This is Part 1 of “Equine Practitioners Are Becoming An Endangered Species,” an exclusive in-depth look at the current state of the equine veterinary industry that originally appeared in the May 8 & 15, 2023, edition of the Chronicle. Read Part 2 and Part 3 as well.
Before the pandemic disrupted everything in 2020, did you ever think about the toilet paper supply chain? Of course not; it was always in the store, and you didn’t know, or need to know, how it got there.
Whether it was toilet paper or two-by-fours, most Americans had never experienced widespread shortages of common items. It was confounding, exasperating and unsettling to be unable to buy everyday staples.
Now imagine experiencing that same frustration when picking up the phone to call an equine veterinarian, whether to make a routine appointment for vaccinations or for an emergency colic—to hear, “I’m sorry, we’re not taking new clients” from every vet in the area or, “I’m sorry, we don’t have a vet available for an emergency. Can you haul to [insert name of veterinary school hospital several hours away]?”
The equine veterinarian shortage isn’t a future problem—it’s already here. It’s also likely to get worse before it gets better.
For horse owners, this might mean a lot of changes as the veterinary profession tries to adapt. Some might find it more difficult to get care, and care might become more expensive. Veterinarians are tackling the issue on multiple fronts while trying to educate clients about how and why things might be changing.
The Missing Veterinarians
For years now, practicing veterinarians have noticed that fewer new equine vets were coming through the pipeline. Amy Grice, VMD, MBA, a veterinary business consultant in Virginia City, Montana, and treasurer of the American Association of Equine Practitioners, spent 25 years as an equine ambulatory veterinarian and was the managing partner of Rhinebeck Equine LLP, a large referral practice in Rhinebeck, New York.
“When we had an opening, we used to get 20 or 25 resumes, people just sending us resumes even when we didn’t have a position,” she recalled. “I left at the end of 2014, and for the last several years before that, when we had an opening, when we were growing [the practice], it was amazing; we might get one, two, possibly three resumes. And that was such a big change.”
Emma Read, DVM, MVSc, DACVS, associate dean for professional programs at the Ohio State University College of Veterinary Medicine and the immediate past president of the AAEP, said industry experts have seen this coming for a while.
“But I think really the crisis point came in the last couple of years,” Read said. “Certainly as I was coming into being AAEP president [in 2022], we really hit a point where we were hearing a lot from practices that now they could no longer hire anybody. Or from horse owners saying, ‘Hey, there’s nobody in my area that will do horses. I can’t get anybody to come out here.’ And so I think now we’re starting to reach the point where people have known it was a problem, but now people are starting to feel that pain.”
Analysis of AAEP data and the results of surveys Grice has conducted have painted a stark image. Approximately 1.3% of new veterinary school graduates go directly into equine practice, while another 4.5% continue their training in equine internships. That number is down from what it was just 10 years ago, Read said.
But most notable is that within five years, 50% of all these new veterinarians leave equine practice, either switching to small animal practice or leaving veterinary medicine altogether.
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The number of new veterinarians pursuing equine medicine is already small, Grice said—about 200 people per year go into equine practice or internships. In total, there were 3,785 veterinarians in equine-focused clinical practice in the U.S. in 2022, according to the American Veterinary Medical Association, comprising just 4.1% of all practicing vets.
“So you have this pipeline that’s been getting smaller and smaller. And now you have half of the students that go into [equine practice] are leaving, so then you really have a small number that you’re retaining at the five-years-out mark. We also have a huge volume of people retiring on the other end,” Read said.
About 33% of AAEP members are over 60, and 57% are over 45. The AVMA estimates that about 60 equine veterinarians retire every year, and that number is expected to increase by 3% each year.
“We’ve got a huge amount of people leaving. We’ve got not many people coming or staying,” said Read. “Then the generation sandwiched in the middle are the practice owners, and they’re working harder than ever and trying to sort of hold up both ends of that. And in the process, they’re overworked, and they’re burning out. This isn’t painting a very good picture.”
“Really the crisis point came in the last couple of years.”
Dr. Emma Read
In 2020, the AAEP convened a Retention Task Force, chaired by Carol Clark, DVM, DACVIM, to collect data and examine the pain points facing veterinary students, new graduates and practice owners and to formulate solutions. Based on information collected by the task force, the AAEP established the Commission on Equine Veterinary Sustainability in July 2022 with five subcommittees focused on separate topics: compensation, strategies for effective emergency coverage, veterinary practice culture, internships and supporting the growth and development of the equine veterinary student.
While there are myriad components to the problem of recruiting and retaining equine veterinarians, there’s one overarching truth: Compared to small animal veterinarians, equine vets work more hours for lower pay and have to provide 24/7 coverage for their clients.
Times Have Changed
The job of being an equine veterinarian hasn’t changed much from the days of the James Herriot books. It’s always been a tough, physical job, one that practitioners truly feel called to do, despite the hardships. So what has changed? Why have the numbers fallen off so precipitously?
“I think that the reasons are generational but also gender-based,” said Grice. “Generationally, these younger people have seen their parents really sacrifice their lives for their jobs. They may not have had a parent at home very much. When they were done with school, they’d come home and entertain themselves until their parents got home. They care about the environment. They care about being outside. They want to have a life outside of their work.”
In addition, the veterinary profession, and particularly equine medicine, has seen a dramatic swing in gender balance over the last several decades. Thirty years ago, less than 10% of equine veterinarians were women; today, the majority of new graduates are women.
By the time an equine veterinarian is entering the workforce—after four years of undergraduate, four years of veterinary school, and possibly an internship—he or she is nearing the end of their 20s, is perhaps married and thinking about starting a family, Grice said. The average starting salary of an equine veterinarian is around $89,000 (with lots of regional variation, of course), and the average student debt is about $180,000. “The debt-to-income ratio is insane,” she said.
Equine veterinarians work an average of 58 hours a week, likely more than that in the busy season, Grice continued.
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“If they want to actually have a family and actually ever see their children awake, it just doesn’t fit with the paradigm that has traditionally been equine practice,” she said.
Rhonda Rathgeber, Ph.D., DVM, is part of the field care service at Hagyard Equine Medical Institute in Lexington, Kentucky. She did an internship at Hagyard, and 29 years later is still with the practice. She managed Hagyard’s internship program for 17 years, and about two years ago she started a recruitment and retention task force at the practice. She also co-chairs the AAEP sustainability commission’s subcommittee on students.
“About 10 years ago, we started to notice in our internship pool the number of applicants had decreased. Mostly women were applying; very few men would apply, which represents the population at the vet schools at the moment,” she said. “I think we felt like it was going to turn around; everyone goes through lulls. I didn’t in any way think it was going to drop like it did.”
Technicians and support staff are also in short supply, and even the Thoroughbred farms that are the lifeblood of Lexington are having a hard time hiring staff, Rathgeber said. “I’m working now more than I’ve worked in probably 10 years, because we just don’t have people,” she said.
When asked how she’s flourished for so long in a profession that has proven to be unworkable for so many others, she says simply: “Help. Getting help. I hired a tech before having a full-time tech was cool, and I had a computer in my truck before that was cool. I had a high school girl that helped me run errands.”
Rathgeber, 56, has two daughters, who are now 20 and 23. “I had been doing seven days a week up until [having children]—and don’t get me wrong, I loved the seven days a week. I loved what I did, and I had a great time doing it,” she said. “But when I had the kids, it’s kind of a game changer, right? Because you can’t afford childcare, and I just wanted to be with my kids a little bit, which is not too much to ask, right? But nobody had ever done that at the practice. No one else had ever had kids. I mean, the men had—but they had wives!”
Rathgeber approached her bosses and said she needed to be able to take weekends off. “Honestly, I didn’t know if I was going to get fired or what. I didn’t know what was going to happen. Back then, [you had] to make X number of dollars to justify your existence here, and I wasn’t sure I could do that in five days versus seven days,” she said. “But to my surprise, they all said, ‘Absolutely. We’d rather have 50% of you than none of you. Just do what you need to do, and we’ll adjust it accordingly.’ ”
The abbreviated schedule forced her to be more organized and set parameters to her day, which also required some cooperation from her clients. “I have clients that will say, ‘Can you come and look at something today? I know you’re probably picking the kids up at four o’clock.’ Like, they still have that in their mind, that I’m going to be unavailable between three and five o’clock, because [I’m] picking up the kids [even though both daughters are in college now],” she recalled with a laugh. “It took some training. And, you know, not everyone stayed with me. That was OK, because there’s plenty to do.”
Rathgeber also noted that when she first started practicing, they were relying on pagers and two-way radios. “Thirty years ago, I didn’t have a cell phone; I had a little suitcase that was a phone. [The clients] didn’t have constant access to me,” she said. “It was much more difficult to get a hold of us 24/7, and that creates a whole different dynamic.”
This article appeared in the May 8 & 15, 2023, issue of The Chronicle of the Horse. You can subscribe and get online access to a digital version and then enjoy a year of The Chronicle of the Horse and our lifestyle publication, Untacked. If you’re just following COTH online, you’re missing so much great unique content. Each print issue of the Chronicle is full of in-depth competition news, fascinating features, probing looks at issues within the sports of hunter/jumper, eventing and dressage, and stunning photography.
