3

Equine Veterinary Medicine

THE EQUINE INDUSTRY

In 2005, the United States had an equine population of over 9.2 million horses (AHC, 2005), the largest horse population in the world. With the recession that began in 2007, the number of horses has probably declined but no recent estimates of total horse numbers are available. The equine industry underwent a similar decline in the recession of the mid-1980s only to rebound and grow in the 1990s. There is an ongoing effort by the industry to expand horse ownership among former horse owners and also to attract new owners. If that initiative is successful it will have a positive impact on equine veterinary medicine. Horses are used for racing, showing, competition, sport, breeding, recreation, and work (AHC, 2005; see Table 3-1). With the exception of the racing industry, the number of horses in all of these activities has increased in the past two decades as a result of the availability of greater disposable income in the general public and the desire for new recreational pursuits. The increase has been driven more by riders acquiring additional horses than by an increase in numbers of individual owners.

TABLE 3-1 Horse Population by Activity

Activity Population
Racing (Thoroughbred and Standard bred) 844,531
 
Showing (show jumping, dressage, reining, performance horses) 2,718,954
 
Recreation (trail riding) 3,906,923
 
Other (includes draft, ranch, rodeo, police, and carriage horses) 1,752,439
 
Total 9,222,847

DATA SOURCE: AHC, 2005.



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3 Equine Veterinary Medicine THE EQUINE INDUSTRY In 2005, the United States had an equine population of over 9.2 million horses (AHC, 2005), the largest horse population in the world. With the reces- sion that began in 2007, the number of horses has probably declined but no re- cent estimates of total horse numbers are available. The equine industry under- went a similar decline in the recession of the mid-1980s only to rebound and grow in the 1990s. There is an ongoing effort by the industry to expand horse ownership among former horse owners and also to attract new owners. If that initiative is successful it will have a positive impact on equine veterinary medi- cine. Horses are used for racing, showing, competition, sport, breeding, recrea- tion, and work (AHC, 2005; see Table 3-1). With the exception of the racing industry, the number of horses in all of these activities has increased in the past two decades as a result of the availability of greater disposable income in the general public and the desire for new recreational pursuits. The increase has been driven more by riders acquiring additional horses than by an increase in numbers of individual owners. TABLE 3-1 Horse Population by Activity Activity Population Racing (Thoroughbred and Standard bred) 844,531 Showing (show jumping, dressage, reining, performance horses) 2,718,954 Recreation (trail riding) 3,906,923 Other (includes draft, ranch, rodeo, police, and carriage horses) 1,752,439 Total 9,222,847 DATA SOURCE: AHC, 2005. 46

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Equine Veterinary Medicine 47 Nearly 4.6 million Americans are involved in the equine industry as horse owners, service providers, employees, and volunteers. There are 2 million horse owners and 70 percent of them live in communities with 50,000 or fewer people (AHC, 2005). The industry is estimated to directly provide 460,000 full-time equivalent (FTE) jobs. In addition to creating jobs, horse farms and training cen- ters maintain open space in peri-urban communities. The American Quarter Horse is the most popular and most numerous breed in the United States and is used for racing, western riding events, and pleasure riding. Figure 3-1 records the number of American Quarter Horse Association registrations from 1995 to 2008. The 10.5% increase in registrations in those 13 years reflects the general increased interest in equine activities and increased available disposable income. The 17.6% decline in registration from 2007 to April 2009 (Duff, 2009)—compared to 2006 peak numbers—parallels the eco- nomic decline in home prices during that same period (S&P Indices, 2011), with accompanying cutbacks in discretionary spending reflecting the sensitivity of the equine industry to prevailing economic conditions. Maintaining horses is expensive. In 2005, the average annual cost of maintaining a horse was estimated at $2,882, a figure that has increased at least 20% since then (Tomseth, 2008). Approximately 46% of horse owners are in households with incomes between $25,000 and $75,000, and 34% are in house- holds with incomes of less than $50,000 (Tomseth, 2008). A major concern for horse lovers and the general public is the issue of unwanted horses. A 2007 survey of horse owners reported that sales of unwant- ed horses had doubled compared to the previous year, indicating the economic downturn as one of the primary reasons (UHC/AHC, 2009). The number of abandoned horses also has increased while many owners have surrendered 3.0 2.9 Registrations (in millions) 2.8 2.7 2.6 2.5 2.4 2.3 Year FIGURE 3-1 American Quarter Horse Association registrations, 1995-2008. DATA SOURCE: American Quarter Horse Association annual reports.

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48 Workforce Needs in Veterinary Medicine their animals to overcrowded rescue organizations (Tomseth, 2008). The prob- lem of unwanted horses has been exacerbated by the closure of horse slaughter facilities in the United States in 2006, when funding for federal inspection was eliminated by Congress. An unintended consequence of the legislation is that roughly the same number of horses previously slaughtered in the United States annually (about 138,000) are now shipped long distances to slaughter facilities in Mexico or Canada, raising animal welfare concerns about the effects of han- dling and transportation on the animals (GAO, 2011). In late 2011, Congress reversed its funding decision, although no facilities have yet reopened. An alter- native to sending unwanted horses to slaughter is euthanasia. However, in 2007, the average cost of euthanasia and carcass disposal was $385 (UHC/AHC, 2009). Thoroughbred racing has traditionally been the premier equine sport in the nation. The industry has declined over the past decade (see Figure 3-2) as a re- sult of waning family interest in horse racing, public aversion to the rare occa- sion of seeing an injured horse destroyed on the track, and competition from other forms of entertainment and gambling. Slot machines have been licensed at racetracks in several states, such as Delaware, Florida, New York, and Pennsyl- vania, and a proportion of the revenues are returned to horsemen where it has increased purses and renewed interest in both Thoroughbred and Standardbred racing. Without revenues from slots, racetracks in these states face a difficult future. This is most acute in states where slot machines have not been licensed at racetracks, including California, Maryland, and New Jersey where several prom- inent racetracks have either closed or face an uncertain future. The racing industry’s decline has resulted in a 35% decrease in Thorough- bred stallions at stud and a 14% decrease in Thoroughbred mares bred (see Fig- ures 3-3 and 3-4). This decline has impacted breeding centers, including those in Kentucky, and the current recession has only exaggerated the ongoing slump. For example, gross receipts were reportedly down 41.5% at the September 2009 yearling sales at Keeneland, the largest reported decline (Felsted, 2009). EQUINE VETERINARIANS Equine veterinarians provide vital services to the large equine industry by caring for the health and welfare of horses. Equine veterinary medicine is more sensitive to fluctuations in the nation’s economy than most areas of the veteri- nary medical profession because the demand for services are strongly linked to the racing industry, an industry that was already in decline prior to the current recession; the recession merely reduced the demand for veterinary services fur- ther (Felsted, 2009). In states where racing purses are generous, owners and trainers can afford to seek the best veterinary care available; conversely, in states where purses are restricted, owners are generally unable to afford the most sophisticated care and quality is less exacting.

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Equine Veterinary Medicine 49 Number of races Year FIGURE 3-2 Number of Thoroughbred races in the United States and Canada/Puerto Rico, 1999-2009. SOURCE: The Jockey Club, 2010. FIGURE 3-3 Registered Thoroughbred stallions, 2000-008. SOURCE: The Jockey Club, 2010. FIGURE 3-4 Thoroughbred mares bred, 2000-2008. SOURCE: The Jockey Club, 2010.

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50 Workforce Needs in Veterinary Medicine In contrast to the thoroughbred industry, values of performance horses, dressage, show jumping, barrel racing, and endurance event animals have risen significantly in the past twenty years, and owners now expect standards of care comparable to that historically provided to the best Thoroughbreds. In response, regional equine centers have developed to provide advanced care to sick and injured sports horses, and veterinary paraprofessionals are increasingly needed to provide all-hours care in these centers. Because of the unique demands placed on horses in different sports, each activity is associated with distinctive health problems and many equine veterinarians are specialized to serve one or more of these specific constituencies. The weak economy in the racing industry has also encouraged many racetrack veterinarians to provide care for sports horses be- tween race meets. Recreational horses generally receive care from veterinarians in mixed- animal practice. In rural areas, that care is likely to come from veterinarians in mixed food-animal/equine practice; in peri-urban areas, from mixed companion- animal/equine practitioners. Data from the American Association of Equine Practitioners (AAEP) shows that 874 practitioners (11% of the total AAEP membership in 2008) were in companion-animal/equine practice (AAEP, 2008). The number of such practices has grown in peri-urban areas with the increasing popularity of pleasure riding, availability of riding trails, and urban sprawl into rural areas. Equine veterinary medicine has experienced a period of prosperity and ex- pansion for the past two decades, but the prevailing economic conditions in the last few years has forced the profession to adjust to new and more challenging economic circumstances. Conditions differ from state to state, and there is lim- ited data on the severity of cutbacks in different parts of the industry. Anecdotal evidence, however, suggests that practices involved with performance horses, equine reproduction, and racetracks are among the hardest hit (Osburn, 2009; Clark, 2009). Practices that are heavily dependent upon pleasure horse work are also experiencing difficulty as a result of declining personal incomes that force cuts in discretionary, horse-related spending (Osborn, 2009). The Size of the Workforce in Equine Veterinary Medicine For 2009, the American Veterinary Medical Association (AVMA) member- ship included 3,204 equine exclusive practitioners (100% commitment to equine practice), and 794 equine predominant practitioners (80% commitment to equine practice) (AVMA, 2010b). Many more mixed-animal practitioners serve the equine industry with a smaller percentage of their time but their numbers are not recorded by the AVMA. The AAEP is the largest veterinary equine organization in the world. As of March 2011, its membership consisted of 7,766 veterinarians and 1,697 veteri- nary students from the United States, Canada, and 64 other countries (AAEP, 2011), a small decline from 2010 (AAEP, 2010). Approximately 83% of the

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Equine Veterinary Medicine 51 veterinarian members of the AAEP work in the United States. California, Texas, and Florida are the top three states represented in the AAEP membership (AAEP, 2011). AAEP membership had been growing for several recent years due to an ac- tive recruitment program both for new graduates and for mixed animal practi- tioners (Opportunities in Equine Practice Seminar, co-sponsored by AAEP) ini- tiated by a group of equine practitioners concerned by the diminishing number of graduates entering equine practice. The objective of the recruitment program was “to promote equine practice as [a] viable and rewarding career option” (OEPS, 2006). The number of new members joining AAEP, which had been constant from 1983 to 1997, increased from 1998 to 2008 (see Figure 3-5). About two-thirds of AAEP members spend over 75% of their time involved with the equine industry, and the remaining one-third devote varying amounts of time to non-equine, mixed animal practice (see Table 3-2). A majority of practi- tioners (29%) work on performance horses, 28% focus on pleasure and farm horses, 13.2% devote their practice to racing, and 12.8% work in reproduction (AAEP, 2011). FIGURE 3-5 Years in which current American Association of Equine Practitioners members joined the Association. SOURCE: Data provided by AAEP. TABLE 3-2 Equine Practices Devoted to Horses Percentage of Practice Devoted to Horses Percentage of AAEP membership 100 44.9 75-99 21.0 50-74 8.4 25-49 9.1 1-24 12.2 Not reported 4.4 SOURCE: AAEP, 2011.

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52 Workforce Needs in Veterinary Medicine Membership Attrition Anecdotal evidence from practitioners suggests that a high percentage of new graduates leave equine practice within 5 to 10 years, and the AAEP has reported that more than half of all equine practices have a hard time retaining employees (AAEP, 2008). In 2007, 37.5% of those who graduated within the previous 4 years did not renew AAEP membership, and 19% of those who had graduated within 5 to 9 years failed to renew AAEP membership (see Table 3-3). The latter group noted the least job satisfaction, with only 28% reporting a high level of job satisfaction (AAEP, 2008). After 9 years, attrition rates de- clined significantly, and most equine practitioners renewed their AAEP mem- bership. The highest attrition rates occur among those with the lowest commit- ment to equine practice. In 2007, 22% of practitioners with less than 25% commitment to equine work did not renew their AAEP membership. These are presumably mixed-animal practitioners who shifted their focus of interest. Rea- sons for the high attrition rates include long hours, too much emergency work, and limited time for personal life (AAEP, 2008). Nearly 85% of equine veterinarians were either very satisfied or somewhat satisfied with their job (AAEP, 2008). However, there were age-related differ- ences in relation to job satisfaction: only 29% of practitioners under 30 years old reported they were “very satisfied,” whereas 64% of practitioners over 60 years old were “very satisfied” (AAEP, 2008). Job satisfaction was strongly correlated with income levels, as is the likelihood of encouraging others to enter equine practice. Young equine practitioners are aware that their classmates in small animal practice have higher starting salaries, better work hours, and experience less stress, risk of injury, and emergency work. Practices with multiple practitioners, which are more commonly found in companion-animal practices, provide practi- tioners with shorter hours and greater flexibility for personal leave: Companion- animal practitioners averaged 42 hours per week with 4 hours of emergency TABLE 3-3 American Association of Equine Practitioners Membership Attrition Rates by Years in Practice 2007 percentage 2006 percentage 2005 percentage Number of years Percentage of all not renewing not renewing not renewing post graduation members in 2007 membership membership membership 4 years or less 18.5 37.5 36 32.1 5- 9 years 15 19.9 19.7 20.7 10-14 12.3 11.2 12.1 11.4 15-19 12.1 10.1 8.4 11.1 20-24 12.1 7.1 7.6 8.6 25 or more 0 14.2 16.3 16 SOURCE: AAEP, 2008.

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Equine Veterinary Medicine 53 duties, whereas equine practitioners averaged 51 hours per week with 8 hours of emergency work (AAEP, 2008). Companion-animal practices limit off hour calls at their emergency clinics, increasing the attractiveness of the lifestyle that the small animal practice affords. On the other hand, with few exceptions, emer- gency clinics have not developed in equine practice and it is questionable whether they will develop because of client expectations: clients develop per- sonal relationships with their equine practitioner and are generally reluctant to accept substitutes. Consequently, equine practitioners spend a great deal of time on call, which presents a special challenge for practitioners with family respon- sibilities. AAEP membership has been predominately male since its inception in 1954, but that is changing. Now AAEP membership is composed of 56% men and 44% women (AAEP, 2011). The number of women involved in equine prac- tice is likely to outnumber men in the next several years, as indicated by a 5:1 female-to-male ratio among current AAEP student members and in the under-30 years-old category. EQUINE PRACTICE AND EARNINGS The mean starting salary for all types of veterinary practice was $46,971, down 3.5% from 2010 (Shepherd and Pikel, 2011). By comparison, the mean starting salary in equine practice was $43,405. The mean educational debt car- ried by graduates in 2011 was approximately $142,613, a 6.5% increase over the previous year (Shepherd and Pikel, 2011). This suggests annual debt payment in excess of $10,000. With the starting pay offered in equine practice, a new grad- uate with a family would have few earnings on which to live. One third of grad- uates entering equine practice in 2009 had debt equivalent to four times their starting salary. Thus it is difficult to see how new graduates can make ends meet let alone considering practice ownership, without a supplementary source of income. It takes time for young equine clinicians to gain the trust and respect of per- ceptive horse owners, especially in the racing and performance horse industries. As a consequence, senior equine practitioners who have gained the trust of own- ers are well remunerated and earn among the best salaries in veterinary medi- cine. A 2007 survey of total personal income among AAEP members revealed that respondents 50 to 59 years of age commanded average salaries of $155,740 while those over 60 averaged $160,240 (AAEP, 2008). At $190,000, practition- ers who focused on the racing industry have traditionally earned the highest sal- aries, and most practitioners in this category were men. Those working with increasingly valuable performance horses now vie with racetrack veterinarians for the best salaries. However, practitioners under the age of 30 are mainly women, and earn an average of $48,280 per year because of their junior status (AAEP, 2008). For those graduating in 2009 with the misfortune of entering the workforce during a

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54 Workforce Needs in Veterinary Medicine recession, the initial earning losses can be expected to eventually fade away af- ter 8 to 10 years, according to an optimistic study on short- and long-term career effects of graduating in a recession (Oreopoulos et al., 2006). In the mean time, educational debts have to be serviced. FUTURE WORKFORCE NEEDS Though no definitive data is available on whether there is a shortage of eq- uine veterinarians, there was, prior to the recession, a perception of such a short- age among equine practitioners (Green, 2008). In the 2007 AAEP Lifestyles and Salary Survey, 68% of respondents reported that their practice had difficulty recruiting new staff, and 39% reported a shortage of practitioners in their area (AAEP, 2008). One estimate of future workforce needs in equine medicine would be to consider the rate at which the current pool of AAEP-member veterinarians in the United States who spend more than 75% of time in equine practice (approxi- mately 4,254) would need to be replaced over time, assuming that an average working career is projected to last 35 years. To determine the number of new graduates needed annually to replace those who retire, the total current work- force (4,254) is divided by the projected career span (35 years). The result is that an estimated 122 new equine veterinarians are needed each year to maintain the size of the current workforce. According to AVMA annual surveys of new grad- uates, a much smaller number of new veterinarians are taking jobs in equine practice, ranging from a high of 66 in 2006 to 37 in 2011 (AVMA, 2011b). The recession that began in 2007 has reduced demand for equine veterinary services and has changed workforce needs in equine veterinary medicine, but to what extent it has done so is still largely unknown. One way to measure the re- cession’s impact is by monitoring the decline in the number of new positions advertised through the AAEP. As of June 2009, AAEP online job postings had fallen by 25% compared to previous years, and had stabilized at this reduced level over the next months. During the same period, overall traffic at the AAEP Career Center had also decreased by 25%. An Aging Workforce Equine veterinarians are aging as a group, with the average age of equine practitioners increasing from 44 to 46 years between 2001 and 2007 (AAEP, 2008). In 2001, 70% of AVMA members who identified themselves as equine practitioners were younger than 50 years old, and by 2009, the proportion had fallen to 60%. Based on a continuation of those trends, AVMA has projected that by 2013 only about 50% of its members who are equine practitioners will be under the age of 50. Inter-related forces appear to influence the advancing age of equine practi- tioners. First, there is an inadequate number of new graduates willing to make

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Equine Veterinary Medicine 55 long-term commitments to equine practice (see Table 3-3), a situation likely to exacerbated by increasing levels of student debt that put practice ownership out of reach. Second, senior equine veterinarians are unable to sell their practices and are therefore continuing beyond their originally planned retirement age. Thus, the aging of equine practitioners as a group appears to be a direct result of the inadequate number of young veterinary practitioners entering the equine workforce to replace those leaving and retiring. Equine medicine is aging and in need of new talent. Presently the racing in- dustry is experiencing difficulties whereas show jumping, dressage, barrel rac- ing events, pleasure riding and other equine sports remain energetic. Horses in all these categories need veterinary care. However, given the present conditions of practice and financial circumstances, it is difficult to attract and retain ade- quate numbers of young graduates in the profession. In order to address future workforce needs, the equine veterinary medical profession will need to consider the challenges related to low starting salaries, a shift in gender, and an aging workforce. Of particular concern is the difficulty of delivering equine care in rural areas, where the population of mixed equine/food-animal practitioners who have traditionally provided services to most of these animals is now declining. As is discussed in Chapter 4, Food-Animal Practice, this is likely to require new ways of delivering equine veterinary services and may provide the needed impe- tus for the creation of emergency equine services. It is unknown how long the equine industry and equine veterinary medicine will take to recover from the recession. Economic forecasts predict that consum- er spending will remain thrifty for the next several years (CBO, 2010). Under these circumstances, planning for future workforce needs in equine medicine will need to be conservative. In the foreseeable future, a majority of new gradu- ates entering equine practice will be women, who may be likely to seek accom- modations to fulfill family responsibilities while being no less committed to succeeding in practice. Large group practices, regional equine centers, involve- ment of paraprofessionals, and part-time work can accommodate the sharing of clinical duties and provide coverage for family emergencies, maternity leave, and elder care. In emergency situations, many clients insist on seeing the veterinarian with whom they have established a trusted relationship; therefore, practitioners gen- erally have to be available to their clients on a 24-hour basis. Unless they are part of a multi-person practice where clinical responsibilities can be shared, vet- erinarians have few alternatives but to work around this obligation. Well-trained paraprofessionals who are capable of follow-up visits after surgeries and other procedures may provide partial relief. It might be advisable that before entering equine medicine, veterinary students undertake externships in equine practice to be fully aware of its stresses and rewards. Academic centers need to find the resources to maintain state-of-the-art facilities and sufficient faculty to educate the next generation of equine clinicians and for research to energize outstanding teaching and create the future of equine medicine. High-quality specialty prac- tices developed through university-private sector collaborations may offer ex-

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56 Workforce Needs in Veterinary Medicine ceptional resources of both infrastructure and highly trained specialists. The instruction of veterinary students and residents in equine medicine and surgery would be best accomplished in clinics situated in areas that have adequate popu- lations of horses to ensure the large caseload needed for strong teaching and clinical-research programs. Support from the USDA and from state legislatures is evaporating as the horse is generally not viewed as an agricultural animal, yet the equine industry is large, generates significant revenues, helps to maintain open space, and provides nearly half a million jobs annually. Support for research on equine health is equally problematic but critically needed for improved animal well-being and improved cures from diseases such as equine laminitis. Voluntary contributions from the public and from the equine industry may be the only way this unmet need can be addressed.