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- [00:12]
A
Welcome to VetBusiness, brought to you by the Veterinary Hospital Managers association, where innovation meets expertise in the veterinary industry. Join us as we delve into the latest business trends, explore emerging technologies, and share strategic insights for today's veterinary practice leaders and managers. Whether you want to enhance your practice's operations, improve client engagement, or stay ahead in this dynamic field, VetBusiness is your go to resource for confidently driving your veterinary practice forward. Let's dive into today's episode.
- [00:47]
B
Well, welcome. I am Brian Conrad and I'm your host for VHMA's Vet Business podcast. Today we're going to discuss the idea of the creation of the Veterinary Professional Associate known as VAN GPA or the Mid level Practitioner, also known as mlp, and kind of the roles and what that encompasses. Joining me today is Anna Santos, who currently serves as the Animal Health Supervisor with the University of Georgia's Office of Research Animal Resources. It is here that she leads and supports teams of animal health technicians. Ms. Santos holds a degrees in Applied Technical Sciences in Veterinary Technology from Athens Technical College, a Bachelor of Science in Animal Science from the University of Georgia College of Agriculture, and a Master's of Public Health from the University of Georgia College of Public Health. Welcome Anna. How are you doing?
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C
I'm doing great. Thanks for having me today.
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B
You're welcome. I try not to, but you have such an incredible background and I'm trying not to butcher it, but I feel like I butchered it a little bit.
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C
It's okay. I have lots of different degrees and I've done lots of different things. I've been in the business for a long time, so for about 30 years. And I'm currently working in lab animal and so that's why I am a animal health technician.
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B
In addition to that, you're also working on kind of a book, is that right?
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C
Yeah, I am working on a book. I'm a co author on a veterinary disaster management book. My MPH is in disaster management. And when you do public health, it's really human based and so I've really tried to kind of emphasize the veterinary component in my practice with public health. So I do some work with different areas in disaster management.
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B
And if all that wasn't enough, you also serve as the president elect of the national association of Veterinary Technicians in America, where almost everybody knows it as nafta, where you're working to support and advance the veterinary technician profession nationwide.
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C
Yeah, I've worked with NAFTA for many years, actually probably about 15 or 20 years. I took a little break when I was doing my master's and then I came back and then I've been appointed president elect. So I'm excited about it. It's a long term commitment, but I think anything working towards some really good goals in our profession is important to have people that are committed to do that.
- [03:20]
B
And I think as we get into kind of our hot topic today of talking about the veterinary professional associate or the mid practitioner, let's talk a little further about kind of your background and kind of what's led you to this point where you just recently headed up the task force for NAFTA and helped them kind of reach a position on this.
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C
So my background has been in academia for the, well, probably the majority of, for the majority of my career. And when I say academia, I've worked at the University of Georgia Med school for about 24 years and then I actually was faculty at Athens Tech full time teaching in their technical college for about four years. So and I've also worked heavily with our state, Georgia's state association, Veterinary Technology Association. So I just have a lot of knowledge on governance component, the legality of stuff and then the educational component of stuff. And so they decided I would be the sucker to appoint the, to the task force leader. But actually I, I really enjoyed it. It was a, also a task force as we know. It's a very hot topic and people are very polarized with it. And so they felt like I would be able to navigate those conversations with fuel to actually get to our end goal of coming up with the appropriate statement for NAFTA members before we actually
- [04:53]
B
get to the NAFTA's VPA statement for some of our audience that is maybe not as familiar with the idea of a veterinary professional associate or a mid level practitioner. Can you give a little description or describe kind of what it is we're talking about?
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C
Sure, yeah. VBAs and mid levels have kind of been talked about for the last 10, 7 to 10 years out there as sort of a secondary line of education. And it's very similar to a physician's assistant to add advanced skill set levels to our veterinary technicians that are already out there. That isn't necessarily how it's, it's played out currently with the one state that has a vpa, but it is to help assist our veterinarians with some upper level skill sets.
- [05:55]
B
And so you said seven to ten years ago this kind of, this idea started and maybe you don't have the answer to this, but do you, do you have the feeling that this was started to give an additional step to credentialed technicians or do you feel like this was to fill a void of a shortage of DVMs? Do you have a sense of that?
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C
I think it depends on who you talk to. I think some people would say that they would have liked it to be a stepping stone for credentialed veterinary technicians, and it's not. So it's probably going to be the latter that you just mentioned of helping to fill potentially some spots for the lack of veterinary manpower in certain areas. So. And that's still questionable.
- [06:50]
B
Well, I think you've kind of already have kind of insinuated that this is. They're trying to kind of model this off of a physician's assistant or a nurse practitioner, if you will. And it's been going on for seven to seven, 10 years, approximately. Talk to me about the NAFTA task force that you led. Like, let's just, let's break that down.
- [07:10]
C
Sure. So the task force itself was formed and I have to think of my dates right now we're in 26. So it was in January of 25 and we spent 25 kind of looking at the BPA. And mainly it's because Colorado did. Pat, Colorado is the only state that has it in the country. They did pass a law to establish a BPA in their practice act and have a program at one of their universities. So we as NAFTA felt like we needed to come up with some sort of a position statement on it because it does affect our members and credentialed technicians all over the country. When I say it, I mean having this type of a position because it's a whole nother line item on the practice act. It's a whole nother credentialing system. It's a, it's, it's, it's a whole different thing than being a credentialed technician. So it was something that we needed to look at. And so initially we started out as a kind of a fact finding mission. We had a really great task force. We had somebody from a fairly large practice, small animal exotics practice. We had someone who is in industry as a consultant in all, all levels of veterinary medicine. We had educators in veterinary technology. I was on, I'm an educator in veterinary technology and an educator in vet schools as well. And then we also had an ABMA individual who was, I won't say a voting member, but we really felt strongly about including the ABMA and discussing this topic as them being one of our sister organizations. As we move forward with any sort of legislative type material in the Us, that's going to affect anybody, you know, veterinarians or technicians. And that was very, very helpful. We had Dr. Erin Casey came in and helped with that, and she brought a few other people just so we could understand exact what Colorado's law was saying, what the VPA was saying, how the ABMA was interpreting it, and then if we would interpret it the same way for technicians. Because as you know, you know, attack isn't a vet, A vet is an attack. It's two different things. Or a nurse, or whatever your state actually calls your support staff, potential support staff. So we tried to look at it very holistically and see, to see if it was the right thing for our members and for credentialed technicians. We looked at a couple of really important points with that, actually making sure that we felt like the education was adequate in it. That was one thing. Another important point we looked at was did this actually integrate our people that are already in the workforce as credentialed technicians? We have I think around 100,000 in the country. So, you know, if this was something that was going to affect everybody, did it integrate those people? And then did it actually strengthen the team, the veterinary health care team, so our nurses and our doctors working together to support our patients and our owners and provide appropriate service. The answer was pretty much to all of those things. We did not feel it answered any of those questions. The BPA did. We didn't feel like it was something that NAFTA could support as it was written.
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A
Sure.
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B
So let's, let's go back. Let's. Let's take a step back. And in your fact finding mission, what were some of the. When you were. So when you were very early on, were some of the facts that you were finding?
- [11:23]
C
So it's hard, you know, it's hard to talk about the vp. It's. Since we only have one state that has it, we can only compare it to that. The VPA in Colorado is a master's program. 85% of credentialed technicians in Colorado are associates. So they are automatically knocked out of the running to even apply to this. So your workforce, it is not a stepping stone for your workforce. So that's one of the, a very big component that we, and I don't like saying this is one state, I can only compare it to that one state, but that's the only state in the country we can compare it to. And it does not effectively promote veterinary technology or veterinary nursing as a career or a stepping stone. So there was that the program that they have in place has a very limited hands on. It's a hybrid program. So there's a hands on and a online component. Their clinical skills component was very limited. If you want to actually compare it to human nursing, like I said, it was very comparable to a physician's assistant. They get around 2000 hours of clinical training during their schooling. And we actually looked at that and compared it. Are we comparing apples to apples? And it's not. It's much less. They only have a semester of clinical training prior to going out. And once they would, if, if and when those boards are created, if they would pass that to go out and work into the field. So, you know, there was just a lot of information that we felt that we were gathering that was not effectively supportive to providing a safe environment for our pets.
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B
Are there other states that are looking at this?
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C
Florida did. It failed. And currently right now I'm not sure that's the other ones, but it did not pass through Florida this year through their. During their legislative time.
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B
Okay. And. And I imagine, I mean, because it sounds like this task force kind of went on for almost a year. Is that right? And so I imagine, I don't want to use the word heated, but I imagine that there was talk that was going back and forth and just good productive conflict.
- [13:57]
C
There was a lot, there was a lot of good productive because the rationale of the whole thing is utilizing individuals that are not veterinarians with a higher skill set, which is an understandable rationale. But we already have that in place with our. Well, with our bachelor's degree program. Well, I mean we can go through several different things, but we already have that in place, especially with our VTSs that are trained, have extended training in certain areas. So was a discussion on when it came down to it is can this help the working credentialed technicians currently that are on the ground, boots on the ground right now, how is that going to help them? That was a huge, like I said, I think I've already said that, but it's a huge component. It wasn't going to help them because we don't have a lot of bridging programs. And that can go into kind of what we decided what we wanted. Our plan was all of that heated discussion really came down to the fact that as a profession we need a better educational ladder for credentialed technicians. And that's where we really started getting into some good movement on, okay, if we don't support this, what do we support to help our task force grow and to thrive and to get these people advanced training. And so that, that's. Then we really started talking about a lot of different things and started getting into where our statement ended up. But yeah, you know, I sort of went in with, I tried to be very open minded. I had a lot of really good people that played the devil's advocate on all, on both sides. Like we'll look at it this way or look at it this way. And it, that was actually a comment that the AVMA gave to us with some of the folks that were involved in. They were very impressed with our ability to look at the, the hole and try to come up with a solution that would work. You know, instead of just saying no, we don't agree with it, you know, we really did assess it and we had to change people's minds and change people's minds back and people would come the next time and say I had to think about this and now I feel strongly about this statement. And they would tell us, you know, okay, this is what I think we should do with this with as we move forward. So yeah, and as you know, you know, in those types of there, those aren't easy to have those conversations. They're not fun to have all the time. And we, I was very lucky with the group that we worked with. Everybody was very respectful and part of the problem was education. We had to educate ourselves and we all helped each other do that. Somebody knew something that was like, well, think about this, I know that this is a fact or think about this type of information. And it took us that long to really educate ourselves to decide that to move in the direction that we did.
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B
Well, let's talk about that. So based off the years worth of conversations and fact finding missions and meeting with different people, NAFTA kind of rolled out with the following VPA sentiment and kind of statement. And let's talk about that.
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C
Yeah, so our statement, our full statement can be found on NAFTA.net if you look under the VPA statement, it's kind of long, it's like three paragraphs long. But on the whole, NAFTA currently does not support the BPA or mid level practitioners. Mid level practitioner models as they're set up, we absolutely support using technicians to their highest skill set and providing additional education for them to have additional skill set. And to do that I am going to read just the last paragraph of our statement and it says NAFTA supports a progressive veterinary technology veterinary technician centered education career path that builds on the profession's existing strengths by advancing Veterinary technology through structured education. From accredited associates programs to accredited bachelor's and master's level advanced veterinary technology programs, in addition to robust specialized credentialing and certifications programs, this approach strengthens the entire veterinary healthcare team and supports the practice sustainability, ensuring the highest standards for patient care and offering an academically supported base for the future of advancing the scope of practice.
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B
Well, as you kind of continue in your leadership role with nafta, kind of sum that up for me. What are some of the effective and efficient uses that you want to see technicians being used within our industry?
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C
You know, I think I was on a call yesterday with another group that nap just working with and we were talking about this. You know, everybody talks about this, like how to utilize technicians, how to utilize. And, and we really started saying, okay, like this, how do we get past this? And, and really getting to part and number one, in my mind. And this is something that people may agree or may not agree with. And I do think it's changing. And it depends again on who you talk to. I think education of our DVMs on how to use technicians is vital. I do not think. And I work in a vet school and I teach vet students, so I can actively say they're not taught how to use us and we need to work on. And when I say we, I don't mean nafta, I mean us as an industry needs to educate our DVMs on how to effectively use credentialed technicians in their practice. And that can look very different on what type of practice you have. We also need to be able to have some unified leadership all the way around that holds everybody to those same standards on how we are going to utilize our technicians. This can be a really big ask, you know, if you're asking a veterinarian in Oklahoma versus a and I'm not picking on Oklahoma, I just picked that out, you know, versus one here in Athens, Georgia, on how they effectively use their veterinary technicians. That might look really, really different because we might be talking about a small animal tertiary practice or a large animal practice. But I do think that vet schools in general have started to understand they need to teach their students how to utilize that. And we're seeing that in some of their professional skills curriculum on how to work with your staff. And so that's. It's new. It's how we have to start learning to work together to get the most efficient and effective work out of everybody and so everybody can go home in a timely manner. All of our patients have the best care all of our owners are talked to and understand the care that they're getting, we can decrease our burnout. We can decrease the attrition of people leaving the industry. So I would say if I have to pick one, I think it's education between all of us, like, how can we work together and how that can really be effective. And it might not look the same in every place.
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B
True. So I'm very big into sports, and so I always look for a scoreboard. So as we, as we looked at some type of metric with this. So obviously some of this work and some of this. Some of this work has already been done and accomplished, but obviously there's much, much more to go. You know, I've had the privilege of getting to, you know, go around to the various clinics throughout the country and, and see. And like you said, you know, there's some hospitals that completely embrace our credentialed technicians and are pushing them right to where the loss is. They can't do anything more. And then we have other credentialed technicians
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C
that are cats and dogs.
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B
Yeah. Yep, exactly. So I, I completely agree with you that there's a lot of work to be done. So I guess what I'm asking is, is how do you scoreboard this metric? What?
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C
You know, I think that's a great question. And I'm sitting here like, how am I going to answer this? I think, I really think. Scope of practice. We need to have our scope of practice in our practice act. We need to have credentialed technicians to be recognized in practice. And that's difficult because we have a huge shortage. So people, you know, I understand that's a, That's a whole nother topic. And, you know, it's sort. It's hard to get folks to, you know, if you can only find one credentialed tech to 10 on the job, train people and you need to run a business. You have to run your business. So how do we, how do we deal with that? So I think, you know, our state boards need. Everybody needs to adopt something very similar and hold to it that is progressive. And maybe that, that may not be the best word to use right now, but being progressive in utilizing, like you said, our technicians to the highest level. And then I also think we can start. We need more BTSs. We need micro credentialing. We need more bachelor's degrees. We need more master's degrees. We've got to keep people in the field. We've done a little bit better. Our last demographic survey went up from five to seven years, up to 13 to 14 years of staying in the field. So I think we are improving. But just like you, you know, nobody wants to do the same thing all the time. Everybody wants to learn. We've got to put some stuff in place for a appropriate educational ladder so people aren't having to go back and forth and they can, they can actually go to the next level.
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B
Sure, I'm putting you on the spot. And so I apologize because this wasn't anything that I had prepared you to be asked. But with the VTS. So you mentioned 100 credentialed, 100,000 credentialed technicians. Do you know approximately what percentage of them have gone on to the VTs?
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C
We have about 1600 in the country.
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B
Okay, so very small, one and a half percent.
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C
So it's something that NAFTA is very aware of and it's something that is on our list to work with. And it also, if you go. I believe my presentation is also on NAFTA.net we have some ideas about increasing our BTS size or potentially master's programs that teach specific skill sets or potentially sort of like mini residency programs, you know, in the specific area. Critical care is our biggest. They have probably, and don't quote me on this, I would say over probably a third of that 1600 is critical care. And then we've got a lot. Sixteen. There's 16 total. So there's believe that's the correct number. Everything else is dispersed through there. So, you know, getting that advanced care and advanced training. We've got to get this training in place. People have, have a hard time accessing that. And so getting the training accessibility to everybody equally and standardized is very important. And sort that sort of came out with our plan also.
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B
Okay, well, you've already kind of described some of the things that you're hoping to see in the next five years. But anything else that you'd like that you're hoping to see for our credentialed technicians growing.
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C
I mean, I would love to see more NAFTA membership if I could fit a little dig in for us because I do feel like we have a really good seat at the table nationally with our other sister organizations. The longer I'm in this field, the. I won't say it's because of. It has grown into this. The veterinary team has grown into a team. When I started 28 years ago, it wasn't as, as much of a team. Now it is a team. Now I see that students that leave and they understand who everybody's role is we just need to provide enough people to give them to have in those roles. You know, if it's an assistant or if it's a credentialed veterinary technician. And it veterinarians absolutely want. I feel this is, this is a Santos opinion. I think veterinarians absolutely want to help us and they absolutely want to do the right thing by technicians and utilize them. They just need to know how to do it. So I would love to see that team just grow a little bit harder or bigger and more solidified about who does what and there's just no question about it and we can get even more efficient.
- [28:34]
B
Any last thoughts as we head off for the day?
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C
I'm sure NAFTA is going to be doing more and more things, so please reach out to us if you ever have any questions or want any more information. I appreciate it, what I do. I'll say that I love. I love being a technician and I love being a nurse. I love being an educator.
- [28:52]
B
Well, the passion certainly comes out. And just getting to know you for the short time that I've gotten to meet you, it's obvious that you love what you do. So that's awesome. It's been such a great pleasure, Anna, getting to speak with you today. From you being able to take us through kind of that journey of almost a year with your task force and getting the point where you guys had a created a statement for the VPA and MLPs and then us understanding, you know, how we're as an industry and as a whole, that we have to work together and come together in creating a kind of a unified way to facilitate the use of our credentialed technicians and to find further job satisfaction for them and decrease that burnout that you talked about. It's been just an awesome time together. So thank you.
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C
Thank you, Brian. I appreciate your time too.
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B
Until next time, for Anna Santos, I am Brian Conrad. I look forward to speaking with you next month on what is impacting managers and the veterinary industry. Have a great day.
- [29:55]
A
Thank you for tuning into VHMA's vet business podcast. We hope today's insights inspire you to push the boundaries of veterinary practice management. Subscribe, review and follow VHMA for more episodes. Until next time, drive your practice forward and create a brighter future for veterinary care.