A market in transition: Is profession ready to seize the opportunities?

Portland, Ore. — Dr. Hugh B. Lewis shared a big vision during his career.

Dr. Hugh B. Lewis

And he had the opportunity to see it become reality.

The former Purdue University veterinary school dean was one of the key architects behind Banfield's DataSavant — now at some 20 million pet records strong — and a collaboration with Purdue's National Companion Animal Surveillance Program.

Lewis' retirement marks the end of his career, and development of the most comprehensive pet disease-surveillance system available to veterinary medicine. In collaboration with Purdue University's National Companion Animal Surveillance Program, the database can provide a type of early-warning system on the spread of infectious disease — zoonotic or otherwise.

Lewis, a boarded clinical pathologist, spoke with DVM Newsmagazine about his vision for veterinary medicine in the next 10 years. The future is bright, Lewis predicts, but the challenges are many. From the supply of veterinarians to preventing the next outbreak, here are some of his predictions:

Issue 1: Need for national database is here

From pet-food recalls to outbreaks of canine influenza, the need for a national disease-surveillance system has become all too evident.

DataSavant started as a tool for Banfield to gather evidence about its practice. It grew from there. In fact, the database is accumulating 3 million to 5 million veterinary cases each year. The data can be tapped as surveillance or to provide a retrospective look at diseases. Case in point? A piece for publication in JAVMA examined some 40,000 cases of advanced periodontal disease. The database was called in to offer analysis of last year's pet-food recall and reportedly helped convince the Food and Drug Administration about the safety of Fort Dodge's Proheart 6, which resulted in the reintroduction of the injectable.

"When you have a large population, you can generate convincing evidence for things," Lewis says. "Scott Campbell (Banfield's chairman of the board) always understood the value of a population database and the responsibilities that came with it."

So how far can this system go?

"I think terrifically far. We have the capability of disease surveillance right now. The data is dumped into the warehouse every day, but never more than 24 hours old. If someone was interested in surveillance for canine flu or avian flu by pet birds or even cats, we can do it in real time. As soon as the system is updated, it can be mined."

Issue 2: The hunt for more veterinarians

The effects of an undersupply of veterinarians is impacting the entire market, and it's going to get worse until it's addressed, Lewis contends. While he understands not everyone in the profession shares this view, he believes the trend will become more and more self-evident to each of the sectors in the market.

"It think it is limiting growth in every direction of veterinary medicine, whether it is small-amimal practice, large-animal practice or public practice. Everyone is crying out for more veterinarians."

An unfilled need starves growth in established areas of the profession and kills it for emerging areas.

"People argue there is simply an imbalance of veterinarians. That is rubbish. There is a lack of veterinarians, period," Lewis adds.

Take public health, for example.

"There are no borders any more. We are at a point where the public health aspect is becoming paramount. You have to be ready to serve the needs of society. The need won't go away."

Issue 3: Anemic funding for education

The financial pinch for veterinary education likely will continue, Lewis adds.

"States are withdrawing money at the same time the need is increasing. I think it has been very difficult for state universities."

At the same time, universities overseas and on the islands have been increasing class sizes as a way to boost supply.

"It is an interesting phenomenon because we have moved into globalization. Our state system is almost preventing our educational system from competing on the global scene. It is not preventing educational systems from other countries from competing. They are gearing up like mad. British universities have been told that we are living in a global environment; go out and educate the world."

"So, why aren't our own veterinary schools accredited overseas? Because there is so much need here, there isn't much of a stimulus to do that."

Simply seeking more money is not a long-term solution, he says. "They are going to have to look for other ways to do it. I think our schools need to restructure the way veterinary education is delivered to make it a lot less expensive."

Consideration should be given to the European style of veterinary education, a five-year veterinary program that begins following high school, Lewis says.

Issue 4: A changing model for advanced care?

When it comes to specialized care, veterinary medicine is falling into a two-tiered structure, Lewis says. Clearly defining the role of the generalist and specialist is critical to avoiding many of the problems emerging with the human health-care system.

Refer the complicated, unusual or difficult cases, Lewis says, but not all cases. The future hazard will be if general practitioners become triage doctors to the specialties, like in human medicine.

"It is impossibly expensive in human medicine. And when you start looking at the body from one discipline, you can't put it all together as a clinician."

Issue 5: An eye toward prevention

Just a few decades ago, food-animal veterinarians changed direction from an emergency role to one of consultation and prevention. The same trend will happen in small-animal medicine, Lewis predicts.

"Medicine has improved dramatically. The bonus is that long life goes along with good health. It is what people want for their pets. It's what food-animal producers wanted 20 years ago. Banfield has some 2 million people purchasing wellness plans. I think it is an important sign for the rest of our profession. As a doctor, if you have to start off with a problem, then you are chasing an ever-diminishing segment of the market."