Does veterinary medicine need a midlevel professional?

dvm360dvm360 June 2023
Volume 54
Issue 6
Pages: 76

The latest installment of Vet World News from Steve Dale, CABC, discussing his opinion on midlevel professionals in veterinary medicine as a solution to access of care

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It’s been the talk of the town; proponents support a midlevel physician’s assistant (PA)-type job in veterinary medicine as a solution to access to care issues. I suggest this idea is totally misguided.

True enough, there are more pets than ever before: Sixty-sevent percent of American homes now have at least 1 pet.1 Although families were very busy bringing furry, feathered, and scaly family members into their homes in record numbers during the COVID-19 pandemic, there was something of a mass exodus of veterinary professionals. Those leaving the profession were citing compassion fatigue and wanting an improved work-life balance, not to mention retirees including, as in many industries, individuals taking early retirement.2

Today, clients in most places have a challenging time making timely appointments for pets who they feel are sick or even for routine care. It’s no secret that clinics that are open 24/7 are often overwhelmed, with waiting times extending past several hours and facilities even closing for the evening.

Of course, something needs to be done. However, adding a veterinary version of a PA equivalent is not the answer, at least not at this time. I suggest that the unintended consequences will do far more harm than good and valuable time will be wasted years before this could ever be implemented.

Today, many practices do not hire certified, licensed, or registered veterinary technicians, preferring a lesser-skilled and lesser-cost option of veterinary assistants. Reality check: If practices aren’t hiring credentialed veterinary technicians because of cost, what makes anyone think they would hire even more expensive midlevel professionals? In the real world, that’s not happening. And where would the money come from? Likely, the money would come from pet parents and from rebalancing budgets, then practices would hire fewer (if any) credentialed veterinary technicians.

Right now, certified, licensed, or registered veterinary technicians are, overall, both underpaid and underutilized. According to various studies, this underutilization directly corresponds with job dissatisfaction, and even more so than underpayment.3-5 Would hiring a midlevel practitioner further devalue credentialed technicians?

However, if certified, licensed, or registered veterinary technicians are given the opportunity to do their jobs at the top of their capability, fewer will leave the profession and more may enter it.5 What’s more, the gap in veterinary medicine between what registered veterinary technicians can do compared with veterinarians and what registered nurses can do compared with physicians isn’t as great. In other words, the midlevel profes- sional instantly filled a larger void in human medicine compared with the void available to fill in veterinary medicine because of the wide-ranging skill set of credentialed technicians.

Does the profession really gain by having midlevel professionals doing little more than what credentialed technicians can do, such as write prescriptions? One argument against this is that the technicians do not have the wide breath of educational knowledge compared with PAs in human medicine, as a result of differences in their schooling. There might be some truth here. Still, adjusting curriculums seems like a far easier and incidentally faster choice compared with adding a total new job description, which 50 state boards will ultimately be required to approve. Instead, let’s fix this: Today, 9 states do not mention licensure for veterinary technicians in their veterinary practice acts.

Who knows, maybe down the road a PA veterinary position will make sense as the profession twists and turns. However, the profession and pet parents need help now. If practices in the United States focused on hiring certified, licensed, or registered veterinary technicians—at increased salaries and actually employ the skills these individuals work so hard to achieve—change will occur quickly.

Steve Dale, CABC, writes for veterinary professionals and pet owners,
hosts 2 national radio programs, and has appeared on TV shows, including Good Morning America and The Oprah Winfrey Show. He is on the dvm360 Editorial Advisory Board as well as the boards of the Human Animal Bond Association and EveryCat Foundation. He appears at conferences around the world. Visit


  1. Pet ownership statistics. Updated April 17, 2023. Accessed May 16, 2023. pet-ownership-statistics/
  2. Bain B, Hansen C, Ouedraogo F, Salois M. 2019 Economic State of the Veterinary Profession. American Veterinary Medical Association. Accessed May 16, 2023. https:// tate-of-Profession-Report.pdf
  3. Larkin M. Survey finds underuse related to retention for veterinary technicians. American Veterinary Medical Association. December 15, 2021. Accessed May 23, 2023.
  4. 3 reasons great vet techs quit (and how you can keep yours). DVM Elite. Updated April 7, 2018. Accessed May 22, 2023. and-how-you-can-keep-yours
  5. Larkin M. Prime issue for veterinary technicians: underutili- zation. American Veterinary Medical Association. Updated November 7, 2018. prime-issue-veterinary-technicians-underutilization
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