Colorado could become the first state to introduce veterinary professional associates by 2026
The Colorado Secretary of State’s office has certified Colorado Proposition 129, formerly known as Proposed Initiative 145, which proposes the inception of a new midlevel practitioner (MLP) position in veterinary medicine known as a veterinary professional associate (VPA). The certification of this ballot initiative confirms that it will appear on November’s ballot in Colorado, and results will determine whether the state will become the first to establish the position.1,2
According to the initiative, VPAs would require a master’s degree in veterinary clinical care, or the equivalent, and registration with the Colorado State Board of Veterinary Medicine (CSBVM).2 The ballot measure tasks the CSBVM with the examination and determination of fitness of VPA applicants, along with the ability to issue, renew, deny, suspend, or revoke their licenses.2 VPAs would be allowed to practice veterinary medicine under the supervision of a licensed veterinarian. If passed, the initiative has an effective date of January 1, 2026, with the first graduates ready to enter the veterinary workforce in 2027.2,3
The official initiative cites a critical veterinary workforce shortage, rising concern regarding access-to-veterinary-care, those in Colorado’s agricultural industry, and Colorado’s food supply, as reasons for the proposal. The initiative claims that there is no way to solve these issues without identifying additional career solutions in the veterinary workforce.
All Pets Deserve Vet Care, one of the initiative’s biggest sponsors, reported that 65% of Colorado voters support VPAs.5 The initiative also referenced that “experts in veterinary medicine” have identified the implementation of VPAs as a solution to the workforce shortage and access-to-veterinary-care. Additionally, the Colorado State University (CSU) College of Veterinary Medicine and Biomedical Sciences is currently developing a degree program that would fulfill VPA requirements.
In an interview with dvm360, Bob Murtaugh, DVM, MS, DACVIM, DACVECC, FCCM, chair, National Academies of Practice (NAP), chair, Coalition for the Veterinary Professional Associates (CVPA), expressed his support for the initiative, not only in Colorado, but across the country. He cited the veterinary workforce shortage in his reasoning.
"You don't have to look any further than [PAs] in the human medical field to see the advantages of having a similar profession in veterinary medicine," Murtaugh said. "It's helping to address the shortage in healthcare on the human medical side, and we have a shortage of providers on the veterinary side... [VPAs] could increase access to care."
Murtaugh also noted his involvement with the CVPA. "[The coalition] is made up of a large number of well-respected veterinarians and technicians that are in favor of this position," he said. VPAs could provide support to shelters that don't have veterinarians, or even technicians in some cases, in addition to large animal, equine, and food animal practices.
“Skilled veterinary technicians are already more qualified than this contemplated VPA,” Karen McCormick, DVM, Colorado State Representative, said in an opinion piece published in the Longmont Times-Call in June.6 “They have comprehensive training, take a national exam, and are regulated by the state… Not only do we not need [this initiative], [it’s] dangerous. Please do not sign these petitions.”
Representative McCormick is not the initiative’s only opponent. The American Veterinary Medical Association (AVMA), the American Association of Bovine Practitioners (AABP), American Association of Swine Veterinarians (AASV), American Association of Equine Practitioners (AAEP), American Veterinary Dental College (AVDC), American College of Veterinary Surgeons (ACVS), Independent Veterinary Practitioners Association (IVPA), and the Veterinary Management Group (VMG) have all publicly opposed the initiative.1
“This ballot measure attempting to create a ‘veterinary professional associate’ would be disastrous for pets and other animals and endangers public health, considering that 75% of emerging infectious diseases in humans originate with animals,” Sandra Faeh, AVMA president, said in an AVMA News article.1 “The proposed training for this position is completely inadequate and will lead to missed or delayed diagnoses, ineffective treatment, and repeat visits, all of which lead to more suffering for the animal and increased cost for the client.”
The Colorado Veterinary Medical Association (CVMA) has also announced their opposition of VPAs. In a February 2024 survey of CVMA members, 60% of respondents did not think VPAs would positively benefit the profession.8 Some of the biggest concerns indicated in the survey’s open-ended section included VPA’s ability to perform surgery with 2.5 years of schooling, additional liability for veterinarians, and the underutilization of existing veterinary technicians.8
These feelings echoed a 2023 survey conducted by the American Association of Veterinary State Boards (AAVSB). The survey found most veterinarians and technicians supported better utilization of credentialed veterinary technicians (CrVTs) as the solution to veterinary workforce shortages, instead of VPAs.9
Addressing concerns
"It's not an either-or in our profession," Murtaugh said. "We need to use technicians more. We need to make sure they have title protection to make sure practices are working at their highest efficiency possible, but we have a shortage of veterinarians in all fields."
He explained the ways in which the initiative could provide not only better access to care, but benefit technicians. "[There is] a limited ceiling for what technicians can [currently] achieve, both in earning power and the ability to practice within their hospital environment," he said. "[The initiative would] allow a career path for technicians that could get them into 6-figures."
In response to concerns about the qualifications of VPAs, Murtaugh explained that the CVPA is collaborating with the Commission on Accreditation of Allied Health Education Programs (CAAHEP), an accrediting agency for human health professions. The collaboration is working on accreditation and standardization programs for VPAs. The CVPA is also in the process of working with 3 different licensing testing organizations to establish a national examination equivalent to the Veterinary Technician National Exam (VTNE) and the North American Veterinary Licensing Examination (NAVLE).
"So, these people would graduate from accredited programs with standardized learning objectives, [meet the] criteria to pass a national certifying examination. They would also require a state license, and they would be under the supervision of a veterinarian," Murtaugh explained. "So, where's the harm?"
To qualify for the ballot, 124,238 signatures were required in support of the initiative. On July 29, roughly 200,000 signatures were submitted by All Pets Deserve Vet Care.2,3 The initiative was initially filed by Apryl Steele, DVM, president and CEO, and Ali Mickelson, senior director of advocacy and education, of the Dumb Friends League, a nonprofit animal welfare organization that is sponsoring the initiative.2,3,4
The future of veterinary medicine in Colorado, and potentially the country, now rests in the hands of Colorado voters on November 5, 2024.
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