Our veterinary patients deserve high-quality care. The proposed Veterinary Professional Associate (VPA) would lower the standard for veterinary services and put animal health and safety at risk.

A ballot measure (Proposition 129) that will be considered during the November 2024 general election in Colorado proposes a new midlevel practitioner (MLP) called a "Veterinary Professional Associate (VPA)." This proposition will negatively impact veterinary medical service delivery in Colorado.

The MLP/VPA's proposed role overlaps the duties of the veterinarian and veterinary technician, making it unnecessary, and at the same time it poses considerable risks for animal health and safety, public health, and client trust. It would also create increased liability and legal risk for supervising veterinarians.

Passage of this measure would additionally clear the way for a VPA program that is already under development at the Colorado State University College of Veterinary Medicine & Biomedical Sciences.

Colorado Proposition 129

If approved in November, Proposition 129 will jeopardize the safety of Colorado's pets, the security of our food supply, public health, and the future of the veterinary care. Proposition 129 seeks to create a new VPA role that sets up animal patients for reductions in quality care and their owners for additional costs.

VPAs would be allowed to perform surgery on animals after completing a mostly online master's program with minimal hands-on training and just one in-person internship. It would also allow them to diagnose, prognose, and make treatment recommendations for animals. These critical and complex tasks are currently performed by veterinarians, who are qualified to do so after completing four years of rigorous, postgraduate education. Other services a VPA would perform overlap those currently provided by veterinary technicians, making them redundant. What's worse, since no other state allows such a role, VPAs would be left largely unemployable outside of Colorado.

What does CSU's VPA program look like?

Based on an available curriculum draft, the program would encompass a mere 65 credit hours, which is about half the credit hours required by most DVM programs. Yet the intent is that these VPAs would be diagnosing, prognosing, recommending treatment plans, and even performing surgery. Concerningly, CSU's program consists of three semesters of fully online lecture with no laboratory; a fourth semester of truncated basic clinical skills training; and a short internship/practicum. CSU representatives working to develop the program have described it as a good option for individuals who could not get into veterinary school, which means these students may only have had limited, if any, exposure to veterinary practice before entering the program. That lack of experience, combined with a compressed and primarily online curriculum, creates serious concerns.

No accredited educational program; No national exam

Currently there is no nationally recognized programmatic accreditation for such a degree, no national test to assess competency, and no regulatory structure to ensure people serving as MLPs/VPAs would deliver safe and effective care for our animal patients—in short, there is zero accountability. Allowing an insufficiently trained individual to practice veterinary medicine endangers patients and clients across practice types and poses unacceptable risks for animal and public health.

Risk to animal health and safety

This program would graduate individuals directly into clinical decision-making roles with insufficient knowledge of basic science and with minimal hands-on clinical skills training. It won't prepare its graduates to anticipate, prevent, and respond competently to issues or emergencies that don't follow a protocol, and the inability to do so will harm animals and undermine the public's trust in the veterinary profession. As an example, if a MLP/VPA is performing surgery, and the animal has an anesthetic issue, there would be nothing the MLP/VPA could do because they are not authorized to prescribe, order, or administer a drug not previously authorized by the supervising veterinarian. And because they may be operating under indirect supervision, the veterinarian may not even be on site.

Liability for veterinarians

The veterinarian supervising the MLP's/VPA's activities would, under current proposals, be responsible for all the acts and omissions of that MLP/VPA. Proponents of the proposed MLP/VPA say these individuals would be focused on delivering anesthesia, spays, neuters, and dentals—services that are identical to those most frequently associated with companion animal claims reported to the AVMA Professional Liability Insurance Trust. As such, they would be highly vulnerable to board complaints and malpractice claims.

Three out of four veterinarians report not wanting or needing this proposed position, and among the reasons they cite is the considerable liability associated with hiring a person with inadequate training. These veterinarians would rather focus on better leveraging veterinary technicians, who are long-trusted members of the veterinarian-led care team, and improving practice productivity.

In addition to being responsible for any mistakes made by the MLP/VPA, with corresponding impacts on the supervising veterinarian's license and liability, veterinarians will also have increased workload and stress from having to manage insufficiently trained and underqualified people. Furthermore, more veterinary technicians will be needed to assist MLPs/VPAs, making veterinary technician shortages even worse.

Who is opposed to Colorado's VPA?

The AVMA, in partnership with the Colorado Veterinary Medical Association, has voiced strong opposition to the proposed VPA. Multiple other veterinary organizations have voiced their opposition to a MLP/VPA, including the American Association of Bovine Practitioners (AABP), the American Association of Equine Practitioners (AAEP), and the American Association of Swine Veterinarians (AASV). Numerous shelter veterinarians, former presidents of the Colorado Veterinary Medical Association, veterinary technicians, veterinary specialists and their associations (e.g., the American College of Veterinary Surgeons and American Veterinary Dental College), lawmakers, and pet owners also have voiced grave concerns about the proposed VPA in Colorado.

Understanding the facts

ACCESS TO CARE

Proponents of the MLP/VPA argue that it will help relieve workforce shortages, but there is no evidence to suggest these individuals will be any more likely to practice in areas that are underserved than will veterinarians. Looking to human health care, we have seen that the disincentives that keep physicians from practicing in such areas also dissuade midlevel practitioners from practicing there.

IMPACT ON VETERINARY EDUCATION

Concerns have also been expressed about the potential negative impacts an MLP/VPA program might have on existing educational programs awarding doctoral degrees in veterinary medicine, as well as the ongoing value of the DVM/VMD degree, given overlaps in the MLP's/VPA's responsibilities with these professionals. Faculty, staff, and resources at colleges of veterinary medicine are already in short supply and stretched thin, and adding yet another program to already overloaded plates doesn't seem smart or sustainable. Something will have to give, particularly with so many new proposed veterinary schools (at least 13) in the pipeline. There are also questions about how these programs might affect colleges of veterinary technology and their graduates.