AAHA opposes mid-level practitioner role in veterinary medicine 

The American Animal Hospital Association (AAHA) has recently taken a firm stance against the introduction of the mid-level practitioner (MLP) role within the veterinary profession, answering the question of where the organization stands on a topic of significant debate. In an official position statement released October 14th, AAHA outlined its concerns about the potential risks associated with this new tier of veterinary care, citing issues related to patient safety, quality of care, and the devaluation of existing veterinary roles. 

What is a mid-level practitioner? 

The concept of a mid-level practitioner in veterinary medicine may seem analogous to roles such as nurse practitioners or physician assistants in human healthcare, but there are significant differences. This position would allow individuals with less training than a veterinarian to diagnose, create treatment plans, and even perform surgeries—all tasks currently limited to licensed veterinarians. Proponents argue that MLPs could help alleviate the growing pressure on overburdened veterinarians and expand access to care, especially in underserved areas. 

However, AAHA—which has long been an advocate for excellence in veterinary care through Standards of Accreditation and the AAHA Guidelines—believes that the introduction of MLPs could have unintended consequences that would compromise patient safety and disrupt the veterinary team structure.  

AAHA’s concerns 

Inadequate education and training

One of AAHA’s primary concerns is the level of education and training that MLPs would receive.  

According to AAHA, MLPs would not undergo the same rigorous and comprehensive training as licensed veterinarians. The association argues that this discrepancy in education could lead to significant risks for patients, particularly when it comes to diagnosing conditions, formulating treatment plans, and performing surgeries. Much like in human medicine, mistakes in these areas can lead to devastating outcomes. 

AAHA’s Position Statement on Midlevel Practitioner (MLP) notes, “There is no established licensing or testing to evaluate the graduate’s readiness for practice, which can lead to unintended fatal errors, increased morbidity/mortality, and more liability for veterinarians and veterinary practices.” Without a robust regulatory framework, AAHA is concerned that the safety and quality of veterinary care could be severely compromised. 

Regulatory and licensing challenges

Another significant issue raised by AAHA is the potential for regulatory complications.  

The association points out that introducing an entirely new category of veterinary practitioners would create additional regulatory burdens without a clear structure in place for overseeing licensing, certification, or prescriptive authority. This lack of clarity could lead to delays in emergency treatment or issues in ensuring that MLPs are competent to carry out critical procedures. 

Impact on credentialed Veterinary Technicians

Perhaps the most contentious aspect of the MLP proposal is its potential impact on credentialed veterinary technicians (CrVTs).  

These professionals already play a critical role in the veterinary team, providing support to veterinarians and ensuring the smooth operation of clinics and hospitals. AAHA is concerned that creating a new tier of mid-level practitioners could undermine the value of CrVTs by blurring the lines between their responsibilities and those of the MLP. 

The association warns that this could lead to decreased recognition, compensation, and career advancement for veterinary technicians. Furthermore, it could exacerbate the retention problems that already exist within the profession, as overlapping roles and responsibilities could create confusion and inefficiency in veterinary practices.  

A better path forward: Focusing on veterinary technicians 

Rather than introducing a new category of mid-level practitioners, AAHA advocates for better utilization and advancement of credentialed veterinary technicians. The association believes that by investing in the development of CrVTs and integrating them more fully into the veterinary care team, practices can increase their capacity to deliver high-quality care without compromising patient safety.  

As AAHA stated in the position statement, “Increasing the capacity for care is best achieved by investing in the comprehensive integration and advancement of the clearly defined role of credentialed veterinary technicians in a team-based environment.” In 2023, AAHA published the first-of-its kind Technician Utilization Guidelines, which has since been adapted by several allied organizations.

The larger debate: “Keep Our Pets Safe” campaign 

AAHA’s opposition to the MLP role aligns with a broader movement in the veterinary community, as proponents of the MLP take the issue to the voters.  

In Colorado, Proposition 129 on the November ballot asks voters whether or not to approve the creation of a mid-level position they term the veterinary professional associate (VPA). In response, the “Keep Our Pets Safe” campaign advocates for maintaining high standards of care and opposes the creation of the VPA position for many of the reasons AAHA has highlighted, with an emphasis on the inadequate training. 

The campaign suggests alternative solutions, such as improving access to veterinary education, enhancing support for veterinarians and technicians, and promoting technological innovations that can streamline workflows without compromising care. 

As the debate around the mid-level practitioner role continues, AAHA’s opposition stands as a significant voice advocating for patient safety, regulatory clarity, and the advancement of existing veterinary professionals. AAHA joins AVMA, CVMA, AABP, AAEP, SAVMA, and numerous other organizations in this position.  

In the meantime, the association calls for continued industry-wide discussions to find solutions that address the growing demand for veterinary services without lowering the standards of care that pets deserve. 

Read the official AAHA MLP position statement here.

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