Food-animal veterinarians are entrusted with the safety and the security of the nation’s foods of animal origin. That responsibility is the first step in the continuum of supply-chain surveillance that safeguards the nation’s milk, meat, and eggs “from farm to fork”. Mastitis, E. coli O157:H7, salmonellosis, bovine tuberculosis, and brucellosis are some of the many diseases that threaten the safety of the food supply and are controlled on the farm by food-animal veterinarians working with food-animal producers. As the “eyes and ears” of the national animal health network, food-animal veterinarians also work to prevent and control foreign-animal disease outbreaks on the nation’s farm lands. The essential public health nature of those responsibilities has come into focus in recent years because of the expansion of global trade and the spread of infectious diseases, including newly emerging diseases, many of which are zoonotic, such as bovine spongiform encephalopathy (BSE), severe acute respiratory syndrome (SARS), highly pathogenic avian influenza (HPAI), and pandemic swine influenza (H1N1). In addition, the events of September 11, 2001 called attention to the potential vulnerabilities of agriculture to bioterrorism and the expanded roles that veterinarians must play in surveillance, early detection, and rapid response (DeHaven et al., 2006).
Foot-and-mouth disease (FMD) is arguably the greatest threat to the American food-animal economy. FMD has not come to the nation’s shores for over 80 years; the last outbreak of FMD in the United States was in 1929 (USDAAPHIS, 2007). Nevertheless, it is unrealistic to believe that FMD could never return or that other foreign animal diseases (FADs) are not a constant concern. One estimate of the economic impact of an FMD outbreak in California projected national agriculture losses of $2.3 to $69.0 billion as detection delay increased from 7 to 22 days, respectively (Carpenter et al., 2011). Assuming a detection delay of 21 days, it was estimated that every additional hour of delay would result in the slaughter of 2,000 animals and an hourly loss of $565 million.
The threats are not limited to FMD. A large-scale outbreak of HPAI could be catastrophic not only for human health but also for the poultry industries. With annual revenues of $40 billion, the U.S. poultry industries are the world’s largest producer and second largest exporter of poultry meat (USDA-NASS, 2009a). A single outbreak of HPAI would halt U.S. exports of poultry products and, based on experiences in Europe, could result in probable declines in domestic consumption (Knowles et al., 2007). Three previous cases of BSE in the United States led to a dramatic and continuing reduction in beef exports to Japanese and South Korean markets that cost the U.S. beef industry between $3 and $4 billion. Similar consequences could follow the diagnosis of a single case, of classic swine fever, exotic Newcastle disease, and other FADs. In today’s global marketplace where there is increased trade in agricultural commodities, the risks of any one of those diseases reaching the nation’s shores are also increasing. At best, lost global markets would recover very slowly. Moreover, the integrated nature of the U.S. financial system would send shock waves to linked industries and damage a broad sector of the U.S. economy.
Of equal importance is food safety, which is affected by farm hygiene. The U.S. Centers for Disease Control and Prevention (CDC) estimate the number of foodborne illnesses in the United States each year at 48 million, with 128,000 of those cases requiring hospitalization and resulting in over 3,000 deaths (Scallan et al., 2011). Many of these disease outbreaks are of animal origin (such as E. coli O157:H7 in ground beef and Salmonella in eggs) and many have resulted in massive food recalls (especially of eggs, spinach, and ground beef). The need for stronger producer-veterinarian relationships to address these issues is reinforced by the recent passage of the 2010 Food Safety Modernization Act, which expands the inspection power of the Food and Drug Administration (FDA) over farms and increases the need for improved hygiene on the farm.
Despite their vital importance, there is concern that the services of food-animal veterinarians are now in jeopardy as numerous reports conclude that there is a critical shortage of food-animal veterinarians in the United States (AVMA, 2006; Fiala, 2006; Gwinner et al., 2006; Prince et al., 2006a,b; Sterner, 2006).
Shortly after World War II, more than half of the American Veterinary Medical Association (AVMA) members were engaged in food-animal practice. In 2010, that proportion has declined to 13% translating into fewer than 11,000 practitioners caring for food-animal populations of 93 million cattle, 5.5 million sheep, 66 million hogs, 338 million laying hens, 248 million turkeys, and 8.5 billion broilers (USDA-NASS 2011 a, b, c; USDA-NASS 2012 a, b, c). AVMA demographic studies confirm that there are unmet needs across the country: there are 750 counties that each have more than 5,000 head of livestock, yet have no resident veterinarian (AVMA, 2006). In Appendix C, Figure C-1 shows a map of animal density in counties that lack a resident veterinarian. In total they are home to over 10 million food animals.
This chapter explores and describes the multiple forces that underpin the reasons for the change in the numbers of food-animal veterinarians, and changes
in the kind of veterinary medicine needed by food-animal producers. Among the concerns is the diminishing number of new graduates who are making a long-term commitment to food-animal practice. Inadequate mentoring and frequency of night and weekend emergency work are commonly given as the reasons for graduates’ not entering food-animal practice or leaving it after short periods. Other reasons are the inability of earnings to keep pace with the rapidly increasing costs of veterinary education and the need to repay educational loans. An additional reason for the lack of veterinary services in some areas is linked to rapid and fundamental changes in the social and economic structure of rural America, driven in large measure by changes in the U.S. livestock and poultry industries.
Since World War II, U.S. livestock and poultry production has evolved from a “small-town America” way of life to a competitive business enterprise that emphasizes entrepreneurship, management, efficiency, and earnings. Profit margins are thin, and small producers have difficulty in competing as they are being replaced by large, intensive systems of production in which higher returns can be realized when fixed costs (such as labor and capital investments) are spread over greater numbers of animals. Most poultry, feedlot beef, and pork production in the United States now takes place in concentrated animal feeding operations (CAFOs) in which management is driven by competition and the demands of supermarket chains for ever-lower food prices. But declining food prices come from declining animal values, and increasingly, the cost of primary animal care administered by a veterinarian is commonly viewed as too expensive relative to the value of the individual animal. In large operations, primary care is now usually administered by adroit lay staff (Jensen et al., 2009).
Figures in the 2009 U.S. Department of Agriculture (USDA) Census of Agriculture for the years 2002-2007 show a continuation in the trend toward an increase in very large (and small) farms and fewer middle-sized operations. However, although the overwhelming preponderance of foods of animal origin come from large operations, most U.S. farms are still small, and there is also a growing trend toward more small livestock operations, usually with more diversified and specialty products, fewer acres, and younger operators, many of whom also work off the farm (USDA-NASS, 2009a). They include organic farms and farms that rear small ruminants for meat and milk production. Development of these small operations is driven by a consumer movement to eat locally-produced foods coupled with concerns about the environment, animal welfare, and the quality and safety of foods produced in concentrated animal-feeding operations. Some believe those small operations present the greatest risk for introducing a food-animal disease into the United States.
Hence, food-animal practice needs for the future appear to be increasingly bisected. Animals in CAFOs and other large operations are likely to be under the supervision of highly specialized, production-medicine veterinarians who manage the health of animals as a group, focusing on “herd health.” Those veterinarians are most likely to be food-animal-exclusive practitioners, recognized by AVMA as those devoting 100% of their professional activity to the care of food-
animal populations, and who, because of the complexity of the work, usually limit their practice to a single species. Appendix C, Figure C-3 is a map of the distribution of food-animal-exclusive practitioners in the United States.
In contrast, animals on small farms may be under the care of mixed-food-animal practitioners, defined by AVMA as devoting over 50% of their professional activities to care and the balance to the care of other species. Services are usually focused on care of individual animals, pregnancy diagnosis, and emergency work. Most mixed-food-animal practitioners live close to populated areas because a substantial amount of their time is devoted to companion animals. Appendix C, Figure C-4 is a map of the distribution of mixed-food-animal practitioners in the United States. The consequence is that livestock farmers who live far from populated areas have difficulty obtaining veterinary care. One solution may be through the use of well-trained veterinary paraprofessionals working in a team with licensed veterinarians who may be at a distant site but are in constant communication with the paraprofessionals via smart phones.
Veterinarians in food-animal-predominant practice comprise the third category of AVMA-recognized food-animal practitioners. They devote 80% of their professional activities to food-animal care and the balance to the care of other species, including horses and companion animals, and are currently the largest group of veterinarians serving the food-animal industries. Over 40% of them practice in the grain states of the Midwest and in Texas, where with mixed-food-animal practitioners, they have been a critical part of the once prosperous infrastructure of small-town America. Since new graduates are not entering this type of practice anymore, food-animal-predominant veterinarians, as a group, are now composed of rapidly-aging members. As will be discussed, it is the imminence of this demographic shift that constitutes the most immediate challenge confronting food-animal veterinary medicine. Appendix C, Figure C-5 is a map of the distribution of food-animal-predominant practitioners in the United States.
Figure 4-1 presents the ratio of food-animal commodity prices to the price of corn (in 2006 dollars) from 2000 to 2012. Since 2006, increases in the price corn—a major component of animal feed and a significant portion of the cost of food-animal production—significantly outpaced the value of livestock products.
Figure 4-1 illustrates why consolidation, management, efficiency, and increased productivity per animal have become so essential for the survival of the livestock and poultry industries. However, because of decreasing animal values relative to the cost of inputs, farmers are unwilling or, more likely, unable to pay veterinarians to deliver primary veterinary care. As a result, revenues for supporting salaries and operating costs in food-animal practices have generally declined.
FIGURE 4-1 The value of livestock products relative to corn from 2000-2012. SOURCE: Schnepf, 2011. Calculations by CRS using data from USDA-NASS, July 31, 2011.
The Food Supply Veterinary Coalition (FSVC) (Andrus et al., 2006) was formed by leaders in the veterinary medical profession to analyze workforce needs and used an expert-judgment forecasting method (the Delphi method) to predict trends. FSVC panelists were not in agreement about workforce needs in any major food-animal sector except poultry; they did not agree on predicted manpower needs for dairy, beef, or swine practice. They did not see the need to increase the number of graduates in poultry medicine. They recognized that consolidation reduced demand for traditional veterinary services, but there was wide disagreement on the long-term effect on the profession. Some panelists saw opportunities for veterinarians to provide new, value-added services to large producers that would far outweigh losses due to consolidation; others expressed a concern that jobs for veterinarians would decrease.
The next section of the report examines more closely some of the trends in segments of industry and their implications for the veterinary workforce.
The Poultry Industries
The U.S. poultry industries were the first of the livestock sectors to consolidate and integrate. That occurred after World War II when the poultry industries originated the vertically integrated production model that is now the norm. The broiler industry introduced the model in the 1960s, and the turkey industry adopted the model in the 1970s. As will be discussed, the hog industry followed the trend beginning in the 1980s.
Poultry veterinarians play a vital role in flock health and management for the turkey, broiler, and egg-producing industries. The American College of Poultry Veterinarians (ACPV), the professional organization of certified poultry-health professionals in North America, has 315 members in the United States and Canada. ACPV was formed in 1991, and over 200 diplomates joined in the following 5 years. However, from 1995 to 2005, the college grew by approximately 9 new members annually. Members are dispersed in the poultry industries, their allied industries, federal and state diagnostic laboratories, and academe. The numbers are small in view of the U.S. industries’ productivity—8.9 billion broilers produced per year and more than 90 billion eggs obtained from 336 million laying hens. Layers are housed principally in the Northeast, Appalachia, and the Corn Belt regions, whereas broiler production is principally in the Southeast (see Appendix C Figures 6a and 6b [USDA-NASS, 2009a]).
Production of both broilers and eggs increased for many years but has recently leveled off because of the maturation of domestic markets. As a result, there is currently no serious shortage of poultry veterinarians in the United States (Glisson and Hofacre, 2006). The FSVC (Andrus et al., 2006) projected a 4.11% increase in the demand for poultry veterinarians between 2004 and 2016. The estimates of Glisson and Hofacre (2006) project three to five new job opportunities per year for veterinarians in live-poultry production, technical services, or diagnostic laboratories. Those estimates do not appear to include poultry veterinarians employed in research and the pharmaceutical industry, where they are involved in product development, including vaccine development, licensing, and provision of technical services to producers; poultry expertise is in demand in this sector of the pharmaceutical industry.
Poultry veterinarians in poultry-producing states commonly hold faculty positions in universities where they provide instruction, maintain poultry-research programs, and provide services in state diagnostic laboratories. Those in live-poultry production are employed primarily by integrator companies that contract with producers; there are few independent veterinary consultants in poultry medicine. To be eligible for positions with integrators, the overwhelming majority of poultry veterinarians undergo specialized post-DVM training in poultry husbandry, disease diagnosis, health management, environmental management, animal welfare, and food safety. There are few specialized training programs: five are active in U.S. veterinary schools, but only three currently report enrolled students.
Veterinarians employed in production facilities are responsible for implementing and managing programs to prevent disease in company flocks. Poultry veterinarians typically work in multiple locations, and each facility functions as a closed system. Health and biosecurity programs are developed in conjunction with production managers and flock supervisors, many of whom have undergraduate degrees in poultry husbandry (Glisson and Hofacre, 2006). To be effective in those positions, it is important for poultry veterinarians to have both first-hand knowledge of primary bird care and the skills in handling managerial issues.
Although the poultry industry employs comparatively few veterinarians, they are supported by an infrastructure of flock supervisors or their equivalent who assume major responsibilities for the everyday care of flocks and can augment surge capacity if emergencies arise. In recognition of the importance of their duties, flock supervisors are provided with opportunities for continuing education in health-care management and biosecurity policies by their corporate employers, by the poultry federation, or through industry-supported courses given by colleges of animal science and veterinary medicine. Broiler companies maintain a cadre of field technicians who are skilled in recognizing problems, conducting field necropsies, and collecting appropriate diagnostic specimens for laboratory submission. Turkey and layer companies provide similar support to their contract producers, and several states certify poultry technicians who are involved in regulatory affairs for the industry. The poultry industries have experienced repeated outbreaks of avian influenza, laryngotracheitis, and other infections and have a strong commitment to the continuing education of producers, flock supervisors, and poultry staff, in addition to their veterinarians. The programs provide a model for the livestock industries in general.
Public concerns about multiple-drug resistant organisms, waste disposal from large poultry operations, animal welfare, and food-safety regulations are increasingly important and occupy more and more of the poultry veterinarians’ time, taking them away from their immediate responsibilities for flock health. Those administrative tasks are likely to increase in the future and will add to the opportunities for poultry veterinarians to contribute to the industry.
Growth of the movement to use locally-produced food, including free-range and backyard flocks, is a concern for the poultry industry because it implies potential sites for foreign-animal diseases, including exotic Newcastle disease and avian influenza, to gain access to the United States. Mixed-food-animal veterinarians usually provide health care and disease surveillance for these birds, which require having knowledge about the symptoms of those and other infections.
The Swine Industry
The nation’s swine industry has undergone massive reorganization, consolidation, and changes in scale of operation in the last 25 years, with the number of hog farms declining by more than 70% since 1992—from more than 240,000 to fewer than 70,000 in 2008 (Figure 4-2). Despite this, the hog inventory has remained stable at around 62 million animals. In Iowa, the nation’s leading producer, the number of farms with pigs declined by 83%, from 59,134 in 1978 to 10,205 in 2002 (Honeyman and Duffy, 2006). Throughout the period of consolidation, the total breeding-herd inventory declined from some 10 million to 6 million sows, but, because of better management and housing, litter sizes have progressively increased with survival, and the annual pig crop has risen by over 30% since 1980 (USDA-NASS, 2009b).
Fewer and larger farms assumed an increasing share of the total output by improving yields and reducing costs of production. Table 4-1 presents the increase in number of farms selling over 5,000 pigs per year from 1994 to 2006. By 2008, farms with over 2,000 sows represented over 85% of inventory (USDA-NASS, 2009b). Consolidation advanced at unprecedented rates in the 1990s, continues more slowly today, and is expected to persist for at least the next decade (Key and McBride 2007). Those changes have resulted in what Carr and Kefalas (2009a) term “the hollowing out” of small towns in the United States, especially in the Midwest Corn Belt, with declining populations and prosperity and reduced demand for food-animal veterinary services.
Large swine operations succeeded in increasing efficiency of production by making use of new technologies, including improved genetics, artificial insemination, more efficient feeding programs with better feed-to-weight-gain ratios, environmentally-controlled buildings, highly-efficient production systems, and strict sanitary (biosecurity) measures for workers to prevent disease from entering or leaving the buildings (Honeyman and Duffy, 2006). Those measures not only improved herd health but permitted one person to efficiently manage the production of much larger numbers of pigs than in the past and in the process altered the requirements for veterinary services.
FIGURE 4-2 Number of hog operations, 1984-2008, in thousands. SOURCE: USDANASS, 2009b.
|Farm size (Number of pigs)||Number of farms (in thousands)|
|0 - 4,999||208||120.3||84.2||71.3||63.5|
SOURCE: National Pork Board, 2011.
As consolidation has proceeded, the industry has concentrated its operations in specific geographic regions of the country, creating high pig densities in some counties and low densities in others. That is illustrated in Appendix C, Figure C-7, which shows the striking changes in distribution of pigs in the United States from 1992 to 1997 during the period of rapid consolidation of the industry. The change is also illustrated in Appendix C, Figure C-8, which shows the number of hogs per square mile by county in Iowa in 1987 and 2002. The pig inventory was relatively evenly distributed through all counties of Iowa in 1987; by 2002 this was substantially changed, inventories in counties in the south of Iowa were substantially reduced while those in counties in the north and west of the state along the Minnesota border were greatly increased. Those locations were selected based on economic factors, including access to packing plants, local prices of corn, transportation facilities, and other established service infrastructures.
In contrast to the poultry industry, veterinarians in private practice serve a significant portion of the swine industry. Consolidation and regionalization of the industry, particularly in Iowa and Minnesota, has permitted some veterinary practices to grow and provide a variety of swine health, managerial, and marketing services to their clients. Veterinarians in these practices are infrequently involved in primary animal care, because it is more cost-effective for the producer to assign such duties to herdsmen who have been trained by veterinarians to fulfill specific, specialized tasks. Instead, one veterinary practice may be given responsibility for the overall health of large herds of sows and pigs. Animals are usually in multiple locations where producers are tied by contract to large swine integrators. Such integrated networks of producers are in marked contrast with the traditional system of independent family farms involved in farrow-to-finish production, where food-animal veterinarians would typically provide primary care for some 10,000 sows. The new responsibilities create much greater expectations of detailed knowledge of swine physiology, nutrition, pathology, herd health economics, management, and marketing than in the past. To meet those needs, a demanding, specialized system of education in swine health management is needed that involves both high-quality academic and practice-based training. Mounting calls for more veterinary oversight in animal welfare, zoonotic diseases, food safety, and antimicrobial resistance are also likely to have a substantial effect on the need to further expand the range of services that veterinary practices should offer and the educational programs needed to prepare students for successful careers in the industry. In view of these needs, it is gratifying that a new Center of Excellence in Swine Medicine Education has been created at Iowa State College of Veterinary Medicine in collaboration with the Audubon-Manning Veterinary Clinic.
The swine industry consolidation may be the cause of the overall decline in food-animal veterinary services in several rural states where swine operations had predominated. Large declines in the number of food-animal-exclusive and food-animal-predominant veterinarians in Iowa, Illinois, Indiana, Kansas, Minnesota, Missouri, North Carolina, Nebraska, and Texas between 2001 and 2007 (see Appendix C, Table 1) closely parallel the progress of consolidation and the
change in the geographic distribution of the swine industry. Although it may not have been the only factor involved, lost opportunity because of swine industry consolidation has almost certainly been a contributor to the rural population’s flight from America’s heartland. Iowa, in common with other Midwestern states, felt the brunt of this population flight that left small rural towns in a weakened state. Loss of resident food-animal veterinarians is just one manifestation of the decline.
The number of Iowa veterinarians who were members of the American Association of Swine Veterinarians (AASV) dropped from 401 in 1993 to 217 in 2004—a decline of 46% in 11 years (Honeyman and Duffy, 2006). Parallel changes are seen throughout the nation. Most swine veterinarians belong to AASV; in 1995, AASV had about 1,400 members; by 2008, the number had decreased to 769—a decline of 45% in 13 years. This was due in part to resignations of mixed-food-animal practitioners, but also to a shift to specialization in a single species by food-animal practitioners. Figure 4-3 shows membership of AASV by year of graduation from veterinary school. AASV averaged 22 new members per year in the 15 years from 1976 to 1990 but just 12 new members per year in the 15 years from 1991 to 2006. This number is consistent with anecdotal estimates that suggest the need for 10 to 15 new graduates per year, depending on the swine industry economy.
If a working career is considered to be 30 years, the addition of only 12 new graduates per year can be projected to yield an AASV membership of 360 veterinarians, and not all will be in clinical practice.
Estimates of future workforce needs in swine medicine will depend on the structure, organization, and success of clinical practices to invest in the local community. Workforce needs will also depend on the competence of farm staff, their knowledge, expertise, and stability in their jobs. The better they are trained, the more of them a single veterinarian can supervise. Presently, there are few training programs for food-animal veterinary technicians in the swine industry. AASV is beginning to address that issue, recognizing that a skilled infrastructure of animal care is in the best interest of animal health and the industry. In addition, veterinarians are required in the conduct of basic and applied research on swine diseases, nutrition, welfare, food safety, environmental impacts, and in regulatory services—all fields that are inadequately supported today.
The Dairy Industry
The dairy industry is more diverse than the poultry or swine industries. Although consolidation is progressing more slowly, the number of dairy farms in the United States fell by 88%, from 648,000 operations in 1970 to 75,000 in 2006 (MacDonald et al., 2007); conversely, the size of herds has increased (Figure 4-4).
FIGURE 4-3 New members of American Association of Swine Veterinarians, 1966-2006. SOURCE: American Association of Swine Veterinarians.
FIGURE 4-4 Number and average size of dairy farms in the United States, in thousands, 1970-2006. SOURCE: MacDonald et al., 2007.
As in every other aspect of livestock production, the movement toward greater specialization and herd size is driven by the economies of scale and lower costs of production. Large dairy enterprises use fewer resources per cow and generate returns that, on the average, substantially exceed the cost of operation. Small enterprises, in contrast, are reported to incur economic losses (MacDonald et al., 2007). Costs per hundredweight of milk produced decline by nearly one-
half as herd size increases from fewer than 50 head to 500 head. Costs continue to fall, although less sharply, in even larger herds (MacDonald et al., 2007). For those reasons, the structure of the industry is changing; from 2000 to 2006, farms with fewer than 30 to 199 cows declined by over 30%, while farms with 2,000 or more cows increased by more than 100% (Table 4-2).
The present trend toward larger dairy farms is expected to continue; reports project that the number of dairy farms could decrease to 15,000 with an average of 600 cows each by 2020 (LaDue et al., 2003; Fetrow et al., 2004,). In addition, consolidation has been accompanied by advances in technology and increased milk yields per cow, from an average of 9,500 lb./cow in 1970 to 19,500 lb/cow in 2008 (MacDonald et al., 2007). Because the demand for milk has remained steady, the improved yields have allowed for the reduction in the number of cows on dairy farms: the national herd decreased by 25%, from 12 million in 1970 to around 9 million in 2008 (MacDonald et al. 2007). It is expected that increases in milk yield per cow will continue and result in a further slow decrease in the number of cows in the national herd.
Those changes in the structure of the dairy industry directly affect the veterinary medical profession. Dairy veterinarians are the largest group of veterinarians engaged in the food-animal industries, in part because the dairy cow is the most valuable food-animal species. As the dairy industry undergoes consolidation, dairy veterinarians are obliged to change from primary animal health-care providers to consultants on herd health, nutrition, animal welfare, sustainability of complex farming operations, establishment of herd health protocols, and the training of herders in the implementation of the protocols. As is the case in the swine industry, dairy veterinarians have to adjust their practices, albeit in a more slowly-evolving marketplace, to ensure that as consolidation proceeds, large and small producers have access to veterinary services appropriate to their needs. These are driven by scale and economics; large operations generally seek consulting services on a wide array of issues, whereas smaller producers typically seek more traditional primary care. For many veterinary practitioners, that presents a dilemma as it requires them to shift from the traditional fee-for-service relationship with clients to a consultative, business relationship that is focused on the financial performance of the entire dairy enterprise. It is not an easy transition and many food-animal veterinarians have difficulty charging for advice that in the past they have given freely. Moreover, without additional training in animal-health economics, practitioners do not necessarily have the background and confidence to make the change. As a consequence, operators of large dairies have looked elsewhere for advice, and the central role that food-animal veterinarians should play in the success of dairy operations is marginalized (DSI, 2006).
The scale of dairy operations varies across the United States, and the effect of consolidation on the veterinary medical profession is regional. Table 4-3 incorporates data on the 16 largest dairy states, which account for 83% of the nation’s milk production, to illustrate the changes in production and herd sizes by region.
|Herd Size - Number of Head||Number of Operations||Percent Change||Percent of Inventory||Percent of Production|
|Total||105 170||75 140||-25 6||100||100||100||100|
SOURCE: Adapted from MacDonald et al., 2007.
The traditional dairy states are in the Northeast, the eastern Corn Belt, and the upper Midwest. Collectively, those states produced 72.4 billion pounds of milk in 2006 compared with 77.7 billion pounds produced by dairies in the Southwest and the West (MacDonald et al., 2007). As Table 4-3 shows, all regions increased milk production from 2000 to 2006, but the rate of increase in the Southwest and West was twice that in the other regions. The change reflects the progressive westward movement and growth of the nation’s dairy industry (see Appendix C, Figure C-9). However, it is uncertain how long the westward trend will continue in view of climate change and water supply problems in the South and West.
Table 4-3 illustrates that a large percentage of the dairy farms in the traditional dairy states are small. Nearly half the farms in Wisconsin have fewer than 100 cows, whereas this type of operation is uncommon in the Southwest and West, where the overwhelming majority of dairy farms have more than 500 cows and the number of dairies with over 12,000 cows is increasing. However, the traditional dairy states are moving slowly toward larger units; the number of herds with over 500 head in the Northeast and Corn Belt states more than doubled from 2000 to 2006 and as this occurs, the type of veterinary services required change.
There are large numbers of food-animal-exclusive practitioners in Wisconsin and the traditional dairy states of the Northeast and many fewer in California and the West (Appendix C, Figure C-3). That is consistent with the premise that continued consolidation and reduced demand for veterinary services will proceed at different rates in different parts of the country. As the size of dairy herds increases, the ratio of cows to veterinarians also increases.
|Region||Production in billions lbs.||Percentage of herd size <100 head||Percentage of herd size< 499 head|
|Northeast NY, PA, VT||24.0||25.5||25.3||46.5||38.9||10.4||21.3|
|E. Corn Belt IN, MI, OH||12.3||12.8||15.3||39.9||28.4||13.1||31.2|
|Upper Mid West MN, WI||31.7||31.0||31.8||56.7||48.2||8.9||15.6|
|S. West NM, AZ, TX||11.6||13.6||17.8||2.8||1.6||78.2||87.3|
|West CA, CO, ID, OR WA||37.3||50.1||59.9||1.8||1.3||73.4||84.2|
SOURCE: Adapted from MacDonald et al., 2007.
Table 4-4 shows the numbers of members of the American Association of Bovine Practitioners (AABP) in 2007 who were designated as dairy veterinarians and the number of cows per veterinarian in California and Wisconsin. These are the two leading milk-producing states in the United States; their dairy industries differ in structure.
Most large dairy facilities in California and other parts of the Southwest and West are dry lot operations; all feed is purchased, and capital investments are focused exclusively on milk production (MacDonald et al., 2007). As those specialized operations enlarge, economies of scale enable them to reduce veterinary bills by employing technicians to provide routine herd health care. Alternatively, foreign-trained veterinarians, some of whom speak little English, are hired as herders and herd health-care providers. Large operations achieve further economies of scale by purchasing dairy supplies and drugs in bulk from sources other than local veterinary practices that have depended on traditional markups. As a result, large farms spend just over half as much as small farms on veterinary services per animal (Remsburg et al., 2007).
In contrast, dairies in Wisconsin and other traditional dairy states are predominantly farm-based family operations that have much larger capital investments per cow for crop machinery and dairy facilities (Bailey, 2000; MacDonald et al., 2007). The 1999 Pennsylvania Dairy Farm Business Analysis on 1,126 farms in Pennsylvania revealed an average of 87 cows per operation and assets of $7,452 per cow (versus $3,500 in large Western farms) (Bailey, 2000).
The current recession and a decline in the price of milk will negatively affect small dairies; many are likely to go out of business, and dairy practitioners will lose clients and, income. In addition, inexpensive serologic tests for pregnancy diagnosis are now competing with a traditional lynchpin of dairy practice—pregnancy diagnosis by rectal palpation, such as those produced by Bio-Tracking LLC and IDEXX Laboratories, Inc. Increases in the use of that and similar technologies have the potential to profoundly alter practitioner-farmer
relationships, veterinary oversight of the nation’s dairy herds, and the structure of dairy veterinary medicine in the United States.
Estimating the Demand for Dairy Veterinarians
The number of veterinarians needed by the dairy industry depends on how the dairy industry evolves, in particular with respect to the rates of consolidation in different regions of the country. For example, an assessment of need could be based on the number of cows for which one veterinarian can effectively provide health care, or based on the number of farm personnel that one veterinarian can effectively supervise. Assumptions or estimates can be made about several model parameters, such as in the following scenario:
• National milk consumption remains at 182 billion pounds.
• Average annual milk yield per cow is 18,000 pounds.
• Average herd size is 500 head.
• Number of farms served per veterinarian is 10.
• Number of cows per veterinarian is 5,000.
• Dairy veterinarians practice for an average of 30 years.
These estimates of parameters in the dairy industry project a need for 20,222 dairy farms, a workforce of 2,022 dairy veterinarians, and 67 new graduates each year with long-term commitments to the dairy industry to sustain that workforce. However, different assumptions, including those that approximate many of the current trends, might include the following:
• National milk consumption remains at 182 billion pounds.
• Average milk yield per cow is increased to 22,000 pounds.
• Average herd size is 2,000 head.
• Number of farms served per veterinarian is 5.
• Number of cows per veterinarian is 10,000.
• Dairy veterinarians practice for an average of 30 years.
|State||Number of AABP Members||Number of Dairy Cows||Number of Operations||Number of Cows per Operation||Number of Cows per Veterinarian|
NOTE: AABP = American Association of Bovine Practitioners.
DATA SOURCE: American Association of Bovine Practitioners membership and USDA National Agricultural Statistics Service.
This scenario projects a need for 4,136 dairy farms, a workforce that is reduced to 827 dairy veterinarians, and only 28 new graduates per year to sustain that workforce. These projections are based on the work of LaDue et al. (2003) and Getz (1997). They illustrate that, unless changes are made in the services that the veterinary medical profession offers the dairy industry, consolidation will lead to substantially reduced demand for dairy practitioners. Figure 4-5 is a snapshot of a “dashboard” analysis tool that can be used to visualize how different estimates of industry parameters affect the number of veterinarians needed by the industry.
Trends in the recruitment of new members to the American Association of Bovine Practitioners (AABP), a professional association for dairy and beef cattle practitioners, are illustrative of the two scenarios described above.
From 1975-1984, 706 veterinarians joined AABP, an average of 70.6 per year (Figure 4-6). Assuming a 30-year commitment to the industry, that level of new practitioners in bovine practice annually would maintain a population of 2,118 veterinarians, a figure that approximates the conclusions of the first scenario. However, during 1995-2004, only 317 joined AABP, an average of 32 per year. Over 30 years, the annual addition of 32 new practitioners would support at most a population of 960 veterinarians in bovine practice, a figure that is within the range estimated by the second scenario.
FIGURE 4-5 Dashboard analysis tool: How many dairy vets? NOTE: http://dgalligan.com/galliganx/howmanyvets/howmanyvets.html. (User and password: howmanyvets). SOURCE: Galligan and Kelly, 2007.
FIGURE 4-6 Recruitment to the American Association of Bovine Practitioners 1975-2005. SOURCE: American Association of Bovine Practitioners, 2007.
The second scenario assumes that the veterinary medical profession makes changes in the services that it offers the dairy industry and takes into account the increased specialization, complexity, and intensity of production in large dairies. As dairy operations increase in size, farm personnel are given specialized responsibilities. The veterinarian would be responsible for establishing the overall infrastructure of herd health, for setting protocols in each specialized production sector, for training farm staff in the implementation of the protocols, for ensuring that excellent records are maintained, and for seeing that the staff is aware of the clinical signs of illness in animals under their care. To succeed, the veterinarian needs an in-depth education on the entire dairy operation and should acquire skills in team-building. Dairy veterinarians also need the business skills to analyze records for an entire dairy farming operation and provide owner-managers with objective advice that will result in improved animal health, productivity, and overall farm profitability.
Consolidation of the dairy industry is expected to persist for at least the next decade with two predictable results: more farms will go out of business, and more rural areas will be without veterinary services. One approach to solving the problem is to develop veterinary public-private partnerships that provide livestock, wildlife, and ecosystem health-surveillance services in underserved areas. Another practical approach is to train a cadre of veterinary paraprofessionals to serve rural areas while working under contract with licensed veterinarians who may be at remote sites but in continuous contact via digital technologies. This approach may permit food-animal veterinarians to offer high-quality consultative services to dairy farms in remote areas.
The Beef Production Industry
The U.S. commercial beef-cow population of about 33 million animals with an additional 4.7 million replacement heifers is distributed on approximately 750,000 ranches in all states of America (USDA-NASS, 2009a). Texas has the largest beef-cow inventory, followed by Nebraska, Kansas, Oklahoma, and California (USDA-NASS, 2009a; see Appendix C, Figure C-10). Cow numbers have been declining for many years, but the number of ranches is decreasing more rapidly, having fallen by 17% between 1988 and 2008 (Figure 4-7).
In contrast with the swine and poultry industries, cow and calf farms (in which a herd of cows is maintained for producing calves that are sold to feedlots) are largely family-owned operations in the United States (Outlaw et al., 1996). However, the trend toward consolidation of the cow-calf industries is proceeding as competition forces producers to seek ways to reduce costs and survive (Table 4-5). Consolidation is driven by the declining value of feeders and by razor-thin profit margins (Andrus et al., 2006; Gay, 2011). As in the other food-animal industries, consolidation affects demand for veterinary services: large herds require consulting services in production medicine delivered efficiently and inexpensively, and small herds typically require basic animal-husbandry services, health testing, vaccination, dehorning, castration, and obstetrics.
Commercial cow and calf producers typically raise cows and calves on grass in warm weather and feed hay and grain supplements in winter. Many are small operations, with 53% maintaining 20-199 cows. Another 16% of cows are on ranches that have 500 to more than 2,500 cows (Table 4-5). Of the cow-calf operators in the United States, 8% own 51%, or 17.5 million, of the beef cows (Gay, 2011).
FIGURE 4-7 Number of all U.S. cattle and beef-cow operations, 1998-2008. SOURCE: USDA-NASS, 2009b.
|Beef herd size||Number of beef herds||Percent of all herds||Number of beef cows||Percent of all cows|
|Average Herd Size: 43||Total: 764,984||Total: 32,834,801|
SOURCE: Adapted from USDA-NASS, 2009a, and Gay, 2011.
Primary-income producers make up only 14% of all producers but account for 79% of herds of over 300 beef cows. For those ranchers, the cow-calf enterprise is the main means of family support. Because of declining animal values, producers have been forced to consolidate, and herds of over 1,000 cows are now considered necessary to support a family of four (Gay, 2011). With larger numbers of animals, routine health problems are more frequent and ranch personnel become accustomed to diagnosing and treating them, while providing other basic husbandry services, such as castration, dehorning, and immunization. Under those circumstances, the veterinarian is responsible for defining treatment protocols, training ranch personnel on routine health care, and consulting producers on managerial issues, including disease prevention and risk management. One survey of producers has found that the larger the cow-calf operation, the greater the use of veterinary consultative services (see Table 4-6).
In contrast with primary-income producers, supplemental-income producers make up 69% of beef producers. Most have herds of fewer than 300 cows and seek veterinarians for routine services. Noneconomic producers make up 17% of producers. Most are small producers who have cattle for noneconomic reasons, such as maintaining a family property. They call on veterinarians for basic husbandry services, such as vaccination, breeding, castration, and dehorning and for traditional care of individual sick animals. Cow-calf operations are usually in areas of low human population density. Services of veterinarians are required mainly for spring calving and in the fall. Because the demand for services is seasonal and the industry is dispersed, many veterinarians serving the industry are in mixed-food-animal practice. The decline in numbers of veterinarians practicing in rural and remote areas of the United States constitutes a serious problem for the security and safety of the nation’s beef industry, as well as for the
|Herd size (cows)||Producer Source of Income|
|Percent of primary income||Percent of supplemental income||Percent noneconomic||Percent reported veterinarian use in 1996|
SOURCE: Adapted from Gay, 2011, and USDA-APHIS, 1997.
stability of the rural economy. Developing a cadre of veterinary paraprofessionals to serve remote areas may provide one solution. In contrast with the cow-calf industry, feedlot operations are highly concentrated. The 25 largest feeding organizations produce 40% of fed cattle (USDA-ERS, 2010). Almost all feedlot operators use veterinary services. There are three common models:
• 3.3% of operations (8.4% of herds that have over 8,000 head) have fulltime food-animal-exclusive veterinarians on staff.
• 34.6% of operations (76.2% of herds that have over 8,000 head) contract for routine veterinary visits, usually by consultant food-animal-exclusive veterinarians who regularly serve a feedlot circuit. Most large feedlot producers use this model. Anecdotal evidence suggests that consultant veterinarians in this part of the industry are appropriately compensated and that there are adequate numbers to serve the industry.
• 70.9% of operations (39.3% of herds that have over 8,000 head) call a veterinarian as needed.
Thus, in contrast to the dairy industry, veterinarians in feedlot operations commonly work under contract with producers and are paid for services as consultants. Their responsibilities include defining health-care protocols for a feedlot, training personnel in the implementation of the protocols, and advising feedlot operators on the overall health-care management of the herd. To perform these tasks, consultant veterinarians draw upon their knowledge of routine animal care with focus on the health of individual animals and their proficiency in production medicine with focus on the performance, profitability, and nutrient management of the entire herd.
Sheep and Goat Industries
The size of the U.S. sheep industry has been falling for over 50 years and suffers from the perception of an “industry in decline.” Since 1991, the U.S. population of sheep and lambs has dropped by nearly 50% (Figure 4-8) to around 10 million head in 2008 as a result of weakness in demand for wool and
lamb. However, the decline has recently leveled off because of several factors, including the emergence of ethnic niche markets for lamb, and for sheep’s milk, and the growing popularity of sheep cheeses. Nearly half of the world’s exports of sheep’s milk cheese are destined for the United States, making it the largest importer of sheep’s milk cheese (NRC, 2008).
The 2009 U.S. goat inventory totaled 3.1 million head and was made up of a variety of breeds used in the production of meat, milk, and fiber. Demand for goat fiber is declining, whereas demand for goat meat and milk is increasing. Growing ethnic niche markets led to a 64% increase in the number of U.S. farms that produce goats for meat from 2002 to 2007, and today there are more than 120,000 meat-goat producers (see Figure 4-9). During the same period, the meat-goat population increased by 24%, from 2.5 to 3.1 million animals. Texas is the largest producer of meat goats in the United States with production concentrated in west Texas, an area that has a large Hispanic population that prefers goat meat to beef (Appendix C, Figure C-11a).
Dairy goats are raised throughout the United States with specific concentrations in Wisconsin and New York (Appendix C, Figure C-11b). Across the nation, dairy-goat inventories increased by 15% from 2002 to 2007 (USDA-NASS, 2009a). The increase was driven by the growing sophistication of U.S. cuisine and niche markets for goat milk and cheeses (Haenlein, 2001).
There are inadequate studies of sheep and goat health and of the economic effects of disease on the sheep and goat industries (NRC, 2008). Parasitic diseases are of particular concern in connection with the development of resistance to the anthelmintic drugs that are used to treat for them. Food-animal veterinary services for the sheep and goat industries are inadequate in many parts of the country (NRC, 2008). Continued expansion of small-ruminant production is expected and seems likely to provide new opportunities for food-animal practice.
FIGURE 4-8 U.S. sheep and lamb population, 1991-2009. SOURCE: USDA-NASS, 2010.
FIGURE 4-9 U.S. sheep and goat operations in 2007 and 2008. SOURCE: USDANASS, 2009a.
The Changing Profile of Food-Animal Veterinarians
As the largest professional organization for veterinarians, the American Veterinary Medical Association (AVMA) maintains data on its members that is useful for examining workforce trends. AVMA membership data can be challenging to interpret, however, because of changes in the way that it members’ practices are reported over time (see Box 4-1).
Nevertheless, the data can be used to see some changes in the composition of the food- animal workforce. Table 4-7 shows the numbers of AVMA members in private practice by practice species from 1966 to 2007. Between 1966 and 2007, total AVMA private and public membership (column 5) increased from 26,632 to 87,946 veterinarians—an increase of 330%. During this time period, the number of large-animal practitioners (LA-exclusive + LA-predominant, column 2)1 grew from 1,861 to 5,090—an increase of 270%.
Care for food animals is provided both by large-animal and mixed-food-animal veterinarians, the latter group defined by AVMA as practicing food-animal medicine 50% of the time. Thus, from 1966 to 2007, the total number of full-time equivalents (FTEs) engaged in food-animal practice (adjusting for 50% of the time of mixed-food-animal practitioners) increased by 11%, from 5,820 FTEs in food-animal practice in 1966 to 6,454 FTEs in 2007 (column 6).
1 The terms large-animal exclusive (LAE) and large-animal predominant (LAP) were used by AVMA until 2009, and are used when discussing historical AVMA data that is labeled as such. However, the more recently adopted terms FA-exclusive and FApredominant are essentially synonymous with LAE and LAP, respectively.
Over the years, the American Veterinary Medical Association (AVMA) has changed the definitions of categories of membership, which provide a more refined picture of the membership, but make it challenging to understand long-term trends. For example, data from 1966 on membership includes veterinarians from all countries, but in more recent years, the figures include only U.S. members. Comparisons, therefore, can be confusing.
In 1994 there were 13,998 members designated as mixed-animal practitioners, who cared for companion animals and probably some portion of the livestock and poultry raised in small-town America. In 1995, the definition of mixed-animal practice was narrowed to include only those who devoted at least 50% of their time to food- animal practice. Under this definition, the number of AVMA members in mixed-animal practice immediately dropped in 1995 to 3,148. Some portion of veterinarians previously categorized as mixed-animal practitioners were likely added to the large-animal practice category, which increased by 1,594 members between 1994 and 1995, and others to the companion-animal category, which added 1,720 members. Others may have been excluded as they were not U.S. members.
In 1995, AVMA split the large-animal practice and small-animal practice categories into four categories: large-animal exclusive (LAE), large-animal predominant, (LAP), small-animal exclusive, and small-animal predominant. From 1995 to 2005, the designation of LAE or LAP was in the hands of members. In 2006, AVMA began assigning the designation depending on specific practice activity, resulting in a sudden change in the large-animal membership profile. In addition, since 2009, AVMA has begun to use the terms food-animal exclusive, food-animal predominant, and mixed-food-animal in place of LAE, LAP, and mixed-animal. All of these changes complicate interpretations of the workforce over time.
To obtain a clearer picture of the composition of veterinarians practicing food-animal medicine over time, Figure 4-10 uses data from Table 4-8 to plot the percentage change in the number of FTEs working in food-animal medicine (LAE + LAP and food-animal mixed-animal) by year from 1995 to 2007. The figure shows that the makeup of the food-animal veterinary workforce is changing toward greater participation by mixed-food-animal practitioners. In 1995, the year that AVMA established the definition of mixed-food-animal practitioners as veterinarians who devoted 50% of their effort to food-animal care, there were 3,148 mixed-food-animal practitioners. They represented 23% of the total FTEs (adjusting for the 50% time of these practitioners) in the food-animal workforce at that time. By 2007, the number had increased to 4,345, representing 33% of the total FTEs in the food-animal workforce, and an increase of 38% over the 1995 number.
|Year||Large Animal (LA)||Total LA||Small Animal||Mixed4||All||Total Food FTEs||Percent of Members|
|20072||1 048||4 042||5 090||38 974||5 811||4 345||87 946||6 454||7 34|
NOTE: FTE=full-time equivalent, LAE=large-animal exclusive, LAP=large-animal predominant, SAE=small-animal exclusive, SAP=small-animal predominant.
1Includes actively employed AVMA members and verified nonmembers in the Membership Database. Between 1996 and 1995, veterinarians from all countries were included. After 1995, numbers reflect U.S. members only.
2Includes only actively employed AVMA members.
3Veterinarians may hold multiple positions (counted in multiple categories). ^2002 is based on estimated percentages and the end of year total number of veterinarians from the 2002 Membership Report.
42001-2005 Equine/Small Animal species code was pulled from Mixed Animal. These numbers will be different than what is published. SOURCE: AVMA.
FIGURE 4-10 Changes in the composition of the food-animal workforce. NOTE: LA=large-animal, Mix=mixed-animal, FTEs=full-time equivalents. There are no data on 2000; figures for 2000 are averages of the 1999 and 2001 values. SOURCE: Based on membership data of the AVMA.
From 1995 to 2007, the total number of LAE and LAP veterinarians declined by 13%, from 5,883 to 5,090. Because the numbers of mixed-food-animal practitioners had increased as described above, the total food-animal FTEs did not change much from 1995 to 2007 (Table 4-7, column 6). Thus, although the total FTEs in food-animal practice have changed very little during this time period, the composition of the workforce has been changing toward mixed-food-animal practice. More food animals are in consolidated livestock facilities that generally require veterinarians with full-time, specialized commitment to food-animal practice, but an overall decline in the demand in food-animal practice and an increase in reliance on companion-animal care to supplement incomes is pushing professional services towards mixed-food-animal practice and delivery of traditional food-animal veterinary services.
There are other changes in the demographics of rural America that may impact the directions of food-animal veterinary practice and explain the rise in numbers of mixed-food-animal veterinarians. Urban areas continue to spread into the countryside and usurp large tracts of farmland. In addition, more isolated, low-density, large lot developments are occurring with increasing frequency further out in the rural countryside, especially in some of America’s richest farmland (Heimlich and Anderson 2001). Across the country these areas are described as under intense pressure from development (AFT, 2011). For example, the population of Tulare County, a center of California’s dairy industry increased by 20% between 2000 and 2010, in the same period the population of Calumet County, Wisconsin increased by 20.5%, and Lancaster County, the heart of Pennsylvania’s dairy industry, by 10%. The increasing populations coexist with farming operations and expand opportunities for companion-animal and equine care in regions that were once purely agricultural and the realm of food-animal-exclusive and food-animal-predominant veterinarians.
The growing movement toward small farming operations and locally-grown and specialty-food markets with increased demand for primary veterinary care may have had an additional effect in supporting mixed-food-animal practices. Appendix C, Table C-1 details the change in distribution of mixed-food-animal veterinarians by state and shows that increases in mixed-animal practice have occurred in all but six states. In view of these trends, the veterinary profession needs to consider how it will be able to meet the needs of all food-animal producers.
Aging and Attrition
The food-animal-exclusive, food-animal-predominant, and mixed-food-animal practice categories have different age compositions, and they are changing at different rates. Figures 4-11, 4-12, and 4-13 provide a snapshot of changes in the age structure of each category of food-animal practice between 2001 and 2007. AVMA membership data (Appendix C, Tables C-2a,b; 3a,b; and 4a,b) show that food-animal practitioners, as a group, are aging in general, with the food-animal-predominant category approaching retirement age the fastest. That is important because food-animal-predominant veterinarians currently make up 50% of the FTEs in food-animal practice (Table 4-8). It is also the segment of food-animal practice that is attracting the fewest new graduates, and as will be discussed later, has the lowest salary.
In 2007, there were 4,042 AVMA members in food-animal-predominant practice in the United States (Table 4-7), with 57% of that group being over 50 years old (Figure 4-12). This is in contrast to 50% and 43% of AVMA members being 50 years and older in food-animal-exclusive and mixed-food-animal practice, respectively (Figures 4-11 and 4-13). Fewer and fewer graduates have entered food-animal-predominant practice for over two decades. Consequently, this sector of the profession is facing an uncertain future.
Mixed-food-animal practitioners have an average age of 47 years, and the group is aging more slowly than the other two categories of food-animal practice. However, the percentage of mixed-food-animal practitioners under 50 years old declined by more than 10 percent between 2001 and 2007 (Figure 4-13).
Appendix C contains several maps (Figures C-12a, b; C-13a, b; and C-14a, b) that show the geographic distribution of food-animal practitioners by age groups, which vary by category of practice. Most of the states that have large numbers of food-animal-predominant practitioners are in the Midwest (Appendix C, Figure C-5) so this region is likely to be the most severely affected by the change in demographics. The shortfall is not strictly sex-driven: comparatively few women have entered this branch of veterinary medicine, and fewer men are going into the field (Chieffo et al., 2008).
Recruitment of Graduates into Food-Animal Practice
According to information from AVMA, 531 graduates of the class of 1989 entered food-animal practice (Figure 4-14). In 2009, the number was 203—a drop of 62% in 20 years. The decline occurred in all three categories of food-animal practice and is attributed to the economy and the decrease in availability of jobs in food-animal practice. There is great pressure to increase the number of graduates going into food-animal practice, but the profession may first need to consider the nature of the opportunities that are available and the education needed by food-animal veterinarians.
The greatest decline involved the numbers of graduates entering food-animal-predominant practice, which fell from 229 in 1989 to 34 in 2009—a decrease of 85%. Entry of graduates into mixed-food-animal practice also declined, falling from 253 to 147—a decrease of 42%. The number of graduates entering food-animal-exclusive practice, presumably with the goal of serving intensive systems of production focused on a single species, increased from 1989 to 2007 and then decreased by nearly 70% from 2007 to 2009. Inasmuch as starting salaries were nearly $10,000/year more in food-animal-exclusive than in food-animal-predominant and mixed-animal practices (discussed later in this chapter), the decrease was most likely due to a decline in the number of food-animal-exclusive positions available.
What will be the size of the future food-animal workforce in comparison to today? In 2007 there were 5,100 food-animal-exclusive and food-animal-predominant practitioners who were members of AVMA (Table 4-8), and approximately 994 of them were over the age of 60 (Figures 4-10 and 4-11). Because of the physical and strenuous nature of food-animal practice, the length of an average career is generally assumed to be 30 years, about 5 years shorter than that of practitioners in either companion-animal or equine medicine. If half of the practitioners over 60 were to retire in the next 5 years, the addition of 99 new graduates each year would be required to maintain the 2007 level of 5,100 practitioners in the future, not accounting for those who retire early or work part-time.
From 2006-2007, an average of 74 graduates each year indicated their intention to pursue food-animal-exclusive and food-animal-predominant practices (Shepherd, 2008). If this level of new additions to the food-animal workforce continues, the number of food-animal-exclusive and predominant practitioners will shrink the present workforce. As half of new food-animal practitioners can be expected to leave food-animal practice within 5 years (Remsburg et al., 2007; Jelinski et al., 2008), the workforce may potentially decline dramatically. On the other hand, if food-animal-exclusive practice becomes less physically intensive and more supervisory, those that stay may work for more years than in traditional food-animal practice.
FIGURE 4-14 Career selection of veterinary graduates entering food-animal practice. NOTE: LA Ex=large-animal exclusive, LA Pred=large-animal-predominant, Mix FA= mixed-food-animals. SOURCE: Data courtesy of AVMA.
|Practice Type||Mean starting salaries ($)||Salary growth/year (percent)|
|Mean Debt ($)||Debt growth/year (percent)|
NOTE: Response rates of annual surveys of graduating DVMs are typically greater than 90%.
SOURCE: Chieffo et al., 2008; Shepherd and Pikel, 2011.
Starting Salaries and Student Debt
From 1989 to the present, starting salaries for new graduates entering food-animal-exclusive practice are higher ($71,096) and have grown faster than those entering either food-animal-predominant or mixed-food-animal practice, according to exit surveys of new graduates (Table 4-8). Student debt, however, has grown even faster, increasing at a rate of 7.6% each year between 1989 and 2007, and by 6.5% between 2010 and 2011. Students now owe an average of $142,613 upon graduation. In 1989, educational debt was approximately 110% of starting salaries. In 2011, those entering food-animal-predominant practice face debts of around 205% of their initial salary. Although interest rates on government-backed educational loans in 2010 were capped at 6.8%, the debt burden mortgages the future for those wishing to enter food-animal practice. State and federal grants to help graduates with their debt burden are useful but will not overcome the depressed market for associates in food-animal veterinary practice.
In a survey of members’ compensation in 2007, AVMA found that food-animal-exclusive practice owners earned the highest median income ($139,000) of all branches of private practice. In AVMA’s 2009 survey (AVMA, 2010a), the figure dropped to $133,000 (Figure 4-15), possibly due in part to the effect of the recession that began in 2006. The reported income of this group had increased previously by 16% from 2005 to 2007 (Burns, 2009). In 2009, mixed-food-animal and food-animal-predominant practice owners had median incomes of $103,000, somewhat less than practice owners in the other branches of private practice; this circumstance may be an impediment in attracting and retaining graduates in food-animal medicine with substantial educational debts. In 2009, the annual median salary of food-animal-exclusive associates was $79,000, while food-animal-predominant and mixed-food-animal associates earned median incomes of $73,000, the same as associates in companion-animal-predominant practice. In contrast, companion-animal-exclusive associates had an annual median income of $85,000. The salary difference is consistent with a view that the problem in food-animal practice in rural America is one primarily of unmet needs and not one of shortages. In other words, demand is there but compensation is too low for veterinarians to survive in rural practice.
FIGURE 4-15 2009 median incomes of practice owners and associates by category. NOTE: FAE=Food-animal-exclusive; FAP=Food-animal-predominant; Mix=Mixed-animal; CAE=companion-animal-exclusive; CAP=companion-animal-predominant; EQU=equine veterinary practice. SOURCE: Adapted from AVMA, 2011a2, Burns 2009.
2 Veterinarian salary data are drawn from the biennial AVMA Compensation Surveys, which are based on a randomized, stratified sample of employed U.S. veterinarians (including AVMA members and nonmembers). The response rate of the Surveys is about 25%. If DVMs who are more successful are more likely to respond, the reported rate of earnings may exceed actual averages.
With the changing nature of food-animal production in America, the overall demand for traditional veterinary services has declined. Nevertheless, if future food-animal veterinarians can master a broad understanding of the complex challenges of production medicine, there is a great potential to redefine the role of food-animal medicine in the intensive livestock and poultry industries, while at the same time fulfilling the profession’s responsibilities to an American public concerned with food safety, drug residues, animal welfare, and stewardship of the environment. If not, the veterinary medical profession is in danger of relinquishing its role in animal production to others who are able to consider the economic needs of producers but who have less understanding of the complexity of animal health and public health (King, 2000). Large dairies already routinely use consultants to advise on such issues as housing, communication, employee training, nutrition, and environmental regulations—matters that are frequently seen by producers as “outside the realms of veterinary medicine” (DSI, 2006). Because of the profession’s declining presence in food-animal care, the nation is losing the all important food-animal veterinarian-producer relationship upon which the health and welfare of livestock populations depend. For the veterinary profession, this is untenable.
A Vision for Food-Animal Veterinary Medical Education
To ensure their future in food-animal medicine, veterinary graduates should be well-grounded in the specialized aspects of the livestock or poultry industries they wish to serve and have the skills needed by these increasingly intensive, specialized, and concentrated industries. This direction was advocated by the late Otto Radostits (2002) who wrote that “meeting the needs of progressive livestock producers is a full time career for a progressive food-animal practitioner and is not a part time job.”
J. B. Herrick was among the first to redefine how veterinary services should be offered to livestock operations and popularized the term production medicine. Herrick emphasized a food-systems approach to food-animal services and defined production medicine in 1990 as “the utilization of many facets of production, e.g. nutrition, environment, genetics, and health, into a well-managed program monitored by records” (Herrick, 1990). With a few notable exceptions, progress in moving food-animal practice in that direction in the intervening two decades has been inadequate. The Food Supply Veterinary Medicine Commission (Andrus et al., 2006) drew attention to the thin supply of new graduates entering food-animal veterinary medicine and to the lack of focus on this field by many veterinary schools. Veterinary schools are accused of being slow in their willingness to change and develop curricula that meet the needs of the dynamically changing livestock industries and of an increasingly apprehensive public. Nielsen (2001) is harshly critical, stating that there has been a failure to
provide graduates with sufficient entry-level competence to practice modern health and production management in herds of food-producing animals.
Large producers who dominate the livestock industries seek veterinarians who are either exclusively or predominantly committed to food-animal practice. Implicit in this is the need for food-animal veterinarians who understand production systems, can read farm records, and can use them to make decisions aimed at increasing herd health, productivity, and the overall profitability of the farming operation. It is these objective services that farmers seek and for which they are willing to pay. Veterinary practitioners also need to know how to charge for their consultative services. Many either don’t know how to charge or don’t like to charge for consulting and would rather bill for primary care or pregnancy exams instead.
In veterinary academe, some faculty members recognize that food-animal curricula must fundamentally change, but the present state-based infrastructure of veterinary education and declining budgets make change difficult. To succeed will require veterinary schools and colleges to share resources and work together to create on-line courses in production medicine and centers of educational excellence that can efficiently provide comprehensive, high-quality veterinary education for the nation. As a start, an accepted definition of a herd health management program should be developed so the goals of the profession are delineated.
Food-animal veterinary medicine is now specialized by food-animal species and focused expertise in the nutrition, reproduction, genetics, housing, economics, risk management, etc. of the relevant species. Authorities in each of these areas are present in veterinary schools and industry across the country and no one school can afford to provide positions in all of the areas. Creation of virtual “centers of emphasis” in the theoretical aspects of poultry, dairy, beef, and swine medicine could be created making use of recognized experts in academe, food-animal practice, the livestock industry, and the pharmaceutical industry and others to provide a portfolio of essential on-line courses in food systems. The courses should be easily available to veterinary students in the United States and internationally.
The benefits of consortia in food-animal veterinary medicine have been reviewed by Miller and Prasse (2006). Troutt and Osburn (2008) proposed the creation of regional centers in veterinary education for the dairy industry. In their model, senior students from cooperating veterinary schools would spend part of, or their entire fourth year at an established regional center. Two-year residency programs would be included in the center program. The University of California at Davis Veterinary Medicine Teaching and Research Center at Tulare, California, the Iowa State Swine Medicine Education Center partnered with the Audubon Manning Veterinary Clinic, and the recent USDA grant to create a National Center of Excellence in Dairy Production Medical Education for Veterinary Students provide encouraging examples. These initiatives could prepare veterinary graduates to fully and successfully participate in the dynamically changing food-animal industries of this country and beyond.
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
come from rural backgrounds or have had other previous experiences with livestock or poultry farming (Schmitz et al., 2007; Jelinski et al., 2008). This is a diminishing population. Furthermore, as livestock and poultry operations are increasingly housed within biosecure facilities, the opportunity for students even from rural background to gain farm experience is diminishing. In view of this, the profession has to look to urban and peri-urban communities and recognize that students from these backgrounds, including students from minority groups that are underrepresented in veterinary medicine, who may know little about their food supply may be unaware of the significant opportunities that food-animal veterinary medicine has to offer. The digital media provides numerous ways of addressing that issue—social media, on-line programs, webinars, and other forms of communication should be prepared to educate high school and college students and the general public about the importance of food-animal medicine to society with regard to food-animal health and welfare, food safety, and environmental health. Such programs could also be aimed at correcting misconceptions about livestock and poultry farming that currently abound and bias students away from considering careers in agriculture.
Expanding the Role of Veterinary Paraprofessionals
As a goal, the veterinary profession should endeavor to provide health care to the largest possible population of livestock and poultry. For economic and other reasons the profession is presently not meeting this goal. In view of this, the committee supports a proposal to integrate rigorously-trained and credentialed food-animal veterinary paraprofessionals (veterinary technicians or individuals with veterinary training) working in health-care teams with licensed veterinarians who may be at a distant site (Remsberg et al., 2007). This is similar to the expanding system of health care in the medical profession in which nurse practitioners in rural locations are linked digitally to physicians who are located distantly. For food-animal paraprofessionals to become part of a veterinary health-care system, state practice acts will need to be modified to permit paraprofessionals to administer primary care services provided that they are subject to collaborative oversight (and constant communication) with licensed practitioners who may be in a different location. This approach offers the potential for clinicians to provide affordable patient care as well as for providing care for patients in underserved rural areas without reducing quality. The system can also improve animal-disease surveillance and provide surge capacity in rural America should emergencies arise.
The food supply is a matter of national security and public health, but generally taken for granted by the American public. As is discussed in Chapter 6, the job of safeguarding food and overseeing the welfare of food animals is a shared responsibility of the private and public sector. Neglecting that responsibility poses significant risks. Additional considerations for strengthening the veterinary oversight of the food-animal sector and the need for research in food-animal health are explored in the final chapter of the report, Chapter 11.