Economic Report

Texas Veterinary Medical Association ECONOMIC REPORT

2017

INTRODUCTION

The Texas Veterinary Medical Association (TVMA) and the American Veterinary Medical Association (AVMA) conducted a workforce analysis of the veterinary profession and the economic impact of the veterinarians in the state of Texas. The objectives of this report are:

• To present the general economic conditions of Texas and their implications on the veterinary profession;

• To evaluate and describe supply and demand in the market for veterinary education;

• To evaluate and describe supply and demand in market for veterinarians, providing an overview of the veterinary workforce in Texas and factors affecting income, student debt, hours worked per week, and underemployment;

• To evaluate and describe the market of veterinary services in Texas; and

• To determine the economy-wide impacts of the veterinary profession in Texas.

In 2016, the AVMA in collaboration with the Survey Research Laboratory of the University of Illinois at Chicago launched the first Census of Veterinarians. The same census questionnaire was sent to all members of the TVMA and to a random sample from the AVMA membership list. Findings from the two groups are presented in this report to allow a comparison between Texas veterinarians and the general population of U.S. veterinarians. Because the random sample was drawn from the AVMA membership list, it is possible that members from the TVMA were selected to take part of the AVMA sample. To avoid duplication, those in the AVMA sample were excluded from completing the TVMA questionnaire. The survey was electronically delivered and kept active for three weeks. A reminder was sent at the end of each week, and the survey officially closed at the end of the third week. Of the 21,638 AVMA questionnaire recipients, 2,545 were returned, yielding a response rate of 11.8 percent of the AVMA member sample. The TVMA questionnaires were sent to 3,212 and 354 responses were received leading to a response rate of 11.0 percent of the TVMA population.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The quantitative analysis of the responses may be viewed in three major aspects: the descriptive statistics, the analysis of variance, and the linear regression or factor analysis. Descriptive statistics summarize the general trends of the data collected. These statistics give an overview of the observations in the sample. A better use of these summary statistics requires that a weighted coefficient be applied to each of these distributions to account for the true distribution of the population.

A generalized linear model was used for the analysis of the variance. The purpose of this analysis of variance is to determine whether there are significant differences in means across selected groups. For instance, one might need to know whether the average number of hours worked per week differs between female and male veterinarians. Another example is to see whether the difference in professional income between veterinarians with board certification and veterinarians without certification is statistically significant.

The third aspect is to determine what factors affect income, student debt, underemployment, and expected years to retirement using quantitative methods. For this purpose, simple linear regression models were applied to the observed data. The simple linear regression models are preferred statistical models when the response variables are continuous and when statistical assumptions such as linearity of the variables, multivariate normality, low multicollinearity, no auto-correlation, and homoscedasticity are met. The estimates produced under these statistical assumptions are then called Best Linear Unbiased Estimators (BLUE).

This report contains five components: (1) the general economic conditions of Texas; (2) the market for veterinary education; (3) the market for veterinarians; (4) the market for veterinary services; and (5) the economic impact analysis of the veterinary profession in Texas. The general economic conditions present macroeconomic measures that can be used to assess the economic health of the state. Veterinary markets are tied to the economic performance of the region, and an overview of the trends or a forecast of performance metrics can help the profession’s decision makers. The market for veterinary education provides information about the supply and the demand for veterinary education in Texas. The Texas A&M College of Veterinary Medicine and Biomedical Sciences is the major supplier of veterinarians in Texas. In this report, a comparison is made, in terms of tuition and fees, living expenses,

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. and NAVLE pass rate, between the Texas A&M veterinary school and veterinary colleges in relatively close proximity. The market for veterinarians provides an overview of the veterinary workforce in Texas. This section presents the demographics of the respondents, and uses quantitative analyses to determine factors affecting some important measures such as income, underemployment, number of hours worked per week, and student debt. It also determines the net present value (NPV) of a DVM degree. The market for veterinary services presents an estimation of the population of each type of pertinent animal in each of the Texas regions using secondary data from the Census of Agriculture or estimated data from the AVMA pet population calculator. The number of veterinary practices per region was estimated using the U.S. Department of Commerce (USDC) estimations. Also estimated was the potential size of the market of companion animal and large animal veterinary services by combining information from the Census of Agriculture, the pet population calculator, and the USDC. For the EIA, the IMPLAN input-output model was used to estimate the economy-wide impacts of veterinarians on regional economies.

EXECUTIVE SUMMARY

As with other states, and the nation as a whole, how the Texas market for veterinary services fares depends on the conditions of the economy in which it operates. To better understand how the Texas market for veterinary services is affected by the economy of the Lone Star State, as well as to consider the relationship among veterinary markets in the State, the Texas Veterinary Medical Association and the American Veterinary Medical Association teamed up to perform a workforce analysis of the veterinary profession and the economic impact of veterinarians in Texas. The findings are related in detail in the pages of this report.

In surveying the economic conditions in the large and diverse state, economic performance metrics and trend analysis were applied to discover signs of potential economic downturns that could negatively affect Texas veterinarians. The Business Cycle Index (BCI), the Leading Economic Index (LEI), the Gross State Product (GSP), the trade-weighted value of the dollar, and the unemployment rate were combed for clues about where the state’s economy might be headed in the near term. In mid-2008 the LEI dropped considerably, and reached a low in early 2009. Following this contraction, a climb to a 2014

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. high point reversed itself with a slide that appears to flatten in 2016. The corollary BCI indicates that the Texas economy is heading in a positive direction, hinting at no imminent recession.

Like the Gross Domestic Product, the GSP is an economic tool used to measure economic health and standard of living. In making a year-to-year comparison, economists check the real GDP, which controls for inflation within the period being examined. As with the nation’s real GDP, the real GSP of Texas declined during the 2009 recession. Between 2010 and 2014, however, the GSP of Texas increased from $1.2 trillion to approximately $1.5 trillion. And though it dropped slightly since the fourth quarter of 2014, it wound up Q4 2016 with a moderate increase from the previous quarter. Cost of living and unemployment were also examined in the study area. It is less expensive to live in Texas than in other largely populated states, and although the unemployment rate increased since 2015, it still registers below 5 percent.

DVM: Expense and Recompense

As the institution in the state charged with turning out veterinarians to serve the population, Texas A&M University (TAMU) College of Veterinary Medicine and Biomedical Science statistics are evaluated for trend information. During the last three academic years, at least 83 percent of the applicants to TAMU – which the majority of veterinarians practicing in Texas call their alma mater – were in-state applicants. The three-year admission rate for all applicants: 30 out of 100. The average annual tuition and fees for the 30 veterinary medical colleges in the country have more than doubled, from $10,549 in 1999 to $27,096 in 2015. Texas A&M University ranks in the middle with a total cost of obtaining a DVM at $173,070. Tuition and fees generally make up about half the total cost, with other expenses including housing, transportation, school supplies and food.

From 2001 through 2016, the mean starting salary for new Texas veterinarians rose from $42,000 to more than $65,000. (These numbers are inclusive of those finding full-time employment as well as those pursuing internships, residencies and advanced education.) Factors speculated to have significant effects on starting salaries are age, gender, location, anticipated work hours per week, and practice type. Similar to the methods used to understand the factors explaining variation in income were applied

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. to determine the factors significant in explaining variation in DVM debt, studying the region in which the school is located, age, gender, and year of graduation. Over the last 16 years, the DVM degree debt of all veterinary students has been increasing at about $5,400 per year nationally and approximately $4,200 for Texas study respondents (for those reporting non-zero debt, the annual increase has been approximately $6,200 and $5,400 for the national sample and Texas sample, respectively).

Companion animal veterinarians comprise 65.9 percent of the respondents in the TVMA sample. The second and the third largest proportion of respondents are college or university employees and mixed animal practitioners – groups whose distribution is consistent with the general population of U.S. veterinarians. More than 80 percent of respondents from the TVMA membership are employed full- time. Of all the respondents in the TVMA sample who were asked if they would like to change their current work load for an adjustment in their compensation, 68.8 percent said they prefer to maintain the same number of hours per week with no change to their compensation.

Mixed animal veterinarians in the state earn the highest average income ($149,737) followed by companion animal veterinarians ($140,003) and equine veterinarians ($129,125). And, while calculations taking into consideration the pet population of the state and the current average per household expenditures on veterinary services estimate the market for veterinary services for companion animals in the state at nearly $2 billion, the report notes, too, that Texas is one of the largest producers of cattle in the country.

Texas Taxes and other Contributions

To capture and quantify changes to the Texas economy resulting from veterinary activity, an economic impact analysis (EIA) was performed using a software tool developed for such purposes. Economic impacts are derived by merging data from government agencies and other sources and then applying multipliers to attain estimates. The results are presented as chained effects of activity: For the veterinary service industry, the direct effect would be the impacts directly generated by a practice’s activity; indirect effect refers, in turn, to the effects generated by the providers of goods and services to the practice; and the induced effect comes from expenditures of the employees of veterinary practices

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. and employees (or hours of employment) resulting from providing local goods and services to a veterinary establishment.

Noteworthy findings of the EIA relative to organization types’ impact the state’s economy are:

• With $531 million in output, corporation-type practices produce 7,239 jobs directly linked to the state’s veterinary industry, generate $411.5 million in payroll for their employees, and provide an estimated $32.2 million in taxes to the state government.

• Texas veterinary S-Corporation output totals $1.2 billion, and these enterprises pay $442.9 million in salaries or wages to the 17,138 workers they directly employ, and contribute an estimated $94.1 million to the state in taxes.

• Individual proprietorships generate 4,846 direct jobs, support a statewide payroll of $286.9 million and generate a total industry output of $713.1 million. These businesses are expected to provide $25.1 million in state tax revenues.

• Partnership-type practices generate 2,687 direct jobs and pay $112.4 million in labor income, while delivering $ 197.2 million in output and contributing an estimated $13.3 million to the state’s tax coffers.

• Not-for-profit practices in Texas support a statewide payroll of $17.6 million through 275 jobs, and reflect $20.2 million in output.

From the High Plains to the “Metroplex” area, and from the Gulf Coast to West Texas, a detailed breakdown of statistics by economic region within the state further examines the contribution of the veterinary industry in Texas to the vibrancy of the state’s economy.

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INTRODUCTION ...... 2

EXECUTIVE SUMMARY ...... 4

LIST OF TABLES ...... 12

LIST OF FIGURES ...... 14

SECTION 1: GENERAL ECONOMIC CONDITIONS ...... 18

1.1 Business Cycle Index and Leading Economic Index ...... 18

1.2 General Economic Condition as Measured by the Gross State Product ...... 21

1.3 Cost of Living as Measured by the Real Value of 100 DollarS ...... 23

1.4 General Condition of Unemployment in Texas ...... 25

SECTION 2: MARKET FOR VETERINARY EDUCATION ...... 25

2.1 The Texas A&M College of Veterinary Medicine and Biomedical Science ...... 26

2.1.1 Resident-to-non-resident Ratio ...... 26

2.1.2 Male-to-female Ratio ...... 27

2.1.3 NAVLE Pass Rate ...... 28

1.1.4 Cost of Education: Tuition and Fees ...... 29

2.2 Texas A&M and the Supply of Veterinarians to the Local Communities...... 34

2.3 Income, debt, and Debt-to-income Ratio of New Veterinarians ...... 35

2.3.1 New Veterinarian Incomes ...... 36

2.3.2 Factors Affecting Incomes for New Veterinarians ...... 41

2.3.3 New Veterinarian Debt ...... 44

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 2.3.4 Factors Affecting Debt for New Veterinarians ...... 55

2.3.5 New Veterinarian Debt-to-income Ratio ...... 56

2.3.6 Factors Significant in Explaining the Debt-to-income Ratio ...... 58

SECTION 3: MARKET FOR VETERINARIANS ...... 62

3.1 Data Source and Summary Statistics ...... 62

3.2 Employment of Veterinarians in Texas ...... 69

3.3 Underemployment in the Veterinary Profession ...... 73

3.3.1 Summary Statistics ...... 73

3.3.2 Work Preference by Number of Years since DVM Graduation ...... 83

3.3.3 Work Preference by Practice Type ...... 84

3.4 Job and Career Satisfaction...... 86

3.5 Income of Veterinarians in Texas...... 89

3.5.1 Income by Type of Position ...... 91

3.5.2 Income by Gender ...... 92

3.5.3 Income by Board Certification ...... 92

3.5.4 Income of Associate Veterinarians vs. Practice Owners ...... 93

3.6 Factors Affecting Income: A Regression Analysis ...... 95

3.7 Veterinarians and Wellness ...... 97

3.7.1 Compassion Satisfaction ...... 97

3.7.2 Compassion Fatigue ...... 102

3.7.3 Determinants of Burnout: A Regression Analysis ...... 109

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 3.8 Internship and Residency: Effects on Income and Professional Success ...... 110

3.8.1 Reason for Undertaking the Internship ...... 114

3.9 Expected Age of Retirement ...... 115

SECTION 4: MARKET FOR VETERINARY SERVICES ...... 116

4.1 Understanding the NAICS 541940 ...... 116

4.2 Demand for Veterinary Services in Texas ...... 120

4.2.1 Companion Animal: Potential Size of the Market ...... 120

4.2.2 Livestock Industry: Potential Size of the Market ...... 123

SCTION 5: ECONOMY-WIDE IMPACT ANALYSIS ...... 130

5.1 Description of the Study Area ...... 130

5.2 About IMPLAN ...... 130

5.3 Economic Impact Analysis by Type of Business ...... 132

5.3.1 Corporations ...... 132

5.3.2 S-Corporations ...... 133

5.3.3 Individual Proprietorships ...... 134

5.3.4 Partnerships ...... 134

5.3.5 Not-for-profit Organizations ...... 135

5.4 Economic Impact Analysis by Economic Regions in Texas...... 136

5.4.1 Employment ...... 136

5.4.2 Labor Income ...... 137

5.4.3 Total Value Added ...... 138

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5.4.5 Revenue to the Government ...... 140

Recognition of Authors ...... 142

Works Cited ...... 143

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Table 1: Tuition/Fees and Total Cost of a DVM Degree by Veterinary School ...... 31 Table 2: Detailed Costs of Attending Texas A&M Veterinary Medical College ...... 34 Table 3: Factors Affecting Starting Salaries of New Veterinarians – AVMA ...... 42 Table 4: Factors Affecting Starting Salaries of New Veterinarians – TVMA ...... 43 Table 5: Factors Affecting Debt of New Veterinarians ...... 56 Table 6: Factors Affecting Debt-to-Income Ratio ...... 60 Table 7: Distribution of Respondents by Employment Status ...... 70 Table 8: Length and Duration of Unemployment ...... 70 Table 9: Unemployment by Gender ...... 71 Table 10: Unemployment Based on First Veterinary Position...... 72 Table 11: Unemployment Based on Age Group ...... 73 Table 12: Underemployment by First Veterinary Position ...... 75 Table 13: Factors Affecting Change in Hours Desired to Work ...... 82 Table 14: Factors Affecting Professional Income of Texas Veterinarians ...... 96 Table 15: Mean Compassion Satisfaction by Graduation Year ...... 97 Table 16: Mean Compassion Satisfaction by Board Certification ...... 98 Table 17: Mean Compassion Satisfaction by First Veterinary Employment ...... 98 Table 18: Mean Compassion Satisfaction by Gender ...... 99 Table 19: Mean Compassion Satisfaction by Level of Income ...... 100 Table 20: Mean Compassion Satisfaction by Ownership Status ...... 100 Table 21: Mean Compassion Satisfaction by Employment Sector ...... 101 Table 22: Mean Compassion Satisfaction by Educational Debt Status ...... 101 Table 23: Mean Burnout by Graduation Year ...... 102 Table 24: Mean Burnout by Board certification ...... 102 Table 25: Mean Burnout by First Veterinary Employment ...... 103

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 26: Mean Burnout by Gender ...... 103 Table 27: Mean Burnout by Level of Income ...... 104 Table 28: Mean Burnout by Ownership Status ...... 104 Table 29: Mean Burnout by Employment Sector ...... 105 Table 30: Mean Burnout by Educational debt Status ...... 105 Table 31: Mean Secondary Traumatic Stress by Graduation Year ...... 106 Table 32: Mean Secondary Traumatic Stress by Board Certification ...... 106 Table 33: Mean Secondary Traumatic Stress by First Veterinary Employment ...... 106 Table 34: Mean Secondary Traumatic Stress by Gender ...... 107 Table 35: Mean Secondary Traumatic Stress by Level of Income ...... 107 Table 36: Mean Secondary Traumatic Stress by Ownership Status ...... 108 Table 37: Mean Secondary Traumatic Stress by Employment Sector ...... 108 Table 38: Mean Secondary Traumatic Stress by Educational debt Status ...... 108 Table 39: Determinants of Burnout ...... 110 Table 40: Internship and Residency Participation by Board Certification ...... 111 Table 41: Internship and Residency Participation by First Employment ...... 112 Table 42: Internship and Residency Participation by Additional Degree ...... 112 Table 43: Internship and Residency Participation by Type of Employment ...... 113 Table 44: Internship and Residency Participation by Type of Position ...... 113 Table 45: Internship and Residency Participation by Gender ...... 114 Table 46: Internship and Residency Participation by Student Debt Status ...... 114 Table 47: Reasons for Undertaking the Internship ...... 114 Table 48: Determinants of Expected Age of Retirement ...... 116 Table 49: Number of Establishments, Total Output, and Average Output by Region ...... 119 Table 50: Number of Pet-owning Household by Region ...... 121 Table 51: Population of Pets by Species and by Region ...... 121

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 52: Number of Veterinary Visits by Species per Year ...... 122 Table 53: Total Veterinary Expenditures by Species and by Region...... 123 Table 54: Economic Impact Summary – Corporations ...... 133 Table 55: Economic Impact Summary – S Corporations ...... 134 Table 56: Economic Impact Summary – Individual Proprietorships ...... 134 Table 57: Economic Impact Summary – Partnerships ...... 135 Table 58: Economic Impact Summary – Not-for-Profits ...... 135 Table 59: Number of Establishments, Output, and Average Output per Establishment ...... 136 Table 60: Effect of Veterinary Industry on Employment ...... 137 Table 61: Effect of Veterinary Industry on Labor Income ...... 138 Table 62: Effect of Veterinary Industry on Total Value Added ...... 139 Table 63: Effect of Veterinary Industry on Industry Output ...... 140 Table 64: Effect of Veterinary Industry on Government Revenue ...... 141

LIST OF FIGURES

Figure 1: Business Cycle Index and Leading Index – 2000 to 2016 ...... 19 Figure 2: Percent Change in Business Cycle Index and Leading Index ...... 20 Figure 3: Percent Change in Business Cycle Index for Selected Major Metros ...... 21 Figure 4: Percent Change in Business Cycle Index for Selected Border Metros ...... 21 Figure 5: Gross Domestic Product (National) and Gross State Product (Texas) ...... 22 Figure 6: Real Value of $100 by States ...... 24 Figure 7: Unemployment Rate in Texas and at the National Level ...... 25 Figure 8: Residents and Non-Residents Students - 2013 to 2015 ...... 27 Figure 9: Distribution of DVM Students by Gender ...... 28 Figure 10: NAVLE Pass Rate - Texas A&M vs. National Average ...... 29

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Figure 11: Change in Tuition over Time ...... 32 Figure 12: Tuition and Fees for Selected Veterinary Colleges (Residents) ...... 33 Figure 13: Tuition and Fees for Selected Veterinary Colleges (Non-residents) ...... 33 Figure 14: Respondents by Regional Location of Veterinary Medical College Attended ...... 35 Figure 15: Mean Starting Salaries of New veterinarians – AVMA Sample ...... 37 Figure 16: Mean Starting Salaries of New Veterinarians – TVMA Sample ...... 37 Figure 17: Distribution of Starting Salaries for New Veterinarians – AVMA Sample ...... 38 Figure 18: Distribution of Starting Salaries for New Veterinarians – TVMA Sample ...... 39 Figure 19: Mean Starting Salaries of Private Practice Veterinarians – AVMA Sample ...... 40 Figure 20: Mean Starting Salaries of Private Practice Veterinarians – TVMA Sample ...... 40 Figure 21: Debt of New Graduates – AVMA Sample ...... 44 Figure 22: Debt of New Graduates – TVMA Sample ...... 45 Figure 23: Difference in Mean Debt – AVMA Sample ...... 46 Figure 24: Difference in Mean Debt – TVMA Sample ...... 46 Figure 25: DVM Debt by Post-graduate Plans – AVMA Sample ...... 47 Figure 26: DVM Debt by Post-graduate Plans – TVMA Sample ...... 48 Figure 27: Mean DVM Debt: Private Practice – AVMA Sample ...... 49 Figure 28: Mean DVM Debt: Private Practice – TVMA Sample ...... 50 Figure 29: Mean DVM Debt: Public Practice – AVMA Sample ...... 51 Figure 30: Mean DVM Debt: Public Practice – TVMA Sample ...... 51 Figure 31: Mean Starting Salaries and Debt of New Veterinarians – AVMA Sample ...... 52 Figure 32: Mean Starting Salaries and Debt of New Veterinarians – TVMA Sample ...... 53 Figure 33: Mean DVM Debt by Gender – AVMA Sample ...... 54 Figure 34: Mean DVM Debt by Gender – TVMA Sample ...... 54 Figure 35: Debt-to-income Measures – AVMA Sample ...... 57 Figure 36: Debt-to-income Measures – TVMA Sample ...... 58

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Figure 37: Gender Distribution ...... 63 Figure 38: Distribution of Respondents by Year of Graduation ...... 64 Figure 39: Distribution of Respondents by Type of Employment – AVMA Sample...... 65 Figure 40: Distribution of Respondents by Type of Employment – TVMA Sample ...... 65 Figure 41: Distribution of Respondents by Race ...... 66 Figure 42: Distribution of Respondents by Age Group ...... 67 Figure 43: Distribution of Respondents by Marital Status ...... 67 Figure 44: Distribution of Respondents by Type of Community ...... 68 Figure 45: Distribution of Respondents by Home Ownership ...... 68 Figure 46: Distribution of Respondents by Type of Position ...... 69 Figure 47: Underemployment by Gender ...... 74 Figure 48: Current Hours Worked and Desired to Change Hours Worked – AVMA Sample ...... 76 Figure 49: Current Hours Worked and Desired to Change Hours Worked – TVMA Sample ...... 76 Figure 50: Current Hours Desired by Gender – AVMA Sample ...... 77 Figure 51: Current Hours Desired by Gender – TVMA Sample ...... 78 Figure 52: Net Hours Desired – AVMA Sample ...... 79 Figure 53: Net Hours Desired – TVMA Sample ...... 79 Figure 54: Desired Number of Hours Worked Per Week at Current Wage Rate ...... 80 Figure 55: Desired to Work More Hours per Week ...... 83 Figure 56: Desired to Work Fewer Hours per Week ...... 84 Figure 57: Desired to Work More Hours per Week by Practice Type ...... 85 Figure 58: Desired to Work Fewer Hours per Week by Practice Type ...... 86 Figure 59: Level of Income and Satisfaction with Compensation ...... 87 Figure 60: Level of Income and Satisfaction with the Profession ...... 88 Figure 61: Level of Income and Satisfaction with Current Job ...... 88 Figure 62: Level of Income and Satisfaction with Lifestyle ...... 89

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Figure 63: Mean Income by Practice Type – Private Practice ...... 90 Figure 64: Mean Income by Employment Sector – Public and Corporate Sectors ...... 90 Figure 65: Mean Income by Type of Position ...... 91 Figure 66: Mean Income by Gender ...... 92 Figure 67: Mean Income by Board Certification Status ...... 93 Figure 68: Mean Income of Associate Veterinarians by Type of Practice ...... 94 Figure 69: Mean Income of Practice Owners by Type of Practice ...... 94 Figure 70: Internship and Residency Participation ...... 111 Figure 71: Cattle Population and Number of Farms by Region ...... 125 Figure 72: Distribution of Farms by Size and by Region ...... 126 Figure 73: Distribution of Cows and Heifers that Have Calved by Region...... 127 Figure 74: Distribution of Beef Cows by Region ...... 127 Figure 75: Distribution of Milk Cows by Region...... 128 Figure 76: Distribution of Horses and Ponies by Region ...... 129 Figure 77: Distribution of Mules, Burros, and Donkeys by Region ...... 129

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The performance of the market of veterinary services depends on the general conditions of the local economy. If the market is perfectly competitive (all service providers have indistinguishable services so that the only factor that separates providers is price), veterinarians will provide just enough services to meet the demand of buyers. That is, the quantity of veterinary services produced by veterinarians is exactly equal to what the pet owners, the government, industry, and laboratories demand (equilibrium quantity). Because there will be no shortage or surplus of services in the market, the price that buyers pay will also be equal to the price that veterinarians were asking (equilibrium price).

An equilibrium point reached, however, is not permanent: Any change in the demographics of the buyers/sellers, in the economic performance, or in monetary or fiscal policy structure can disturb the equilibrium, with consequences for both veterinarians and buyers. This analysis presents different economic performance metrics and investigates trends to identify potential signals of economic downturns that could be detrimental to Texas veterinary businesses. The indicators used are the Business Cycle Index (BCI), the Leading Economic Index (LEI), the Gross State Product (GSP), the trade- weighted value of the dollar, and the unemployment rate.

1.1 BUSINESS CYCLE INDEX AND LEADING ECONOMIC INDEX

The BCI provides a monthly forecast of the strength of the economic performance (expansion or recession) over a period of time. In Texas, the business cycle indexes are published on a monthly basis by the Federal Reserve Bank of Dallas. An increase in the BCI indicates an improvement, while a decrease signals worsening business conditions. Veterinary practice owners should keep an eye on this index to better manage their businesses, as knowing ahead of time that challenging economic conditions are coming will help inform production decisions, such as staffing moves. Additionally, the LEI signals a change in the direction of economic performance. Knowing when the economy is heading for recession is critical to making effective investment decisions.

Figure 1 presents the BCI and the LEI in Texas during the period 2000 to 2016 and Figure 2 presents the percent changes for each of these two indexes. The two-vertical black dashed lines indicate the period

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. of the last recession. The LEI declined sharply around the middle of 2008 and reached its lowest point in the first quarter of 2009. This period is called the contraction period and is characterized by an economic downturn that slows all economic activities. Demand is reduced, production declines, and income level decreases. Because of the low level of demand and lower production rates, the unemployment rate can increase. Looking at the recent three years, the LEI in Texas reached its highest point in 2014 and has since seen ups and downs. The last three years show a downward trend, which appears to flatten to around 110 in 2016. The trend in the BCI suggests that the local economy is heading in a positive direction and that a recession is not on the near horizon.

The percent change in the BCI offers a clear view into the relationship between the index and the performance of the economy. The BCI begins to decline several months before an economy is officially declared to be in recession. The behavior of this index at the end of 2016, for example, shows an increasing upward trend, which barring a major exogenous factor precipitating a recession, indicates continued growth in the economy for at least the next six months of 2017. The percent change in the LEI decreased between 2014 and 2015 but declined since the second quarter of 2015.

Leading Index (Jan. 2007 = 100) Business-Cycle Index (Jan. 2007 = 100)

120 150 115 140 110 130 105 120 100 110 95

100) = 2007 (Jan. Index Cycle 90 100

85 90 2007 Index (Jan. = Leading 100) - Business 80 80

Jan-00 Jan-01 Jan-02 Jan-03 Jan-04 Jan-05 Jan-06 Jan-07 Jan-08 Jan-09 Jan-10 Jan-11 Jan-12 Jan-13 Jan-14 Jan-15 Jan-16

Figure 1: Business Cycle Index and Leading Index – 2000 to 2016

Source: Federal Reserve Bank of Dallas

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Texas Business-Cycle Index: 177.1 (2000) Texas Leading Index: 125.8 (2000)

20% 15% 10% 5% 0% -5% -10% -15% -20% -25% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 2: Percent Change in Business Cycle Index and Leading Index

Source: Federal Reserve bank of Dallas

Figure 3 presents the percent change in the business cycle index for selected major metro areas in Texas, and Figure 4 presents the same index for border metros in Texas. The deep decline observed between 2008 and 2010 indicates the period of the last recession. All metro cities have experienced a decline in businesses during the 2009 economic downturn, with McAllen, Laredo and Houston having suffered the most. Among the major metros, Houston continues to struggle to recover from the recession. The percent change in BCI during the last three years in the Houston metro area has been negative.

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1.5%

0.5%

-0.5%

-1.5% Austin – Round Rock Houston – The Woodlands – Sugar Land -2.5%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 3: Percent Change in Business Cycle Index for Selected Major Metros

2.5% 2.0% 1.5% 1.0% 0.5% 0.0% -0.5% -1.0% -1.5% -2.0% McAllen – Edinburg – Mission El Paso -2.5%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 4: Percent Change in Business Cycle Index for Selected Border Metros

1.2 GENERAL ECONOMIC CONDITION AS MEASURED BY THE GROSS STATE PRODUCT

The Gross Domestic Product (GDP) measures the monetary value of a nation’s total output in a specified time period. At the state level, we will refer to the value of the state production of goods and services as

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. the Gross State Product. The GDP is a widely used economic tool to assess the economic health of a nation as well as to gauge its standard of living. For year-to-year comparison, economists prefer to rely on the real GDP, derived by applying a price deflator to the nominal GDP to keep the value of the dollar constant, controlling for inflation, for the entire analysis period.

The real GDP declined in 2009 during the last recession, likewise observed in the real GSP of Texas (Figure 5). The X-axis in the chart below presents the years in quarterly increments, while the left Y-axis corresponds to the real GDP of the United States; the right Y-axis represents Texas’ real GSP. Between 2010 and 2014, the GSP of Texas increased from $1.2 trillion to approximately $1.5 trillion. The state GSP has slightly declined since the fourth quarter of 2014, but the last quarter of 2016 ended with a modest increase in the GSP compared to the third quarter.

United States Texas

19,000,000 1,800,000

18,000,000 1,600,000 17,000,000

16,000,000 1,400,000

15,000,000 1,200,000 14,000,000

13,000,000 1,000,000

12,000,000 800,000 U.S. (millionsGDP of current dollars)

11,000,000 Texas GDP (millions of current dollars)

10,000,000 600,000

2006Q1 2006Q3 2007Q1 2007Q3 2008Q1 2008Q3 2009Q1 2009Q3 2010Q1 2010Q3 2011Q1 2011Q3 2012Q1 2012Q3 2013Q1 2013Q3 2014Q1 2014Q3 2015Q1 2015Q3 2016Q1

Figure 5: Gross Domestic Product (National) and Gross State Product (Texas)

Source: Bureau of Economic Analysis

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 1.3 COST OF LIVING AS MEASURED BY THE REAL VALUE OF 100 DOLLARS

An important variable in analyzing the market for a specific good or service is the cost of living in the study area. When the cost of living is high, resources will be allocated to essential needs, with pet health care potentially left off the priority list. For this study, we examined the real value of the dollar in each of the 50 states, to see which of these states presents the lowest value of the dollar. A lower value of the dollar implies that the cost of living is relatively expensive. Comparing the value of $100 in each state, the red vertical line indicates $100 in Figure 6, with states to the left of that line being relatively expensive to live in compared to states to the right of the line. Texas is one of the states to the right of the line, so that we can conclude that life is relatively cheaper in Texas than it is in other states.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Wyoming Wisconsin West Virginia Washington Virginia Vermont Utah Texas Tennessee South Dakota South Carolina Rhode Island Pennsylvania Oregon Oklahoma Ohio North Dakota North Carolina New York New Mexico New Jersey New Hampshire Nevada Nebraska Montana Missouri Mississippi Minnesota Michigan Massachusetts Maryland Maine Louisiana Kentucky Kansas Iowa Indiana Illinois Idaho Hawaii Georgia Florida Delaware D. of Columbia Connecticut Colorado California Arkansas Arizona Alaska Alabama $80 $85 $90 $95 $100 $105 $110 $115 $120

Figure 6: Real Value of $100 by States

Source: Tax Foundation

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 1.4 GENERAL CONDITION OF UNEMPLOYMENT IN TEXAS

The unemployment rate in Texas is below the national average (Figure 7). The unemployment rate by definition measures the percentage of the labor force that is jobless. Since its peak at 8 percent during the recession of 2008-2009, the unemployment rate in Texas has continuously declined, reaching its lowest level in 2015 at around 4.4 percent. Since 2015 the unemployment rate increased, but is still below 5 percent.

Texas National

6 Unemployment rate Unemployment 5

4 Jan-06 Jan-07 Jan-08 Jan-09 Jan-10 Jan-11 Jan-12 Jan-13 Jan-14 Jan-15 Jan-16

Figure 7: Unemployment Rate in Texas and at the National Level

Source: Bureau of Labor Statistics

SECTION 2: MARKET FOR VETERINARY EDUCATION

The market for veterinary education is an important component in understanding the veterinary industry. The ability to provide veterinary services starts in the market for veterinary education. In total, 30 U.S. Veterinary Colleges and 19 foreign, U.S.-accredited colleges contribute to training the U.S veterinary workforce. Texas is home to one of the domestic veterinary medical colleges: the Texas A&M College of Veterinary Medicine and Biomedical Science – TAMU. Over nearly a century, TAMU has graduated more than 6,000 veterinarians. Established in 1916, the Texas A&M College of Veterinary

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Medicine and Biomedical Science is today a major research center, producing high-qualified veterinarians to meet the local demand and to supply the national and the international markets. In 1920, the college graduated its first veterinarians.

This section of the report uses information form the 2016 Census of Veterinarians, the 2016 Senior Survey, and other secondary sources to present key points about this Texas veterinary medical college and compare them with other, competing colleges.

2.1 THE TEXAS A&M COLLEGE OF VETERINARY MEDICINE AND BIOMEDICAL SCIENCE

2.1.1 Resident-to-non-resident Ratio

The admission statistics indicate that at least 83 percent of the applicants to TAMU during the last three academic years are from the state of Texas (in-state applicants) and the remaining 17 percent are out- of-state applicants. The three-year admission rate for all applicants is 30 out of 100 applicants.

The applicant-to-admitted student ratio for both resident and nonresident veterinary students is presented in Figure 8. The values in the figure indicate, for example, that in 2015, 30 applicants out of 100 resident applicants were admitted to the program, while13 non-residents out of 100 applicants received admission. In 2014, the number of admitted students from a sample of 100 applicants was 34 and 15, respectively, for residents and non-residents.

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0.5

0.4

0.3 Admitted Ratio Admitted - to - 0.2

0.1 Aplicant 0.0 2013 2014 2015 Non-Resident 0.09 0.15 0.13 Resident 0.37 0.34 0.30

Figure 8: Residents and Non-Residents Students - 2013 to 2015

Source: Texas A&M Veterinary Medicine and Biomedical Science

2.1.2 Male-to-female Ratio

During the three academic years of 2013-2015, the proportion of admitted female students increased from 78.1 percent in 2013 to 82.6 percent in 2015, whereas the admisison rate for male students has declined from a little more than 20 percent to 17.4 percent in 2015 (Figure 9).

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78.1% 79.6% 82.6%

21.9% 20.4% 17.4%

2013 2014 2015

Figure 9: Distribution of DVM Students by Gender

2.1.3 NAVLE Pass Rate

Graduates who intend to practice veterinary medicine are required to pass the North American Veterinary Licensing Exam (NAVLE) administered by the International Council for Veterinary Assessment. Figure 10 shows the NAVLE pass rate for TAMU and the national average. Except for 2015, the NAVLE pass rate (2011-2014) for TAMU has been consistently higher than the national average and always above the 95 percent level.

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100

96 Pass Pass (in Rate %) 95

93 2011 2012 2013 2014 2015

Figure 10: NAVLE Pass Rate - Texas A&M vs. National Average

1.1.4 Cost of Education: Tuition and Fees

Veterinary education in the United States is provided by both not-for-profit (public) and for-profit (private) institutions. The tuition and fees can be viewed as the price of a seat. Unlike the market for veterinary services, where the concept of a competitive market can be applied, the market of veterinary education does not meet the requirements for a competitive market. The principle of many players (buyers and sellers) in the market so that one player’s behavior does not affect the equilibrium in the market is disrupted. In fact, only 30 veterinary medical colleges exist in the United States for thousands of applicants, and these colleges have a limited number of seats. And, because of the differentiation in tuition and fees between resident and non-resident students, some of the veterinary colleges exhibit a certain level of monopolistic power in the veterinary education market within their own state. As a result of this departure from a perfectly competitive market, the quantity of services sold will be lower than the quantity of services demanded at a price agreed to by college and student.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Relative to the economic principle that what is limited is more expensive than what is abundant, one of the consequences of this supply-demand gap, is that veterinary colleges will be able to establish the price they desire for each seat until the price exceeds what the applicants are willing to pay to fill the last seat. Hence, it is not surprising that the annual rate of increase for veterinary college seats is exceedingly high. Colleges exercise their market power over the buyers by setting prices to ensure positive profits or balance their budgets.

The average annual tuition and fees for the 30 veterinary medical colleges in the United States have more than doubled, from $10,549 in 1999 to $27,096 in 2015 (Dicks et al. 2016). The total cost of obtaining the DVM and the tuition/fees for the veterinary medical colleges in the United States are presented in Table 1. The blue bars represent the tuitions and fees for the entire four years in the DVM program and the red bars include the tuitions and fees as well as all other necessary expenses that students typically encounter in their DVM program. These expenses include but are not limited to housing, transportation, school supplies and food. Among the most costly colleges are Western University-California ($352,992), Tufts University ($297,744), and the University of Pennsylvania ($288,611). The least expensive schools are Kansas State University ($114,520), followed by North Carolina State University ($128,382), and Oklahoma State University ($132,080). Texas A&M University is in the middle of the ranking with $173,070. In most cases, the tuition and fees represent around 50 percent of the total cost.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 1: Tuition/Fees and Total Cost of a DVM Degree by Veterinary School

Total Cost (in $) Tuition & Fees (in $) Auburn University 160,914 74,079 Tuskegee University 206,928 134,928 University of California-Davis 230,903 139,169 Colorado State University 188,272 108,192 University of Florida 193,312 125,680 University of Georgia 138,910 87,812 University of Illinois 193,616 127,056 Iowa State University 173,360 96,166 Kansas State University 114,520 69,960 Louisiana State University 171,064 72,326 Tufts University 297,744 207,240 Michigan State University 197,484 107,108 University of Minnesota 240,873 125,296 Mississippi State University 149,540 80,526 Purdue University 161,920 97,400 Cornell Veterinary College 218,336 164,680 Oklahoma State University 132,080 76,040 University of Pennsylvania 288,611 179,032 Texas A&M University 173,070 91,364 Washington State University 165,216 92,800 University of Missouri-Columbia 162,348 74,784 The Ohio State University 213,960 115,144 Oregon State University 162,788 92,316 University of Tennessee 175,476 94,744 Virginia-Maryland College 168,712 122,432 North Carolina State University 128,382 95,462 University of Wisconsin 154,984 113,712 Western University - California 352,992 223,192

The tuition for TAMU veterinary students has risen sharply in recent years (Figure 11). The median annual tuition for residents has increased from below $16,000 in 2006 to more than $22,000 in 2015. This is equivalent to a 45 percent increase in 10 years. The median annual tuition for non-residents has

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. increased during the same period by 18 percent. The 10-year average tuition rates are $19,284 and $43,382 for residents and non-residents, respectively.

Median Resident Tuition Median Non-Resident Tuition

$48,000 $24,000 $46,000

$22,000 $44,000

$20,000 $42,000

$40,000 Inflation) $18,000 $38,000 Resident Tuition (Adjusted for for (Adjusted Tuition Resident $16,000 - $36,000 Non

Resident Tuition (Adjusted for Infaltion) for (Adjusted Tuition Resident $14,000 $34,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Figure 11: Change in Tuition over Time

In comparison to the tuition and fees of TAMU with the neighboring veterinary medical colleges, the increase has been sharper for residents than it has been for non-residents. All three of the other colleges considered have a higher non-resident tuition than TAMU and the increase in non-resident tuition for TAMU has been relatively flat over during the period. In terms of resident tuition (Figure 12), TAMU had the second lowest tuition in 2006 just ahead of Oklahoma State University. In 2013, however, TAMU maintained the second highest tuition in the region, just below Colorado State University.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. $26,000 Oklahoma State University Louisiana State University $24,000 Texas A&M University Colorado State University

$22,000

$20,000

$18,000

$16,000

$14,000 Tuition and Fees Tuition (Residents)

$12,000

$10,000 2006 2007 2008 2009 2010 2011 2012 2013

Figure 12: Tuition and Fees for Selected Veterinary Colleges (Residents)

$60,000 Oklahoma State University Louisiana State University $55,000 Texas A&M University Colorado State University

$50,000 $45,000 Residents) - $40,000 $35,000 $30,000 $25,000 $20,000 Tuition and Fees Fees (Non and Tuition $15,000 $10,000 2006 2007 2008 2009 2010 2011 2012 2013

Figure 13: Tuition and Fees for Selected Veterinary Colleges (Non-residents)

Table 2 presents the detailed cost of the DVM degree in Texas for both residents and non-residents. For residents, tuition and fees represent, on average, 55 percent of the total cost; room and board

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. represent 27 percent; personal expenses 8 percent; transportation 6 percent; books and supplies 4 percent; and, finally, loan fees 1 percent. The picture for non-residents is a little different. Tuition and fees represent more than 64 percent of their total cost to attain a DVM degree.

Table 2: Detailed Costs of Attending Texas A&M Veterinary Medical College

1st year 2nd year 3rd year 4th year Resident Tuition & fees 22,224.00 22,904.00 23,586.00 24,842.00 Loan fees 246.00 246.00 246.00 246.00 Book and supplies 1,424.00 980.00 1,480.00 2,812.00 Room and board 10,626.00 10,626.00 10,626.00 14,168.00 Transportation 2,404.00 2,404.00 2,404.00 2,404.00 Personal expenses 3,474.00 3,474.00 3,474.00 3,474.00 Total 40,398.00 40,634.00 41,816.00 47,946.00 Non-Resident Tuition & fees 33,622.00 34,380.00 35,442.00 36,364.00 Loan fees 246.00 246.00 246.00 246.00 Book and supplies 1,424.00 980.00 1,480.00 2,812.00 Room and board 10,626.00 10,626.00 10,626.00 14,168.00 Transportation 3,044.00 3,044.00 3,044.00 3,044.00 Personal expenses 3,474.00 3,474.00 3,474.00 3,474.00 Total 52,436.00 52,750.00 54,312.00 60,108.00

2.2 TEXAS A&M AND THE SUPPLY OF VETERINARIANS TO THE LOCAL COMMUNITIES

The majority of veterinarians practicing in Texas as well as members of the TVMA graduated from Texas A&M. Of the 69 percent in the West South-Central Region (Figure 14) who graduated from veterinary school, 61.3 percent are Texas A&M graduates, with the remaining 7.7 percent having graduated from Oklahoma State University (3.6 percent) and Louisiana State University (4.07 percent). This breakdown is attributed to educational costs.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Middle Atlantic , New England , 0.2% 1.0% South Atlantic , 2.0% East South Central , 4.1% Outside U.S.A, 9.0% East North Central , 4.9% West North Central , 5.7%

West South Central , Pacific , 2.0% 69.0%

Mountain , 2.0%

Figure 14: Respondents by Regional Location of Veterinary Medical College Attended

2.3 INCOME, DEBT, AND DEBT-TO-INCOME RATIO OF NEW VETERINARIANS

Data used in this analysis come from the annual senior surveys. The Senior Survey is a survey distributed every year to fourth-year veterinary students, just weeks before graduation. The survey has been distributed by the AVMA for decades but data are only available from 2001 from the 28 U.S. AVMA- accredited veterinary colleges. The response rate is approximately 93 percent.

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From 2001 through 2016, the mean starting salary for new graduates in the national sample increased from just under $40,000 to more than $58,000, while that for Texas new veterinarians increased from $42,000 to more than $65,000. These numbers are inclusive of those finding full-time employment along with those pursuing internships, residencies and advanced education. The mean changes over the 15- year period 2002-2016 are $1,220 and $1,420 per year, for the national sample and the Texas sample, respectively. More specifically, over the same period, new veterinarians in the national sample employed in private and public practice experienced an annual increase of $1,873 and $1,201, respectively, while their similar colleagues from Texas are experiencing an annual increase of $2,230 for private practice veterinarians and $850 for public practice veterinarians.

The mean salary of public sector veterinarians has been very close to that for private practice veterinarians during the pre-recession period (Figure 15), but the gap has increased during the post- recession period due to consequences of the recession to the state and federal budgets. The mean starting salaries between 2002 and 2008 were $53,292 for public veterinarians and $53,577 for their colleagues from the private sector. The mean salaries after the economic downturn, however, yield a different story. The average starting salary for private veterinarians is more than $72,400 and barely $63,000 for public veterinarians.

In both the national sample and the Texas sample, the mean starting salaries for new veterinarians in residency programs is higher than that for veterinarians in internship programs. Comparing the means across strata, it appears that the mean starting salaries for new veterinarians in the national sample is higher during the period 2010-2016 than that for new Texas veterinarians.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. ALL Public Practice $75,000 Private Practice Advanced Education $70,000 $65,000 $60,000 $55,000 $50,000 $45,000 $40,000 $35,000 $30,000 $25,000 $20,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 15: Mean Starting Salaries of New veterinarians – AVMA Sample

ALL Public Practice Private Practice Advanced Education Internships Residencies $75,000 $70,000 $65,000 $60,000 $55,000 $50,000 $45,000 $40,000 $35,000 $30,000 $25,000 $20,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 16: Mean Starting Salaries of New Veterinarians – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The following chart illustrates the mean starting salary. The amount of variation in salaries is indicated by one standard deviation around the mean. That is, in 2016, 68 percent of new veterinarians employed in full-time positions nationwide earned between $57,000 and $89,000, and during the same period, 68 percent of new veterinarians of the same status but employed in Texas earned between $64,000 and $91,000.

$90,000

$80,000 One - third $70,000

$60,000 One - $50,000 third

$40,000

$30,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 17: Distribution of Starting Salaries for New Veterinarians – AVMA Sample

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$80,000

$70,000

$60,000

$50,000

$40,000

$30,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 18: Distribution of Starting Salaries for New Veterinarians – TVMA Sample

For the national sample, the mean starting salaries for two-thirds of the new veterinarians pursuing full- time employment had a range of more than $30,000. Although starting salaries among new veterinarians in private practice have been on a steady incline, new veterinarians pursuing employment in the equine industry have consistently experienced the lowest starting salaries. For new veterinarians in 2016, food animal exclusive practice yielded the highest income, with professionals in companion animal exclusive practice and companion animal predominant practice following closely behind.

For Texas respondents, companion animal exclusive ($83,387), companion animal predominant ($80,676) and food animal predominant ($77,000) lead the group in terms of higher mean starting salaries. Equine veterinarians ($42,000), as in the national sample, have the lowest starting salary in Texas.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. $95,000 Food animal practice (exclusive) Food animal practice (predominant) $85,000 Mixed practice Companion animal practice (predominant) $75,000 Companion animal practice (exclusive) Equine practice $65,000

$55,000

$45,000

$35,000

$25,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 19: Mean Starting Salaries of Private Practice Veterinarians – AVMA Sample

Food animal practice (exclusive) $95,000 Food animal practice (predominant) $85,000 Mixed practice Companion animal practice (predominant) $75,000 Companion animal practice (exclusive) Equine practice $65,000

$55,000

$45,000

$35,000

$25,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 20: Mean Starting Salaries of Private Practice Veterinarians – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 2.3.2 Factors Affecting Incomes for New Veterinarians

Numerous factors explain the variation in income. The following tables describe the effect on starting salaries of various factors identified by analyzing these starting salaries through a multiple linear regression in which the dependent variable is the starting salary of new veterinarians. The data used in this analysis comprise 16 years of responses from more than 92 percent of all graduates of the 28 U.S. veterinary colleges (35,056 total observations). Two models were estimated (one unrestricted model in which all new veterinarians that meet the criteria were considered and another model that uses only new full-time veterinarians employed in Texas). Factors hypothesized to have significant effects on starting salaries are age, gender, location, anticipated work hours per week, and practice type.

The estimates of the effect of the covariate are reported in the column labelled “B.” The constant represents the intercept of the model. It corresponds to the starting salary when none of the suspect factors is accounted for. As stated before, the mean starting salary keeping all factors constant is higher for the national sample than that for the Texas sample. The constant is $51,195 for the national and $39,835 for Texas.

Column labelled “Sig.” shows how significant the factor is in explaining the variation in starting salary. These values, also known as the p-values, are such that for a ‘sig’ less than 0.05, the coefficient of ‘B’ is statistically and significantly different from 0. In other words, the factor has a significant effect of the response variable.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 3: Factors Affecting Starting Salaries of New Veterinarians – AVMA

B Std. Err. Sig. (Constant) 51,795.0 1,052.8 0.00 Year (use last 2 digits of grad year) 1,759.8 23.4 0.00 Age 32.8 30.0 0.27 Gender: F=1, M=0 3,699.6 235.3 0.00 Anticipated Hours Per Week -191.4 11.9 0.00 DVM debt 0.0 0.0 0.00 Admitted to DVM Program Before -247.0 308.7 0.42 DVM + Bachelor’s Degree Omitted

DVM + Master’s Degree 501.2 426.8 0.24

DVM + Doctorate Degree -801.9 1,413.7 0.57 DVM + Other Professional Degree 2,020.0 1,871.0 0.28 DVM + Other Degree -1,235.5 1,361.0 0.36 Basic Info Region 0 1,344.3 524.5 0.01 Demographics Region 1 2,749.8 476.6 0.00 Region 2 1,078.9 396.7 0.01 Region 3 Omitted Region 4 -221.4 399.1 0.58 Region 5 -1,484.8 441.9 0.00 Region 6 -1,087.4 418.2 0.01 Region 7 1,990.7 384.0 0.00 Region 8 3,105.8 428.8 0.00 Region 9 4,086.2 421.6 0.00

Food Animal (exclusive) 1,407.8 576.6 0.02 Food Animal (predominant) -2,995.7 544.4 0.00 Mixed Practice -4,599.0 301.3 0.00

Companion Animal (exclusive) Omitted Companion Animal (predominant) -1,434.1 310.2 0.00 Private Practice Equine -18,348.0 527.2 0.00

Federal Government -5,837.0 1,331.4 0.00 Graduate Plans Graduate - Uniformed Services -2,494.5 642.9 0.00 College or University -27,913.0 1,447.5 0.00 Post State or Local Government -10,617.0 2,910.0 0.00 Industry 9,199.3 1,701.0 0.00 Public Practice Not-for-Profit -8,985.5 1,378.4 0.00 Sample size N = 14,914. R-square = 0.436.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 4: Factors Affecting Starting Salaries of New Veterinarians – TVMA

B Std. Err. Sig. (Constant) 39,835.0 3,349.9 0.00

Year (use last 2 digits of grad year) 2,115.6 70.3 0.00 Age 308.5 97.3 0.00 Gender: F=0, M=1 3,956.2 712.0 0.00

Basic Info Anticipated Hours Per Week -69.6 39.6 0.08 DVM debt in thousands 0.0 0.0 0.00 Admitted to DVM Program Before 652.6 833.1 0.43

Demographics DVM + Bachelor’s Degree Omitted DVM + Master’s Degree -270.0 1,336.2 0.84 DVM + Doctorate Degree -1,707.6 6,443.7 0.79

Degrees Held Degrees DVM + Other Professional Degree -4,321.0 5,034.6 0.39 DVM + Other Degree -939.5 3,568.2 0.79

Food Animal (exclusive) -6,173.6 2,786.9 0.03 Food Animal (predominant) -3,984.9 2,152.6 0.06 Mixed Practice -4790.4 854.8 0.00

Companion Animal (exclusive) Omitted Private Practice Companion Animal (predominant) -705.3 966.6 0.47 Equine -25,527.0 1,644.6 0.00

Federal Government -8,087.6 4,253.6 0.06 Graduate Plans Graduate - Uniformed Services -8,396.4 1,634.9 0.00

Post College or University -46154.0 11,111.0 0.00 State or Local Government NA NA NA Public Practice Industry -311.4 7,878.5 0.97 Not-for-Profit -16,235.0 11,101.0 0.14 Sample size N = 1,288. R-square = 0.728

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Over the last 16 years, the DVM degree debt of veterinary students has been increasing at approximately $5,400 per year at the national level and approximately $4,200 for Texas respondents; for those reporting non-zero debt, the annual increase has been approximately $6,200 and $5,400 for the national sample and the Texas sample, respectively.

$170,000 All Graduates Graduates with Debt

$150,000

$130,000

$110,000

$90,000

$70,000

$50,000

$30,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 21: Debt of New Graduates – AVMA Sample

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$170,000

$150,000

$130,000

$110,000

$90,000

$70,000

$50,000

$30,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 22: Debt of New Graduates – TVMA Sample

In 2015, the mean debt of all students at the national level was $18,041 less than the mean debt of persons reporting non-zero debt, with 11.9 percent of students reporting having no debt from veterinary college in 2015. For Texas, in 2016, the mean debt of all students was $20,171 less than the mean debt of persons reporting non-zero debt. While the gap between mean debt of all students and the mean debt of persons reporting non-zero debt has been relatively small for Texas new veterinarians, it has substantially increased for the national sample going from a difference of $18,041 in 2015 to $23,777 in 2016.

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$25,000 25% $23,000 $21,000 20% $19,000 $17,000 15% $15,000 $13,000 10% $11,000 $9,000 5% $7,000 $5,000 0%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 23: Difference in Mean Debt – AVMA Sample

Nominal Difference Percent Difference

25,000 25.0% 23,000 21,000 20.0% 19,000 17,000 15.0% 15,000 13,000 10.0% 11,000 9,000 5.0% 7,000 5,000 0.0%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 24: Difference in Mean Debt – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. DVM debt incurred by new veterinarians varies by post-graduation plans. Over the period 2001 through 2016 new veterinarians finding employment in public practice consistently had the lowest debt load, while new veterinarians pursuing internships and residencies had the highest debt loads. There are certainly many plausible hypotheses to explain the larger differences in debt by post-graduate careers, but research on the factors that influence the career choices of graduating seniors is strongly needed.

Private Practice Public Practice $170,000 Advanced Education Internships Residencies ALL $150,000

$130,000

$110,000

$90,000

$70,000

$50,000

$30,000

$10,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 25: DVM Debt by Post-graduate Plans – AVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. $190,000 Private Practice Public Practice Advanced Education Internships $170,000 Residencies ALL

$150,000

$130,000

$110,000

$90,000

$70,000

$50,000

$30,000

$10,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 26: DVM Debt by Post-graduate Plans – TVMA Sample

For the 2015 graduating class, within private practice, 68 percent had a debt load between $50,000 and $222,500. Comparatively, for the 2016 class, 68 percent of graduates within private practice had a debt load between $54,500 and $232,000. Approximately 16 percent carry a debt load of more than $231,700, while the lowest 16 percent had debt below $54,000.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. (-1σ) DVM Debt (+1σ) $230,000 $210,000 $190,000 $170,000 $150,000 $130,000 $110,000 $90,000 $70,000 $50,000 $30,000 $10,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 27: Mean DVM Debt: Private Practice – AVMA Sample

In the same way, 68 percent of new private practice veterinarians in Texas from the class of 2015 had a debt load between $31,000 and $172,700. Of those who graduated in 2016, 68 percent of graduates within private practice had a debt load between $26,000 and $209,000.

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$230,000 $210,000 $190,000 $170,000 $150,000 $130,000 $110,000 $90,000 $70,000 $50,000 $30,000 $10,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 28: Mean DVM Debt: Private Practice – TVMA Sample

Of those who graduated in 2015 and are employed in the public sector, 68 percent incurred DVM debt between $35,000 and $198,000, however, in the 2016 class, 68 percent incurred debt between $37,000 and $216,000. Evidently, in the 2016 class more graduates pursuing public practice had larger debt levels than the class of 2015.

For Texas, 68 percent of the class of 2015 carries between $24,000 and $153,000, which is relatively lower than that of the national sample. For the class of 2016, 68 percent of new veterinarians carry between $53,000 and $150,000.

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$200,000

$150,000

$100,000

$50,000

$0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 29: Mean DVM Debt: Public Practice – AVMA Sample

(-1σ) DVM Debt (+1σ)

$300,000

$250,000

$200,000

$150,000

$100,000

$50,000

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 30: Mean DVM Debt: Public Practice – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. For each sector, whether public practice, private practice, advanced education, internships or residencies, the growth rate of DVM debt has continued to outpace the growth rate of the starting salaries of new veterinarians. Although the growth rates of debt and starting salaries prior to 2005 were comparable, the rate of growth in debt began to accelerate in 2006 and continued to grow much faster than incomes almost continually through 2016. The largest factor in the increasing debt is the cost of education. This increased cost of education is tied closely to the declining amount of state and federal funding received by the veterinary colleges. In addition, the proportion of female veterinarians whose debt is significantly higher than male veterinarians, has increased over time, and now comprises more than 80 percent of each new class of veterinarians.

ALL Public Practice $140,000 Private Practice Advanced Education Internships Residencies Internships/Residencies/Adv Educ DVM Debt $120,000

$100,000

$80,000

$60,000

$40,000

$20,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 31: Mean Starting Salaries and Debt of New Veterinarians – AVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Mean Income Inc. Public Practice Inc. Private Practice Mean DVM Debt

$140,000

$120,000

$100,000

$80,000

$60,000

$40,000

$20,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 32: Mean Starting Salaries and Debt of New Veterinarians – TVMA Sample

While female graduates have had higher veterinary college debts than their male counterparts throughout the observed period at the national level, the pattern was not consistent for new veterinarians in Texas. In 2015, for instance, mean debt for male veterinarians was higher than that of their female counterparts, and in 2016, mean debt for female veterinarians was higher than that of male colleagues.

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$120,000

$100,000

Nominal Debt Nominal $80,000

$60,000

$40,000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 33: Mean DVM Debt by Gender – AVMA Sample

Male Debt Female Debt

$160,000

$140,000

$120,000

$100,000

Nominal Debt Nominal $80,000

$60,000

$40,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 34: Mean DVM Debt by Gender – TVMA Sample

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Similar to the methods used to determine the factors explaining the variation in income, a multiple linear regression was calculated to determine the factors significant in explaining the variation in debt. The factors under observation were the region in which the school is located, age, gender, and year of graduation.

The unconditional mean debt was estimated at $29,300 for national sample and at $21,000 for Texas respondents. Region 7, in which Texas is located, was used as the baseline region in the model. The results indicate that for the national sample, mean debt for all other regions is higher than that for Region 7. For new veterinarians in Texas, the picture is almost similar except for those who graduated in Region 2, who have a low mean student debt compared to those who graduated in Region 7. New veterinarians in Texas who graduated from Region 0 seem to have the highest mean student debt (slightly more than $97,000). From the national sample, the same trend appears with those who graduated in Region 0 leading the group with an average debt of approximately $43,000.

Using the national sample, the results indicate that female veterinarians graduated with more than $4,800 more debt, on average, than male veterinarians. The Texas sample also confirms that female veterinarians graduate with more debt than their male counterparts. The difference in debt between female and male veterinarians is approximately $5,400 using the Texas sample.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 5: Factors Affecting Debt of New Veterinarians

National Data Texas Data B Std. Error Beta B Std. Error Beta (Constant) -29,301.0 3,649.6 0.00 -21,004.0 12,449.0 0.09

Year of the survey 7,195.5 82.0 0.00 4,849.9 288.4 0.00

Age 1,971.9 111.3 0.00 2,362.8 387.6 0.00

Gender -4,873.2 875.7 0.00 -5,473.7 2,907.4 0.06

Region of School 0 43,000.0 2,307.7 0.00 97,098.0 29,053.0 0.00

Region of School 1 28,564.0 1,787.3 0.00 34,549.0 11,381.0 0.00

Region of School 2 4,761.6 1,772.5 0.01 -1,395.0 9,190.0 0.88

Region of School 3 18,558.0 1,396.7 0.00 38,084.0 4,173.4 0.00

Region of School 4 28,440.0 1,506.0 0.00 35,119.0 7,736.0 0.00

Region of School 5 26,986.0 1,779.7 0.00 42,573.0 11,113.0 0.00

Region of School 6 17,749.0 1,429.0 0.00 31,923.0 4,920.2 0.00

Region of School 7 Omitted Omitted

Region of School 8 10,833.0 2,072.0 0.00 17,189.0 9,375.0 0.07

Region of School 9 30,784.0 1,598.3 0.00 16,111.0 8,006.2 0.04

Observations 21,778 1,488

R-Square 0.3041 0.2812

2.3.5 New Veterinarian Debt-to-income Ratio

The debt-to-income ratio (DIR) is an important measure of the economic performance of the market for veterinary education. By definition, the debt-to-income ratio measures what percentage of debt is covered by annual income. Although some economists suggest that a DIR of 1:1 might be the limit that should be considered to guarantee personal financial sustainability, this theory best applies to non- professional undergraduate degrees. Because the increases in income associated with experience is much greater for those with professional degrees, especially graduate professional degrees, the level of debt-to-income that can be serviced without posing serious financial stress is likely closer to 1.4:1.

A 1.4:1 debt to income ratio was determined as a first goal for the profession as this level of debt to income is appropriate under projections of income and a standard repayment plan that translates into less than 10 percent of the disposable income of the graduate being used to service their debt five years after graduation.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The following charts illustrate the DIR for the national sample and the Texas sample. The blue line represents the unweighted debt-to-income ratios and the orange line represents the adjusted ratios. Adjustments were made to account for the changes in the proportion of male and female and the changes in the percentage of respondents by type of practices during the observation period. In all cases, only the incomes of those graduates with full-time employment are included and all reported debt values are included. The AVMA DIR that is used as a KPI is the fully weighted, individual DIR or the RWI. The real weighted DIR (national) in 2016 was 2.0 and that for Texas was 1.8. The fully weighted DIR for Texas has increased linearly between 2012 and 2016.

2.2 Unweighted Debt-to-Income Ratio 2.1 Fully Weighted, Individual Debt-to-Income 2.0 1.9 1.8 1.7 1.6 1.5 1.4 1.3 1.2 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 35: Debt-to-income Measures – AVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 2.2 Unweighted Debt-to-income Fully Weighted- Individual Debt-to-income

2.0

1.8

1.6

1.4

1.2

1.0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Figure 36: Debt-to-income Measures – TVMA Sample

2.3.6 Factors Significant in Explaining the Debt-to-income Ratio

The analysis of the factors that contribute to the difference between the individual level of income and the mean income, and for individual debt and mean debt, for graduates from 2001 to 2016 have been illustrated previously. This analysis illustrates the factors that explain the differences between the DIR for each individual and the mean DIR for the sample of all graduates between 2001 and 2016 who reported income and debt. Two separate regression models were estimated. For the national data, a regression of debt-to-income as a function of year, age and gender; whether the respondent had children, sought employment, or received any offers; and number of hours and weeks expecting to work, additional degrees held, location of anticipated place of employment, practice type, GDP lagged one year, and veterinary college was performed. For the Texas model, the national model was reduced and factors such as whether the respondent had children, sought employment, received any offers, and GDP lagged one year were omitted from the model. Results are provided in the Table 6 below.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The column labelled “Sig.” the level of significance that the factor estimated has in explaining the variation in DIR across observations. A sig < 0.05 indicates that the factor is statistically significant at the 5 percent significance level. Year of graduation, age, gender, and hours respondents expect to work were statistically significant in explaining the variation in the debt-to-income ratio in both the samples. The results indicate that each additional year after graduation increases the DIR of TVMA members by 0.06, while for the AVMA members, the increase is 0.14. Gender is statistically significant at a 5 percent level of significance of AVMA members and implies that male respondents’ DIR is 0.18 lower than that of female respondents. For TVMA members, the effect of gender on DIR is only statistically significant at the 10 percent significance level and indicates that the DIR of female respondents is 0.17 lower than that of male respondents. An increase in the anticipated hours worked per week increases the DIR by 0.02 for AVMA members and by 0.05 for TVMA members. The results also indicate that general economic conditions significantly affect DIRs.

Other factors found significant in explaining the variations in DIR are practice type and and the college of graduation. The DIR of companion animal predominent veterinarians is considered the benchmark DIR in this analysis. The results for the TVMA sample indicate that except for veterinarians working in industries and colleges or universities, companion animal predominant practitioners have the highest DIR. The DIR for food animal exclusive veterinarians, for example, is 1.6 lower than that of companion animal predominant veterinarians. Mixed animal veterinarians and equine veterinarians have, respectively,a 0.62 and 0.77 lower DIR than their colleagues in companion animal exclusive practices.

An additional degree does not affect the DIR of TVMA respondents and it also shows a weak effect on AVMA members’ DIR. The veterinary medical college attended has statistically significant effect on DIR. In this analysis, The Ohio State University was identified as the base dummy. The results indicate, for instance, that veterinarians who graduated from Texas A&M have a DIR 2.02 lower than those who graduated from The Ohio State University.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 6: Factors Affecting Debt-to-Income Ratio

National Data Texas Data B Std. Err. Sig. B Std. Err. Sig. (Constant) 0.04 0.76 0.95 -0.44 0.58 0.45 Last 2 digits of Grad Year 0.14 0.01 0.00 0.06 0.01 0.00

Age 0.04 0.00 0.00 0.05 0.01 0.00 Gender: Female=1 0.18 0.03 0.00 -0.17 0.09 0.06 Have children: No=1 0.00 0.05 0.99 NA Seeking Employment or Adv. Edu. -0.15 0.15 0.32 NA Received offers 0.23 0.38 0.54 NA

Basic Information Anticipated Work hours/ week 0.02 0.00 0.00 0.05 0.00 0.00 Work at least 48 weeks/ year 0.10 0.10 0.36 NA GDP lagged 1 year 0.00 0.00 0.03 NA Food animal practice (excl.) -1.56 0.09 0.00 -1.60 0.42 0.00 Food animal practice (pred.) -1.47 0.09 0.00 -0.94 0.32 0.00 Mixed practice -1.30 0.05 0.00 -0.62 0.11 0.00 Companion animal practice (excl.) Basis Basis

Companion animal practice (pred.) -1.29 0.04 0.00 -0.46 0.14 0.00 Equine practice -0.73 0.08 0.00 -0.77 0.21 0.00 Federal Government (civil service) -1.51 0.23 0.00 -0.87 0.59 0.14

Practice Type Uniformed services -2.04 0.10 0.00 -1.66 0.24 0.00 College or University -0.28 0.24 0.25 1.01 1.53 0.51 State or Local Government -0.25 0.52 0.63 -2.88 1.13 0.01 Industry or commercial org. -1.65 0.29 0.00 0.40 1.52 0.79 Not-for-profit organizations -1.13 0.24 0.00 -0.31 1.08 0.77 Admitted Before earning degree 0.32 0.31 0.30 -0.15 0.11 0.16 Bachelor’s degree 0.59 0.31 0.05 0.01 0.16 0.95 Master’s degree 0.58 0.31 0.06 0.23 0.69 0.74 Doctorate degree 0.21 0.35 0.55 -0.02 0.63 0.97 Other Professional degree -0.06 0.40 0.88 0.48 0.43 0.27

Additional degrees Other degree 0.86 0.36 0.02 NA

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Factors Affecting Debt-to-Income Ratio (Cont.)

National Data Texas Data B Std. Err. Sig. B Std. Err. Sig. Auburn University -0.87 0.09 0.00 -1.16 0.49 0.02 Tuskegee University 0.04 0.11 0.69 0.85 0.47 0.07 University of California-Davis -0.72 0.10 0.00 -1.22 0.57 0.03 Colorado State University -0.48 0.09 0.00 -1.07 0.49 0.03 University of Florida -0.45 0.10 0.00 -0.78 0.50 0.12 University of Georgia -1.12 0.09 0.00 -0.79 0.50 0.12 University of Illinois -0.56 0.09 0.00 -1.26 0.54 0.02 Iowa State University -0.34 0.09 0.00 -1.54 0.50 0.00 Kansas State University -0.05 0.09 0.55 -0.81 0.44 0.07 Louisiana State University -0.80 0.09 0.00 -1.36 0.43 0.00 Tufts University -0.03 0.09 0.73 2.71 0.96 0.00 Michigan State University 0.05 0.08 0.55 1.08 0.54 0.05

University of Minnesota 0.51 0.10 0.00 1.62 0.62 0.01 Mississippi State University -0.20 0.10 0.04 -0.61 0.46 0.18 Purdue University -0.65 0.11 0.00 -0.64 0.60 0.29 University Cornell University -0.78 0.09 0.00 -0.08 0.59 0.89 Oklahoma State University -0.78 0.10 0.00 -1.57 0.42 0.00 University of Pennsylvania 0.11 0.10 0.27 1.98 0.72 0.01 Texas A&M University -1.28 0.09 0.00 -2.02 0.40 0.00 Washington State University -0.72 0.10 0.00 -1.92 0.55 0.00 University of Missouri-Columbia -0.66 0.10 0.00 -1.45 0.51 0.00 Ohio State University Basis Basis Oregon State University -0.38 0.13 0.00 -1.99 0.74 0.01 University of Tennessee -0.59 0.10 0.00 -1.14 0.55 0.04 Virginia-Maryland College -0.59 0.09 0.00 -1.24 0.62 0.05 North Carolina State University -1.15 0.09 0.00 -1.60 0.52 0.00 University of Wisconsin -0.41 0.10 0.00 -0.71 0.61 0.25 Western University - California 2.03 0.11 0.00 0.47 0.73 0.53

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This section discussing the market for veterinarians provides an overview of the veterinary workforce in Texas. Specifically, the section will present the demographics of the veterinary workforce in Texas, offer an analysis of the underemployment level and the satisfaction of veterinarians with their profession, identify factors affecting income, and discuss obstacles to the profession’s progress, including student debt.

3.1 DATA SOURCE AND SUMMARY STATISTICS

As noted previously, the data for this report were obtained from the AVMA annual Census of Veterinarians. In 2016, surveys were sent out to four different samples: a sample from the AVMA members, and VMA members from three states (Texas, Colorado and Arizona). The AVMA sample consists of a random draw of 21,638 members from the association database, and yielding a response rate of 11.8 percent of the sample (approximately 2.3 percent of the population). For the three states, their membership list was used as sampling frames and all individuals on these lists have been included in the survey except for those who were part of the AVMA sample. The response rate as a percent of the population of members was 11.0 percent for Texas (n=3,212), 9.4 percent for Colorado (n=1,408), and 11.9 percent for Arizona (n=860). Only the Texas and AVMA responses are reported on and throughout the report the Texas sample is called the TVMA sample, while the AVMA membership sample is referred to as the AVMA sample.

The proportion of female respondents is greater than that of their male counterparts in both samples (Figure 37). The general population of U.S veterinarians is currently populated by more female than male veterinarians. In 2010, there were as many men as women in the profession, but eight out of 10 students enrolled in veterinary schools were female (Larkin, 2010). With respect to gender, the TVMA sample closely resembles the TVMA membership profile and that of the population of veterinarians in Texas as a whole.

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67.9% 55.9% 44.1% 32.1%

AVMA Sample TVMA Sample

Figure 37: Gender Distribution

The survey was not restrictive and all veterinarian members of the TVMA with valid contact information received the survey questions. For the AVMA members, a random sample was taken from the most recent list of veterinarians and the questionnaire was sent to those veterinarians with valid contact information. People who returned usable responses were then categorized into four groups based on the number of years since graduation from veterinary medical school. This distribution enabled an examination of skewness and kurtosis in the data that might affect estimates drawn from the sample(s). If a large majority of respondents graduated more than 30 years ago, for example, their average income would tend to be higher than if the majority of respondents graduated during the last 10 years.

Our descriptive statistics (Figure 38) show a right-skewed data set for the AVMA sample, indicating that the majority of the AVMA sample respondents are veterinarians who graduated no more than 10 years ago. All averages coming from the AVMA sample need to be considered carefully in applying the survey findings to the entire AVMA membership. Applying a weighted coefficient that accounts for the true proportion of each category in the entire population is an effective method of accounting for such data. The distribution of the TVMA sample was normal and does not exhibit any skewed pattern.

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52.3%

35.1% 31.1%

17.5% 16.7% 16.2% 14.8% 16.2%

0 to 10 11 to 20 21 to 30 30 and over

Figure 38: Distribution of Respondents by Year of Graduation

The distribution of respondents by type of employment is presented in Figure 39 (AVMA Sample) and Figure 40 (TVMA Sample). It is important to account for the differences in employer type (professional sectors) when conducting a workforce study, as demand for veterinarians varies across the different sectors of the profession. As demand varies, the equilibrium prices in the markets (salaries) are also expected to differ from sector to sector. In other words, professional income is also subject to the law of demand. If the demand for a particular type of veterinarian increases, employers have to offer higher wages to attract veterinarians. Since the actual distribution of U.S. veterinarians by type of employment is known, any determination of selection bias that might affect the mean can be made.

Both samples present the same “big picture,” with the majority of respondents being companion animal veterinarians. Companion animal veterinarians represent, respectively, 65.9 percent and 63 percent of the respondents for TVMA and AVMA sample. The second and the third largest shares of respondents are the college or university employee and mixed animal practitioner groups. These distributions are consistent with the general population of U.S. veterinarians.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 0.6% College or University 3.1% 3.5% Advanced education 3.1% 5.3% 2.7% 8.5% Companion animal 0.5% Equine 1.5% Food animal 2.6% 2.2% Civil services State/Local Government 3.4% Uniformed services Industry/Commercial org. Mixed animal Not-for-profit Org. 63.0% Non-Veterinary employment Other veterinary employment

Figure 39: Distribution of Respondents by Type of Employment – AVMA Sample

3.6% 2.0% 0.2% College or University 0.4% 1.8% Advanced education 1.1% 0.7% Companion animal 7.1% 13.4% 1.3% Equine 0.9% Food animal 1.6% Civil services State/Local Government Uniformed services Industry/Commercial org. Mixed animal Not-for-profit Org. 65.9% Non-Veterinary employment Other veterinary employment

Figure 40: Distribution of Respondents by Type of Employment – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The distribution of respondents by racial group is presented along with the racial distribution of the general population in Texas (Figure 41). More than 90 percent of the respondents are Caucasians (White). The TVMA sample of veterinarians is similar to the AVMA sample in terms of diversity but does not reflect the diversity in the Texas population.

White Non-White

90.9%

70.4%

29.6%

9.1%

TVMA Sample Texas Population

Figure 41: Distribution of Respondents by Race

In terms of age of respondents, the majority of the TVMA sample respondents (52.7 percent) are between 25 and 50 years of age (Figure 42). Unlike the TVMA sample, the AVMA sample is skewed to the right, indicating that more of the population is relatively younger.

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40.0% 35.0% 30.0% 22.7% 25.0% 21.3% 20.0% 16.2% 15.2% 15.7% 15.0% 8.9% 10.0% 5.0% 0.0% 25 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 and over

Figure 42: Distribution of Respondents by Age Group

Marital status of respondents is presented in Figure 43. The majority of the TVMA sample respondents are married (84.0 percent) or previously married (7.4 percent). Only 8.5 percent of the respondents have never been married. The higher percentage of “single” in the AVMA sample is indicative of the younger population of the respondents.

AVMA Sample TVMA Sample 84.0% 73.3%

19.6% 8.5% 5.5% 4.8% 0.6% 1.1% 1.1% 1.5%

Married Separated Widowed Divorced Single

Figure 43: Distribution of Respondents by Marital Status

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Of the respondents who indicated the type of community in which they currently live, the majority (54.3 percent) are from suburban areas (Figure 44). About 30 percent live in rural areas and only 16.3 percent are in urban areas.

AVMA Sample TVMA Sample

60.0% 54.3% 50.0% 40.0% 29.5% 30.0% 20.0% 16.3% 10.0% 0.0% Rural Urban Suburban

Figure 44: Distribution of Respondents by Type of Community

More than 88 percent of the TVMA sample respondents own their home, 10 percent are in a rental home, and less than 1 percent are still living with their parents or reside in an apartment provided by their employer.

AVMA Sample TVMA Sample

88.9% 73.5%

23.9% 10.2% 2.5% 0.9%

Rent Own Other

Figure 45: Distribution of Respondents by Home Ownership

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Another important component of this analysis is to identify the type of position held by the respondents. Of those who indicated their position type, 45.4 percent of the TVMA respondents are practice owners, 42.9 percent are associate veterinarians, and the remaining are either relief employees (9.8 percent) or hospital directors (1.8 percent).

TVMA Sample AVMA Sample

Relief employee 9.8% 6.8%

PO: Franchise 0.1%

PO: Limited Liability Co 11.3% 6.4%

PO: Corporate Shareholder 9.5% 4.1%

PO: Partner 7.7% 4.1%

PO: Sole proprietor 16.9% 10.5%

Hospital Director 1.8% 1.8%

Consultant 0.6% 42.9% Associate Employee 65.6%

Figure 46: Distribution of Respondents by Type of Position

3.2 EMPLOYMENT OF VETERINARIANS IN TEXAS

The summary statistics presented in Table 7 show that the majority of respondents for both the AVMA sample (78.3 percent) and the TVMA membership (80.5 percent) are employed full time. Full-time employees’ demographics will be heavily used in this analysis as they contain useful information about the current workforce and will help establish important conclusions about the current state of the

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. profession, an exercise that can support relevant projections concerning the future of the veterinary profession. Part-time employees represent less than one-sixth of the respondents in both samples.

Information from retired respondents will be used to determine the reasons why people retire sooner (or later) than expected. Information from unemployed respondents will be used to determine factors affecting unemployment. The AVMA sample averages are used as benchmark values and are compared to the TVMA values.

Table 7: Distribution of Respondents by Employment Status

Currently Employment Status AVMA Sample TVMA Sample 1. Full-Time Employee 78.3% 80.5% 2. Part-Time Employee 12.6% 13.7% 3. Unemployed 3.3% 1.5% 4. Retired 5.9% 4.4%

Of those reporting unemployment in the TVMA sample, the mean number of weeks they have been unemployed was 30.6 weeks over a mean of two separate periods, less than AVMA sample of an average of 36.4 weeks over 1.6 periods (Table 8).

Table 8: Length and Duration of Unemployment

Mean Std. Dev.

How many weeks have you been 36.4 20.3 unemployed in veterinary medicine? AVMA Sample Respondents How many isolated periods of 1.6 1.1 unemployment have you had?

How many weeks have you been 30.6 22.4 unemployed in veterinary medicine? TVMA Sample Respondents How many isolated periods of 2.0 1.8 unemployment have you had?

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. In the TVMA sample, only women were unemployed, with an unemployment rate of 2.4 percent. The AVMA sample has also shown that women were more likely than men to be unemployed, with an unemployment rate of 3.4 percent, compared to an unemployment rate of 2.8 percent for men.

The rates computed here need to be weighted for a better representation of the actual unemployment rate of the total veterinarian population. To do so, we applied the unweighted rates to the general distribution of the veterinarians in the United States. For example, the national distribution of U.S. veterinarians by gender reveals that 56 percent of the active veterinarians are women. Using the unweighted rate of 3.4 percent for females in the AVMA sample and knowing that 56 percent of the entire veterinary population is female, a weighted rate of 2.7 percent is obtained for females and 0.6 percent for male. The same approach can be used to compute the weighted unemployment rate for veterinarians in Texas using 50.3 percent females and 49.7 percent males, as indicated in the Health Professional Resource Center (HPRC) 2015 Report, but caution might be observed here since the unweighted rate for males is 0 percent.

Table 9: Unemployment by Gender

Are you currently employed? No Yes AVMA Sample Respondents Female 3.4% 96.6% Male 2.8% 97.2% TVMA Sample Respondents Female 2.4% 97.6% Male 0.0% 100.0%

Of the veterinarians who reported being currently unemployed in the AVMA sample, those who had indicated food animal practice as their first position in veterinary medicine had the highest unemployment rate among private practitioners, with an unemployment rate of 7.7 percent in 2016. The survey results show that within the public practice areas, however, the unemployment rate is alarmingly high at 15 percent for those who were employed in the federal government as their first professional position. Corporate employees reported an unemployment rate of 12.9 percent.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Among the TVMA sample respondents, the highest rate of unemployment was reported by those who indicated that equine practice was their first professional position, with an unemployment rate of 7.1 percent. Here, again, the state distribution of veterinarians will be required to compute the weighted rates of unemployment.

Table 10: Unemployment Based on First Veterinary Position

Are you currently employed? First Veterinary Position AVMA Sample TVMA Sample

No Yes No Yes Food animal practice (excl.) 7.7% 92.3% 0.0% 100.0%

Food animal practice (pred.) 1.4% 98.6% 0.0% 100.0%

Mixed practice 3.9% 96.1% 3.7% 96.3%

Companion animal (pred.) 4.6% 95.4% 0.0% 100.0%

Companion animal (excl.) 2.0% 98.0% 0.5% 99.5%

Equine practice 1.6% 98.4% 7.1% 92.9%

Federal Gov. (civil service) 15.0% 85.0% 0.0% 100.0%

Uniformed services 0.0% 100.0% 0.0% 100.0%

College or University 4.1% 95.9% 0.0% 100.0%

State/Local government 7.1% 92.9%

Industry/commercial org. 12.9% 87.1% 0.0% 100.0%

Not-for-profit org. 0.0% 100.0% 0.0% 100.0%

The highest rate of unemployment among TVMA respondents under age 60 came from those aged 20- 39, 5.4 percent of whom reported being unemployed.

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AVMA Sample TVMA Sample Employed Unemployed Employed Unemployed 20 -- 29 YEARS 95.6% 4.4% 96.9% 3.1% 30 -- 39 YEARS 96.2% 3.8% 97.7% 2.3% 40 -- 49 YEARS 97.7% 2.3% 100.0% 0.0% 50 -- 59 YEARS 96.1% 3.9% 98.9% 1.1% 60 -- 69 YEARS 99.2% 0.8% 98.3% 1.7% 70 -- + YEARS 94.6% 5.4% 100.0% 0.0%

3.3 UNDEREMPLOYMENT IN THE VETERINARY PROFESSION

Underemployment as discussed here refers to two conditions that need to be defined: an individual is not able to work as many hours as he or she would like, or a person intentionally accepts employment below his or her training and experience.

Underemployment is typically measured in two ways, but for this report, the focus will be on to the number of hours that veterinarians desire to work above what they are currently working. This was measured as the desire to increase/decrease hours worked for a corresponding increase/decrease in compensation. The survey question asked if veterinarians wish to work more for greater compensation or work less for less compensation. The responses to this question were used to determine the underemployment rates and the net hours desired.

3.3.1 Summary Statistics

The total underemployment for the TVMA sample respondents was estimated at -856 hours; applying this estimate across the entire population of Texas veterinarians (6,901 veterinarians) yields a total of - 18,637 hours. This negative number of hours implies more veterinarians wish to reduce their working hours below those that they are currently working, and accept a reduction in compensation, than veterinarians who wish to increase their working hours with increased compensation. At a work load of 40 hours per week, an estimated 466 new veterinarians would be required in order to offset the net

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. difference in total hours between those veterinarians who wish to work less and those who wish to work more hours during their work week. In total, 25.1 percent of respondents indicated they wish to reduce the hours they work by a mean of 16.3 hours, while only 11.8 percent of respondents wish to increase the hours they work by a mean of 20.6 additional hours per week. Figure 47 presents the work load preference by gender for both the TVMA and the AVMA samples. The distribution indicates that 28 percent of women and 20.1 percent of men in the TVMA sample desire to work fewer hours than they currently work. Only a minority of respondents (6.3 percent for women and 6.2 for men) prefer to increase the number of hours they work.

Among the AVMA sample respondents, the distribution is still high for those who desire to work fewer hours per week (24.2 percent of females and 18.9 percent of males) than it is for those who desire additional work hours. The proportion of respondents who desire additional work hours is higher for the AVMA sample, however, than it is for the TVMA sample. More than 12 percent of females in the AVMA sample desire an increase in their current work hours against only 6.3 percent for the TVMA sample. Similarly, 11.1 percent of men in the AVMA sample desire an increase in their work hours against only 6.2 percent in the TVMA sample.

30%

20%

10%

0% Fewer Hours More Hours Fewer Hours More Hours AVMA Sample Texas Sample Female 24.2% 12.4% 28.0% 6.3% Male 18.9% 11.1% 20.1% 6.2%

Figure 47: Underemployment by Gender

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Underemployment by first practice type (Table 12) follows the same trend in most cases with the majority of practice types having more veterinarians who wish to work fewer hours for less compensation than those who wish to work more hours for more compensation. For veterinarians who started their veterinary profession in the government (civil service or uniformed services), the trend is somewhat reversed in both samples. More uniformed service workers (27.3 percent) desire an increase in the number of hours they work per week.

Table 12: Underemployment by First Veterinary Position

AVMA Sample TVMA Sample Work Less Work More Work Less Work More Food animal practice (excl.) 19.4% 11.1% 40.0% 0.0% Food animal practice (pred.) 17.7% 13.2% 41.7% 8.3% Mixed practice 24.9% 9.6% 22.3% 4.9% Companion animal practice (pred.) 22.4% 12.9% 30.2% 9.3% Companion animal practice (excl.) 23.7% 11.3% 26.0% 4.0% Equine practice 21.9% 17.7% 23.1% 7.7% Federal Government (civil service) 5.9% 17.7% 33.3% 33.3% Uniformed services 12.1% 6.1% 9.1% 27.3% College or University 19.3% 9.7% 21.4% 7.1% Industry/commercial organizations 14.8% 11.1% 33.3% 0.0% Not-for-profit organizations 16.1% 12.9% 20.0% 20.0%

Figure 49 shows the actual hours per week for TVMA respondents who desire a change in their current hours and those who prefer to keep the exact same hours. Overlapping these two distributions in one graph will help us understand why some people need additional hours while others do not. The number of actual hours per week varies from one hour to 100 hours for both groups. There is no clear trend indicating that people who prefer no change in their current work hours are actually working more hours than others. The distribution of their actual number of hours per week is normal, but the majority of the respondents were working between 30 and 60 hours per week.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Comparing the distribution by hours worked per week of those who wish to maintain their current number of hours of weekly work to the distribution of those who wish to change the number of hours in the work week shows little difference.

No Change Desire Change

50%

40%

30%

20%

10% Percent of Percent of respondents 0% 0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80 + Hours Per Week

Figure 48: Current Hours Worked and Desired to Change Hours Worked – AVMA Sample

No Change Desire Change

45% 40% 35% 30% 25% 20% 15% 10%

Percent of Percent of Respondents 5% 0% 0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80 + Hours Per Week

Figure 49: Current Hours Worked and Desired to Change Hours Worked – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The distribution of the number of hours that veterinarians wish to change their hourly work week is presented in Figure 50 (AVMA sample) and Figure 51 (TVMA sample). The desired number of hours of change varies from a reduction of 50 hours per week to an increase of 50 hours per week from their current hourly work week. The majority of respondents in both groups (male and female) wish to reduce their work week and within this group, the majority wishes to reduce their work week by 10 to 19 hours.

Female Male

40%

35%

30%

25%

20%

15%

10% Percent of Percent of Respondents

0% 50 + -50 + 1 to 9 -1 to -9 to -1 10 to 19 20 to 29 30 to 39 40 to 49 -40 to -49 -30 to -39 -20 to -29 -10 to -19 Desired Change in Hours

Figure 50: Current Hours Desired by Gender – AVMA Sample

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60%

50%

40%

30%

20% Percent of Percent of Respondents 10%

0% 50 + -50 + 1 to 9 -1 to -9 to -1 10 to 19 20 to 29 30 to 39 40 to 49 -40 to -49 -30 to -39 -20 to -29 -10 to -19 Desired Change in Hours

Figure 51: Current Hours Desired by Gender – TVMA Sample

The distribution of the net desired hour per week is presented for both females (Figure 52) and males (Figure 53). For those who did not indicate a desire to either increase or decrease their current hours, the current hours worked was used as their desired level. For those who wished to increase or decrease the number of hours they work per week the desired change was added to their current hours to obtain their desired hourly work week.

The majority of TVMA female respondents (58.8 percent) have a preference for work hours of between 30 and 50 per week. This preference is consistent with that of AVMA female respondents. The choice of the majority of the AVMA female respondents also is in this duration of hours. For male respondents in the TVMA sample, 52.2 percent have a preference for 30 to 50 hours per week and the proportion of respondents who prefer between 20 and 30 hours is also high (21.7 percent).

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40%

35%

30%

25%

20%

15%

10% Percent of Percent of Respondents

0% 1 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80 + Current Hours Plus Desired Change in Hours

Figure 52: Net Hours Desired – AVMA Sample

Male AVMA Sample Male TVMA Sample

35%

30%

25%

20%

15%

10%

Percent of Percent of Respondents 5%

0% 1 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80 + Current Hours Plus Desired Change in Hours

Figure 53: Net Hours Desired – TVMA Sample

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Of all the respondents of the TVMA sample who were asked if they would like to change their current work load for an adjustment in their compensation, 68.8 percent said they prefer to keep the same number of hours per week with no change to their compensation. About 25 percent of the total respondents are looking for a decrease in their work hours even though this will lead to a lower compensation. Only 6.1 percent are in favor of an increase in their work hours for a higher level of total compensation. The distribution of the TVMA sample is similar to that for the AVMA sample. As appears to be typical, the majority of the veterinarians are satisfied with their work load and do not wish any change.

TVMA AVMA

Work addditional hours per week for a higher 6.1% level of total compensation

Work the same number of hours per week, 68.8% with no change to my current compensation

Work fewer hours per week for alower level of 25.1% total compensation

0% 20% 40% 60% 80%

Figure 54: Desired Number of Hours Worked Per Week at Current Wage Rate

The following sub-sections delve into the demographics of respondents who wish an increase in their current work hours to understand why these particular people need to work more hours than they do currently. Factors of investigation considered are the number of years since graduation, the type of practice, the type of community, and the type of position. We hypothesized that, upon graduation new veterinarians are trying to maximize their income. New graduates who have incurred student debt are

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. expected to start servicing that debt. Given these expectations, young veterinarians are more likely to desire more hours per week. The analysis by number of years since graduation will help confirm or reject this hypothesis.

The analysis by type of practice will help determine whether some sectors of the veterinary profession are confronted with underemployment. The analysis by community type is carried out to determine whether some communities offer more opportunities than others.

In addition, a linear regression was used to determine factors affecting change in hours desired to work. The model under investigation is change in hours desired to work as a function of age, practice type, income, family status, number of children, gender, practice ownership status, practice location, and health conditions. The results are reported in the Table 13 below.

At a 5 percent significance level (sig > 0.05), most factors for the TVMA sample are not statistically significant ̶ a condition that might be due to the modest sample size (47 observations). From the AVMA sample it appears that factors such as type of practice, number of hours worked per week, educational debt, marital status, and location of the practice have some significant effects on hours desired to work.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 13: Factors Affecting Change in Hours Desired to Work

AVMA Sample TVMA Sample Std. Std. B Error Sig B Error Sig Intercept 32.91 8.62 0.00 49.99 34.39 0.16 Food animal practice 8.81 5.17 0.09 NA Mixed animal practice -2.36 3.34 0.48 5.69 12.34 0.65 Companion animal practice Omitted Omitted Equine practice -2.17 3.97 0.58 -21.23 15.82 0.19 Public practice 16.47 5.68 0.00 -22.60 17.41 0.20 Advanced education 6.01 6.06 0.32 NA Other veterinary employment 13.59 6.39 0.03 NA

Number of hours worked per week -0.64 0.07 0.00 -0.96 0.25 0.00 Annual income 0.00 0.00 0.51 0.00 0.00 0.40 Educational debt 0.00 0.00 0.04 0.00 0.00 0.69 Age -0.10 0.12 0.40 -0.28 0.28 0.33 Type of position (Owner = 0) -0.79 2.59 0.76 -5.49 6.52 0.41 Married -4.53 2.08 0.03 -9.44 7.90 0.24 Rural Area -6.29 2.79 0.02 -2.56 10.32 0.81 Suburban Area -3.55 2.41 0.14 -3.05 6.77 0.66 Urban Area Omitted Omitted Rent home 0.70 2.25 0.76 -0.43 9.01 0.96 Other home 5.28 4.60 0.25 1.00 16.62 0.95 Own home Omitted Omitted Number of kids -0.41 0.89 0.65 4.09 2.36 0.09 health conditions 0.72 0.94 0.45 1.35 3.31 0.69 Observations 464 47 R-square 0.25 0.54

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 3.3.2 Work Preference by Number of Years since DVM Graduation

The percentages on the top of each bar indicate the portion of people in the strata (year of graduation) who desire an increase or a decrease in their current work load. For Texas and AVMA respondents, the distribution shows that the percentage of respondents who desire to work more decreases with years of experience until 30 years of experience is acquired, and then increases (Figure 55); for both samples, the trend is reversed for respondents who graduated more than 31 years ago. For those who wish to work fewer hours per week, the percent of respondents who wish to work fewer hours were evenly distributed across the years post-graduation (Figure 56).

AVMA Sample TVMA Sample

14.0%

10.8% 10.0% 9.2% 8.5% 6.8%

4.2%

1.4%

1 to 10 11 to 20 21 to 30 31 and over Years since graduation

Figure 55: Desired to Work More Hours per Week

Page 83 of 151

27.1% 25.4% 24.2% 22.9% 21.7% 22.2% 21.5% 22.1%

1 to 10 11 to 20 21 to 30 31 and over Years since graduation

Figure 56: Desired to Work Fewer Hours per Week

3.3.3 Work Preference by Practice Type

Work preference also varies by type of practice. All the respondents who provided information regarding their employment type were categorized and the proportion of respondents in each category who desire more hours or fewer hours per week was reported in Figure 57 and Figure 58. In the TVMA sample, not-for-profit organizations have the highest proportion of veterinarians who wish to work more hours for a higher total compensation. Industry/commercial organizations, equine practices, and companion animal practices (predominant) follow with a proportion in double digits. The type of practice with the lowest proportion is mixed animal (3.1 percent). The distribution shows that in Texas, uniformed service has the highest proportion of veterinarians who desire to work fewer hours for a lower level of total compensation.

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Other Vet Employment 25.0%

Not-for-profit organization 28.6%

Mixed practice 3.1%

Industry/commercial organization 11.1%

Equine practice 14.3%

Companion animal practice (pred) 10.9%

Companion animal practice (exc) 4.1%

College or University 5.2%

0% 5% 10% 15% 20% 25% 30%

Figure 57: Desired to Work More Hours per Week by Practice Type

Page 85 of 151

Uniformed services 50.0%

Other Vet Employment 6.3%

Mixed practice 34.4%

Industry/commercial organization 11.1%

Federal Government - civil service 33.3%

Food animal practice (exc) 33.3%

Equine practice 28.6%

Companion animal practice (pred) 28.3%

Companion animal practice (exc) 27.5%

Advanced Education 33.3%

College or University 17.2%

0% 10% 20% 30% 40% 50% 60%

Figure 58: Desired to Work Fewer Hours per Week by Practice Type

3.4 JOB AND CAREER SATISFACTION

Figure 59 through 62 show the satisfaction of veterinarians with their level of compensation, their profession, their current job, and their lifestyle at different levels of income. Current income is expressed in term of annual professional income received by the veterinarian. All respondents were categorized into five groups of income. Level of satisfaction is segmented into seven groups with 1 = “not at all satisfied” and 7 = “extremely satisfied.” From Figure 59, it can be seen that “pretty satisfied” was well expressed by veterinarians with income between $20,000 and $100,000, “very satisfied” and “remarkably satisfied” for veterinarians with income between $100,000 and $200,000, and “extremely satisfied” by veterinarians who have an annual income above $200,000.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 40 Not at all satisfied Not very satisfied Slightly satisfied 35 Pretty satisfied Very satisfied Remarkably satisfied

Number of Respondents of Number Respondents 10

0 $20,000 - $49,999 $50,000 - $99,999 $100,000 - $149,999 $150,000 - $199,999 $200,000 - $500,000

Figure 59: Level of Income and Satisfaction with Compensation

The trend for satisfaction with the profession (Figure 60), with current job (Figure 61), and with lifestyle (Figure 62) is similar to that with the level of compensation. The majority of lower earners indicated they were “pretty satisfied” with the profession while the majority of higher earners indicate they were “extremely satisfied” with the profession. Income is correlated with number of years of experience, so it is apparent that respondents with a lower income level are new veterinarians. Their satisfaction with the profession and current job might have been colored by the challenges they face as new professionals.

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Number of of Number Respondents 10

0 $20,000 - $49,999 $50,000 - $99,999 $100,000 - $149,999 $150,000 - $199,999 $200,000 - $500,000

Figure 60: Level of Income and Satisfaction with the Profession

40 Not at all satisfied Not very satisfied Slightly satisfied Pretty satisfied 35 Very satisfied Remarkably satisfied Extremely satisfied 30

Number of of Number Respondents 10

0 $20,000 - $49,999 $50,000 - $99,999 $100,000 - $149,999 $150,000 - $199,999 $200,000 - $500,000

Figure 61: Level of Income and Satisfaction with Current Job

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 40 Not at all satisfied Not very satisfied Slightly satisfied Pretty satisfied 35 Very satisfied Remarkably satisfied Extremely satisfied 30

Number of of Number Respondents 10

0 $20,000 - $49,999 $50,000 - $99,999 $100,000 - $149,999 $150,000 - $199,999 $200,000 - $500,000

Figure 62: Level of Income and Satisfaction with Lifestyle

3.5 INCOME OF VETERINARIANS IN TEXAS

In this sub-section, summary statistics of professional income of veterinarians and a regression analysis of factors affecting income are reported. The summary statistics present the mean professional income for selected attributes.

Figure 63 displays the mean professional income for private practice veterinarians, regardless of their position and years of experience. For the Texas sample, mixed animal veterinarians receive the highest average income ($149,737) followed by companion animal veterinarians ($140,003) and equine veterinarians ($129,125). In the AVMA sample, however the highest mean income is maintained by companion animal veterinarians ($110,544) followed by food animal veterinarians ($96,491). For all categories, mean income for veterinarians in Texas is higher than that of those in the AVMA sample.

In the public practice sector (Figure 64) the highest mean income is maintained by veterinarians working in industry or commercial organizations, and the lowest mean income is reported by government employees ($117,800) and veterinarians in all other employment not listed ($102,125).

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. $149,737 $140,003 $129,125 $120,279 $110,544 $96,491 $91,606 $83,488

Food animal practice Mixed animal practice Companion animal Equine practice practice

AVMA Mean TVMA Mean

Figure 63: Mean Income by Practice Type – Private Practice

$157,929

$135,189 $141,980 $121,064 $117,800 $101,512 $98,305 $102,125

Academia Government Industry Other employment

AVMA Mean TVMA Mean

Figure 64: Mean Income by Employment Sector – Public and Corporate Sectors

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In general, practice owners earn more than associate veterinarians. Figure 65 presents the average income for practice owners, hospital directors, associate employees, and relief employees for AVMA and TVMA samples. Practice owners are categorized into different sub-groups based on the type of ownership. For TVMA respondents, corporate shareholders have the highest mean income ($213,690) and that for LLC co-owners, partnership co-owners, and sole proprietors is $207,387, $194,174 and $181,453, respectively. Hospital directors in Texas earn on average $147,429, and relief employees typically receive $119,714 per year. Associate employees have the lowest mean income in Texas, at roughly $95,900 per year.

AVMA Mean TVMA Mean

$250,000

$200,000

$150,000

$100,000

$50,000 Mean Annual Income Annual Mean $0 PO*: LLC PO*: Partner PO*: Relief employee corporate practice Hospital director of Associate employee Associate PO*: Sole proprietor

PO*: Corporate shareholder Corporate PO*:

*Practice Owner

Figure 65: Mean Income by Type of Position

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Income disparity between female and male veterinarians is also exhibited in Figure 66. Male veterinarians in Texas receive on average 56 percent higher income than their female counterparts. For the AVMA sample, the gap is 59 percent higher income for males than their female colleagues.

AVMA Mean TVMA Mean

$172,476

$139,682 $110,901 $93,756

Female Male

Figure 66: Mean Income by Gender

3.5.3 Income by Board Certification

Board certification improves professional income. The distribution of mean income by board certificate status (Figure 67) shows that TVMA board certified members earn an average annual income of $151,881, whereas their non-certified colleagues receive on average $132,085.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. AVMA Mean TVMA Mean $150,981 $151,881 $132,085

$99,049

Non-Board Certificated Board Certificated

Figure 67: Mean Income by Board Certification Status

3.5.4 Income of Associate Veterinarians vs. Practice Owners

Mean annual income for associate veterinarians and practice owners by type of practice is presented in Figure 68 and Figure 69. Mean income of TVMA members is higher than that of AMVA members. For associate employees, mean annual income ranges between $93,431 and $108,600 and the mean income for practice owners ranges between $120,279 and $231,636. In Texas, associate veterinarians in equine practice receive the highest mean income ($108,600) and for the AVMA sample, companion animal associate veterinarians earn the highest mean income ($94,915). Among practice owners, mixed animal practice owners have the highest mean income in Texas, whereas among the AVMA sample, companion animal practice owners receive the highest mean income.

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$108,600 Equine practice $66,876

$93,431 Mixed animal practice $74,119

$102,611 Companion animal practice (excl.) $89,058

$98,194 Companion animal practice (pred.) $94,915

Figure 68: Mean Income of Associate Veterinarians by Type of Practice

TVMA Sample AVMA Sample

$231,636 Mixed animal practice $131,499

$120,279 Food animal practice (excl.) $101,143

$163,333 Equine practice $111,967

$180,425 Companion animal practice (excl.) $126,233

$190,739 Companion animal practice (pred.) $146,828

Figure 69: Mean Income of Practice Owners by Type of Practice

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. 3.6 FACTORS AFFECTING INCOME: A REGRESSION ANALYSIS

A linear regression model was used to fit the income data for 265 veterinarians in Texas. The SAS 9.4 was used for the statistical analysis. The R-squared of 0.4626 indicates that at least 46 percent of the variations in the observed income data across veterinarians can be explained by the variables incorporated into the model. The overall test of the model has yielded a p-value less than the significance level of 0.05, supporting the notion that the model is helpful in explaining the variations in income.

Since the natural log of the income in the model, the value of the constant cannot be interpreted unless its exponential is taken. The exponential of the constant ($20,394) represents the expected professional income for veterinarians when none of the covariates are considered.

The results also indicate that a 1 percent increase in the number of years since graduation increases the professional income by 0.25 percent. That is, holding other factors constant, a veterinarian who is newly employed receives $20,394 per year and his colleague who has one year of experience will receive $25,493. In the same way, a 1 percent increase in the number of hours worked per week increases income by 0.28 percent.

The results indicate that the difference in income between female and male veterinarians is statistically significant at a 5 percent significance level. The p-value for the gender (0.0001) variable is less than 0.05. Male veterinarians earn a 28.6 percent higher income than their female counterparts after controlling for the factors indicated.

The education effect (internship and residency participation, board certification) on income was also estimated, but none of these factors were statistically significant enough to explain the variation in income.

Respondents were categorized by type of employment, and the difference in their professional income was analyzed. Companion animal practice was kept as the base for comparison. Thus, other income comparisons are made against incomes associated with companion animal practice. The results indicate

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. that among Texas veterinarians (food animal practice and equine practice), companion animal veterinarians maintain the highest mean income. Income for veterinarians in colleges or universities is statistically lower than that for companion animal practices.

Table 14: Factors Affecting Professional Income of Texas Veterinarians

Estimate Std. error Sig.

Constant 9.92 0.52 0.000 Log(Number of years since graduation) 0.25 0.03 0.000 Log(Hours per week) 0.28 0.13 0.039 Gender (1= male) 0.29 0.06 0.000 Education Internship participation 0.08 0.12 0.500 Residency participation 0.07 0.18 0.682 Board certificated 0.08 0.17 0.642 Private practice employment Food animal practice -0.86 0.46 0.061 Equine practice -0.42 0.19 0.030 Companion animal practice Omitted Public and Corporate sectors Government -0.16 0.48 0.744 Academia -1.16 0.47 0.015 Industry/Commercial Org. -0.01 0.29 0.968 Other employment -0.51 0.21 0.018 Advanced education -1.01 0.22 0.000 Position Type Hospital Director -0.07 0.19 0.697 Relief employee -0.09 0.20 0.664 Practice owner 0.04 0.08 0.675 Associate veterinarian Omitted N = 265, R-squared = 0.4626

Page 96 of 151

A professional quality of life analysis was used to assess the wellness of veterinarians in Texas. Wellness was evaluated using the Professional Quality of Life Scale (ProQOL), Version 5. PROQOL is typically used to compute the level of compassion satisfaction and compassion fatigue for workers in a specified industry (Hudnall Stamm, 2009). The three indexes of wellness considered here are compassion satisfaction, burnout and secondary traumatic stress (compassion fatigue). Using this tool, each question is scored and a sum of scores calculated for both compassion satisfaction and fatigue. Sum of scores above 40 are considered high after comparison across more than 90 professions, while sum of scores below 20 are considered low.

3.7.1 Compassion Satisfaction

Compassion satisfaction measures the pleasure an individual derives from being able to perform adequately his/her work. Tables 15 through 22 present mean compassion satisfaction scores for different groups of veterinarians. The analysis of variance was used to test whether mean scores differ by categories. Mean scores of the TVMA and the AVMA samples were reported for comparison.

Table 15 presents the results of the mean score analysis by graduation year. Mean compassion satisfaction score increases with experience. Veterinarians in the AVMA sample who graduated during the last 10 years have a mean score of 35.4 while those who graduated more than 30 years ago have a mean score of 39.2. Because of the stress associated with the new professional life and the burden of student debt, satisfaction tends to be lower at the outset of a career, but improves with time.

Table 15: Mean Compassion Satisfaction by Graduation Year

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error Less than 11 years 35.4 0.2 36.3 0.6 10 to 20 years 35.5 0.4 37.4 0.9 21 to 30 years 37.8 0.4 38.6 0.8 31 years and more 39.2 0.4 41.0 0.6

Page 97 of 151

Board certification also increases compassion satisfaction score, although the difference in mean score between the two groups is not statistically significant (p-value = 0.3365).

Table 16: Mean Compassion Satisfaction by Board Certification

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error Non-Board Certificated 36.3 0.2 38.3 0.4 Board Certificated 37.1 0.4 39.2 0.9

With respect to first employment type, the results indicate that veterinarians who began their career in government (federal government civil service, uniformed service, local/state government) are typically more satisfied than their colleagues in other veterinary sectors are with their work. Government- employed veterinarians and food animal veterinarians lead in mean compassion satisfaction among TVMA respondents with scores of 42.4 and 41.6, respectively. At the bottom of the scale are companion animal veterinarians (38.0), faculty members (37.4), and equine veterinarians (36.1). Veterinarians enrolled in advanced education at the time of the survey have a mean score of 35.7.

Table 17: Mean Compassion Satisfaction by First Veterinary Employment

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error Academia 37.2 0.7 37.4 1.9 Companion animal practice 35.9 0.2 38.0 0.5 Equine practice 35.8 0.6 36.1 2.0 Food animal practice 37.3 0.6 41.6 1.8 Federal/state/local gov. 37.6 0.8 42.4 1.6 Industry 36.3 1.3 39.0 6.4 Mixed animal practice 37.1 0.4 38.6 0.7 Other employment 37.2 0.7 39.5 1.9

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. The mean score is statistically and significantly different between men and women (p-value = 0.0205) in Texas. Among both organization samples, the mean score for men appears to be higher than for women. More investigation is needed for a reasonable conclusion since veterinarian data are found to exhibit skewness with respect to age and gender. In fact, the majority of male veterinarians in the United States are age 40 and above, whereas the majority of female veterinarians are below 40 years of age.

Table 18: Mean Compassion Satisfaction by Gender

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error Male 37.3 0.3 39.3 0.5 Female 35.9 0.2 37.7 0.5

Compassion satisfaction also seems to increase with increased level of income. Scores are typically lower for lower income categories and higher when moving upward.

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. Table 19: Mean Compassion Satisfaction by Level of Income

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error $20,000 to $29,999 37.1 0.9 37.6 2.4 $30,000 to $39,999 35.6 0.7 37.7 2.1 $40,000 to $49,999 35.4 0.6 40.4 2.1 $50,000 to $59,999 35.8 0.6 36.2 1.8 $60,000 to $69,999 35.3 0.5 39.0 2.3 $70,000 to $79,999 35.3 0.4 37.9 1.4 $80,000 to $89,999 35.9 0.4 35.8 1.4 $90,000 to $99,999 35.8 0.5 35.8 1.3 $100,000 to $124,999 36.6 0.4 36.9 0.8 $125,000 to $149,999 36.8 0.5 38.5 1.3 $150,000 to $174,999 38.7 0.7 37.9 1.3 $175,000 to $199,999 38.9 0.9 39.0 1.8 $200,000 to $249,999 38.6 0.7 40.3 1.5 $250,000 to $500,000 38.3 0.8 40.9 1.1

In terms of ownership status, the results indicate that for both samples, practice owners reflect a greater level of compassion satisfaction than do associate veterinarians. The mean score for practice owners in Texas is 40.4, whereas that for associate veterinarians it is 36.3. The AVMA sample also yields the same trend with a score of 38.4 for practice owners and a score of 35.4 for associate employees. Again this could be due to the owners being, on average, older than associates.

Table 20: Mean Compassion Satisfaction by Ownership Status

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error Associate veterinarian 35.4 0.2 36.3 0.6 Practice owner 38.4 0.3 40.4 0.6

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04.21.17 AVMA Assistance Animals: Rights of Access and the Problem of Fraud © Copyright 2017. American Veterinary Medical Association. All rights reserved. When examined by current employment type, the results indicate that Texas food animal veterinarians carry the highest mean score (46.0) followed by companion animal veterinarians (38.5), and faculty members (38.3). Equine veterinarians have the lowest compassion satisfaction score.

Table 21: Mean Compassion Satisfaction by Employment Sector

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error Academia 37.6 0.5 38.3 1.2 Companion animal practice 36.1 0.2 38.5 0.4 Equine practice 36.9 0.8 35.2 2.7 Food animal practice 37.3 1.0 46.0 3.8 Federal/state/local gov. 35.3 0.7 37.4 2.9 Industry/com. org. 36.0 0.8 36.2 2.9 Mixed animal practice 37.3 0.6 37.0 1.4 Other employment 37.1 0.6 39.3 1.9

Finally, the effect of student debt on compassion satisfaction score was examined. For this analysis, respondents were categorized by educational debt status. Respondents with student debt were placed in one group and respondents without debt in another group. Then the mean compassion satisfaction score was computed for each group and a t-test used to determine whether the observed difference is statistically significant. The significance level was set to 5 percent. The results indicate that the mean score for Texas veterinarians without student debt is statistically significantly higher (39.8) than that for indebted veterinarians.

Table 22: Mean Compassion Satisfaction by Educational Debt Status

AVMA Sample TVMA Sample Mean Std. Error Mean Std. Error With Student Debt 36.1 0.2 37.1 0.4 Without Student Debt 37.6 0.3 39.8 0.6

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Compassion fatigue has two components: burnout and secondary traumatic stress.

3.7.2.1 Burnout

The summary statistics of burnout score by selected covariates are presented in Tables 23-30. Burnout is observed to decrease with years of experience. Among the TVMA sample, veterinarians with less than 11 years of experience have a mean burnout score of 26.9, whereas those with at least 30 years of experience have a mean score of 20.7. Respondents who are board certified have a lower mean burnout score than those without certification. Veterinarians who started their professional career as a government employee have the lowest burnout score. With respect to gender, the results indicate that the mean burnout score for female veterinarians is higher than that for male veterinarians.

Table 23: Mean Burnout by Graduation Year

AVMA Sample TVMA Sample