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Running head: VETERINARY INSURANCE MIGHT SAVE THE VETERINARY TECHNICIAN 1

Veterinary Insurance Might Save the Veterinary Technician

Tiffany Bartlett

Tarleton State University

VETE 4208- Veterinary Research


Index

Abstract……………………………………………………………………………………3

Introduction……………………………………………………………….……………….4

Statement of problem………………………………………………………………..…….5

Purpose and significance of study…………………………………………………………5

Hypotheses………………………………………………………………………………...5

Research Questions……………………………………………………………………..…6

Definitions………………………………………………………………………………....6

Assumptions…………………………………………..…………………………………...7

Limitations……………………………………………………………………………...….7

Delimitations…………………………………………………………………………….....8

Literature Review…………………………………………………………………………..8

Methodology……………………………………………………………………………….9

Data Analysis………………………………………………………………………………10

Findings…………………………………………………………………………………….21

Summary and Conclusions…………………………………………………………………22

Recommendations………………………………………………………………………….22

References……………………………………………………………………………….....23


Abstract

The veterinary technician shortage has negatively impacted clinics and hospitals

nationwide. Veterinary technician positions are being left vacant for months leaving veterinary

care teams short staffed and over worked. This leads to increased mistakes in patient care and

poor client service. So, where have all the veterinary technicians gone? To a field of work where

they are better compensated. With veterinary spending increasing every year, why hasn’t the

veterinary technician wage kept pace? Because veterinary charges do not support the increased

knowledge base, dedication, or livelihood of veterinary technicians. A job that was once able to

be filled by a pre-vet student during the summers now requires working knowledge of anatomy

and physiology, anesthesia, performing advanced laboratory diagnostics, radiology,

ultrasonography, parasitology, advanced CPR and life support, critical care nursing, surgical

assisting and instrumentation, as well as mechanical maintenance and hospital inventory.

Veterinarians want veterinary technicians they can trust to perform these tasks and they want to

pay them more (DVM360, 2015). How do we bridge this gap?

Veterinary insurance. Human medicine’s cost obscenely outpaces that of veterinary

medicine. Imagine the number of clients who would say yes to a referral if the owner only had to

pay $25 for a specialist visit instead of $140. How many more dentals would be done if the client

only had to pay $50 but the clinic was still able to get the full $450 necessary to perform the

procedure? An increase in cases seen, increase in average transaction per client, and increased

owner compliance generates more revenue. Increased profitability for a hospital supports

increased wages of veterinary support staff.


Introduction

Veterinary medicine as an industry struggles to pay veterinary technicians a wage

commensurate with skill and experience. This drives veterinary technicians from the veterinary

field to other professions. With the average veterinary technician leaving the field after twelve

years, many hospitals struggle to find qualified candidates for open positions, have high turnover

rates plus the costs associated with having high turnover, and suffer from lack of consistency

with training (Dittmar, 2016). The average American has less than $1,000 in savings which does

not go far for non-routine care. This is a major factor in how veterinary hospitals can charge for

services as they are restricted to what the average American is capable of spending out of pocket.

Veterinary hospitals pay the same price for medicine and diagnostic equipment as human

hospitals do, lending to a narrow profit margin. This narrow profit margin of keeps veterinary

technician wages low. Which leads to the question, can veterinary insurance make the veterinary

industry a sustainable career choice for veterinary technicians? There have been major changes

to veterinary insurance since 2007, with an increasing number major insurance companies

underwriting policies, more are covering breed specific diseases as well as preventative care.

This has allowed veterinary insurance to become a bigger presence in the veterinary economy.

Looking at our closest market for comparison, human medicine, human nurses have appropriate

wages with the benefits previously mentioned because human insurance allows human hospitals

to charge exorbitant prices. While this review does not delve into the issues that plague human

medical insurance, it is important to note how a human nursing career is a sustainable livelihood

compared to that of a veterinary technician. Pay is not the only factor driving veterinary

technicians away, benefits like employer sponsored health care, 401K, paid vacation time,

recognition, and upward mobility are not common among privately owned veterinary hospitals.


Statement of Problem

Average technician burnout is 12 years and the number one reason for technicians

leaving the field is pay (Dvm360.com staff, 2014). In Arizona, there are roughly 1,000 licensed

veterinary technicians (LVTs) in the entire state and they issued less licenses this year, 66, than

last year, 79 (Carlson, 2017). LVTs, depending on state nomenclature RVT/CVT/etc., are

declining due to high exit and low entrance. Low pay, low public recognition for the position,

long hours, emotional toll, and student debt are all factors. However, low wages is the top reason

for veterinary technicians leaving the field. Veterinary hospitals are sending out wanted ads and

getting few qualified respondents. If they do hire a credentialed technician, keeping them is

another challenge.

Purpose and Significance of Study

The rise of comprehensive veterinary insurance could be the answer to this problem. As

comprehensive veterinary insurance usage rises, owner compliance and willingness to pay

increases, leading to increased revenue. Theoretically, increased revenue to veterinary hospitals

mean increased wages and benefits for technicians. Can veterinary insurance change the

landscape of veterinary medicine to make veterinary technology a sustainable career choice? In

other words, can veterinary insurance save the veterinary technician? I think it can. Literature on

veterinary economics, veterinary insurance, as well as literature on veterinary technology will be

reviewed. The goal is to find common factors that support the hypothesis that veterinary

insurance is not only good for owners and pets, but the veterinary industry as a whole.

Hypothesis

H01 states that veterinary insurance creates an environment where pet owners are more

likely to spend money on veterinary care.


Research Questions

1. What difference does veterinary insurance make in the treatment of a patient?

2. Why are veterinary technicians leaving the field?

3. How do veterinary economics play a part in the lack of credentialed veterinary

technicians?

4. What is a livable wage?

5. What other factors play a role in veterinary technician exodus from the field of

veterinary medicine and would increase in pay or benefits make a difference?

Definitions

Veterinary technician- anyone acting in the capacity of a veterinary technician who has

completed an AVMA accredited program and is qualified to sit for the VTNE

VTNE- Veterinary Technician National Exam

Livable wage- pay capable of living on one’s own, without support from parents, spouse, or a

secondary income.

Client- Legal owner of a pet that is being seen as a patient and has an established

client/patient/veterinarian relationship.

TX- Shorthand in figures for the word treatment.

AMA- Against medical advice, a client took a patient home against the advice of the attending

veterinarian.

Euthanasia- the act of putting to death painlessly or allowing to die, as by withholding extreme

medical measures, a person or animal suffering from a disease process.

Assumptions


For the purpose of this study, it is assumed that without a change in the veterinary industry that

veterinary technicians will be harder for veterinary hospitals to find, thus limiting the capacity of

a veterinary hospital to care for patients.

The second assumption. The second assumption is that veterinary technicians seek financial

independence and the ability to support themselves financially without assistance from a spouse,

parents, or another form of additional income.

The third assumption. The third assumption is that in order for veterinary technicians to earn a

better income, spending at veterinary clinics needs to increase in either the amount spent per

client or an increase in clients.

The fourth assumption. The fourth assumption is that respondents to the questionnaire responded

honestly since their responses were anonymous and without repercussion.

Limitations

1. This study is limited due to time restraints. What was true when this study was begun

may have changed.

2. This study is limited due to the availability to reach respondents to the questionnaire. The

questionnaire was released to a Facebook page called Veterinary Support Staff

Unleashed, limiting the reach to those involved in that particular group of 9,314 members

as of 11/3/17. Additionally, the questionnaire was only available for 24 hours.

3. This study is limited to clients of one veterinary specialty clinic and emergency hospital

in the greater Houston, TX area over the last 3 years and may not reflect regional or

national trends.


Delimitations

1. This study was limited to the veterinary economics of the United States and more

specifically of Houston, Texas.

2. This study only assessed veterinary insurance and did not address other, previously

proposed, solutions.

Literature Review

Veterinary technicians are becoming fewer and filling open positions are becoming

harder with longer time to hire, therefore increasing the cost to veterinary hospitals. The number

one reason veterinary technicians are hard to find is that compensation is low. The average

veterinary technician in Texas can make $12.98/hr but in order to afford renting a two-bedroom

apartment, they would need to make a minimum of $18.38/hr (Indeed, 2017) (Strutner, 2017).

So, even though $12.98/hr is an industry benchmark, it isn’t enough to make veterinary

technology a sustainable career. However, veterinary practices revenue growth before interest,

taxes, depreciation, and amortization has shown strong growth since 2013 (AVMA, 2017). The

overall outlook for veterinary economics is strong. Denise Tumblin, a CPA in Columbus, Ohio

surveyed practice owners, her clients, and 90% of them say a primary objective is to be more

profitable so that they can pay their team members more (DVM360, 2015). The desire for

employers to pay their employees more is there and there are well educated, trained, technicians

who would like to stay but are leaving the field due to low pay. How do we bridge the gap?

Veterinary insurance among clients is still rare but 56% of veterinarians wish all clients

had veterinary insurance. If veterinary insurance continues to grow as projected, historically 12%

annually since 2014, veterinarians would be able to charge closer to what their services are worth

and increase their staff pay. This is because clients with veterinary insurance spend more on


veterinary care (Volk, 2016). Enrolled dogs saw an increase of 29% on veterinary spending and

enrolled cats saw an increase of 81% on veterinary spending. This directly translates to increased

revenue earned in veterinary hospitals. As an industry, we need to increase the average dollar

amount spent per client, not necessarily bring in new clients who can’t afford diagnostics,

treatments, or even preventative care. The number of potential clients is ever growing as the

number of households with pets continues to rise (Springer, 2017). It is their ability to pay for

our services that requires our focus as an industry.

A survey was published to Facebook group, Veterinary Support Staff Unleashed. Of its

9,314 members, 172 responded in 24 hours. Veterinary Support Staff Unleashed vets its

members to ensure active employment as veterinary support staff. More than half of technicians,

51.7%, have received zero training on the currently available veterinary insurance options. Of the

technicians polled, 16.4% say they offer wellness plans at their veterinary clinic and of those

99% of them say they have received training on how to present these to clients. This would

indicate that hospitals are more concerned with selling their wellness plans over and above

discussing veterinary insurance. This is a problem for the industry as well as consumers. From

the same survey, only 17.2% of respondents believe that pet owners understand the differences

between wellness plans and veterinary insurance. Having focused on wellness plans, we have

confused the consumer/owners. Wellness plans are not transferrable whereas veterinary

insurance is.

Methodology

Research Design

This study pulled 300 clients at random from a specialty and emergency clinics database.

The randomization was ensured using an online number randomizer from www.randomizer.org.


This retrospective study went back 3 years starting from 10/1/2017. These were cases whose

visit to this specialty and emergency clinic were within the last three years and did not include

patients or clients not seen within the last 3 years for a new diagnosis. Patients seen within the

last three years for a recheck and not a new diagnosis were excluded. Of those pulled cases were

reviewed to establish who, if any, had veterinary insurance for their pet at the time of being seen

for initial exam and consultation. Veterinary insurance is the independent variable. Based on

that, the dependent variables examined were which clients moved forward with first

recommended treatments, who did any treatments or diagnostics also called second suggested

treatments, euthanatized, or who left against medical advice. Prognosis was also evaluated and

categorized as excellent, good, guarded, poor, and grave.

Data Analysis

300 cases were reviewed after randomly being selected by case number using an online

number randomizer. The range of cases were seen over the last three years, from October 1, 2017

to October 1, 2014 and included cases seen by all departments of a specialty hospital in Houston,

TX: Emergency and Critical Care, Oncology, Internal Medicine, Surgery, and Neurology. Of the

300 cases reviewed 34 case files were discarded because the patients either never showed up for

their initial exam & consultation, left without examination through the Emergency and Critical

Care department, or had seen the radiologist as an outpatient for ultrasound only. Cases were

reviewed for documentation of having veterinary insurance and a 1 entered under yes or no. Next

client selection of treatment was divided into fist recommendation, second recommendation,

euthanasia, or leaving against medical advice. A 1 was entered under which category the case

fell. Finally, the case was evaluated for prognosis as assessed by the attending veterinarian. A 1

was entered under either excellent, good, guarded, poor, or grave. Then the results were tallied


using an Excel spreadsheet. The cases with veterinary insurance are listed in the table 1. The

cases without veterinary insurance are listed in table 2. Presentation of the data in relation to

veterinary insurance and prognosis are in the subsequent tables 3-7.

Table 1

Cases with veterinary insurance.

Veterinary Insurance's Influence on the Outcome of Veterinary Cases from a Specialty & Emergency Center in Houston, Texas

Patient ID

Veterinary Insurance Treatment Prognosis

Yes No 1st Rec. 2nd. Rec Euth. AMA Excellent Good Guarded Poor Grave33163 1 1 1 48796 1 1 1 53321 1 1 1 52478 1 1 1 33551 1 1 1 48812 1 1 153490 1 1 1 42573 1 1 1 46411 1 1 1


Table 2

Cases without veterinary insurance.

Patient IDVeterinary Insurance Treatment PrognosisYes No 1st Rec. 2nd. Rec Euth. AMA Excellent Good Gaurded Poor Grave

47140 1 1 152635 1 1 147770 1 1 144358 1 1 136870 1 1 141672 1 1 132928 1 1 131212 1 1 149843 1 1 148823 1 1 142916 1 1 132997 1 1 150075 1 1 138326 1 1 1 38475 1 1 1 32592 1 1 1 47272 1 1 1 39790 1 1 1 39380 1 1 1 50547 1 1 1 38004 1 1 1 43908 1 1 1 40671 1 1 1 42327 1 1 1 52291 1 1 1 31675 1 1 1 52163 1 1 1 47594 1 1 1 30364 1 1 1 40584 1 1 1 42326 1 1 1 44394 1 1 1 32964 1 1 1 34415 1 1 1 38000 1 1 1 41201 1 1 1


52925 1 1 1 41599 1 1 1 45270 1 1 1 31641 1 1 1 37353 1 1 1 49711 1 1 1 36135 1 1 1 32943 1 1 1 49461 1 1 1 48605 1 1 1 37098 1 1 1 40643 1 1 1 39180 1 1 1 41734 1 1 1 31271 1 1 1 48686 1 1 1 50488 1 1 1 34322 1 1 1 44597 1 1 1 39895 1 1 1 39169 1 1 1 49540 1 1 1 40025 1 1 1 49075 1 1 1 49330 1 1 1 36786 1 1 1 40028 1 1 1 51554 1 1 1 33252 1 1 1 43411 1 1 1 42309 1 1 1 37187 1 1 1 31313 1 1 1 49641 1 1 1 44936 1 1 1 52343 1 1 1 36377 1 1 1 47144 1 1 1 40877 1 1 1 48376 1 1 1 52366 1 1 1 52569 1 1 1 31502 1 1 1


34530 1 1 1 53172 1 1 1 45119 1 1 1 41815 1 1 1 50617 1 1 1 49016 1 1 1 47341 1 1 1 51800 1 1 1 48200 1 1 1 34643 1 1 1 33247 1 1 1 41023 1 1 1 49270 1 1 1 52597 1 1 1 52624 1 1 1 30920 1 1 1 45137 1 1 1 39793 1 1 1 32018 1 1 1 32274 1 1 1 34706 1 1 1 37908 1 1 1 32464 1 1 1 33642 1 1 1 40146 1 1 1 48551 1 1 1 39994 1 1 1 47922 1 1 1 43414 1 1 1 44391 1 1 1 45123 1 1 1 31737 1 1 1 32530 1 1 1 33725 1 1 1 43819 1 1 1 35185 1 1 1 39337 1 1 1 33292 1 1 1 45934 1 1 1 52190 1 1 1 38491 1 1 1 44340 1 1 1 36128 1 1 1


33872 1 1 1 41094 1 1 1 45937 1 1 1 50820 1 1 1 37529 1 1 1 31111 1 1 1 53530 1 1 1 45468 1 1 1 35114 1 1 1 37262 1 1 1 48470 1 1 1 41939 1 1 1 34686 1 1 1 47266 1 1 1 48211 1 1 1 51740 1 1 1 47953 1 1 1 37981 1 1 1 45591 1 1 1 46259 1 1 1 52267 1 1 1 36625 1 1 1 40054 1 1 1 38180 1 1 1 48805 1 1 1 35225 1 1 1 49758 1 1 1 37109 1 1 1 52821 1 1 1 35535 1 1 1 51163 1 1 1 52710 1 1 1 32625 1 1 1 31308 1 1 1 30219 1 1 1 30355 1 1 1 48098 1 1 1 35564 1 1 1 33535 1 1 1 46079 1 1 1 36709 1 1 1 33682 1 1 1 39005 1 1 1


30196 1 1 1 50120 1 1 1 35060 1 1 1 53510 1 1 1 31047 1 1 1 49770 1 1 1 45557 1 1 1 33866 1 1 1 50484 1 1 1 38512 1 1 1 31043 1 1 1 51055 1 1 1 37718 1 1 1 32282 1 1 1 49632 1 1 1 48013 1 1 1 41838 1 1 1 39805 1 1 1 40459 1 1 1 46408 1 1 1 40483 1 1 1 30977 1 1 1 30702 1 1 1 46642 1 1 1 30893 1 1 1 44350 1 1 1 43233 1 1 1 34668 1 1 1 31360 1 1 1 33701 1 1 1 51362 1 1 1 39389 1 1 1 31970 1 1 1 42635 1 1 1 47532 1 1 1 46849 1 1 1 44244 1 1 1 36485 1 1 1 47881 1 1 1 35075 1 1 1 42952 1 1 1 48407 1 1 1 44072 1 1 1


33885 1 1 1 50490 1 1 1 35497 1 1 1 38891 1 1 1 47342 1 1 1 31356 1 1 1 34853 1 1 1 34026 1 1 1 34022 1 1 1 50022 1 1 1 53097 1 1 1 30986 1 1 1 37872 1 1 1 35967 1 1 1 43038 1 1 1 53511 1 1 1 46247 1 1 1 46180 1 1 1 48501 1 1 1 46632 1 1 1 47429 1 1 1 32342 1 1 1 40109 1 1 1 33967 1 1 1 40620 1 1 1 47858 1 1 1 50747 1 1 1 33850 1 1 1 52798 1 1 1 36757 1 1 1 43020 1 1 1 47114 1 1 1 34823 1 1 1 42202 1 1 1 36682 1 1 1 39378 1 1 1 43182 1 1 1 33786 1 1 1 47430 1 1 1 43195 1 1 1 47372 1 1 1 32789 1 1 1 40701 1 1 1


52278 1 1 1 47365 1 1 1 34135 1 1 1 45444 1 1 1 19801 1 1 1 16556 1 1 1

Figure 3

Cases with veterinary insurance who moved forward with primary course of treatment.

100%

Cases With Veterinary Insurance Treatment Dis-tribution

1st TX 2nd TX Euth. AMA


Figure 4

Cases without veterinary insurance who moved forward with primary course of treatment.

1st TX41%

2nd. TX21%

Euth.15%

AMA23%

Cases Without Veterinary Insurance Treatment Distribution

1st TX 2nd. TX Euth. AMA

Figure 5

Excellent Good Gaurded Poor Grave0

20

40

60

80

100

120

Cases Without Veterinary Insurance- Treatment Selection By Prognosis



Figure 6

Excellent Good Gaurded Poor Grave0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Cases Without Veterinary Insurance: Treatment Selection by Prognosis as Percentages of Cases


Figure 7

Excellent Good Gaurded Poor Grave0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Cases With Veterinary Insurance: Treatment Selection by Prognosis as Percentages of Cases



Findings

Of the 266 cases eligible for review, 9 cases had documentation of veterinary insurance

making the retrospective study skewed (see figures 1 and 2). In order to examine the two

different groups, those with veterinary insurance and those without veterinary insurance, it was

best to use percentages due to the large disparity in actual case number (see figures 6 and 7).

None of the cases with veterinary insurance were given a prognosis of excellent however it was

still listed in order to make analysis easier. More than 60% of the cases had a prognosis below

good (see figure 5). None of the cases were seen for preventative care due to the nature of the

veterinary emergency and specialty hospital so, the patients and cases reviewed either had an

accident, illness, or injury.

The only case with a grave prognosis to receive primary suggested treatment was the case

with veterinary insurance. As the prognosis of cases without veterinary insurance declined so did

the clients’ willingness or ability to move forward with the primary suggested treatment (see

figure 6). However, that is not true for cases that had veterinary insurance- ability or willingness

to move forward with primary treatment does not appear to have a relationship with prognosis

(see figure 7). Finally, this study shows that cases without veterinary insurance only follow

initial treatment options 43% of the time and have a high rate of leaving against medical advice,

23%, or euthanizing, 15% (see figures 3 and 4).

Summary and Conclusions

This study suggests that when financial constraints are alleviated, owners will choose the

first recommended course of treatment. It also correlates prognosis to treatment options. As

prognosis becomes poorer, less owners will choose the initial treatment plan when there isn’t

veterinary insurance. When veterinary insurance is present, this correlation does not exist.


Implications of Findings

When the clients are readily able to follow through with first recommended treatment

plans client compliance increases, patient care is better, and profits increase. Increased profits

would allow veterinary hospitals to increase pay of their veterinarians and paraprofessionals

(veterinary technicians, veterinary assistants, kennel staff, and receptionists). With pay being the

number one reason veterinary technicians are leaving the veterinary field, an increase in

pay/benefits would allow more veterinary technicians to stay in the field. Essentially, this could

end the veterinary technician shortage and make veterinary technology a sustainable career

choice.

Recommendations

This retrospective study could be performed on a larger scale with cooperation from

several day practices in an area to see if this holds true in other areas throughout Houston, Texas,

or any other area in the United States. At a minimum, a retrospective study using a larger pool of

clients/patients is warranted to see if this can be repeated. Additionally, I recommend that the

veterinary community support veterinary insurance by advocating it to every client at every visit.


References

Carlson, J., CVT. (2017, September 22). Where have all the technicians gone? Retrieved

September 23, 2017, from http://veterinarynews.dvm360.com/where-have-all-

technicians-gone

Dittmar, C. A., LVT. (2016). The Relationship Between Continuing Education and Job

Satisfaction for Veterinary Technicians. The NAVTA Journal, (2016 Convention Issue),

20-22. Retrieved September 18, 2017, from www.navta.net.

Dvm360.com staff. (2014, May 30). The truth about the veterinary technician shortage.

Retrieved September 16, 2017, from http://veterinaryteam.dvm360.com/truth-about-

veterinary-technician-shortage

Dvm360.com staff. (2015, February 03). Veterinary Team Pay Report. Retrieved November 1,

2017, from http://veterinarynews.dvm360.com/team-pay-report?pageID=5

Dvm360.com staff. (2016, December 15). Pet insurance: Fact and fiction. Retrieved September

25, 2017, from http://veterinarybusiness.dvm360.com/pet-insurance-fact-and-fiction?

pageID=1

Indeed.com. (2017, September). Salaries. Retrieved October 20, 2017, from

https://www.indeed.com/salaries/Veterinary-Technician-Salaries,-Texas

NAPHIA. (2016). North American Pet Health Insurance Association State of the Industry Report

(pp. 1-15, Rep.). Willis Towers Watson.

Rollo, A., Metzger, F., & Ward, E. (2015, November 09). The power of pet insurance. Retrieved

November 1, 2017, from http://veterinarybusiness.dvm360.com/power-pet-insurance

Springer, J. (2017). The 2017-2018 APPA National Pet Owners Survey Debut: Trusted Data for

Smart Business Decisions (pp. 1-50, Rep.). Greenwich, CT: American Pet Products

Association.

Strutner, S. (2017, November 19). The Hourly Income You Need To Afford Rent Around The

U.S. Retrieved November 20, 2017, from https://www.huffingtonpost.com/entry/how-

much-you-need-for-rent_us_5942cc92e4b0f15cd5b9e2ee

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