The Cost of Going to the Country

Graduating heavily in debt, many veterinary students are turning to a small animal practice to reap the financial rewards.

By Kristen Tribe

You’re a college graduate, itching to make your mark and determined to make the world a better place. But you’ve got $55,000 in school debts staring you in the face, not to mention a family to provide for and consider.

You have two choices.

One, pursue a position putting your newly acquired skills to use, making only about $26,000 to $28,000 a year in a rural community. Or two, pursue a very similar position, also using your newly acquired skills, making $35,000 to $42,000 a year in an urban setting.

It’s not hard to do the math. Decision made.

The above example describes what veterinary school graduates face at the completion of their course work – enormous debt and the choice to pursue the more lucrative small animal practice or the lesser paying large animal practice.

Although 30 percent to 40 percent of a 128-member class enter Texas A&M University’s College of Veterinary Medicine with an interest in large animals, only 20 percent to 30 percent of the students pursue a large animal practice after graduation, says Dean Richard Adams. "Large animal" is defined by the university as an exclusive food animal practice, exclusive equine practice or a mixed animal practice of approximately 50 percent large animals and 50 percent companion animals.

"These kids now are facing so much debt, they have to go where the money is and I can't blame them. The cost of procedures we do on large animals has increased, but not at the pace of what procedures for small animals have increased," says Dr. Cary Bielamowicz of Groesbeck, Texas.

But there probably won’t be any significant fee increases anytime soon. Rural veterinarians find themselves facing a client base plagued by poor market conditions the past several years. Many producers have been forced out of the cattle business, and those that are left have a hard time justifying the cost of veterinary procedures for animals that may barely be worth the vet bill.

"The economy has just moved forward and left agriculture standing. The cattle producer today can’t afford to hire me to drive 30 miles out in the country, spend an hour-and-a-half pulling a calf and then drive back," says Dr. Cliff Skiles of Hereford, Texas. "If I charge him what it costs me to break even on that deal, he might as well just give that cow away."

But without a change in the fee structure to make large animal practice an economically appealing choice for young veterinarians, where does that leave an aging population of large animal practitioners and the clients they serve in rural Texas?

Many older veterinarians, with their retirement invested in their practices, are unable to sell out because most students are so far in debt following graduation, they can’t qualify for a loan.

"We'll have an opening that will be difficult to fill," says Dr. Gary Warner of Elgin, Texas. "The biggest challenge is being able to provide a quality service to our clients based on the economic value of the animal."

"Quality service" has been something that many veterinarians have had to redefine to be able to pay their own bills and meet the needs of a changing clientele.

"When I first got out of school in 1985, we did a lot of ambulatory work, a lot of fire engine medicine," says Bielamowicz. "Where I made the money a certain way with farm calls and things like that in the past, I've had to switch and concentrate here at the clinic toward advising and consultation."

Bielamowicz says quality service means making money for his clients, and by making fewer field calls, it lowers his overall costs and reduces the cost passed on to the producer. He also reduced field calls because "[they] are still fairly vet short in the area, and [he] just can’t cover all the bases.

"We just have to do what we have to do, in order to service as many clients as possible, and I just couldn’t do that by staying on the road like I used to," he explains.

Bielamowicz says producers are now more educated and have a better understanding of the diseases, and many producers already do some procedures themselves. He thinks this will become even more common, and necessary, in the future. Although many veterinarians may hesitate to train their clients to do some procedures, he says he’d rather train them to begin with and have them do it right.

Veterinary practices across the state are evolving into more of a consulting role, and Adams says more and more of A&M’s students are becoming "herd health/population dynamics consultants." Translated, that means some veterinarians are becoming consultants to large operations or feedlots that want a veterinarian to develop herd health plans, which are then implemented by the personnel under the veterinarian’s supervision.

Dr. David Bechtol of Canyon, Texas, has actually evolved into this role through his 35 years of practice. He started out as a general practitioner in 1965 and then specialized in food animals, which includes swine and feedlot cattle. But now he specializes strictly in cattle with a feedlot emphasis.

Besides serving as a consultant to the feedlot, he also works to educate smaller producers on preventative steps they can take so their calves will perform better in the feedyard and better meet market demands. Consulting veterinarians aren’t just for the big guys.

"Rather than their contact with a veterinarian being an emergency, producers need to participate in more preventative programs," he says. "If a producer doesn’t use a veterinarian routinely, he’s not getting the full benefit of what a prevention program can be."

Even though the shift to a consulting large animal practice seems to be the trend, Adams admits it’s tough to address the topic in the curriculum at A&M. He says students interested in large animal practice probably benefit most from a program established with the Texas Department of Criminal Justice. Students have the opportunity to treat and prepare herd health management plans for the prison’s livestock program, which includes 10,000 cows, 1,500 bulls and 1,200 horses.

"It’s a real dilemma. Even though we have 25 percent of our students going into large animal practice, that’s still only one out of four," he says. "We’ve got to meet the demands of the companion animal veterinarian and the biggest population of our state, which is companion animals in urban areas.

"But we are trying to find ways to enhance and attract students with an interest in large animal medicine," he continues. "Now, the statistics that I gave you earlier (percentages of students interested in large animal) indicates that our admissions criteria, and the way that our admissions committee evaluates students, is doing a pretty effective job of making sure that students interested in large animal medicine, in fact, are being accepted."

On the other hand, Warner says he would like to see more students admitted to the veterinary school that come from a rural background.

"There are applicants to veterinary school [from a rural background], that even considering the difference in income, would like to go back and work in a rural environment," he says. "I was a student from a rural background thrown into the mix of a large university with fellow colleagues who had masters degrees and PhDs. I came in with the bare minimum and I struggled the first year. But after that I was very successful, but we don’t seem able to get that point across."

Although no statistics are available on rural vs. urban students admitted, Adams says many students from a rural background tell them they want to become a veterinarian to move to a city.

"What we’re often finding when we talk to outstanding students from rural areas is that they’re sometimes being discouraged from going into large animal practice because of the difficulty of the work hours, the work conditions and the financial compensation," he says. "We need to get more people in rural areas, including veterinarians, to be encouraging the brightest and most capable to apply to veterinary school."

Warner says the local veterinarian where he grew up did actually discourage him from entering the field.

"There was a kid a year behind me that was dissuaded," Warner says. "He went on into human medicine, became a specialist and is very successful. But I was too hardheaded. And I have never forgotten that. I never try to dissuade young persons that think they want to go to veterinary school."

Whether students are from rural backgrounds or urban backgrounds, the bottom line still comes down to economics, but it seems that past attempts to address the issue haven’t been very successful.

"There is no ready, one, two, three solution," Adams says.

He says last year the state legislature passed the Rural Veterinarian’s Incentive Act, but it has not yet been funded. He says it’s unlikely they’ll get private funds for it, but if the legislature will fund it, this is how it will work:

"We would loan students the equivalent of tuition and educational fees each year while they’re in veterinary school," Adams explains. "Then in return, they would contractually commit to practicing in a rural area, meaning a county with less than 50,000 people, a year for every year they were given support in veterinary school.

"If they fulfill that commitment, the loan would be forgiven. If not, they would have to pay it back with interest," he says.

Warner, who is also chairman of the beef practice committee for Texas Veterinary Medical Association, says this is an issue TVMA has been concerned with for the past 10 to 15 years. Although they have passed resolutions in the past regarding this topic, they plan to address it more directly at their next committee meeting.

Adams suggests that rural communities recruit veterinarians and work to make it financially beneficial. Some regional groups might even want to consider an arrangement similar to the Rural Veterinarian’s Incentive Act. If there was a student in the community that was bright and was interested in large animal medicine, it might be worth sponsoring his or her education or providing partial scholarships, if the student made the commitment up front to return to your rural region to practice.

The beef industry has probably seen more advances the last few years than in all of recent history, and in turn, the field of veterinary medicine is suffering from growing pains. Progressive and innovative veterinarians have the opportunity to grow with a changing large animal practice and make it more profitable for themselves and more appealing to their future colleagues.

"To be successful takes a lot of hard work, but if you’re willing to work hard, you can be rewarded for that," says Warner. "The first thing we need to do to recruit kids back into large animal practice is to reflect a positive attitude to young people interested in veterinary medicine."