I consider myself an enduring advocate for what is good – at least I try to be. I am sharing some thoughts on a subject that has been surprisingly controversial, the Veterinary Professional Assistant (VPA) – because I care. I care about our profession, my Veterinary colleagues, our Veterinary technicians who deserve our help and support, the animals and pet parents seeking Veterinary care, and the livestock industries and rural communities that continue to struggle with access to Veterinary care. One answer staring us in the face is the VPA.
The role of the VPA is emerging as a natural, beneficial, and perhaps necessary evolution in Veterinary medicine, much as the Physician Assistant (PA) did in human healthcare decades ago. A well-designed VPA role offers numerous benefits in modern Veterinary practice, most notably helping address workforce shortages, providing a viable career path for Veterinary nurses/technicians, improving access to care, and enhancing both client services and animal welfare – all while preserving the veterinarian’s ultimate authority and responsibility.
Below is a justification for the VPA, followed by a concise historical look at PAs in human medicine, the early objections they faced, and why they are now widely supported.
What Is a VPA?
A VPA is a mid-level Veterinary assistant/practitioner who works under the supervision and license of a veterinarian, within a defined and regulated scope of practice. While details could vary with jurisdiction, the role would likely include:
- Collecting histories
- Performing focused physical assessments
- Performing common technical procedures e.g., venipuncture, sample collection, bandage changes, some imaging tasks
- Managing follow-up care, client communication, and chronic disease monitoring
- Participating in preventive care, e.g., vaccination protocols, nutrition counseling under Veterinary direction
- Assisting in anesthesia monitoring and peri-operative care, not as the primary anesthesiologist or surgeon
- Performing certain minor procedures as delegated by the veterinarian, depending upon law, training, and preferences of the veterinarian
The VPA could also be charged to become knowledgeable in advanced technologies of value to Veterinary practice and help implement the latest advances, such as:
- Augmented/artificial intelligence and its applications in the practice
- Digital health
- Telemedicine, telecommunications, telemonitoring, teleconsultation management
A key feature is supervision. VPAs extend the veterinarian’s reach, they do not replace veterinarians or act independently. They can help manage the Veterinary healthcare team effectively and efficiently, as directed by the veterinarian.
Why Veterinary Medicine Needs the VPA Role
There is a national shortage of veterinarians, described by some as having reached crisis proportions. Studies show they we cannot “graduate our way out” of this shortage in the foreseeable future even with increasing class sizes and new Veterinary schools. Some areas are affected more than others, such as rural communities, large animal practice, public health, and shelters. The ripple effect is staggering. Poignant stories abound about pets being compromised because frustrated pet parents were unable to obtain appointments. Some shelters are forced to operate without adequate Veterinary staffing and pets have been returned to shelters after adoption because Veterinary care was inaccessible. Rural communities have been chronically underserved. Livestock operations have turned to using nonprofessional staff instead of licensed veterinarians. A notable consequence is burnout by dedicated veterinarians and the healthcare team.
A transformative solution is needed. VPAs can help meet demand by handling appropriate portions of the workload under supervision, freeing veterinarians to focus on diagnosis, complex cases, surgery, and medical decision-making – what they are trained to do and what fulfills them.
VPAs can improve practice efficiency and workflow. They can offload some of the work created by overbooked schedules and long appointment backlogs. They can help manage the utilization of well-trained support staff. Offloading designated tasks that do not strictly require DVM-level expertise can help veterinarians spend more time with clients, engaging them more in the care of their animals. Veterinarians would be able to see more cases per day without sacrificing quality and would be able to spend more time with clients, enhancing communications and strengthening the veterinarian-client relationship. Veterinarians would be able to focus on tasks that require their highest training, have more sustainable work schedules, and potentially increase job satisfaction and practice longevity.
VPAs can serve as “clinical extenders” to promote improved client understanding and follow through, leading to better patient outcomes. VPAs can spend additional time educating clients and answering their questions. They can reinforce preventive care recommendations. They can provide continuity of care for chronic conditions. These benefits can occur in the hospital, by phone, online, and with telemedicine.
VPAs would not replace Veterinary nurses/technicians but could benefit them substantially. A critical role of the VPA must be advocating for Veterinary nurses/technicians to ensure they are well utilized at the top of their training and that they are recognized and respected, thus more fulfilled. They could elevate the culture of delegation and team-based care, leading to better utilization of all team members. VPAs could create a career ladder, where highly experienced or specially trained technicians could progress in their jobs and maybe ultimately transition into VPA roles, depending on educational pathways. They could strengthen the argument for advanced training, licensure, and appropriate compensation for Veterinary nurses/technicians.
VPAs could affect revenue stability through more efficient handling of cases and expanded service offerings. A more stable practice income could support higher wages for the entire team. VPAs could help stabilize the workforce and improve continuity of care.
Opponents of the VPA express concerns that VPAs will replace veterinarians. They fear that practices will rely on VPAs instead of veterinarians and corporate models especially will use VPAs to reduce costs. Properly structured regulations will require supervision by licensed veterinarians and defined limitations of scope of practice. Human medicine had the same concerns when the PA was proposed initially. Decades later PAs have not replaced physicians; rather, they have become integral members of physician-led teams, with physicians still central to complex care.
Opponents of the VPA argue that VPAs will dilute professional standards and reduce quality of care. The VPA model must be tied to accredited educational programs with standard curriculum and clinical training. Licensing exams and continuing education requirements will follow graduation. By codifying scope and training, a VPA role can actually raise standards compared with informal delegation already occurring in some practices. Noteworthy is that all the above is being established by veterinarians, not independent of veterinarians. PAs now undergo rigorous training and are overseen by accreditation and licensing bodies, which have consistently supported high standards of care in human healthcare.
Opponents of the VPA claim that VPA will undermine and devalue Veterinary nurses/technicians. The opposite is true. Veterinary nurses/technicians have been trying to tell us for years/decades that they are not utilized at the top of their training, they cannot earn a living wage, and thus, they do not feel appreciated or respected. The result is that they leave the profession in approximately five years. Now our response to the VPA initiative is to better utilize Veterinary nurses/technicians rather than establish VPAs. The reality is that we have failed in elevating the Veterinary nurses/technicians as we should have years ago. VPAs have the potential to elevate the entire Veterinary nurse/technician profession. They can advocate for the nurses/technicians, demonstrate that advanced skills are valued, and create new leadership and mentorship roles for them. In my opinion, the VPA offers the first viable solution to elevate the Veterinary nurses/technicians. In human healthcare, PAs have not eliminated or devalued nursing; instead, they have expanded the range of clinical careers and fostered team-based care.
The American Veterinary Medical Association (AVMA) currently opposes the VPA. Initially, the American Medical Association (AMA) contested the PA with concerns that largely mirror those of the AVMA today; however, the AMA moved from opposition to caution to support as a viable solution to physician shortages. The AMA worked with PA leaders to establish accreditation standards and a national certification process. The AMA remains supportive today, while it maintains its vigilance about physician supervision and creep of scope.
Origin of the PA
Duke University launched the first formal PA program in 1965 under Dr. Eugene Stead. The initial cohort consisted of former Navy corpsmen and medics, whose skills were underutilized in civilian life. Other universities quickly developed PA programs modeled after the medical school curriculum, but shorter and more clinically focused. In 1970, the American Medical Association (AMA) recognized the PA profession. In 1971, the first national certifying exam for PAs was offered. The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) and the National Commission on Certification of Physician Assistants (NCCPA) helped standardize training and certification. All U.S. states and many countries now license PAs with defined scopes of practice, generally under physician supervision.
History is repeating itself as the Veterinary profession is pushing back on VPAs rather than embracing them. Sixty-one years ago, physicians and other stakeholders initially raised concerns that mirror those in Veterinary medicine today. They were concerned about replacing physicians, driving down physician salaries, encroachment of the physician’s role, competent care, malpractice risk and liability, confusion over roles on the healthcare team, disrupting hierarchies in nursing, and integration into hospital workflows. None of these concerns became reality. Today, PAs are widely accepted and valued in human healthcare.
Conclusion for Veterinary Medicine
VPAs, properly designed and regulated, can be a strategic answer to many of the pressures facing Veterinary medicine, such as limited access to care, overworked veterinarians and team members, underutilized staff support, and rising client expectations. The experience of PAs in human medicine indicates that VPAs can be integrated without eroding authority, status, or central role of fully trained veterinarians. Objections about quality, replacement fears, and role confusion can be overcome by rigorous training, clear legal frameworks, and evidence-based outcomes.
Over time, VPAs are destined to become essential components of modern, team-based care. By learning from the PA model and tailoring it to the unique needs of Veterinary healthcare, the profession can create a VPA role that strengthens Veterinary teams, improves care for animals, and supports the long-term sustainability of Veterinary medicine. And remember, anyone who does not want to utilize VPAs in practice does not have to hire one.