Providing Veterinary Services to Rural America
In the last 25 years, many farms that produced food animals have gone out of business which resulted in food-animal practitioners being unable to survive. This difficulty is not new; in 1982, a National Research Council committee report Specialized Veterinary Manpower Needs Through 1990 (NRC, 1982) noted that “the problem is in large part a matter of the economics of food-animal veterinary practice, [and] areas with perceived shortages commonly do not provide satisfactory remuneration.” The report raises a question that is as salient today as it was in 1982: Are there unmet needs for food-animal veterinarians in rural America because of economic circumstances, or are there real shortages with adequate compensation but inadequate numbers of food-animal veterinarians? (NRC, 1982).
The changing circumstances of food-animal veterinarians in rural America should not be viewed in isolation but in the broad context of the changing demographics of small-town America and the impact of concentrated-feeding operations on these societies. These once flourishing rural communities are described as suffering from “a slow acting wasting disease” being transformed by the flight of so many young people (Carr and Kefalas, 2009a, b; see also Artz, 2003; Romer and Wolverton, 2010). Appendix C, Figure C-2 illustrates changes in population in the United States between 1990 and 2000. Carr and Kefalas (2009a) describe local ownership as suffocated by the rise of CAFOs and large box-stores with the result that the rural middle-class of merchants, bankers, and professionals has left. Moreover, as farming operations increase in size, the American-born workforce is progressively replaced by migrant labor (WisconsinWatch.org, 11/21/11). Carr and Kefalas (2009b) further report that 42% of Mid-western farmers now earn less than $20,000 per year making it difficult for them to afford professional veterinary services and highlighting the need for a different system of food-animal care.
To attract more students into rural practice, several state legislatures have passed or are considering legislation to provide educational-loan forgiveness to graduates who move into rural and underserved areas. The federal Veterinary Medicine Loan Repayment Program has also made awards to veterinarians willing to practice for at least three years in areas designated by the Secretary of Agriculture as having shortages in food-animal or public practice veterinarians. The average award size (to cover federal and commercial loans taken to attend an AVMA-accredited college of veterinary medicine) was $96,582 (USDANIFA, 2010). In the present economic climate, those initiatives are important as they will immediately help debt-burdened graduates to accept positions in underserved areas of America. In the longer-term however, additional solutions are needed as half of the graduates entering food-animal practice are reported to leave within 5 years (Remsberg et al., 2007; Jelinski et al., 2009).
To change these demographics, the veterinary profession has to make a concerted effort to recruit and retain more students in food-animal veterinary medicine. In the past, most students who went into food-animal practice have