Is There a Doctor in the House? Experts Say "Maybe Not for Long"

by Suzanne Bush

"Call the vet." "Ask the vet." "Get the vet to look at it." Because horses are often clumsy, and because they're far more fragile than one might think—given their size and apparent strength—vets are integral partners in equine activities. Horses injure themselves while chasing each other in the pasture. They colic. They roll in the mud and inadvertently cut themselves on exposed branches or sharp rocks. They get colds and fevers and all sorts of ailments that can seem deadly but are usually resolved easily. Calling the vet is prudent when horses get hurt or sick. But what would happen if there were no vet to call? What would happen to a beloved horse in need of emergency care? That question is being asked more frequently as America confronts a looming shortage of large animal vets.

Veterinary students who might once have dedicated themselves to caring for large animals on farms are choosing to focus on smaller animals: dogs, cats, gerbils. Some people theorize that the reason for the declining population of large animal vets is a function of vanishing farms. Young people who grew up on farms recognize the importance of caring properly for cattle, horses and other farm animals. But Dr. Alan Kelly, former Dean of the School of Veterinary Medicine at the University of Pennsylvania, believes the issue is purely economics. "It's difficult for the veterinarian to make ends meet these days," he says. "Education is very expensive. The average indebtedness (of veterinary school graduates) is high."

Along with their diplomas, Kelly says, veterinary school graduates leave with staggering debts—often in the neighborhood of $100,000 or more. "The opportunities are in small animal practice," he says. The economics of caring for large animals are daunting. First there are the hours. Large animal vets may travel hundreds of miles a week visiting farms. Often they work 80 hours a week or more, handling routine calls as well as emergencies.

Then there are financial costs and the physical tolls. All that travel eats up time as well as fuel. Horses and cows substantially outweigh the people who are treating them for everything from complicated pregnancies, to twisted guts, to broken bones. In many cases, the patients are not in climate-controlled environments. The veterinarians have to deal with whatever the weather happens to be—snow, ice storms, sleet or blistering heat. A sick cat might claw or bite the vet trying to treat her, but a horse or other large animal in pain or distress can inflict life-threatening injuries.

Kelly says that there are numerous reasons why the declining number of large animal vets is so alarming. "It's a real problem, because if we have an outbreak of any serious disease," he says, the impact could be disastrous. "Vets provided surveillance," and were able to recognize potentially catastrophic outbreaks. "But the infrastructure is crumbling." He says that farms are not as likely to have regular veterinary care for their herds. "Particularly in the dairy, swine and poultry industry, you have consolidation. The average value of a single animal has declined."

Whereas vets might have been able to supplement their incomes in the past by doing tests for various diseases and conditions, those opportunities are evaporating. "The pregnancy exams for cattle are now done with a $10 blood test," he says.

While Kelly sees the most immediate problems for the dairy and beef industry in Pennsylvania, he foresees difficult times ahead for farming in general, as a result of economics.

Dr. Richard A. Mansmann, Clinical Professor in the Equine Health Program at North Carolina State College of Veterinary Medicine is also concerned. He says that there haven't been extensive studies to document what's happening to prospective large animal vets, but he thinks there is a constellation of issues in play. "The applicants we get for veterinary school are very smart and they have some horse experience," he says, "but they don't have the experiences with the industry that small animal vets do." Often, he says, they've ridden with vets, but have not been employed by veterinarians in large animal practices. Many of the students who go into small animal practices, he says, have worked in clinics and experienced first-hand the day-to-day routines. He agrees with Kelly that the indebtedness vet students have amassed by the time they graduate is another facet of the problem.

Some people suggest that the states should provide funds to help reduce the debt load. Mansmann disagrees. "I don't think the states have to ante up. I think the horse owners have to ante up." He's not necessarily talking about money. He thinks that the people with the largest stake in the health of equines are the ones who should be leading the search for solutions.

"Encourage people with experience as blacksmiths or veterinary technicians to go to vet school," he says. Sometimes people who already have a passion for caring for horses only need some encouragement to go further with their commitment. "Owners that have horses in more rural areas may get together as a group and figure out how to make the area more attractive to large animal vets," he says. "A regular doctor doesn't have to build his own hospital in order to have a practice," he explains. But often, in rural areas, there are no facilities where vets can treat horses. Mansmann says that these rural areas might be best served by a cooperative arrangement where one farm might dedicate part of the barn for a clinic. "A haul-in clinic wouldn't need a fancy situation," he says. A covered space where horses could be examined and treated would suffice.

Mansmann also believes that a significant factor in the declining number of equine vets is America's shrinking farmlands. Suburban areas once dotted with large farms are now wall-to-wall housing developments, shopping centers and office parks. "The rural work ethic is not as prevalent as it used to be," he says. Kids who grew up on family farms head off to veterinary school with a passion for caring for the animals that they have seen all their lives. Kids growing up in suburbia lack that vital connection to the animals, even though they might have extensive experience with horse ownership. The experience gained from being involved in the daily lives of farm animals forges perspective and understanding that are difficult to replicate.

Robin Murray of Rood & Riddle Equine Hospital in Lexington, KY, says that the situation presents an interesting dilemma. "AVMA (American Veterinary Medical Association) stats were showing trends that fewer students were going into equine. That trend is up against an equine industry that is booming." Murray is the Client Service Director at Rood & Riddle and coordinates the hospital's unique internship program aimed at third-year vet students. The Opportunities in Equine Practice Seminars (OEPS) are held annually on Labor Day weekend, bringing vet students from all over the United States together. "Presentations focus on what it's like to be an equine vet—rumors, stigmas, etc., such as low pay, long hours." She says the program demonstrates different ways equine practices manage these difficult issues. Murray says this year will be the fifth OEPS, which is supported by businesses, clinics and veterinary hospitals. They guarantee stipends for travel and hotel accommodations for up to 15 students per vet school. In 2006 there were 470 students at OEPS. During OEPS, students get the chance to hear presentations about the rewards of equine practices, but, Murray says, they also make valuable contacts.

Many of the presenters run large equine clinics. And, the students develop friendships with peers who are facing the same issues. The contacts, friendships and relationships that coalesce during OEPS frequently turn into internships and job offers—even as they strengthen networks that might keep vet students focused on equine practices instead of drifting toward other specialties.

The OEPS program offers something else that practicing veterinarians have identified as a critical gap in the vet school curriculum: literal hands-on experience with large animals. That point was reinforced at a series of meetings held last year in Tennessee. The meetings brought state agencies, university faculties and other groups together to investigate ways to address the shortage of large animal vets in rural areas. Speaker after speaker noted that many vet schools no longer require agriculture courses for students. Dr. James Brace, of the University of Tennessee College of Veterinary Medicine, said that vet students need this practical, hands-on experience. "I think you can take horses and book learning, et cetera, and that only gets you so far. You really have to have the opportunity to get out there and experience, understand what a large animal practice or small, whatever it is you want to do, is about, in order to make informed decisions."

Dr. Jerry Gresham, of the University of Tennessee Agriculture Science Department agreed. "Let these young people have experiences. Provide resources where they can touch animals, where they can work with the animals. A lot of people think that the solution now is do everything by computers, simulate everything," he said. "Until those young people have been kicked and stepped on, they really don't know where they are going with this."

Any program intended to reverse the decline of large animal vets will need to contend with other factors besides economics and practical experience, though. Demographics are driving profound changes in America, and those changes permeate virtually every aspect of life. No institution, no profession, no community is immune to the demographic tides. So it is with veterinarians. The generation of large animal vets who developed mixed practices and served numerous farms are headed for retirement. There are not a lot of vets who are willing to take on those practices—practices that have lost substantial numbers of clients because of suburban sprawl, consolidation of farms and other changes that have radically altered the farm economy.

Near the end of the 20^th Century, more than 70 percent of veterinary students were females. In the 1960s, only five percent of veterinary students were females. According to the Employment Policy Foundation, the number of female veterinarians in the United States has more than doubled since 1991. In that same time period, the number of male veterinarians has dropped 15 percent. That shift has coincided with the enormous increase in demand for small animal veterinarians. More than 60 percent of households in the U.S. have at least one dog or cat. As the baby boom generation confronts retirement, pet ownership will continue to increase, creating more demand for vet services.

Combine the debt burdens of graduating veterinarians with the lucrative opportunities in small animal vet practices and you can see the potential problems emerging for states like Pennsylvania, where horse ownership is increasing. The demographic trends are harbingers of challenges for our country's agriculture industry as well. As the University of Pennsylvania's Kelly pointed out, veterinarians have historically been at the forefront in identifying and containing diseases that affect our nation's food supply. With the consolidation of farms, the reduction in the average value per farm animal and the consequent lack of routine veterinary care for farm animals, emerging diseases can move quickly, escaping detection.

Is there a doctor in the house? It's a question that stakeholders in our nation's agriculture industry—from consumers, to horse owners, to the growing casino industry, to farmers—need to ask before it's too late.