Sunday, December 16, 2012

It starts all over again

Others focused on a concern that the COE has relaxed its standards to allow subpar programs to earn accreditation. Western U was given as an example, with Marshak noting that unlike in most other programs, veterinary students there are expected to develop their clinical acumen by rotating through private practices rather than a traditional veterinary medical teaching hospital. 
Given that Western U contracts with upwards of 700 private practices, it’s impossible for academicians to monitor what students are learning, if anything, Marshak said. What’s more, now that building an expensive teaching hospital no longer is required for accreditation, several new Western-like programs are emerging across the United States.  
By accrediting Western U, the COE “ensnared themselves in a trap,” Marshak testified. “How do you turn down the next crummy school without being sued?” 

 Now, these quotes come from the same Dr. Marshak I wrote about last November.  I don't want to be too redundant, but the argument comes down to the fact that we do our rotations outside of an official teaching hospital, so there's no standardization of what we're learning, therefore WesternU doesn't deserve to be accredited.  That and PBL is new and scary, therefore ineffective.  I think what these people forget is that the teaching hospital standard may not be effective either - case loads are variable, students don't see primary level cases, and students are at the whim of faculty at teaching hospitals - some students may get hands on experience, while others may be stuck doing scut work.  Same with lectures - students may listen during lectures, yet never open a textbook, they may skip class and teach themselves, or they may skim friend's notes and manage to stay afloat that way.  Yet we all pass the National Boards, and most of us, no matter which school we go to will be competent veterinarians.

But I don't believe that the new uproar over over school accreditation really revolves around veterinarians being worried that WesternU's not churning out good veterinarians.  I think this all comes from a place of fear. A place of fear that I understand 100%, but I plan to be flexible about, and I plan on adapting to a new direction of the profession.  What fear is that?

First, veterinarians were used to an easy source of income - flea and tick products.  Most of these were sold ONLY through vet's offices, and vets came to rely on the income they produced.  Then various "greymarket" sources started carrying them - websites, and now supermarket pharmacies and pet stores.

Then the big pharmacies - Target, Walmart, Walgreens, Costco and others started pushing programs advertising that they were now carrying pet prescriptions.  Legislation is in the works trying to force veterinarians to write a prescription, whether or not their clients want to buy their medications from the veterinary hospital.  Veterinarians have traditionally structured their business plan to where their pharmacies subsidized the care of patients - basically drug sales through a vet's office allowed vets to keep other costs low.  This is now being chipped away at.

Here's where WesternU comes in - We were the first new school to open in decades.  (I'm not going to look up the exact span of years right now.)  It's a private school.  It's not attached to a landgrant university.  And the school accepted a partnership with Banfield (which I think was a massive PR mistake, but nobody asked me.)  We were different.  A lawsuit was involved to even get the COE to consider accrediting the school.  Since then, the COE has accredited several Caribbean schools, a Mexican school, and there's news articles about new vet schools potentially opening up in Arizona, Utah and New York.  Which means more veterinarians coming into the job market every year. Which scares vets shitless in an already shaky economy.  Fingers get pointed at Western because it's seen that we started a trend of new accreditations.  Vets are afraid of too many clinics, too much competition in a field where we're already extremely underpaid for the number of hours we work, and the level of education we've attained.  They look to law schools, and see the horrific unemployment statistics among lawyers and fear that we're next.

So they pick targets like the COE, WesternU, and any foreign schools that seek accreditation.  I get it.  We make convenient scapegoats.  And higher education is fucked up.  As long as dumb-ass students like me can continue to get federal loans, and as long as the feds are willing to dish out money (that can't be discharged in bankruptcy,) new schools will open up, or existing schools will increase class size.  I've read so many economists that talk about how student loans will be the next economic bubble to burst, because the rate at which tuition increases is completely unsustainable.  Existing vets worry about increased competition, and newly graduating vets are terrified about the loan burden we signed on for.  I know when I got accepted into vet school, I did the math, and decided that the loan burden was doable.  But it's only doable if I can find a job.  Otherwise, I'm fucked, and I'm sure as the economy continues to tank, more and more of us will be fucked.

There's this current of fear in every industry, and people see the good times get farther and farther out of our grasp.  The federal reserve will continue to print money with impunity, and bail out the richest people who don't deserve to be bailed out.  (Google 43 trillion dollar lawsuit if you want to shit your pants.)  Our salaries will remain stagnant, while inflation continues, making us the working poor.

The problem with the veterinary field isn't the schools, or the new grads - although they sure as hell aren't helping matters.  Parts of the problem are the AVMA being so far up the asses of big agriculture, willingly giving up veterinary services to laypeople, and refusing to take a stand for animal welfare in the face of cruel factory farming practices.  We've lost veterinary jobs there.  As a profession, instead of lobbying for the public to value their animal's health, we've been freaking out about the possibility as pets being seen as more than property - even though that's the basic principle that we earn our money on.  On one hand, vets want owners to see their pets as valuable family members, and pay for that dental cleaning or TPLO, while on the other hand, vets freak at the aspect of being sued for those "family members" when something goes badly.  We can't have it both ways.  The veterinary field is it's own worst enemy, looking to point fingers instead of adapting to a changing societal and economic reality.

But that only begins to scratch the surface.  See, we think we're special.  We think we deserve so much better than other professions, and we've historically been a group of hardheaded non-conformists. (I say that affectionately.)  When human health care was getting ruined by health insurance, we watched their mistakes and learned from them.  Now if you ask physicians if they would recommend their kids become doctors, the answer is more often than not a resounding "NO."  Lawyers are hurting.  Dentists are hurting.  Mechanics are hurting.  Tattoo artists are hurting.  The tech industry is hurting.  All of the money is getting funneled away from the average working American, into the banks and the investors.  Our economy is broken, and no talk of bailouts, or fixing the fiscal cliff, or tweaking tax rates, or reducing spending will fix a damn thing, because the entire system is designed to self-implode, leaving the average person starving, and the 147 companies that own everything with all the resources and power.  As it stands, the Federal reserve is more powerful than the president, more powerful than congress, and it's completely unregulated, no transparency, no accountability.  And it's fucking all of us.  And it's going to get a lot worse before it gets better.

So point fingers at WesternU.  Yes, they play the system that makes education so profitable of a venture, that supplies jobs for a shitload of amazing professors, and gives hundreds of students hope for a future where they can make a dent in the world, and in the lives of multiple animals and their owners.  But they're a small symptom of a much bigger societal problem.  And the problem isn't that the school I love is doing a bad job educating veterinarians.  Because they're not.  The problem isn't that there's too many vet students - that's one symptom of a system that's much bigger than any of us, that I don't know if any of us can fix.  Because we're at the bottom of the pyramid scheme, and we have no way of disentangling ourselves.

And now I sound crazy.


  1. That was a great post, and really important to read. I have heard many current vets say this very thing- that the entire system needs to be fixed, not just the symptoms.

  2. I don't think you sound crazy, I think you sound reasonable and intelligent. And you're right. It's a shame that people are trying to turn Western U and the COE into scapegoats instead of fixing the larger problems looming over us.