Wild Accusations: LMU sues the AVMA

LMU unleashes a lawsuit that seeks the divorce of the AVMA and the Council of Education

The largest¹ U.S. veterinary school, Lincoln Memorial University has sued the American Veterinary Medical Association for anti-competitive practices.² ³

This one immediately struck me as interesting, and I think it’s a story worth telling. Although the news is not even three days old, the deeper I dig, the more interesting (even bizarre) it becomes.⁴ It’s like going to a house call and unavoidably noticing an overwhelming number of tchotchke collectibles on the walls. They don’t meaningfully distract from what you set out to do, but they do make it more memorable.

The allegations that LMU has leveled at the AVMA are serious, and the complaint is well-written.

But allegations aren’t facts, at least not yet.

I’m going to outline LMU’s complaints (and highlight how they meaningfully differ from the sloppy press release), include some of what I consider to be relevant information, and give my strongly-worded-but-lightly-held opinion of it at the early stage. There’s more to come, of course. I’m going to dig into the COE and see if I can’t find any potential conflicts of interest. I’ll keep an eye out for the AVMA’s response. And I’ll keep digging.

In the interest of full disclosure: I'm an AVMA member serving on its Task Force for Emerging Technology and Innovation, with a pair of lectures scheduled at next month's convention in D.C.

I'm also a graduate of a distributive-model veterinary school who has faced colleagues' demeaning comments and witnessed firsthand the bias against such programs.

As both veterinarian and practice owner, I have conflicting financial interests in salary trends. They’re simultaneously good and bad for me.

I research hard, think intensely, then write accordingly. For unbiased reporting, try Reuters. For the perspective of a notoriously intense, ferociously ethical veterinarian who's turned his hyperfocus on this topic, keep reading.

There's a summary at the end if you want to skip ahead. But you'll miss the flavor!

GPT 4o; essay as prompt; I resisted the urge to alter this one, as its the first one in awhile to miss the mark for me.

Lincoln Memorial University’s Complaint

I’ll summarize the document, and then include my thoughts in italics.

The Core Issue: LMU, a 501(c)(3) nonprofit with an annual revenue of more than $200 million, claims that the AVMA is illegally restricting competition in veterinary education and services, thereby causing prices to be artificially high for consumers.

How the Alleged “Scheme” Works:

1. Control: The AVMA controls veterinary school accreditation through its Council on Education (AVMA COE) - the only body that can accredit vet schools in the U.S.

2. The Conspiracy: AVMA members (practicing veterinarians) have agreed to limit the number of new veterinary schools to prevent "downward economic pressure" on veterinary service prices.

3. The Method: The AVMA COE is imposing arbitrary, impossible-to-meet research requirements on new schools, particularly targeting schools that use innovative "distributive" education models instead of expensive research facilities.

Doc’s Initial Opinions

1. The LMU complaint is bold and full of seemingly plausible claims… if you haven’t spent much time in veterinary medicine. I joke that I can’t get five veterinarians to agree on what day of the week it is. A conspiracy involving dozens of veterinarians, from all over the country, mixing of volunteers and full-time employees, to collude and conspire for a single insidious goal of disrupting a single brave university’s noble efforts to train veterinarians? Color me skeptical. LMU’s complaint refers to the AVMA and its members as “conspirators” and its actions as a “conspiracy” at least 29 times in the complaint.

2. The cost of veterinary care has risen much higher than inflation over the past ten years, but we were also lagging behind for the past 30 or so. A market normalization isn’t unusual — heck, it’s called “normalizing.”

3. The cost of veterinary care is not rising only because of the cost of veterinarian salaries. The cost of diagnostic tests and supplies has risen above the rate of inflation as well. In fact, I suspect that as many veterinary salaries are based on overall production, the increase in COGS and diagnostics (and concurrent increase in prices) has contributed to the overall salary increase for veterinarians.

4. The AVMA can reasonably and does effectively fulfill its obligations as a trade organization and those of an accrediting body without “conflicts” of interest. Demanding high standards for universities training veterinarians sounds like a really good way to protect the public from harm. Those aren’t conflicts of interest; those are aligned interests — interests of the students, the veterinarians, patients, and the public.

5. The outspoken president of Lincoln Memorial University,⁵ Jason McConnell, DBA, an intense-looking, goateed fellow without a LinkedIn page, has received what seems his entire adult education at Lincoln Memorial University and, per his university website bio, seems to have spent a large portion of his career there as well. That makes me wonder if his well-credentialed educational and work experiences have left him with a limited notion of collaboration.

Claims of Specific Harm to LMU

Tennessee Campus (LMU-TN):

• Was fully accredited since 2019 with no issues per the complaint.

• In 2022, got approval to increase class size from 125 to 225 students.

• In October 2024, placed on probation for alleged "research deficiencies."

• Same research program that was previously deemed adequate.

Florida Campus (LMU-OP):

• LMU invested millions in a planned second campus in Orange Park, Florida

• AVMA COE is blocking accreditation using the same arbitrary research standards

• Would serve 450 students if allowed to operate.

I’m unsympathetic. This is education for the practice of medicine. Meet the standards or go home. I understand that it costs a lot of money to train doctors well, but we need well-trained doctors and Lincoln Memorial’s gripe here seems to be that it’s expensive to meet the Council of Education’s Standards. You have more students? Of course you need more opportunities to expose them to research, the standards don’t dilute for the second cohort.

I read the complaint and think, “yes, and?” Which is more polite than “so what?” I’m told.

The AVMA's Public Statements

The complaint includes quotes from AVMA officials openly discussing its economic motivations:

• Warning about "downward economic pressure" from new schools.

• Stating that new veterinary schools threaten "the economic health of the veterinary profession.”

• Acknowledging its goal is to make "veterinary medicine a more profitable endeavor."

Yeah, okay, I get that we should all be so noble that we’d do this job for free. And, honestly, I have. My hospital’s accounts receivable border on catastrophic.

Good medicine isn’t always cheap and cheap medicine isn’t always good. If I don’t get paid, I can’t do this job. A financially healthy profession is necessary not only the profession, but in serving the public interest as well.

If we don’t pay good doctors fairly, we’ll end up with desperate ones who are forced to cut corners or upsell care to survive. Ethical care requires ethical compensation, and that requires a more sophisticated economic understanding than is demonstrated in LMU’s complaint and press release.

I’d worry about this more if not for the existing firewalls between the AVMA and its Council of Education.

Economic reports from the AVMA are not a new feature. They’ve been performing, publishing, revising, and refining economic research for years.

Market Impact

Current “Shortage:”

• Only 34 veterinary schools in the entire U.S. (vs. ~200 medical schools)

• Veterinary care costs have risen 60% since 2014.

  • Not exclusively, growls this clinician and practice owner, due to rising veterinary salaries.

• One-third of pet owners forgo needed veterinary care due to cost.

  • A $1,000 investment in Idexx Reference Laboratories (IDXX) in May of 2015 would be worth $7,661.93 as of yesterday; an increase of 666%.

• Significant shortages in rural areas and food animal veterinarians.

  • LMU’s complaint claims to disproportionately pull students from impoverished areas of Appalachia. The complaint includes statistics on where the students are from, but not where they work after they graduate.

LMU's Successes:

• Largest veterinary school in the U.S. by enrollment.

  • LMU-CVM received AVMA approval to add a second cohort to the CVM in 2022.

• 90% pass rate on licensing exams

  • This is actually interesting. The AVMA COE mandates that 80% of students must pass “at the time of graduation.”

    • This matters for more than just quality control. I am a graduate of St. George’s University School of Veterinary Medicine and was enrolled when they received their first full accreditation. One of the concerns during accreditation was that because a number of my classmates were not American, and did not intend to take the NAVLE, that the American pass rate would need to be higher than 80% to receive accreditation.

  • This document from LMU presents “student achievement data,” and lists the NAVLE scores and pass rates.

    • The document shows that in 2021, 2022, and 2023, LMU’s first-time pass rate was under the 80% standard.⁶

    • The student achievement data shows that of the number of students tested, the first-time pass total and rate, the number of retakes, the retake pass total and rate, and the total pass rate.

    • Potentially crucial omissions:

      • The data does not include the total number of veterinary students enrolled or graduating, only the total number of students tested. If the total number of students is greater, then it would diminish the overall pass rate.

      • The data does not specify that the pass rate is at the time of graduation, only that the students retook the test and passed it.

      • Why it might matter:

        • These are relatively small numbers, so a few nudges here or there could drop the pass rate below the standard.

        • An illustrative hypothetical: imagine that in 2021, 116 of 125 students took the NAVLE, and 91 of them passed on the first try. Of the nine of the 22 students who retook and passed the NAVLE, two of them passed it after graduation. That makes the pass rate at the time of graduation 98/125, instead of 100/116, lowering the pass rate at the time of graduation from 86.2% to 78.4% — which is below the COE standard.

        • LMU’s website indicates that they accept 125 veterinary students for their fall semester.

• Graduates are highly sought after by employers.

  • Have you ever seen a university’s website that reads, “Sorry, but we have no faith in the students we accept and graduate, please put our grads’ resumes at the bottom of the pile”? This is more advertisement than argument.

• Uses “innovative distributive model”

  • “innovative, adj., characterized by, or tending to introduce, innovations; introducing or using new ideas or methods; original and creative in thinking.”

  • I graduated from a university using the distributive model before Lincoln Memorial University welcomed its first class of veterinary students. St. George’s University welcomed its first class of veterinary students before the turn of the century.

Legal Claims

1. Sherman Act Section 1 - Illegal agreement to restrain trade in both the veterinary education and services markets.

   1. Sherman Act Section 1 prohibits agreements or conspiracies between two or more parties that unreasonably restrain trade or competition.

2. Sherman Act Section 2 - Unlawful use of monopoly power in accreditation to harm competition.

   1. Sherman Act Section 2 prohibits a single entity from using monopoly power to unfairly dominate a market or exclude competitors.

      1. Given that the AVMA has newly accredited a number of universities in the last ten years, I’d be surprised to learn that

3. Due Process Violation - Arbitrary and unfair accreditation process.

   1. Alleged. Can’t know yet.

What LMU Wants

1. Injunction stopping AVMA from applying accreditation standards in an anticompetitive manner.

   1. Accreditation is, by nature and by structure, anticompetitive in a way that’s designed to serve the public interest. It creates formal barriers to entry and restricts the ability of institutions to operate freely in the market. It’s not only legal, it’s beneficial. It ensures educational quality, public safety, and consumer protection.

2. Structural Relief - Complete separation of the accrediting body from the trade association.

   1. A big ask. Potentially an intentionally outlandish anchor as a negotiating tactic.

3. Legal Fees and other appropriate relief.

   1. $.

Key Legal Arguments

• Direct Evidence: AVMA's public statements about economic circumstances.

  • I’m not convinced that this the casus belli that the complaint makes it out to be. The AVMA publishes research and economic reports regularly and has done so for years.

  • Unless, of course, there is direct and demonstrable evidence that another university was not required to meet the same standards from the Council of Education. If that’s the case, the AVMA could get clobbered.

• Timing: The sudden change in treatment coincides with AVMA's conclusions on economic research.

  • I’m also not convinced. LMU also nearly doubled their yearly cohort from 125 to 225 students annually. It shouldn’t really need to be explained that the quality of and exposure to research in the educational environment must keep pace with the expansion.

• Market Power: AVMA has “monopoly” control over accreditation.

  • I’m not sure that it’s a failure of the AVMA that no one else has created an accrediting body for veterinary universities in the United States. Veterinary medicine, law, pharmacy, architecture, and public health all have a single respective accrediting body, while physicians (LCME and COCA), nurses (CCNE and ACEN), theological education (ATS and TRACS), and others have more than one.

  • If you want another accrediting body, you’re allowed to do that. This is America, and here’s the link to the U.S. Department of Education Postsecondary Accreditation. You can create an organization and establish your own accrediting body. Reach for the stars!

• Consumer Harm: Clear evidence of rising prices and reduced access to veterinary care.

  • Blaming all of the rising prices on an alleged shortage of veterinarians, especially in light of economic evidence to the contrary, is rather oversimplified for me. The argument essentially takes a complicated, changing economic environment and asserts that it can be solved if LMU-CVM can train more doctors. Are we going to blame all-time highs on milk and egg prices on “the shortage” of veterinarians too?

Where the Allegations Fail for Me

I’m not a lawyer. I’m not claiming to be a lawyer. What follows is just a bit of my opinion about this whole thing given what I know today.

• The complaint emphatically alleges that the AVMA’s economic reports amount to directives to the Council of Education to limit competition. While the complaint makes no note of it, the AVMA has a well-documented history of “firewalling” the COE from the rest of the organization.

• The complaint alleges that Standard 10 (Research) was not enforced the same way in an earlier accreditation. But that’s not the only thing that could’ve changed, right? LMU’s complaint doesn’t note anything that might indicate that their students’ access to research might’ve diminished at LMU in between the two visits.

• The AVMA COE probation doesn’t remove accreditation, only that there’s a deficiency that needs to be corrected in a timely manner (October 2026). And while the complaint notes the high cost of meeting the standard, I find myself unsympathetic to their claimed plight. A lawsuit of this nature means that LMU, an organization bringing in more than $200M a year in revenue, is⁷ spending at least $250,000 to $500,000 if the case settles and potentially $2-3M or more in legal fees if the case goes to trial and appeal.

  • LMU, according to their 990 filing, has 29 employees making more than $200,000 a year. If they added two more, and said, “head up the research initiative at the veterinary college,” you’d probably have saved the university money and met the accreditation Standard.

• The complaint alleges that LMU-CVM was not given “enough” notice about the changes in the enforcement of Standard 10 (Research).

  • LMU-CVM was informed in October of 2024 that it would be placed on probationary accredited status for major deficiency in Standard 10. They were given until October 2026 to correct the deficiency.

    • “The college must maintain substantial research activities of high quality that integrate with and strengthen the professional program. Continued scholarly productivity within the college must be demonstrated and the college must provide opportunities for any interested students in the professional veterinary program to be exposed to or participate in on-going high-quality research.”

    • The website goes on to note that over 40 students have co-authored papers in the last 10 years.

      • That’s not really a lot of publications for a university. There are four or five peer-reviewed publications associated with Old Ridge Veterinary Hospital in the last five years, and I’m a one-doctor general practice.

• Finally, veterinary medicine is a small world. And it’s hard to imagine that this kind of hostile, aggressive, litigious approach will be looked upon with grace and fondness by the veterinary community.

  • The outspoken president of Lincoln Memorial University, Jason McConnell, DBA, has received what seems his entire adult education at Lincoln Memorial University and, per his university website bio, seems to have spent a large portion of his career there as well. That makes me wonder if his well-credentialed educational and work experiences have left him with a narrower perspective on the world, less inclined to collaboration and compromise.

  • This complaint is aggressive, even bitter. It’s a bridge-burner of a thing, full of outrage, a call for dramatic institutional change from an organization much, much smaller than itself.⁸ It feels self-righteous and entitled, the attitude of a bully rather than a colleague. I find myself thinking that the lawsuit will cause more reputational harm to Lincoln Memorial University, its faculty, its graduates, and its students than a temporary probationary action ever could.

Summary

As promised! Lincoln Memorial University has sued the AVMA, claiming the veterinary accrediting body is illegally restricting competition by imposing arbitrary research standards on new schools to keep veterinary service prices artificially high. LMU alleges this conspiracy has harmed their Tennessee campus (placed on probation in 2024) and blocked their planned Florida expansion.

While LMU's legal complaint is well-written, the allegations are troubled and problematic. The supposed conspiracy among dozens of veterinarians across the country strains credibility in a notoriously disagreeable profession. Rising veterinary costs stem from multiple factors beyond veterinarian salaries, including increased diagnostic and supply costs, that cannot be solved by LMU’s increased class size. The AVMA's economic research and advocacy for professional financial health serves legitimate purposes - financially desperate veterinarians pose greater risks to patient care than financially stable ones.

LMU's specific grievances are less compelling upon examination. Their NAVLE pass rate data may not meet the 80% standard when properly calculated. Their research output appears minimal for a major university. Most importantly, accreditation is inherently anticompetitive by design - it's designed to create barriers that protect public safety and educational quality.

The lawsuit feels like an expensive tantrum from a $200+ million revenue institution that could have simply hired two research directors for less than their legal costs. Given veterinary medicine's small, collegial community, this aggressive approach may ultimately damage LMU's reputation more than temporary probation ever could.

At first glance (okay, after six hours of research and writing) the case reveals more about LMU's institutional mindset than about AVMA misconduct.

1. LMU’s press release referred to the university as the “largest U.S. veterinary school,” which was vague. So I checked. LMU has the largest class sizes. Does that mean “largest”? Meh, the language doesn’t feel right there. There’s more to universities than the student bodies.

2. The press release states that LMU has filed the suit to “protect consumers and their pets.” An obnoxious, ham-handed grope at narrative control that smacks of an attempt to provoke —if not righteous, at least recreational — outrage.

3. I’ve got two footnotes in the first sentence criticizing the hysterical language of the press release, a document which immediately feels like it was written in the hopes of rallying a mob of Karens and Kevins of a Facebook comments section. And I’m really not going to be able to focus on anything else until I got it out of my system.

4. Little things stick out as strange. The law firm representing LMU is Maynard Nexsen, formed by a merger in 2023. The Wikipedia page states that, “[i]t is the largest law firm in Alabama by a number of lawyers.” The language sticks out to me, I think, because of the competing expectations of a strong superlative assertion (“the largest law firm in Alabama…”) followed by the soft, generalized expression (“a number of lawyers”).

It sounds even stranger when you check the citation on Wikipedia, and the precise number of lawyers is provided (271, with second place having 233).

And if you look at its list of “Notable attorneys and alumni,” included is a former US assistant attorney general who is now the Chief of Staff for former Auburn University Football head coach and current United States Senator Tommy Tuberville, as well as an impressively credentialed and memorably appellated man named John Johns.

It starts to feel like something out of an Alabama edition of Mad Libs.

5. Who, impressively, “exemplifies a paradigm of visionary leadership” according to his website bio.

6. During COVID, scores of all sorts fell for more than just Lincoln Memorial University’s College of Veterinary Medicine. It’s almost like it’s hard to learn things exclusively in front of a computer screen.

7. Assuming $500/hour for blending billing rate.

8. The AVMA’s annual revenue is less than a quarter of LMU’s.