Readers Respond: Recruiting Rural Veterinarians

Rural practice features challenges and opportunities that differ considerably from those in an urban companion-animal setting. ( John Maday )

Bovine Veterinarian recently asked readers for their thoughts on how to sustain critical numbers of veterinarians serving rural areas. The responses represent a variety of ideas illustrating the complexity of the problem, with no single solution.

Our question:

Q. What should be done to increase the number of large animal veterinarians to serve in rural areas?

A.The nation’s vet schools have turned a deaf ear to the rural vet shortage, no matter what they say. They are making up for funding shortfalls by increasing tuition and increasing class sizes. The debt that the average student graduates with is nothing short of debilitating in terms of buying into a practice, buying a home, and starting a family. It’s difficult to justify in a metropolitan area, where salaries tend to be higher; it’s damn near impossible in the rural setting. Federal and state programs that aim to forgive some student debt aren’t the answer either, as they only benefit a very few students and on top of that, are poorly funded. The debt these graduates are saddled with has to be relative to the income they receive once out of school. If this is not returned to a manageable, liveable amount, what is the point? Who in their right mind would take on a student debt that they would spend their entire professional career trying to pay off? The trend is towards disappearing rural vets? You bet. In fact, the trend is towards extinction.

A.First, don't keep doing the same thing and expect different results. Change veterinary curriculum drastically. Change some veterinary colleges to graduate only large animal veterinarians. Most to graduate small animal only veterinarians. This would result in limited-license veterinarians. This would save the taxpayers a lot of money. If a veterinarian wanted to be licensed for pets and cattle, they would have to go back for more schooling and exams. This is where the problem lies. Most rural veterinarians rely on pets to make a living. Good luck to all. Major changes are never easy. Reducing government red tape would make this easier.

A.I graduated from vet school in 2010 and started to work for an older veterinarian in a very rural area. Life has taken me down a different path in the last few years, but I often reflect on my time with him and the conversations that we had regarding the veterinarian shortage. When he first graduated and started practicing in the early 1970s, there were government programs that almost ensured that he got onto people’s farms. He always said that the reason for his successful mixed animal practice was Brucellosis eradication program. This made people have to call him, a veterinarian, and while there he would try and build a relationship with those farmers and show them what value he added to their operations.

Everyday that I worked with him, I saw that in action through their continued loyalty to his practice through services and supplies. He and I would talk often about how those programs led to the success of his practice and how he wished something else like that would come along for today’s veterinarians. I hope that below I can articulate reasons that my older mentor was able to be successful, but today might even struggle in the same area. I told that story to give some background into my answer which is that what we really have to address is: community support of a practice through the purchase of goods and services.

Every area of the country is so different, but it seems sometimes we all struggle with the same things. What if the real problem is not that there are not enough veterinarians, but a shortage of people willing to purchase goods or services from them in a given area. Business management becomes an incredibly crucial part of these rural practices. The debt relief program does help to address that in terms of lowering debt owed so that people can build a business, but what if it turns into a band-aid to cover up the actual wound which is not enough financial support for a practice.

The veterinarian who I worked with also got incredible support from his community over the years when it came to goods purchased: antibiotics, repro supplies, even needles and syringes. That climate is much different today, even in our area, as large “animal health” companies and online retailers are able to offer a lot of those products for sale for a lower price than my mentor was even able to purchase them for. The new antibiotic rules may change this in the future, but I do get concerned that even programs like that will have unintended consequences for our veterinary community when it comes to our role implementing the rules. This is an extremely complex issue, one that will likely take a myriad of forces to arrive at a solution. I hope I at least have some insight from my perspective and experience that could help someone else along the way.

A.It appears schools are chasing more out of state kids to help cover expenses, and for Kansas, that typically means admitting more non rural kids. But is our admissions process correct? Is it targeting kids with grit, potential, emotional intelligence, self-awareness, and passion? How can we make it better? Does GPA matter once it's above 3.0 in terms of successful career in 20 years? Does GRE score accurately predict success of a veterinarian in 20 years? Does a one-time interview predict success in 20 years?

A. Financial aid of some kind to help with schools loans when graduating would be helpful. Advertising this to high school students may help to get more rural community kids to go back home to practice large animal veterinary medicine. Tax breaks to open new clinic or to take over existing one is another idea.

A. I have been a large animal veterinarian in a rural Delaware county and in northeast Iowa for almost 45 years. As consolidation in the livestock industry continues, the number of livestock farms continues to decline. Local practitioners do almost nothing for the big swine integrators. The true family-farm dairies are being pushed out by the multi-thousand cow dairies. As this consolidation continues there are less and less farms for a veterinarian to service. Pretty soon there is not enough business to support a practice and it closes. I think most of the so-called shortage areas are just that. There is just not enough livestock left to support a vet in these areas. A lot of practices that used to be all or mostly large animal are now mostly small animal just to survive.

 


 

Comments
Submitted by Edward on Wed, 12/26/2018 - 16:10

I went to the U of I to go to Vet. school in 1971. I could see them that it wouldn’t
work out. Fast forward to 2018. The same problem of too much work, debt and
sacrifice has been multiplied time 4 or 5.

Production Ag has the same problem.
Saddle up boys, our situation is one that
we all have been a part of, and have allowed to happen to this point.

Both the lack of Vets. and farmers is
rapidly catching up with NOOOO
solution in sight.

Better put this to the politicians to handle.

By the time they get done screwing around
we will all be dead from old age.

Submitted by John on Wed, 12/26/2018 - 17:00

Great analysis. I would add that it is not just rural America. We have cattle outside a medium size city with many veterinarians, but only about 3 will work on large animals. The chances of getting one to come out for an emergency is slim, and the cost is more than the animal is worth. Can’t blame the vets. My only point is that large animal care is a problem everywhere so we all need to help with a solution.

Submitted by Old Cow Doc on Wed, 12/26/2018 - 20:16

You got the answer to the problem when the veterinarian above stated that you had to get the client to call the veterinarian and support him, and this is not happening. Further more it is not going to happen as long as feed company veterinarians and drug company veterinarians ride up and down the road with a prescription pad and free advice if the client buys the product that is always the answer. It is as bad as the opioid crisis in people. Good husbandry and proper management overseen by a veterinarian are viewed by owners with maybe some type of agriculture degree as demeaning. They mistakenly see themselves as being as qualified to diagnose and treat disease or develop management programs as a trained veterinarian. This attitude causes them to purchase every magic drug and vaccine that comes available. They use these drugs with no oversight and beyond that they share drugs willingly with all their neighbors who want cheap drugs. Generally these large livestock operations buy drugs in quantity at a price less that the price the veterinarian would pay for them. What this really amounts to is abuse of livestock from no diagnosis and no oversight of the drug used or the dose used.

This problem began in the early seventies with drug company reps riding the road and stopping at every farm to promote drugs for the sake of making sales. Later when the public called on the FDA to curb this practice, the drug companies hired veterinarians who were just drug pushers. As the number of farms decreased this spiraled out of control to the point that drugs flow like water with a wink wink oversight. The VCRP promoted by FDA is mostly a joke. The animals get an injection of what ever drug seems to be hot at the moment. These owners have the misconception that it is cheaper to loose a few head than to be bothered with a veterinarian that might disagree with their diagnosis from their long experience. It is like you going to the family physician with intestinal pain and the physician without any examination prescribing you a new hot antibiotic for pneumonia because he thought most of the people who came in that day had pneumonia and he didn't want to be bothered with something different.

It has taken over 40 years to get to this point, and it is good that people are talking about the problem. I don't think there any quick cures for the problem. My guess is that regulatory action, and complete control of drugs by the veterinarians as in Europe will cycle large animal veterinarians back to the top. If you really want to do something constructive, educate the owners of these animals about the cost savings and management success they can achieve with a hands on veterinarian on their team and not just a shill for a drug company.

Submitted by Lillian Yontz on Fri, 12/28/2018 - 08:40

We need vets that do not specialize in one species. Here where I live in Virginia you have to have a vet for two-toed species, another for horses, another for dogs, and none for chickens, and other small animals for rodents like rabbits and guinea pigs? Do not take me wrong. I love vets. They are some of my favorite people. But I would like to have a dr. Pol here.

Submitted by Phil DVM on Fri, 01/11/2019 - 15:09

Who is pushing this big need for rural large animal vets. If you read the comments above you will see that the need is very small and the economics aren't there. AVMA threw in with industrial AG years ago because they said that was the future. Well the future AVMA wanted is here. When the economics or animal disease crisis requires more veterinarians then it will happen. Most people I talk to aren't that enthusiastic about the cost of veterinary care now days so I see a future with a shrinking pet population and less need for small animal vets also.