Episode #46 – Dr. Andy Maccabe

Do you work in the animal health industry or veterinary profession? Have you ever wondered how people began their careers and how they got to where they are today? Hi everyone. I’m Stacy Pursell, the founder and CEO of The VET Recruiter, the leading executive search and recruiting firm for the animal health industry and veterinary profession. I was the first recruiter to specialize in the animal health industry and veterinary profession in the United States and built the first search firm to serve this unique niche. For the past 25 plus years, I have built relationships with the industry’s top leaders and trailblazers. The People of Animal Health Podcast highlights the incredible individuals I have connected with throughout my career. You will be able to learn more about their lives, careers and contributions. With our wide range of expert guest, you will be sure to learn something new in every episode. Thanks for tuning in and enjoy the episode.

Welcome to The People of Animal Health Podcast. On today’s show, we are talking with Dr. Andy Maccabe. Dr. Andy Maccabe is the global vice president for Veterinary Education at Mars Veterinary Health, overseeing training for more than 3,000 veterinary clinics worldwide. Dr. Maccabe’s impressive career includes 24 years as a public health officer in the U.S. Air Force and leadership roles in veterinary education, including as CEO of the American Association of Veterinary Medical Colleges. He holds degrees in veterinary medicine, public health and law, and has pioneered initiatives like Competency-Based Veterinary Education and Diversity Matters. We’re excited to hear his insights on the future of veterinary medicine and education. Welcome, Dr. Andy Maccabe.

Thank you, Stacy. I’m glad to be here and looking forward to visiting with you.

Well, I am as well. I’m so glad to have this time with you today. Andy, your career spans several decades across veterinary medicine, public health and law. What initially drew you to pursue a career in veterinary medicine and how did it evolve into the multifaceted path that you followed?

Well, you’re right. It is somewhat of a unique career, and I have to say, I don’t believe that any rational person could have anticipated this type of a career with this many different changes. I would say my interest in veterinary medicine began when I was working on farms in Central Ohio as a young boy, and I got interested in production agriculture, which led to my interest in dairy herd health, dairy production. So my undergraduate degree was in agriculture with a major in dairy science, and I began my career in mostly dairy practice in Northeast Ohio. And that’s where I planned to spend my career, and I really enjoyed it. I especially enjoyed the long-term relationship that as a food animal veterinarian, I developed with my clients, visiting them many times over the course of a month and getting to know them and their families. But the industry changed. All of a sudden there was a lot of consolidation in the dairy business.

So instead of lots of small to medium-sized family farms, many of those producers went out of business. And nowadays, you’re probably familiar that dairy herds are often 10, 20 and 30,000 cows. So it was a very different type of business, and that prompted a change for me. And I thought I would use my background in epidemiology and herd health and apply it to human health, public health. And a classmate of mine at the same time was entering active duty in the Air Force. So I thought, “Well, I didn’t have any particular interest in the military, but I could try that for a while.” And sure enough, it turned out to be a good fit. So that’s when I entered active duty and that opened up a lot of opportunities including a global perspective on public health.

Wow, so interesting. I didn’t know that, that you had started off in the dairy cattle business. Well, as the global vice president for Veterinary Education at Mas Veterinary Health, you’re responsible for overseeing training programs for thousands of students, interns and residents worldwide. What are some of the biggest challenges in veterinary education today and how are you addressing them?

The way I’ve been talking about this, Stacy, is that academic veterinary medicine is not broken, but it’s under considerable stress. This is due primarily to the decline in public support for higher education generally and for health professions education in particular, and graduate and professional programs. So what that means is the model for veterinary education, as I said, is it’s being under stress, is that the rest of the veterinary industry, I believe, has an obligation to support academic veterinary medicine. The fact is that all of us across this entire industry depend on a well-trained veterinary workforce. We all have a stake in this.

So in my role as the global vice president for Veterinary Education at Mars, my goal is to partner with universities and colleges of veterinary medicine around the world to, first of all, clinical training opportunities for veterinary students. I think that’s key and I know that when distributed or community-based clinical training is done well, it can have a tremendous impact, and I’m committed to doing it as well as it can be done. The second part is with interns and residents leading to specialty practice and board certification. There’s still a tremendous need for growth in those areas. And at Mars Veterinary Health, we both sponsor residency programs at universities, but then we also conduct several of our own, especially at our BluePearl practices. So growing the population of specialists is also a big part of what we do.

Do you believe there’s a shortage of veterinarians?

Yeah, I certainly believe at the current time there is, without question. I know we certainly, across our practices, have several vacancies that continue to go unfilled, and I know that that’s the experience of most veterinarians today. I think the question is, where there’s some debate is, is this shortage a sort of like a temporary event that will self-correct due to market forces, or is this indicative of a long-term trend? And I think that’s where I’ve seen a lot of debate in the profession with kind of two camps evolving on those two separate sides. My own belief is that there is a need for more veterinary colleges, more seats for students to study veterinary medicine. I believe that every qualified student who wants to study veterinary medicine should be able to do so.

I don’t believe it’s up to me or anybody else in this profession to tell a young person, “No, I’m sorry. There’s no room for you here.” I think that, again, we are obligated to provide opportunity for students, and then once they graduate, they have the opportunity to blaze new career paths and develop new ways of doing things and perhaps new business models that none of us might have anticipated. In fact, it’s only if we have a little bit of excess capacity in our profession that we can have the ability to innovate and try new and different things. When we’re facing shortage, it’s all we can do just to keep the lights on and answer the mail, get through the day. It’s only if we have a little bit of excess capacity that we can expand into new and emerging markets.

Yeah, so interesting. Well, Andy, your experience includes serving as a public health officer in the U.S. Air Force for 24 years. How did your military background shape your approach to veterinary medicine and public health?

Well, in so many ways, frankly, it’s kind of hard for me to pinpoint anything in particular. But here’s what I would say is there’s several things that a large organization like the United States military does particularly well, and one of those is clarity of mission and focus on mission accomplishment. So my time in leadership roles in the Air Force taught me to be able to communicate a vision pretty clearly and to focus on core values and core principles in service to accomplishing a specific mission. And I’ve kind of carried that ethos with me ever since that time in the work that I did both at AAVMC and that I do here with Mars Veterinary Health. Again, it’s a matter of identifying what the mission or the goal is and clearly articulating a vision for how we’re going to get there and then leading a team to get that accomplished.

So that’s kind of the big picture. But I think another piece of that is our military forces have a global approach. So that was the first time I was exposed to looking at health generally and public health in particular in terms of the global impact and the effect of what we do. And what I mean by that is I think every veterinarian who studies infectious diseases recognizes that the pathogens we deal with do not respect political boundaries. They will move regardless of where we put up our boundaries. So understanding focus on prevention and intervention at earlier stages to limit morbidity and mortality has been the focus of my entire career, and that’s where I’d like to continue working and having that impact.

Yeah, I like that. Well, you have played a key role in launching initiatives like the Competency-Based Veterinary Education framework and the Spectrum of Care Initiative. Could you tell us about these programs and how they’re impacting veterinary education globally?

Yeah. Well, first of all, just maybe to put up a correction to that insofar as I didn’t have anything to… I mean, I had very little to do with the actual work there. I am not a professional educator. I have never served on a faculty at a veterinary college. I’ve never been employed by a university, but I had a remarkable privilege to be able to serve as the CEO of the American Association of Veterinary Medical Colleges, where again, I was privileged to work with the world’s leading veterinary educators, and it’s just an incredible group of dedicated professionals working in this area. And that’s where the initiative for the Competency-Based Veterinary Education framework developed. And it was truly an international group led by educators from around the world that developed that framework.

All that I did was create space for them within AAVMC to do their work and support them with some professional facilitation, but that group conceived entirely of the competency-based framework, which today is serving as a basis, a foundation and a framework for many different competency-based frameworks. So it has served a remarkable purpose to really advance veterinary medical education. And similar with the Spectrum of Care Initiative, in fact, that was developed through a partnership with the Stanton Foundation and Ohio State University. Once they developed the concept of spectrum of care, once again, what we did at AAVMC is just create some space for them to work with other primary care educators and further develop the concept. And now of course, it’s becoming widespread.

And by the way, I would say if I look back at my practice in rural Northeast Ohio, and I mean, we practiced across the spectrum of care because we were in an economically depressed area where we were constrained with resources. And so what we did is we offered a range of options to our clients, and including everything from minimal intervention and palliative care all the way up to referral to specialty care. And to me, that’s what spectrum of care is is you meet the client where they are and invite them to be part of the decision-making process.

Well, during your tenure at the AAVMC, veterinary education saw significant growth in both applicants and member institutions. What were some of the key strategies behind this growth, and how did international outreach contribute to that success?

Well, first of all, the number of applicants, you’re right, we saw a dramatic increase during the pandemic. So in 2020, the number of applicants to all of our schools through the centralized application service jumped by 19%. None of the other health professions saw an increase like that. It was pretty dramatic. And in fact, our prediction was that it was a one-off thing that would not be repeated and that we would return and have a decrease in applicants in the subsequent years. That didn’t happen. We saw a 19% jump in applicants, and then for the next several years, it was 2 to 4% and maybe a minus, close to 0%, but then since then it’s continued to grow moderately. And it’s really hard for me to understand exactly what might have caused that in the midst of the pandemic.

But we do know that there was also an increased attention placed on companion animals, the role of companion animals in the family and the number of people owning pets during that time. So there may have been a bit of a spinoff to that, but what I would say is we didn’t have a particular strategy to increase the number of applicants. It just happened. In contrast, we had a very targeted specific strategy to shift to becoming a truly international organization. Now, this started when the AVMA Council on Education began offering accreditation to veterinary schools outside the U.S. and Canada in the early 2000s. And once those schools became fully accredited, they were eligible for full membership in the AAVMC. And initially we treated them differently because the concept was, “Well, we do a little bit of federal government relations. That’s not so relevant to our international members.”

But then it became very apparent that that was only a small part of the services we did, and education is one of those things that is truly a global effort. I mean, we’re teaching veterinarians the same concepts, whether they’re in Australia or Asia or Arkansas or Alabama, right? That’s the same stuff. So the ability to work more closely with the education community globally, I think has had a tremendous impact on expanding our worldview and that of the schools that have chosen to seek accreditation by the AVMA Council on Education.

Well, with your background in public health, what role do you see veterinarians playing in the broader context of global public health, especially in the wake of the COVID-19 pandemic and other zoonotic diseases?

Well, this is another one of those areas, Stacy, where I think it’s essential that veterinarians promote and advance their role as public health practitioners. The fact is that every veterinarian is a public health practitioner, whether they think of themselves as that or not. And what I mean by that is many of us consider public health as a separate career, distinct from companion animal, fee-for-service practice and primary care or specialty practice. But the fact is that when we are doing primary care, we are in fact contributing to public health in many, many ways. The easy ones are thinking about, well, rabies prevention, right? That’s pretty basic.

But what about other potentially infectious diseases with companion animals? What about contributing to mental health and wellbeing for both people and animals by fostering and supporting the human-animal bond? These are ways that veterinarians contribute to public health and wellbeing more broadly than just in clinical care for companion animals. And I think when we think about emerging infectious diseases, the vast majority, about 75% of those have a reservoir in animals. So it is not a matter of if, but rather a matter of when the next infectious disease outbreak occurs, the next emerging infectious disease, whether it’s viral or bacterial or whatever, that it will likely have an animal reservoir and veterinarians will be involved in isolating the source of that and intervening and taking preventive measures.

Yeah. As we’re talking, I’m thinking about all the different career opportunities there are for veterinarians, and I’m curious, looking ahead, what emerging trends or innovations in veterinary medicine are you most excited about and how do you see these shaping the future of veterinary education and practice?

Well, I think the biggest one, the most exciting and also the most fearful is artificial intelligence. So I look at it both in terms of the practice of veterinary medicine, but then also more directly related to the work that I’m doing now is how we educate and train veterinarians. This is a remarkable tool that is like all technology is growing exponentially, so it starts off at a very slow rate of increase, and everybody’s looking, “Well, it’s not all that great. Oh, they said it could do all of this, and it turns out it’s not meeting expectations.” Well, that’s very typical in an exponential curve. But right now, especially with the open language artificial intelligence tools that are available, we are approaching the knee of the curve when all of a sudden the growth and expansion and ability of these tools is going to grow extremely rapidly.

And for instance, I think one of the greatest potentials is in the electronic medical record. So the ability for a veterinarian to have a microphone in the exam room that will capture the conversation with the client and convert that to a medical record in a SOAP format, I think is going to relieve a lot of burden, administrative burden from veterinarians, and that may well contribute to better wellbeing, less stress, and the ability of veterinarians to do more of what they’re really trained to do, which is build relationships with clients and their animals. So I think that’s the great potential.

The great fear, of course, is, “Wow, will it replace veterinarians?” I don’t know. My own view is I tend to take a more optimistic approach, and that is that there will always be a human element, and the role of the veterinarian will be to utilize artificial intelligence in a way that augments the work they do and helps them build better, stronger and more meaningful relationships with their clients and the animals that they serve. And then I think it will have great potential.

Yeah. My son is studying computer science at the University of Oklahoma, and he’s studying AI, and it’s hard to imagine what the world will be like five years from now with all this artificial intelligence.

And that’s just it, Stacy. We used to think, “Oh, in 20 years from now, it’s going to be so different.” And now he’s saying five years from now, right? And my guess is in another couple of years, they’ll say within a year. Some of these things are just amazing, and I don’t want to hype it and make it maybe more than it is, and it’s certainly got some growing pains and things like that. It’s not going to be the answer to everything, but I see great potential for it to relieve the pain points that veterinarians and the teams that we work with are facing now and to make their lives easier. And the same thing for educators. If we can relieve the administrative burden of teaching and assessment and turn some of that over to the machines, then teachers and instructors can develop more meaningful relationships with learners and students, and that’s the human connection that we’ll be able to focus on more. That’s my hope.

Fascinating. Well, Andy, you’ve had a distinguished career working with organizations like the CDC, the FDA, the AAVMC. What advice would you give to veterinary professionals who are considering taking on leadership roles within organizations or moving into interdisciplinary fields?

Well, a couple of things. Like I said, first of all, at the beginning when I described my career trajectory, as I said, no rational person could have predicted a career like this with as many different changes that I’ve had. So if I were to offer advice to a young person starting their career, the first thing would be never say never. I was very fortunate that I was able to take advantage of opportunities that came up. Not everybody can do that. So I had the opportunity to enter private practice with a great mentor and employer that really taught me a great deal about the practice of veterinary medicine. I had the opportunity to shift careers and go in the military. I had the opportunity to get my public health degree, all of these things, right? But the key is be open to new opportunities. That’s the basic message.

The other one in terms of leadership is leadership occurs at all levels in every organization, large or small. So consider, many of your listeners may be veterinarians in private practice, whether they own a small practice or maybe they’re part of a group practice, and they might say, “Oh, well no, the leaders are the practice manager and the chief medical officer, and the rest of us are just workers here, whether we’re associates or staff or whatever.” And that’s not true. The fact is that every one of us, no matter what our position is in an organization, has a leadership role. And part of it is to understand what is the vision of the formal leadership? What is their vision and what is your role in carrying that out and making sure that it happens? So that’s my take on it, Stacy, is leadership is not the purview of just the boss. It’s a role that every single person in every organization has.

That’s such great advice. So three points Andy made. So everyone has a leadership role, be open to opportunities and never say never. I love that. Well, Andy, the diversity gap in veterinary medicine is a well-recognized issue. Can you speak to the importance of the Diversity Matters initiative and what progress has been made in increasing representation of under representative minorities in the field?

Yeah, absolutely. But I’ll start this, Stacy, by saying that I believe the single most important thing that we can do as a profession to assure and safeguard our future is to diversify our profession. And by that I mean to include more people from underrepresented and marginalized groups, whether that is based on race, ethnicity, gender, socioeconomic status, geographic origin, by any measure. And here’s why. What we know is that groups of people who come from different backgrounds that are more diverse in their way of thinking come up with better solution when they’re confronted with problems or challenges, it’s well documented. If you take a group of people that all have the same background and grew up under similar circumstances, they’re going to have a very narrow, necessarily narrow view of the world based on their life experience. If you broaden that group to include people with different life experiences, then you’re going to have a better decision-making.

And the reason that’s important in particular to veterinary medicine is that the challenges we will face in the future are not only unknown, but they’re unknowable. Nobody can predict what the challenges we’ll face 50 years from now or even 10 years from now. People, we can look at trends and we can say, “Yeah, our best guess is this trend is going to continue,” but we’ve already seen situations where a radical disruption occurs, and suddenly all of the assumptions are thrown out the window. So what’s our best hedge against an unknowable future? That’s simply to have a more diverse workforce. And by having people with different worldviews, different backgrounds, different viewpoints, we will be better able to withstand these unknown and unknowable challenges because we’ll have people that will think about solutions differently and they’ll come up with ideas that me and people like me would not come up with.

That makes sense.

That’s why I think it’s so important.

Yeah, that makes perfect sense. Well, I’m curious, Andy, what has been the most surprising thing to you so far during your career in the veterinary profession?

The most surprising thing, I think, is the ability of this profession to adapt and to change. And that’s kind of more the historic view. We started as a profession that was kind of created as a standalone profession to take care of horses, because horses were part of the critical infrastructure for agriculture, transportation, war fighting. Every single thing revolved around the horse in the 19th century, well, up until the 19th century. And then suddenly along comes the internal combustion engine. Well, that’s the end of the horse, right? It’s the end of veterinary medicine. Well, no, then all sudden the value of food producing animals increased to the point where we could invest money into research and genetics and then treatment of individual animals.

And that was the next phase, and then as agriculture or the value of pets rather continued to increase, now we have some of the highest quality medicine available for companion animals. So what’s next? To me, that’s the exciting thing. What will be our role in the future in terms of infectious diseases, our role with animals? I don’t know, I can’t predict that, but to me, that’s the exciting thing is to watch this profession adapt and change and overcome.

Well, you talked about how you’ve seen the profession change over the years. What does your crystal ball say about the future of the veterinary profession?

I think it’s bright. And again, part of that is optimism many times is a choice. We all have access to information today, trends and news and world events, and we can choose to look through some of those things and say, “Well, all of this portends bad news. The economy is going to fracture. We’re going to have all of this strife and global conflict.” But frankly, that’s always been a part of the human condition. So we also have the choice to look at that same information and say, “Yeah, it’s not going to be a bed of roses, but there are ways that we can contribute to improving the quality of life for people and animals on this planet, and we can jump in there and get to work and doing it.” So again, I choose to see that as a constructive way for this profession to contribute to societal needs. And I think that with the young people that we’re admitting today that are choosing to come into veterinary medicine, it’s a very bright future indeed.

It certainly is. Well, I am curious, what are a few of your own daily habits that you believe have allowed you to achieve success along the way?

A couple of things. I always try to make time for some degree of exercise. I just think it’s really important. I used to run more than I do now. My knees don’t hold up as well, but even a brisk walk to get moving and do some exercise. My favorite pandemic purchase is an indoor water rowing machine that I absolutely love. So those are daily habits like that to me are very important. I also try to find some time every day to pause and reflect. And I got to admit, that’s a challenge for me sometimes. Like many people in the type of work that I do, I feel like I am tied to my email inbox and I need to tame that beast and keep up with my email. And that’s important, but it’s also important to find time to just pause and reflect and think about… Let ideas ferment a little bit and experiment with some ideas and put pen to paper once in a while and pause and think. So those are some things that I try to do, not always successfully, but that’s my goal.

I can relate to your point about email, because some days I feel like I am bailing water out of a cruise ship with a thimble when it comes to my email.

Indeed. And like I said, we can get wrapped up in it. So it’s important to be responsive, but we’ve also got to set boundaries. And a trick that I do is I actually schedule time on my calendar for time to do other things. And I know it’s different for everybody, but as I’ve heard other leaders say to the teams that they work with is find out what works for you and do that because each of us needs to do what works for us so that we can perform at our best capability.

Well, that makes sense. What advice would you give the younger version of yourself?

Yeah, be prepared. Don’t plant your flag too far in the future in terms of your career goals. Be prepared for changes that may come up. And again, be open to try new and different things. Like I said, it goes back to what my advice for other people, it’s the same I would give myself is never say never. Give it a shot. You may find out that there’s something there.

Yeah. So true. Well, some of our guests say that they’ve had a key book that they’ve read along the way that helped them with their mindset and approach to success. Do you have a key book in your life that has impacted you the most? I’d love to hear that story.

Well, one that did particularly, especially with regard to technology in the role of technology and society, is Ray Kurzweil’s The Singularity Is Near. And that book described again the exponential growth of technology that I spoke to. And I like to tell this story about a conversation I was having with my brother. It happened to involve a martini or two, which probably made it a more meaningful conversation, I’m sure. But he’s a computer scientist, and in fact, he was the director of the supercomputing laboratory at Oak Ridge National Laboratories, yeah, kind of a minor job.

Wow.

And we got talking about stuff about my career in veterinary medicine and his career in computer science. And I told him, I said, “Listen, your job, it’s easy. You can reduce everything you can do to zeros and ones, all of your terabytes and petaflops and nanoseconds, it’s just zeros and ones, right? That’s computer language.” And I said, “On the other hand, I work in veterinary medicine, biological sciences.” I said, “I work with living systems that are evolving, both the animals themselves, the pathogens that we’re dealing with and all of these things.” I said, “You can’t reduce that to a simple formula.”

No, you can’t.

He said, “Not yet.” And that’s what stimulated my interest in this, Stacy, is when you get to supercomputing, quantum computing, artificial intelligence, that may unlock some secrets that will just blind us with their revelations. So again, I’m not suggesting that it’s all going to happen at once, but it stimulated my interest in thinking about the role of technology in living systems, and I think there’s much to be learned from that.

Yeah, that quantum computing, it’s fascinating. Again, what is the role going to look like in five years.

Indeed.

Well, Andy, you’ve got the mic. What is one thing that you want to share with our listeners at The People of Animal Health Podcast before you drop the mic today?

I had like to come back to that concept of diversity, and again, the importance for the future of the profession. As I said, I think really it’s the most important thing we can do to safeguard our future is to diversify our profession. So my message to every veterinarian who is listening and everybody involved in the veterinary industry who is listening is reach out to a young person. Try to find a relationship with a school in an underserved part of your community, and reach out to them and build a relationship and maybe encourage a young person there to consider a career in veterinary medicine someday in the future. I think we will be better off for it and I know society will be.

That’s so good. Well, Andy, I enjoyed our conversation today, and thank you for being here.

Stacy, it’s been a blast. I’ve enjoyed it and I look forward to seeing you again in the near future.

I look forward to it as well. Thank you again.

All right. Bye.