Production-Animal Veterinarian Shortage: A Rural Case Study of West Virginia

This study reports the results of studies conducted to explore solutions to the shortage of veterinarians to service production animal and rural service needs. Based on the results, various programs are recommended to be implemented and directed toward rectification of the national shortage of production-animal veterinary services and rural farm service large-animal veterinarians in the United States. These programs are enumerated, promoted and evaluated for Productivity, Difficulty of implementation and Overall Payoff in meeting the issue. Results based on experience and professional guidance from the communities of livestock owners and production-animal veterinarians indicate that the following programs should be prioritized nationally:  State sponsored tuition relief for veterinary students in return for a term of service to rural production-animal service following graduation.  Regional veterinary clinics augmented by state supported veterinary treatment vans.  Scholarships directed toward students expressing interest in large-animal veterinary medicine.  Modification of treatment and drug administration laws to allow a fuller function for veterinary technicians in the treatment of production animals in rural environments. The Issue: Shortage of Production-Animal Veterinary Services in Rural Areas Some statistics with regard to the availability of veterinarians to service rural communities are shocking. According to a USA Today report in 2008, approximately 500 counties in the USA have no veterinarian based in that county despite the fact that these counties also have over 5000 head of livestock residing in each county. 1 That report also indicated that around 1,300 counties in the USA had fewer than 1 veterinarian per 25,000 head. With approximately 2,500 new veterinarians graduating each year, this data is difficult to comprehend. Although the demand for Production-Animal Veterinarian Shortage: A Rural Case Study of West Virginia Vol. 5, Issue 7 (2010) 2 rural veterinarians has remained strong, the demand for pet or companion animal veterinarians has increased exponentially during the same period. Women now make up the majority, approximately 78%, of veterinary school enrollment. Women veterinary students seem less likely to enter large animal practice as compared to their male counterparts. 2 These issues are well recognized nationally. In some regions, the crisis is more severe. In order to ascertain the consequences of the declining status of production-animal veterinary support on the local level, a survey was performed to elicit experiences from local livestock breeders in a specific county. 3 This survey included beef, sheep, goat, hog, horse and dairy producers. The results of the survey showed a severe deficiency in the number of veterinary services currently available and identified a need for identifying mechanisms to resolve the problem of insufficient veterinary care in rural areas. Only 25% of the respondents to the survey were successful in obtaining emergency service for their livestock. Over 56% reported that they felt that they had lost an animal due to the unavailability of veterinary service in their area. Those producers having an established relationship with a veterinarian reported that the average driving distance for service was 58 miles. In rural West Virginia, this is equivalent to a fourhour round trip service call. This creates additional hardship for the producer because of the cost of millage (transportation and amortization on the service vehicle) and professional time. Producers expressed concerns that they would be faced with trip fees exceeding $250, resulting in a final bill of at least $500. In the case of production-animals, the gross economic value of the animal could be equivalent to that amount and the net economic return might be dramatically less. An alarming finding of the survey was that 84% of the livestock production facilities reported that they are now performing their own veterinary work on a routine basis because of their inability to obtain production-animal veterinary services on a regular basis. Of these farms, 31% reported that they have no access to any veterinary services for their livestock. 4 Although this survey was conducted in a single county in West Virginia, the results represent a rural livestock-producing area that is representative of this region of Appalachia. The results of this survey have relevance to the more than 5,000 counties in the USA that have some degree of crisis in veterinary services availability. Means of addressing the issue New and unique solutions to these problems must be developed. At the county level, long-term methods being explored in rural West Virginia include active recruiting of new veterinariangraduates through interviews, provision of housing, and assistance with business management and start-up. Short-term solutions include the creation of a directory of names and contact information for veterinarians willing and able to perform services to farm animals. At the state level in West Virginia, an awareness of the issues and several recommendations were reported to the State Veterinarian. Efforts were made to educate state authorities concerning the severity of the lack of large-animal veterinary services and the detrimental effect that this is The Online Journal of Rural Research and Policy Vol. 5, Issue 7 (2010) 3 having on farm productivity and the local community. One consequence of this situation is that too few veterinarians are available to perform regulatory activities such as health checks and interstate transfer papers for livestock. In addition, fewer accredited, licensed veterinarians are available to perform testing for TB, Brucellosis, Bluetongue, BVD, etc. Rural West Virginia is increasingly without large-animal veterinary service: many of the local veterinarians are nearing retirement or work for contract service agencies that do not perform routine services to livestock farmers. Extremely few veterinary services are available to the beef, goat, sheep, horse and other food and fiber animal farmers in the Preston County region. A confounding factor is that local small-animal veterinarians are increasingly unwilling or unable to provide farm services for routine or emergency veterinary care. Innovative solutions to the problems One producer-driven solution to the problem has been the organization of farms into “veterinarian days.” The community works together to organize days where a veterinarian can drive from some distance and work on 5 to 6 farms on a single day. This collaboration creates a profitable opportunity for the veterinarian and helps to make services affordable for the individual farms. Scholarships for students in the veterinary schools can increase student awareness of opportunities for employment or business start-up in under-served communities. As an example, the Joyce Colbert Veterinary Scholarship program was created, $22,000 was raised, and four scholarships given to students that indicate an interest in doing production-animal veterinary service in the future. State services need to be developed to help solve this crisis. Various outreach programs have been proposed including "veterinary examination vans," and "regional veterinary drive-by clinics" in West Virginia and Maryland. Livestock owners and other effected farmers must take an active role to identify solutions to this problem. Actions and proposals currently being done are summarized below:  The Agricultural Extension Service has conducted a survey of the veterinary needs and issues of local farmers. These results are being used to develop plans for implementation. A local Veterinary Resource Advisory Panel has been organized at the grass-roots level. This panel provides for a coordinated farm program to cooperatively import non-local veterinary services on an as needed basis. This panel has surveyed all regional veterinarians for support in providing production-animal services. Results of this survey have been discouraging regarding local farm support. The response of veterinarians has not been enthusiastic. Common themes from veterinarians in their survey feedback has been that: Production-Animal Veterinarian Shortage: A Rural Case Study of West Virginia Vol. 5, Issue 7 (2010) 4 (1) Their companion-animal practice is too busy to allow services to be extended to the rural production-animal community; (2) The financial benefit of production-animal practice is insufficient to meet the needs of animal hospital and companion-animal clinic personnel; (3) The working conditions in the farm environment are inadequate for professional service; and (4) A general lack of interest in the production-animal area of veterinary service.  The community has established the Dr. Joyce Colbert Veterinary Scholarship Fund under the management of the Tucker Community Foundation to encourage and support education in rural veterinary practice. The value of the fund stands currently at $22,000. The Foundation has awarded four $1,000 scholarships over the past two years to students for the study of veterinary medicine. The Foundation expects to award two more scholarships at a similar level in 2010.  The community initiated a program advertising the desirable characteristics of this region and directed it to students in the nation’s veterinary colleges. This program has resulted in interviews with two students enrolled in veterinary school. The program has been extended to include lectures and promotional programs to students in veterinary technician programs.  An advertisement indicating the availability of a rural production-animal practice in our area has been submitted to the Journal of the American Veterinary Medical Association for publication in the journal. The Veterinary Resource Advisory Panel is bearing the expense of the advertisement.  We are actively promoting veterinary sciences to our younger people through 4H and othe

 State sponsored tuition relief for veterinary students in return for a term of service to rural production-animal service following graduation. Regional veterinary clinics augmented by state supported veterinary treatment vans. Scholarships directed toward students expressing interest in large-animal veterinary medicine. Modification of treatment and drug administration laws to allow a fuller function for veterinary technicians in the treatment of production animals in rural environments.

The Issue: Shortage of Production-Animal Veterinary Services in Rural Areas
Some statistics with regard to the availability of veterinarians to service rural communities are shocking.According to a USA Today report in 2008, approximately 500 counties in the USA have no veterinarian based in that county despite the fact that these counties also have over 5000 head of livestock residing in each county. 1 That report also indicated that around 1,300 counties in the USA had fewer than 1 veterinarian per 25,000 head.With approximately 2,500 new veterinarians graduating each year, this data is difficult to comprehend.Although the demand for rural veterinarians has remained strong, the demand for pet or companion animal veterinarians has increased exponentially during the same period.Women now make up the majority, approximately 78%, of veterinary school enrollment.Women veterinary students seem less likely to enter large animal practice as compared to their male counterparts. 2ese issues are well recognized nationally.In some regions, the crisis is more severe.In order to ascertain the consequences of the declining status of production-animal veterinary support on the local level, a survey was performed to elicit experiences from local livestock breeders in a specific county. 3This survey included beef, sheep, goat, hog, horse and dairy producers.The results of the survey showed a severe deficiency in the number of veterinary services currently available and identified a need for identifying mechanisms to resolve the problem of insufficient veterinary care in rural areas.Only 25% of the respondents to the survey were successful in obtaining emergency service for their livestock.Over 56% reported that they felt that they had lost an animal due to the unavailability of veterinary service in their area.
Those producers having an established relationship with a veterinarian reported that the average driving distance for service was 58 miles.In rural West Virginia, this is equivalent to a fourhour round trip service call.This creates additional hardship for the producer because of the cost of millage (transportation and amortization on the service vehicle) and professional time.
Producers expressed concerns that they would be faced with trip fees exceeding $250, resulting in a final bill of at least $500.In the case of production-animals, the gross economic value of the animal could be equivalent to that amount and the net economic return might be dramatically less.
An alarming finding of the survey was that 84% of the livestock production facilities reported that they are now performing their own veterinary work on a routine basis because of their inability to obtain production-animal veterinary services on a regular basis.Of these farms, 31% reported that they have no access to any veterinary services for their livestock. 4though this survey was conducted in a single county in West Virginia, the results represent a rural livestock-producing area that is representative of this region of Appalachia.The results of this survey have relevance to the more than 5,000 counties in the USA that have some degree of crisis in veterinary services availability.

Means of addressing the issue
New and unique solutions to these problems must be developed.At the county level, long-term methods being explored in rural West Virginia include active recruiting of new veterinariangraduates through interviews, provision of housing, and assistance with business management and start-up.Short-term solutions include the creation of a directory of names and contact information for veterinarians willing and able to perform services to farm animals.
At the state level in West Virginia, an awareness of the issues and several recommendations were reported to the State Veterinarian.Efforts were made to educate state authorities concerning the severity of the lack of large-animal veterinary services and the detrimental effect that this is having on farm productivity and the local community.One consequence of this situation is that too few veterinarians are available to perform regulatory activities such as health checks and interstate transfer papers for livestock.In addition, fewer accredited, licensed veterinarians are available to perform testing for TB, Brucellosis, Bluetongue, BVD, etc.
Rural West Virginia is increasingly without large-animal veterinary service: many of the local veterinarians are nearing retirement or work for contract service agencies that do not perform routine services to livestock farmers.Extremely few veterinary services are available to the beef, goat, sheep, horse and other food and fiber animal farmers in the Preston County region.A confounding factor is that local small-animal veterinarians are increasingly unwilling or unable to provide farm services for routine or emergency veterinary care.

Innovative solutions to the problems
One producer-driven solution to the problem has been the organization of farms into "veterinarian days."The community works together to organize days where a veterinarian can drive from some distance and work on 5 to 6 farms on a single day.This collaboration creates a profitable opportunity for the veterinarian and helps to make services affordable for the individual farms.
Scholarships for students in the veterinary schools can increase student awareness of opportunities for employment or business start-up in under-served communities.As an example, the Joyce Colbert Veterinary Scholarship program was created, $22,000 was raised, and four scholarships given to students that indicate an interest in doing production-animal veterinary service in the future.
State services need to be developed to help solve this crisis.Various outreach programs have been proposed including "veterinary examination vans," and "regional veterinary drive-by clinics" in West Virginia and Maryland.
Livestock owners and other effected farmers must take an active role to identify solutions to this problem.Actions and proposals currently being done are summarized below:  The Agricultural Extension Service has conducted a survey of the veterinary needs and issues of local farmers.These results are being used to develop plans for implementation.
A local Veterinary Resource Advisory Panel has been organized at the grass-roots level.This panel provides for a coordinated farm program to cooperatively import non-local veterinary services on an as needed basis.This panel has surveyed all regional veterinarians for support in providing production-animal services.Results of this survey have been discouraging regarding local farm support.The response of veterinarians has not been enthusiastic.Common themes from veterinarians in their survey feedback has been that: (1) Their companion-animal practice is too busy to allow services to be extended to the rural production-animal community; (2) The financial benefit of production-animal practice is insufficient to meet the needs of animal hospital and companion-animal clinic personnel; (3) The working conditions in the farm environment are inadequate for professional service; and (4) A general lack of interest in the production-animal area of veterinary service.
 The community has established the Dr. Joyce Colbert Veterinary Scholarship Fund under the management of the Tucker Community Foundation to encourage and support education in rural veterinary practice.The value of the fund stands currently at $22,000.
The Foundation has awarded four $1,000 scholarships over the past two years to students for the study of veterinary medicine.The Foundation expects to award two more scholarships at a similar level in 2010.
 The community initiated a program advertising the desirable characteristics of this region and directed it to students in the nation's veterinary colleges.This program has resulted in interviews with two students enrolled in veterinary school.The program has been extended to include lectures and promotional programs to students in veterinary technician programs.
 An advertisement indicating the availability of a rural production-animal practice in our area has been submitted to the Journal of the American Veterinary Medical Association for publication in the journal.The Veterinary Resource Advisory Panel is bearing the expense of the advertisement.
 We are actively promoting veterinary sciences to our younger people through 4H and other organizations in the hope that the future may see more local rural veterinarians.We are encouraging the education of local students at accredited veterinary technician online schools.

Future Programs for Implementation
 A proposal to provide rural veterinary support services on a national level.The problem that we are facing in West Virginia is severe, but is also endemic across this nation.
 A proposal for legislative consideration to increase the legal activities and capabilities of veterinary technicians similar to those used by Nurse Practitioners and Physician Associates.
 Development of a Mobile Veterinary Service, possibly as a state extension service, that would provide emergency veterinary care to farmers in areas where commercial veterinary services are unavailable.
 Development of a regional large-animal veterinary clinic appropriately designed to meet the health and sanitation needs of the state and staffed by veterinarians on an on-call or as-needed basis.
 Develop a tuition relief program in West Virginia that would provide tuition forgiveness for veterinarians that agreed to work in the state for a period of time.This would supplement current federal debt forgiveness programs.
 Encourage the State Department of Agriculture and the state Farm Bureau to form a cooperative program of recognition for veterinarians that meet the needs of the largeanimal and food and fiber animal producers in West Virginia.
 Continue to promote a two-tier veterinary price structure for consideration by smallanimal veterinarians that would provide cost relief for treatment of farm-necessary smallanimals such as guard dogs, barn cats, rabbits, poultry and other farm-necessary animals and products.This could be accomplished by state or federal subsidies or tax benefits.

Future directions and mechanisms for dynamics feedback
Subsequent to presentation of the needs for production-animal veterinary service in our area to the West Virginia State Veterinarian and to the US Department of Agriculture, Preston County, WV, was approved for a Federal Tuition Repayment Grant that will compensate a veterinarian up to $25,000 in tuition repayment per year for five years if the approved applicant practices production-animal veterinary service in the region centered around Aurora, WV, in southern Preston County.At this writing, the student applications are being reviewed by USDA.