survival of the fittest?
Is it not better to adopt a herd mentality where we stick together and work for the good of the health.Sure some stragglers will get picked off, but the rest of the herd will survive and be stronger.

The first schools to figure this out in my mind will be the ones most likely to survive the inevitable 400lb gorilla that stomped all over the dental and law schools.

So If I offended anyone I apologize.It was not my intent.But please understand I am really tired of getting fed a line of BS that is clearly not true or a distortion of the facts to defend what is really nothing more than chasing the money.

It boils my barnacles when I hear about a school opening up a practice for its students to get experience or buildinh a new state of the art secondary care facility because competition has reduced the vet schools teaching caseload. Dont reinvent the wheel. Universities are about as good at running these facilties as are GPs at teaching veterinary students.Stick to what you know and partner with others that have the facilties and expertese that you dont for the good of everyone.

commented 2013-07-17 12:12:15 -0400 · Flag
Eden & Carl;

I commend you both for a lively and spirited discussion!

One point, you both seem to be making, the current schools are failing.

Carl states; “certainly dont think the current vet schools are doing a very good job” and Eden; “What’s the harm in letting another school try to do it differently? Cause what we’re doing now sure ain’t workin”

Please define what you insinuate in these statements. I take exception to these points in some contexts, but not in others!

All my best-

commented 2013-07-17 00:17:24 -0400 · Flag
See Eden,
I think your reply shows why you should stop drinking.It is clouding your thinking.

You say what is the harm in letting another school try something different.
I have no problem with that as long as it has some benefit to everyone.

I have no interest in supporting an effort that makes a school richer and has no benefit to the students.
Can you point to one advantage that Westerns model offers to students over the current teaching modalities?
Are the Western and Ross students better educated, do they have lower debt, are they in any way different from the rest of the new grads.No.
So what have we gained by the distributive model? We have put more money into Western and Ross pockets.Period.
How the hell can you call that progress.Do you honestly think that Arizona and the other planned schools are forging a new way of teaching vet students.Is that why they are all rushing to start schools.If you believe what we are seeing is anything more than a money grab I have a bridge to sell you.
The ONLY benefit that has resulted from AVMA allowing the distributive model is the ease of which schools can jump on the veterinary bandwagon.

Veterinary education is big business as you have pointed out in other articles on your website.I cant understand why you give the new schools a pass just because they are doing something different.Their motives are exactly the same as other schools and it is disgraceful when the cost savings they are achieving by using the distributive model is not being used to lower student debt loads because they all charge a “going rate” for a veterinary degree.

The new schools are the hit and run model of education.Set up cheaply, rake in the cash and fold when the enrollment drops.Great business model for the schools-Not so great for the profession. Show me a school that is truly doing it differently.Show me a school that uses videotaped lectures to share faculty with another school. Show me a school that sends its specilaists out into the surrounding area to help staff private specialty hospitals and share the cost of salary and benefits foer the school.Show me a school that has the balls to say -you know what-we dont have any cows around us-Lets give up our LA clinic and swap students with another school that is in a more rural area and doesnt have a big SA caseload.

Show me a school that is willing to pass on any savings in running expenses to its students rather than pocket the money.
THAT is what I am talking about with symbiosis and that is a school I would welcome because that is a school that has a chance of improving the profession as a whole.

C`mon Eden dont be so naiive to think that Buffalo was a symbiotic venture.It would have been great for the lucky few invited into the circle and screw the rest of the veterinary community in that area.
What is sad about Buffalo is I am sure that lots of people made a lot of money on this attempt and that bill will ultimately be paId for by the Ross students of the future.

You think the local vets attention was poorly thought out.BS. They have seen enough of these “collaborative efforts” morphing over time into something that has decimated the local veterinary communities.Are they a little jaded.Sure.But until you sink every penny you have into a veterinary hopsital so you can walk in there shoes dont be so quick to judge them.

You say ROSS supports vet teaching hospital.No way.They rent space in them and we all know that renting is much cheaper than buying.They have no capital investment in these hospitals and if they are at the mercy of the land grant colleges then that was a decision they made when they started.

Do you think Ross opened in the Caribbean because they worried about the health of the students.No.It was a financial decision and if the millions of dollars they have saved in land purchase, operating expense,payroll and lack of capital investment in an advanced teaching hospital was reflected in the cost of education not DeVry share prices I would be waving the flag just like you.

I dont know where you got your tuition figures from.Mine were from schools 2011 re[porting on the VIN cost of education map.

There is absolutely no need to expose students to corporations or non-profits because as you say most of them wil be SA practitioners in 2-3 DVM practices.After all they get very little exposure to vet practices as it is and they seem to able to cope just fine.

I would support an effort involving collaboratiob between a school and a non profit and/or corporation as long as it didnt impact negatively on the surrounding veterinary community.

But theres the rub.When these plans emerge ( the Tufts plan is a classic example) they are so poorly conceived that ANYONE with half a brain can realize that without major changes they wont survive and if it wasnt for university financial support these efforts would never see light of day.
I calculated the Tufts school would need to see 30-40 patients per day just to break even.How is that possible with vet students,tech students and 1 GP? What may seem like a good idea on paper to someone from academia is very different from what a private practice owner would want to see.So the program starts and it loses money.But you are helping the poor because the clinic only treats the poor.What does the school do? If it pulls out it will get terrible PR that it abandoned the poor and it will lose a few big donors.Cant have that says the university board.So what do they do? They keep the program alive, but scale it back so it doesnt got so much.Only 1 student per week gets to go there and the future students get the expense of running the program added to their tuition.
Is that Evolution?

The Buffalo plan was the same.It was started on a shaky foundation with the “mavens” that were hired to push the plan talking about shortage of vets and 50% of pet owners never seeking vet care.And then the ASPCA got involved with some idea about maybe funneling their patients through the hospital.Would it be first opinion or specialty or both? What was the projected casload.Would they see clients from the local community as well.If so would ASPCA or Ross subsidize it to keep it busy enough?
Even though this was supposed to be a community effort no-one seemed to be able to answer those questions and there were confidentiality agreements preventing ANY discourse on it.And you are surprised and expressed sarcasm at the suspicions of the local veterinary community?
I am sure all the high powered mavens got paid even though the school failed.its a win win for them.

The profession is changing rapidly and we have to adapt to those changes.We also have to be aware though that some will take advantage of the changes for their own gain and that is actually what has happened.
Dont tell me it MAY be cheaper or better.Prove it to me and i will be your biggest fan.
I dont like being peed on and then being told its raining.

I will not give a new school a free pass because it says it is doing something differently.

I am all about change.I havent seen change.I have seen a few getting very wealthy off the rest and giving nothing back in return.

Having been a vet for 22 years I can still recognize a pig regardless of how much lipstick you put on it.

I certainly dont think the current vet schools are doing a very good job.I can think of lots of ways to improve in a symbiotic manner to the benefit of everyone.I think there are a lot of ways the profession can work with schools to mutual advantage.It will happen once the loan money dries up anyway.No harm in trying to start before then.

I have no problem tearing down a barn to build a bigger one

I have a problem buying gasoline to burn the barn from the company that sells gas AND new barns.

I also have no problem with trying to fix the barn as long as it is useful to me.

I am not going to buy a new barn because the barn builder tells me it is fireproof without seeing him set fire to one and show me it can survive the fire.

Enough analogies?

commented 2013-07-16 22:35:38 -0400 · Flag
See, Carl, this is why you should drink. Maybe if you would join me and Scott in downing three fingers (Buffalo Trace ok?) you’d slow down a little and consider some of the contradictions you put out here.

I agree that stemming the ever increasing supply of students who incur six figure debt to be a companion animal private practitioner is worthwhile. Like Scott said, training fewer vets is part of the solution. There’s also the little matter of training them to do different things. There are ways to drop the number of petvet wannabes that are FAR MORE EFFECTIVE than shutting down schools that might offer lower cost or a different focus. Like say, having the ability and the courage to give a New York Times reporter numbers… and point out they suck. How many people read that article? Or compiling sheets that show prevets how much total debt they’re racking up over four years. Those sheets I made have racked up 47 THOUSAND views by prevets since I made them not quite two years ago.

You’re the one saying we shouldn’t discount ANYTHING that potentially improves the future of the profession… What’s the harm in letting another school try to do it differently? Cause what we’re doing now sure ain’t workin! If they are the first ones to fold when the bubble bursts… good! As you say, they’ll fold quicker.

You also say you want symbiosis, you’d be fine with new schools if they were symbiotic, and that’s why you are glad Buffalo isn’t opening. So… you think holding onto the model where only land grant state supported universities educate almost exclusively companion animal practitioners to go into largely solo private practice… is symbiotic? As opposed to a school that was a collaboration between several existing schools, a non-profit, a tech program and thus had the possibility of producing a lower debt spectrum of grads which could then enter at non-profit, corporate, government and private practice.

Symbiotic means living together. Which model does that?

Having said that, I agree that the Buffalo school suffered from an atmosphere of secrecy and distrust. Of course, given the sort of reception even the idea of a new school meets (witness this discussion)… sort of tough to put something together in the glaring light of an entire profession’s poorly thought out attention, eh?

Now, regarding your comment that the ‘new’ schools Ross and Western are the most expensive in the country…

Ross is not new, nor do they use a distributive model. They DO pay to support a teaching hospital; a BUNCH of teaching hospitals, matter of fact, all the ones that contract with Ross to provide clinical space in their final year. You wanna complain Ross’s clinical year is too expensive? Point the finger at your vaunted land grants, they are the ones setting that cost!

Now, as far as Western goes…
Western is THIRTEENTH DOWN the list in cost if you were one of the 960 students- that’s 34% of all US vet students last year- who started last year paying non-resident tuition. Ross was TWENTY-NINTH. In fact, only two land grants were cheaper.

You want to minimize economic damage to students? The five top land grants charged $26 MILLION in tuition and produced 23% of the graduates. Since they’re in the US, and state subsidized, seems like they’d be easier to influence, huh. You know, if one wanted to affect schools charging a lot of money and producing a lot of graduates.

“This is not the future I want for the profession.” I think this is the crux of it Carl. What we want… doesn’t matter. No matter how much we want it to. What we already have wil not remain the ruling paradigm. Non-profits are here, corporates are here, distributive models are here, big box pharmacies are here, the country is an information economy and we can CHANGE or we can die.

Well, we’re going to die either way, actually- but if we allow and encourage change, if we intentionally and thoughtfully and deliberately destroy what we have worked so hard to bring to be- then our successors will do better than if we don’t.

It’s ok to tear down a barn to build a bigger barn.
commented 2013-07-15 23:51:54 -0400 · Flag
If edens post made you feel uncomfortable mine will positively give you the willies.

Firstly I disagree that making efforts to stem the ever increasing supply of vets is not worthwhile. The “body count” will include bright young people with six figures debt loads and no jobs.If we can prevent even a few of them falling into this trap we will have helped.
There is no one magic bullet for the profession, but we should not discount ANYTHING that potentially improves the future of our profession.

To use your analogy It is like a bleeding patient.We can either clamp the bleeding vessel or clamp the vessel, start IV fluids, measure BP and give colloids or whole blood to support the patient.
Giving whole blood without clamping the vein is not likely to be very successful, but if you clamp and give blood you WILL increase your patients chance of survival.
its not about fixing all the problems as much as buying time for the patient to stabilize.

I agree that until student loan spigot is curtailed the colleges will likely do nothing to stem the flow, but there are 2 things you are not considering;

1.Where do students gets their advice from about being a vet?From the glossly ad from vet schools.NO. From their vet.
As I have pointed out to the schools we in practice are the first in line to recommend vet school.If you look at my petition many GPs are already stating they are discouraging students from applying to vet school.
The profession has the power to stem at least some of the supply of students if the schools wont act responsibly.

2.History.Look at the history of the dental and law colleges.They have gone through the same unregulated expansion that we are facing.This was not due to readily available loans, but a perception of a shortage of lawyers and Dentists and promises of high salaries.The bubble burst and vet and law schools closed and the legal profession is still way oversaturated and only recently have dental schools started expanding again. So what drove the collapse of this expansion? Decreased demand for seats because of publicity that the job market was not very good. Enrollment sharply declined and schools folded.

You say the oversupply had a minimal effect on our current situation.That is not based on any data and in fact the fact we have excess capacity even in a market where clients can get low cost care suggests that the number of vets trained has exceeded the market demand for a while.

The idea that the new schools can reduce their fixed costs and therefore reduce tuition in theory sounds good, but in practice what has happened?

The 2 MOST expensive schools to attend are Western and Ross.
They have no teaching hospitals so why is their tuition not much cheaper than say for example Cornell?

So even though they have significantly lower costs they are still charging the same if not more than other schools.Why? Because they can.

The distributive model for veterinary education is in theory a good idea.In practice, however, it has opened the door for ANY college to start a veterinary program and that is exactly what is happening.

I`m sure the schools were overjoyed when AVMA allowed the distributive model.It hasnt caused an evolution or revolution of veterinary teaching.It just has made it easier for schools to grab some of that nice federal loan cash.

What will happen when the bubble bursts? The distributive models colleges will fold first because the college has no large financial investment in them. They will fire the faculty and reassign the labs and lecture halls to something else they can make money with.
The schools that spent millions of vet schools will stay afloat as long as long as they can to recoup their financial investment,

If the distributive model succeeds where is all the clinical research going to be done? How can AVMA say it is the gold standard when it accredits colleges that do little veterinary research?

As usual AVMA changed accreditation standards with absolutly no understanding of the effects of that change on the profession.

As far as the non-profits go I think vet schools getting involved with them is a minefield. Many Gps have firsthand experience of the damage that non-profits can do when they spread their model to encompass more than charity care.

I think it is unethical to offer care to some pet owners at reduced cost and not to others.Why should clients that cant afford to take care of their pets get free or low cost care when other clients make significant sacrifices to care for their pet.

I have no problem with non-proftis feeding hungry children, but I resent them encroaching on my livelyhood.

The non profit is NOT where the health care delivery model has gone.

The problem many vets in practice are facing is the lack of basic education and lack of bonding to a veterinarian that non-profits have exacerbated.The clients get the free spay and whatever vaccine the non proift does and then the clients are cut free.There is little follow up and often these clients only visit the vet when their pet gets sick.At this point they are expecting the low cost care they have previously received and are absolutely floored when they get an estimate from a private clinic.

Dont even get me started on the Tufts plan. It was readily apparent that the Tufts project was a poorly conceived and likely expensive proposition for the school.They had no permanent staff, no reminder system, no fee schedule and sporadic hours at best.
Their proposal would never pass a banks inspection to borrow money, but since money was being donated it didnt matter that there was no business plan in place.

BUT the major problem to my minds is why is Tufts creating a “model” veterinary practice WHEN IT IS SURROUNDED BY VETERINARY PRACTICES?

Here`s an idea.Send the students to local practices.Doesnt cost Tufts anything and gives the students real life experience rather than a fake hospital where they have to make ud fake fee schedules because the clients wouldnt be paying anything *(or vey little).How would that help the students learn the important lesson of working within the clients budget.

The same argument applies to partnering with ASPCA or Banfield. Not everyone will be working for them so why train students in their model?

We are NOT an information industry.We will never be that because you cant make a living doing that.Information is cheap these days.We cant charge enough on paid websites and it is a terrible way to practice medicine.

Vet schools just dont get it.They seem to be going out of their way to distance themselves from the profession.They would rather make their own practices than integrate with the private practices.Its not rocket science.There are fantastic opportunities to work with the profession.

You dont need new schools to evolve.Evolution occurs as there is pressure on a species to adapt.We are not seeing evolution.We are seeing predatory behavior by the education system to make money at the expense of the health of the profession.I am not going to support that.

I would support ANY partnership that is mutually beneficial for the school and the profession.That is evolution.The resources are in place-All it needs is the vision to make the first move.

Am I glad the BUffalo project failed.YES.Why? Not because I am a proponent of fewer vet schools.No.

I am glad it failed because it represents everything that is wrong with the current relationship between vet schools and the profession.
There was no open dialogue about how this could help the Buffalo veterinary community-just backroom deals, confidentiality agreement, secrecy and total lack of transparency.

This is not the future I want for the profession.It is about as far away from community,communication and trusty as you can get.

We shouldnt be talking about evolution.Evolution is about survival of the fittest.It is not an inclusive paradigm.

We should be talking about SYMBIOSIS. That is where the future lies.If something doesnt benefit everyone it doesnt get done.

The more I see our profession being prayed on the more I feel we should resurrect the “dont tread on me” flag and make it the new AVMA logo.
commented 2013-07-15 21:36:16 -0400 · Flag
Absolutely, Bourbon is my preference!

Too many veterinarians is only part of the problem – excess capacity encompasses the entire infrastructure of the profession, from private practices to veterinary schools. Training fewer veterinarians is potentially part of the solution. Other potential pieces include – fewer practices, fewer emergency clinics, fewer hospitals, etc. Devising methods to convert need into profit generating demand. If the profession becomes more efficient margins will increase.

More preventive care? Absolutely! Fewer doctors? Absolutely! Fewer practices? Absolutely! Attack the excess capacity from every angle – I think we are both thinking the same thing from slightly different perspectives!

So, Buffalo halted, a good thing? Absolutely!
commented 2013-07-15 21:09:45 -0400 · Flag
Agreed, capacity to provide service has been completely uncoupled from need and demand- and yes, largely by unlimited student loans issued on request.

Also agreed we have excess capacity, I would never argue that. I would argue rather that it’s not a useful way to phrase solving the problem of too many vets.

We know we’re going to graduate too many vets, increasing excess capacity even more, for at least another ten years. Over that ten years, and another ten, demographics dictate there will be fewer people, with less money, most likely owning fewer pets.

So even if we converted need into demand, there’s going to be less need to convert to demand, and less money with which people can satisfy that demand. In the face of additional excess capacity. So to me thinking in terms of excess capacity just means I’ m spending my time determining how screwed we are rather than how we can get unscrewed.

Need and demand are different. Demand is easily understood- what people are willing and able to pay for. There is great demand for seats in veterinary school, for example. This demand will drop when ability to pay drops as student lending reforms are enacted. Need? I do not think this is so easily defined. Need is a value judgement. The country needs a populace that doesn’t spend money it doesn’t have. So if we are to remain relevant in companion animal medicine, the profession needs to get much MUCH better at promoting preventive care, cost effective care and efficient care delivery models. Of course, the dirty flip side of efficiency no one likes to talk about is that we need fewer service providers in a more efficient model. Hmm…..

Again, welcome to the dismal science. Can I pour you a drink?
commented 2013-07-15 16:49:42 -0400 · Flag
Eden – I concur with nearly all your thoughts in this blog post! Yes, easy access to cheap student loans contribute greatly to the present situation. Yes, veterinary schools have extremely high fixed costs and this is a challenging problem to remedy in the short-term. Yes, we need to consider changes to our educational system and consider all alternatives.

I prefer the term excess capacity – the situation we find the profession in today is not simply a matter of there being too many veterinarians, we currently have more capacity in the system than we have demand for professional services. Yes, the number of veterinarians is high, you can make the case there are too many practices, too many x-ray machines, too many surgery suites, etc. This problem does not go away by simply reducing the number of students we’re educating! Excess capacity is the correct term!

We have a tremendous unmet need for veterinary care, without a doubt. One challenge for the profession is to turn this need into demand. How is this accomplished? Is price for professional services part of the solution? We don’t understand the elasticity of pricing for veterinary services well enough to know; will decreasing prices increase demand? I don’t think it’s that simple.

Many of the other comments you make could potentially train veterinary students to be more successful in turning this unmet need into profitable demand for the profession.

Why did the Kaleida Proposal fold? Not sure anyone knows, maybe a rational consideration of the state of the profession allowed the conclusion; adding more veterinary students isn’t prudent at this point!
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