The State of Emergency and Specialty Veterinary Care in 2024

Introduction and Methodology

In our second annual State of
ER and Specialty Veterinary Care report, we surveyed 545 professionals from emergency, specialty, and urgent care practices.

At the time of our
survey, we estimated approximately 1,600 total emergency, specialty, and urgent care centers in the US in 2024

Demographics

Which of the following best describes your practice?

44.6% of respondents identified as belonging to a large specialty/emergency practice, with emergency-only and specialty making up most of the remainder, followed by a small percentage of urgent care, university, and general practice.

How many locations does your hospital group operate?

40.9% of respondents work in either a single-location practice or a group that operates 2-5 locations. About one-third of respondents work in a group that operates 6 or more locations.

Which of the following describes your hospital’s ownership?

Of the respondents, 32.5% work at privately owned hospitals, 42% work at corporate-owned hospitals, and 18.6% work at partnership or group-ownership hospitals.

What are your hospital’s business hours?

Most survey respondents reported being open 24/7/365, aligning with the primary hospital types surveyed (large emergency and specialty organizations).

How many full-time equivalent veterinarians work in your practice?

51.3% of respondents work in a hospital with 6-20 full-time veterinarians.

How many full-time nurses/technicians work in your practice?

63.6% of respondents work in practices that have 20+ nurses/technicians.

What is your role in practice?

About 61% of survey respondents were full-time veterinarians or nurses/technicians. This is slightly increased from last year’s breakdown, in which about 50% were full-time veterinarians/technicians. The other primary roles surveyed this year were administrators, practice managers, and practice owners.

How long have you been in veterinary medicine as a working professional?

62% of survey respondents have worked in veterinary medicine for at least 10 years, with the largest segment having 10-20 years of experience.

How long have you been in your current practice?

Despite employees’ tenure in the field, about 40% of respondents have worked in their current practice for under 2 years.

This is consistent with job-hopping trends in the veterinary profession. AAHA surveyed 14,856 people in 2023 and found that ~30% of people in the veterinary profession are looking to leave their job.

Top Challenges in 2024

Which of the following challenges has your practice experienced in the last year?

Staffing shortages remained the most reported issue in 2024 at 78%, a decrease from 86% in 2023.

Notably, concerns over increased patient volume significantly dropped from 59% in 2023 to 36% in 2024.

The challenge of completed services getting left off of final billing decreased from 43% to 35%.

Challenges related to stress, compassion fatigue, and mental health decreased from 83% in 2023 to 72% in 2024.

Conversely, the costs of equipment, supplies, and overhead rose from 60% in 2023 to 66% in 2024, reflecting growing financial pressures.

How Are Hospitals Responding to Challenges?

In response to these challenges, has your practice experienced any of the following?

In response to top challenges in 2024, veterinary practices have predominantly increased staff overtime hours to handle workloads, with 56% reporting this change.

About 40% reported hiring more relief veterinarians, and about 30% referred more cases to other specialty practices to manage demands amid staffing shortages.

Patient Volume in 2024

Compared to this time last year, is your patient volume...

Patient volume remained about the same as last year for 27% of practices, while 32% reported being less busy, indicating a general decline in patient loads.

When looking at this question from our year-over-year data, practices reporting being “less busy” increased by 12% between 2023 and 2024.

This may signal a reduction in the high demand levels observed during the peak of COVID.

Average Wait Times

What is the average wait time for patients at your practice?

From 2023 to 2024, about 55% of respondents reported no change in wait times.

Comparing the year-over-year data, the percentage of patients waiting under 15 minutes increased from 7% in 2023 to 16% in 2024, showing a notable reduction in wait times.

The proportion of patients waiting 1-2 hours remained fairly stable, with 22% in 2023 and 21% in 2024, indicating consistent challenges in managing longer wait times.

Interestingly, the percentage of patients waiting over 2 hours decreased slightly, from 27% in 2023 to 16% in 2024, suggesting some progress in reducing the longest wait times.

Wait Times by Organization Type

What is the average wait time for patients at your practice?

Across organization types, 41% have an average wait time of 1 hour or more.

In specialty practices, 40% of patients are seen in under 15 minutes, indicating shorter wait times for a significant portion of their patients.

Large specialty/emergency practices constitute 56% of practices with an average wait time of 1 hour or more.

Hours Worked per Week by Full-Time Roles

How have your hours changed over the last year?

Approximately 51% of staff members experienced no significant change in their working hours over the past year. About 31% reported an increase in hours, with 14% citing a significant increase. On the other hand, approximately 18% noted a decrease in hours worked, with 11% citing a significant decrease.

In the past year overall, most veterinary professionals across various roles reported stable working hours. Significant fluctuations were noted among part-time veterinarians, locum/relief veterinarians, and practice managers, with part-time veterinarians experiencing a notable decrease in hours. Full-time veterinarians and administrators mostly maintained their usual hours, while practice managers frequently reported an increase in working hours.

Staff Changes 2023-2024

How has your staff changed over the last year?

Staffing trends have shifted in the last year, pointing to more hires in 2023.

Half of respondents reported hiring veterinary staff in the last year, down from 55% in 2023, while hiring additional technicians/nurses also dropped from 68% to 63%.

Our data shows a small increase in practices reducing the number of veterinarians on staff, from 13% in 2023 to 15% in 2024, and a more noticeable rise in the reduction of technicians/nurses on staff, from 12% to 16%.

Administrative staff saw a significant 10% drop in new hires and a minimal decrease in reductions. The percentage of practices reporting no changes rose from 4% in 2023 to 8% in 2024.

Hiring Challenges Over 2023-2024

What were your top challenges related to hiring this past year?

In 2024, veterinary practices seeking to hire encountered a mixed bag of progress and ongoing challenges.

The biggest change from 2023 was a drop in the shortage of candidates, which decreased by 8% (from 83% in 2023 to 75% in 2024).

Challenges related to remote work requirements and skills alignment with job roles both fell slightly by 2%.

On the other hand, issues with compensation increased by 8%, rising from 27% in 2023 to 35% in 2024.

There was a notable decrease in candidates not showing up for interviews, from 41% in 2023 to 28% in 2024.

Employee Turnover in 2024

In the last year, which positions were most affected by employee turnover?

Over the last year, veterinary practices experienced the highest turnover among veterinary technicians/nurses, with 79.3% of practices reporting staff turnover for this role.

Administrative/support staff and veterinarians also saw significant turnover rates at 32.5% and 24.6%, respectively.

Management positions were less affected, with a turnover rate of just 9.5%.

Reasons for Turnover

What were the primary reasons for employee turnover in the last year?

In the past year, the most common reasons for employee turnover were burnout or mental health challenges (52%), better job opportunities elsewhere (44%), workplace culture or issues with team dynamics (45%), and insufficient compensation or benefits (42%). These factors underscore critical areas for improvement to enhance staff retention and improve morale in veterinary ER/specialty medicine.

A National Healthcare Retention report conducted by AAHA found that veterinary technicians had a significantly higher turnover rate than registered nurses (26% compared to 18%).

This high turnover is driven not only by understaffing and demanding work hours but also by insufficient pay.

Our 2024 survey indicates that the average annual salary for a veterinary technician in this sector is $57,000.

According to the AVMA, one-third of technicians carry school debt, averaging $29,700 per person. Their 2023 report identified understaffing, lack of competitive pay, and under-appreciation as key factors contributing to high employee attrition—mirroring the reasons identified in our findings.

With these considerations in mind, we’ll explore elements driving improved morale and recommendations for staff retention.

Overall Morale in 2024

How would you rate your overall morale and job satisfaction?

In 2024, 12% of respondents reported very high morale and job satisfaction, up from 2% in 2023. High morale increased to 42% from 32%, while neutral responses decreased to 31% from 43%. Low morale dropped to 11% from 21%, and very low morale remained consistent at 4%.

Overall, it’s encouraging to see that 54% of staff reported overall high to very high job satisfaction and morale, while only 16% reported low to very low job satisfaction and morale.

As wellness programs, team building, and additional practices are rising to meet pressing mental health challenges across veterinary medicine, this is a great starting indicator we’re moving in the right direction.

Part-time veterinarians had the highest job satisfaction, while full-time nurses and technicians had the lowest job satisfaction.

Employer Responses to Morale Challenges

How has your practice addressed feedback and concerns to improve job satisfaction and retention this past year?

Practice managers and executive staff have implemented several changes to enhance employee satisfaction and retention this year.

A notable 59% report conducting regular staff meetings and check-ins, reflecting a 6% increase from last year’s survey results. Additionally, 44% of practices have made changes based on staff feedback.

Only 25% of respondents work at practices that have implemented increases to base salaries, marking a 14% decrease from last year’s results.

Do Workplace Programs Boost Employee Morale?

How does morale correlate with employer programs?

Our data reveals a strong correlation between proactive engagement strategies—like regular meetings, open communication, and responsiveness to feedback—and higher levels of employee morale.

High Morale: Practices with high morale often hold regular meetings and communicate openly. About 80% of “Very High” morale practices check in regularly with staff, and 70% promote open communication. These practices actively listen to their employees, and more than half implement changes based on feedback.

Neutral Morale: These practices have moderate engagement in staff meetings (about 58%) and are somewhat open in their communication (42%). However, they are less responsive to feedback, with less than 40% making changes based on staff suggestions.

Low Morale: In practices with low morale, less than 36% regularly meet with staff and only about 24% foster open communication. They also show minimal responsiveness to feedback (around 22%).

Financial Incentives: Across all levels of morale, increasing pay and bonuses was less common. Even in practices with the highest morale, only about 30% raised salaries, and around 26% increased bonuses. There is an opportunity for improvement here across the board.

Supporting Mental Health

What initiatives or programs does your practice offer to support the mental health and well-being of your team?

The high-pressure environment of veterinary workplaces can lead to burnout, compassion fatigue, moral injury, and high turnover rates, with some professionals choosing to leave the field entirely. However, cultivating a healthier workplace can counter existing challenges and equally benefit staff and employers.

In 2024, the top initiatives veterinary practices offered to support the mental health and well-being of their teams were:

Employee Assistance Programs (EAP): Available in 53% of practices
Recognition and Appreciation Programs: Provided by 36% of practices
Team Building and Social Activities: Offered by 34% of practices
Professional Counseling Services: Implemented in 32% of practices

The instances of programs reported in 2024 trended slightly down from 2023.

(Note: This is a self-reported question that reflects programs employees are aware of.)

Mental health in the industry has reached a critical juncture, and there is significant opportunity for hospitals to enhance their support for staff well-being. Let’s drill into the details.

40% of respondents emphasized the need for increased wages or improved employee benefits to reflect the demanding nature of their work. As one respondent noted, highlighting the financial strain veterinary professionals experience, “We have food insecure employees—pay them more! That will enhance team morale and mental well-being.”

Suggestions for employee benefits included better medical insurance that incorporates mental health support, more PTO and sick time, and paid mental health days.

Improved Compensation & Benefits

35% of responses mentioned therapy or enhanced wellness programs.

Access to Therapy: Therapy and counseling services were a recurring theme. Respondents suggested free therapy, veterinary-specific counseling, and having an on-site social worker or grief counselor for both staff and clients to help relieve some of the emotional burden on employees.

Wellness Initiatives: Many respondents called for mandatory health and wellness programs, relaxation rooms, and mental health awareness programs. One respondent recommended “implementing standards for client behavior when relating to employees.”

Mental Health & Wellness Programs

Flexible Scheduling: Respondents highlighted the importance of job flexibility, reduced overtime, and rotating shifts to prevent burnout.

Adequate Staffing: Respondents were emphatic about hiring more veterinarians and technicians to distribute the workload evenly and avoid burnout. “Hiring more technicians/support staff would solve many of the problems,” stated one respondent. Another response emphasized, “We need another vet so we can have time to be present for the staff and still have a life.”

Nearly one-third of respondents (31%) mentioned staffing or more flexible schedules.

Work-Life Balance

A significant 45% of respondents emphasized the importance of top-down improvements in leadership and administrative support.

Effective Leadership: Better communication, transparency, and support from management were frequently mentioned. Respondents called for administrative staff with leadership skills and a more compassionate approach. One respondent expressed, “Owners and management need to re-develop some sense of compassion. Too much focus on the bottom line and not enough on people’s lives and mental health.”

Feedback Mechanisms: Respondents suggested implementing systems for employees to provide feedback and see impactful change based on that feedback.

Management & Administrative Support

Quick Actions Your Hospital Can Take to Enhance Staff Well-Being

Adopt core technologies to simplify staff workflows.

More than half of respondents (57%) reported that adopting new technology contributes to better work-life balance, suggesting that investment in modern tools can lead to happier, more balanced teams.

Integrating digital treatment sheets, identified by 61% of respondents as the most impactful productivity tool, and cloud-based PIMs/EMR, noted by 54% for improving daily tasks and efficiency, can streamline workflows and enhance organizational productivity.

Bonus: Missed charge revenue capture and process optimization from these types of technology can enable improvements to employee wages sooner rather than later.

Implement and communicate counseling initiatives.

Enhancing staff well-being through therapy or wellness programs is necessary, as mentioned by 35% of respondents. Offering free therapy, on-site social workers, or grief counselors can alleviate the emotional burden on employees.

Ensure adequate staffing and flexible scheduling.

Think about implementing or improving rotating shifts and reducing overtime to help maintain a healthy work-life balance. Consider hiring relief workers if your team is overwhelmed or understaffed.

Organize regular social events.

To strengthen team connections, 25% of respondents expressed the need for more team-building activities. Organizing regular social events and workshops can create a more supportive work environment.

Foster a supportive environment.

Top-Down Improvements: Leadership and administrative support are crucial for enhancing morale, as 45% of respondents emphasized. Fostering a supportive and communicative leadership approach can significantly impact staff well-being.

Communication and Transparency: Improving communication and transparency within the organization is critical for boosting morale, as highlighted by respondents.

Productivity Improvements

What improvements, if any, have your practice made that have impacted your productivity in the last year? (Select the top 3)

In the past year, emergency, specialty, and urgent care veterinary practices have made several improvements to enhance productivity. The most significant changes were in workflow improvements (50%), team expansion (48%), and technology-related enhancements like PIMs, EMR, and digital treatment sheets (33%).

These top 3 improvements were followed closely by efforts to improve team culture (41.5%) and better staff training (37%), highlighting a focus on both operational efficiency and employee development.

Prevalent Technology in 2024

Digital treatment sheets and cloud-based PIMs/EMR are the most widely used technologies across all veterinary practice types surveyed, with adoption rates of 76% and 71%, respectively.

Large specialty/emergency practices lead in usage, with 83% utilizing digital treatment sheets and ≈70% using cloud-based PIMs/EMR. Additionally, these practices show significant recent adoption, with 16% newly implementing both cloud-based PIMs/EMR and digital treatment sheets in the past year.

Emergency-only practices are also leading the way in technology use, particularly in RFID/microchip readers (41%) and AI for medical record assistance (14%).

Specialty practices have notable adoption rates for inventory management software (28%) and have recently adopted cloud-based PIMs/EMR (18%) and digital treatment sheets (13%).

Urgent care centers strongly emphasize client communication. Nearly 39% use online booking platforms, the highest percentage among all practice types. Nearly 45% of urgent care staff noted using social media tools.

Veterinary practices with higher revenues tend to adopt more advanced technologies. Practices earning over $4 million annually report some of the highest usage rates for digital treatment sheets, AI for medical records, and wearable devices.

Specifically, practices earning over $6 million annually show significant adoption across all categories, with 81% using digital treatment sheets and over 11% incorporating AI. This suggests that financial capacity significantly influences the ability to invest in and leverage cutting-edge technology within veterinary practices.

AI Use Cases in ER/Specialty

The majority of respondents (79%) are not yet using AI in practice or are not aware that it’s being used in their practice. For those who have started using AI, the most common use cases noted were for diagnostic assistance, client communication, administrative tasks, medical records, and inventory management.

Although AI is already fairly widely used in general practice for medical records, documentation, client communications, and social media management, there are mixed reviews regarding its effectiveness in diagnostic processes. AI adoption is still in its early stages within this segment of veterinary care.

Medical Records & Documentation

Many respondents indicated that AI is primarily used for record-keeping, dictation, and scribing. One respondent shared, “We use AI to record conversations with clients, which types up our histories, exam findings, assessment, and plans as well as discharge letters.”

Client Communication & Social Media

Several practices use AI for client communication, including email writing, social media management, and responses to reviews. “I use AI to help write emails to staff and clients as well as for all of our social media presence and reviews.”

Diagnostic Support

AI tools like the Imagyst machine are being used to assist in cytology by reading slides. However, there are mixed reviews on AI in diagnostics. One respondent noted, “We attempted to utilize AI in radiology diagnostics, and it greatly decreased the quality of the results we were getting.”

What makes a care center state of the art in 2024?

Advanced Medical Technology

Incorporating the latest diagnostic and therapeutic equipment, such as high-definition imaging systems, robotic surgery tools, and real-time patient monitoring technologies.

Expertise & Specialization

Employing veterinary specialists who are leaders in their fields and can offer advanced treatments in areas like oncology, cardiology, and neurology.

Integrated Care Systems

Using comprehensive practice management software that integrates electronic medical records (EMRs), client communication, and billing systems seamlessly.

Cutting-Edge Facilities

Designing facilities that support advanced surgical suites, rehabilitation centers, and isolation units for infectious diseases, all equipped with the latest medical hardware.

Research & Development

Actively participating in veterinary research that contributes to innovative treatments and breakthroughs in animal health care.

Client-Centered Services

Providing telemedicine options, mobile vet services, and client education programs that use modern technology to improve client engagement and access to care.

Emergency Preparedness

Maintaining fully equipped emergency rooms, ready to handle any veterinary crisis at any time, supported by advanced triage and critical care protocols.

Continuous Education & Training

Emphasizing ongoing professional development and training for staff to ensure they remain at the forefront of veterinary medicine.

Sustainability Practices

Integrating environmentally sustainable practices in the clinic’s operations, from energy-efficient buildings to waste reduction protocols.

Salary Breakdown

Wages trend slightly higher within the emergency/specialty space compared to the rest of the industry. BLS data reports the average annual pay for veterinarians as $119,100 (May 2023). Employment of veterinarians is projected to grow 20% from 2022 to 2032, much faster than the average for all occupations. The same report found that the average technician earns $43,740 (May 2023).

Our salary data shows diverse ranges among various veterinary roles, with the majority of full-time veterinarians earning between $160,001 to $200,000 annually.

Full-time nurses/technicians mostly earn between $40,000 to $80,000, reflecting the variance in compensation across professional roles.

Practice managers and administrators generally see a mid-range income, with most earning between $40,000 and $120,000.

Administrators mainly earn between $40,000 and $80,000 (54%) or $80,001 and $120,000 (25%).

Salaries for practice owners vary widely, with significant percentages earning in each of the higher brackets: 17% earn between $240,001 and $280,000, and 13% earn more than $360,000.

In 2024, salary shifts varied across roles. Full-time veterinarians and practice owners saw significant average pay increases of 13.5% and 15.9%, respectively, while practice managers experienced the steepest decline, with salaries dropping by 11.8% compared to 2023. These trends underscore rising pay for leadership roles but ongoing challenges for managerial and support staff, signaling the need for more balanced compensation strategies across the board.

Overall, only 25% of respondents reported salary increases this year, down from 39% in 2023, signaling tighter compensation trends in other areas. Pay remains a major concern, with 35% of respondents citing insufficient compensation as a key issue—up from 27% in 2023. As we look ahead, addressing the compensation gap will be crucial in attracting and retaining top talent across all roles.

Key Findings

As we examine the trends of 2024, we see signs of stabilization in patient volumes and morale and ongoing challenges in staffing, compensation, and operational costs.

The emergency and specialty sector is experiencing a slight correction in patient volumes, with 59% of practices reporting about the same or lower volume compared to last year. This correction may indicate an easing of the high demands seen during peak COVID years.

Staffing shortages remain a prevalent issue, impacting 78% of practices, though this is an improvement from 86% in 2023. Hiring has slowed, and turnover remains a critical challenge, especially among nurses and technicians, driven by burnout, mental health struggles, and compensation concerns.

However, investments in employee well-being are starting to pay off this year, particularly in practices that have prioritized wellness programs and strong leadership support. Morale has seen a notable boost, with 54% of staff reporting high or very high job satisfaction, up from 34% last year.

Financial pressures are mounting, with 66% of practices reporting rising costs for equipment and overhead. We can see financial strain play out in a tighter employer’s market, with fewer salary increases in 2024.

While technology is enhancing work-life balance, there are further opportunities to help offset rising operational costs by optimizing revenue capture. Hospitals can consider using advanced tools to automate billing and recover missed charges, and use inventory management tools to improve supply chain efficiency.

Hospitals that focus on strengthening their teams through competitive wages, wellness, mental health and career development programs, and technology advancements will be better equipped to navigate the challenges we’re seeing and sustain long-term success. As the landscape continues to evolve, investing in both people and innovation will be key to thriving in the years ahead.

The State of ER & Specialty Veterinary Care in 2024