Breaking Down Veterinary Practice Acts and Our Credentials

“What is the most important issue for our profession today?” was a question that Ashli Selke, NAVTA president, asked the veterinary community over social media while serving as president elect. The hope was to spark discussion among the community. Among the answers that came up were “title protection,” “unified credentials,” “scope of practice,” “credential title,” “reciprocity,” and “pay.” There was an especially robust discussion surrounding the relationship of title protection and pay. Many people felt that if there was title protection then the pay would follow. If the pay was better, the retention rate would vastly improve for credentialed technicians.

We’ll set the topic of pay aside for today. We all know that a national average of $17/hour in 2020 is not sufficient pay for credentialed veterinary technicians in the way we function.¹

The rest of the issues brought up by the community can often become a complicated discussion because they are so intermingled that it is often hard to keep the concepts separate. And ultimately, all items mentioned need to be addressed; progress on one of them is often progress in other areas due to their relation. It is, however, useful to be clear on the terminology when discussing the profession and solutions. 

Let’s dive into some of these concepts:

• Credentialing requirements
• Credential title
• Title protection
• Scope of practice
• Unified credentials
• Reciprocity

Credentialing requirements are set by each individual state’s governing organization for a person to become credentialed as a part of the veterinary nursing profession. The veterinary field has a mostly standardized set of requirements based on standards established over the course of many years. The current standards include obtaining an associate or bachelor’s degree from a program accredited by the AVMA’s Committee on Veterinary Technology and Education Activities (CVTEA), a passing score on the veterinary technician national examination by the American Association of Veterinary State Boards (AAVSB), and a varying number of continuing education hours within the renewal process. While these standards exist, there are many states that have alternate routes in which individuals can qualify, and there are many members of the profession who have qualified in various manners as standards have changed over the decades (see “Navigating the Veterinary Technician Credential Conversation” in the Fall 2020 issue of Today’s Veterinary Nurse). Credentialing requirements are about how we qualify to do the work that we do.

Credential titles are used by credentialed individuals to provide an identifiable label for the profession and describe the profession in the type of work it conducts. In the 40 states with state-governed credentialing for our profession, certified veterinary technician, licensed veterinary technician, registered veterinary technician, and licensed veterinary medical technician are written into the state laws as the titles used. In the 10 states with private certification, certified veterinary technician is used. NAVTA’s Veterinary Nurse Initiative includes within its goals a title change to “veterinary nurse,” which describes the type of work veterinary technicians are performing today. This doesn’t just apply to the veterinary nursing profession either—a recent article was published regarding the efforts by the physician assistant and nurse anesthetist professions to change their titles to reflect the work they do and to eliminate public confusion.² Titles serve as a description of who we are and need to make sense to people outside of our field. 

Title protection laws are ones that not only define a title but also specify that the title can be used only by those holding the legal credentials, so that it is clear to the public which individuals have met the qualifications and which have not. Title protection for veterinary technicians exists in varying forms around the nation. Twenty-one U.S. states have laws governing title protection while 29 do not. In states that do have title protection, 5 specify a penalty (fines or misdemeanor). While title protection does exist in 21 states, a common concern from our profession is the low degree of compliance to the title protection laws. We have seen many veterinary medical boards being more proactive in issuing statements advocating for better title protection in their states (e.g., Tennessee, Alabama, South Carolina). Title protection is about who can call themselves a “veterinary technician.” 

This takes us to scope of practice, which describes the type of work performed by the profession and defines the roles played in practice. From a national overview standpoint, there are not many states that strictly define the scope of practice of a veterinary technician. The reason why we emphasize “strictly” is because while many states describe the type of work performed by veterinary technicians, they do not restrict the work to those who are credentialed. In effect, veterinary practice acts often designate what veterinary technicians can do, but not what non-credentialed individuals cannot do. As a result, veterinary practices sometimes use discretion in determining who can perform the role of a veterinary technician. NAVTA gave input into the AAVSB’s Model Regulation on the Scope of Practice for Veterinary Technicians and Veterinary Technologists through our representation on the Regulatory Policy Task Force and endorsed the document for state veterinary medical boards to use as reference on our scope. The scope of practice is about who can perform the veterinary technician’s role. 

There are often discussions of establishing a unified credential system for veterinary technicians to have the same credentials in requirements, titles, title protection, and scope of practice. The governmental system in the United States allows states to create their own laws, which leads to the current situation of our profession being governed by differing state-to-state laws. When we discuss unified credentials, we should keep in mind it is an effort focused on bringing all of the states on the same page in all aspects instead of creating a single, federal credentialing system (which happens only for professions that require federal oversight). Creating a unified credential is about making the laws and regulations look the same across all states. 

This then takes us to the topic of what is commonly referred to as reciprocity, though phrases like “license portability” and “license transferability” might be more descriptive. As credential requirements are standardized across different states, members of the profession should be able to cross borders and continue their career without disruption to their licensing status. This is helpful for those who permanently (e.g., upon moving) or temporarily (e.g., emergency response, travel work, military family reassignments) relocate to a different state and the people and animals we serve. The current situation is that some states allow for licensees from other states to obtain a license in theirs through an expedited licensing application process, which many times can take just as long as applying anew. There are efforts by the veterinary state boards to create ways in which “licensure by endorsement” can be facilitated, such as their AAVSB Veterinary Care Elite program, though its effectiveness and adoption is yet to be proven as it is a new program. Reciprocity is about the ability to use your credentials across state borders. 

When discussing these issues, it is helpful to ensure that we all have a good understanding of each aspect of our credential to have a productive discussion. Terms like “title protection” should not be confused with “scope of practice” in that the veterinary technician title being protected is a separate point from what non–veterinary technicians are restricted from doing. The effect of achieving title protection is lessened if the scope of practice isn’t set, and setting the scope of practice alone will not be a complete solution without title protection. Each of these elements are separate but intermingled. All of them are necessary to unify our credentials. As you could imagine, bringing 50 different states to agree fully on every detail down to the scope of practice of a profession is a very heavy lift and takes years of work. And truthfully, the work will never end since our profession will continue to evolve and change over the course of time. Let’s use these terms intentionally and with clarity to raise the awareness of our issues within the profession.