Shortage of veterinarians persists as pandemic wanes

FAIRFAX — The number of animal patients veterinarian Dr. Loni Ellsworth saw during the worst of the COVID-19 pandemic doubled to tripled on an average day.

“I was seeing appointments every 15 minutes,” Ellsworth said. “ … I was starting to get really burned out, so I’ve had to figure out what my own boundaries are and what works for me.”

Ellsworth, originally from Fairbanks, Alaska, has wanted to be a veterinarian since she was 5 years old. She graduated from Iowa State University’s College of Veterinary Medicine in 2019 and practiced in Des Moines for about two years before joining Heartland Animal Hospital, in Fairfax, in 2021.

Three years after the start of the pandemic, Ellsworth continues to have new clients come in, which she said is great, but it also sometimes “feels like there’s no end in sight” to the challenges facing the industry.

The demand for veterinary services in Iowa — and across the country — grew during the pandemic as adoptions and the pet population increased. About 23 million households — or one in five — across the country added a cat or dog at the start of the pandemic.

This demand has outpaced the number of graduating veterinarians, causing strain on a system that already was facing shortages and challenges pre-pandemic, various professionals said. Veterinarians across the industry are experiencing a higher patient load and short staffing, along with the mental and emotional toll from the job.

“Because of that continued pounding that these veterinarians and these hospitals and private practice clinics take on a daily basis by trying to absorb all of these additional pets, the system has been breaking down and there is burnout,” said Jan Erceg, medical coordinator with Critter Crusaders of Cedar Rapids. The nonprofit focuses on advanced medical and surgical care for sick or injured pets in Iowa shelters.

While there’s no quick fix to the challenges, solutions are being explored, and Iowa is likely in a better spot than some other states, experts said.

“There is a real shortage,” said Randy Wheeler, executive director at Iowa Veterinary Medical Association. “The good news is that Iowa is fortunate compared to many states in that we do have a great veterinary school. … We're trying to mitigate a lot of these problems.”

Many local practices are hiring

Almost every veterinary practice in the area is hiring, said veterinarian Dr. Marty Weber with the Cedar Rapids Animal Hospital. The animal hospital is short one veterinarian, he said, and has a relief vet who comes in several times a month to help out.

Weber, who has been a veterinarian for 22 years and been with the animal hospital since 2006, has also seen an increase in new pets and appointments. The increase had been “steady,” but was "exacerbated during the pandemic,” he said.

“There's been at least two veterinary practices close in town in the last three to four years, so that puts a little bit more pressure on the existing day practices,” Weber added.

What can pet owners do?

As veterinary practices experience staffing shortages, the American Veterinary Medical Association has recommendations on what pet owners can do.

Dr. Lori Teller, president of the organization, suggests pet owners without a primary care veterinarian establish a relationship with one now before scheduling a visit becomes an emergency.

Teller said all pet owners should commit to seeking wellness care for their pets to avoid preventable illnesses. Also, scheduling these preventive appointments well in advance helps ensure pets are up to date on vaccinations and other care.

Veterinarians The Gazette spoke with also voiced the importance of community support from pet owners.

The shortage of veterinarians is being felt across the industry, but some clinics — such as specialty and emergency practices — “have been particularly challenged,” said Dr. Lori Teller, president of the American Veterinary Medical Association.

BluePearl Pet Hospital in Cedar Rapids sends local providers a list every month of when its emergency room will be closed. This is typically seven days out of the month. Bright Eyes Bushy Tails in Iowa City transitioned from 24/7 care to a day practice last year.

The Iowa Humane Alliance in Cedar Rapids, a high-quality, low-cost spay and neuter clinic, has been trying to hire for more than a year. It currently has one staff veterinarian.

Both Ellsworth and Weber brought up changes to their own practices when emergency services are closed or limited, including seeing additional emergencies when they can.

“We allow people to contact us on Facebook on days that the emergency clinic is closed up to certain time, so we've tried been more flexible with that,” Weber said.

Toll on emotional, mental health

The COVID-19 pandemic not only exacerbated the demand for services but it also impacted the emotional and mental toll of the job. Veterinarians who The Gazette spoke with talked about the job’s impact on mental health.

In addition to stress from the staffing shortage, veterinarians face compassion fatigue, euthanizing pets, burnout and sometimes rude clients.

Veterinarians face disproportionately high suicide rates. Not One More Vet is a national organization dedicated to supporting veterinary professionals struggling with suicide and mental health.

“It's hard enough to deal with tragedy and death and emergency and things like that,” said Jessica Martens, hospital manager at Bright Eyes Bushy Tails in Iowa City. “There's extreme highs and there's extreme lows, and you're going through that hour by hour by hour by hour.”

“We hear all of the stories with human medicine and how hard everybody works in human medicine and how the nursing staffs are short and the occupational therapists are short and all of those, that whole industry,” Martens said. “It is exactly the same in veterinary medicine, and it's just not widely spoke about.”

With the increased patient load, Ellsworth has had to create boundaries. Now, she works four days a week, seeing appointments two of the days and a combination of appointments and surgeries the other two.

“When I was stretched more thin, I feel like I couldn't practice the best way I could. I couldn't be as good of a vet as I wanted to be. So I've had to cut back in order to have higher quality medicine. I don't want to do my patients any disservices.”

Wheeler emphasized the importance of work-life balance in the profession.

“A veterinarian has so many different species that we're trained to treat,” Wheeler said. “It's a unique profession — we're radiologists, we're surgeons, we're podiatrists, we're funeral directors, we're morticians.”

What is the role of higher education in solving the shortage?

There remains a high interest in pursuing veterinary medicine education, but spots are limited. One potential solution to the veterinarian shortage is to expand current programs or create new ones.

“There is no doubt right now that there is a shortage of veterinarians in the United States — in fact, honestly, it's globally,” said Dan Grooms, dean of veterinary medicine at ISU. “ … Until we are able to get more veterinarians trained, that's going to continue.”

There are 32 accredited schools of veterinary medicine in the United States, and about 3,200 students graduate each year from these schools, according to the American Association of Veterinary Medical Colleges.

ISU’s College of Veterinary Medicine is the second largest in the country, behind Ohio State, Grooms said. About 30 to 40 percent of graduates stay in Iowa, he added.

ISU’s college has increased its class size over the last couple of decades, going from about 100 students in 2000 to about 160 students now. Throughout a four-year term, there are roughly 600 students, Grooms said.

The program received 2,100 applications for the 160 seats for the fall 2023 class.

“At this point, we're pretty much capped out on our ability to grow because of physical facilities, classroom sizes, our training centers, our laboratories and everything like that,” Grooms said.

Some new veterinary medicine schools are opening elsewhere. Some of the newer programs include: University of Arizona, which accepted its first class in 2020; Texas Tech University, which began its in 2021; and Clemson University, which is currently working to create South Carolina’s first veterinary school.

“It's not going to fix the problem today, but hopefully, it'll help alleviate the problem in the future,” Grooms said.

Loan repayment programs helping

But Grooms said the shortage in some sectors, like rural veterinary medicine, won’t be solved simply by creating more veterinarians.

“There have to be some other things that make it more attractive to practice in rural areas,” Grooms said. “Loan repayment is one of them. I think small communities doing things that make it more attractive to the new generations of veterinarians that we are training.”

Iowa has its own loan repayment program in addition to the federal program. Both programs focus on veterinarians working in rural or underserved areas, Grooms said.

Wheeler also mentioned loan repayment programs as a potential solution, especially with the high student debt some graduating veterinarians have. The average debt for veterinarian graduates in 2022 was $147,258.

“I look for that to continue to be important and good program for folks that want to work in underserved areas here in the state of Iowa,” Grooms said.

What are some other solutions?

A number of the professionals The Gazette spoke with said another potential solution would be to have a role similar to a nurse practitioner in health care. This position could help administer vaccines and do routine wellness exams.

Grooms said having midlevel practitioners and veterinary technicians with increased responsibilities is something he sees coming into the profession in the future.

Ellsworth said she would be in favor of such a program and it seems realistic to her. Having a practitioner do exams would free up time for surgeries, emergencies and seeing sick pets, she said.

“There are a lot of things that certified vet techs or registered vet techs can do that are overlooked,” Ellsworth said. “I know techs that are great at doing physical exams.”

The Iowa Legislature is looking at measures that would better define what a veterinary technician can do in the state, Grooms said. “With that better definition, potentially, those technicians can do things that they historically weren't able to do or at least we believe they weren't able to do so,” Grooms said about Senate File 541.

The American Veterinary Medicine Association currently is focusing on an workforce modeling project, Teller said. “We expect this tool to be helpful to understand the profession’s current labor and economic situation and guide longer-term planning for the veterinary workforce,” Teller said.

Grooms said telemedicine is another solution and one that ISU is starting to use and explore.

About the various solutions being explored, Wheeler added, “There’s some light at the end of the tunnel.”

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