University of Kentucky UKnowledge

Martin School of Public Policy and MPA/MPP Capstone Projects Administration

2013

Veterinary Specialty Certification: Analyzing the alueV of Certification Through the American Board of Veterinary Practitioners

Jeff Allen University of Kentucky

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Recommended Citation Allen, Jeff, "Veterinary Specialty Certification: Analyzing the alueV of Certification Through the American Board of Veterinary Practitioners" (2013). MPA/MPP Capstone Projects. 220. https://uknowledge.uky.edu/mpampp_etds/220

This Graduate Capstone Project is brought to you for free and open access by the Martin School of Public Policy and Administration at UKnowledge. It has been accepted for inclusion in MPA/MPP Capstone Projects by an authorized administrator of UKnowledge. For more information, please contact [email protected]. ANALYZING

AMERICAN

VETERINARY

Martin

THE

BOARD

School

Dr.

VALUE

J.S.

of

Graduate

SPECIALTY

OF

Butler, Public

Summer

OF

Jeff

VETERINARY

CERTIFICATION

Policy

Allen

Faculty

Capstone

2013

CERTIFICATION:

and

Adviser

Administration

PRACTITIONERS

THROUGH

THE

1 Appendices

Discussion Wor}{S

Research Findings Problem Background

Executive TABLE

Limitations Analysis Conclusions PVCT Veterinary

Sample Perceived

Specialization

Appendix

Table

Table

Table Table

Cited

Statements

......

Statement

OF

Design

Characteristics

Summary

4 2 3

1:

......

......

......

......

Value

Certification

&

Perceived

......

CONTENTS

&

A:

......

Literature

Further

vs.

......

Survey

of

General

......

......

Certification

Value

Research

......

......

......

Review

Practice

of

Certification

......

......

......

......

Tool..

......

,

......

23 27 25 27 24 20 22 23 23 22

21

19

17

19

16

15

I 0

6 3 4 6

2 primarily concerned

advance

confidence.

obtaining

that

value.

diplomates

perceived

the

Overall, ABVP

developed

the

for

enhanced

certification

EXECUTIVE

the

Perceived

organizations

statements

Regressiona

American

certification

This

The

When

the

respondents

ABVP

career

value

to

were

However,

survey

quality

study

programs.

collect

Value

it

with

SUMMARY

comes

of

opportunities

more

certification.

Board

that

supports

ABVP

was

analysis

of

with

higher

with

of

data

agreed

offer

these

veterinary

likely

to

This

Certification

completed

of

regard

from

external

professional

certification

Veterinary

the

intrinsic

them.

revealed

benefits

with

study

to

Other

are

ABVP

argument

agree

to

medicine

17

Self-improvement,

just

rewards.

was

improved

by

value

of

Tool (PVCT). Tool

are

variables

the

with

415

certified

Practitioners

a

certification

conducted

within

the

few

largely

intrinsic

that

who

received

them

by

18

of

income,

ABVP

PVCT the

instilling

had

and

the

internal

than

factor

veterinary

to

low

frequently

a

more

non-certified

(ABVP)

identify

is

number

non-dipomates.

statements;

recognition

enhanced

or

indeed fulfilling

veterinarians

to

and

agreement

negative

have

less

community.

by

provided

the

of

mentioned

ability

recording

potential

a

primary

likely

veterinarians,

however,

by

strong

correlation.

than

peers,

with

Factor

opinions

and

to

its

predictive

values those with those benefits

An

benefits

attract

and

greater

other

ABVP

public

stated mission

analysis

online

analyzing

relying

on

associated

veterinarians

benefits.

of

knowledge

benefit

can

certified

the

correlation

survey

extrinsic

certification

determined

be

value

heavily

the

cited

and

to

was

with

of

and

by

to

on

J PROBLEM STATEMENT

In today's competitive, knowledge-based workforce, specialized skill development offers

the opportunity to excel in one's chosen profession. When traditional education alone does not

confer upon its recipients the full range of ability or recognition that may be required in highly­

focused fields or subfields, many professionals seek out an additional measure of achievement in

the form of a specialty certification (Institute for Credentialing Excellence).

Within the veterinary community, certification is widespread but far from ubiquitous; although veterinarians often seek out advanced training after medical school in the form of internships and residencies, these common precursors to board certification are not mandatory as they are in human medicine. For those who do wish to identify themselves as specialists, there are many recognized non-governmental organizations that provide a variety of veterinary certifications (AAVMC 1-2). Among them is the American Board of Veterinary Practitioners

(ABVP), which offers certification based on one's expertise in certain species groups (AVMA,

"Veterinary Specialists - 2012").

As is the case with most other veterinary certifying bodies, earning and then maintaining an ABVP certification is a lengthy process that is not without a significant commitment in both time and money, leaving some to wonder if the benefits of certification are worth the sacrifice.

Consequently, a fundamental question exists for ABVP, one shared by many professional ce1iifying boards, veterinary or otherwise, and that speaks to the very core of their existence­ what is the true value of certification?

For ABVP, the intended value of the certifying process can be gleaned from their mission statement: "The American Board of Veterinary Practitioners advances the quality of veterinary medicine through certification of veterinarians who deinonstrate excellence in species-oriented

4 motivations. information

nobility Only truly

with Declarations certifying

than

ABVP's

that for encouraging, their assumes specialist-level correlation

clinical practice"

settle evidence

being

veterinarians

its

such

non-certified

want

research

the

What

Financial

mission statement:

of

Applicant

a

to

question

is

veracity,

entities,

to

strong

intent

between

at

support

and

For

like

understand

would

are

present

can

skills

could

example,

simply nor

data

this,

correlation

(Applicant

certified

uncover

peers

in

ofrelevance

Handbook

and

or

be

certification

part

the

and

collected

inadequate.

with

make

oppose

the

in

(Report not

the

poetry

knowledge"

because

part

documented

by

result

the "The

their

the

value

better

Handbook

between

ABVP

about

the

because

true

for

by the

of

principal

appeal

main

on

and of

position they

Perhaps

and words

decisions

ABVP.

value

this

Veterinary

the

and

veterinary

the

purpose

(

American

impact

truly

they 4).

correlations

to

4).

research?

intent

can

of

other

income

goal

personal

This

the

that

Any

While

certification.

make

embody

about

prove

of

only of

of

is

veterinary

they

Compensation

gives

economic

excellence

certification;

Veterinary

self-improvement

the

certification

(y)

ABVP's

Veterinarians

for

ce1iification

growth

area

that

between

are

organization.

and

the

us

great

actually

a

a better

where

beliefs

ce1iification

mission

boards

gains

mission

and

is

marketing copy.

Medical

ABVP

in

which

however,

21).

research

achievement,

based

regard would to

enjoyed

starting

succeeding

do

statement

which

Consider

Unfortunately,

is

through

certification

typically

is

Association

an

on (x)

have

even to

has

it

point

admirable

by

their

these

variables,

income.

is

specialists,

demonstrating

demonstrated

in

Yet

the

more

greater access

is only

are

earn

than

personal

being

their

groups

following

neither

and

common

starting

(A

to

even

more

income

one,

it

stated

VMA)

the

fulfilled.

firmly

does

adhere

while

if

the

the

point

than

point.

one

any

among

from

reason

to

not

if

show

held

we

to

5 values would not only be a key decision-making factor in favor of pursuing certification, it

would also serve as a motivational force throughout the difficult certifying process.

For ABVP, detailed evidence that they are indeed fulfilling their mission would provide

an internal sense of validation while confirming their importance to the broader veterinary

community. However, just as it helps to know the true benefits of certification, so to is there

merit in discovering any lack thereof. If, for instance, ABVP's certification process ultimately

results in no measurable positive outcomes, they will have effectively failed at their mission.

Such a revelation would likely result in needed reforms that might not otherwise have been

implemented.

An attempt to collect and analyze the relevant data for these purposes forms the basis this research.

BACKGROUND & LITERATURE REVIEW

Veterinary Certification

The AVMA reports that approximately 97,000 veterinarians are practicing in the United

States today. About two-thirds work in private practice, typically as either an associate or practice owner; the rest are employed by public or corporate entities. Just over 75% of those in private practice work either predominantly or exclusively with pets, also known as companion animals. Those who fall outside of this category are mostly large animal practitioners, working with either horses or food animals, such as cows, pigs and poultry. Among the veterinarians employed in the public or corporate arenas, the largest contingent-about 42%-work for universities. The rest are chiefly divided among various government agencies and private industries ("U.S. Veterinarians- 2012").

6 these

certifying with is experience perfunctory

American graduated the

confirm

competency

certifying state ability the influenza traditional profession. creating house subfields.

not

case

veterinary

colleges

or

organizations,

bestowed

calls

(AVMA,

In

This

other

that

with

a

strains

examination response

From

organizations have

from demand

Veterinary

concept

(American

has

Much

steps

to

snapshot

a

many

governmental

that

community

practitioner

be

faded

an

by

the

"A

keep

such

like

award

employed

accredited

for

government

of

to

VMA

professions,

neighborhood

they

Licensing

away

the of

the

researchers

niche

in

Veterinary

as

(ABVS,

veterinary

degrees).

human

all

providing family

expanding

Guidelines").

are

has

in

jurisdiction.

require

services,

in

been

college

evident (Bureau

favor

the

a

entities

"Policies

Exam

veterinarians

medicine,

given

Medical

hard

appropriate

clinic,

While

founded

medicine

the

veterinarians

of

depth

of

to

(AA

the

profession.

at

but

appropriate

Being

veterinary

the

Licensure

where

the

&

work,

highly

Association,

where

and

VMC

by

to

Procedures" Centers

conditions

demonstrates

evolved

are

education

aid

nonprofit

certified

of

breadth

the

the

5).

Labor

to specialized

required

the

in

For

medicine

is

burgeoning

state

increasingly

obtain

for

Veterinary

developing

quaint

a

into

veterinarians,

form

of

is

"A

Disease

for

Statistics,

boards

and

4-5).

licensing

not

veterinary

a

to

VMA

the

some

becoming

myriad

image

of

as

has

obtain

field

equivalent

broad

public

well

popularity

and

specialty

Control,

specialized

specialized

met

form

Guidelines")

"Occupational

we

board

of

of

colleges

a

as

science,

this typicallythis

and

the minimum

the

license

know a

protection

of

highly

scores

specialist

to

with

additional

where

town complex

certification,

of

being

knowledge

today,

skill

(not

to

exotic

a

advanced

evidence

from

as

doctor

number

practice

avian

designed

well

sets

to

Outlook").

licensed.

vary

nature

involves

so

standards

the

training

be

pets

required

too

and

who

as

among

however,

confused

North

of

of

fields

and

in

is

pass

of

has

having

swine

to

makes

As

their

fairly

the

or

of

the

a

and

is

of

7 The origins of veterinary specialty certification date back to 1950, when the first two

organizations petitioned the A VMA for recognition. The following year, the original guidelines

for the approval of veterinary specialty organizations were put in place, opening the door for the

formal recognition and advancement of numerous fields and subfields of veterinary science. In

1959, the AVMA established what is today known as the American Board of Veterinary

Specialties (ABVS) to facilitate the creation of new specialties and provide oversight for existing ones (ABVS, "Policies & Procedures" 1). According to A VMA nomenclature, an approved certifying board is known as a Recognized Veterinary Specialty Organization, or RVSO, while the specialty itself is called a Recognized Veterinary Specialty, or RVS. There are currently 22

RVSOs in the United States offering veterinary specialties in 40 categories-from anesthesia to zoological medicine (AAVMC 2).

Founded in 1978, the American Board of Veterinary Practitioners is a well established

RVSO that focuses on species-based care of the whole patient. While most RVSOs award specialties in specific medical disciplines, such as surgery or , ABVP was developed for veterinarians who demonstrate advanced ability and knowledge across the broad spectrum of clinical practice, yet focused on a single species group. ABVP began with three

RVS categories-Companion Mammal, Equine and Food Animal-but has since expanded to cover the following specialties: Avian, Equine, Beef Cattle, Feline, Canine & Feline, Food

Animal, Dairy, Exotic Companion Mammal, Reptile & Amphibian, and Swine Health

Management (ABVP, Applicant Handbook 4). Within these ten categories, ABVP boasts 900 active diplomates (as certified veterinary specialists are called) making it the fourth largest of the

22 RVSOs (AVMA, "Veterinary Specialists-2012").

8 2008 candidates percent candidates

48.5%

For

even

long

also

credentials

applicants pursue Credentials

portions

commitment. both

ce1iifying

their

curriculum must

Committee

species

those

given

as

sections,

at

advanced

(9).

submit

of

Not

its

six,

To

of

category

of

Unlike

the

distinguished

examination

examinees

most

annually,

in are

become

accepted

the

vitae,

members if

surprisingly,

are

a

375

the

A

it is

ce1iification

retaking

credentials

packet

clinical

then

efficient,

thorough

the

first

by

credentials

record

the

achieved

a

completing

reviewed

typically

credentialing

(8)

diplomate

necessary evaluate

who

year,

have

that

the

ability

enough

and

of

the

ABVP

credentials

packet that

pass

exam is

passing

continuing

takes

at

been

then

pursuit

applications

awarded

in

all.

only

(ABVP,

the

both

to

of

continuing

an

October.

certification

accepted,

or

three

place

ABVP

application

process,

sit

ABVP,

extensive

once a

rates

sitting

of

sections

for

packet

includes,

(25).

education

Applicant

ABVP

more

over

the exam,

for

records

were

Applicants

a

year,

it

the applicant which

education hours

veterinarian

the exam

the

can

for

chances

of credentialing

is

materials

certification

among

approved

the exam

beginning

a

course

the

take

and

indicate

Handbook

year-long

rather

the

first

have

to

two

over

do

other

road

of

and

pass

decisively

time.

may

must

not (2012

that

every

case

a

a

three

in January

and

requires

day

process

and

ahead

grade

year

documents,

13).

the

deviate

register

between

demonstrate

study

examination

ABVP

year

and

develop

opportunities

examination

A

to

the

is

filters

team

a

complete

and

a

slightly

manuscripts

has

much

significant

to

(8).

manuscripts.

half.

RVSO

2008

could

sit

their

an

averaged $75.5%

of

out

The

based

If

expertise

for

official

Credentials

process.

and

more

Annual

the

a

(24). as

case

to

examination

possibly

a

candidate

aspiring

two-part

time

have

2012

least

on

that

favorable.

reports.

Therefore,

Once

application,

whether

in

Report Applicants

document

their

suitable

only

their

take

all

passes

since

is

as

8).

The

9 All of this also comes at a financial cost for the applicant. The application fee is $400 and

the examination fee is $525 (26). Many veterinarians also hire proofreaders and editors to review

their case reports. When an interesting case comes along that an applicant thinks would be ideal

for a manuscript, many have chosen to pay for lab work and other procedures out of their own

pocket to ensure the case is fully documented (32). Once a candidate becomes certified, they must pay an annual fee of $250 to maintain that certification (26).

Specialization vs. General Practice

Of the roughly 97,000 licensed veterinarians in the United States, only about 11,000 can claim to have a certified specialty recognized by the American Veterinary Medical Association

(AVMA, "Veterinary Specialists - 2012"). The long and rigorous process to become a board­ certified diplomate of ABVP reflects the fact that so few veterinarians achieve a specialty certification. However, a number of variables influence the decision whether or not to specialize.

The economic climate for veterinary medicine and its various subfields is no doubt among the most salient considerations.

The professional outlook for veterinarians has been subject to considerable research and speculation over the years as analysts have attempted to predict the job market for veterinary medicine and reconcile it against both the strong interest in veterinary medicine among aspiring health professionals and the comparatively lower wages veterinarians receive in the medical field relative to their training. From a scholarly standpoint, one of the most thorough works on the subject was published in 1997 by Malcolm Getz, whose research did not look optimistically on the prospects for current and future veterinarians. In Veterinary Medicine in Economic

Transition, Getz argued that veterinarians were becoming increasingly oversupplied in the market, due, in part, to state government subsidies of veterinary schools, a very positive

10 perception In

medicine a terms where be remarkable

population Interestingly, in veterinarians, gains 2011 traditional put expand Compensation experienced

snakes

1997

year

his

2005,

a

the

downward

(11) dollars,

for

forecasting

(3).

while

salaries

and Despite

number

What

even

resulting

veterinarians

are

Getz

compared

of

companion

would

other

progress.

the

a

more

unlikely

accounts veterinarians this

this

mean

surge

for

lists

these effectively

pressure

of

actual

once

model,

represents

growth in reach

veterinarians

active

than

the

2011

of

a to

dire

In

to

period

unlikely

animals

have number

for

interest

mean

$65,208

expected.

the

a

become on

veterinarians

Getz

has income predictions,

steady

the

summarized

by

salaries

15

outpaced

real

full-time

of

occurred

surprisingly

society,

predicted

years

would

like

in

household

had

rapidly

in

state increases more

was

specialty

Getz

1997

dogs

and

already

since

inflation.

increase

of

market

$132,205

and

at

income

attractive

while

estimated

his

decelerated

fewer

the (35).

and about

97,111

companions

the

strong of an

conclusions

and

demonstrated

demand

cats

the

$19,506

For conditions increasing

publication

employment

for

by

80,000

exotic The

(11)

(AVMA,

economically

supply

that

continue demand

corporate

1,336

veterinarians

growth

AVMA's

for

versus $76,275

the

pets. and

(35).

has

by

of (33-35). veterinarians

interest

for

oversupply

little

for

of "U.S.

$18,057,

to stating,

new

increased

opportunities-all As until

and

However,

veterinarians

Getz'

remain

veterinary

Report

over

a

change

veterinarians

in

publically

Veterinarians

result,

in

2015

The

private

s

"careers

the

respectively

the

research,

in popular,

considerably

of

results,

on

would

AVMA

when

field

since

the

1997

next

veterinarians

services?

Veterinary

have practice

employed

population

in

from

the veterinary

decade"

the

grow

(36).

has he

annual

the

veterinary

-

in

estimates

demonstrated

argued,

(12). 1970s

an

continued

pet

2012"). women

While

In by at in

industry

income

$118,726

recent

terms industry

(13).

would

modest

of

in

would

for

turtles,

real

(153).

of

to

years

2012

peak

888

has

in

11 (AVMA, US Pet Dlvnership 46). In addition to the broadening diversity of animals in American

homes, pet owners themselves also appear to go undergoing a change. A VMA research shows

that 63.2% of pet owners consider their pets a part of their family, up considerably from 49.7%

just five years earlier (7).

Another development with significant affecting on the industry is the rapid advancement

of many areas of veterinary science. Ailments that are commonly treated in humans but that

typically required euthanasia for animals are now faced with greater parity as new technologies,

surgical procedures, and pharmaceutical options are being developed. Veterinary medicine has

also experienced increased demands in fields related to public health and biomedical research.

Concerns regarding avian influenza and other zoonotic diseases as well as the ongoing threat of bioterrorism will likely continue to fuel the need for veterinarians with training in these areas

(Bureau of Labor Statistics, "Job Outlook").

In light of these recent developments in the broader veterinary community, one should have no trouble seeing how these events have influenced the development of veterinary specialties. The advances in the breadth and depth of veterinary science, when combined with a more informed and, at times, emotionally invested consumer base, create opportunities for specialists to occupy and develop a number of new market niches. Dr. Larry R. Corry, former president of the AVMA, put it this way, "As the human-animal bond continues to grow, veterinarians are being asked by pet owners to provide increasingly advanced treatments, and this is driving them into specialties like internal medicine, and oncology" (AVMA,

New A VMA Market Data).

With regard to ABVP specifically, there exists a number opportunities for certified individuals to have a competitive advantage over other practitioners. For example, while equine

12 growing hospitals

diplomates feline

"Veterinary specialists

or veterinarian veterinarians loans graduation is salary feel $29,000, bigger

salary certification a

certified.

mean

imposing

three

as

to or

of

data

paycheck Despite

if

Despite

annual years

pay demand

exotic

have

they about

it

Though

by

certified with

may

collected

Specialists

enough;

can

off.

are

to

the

after

have

been

animal

income a

$65,500

engage the

the

seem

typically

significant.

Approximately

and

market

today.

thousands,

not

graduation.

no

additional around

average

in

for

willingness by

nearly as

those

medicine. choice

of

-

in

a the

residents

environment

pronounced, 2012").

make-a year

$179,920

additional

for

AVMA

amount

In the species

insmmountable

but

work

decades,

for

2011, However,

vast

89%

Not This

to

to

and

veterinarians

significant

pay

and compared

eschew suggests

groups

owed

training

majority

veterinary

surprisingly,

of

that specialists

may interns

a

for

income

veterinary

these

number

seems

being

have

specialized

(Lightfoot).

the

through

(Shepherd

that

in

of

to

disincentive

positions

long-term not

specialists restrictions advance

to

veterinarians never pursue in

also

near

$113,474

the of

many

due

students report

excess

pursuing

veterinarians

enjoyed a long-term

perfectly

to

care

and

of

study usually

the

benefits of

for who

for

these

imposed by

Pikel

specialties $150,000.

fact

a

those

programs, a

establishing

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27 7. Below are statements that relate to perceived values of certification by the American Board of Veterinary Practitioners. Please indicate the degree to which you agree or disagree with the statements as they relate to ABVP certification by indicating SA for strongly agree, A for agree, D for disagree, SD for strongly disagree and NO for no opinion.

Validates specialized knowledge SA A D SD NO

Indicates level of clinical competence SA A D SD NO

Indicates attainment of a practice standard SA A D SD NO

Enhances professional credibility SA A D SD NO

Promotes recognition from peers SA A D SD NO

Promotes recognition from other health professionals SA A D SD NO

Promotes recognition from employers SA A D SD NO

Increases consumer confidence SA A D SD NO

Enhances feeling of personal accomplishment SA A D SD NO

Enhances personal confidence in clinical abilities SA A D SD NO

Provides personal satisfaction SA A D SD NO

Professional challenge SA A D SD NO

Enhances professional autonomy SA A D SD NO

Indicates personal growth SA A D SD NO

Provides evidence of professional commitment SA A D SD NO

Provides evidence of accountability SA A D SD NO

Increases marketability SA A D SD NO

Increases salary SA A D SD NO

8. What is your gender? r Female

Male r Prefer not to answer

28