Creating a Better Future for Equine Veterinarians

What steps can be taken within veterinary practices and the industry at large to retain more equine veterinarians?

“I’ve always wanted to be an equine veterinarian. You are so lucky!”

These are words equine veterinarians frequently hear, but the reality of this career isn’t always rainbows and pony kisses. Equine veterinarians play a crucial role in the health and welfare of horses, but numerous factors impact the sustainability of equine veterinary practice.

According to data compiled by the American Association of Equine Practitioners (AAEP), approximately 1.3% of veterinary graduates enter equine practice and 4.5% gain further training through an equine internship. However, within five years, 50% of these newly minted equine veterinarians leave for small animal medicine or seek employment in a completely different field. This has led to an equine veterinary shortage, endangering equine welfare in many areas. Changes are necessary to prevent more veterinarians from leaving the field, but many practice owners have trouble instigating new policies and work models.

Recognizing the challenges

Veterinarians in all fields face issues, such as burnout and compassion fatigue, that make the career challenging, but equine veterinarians encounter additional, unique obstacles.

Long hours

Equine veterinarians work long hours, including nights, weekends and holidays, because emergencies, such as colic, foaling difficulties and severe injuries, don’t adhere to a 9-to-5 schedule. This can lead to an unpredictable work-life balance, and planning personal time or family activities can be a challenge.

According to practice owner Katy Cilinski, DVM, “Our schedule can change at a moment’s notice with add-ons and emergencies, so we never know how long the day will last. And, as an equine ambulatory veterinarian, we cover all our own emergencies, which means we have to be available to see horses 24 hours a day, 365 days a year.”

According to the American Veterinary Medical Association (AVMA) 2023 statistics, 56.5% of equine veterinarians are female, and the extensive job demands can make juggling family time difficult. As the mother of 3- and 5-year-old daughters, practice owner Sarah Jo Luby, VMD is familiar with these struggles.

“I was missing a lot of things, like first steps, and it was keeping me up at night, because I felt like I was giving my family the short end of the stick.” She left ambulatory practice and started her own practice, where she offers elective services, such as chiropractic, acupuncture and dentistry, and relief work. This gives her more control over her schedule and she can set boundaries that work for her and her family.

Travel

Traveling to see equine patients on farms, stables and training facilities can involve covering large geographic areas. “Driving long distances made the day extremely inefficient,” said Dr. Luby. “This problem is only going to worsen as urban sprawl continues, and figuring out how to plan my day without wasting an excessive amount of time was sometimes challenging.”

Unpredictable patients

Another factor is the horse’s unpredictable nature. “Most of our patients are amenable to being handled,” said Dr. Cilinski, “but sometimes you get the surprise horse that has a bad reaction to what you’re trying to do. This creates safety concerns for myself, my technician and the other people on the farm, and it’s my job to keep everyone safe.”

Staff turnover

Many practice owners cite difficulties with support staff turnover. Dr. Cilinski said, “In talking with other business owners, there seems to be a group of individuals that like to try something different, and they migrate from job to job.” This can make keeping and building a strong team difficult and puts a strain on those who are loyal to the practice when they have to cover extra shifts.

Rising costs

The increasing prices of veterinary care and other expenses associated with horses are forcing many people with low to mid-level income out of the industry. “Horses are becoming more of a luxury item,” said Dr. Luby. When clients call around to price shop for services, veterinarians may feel pressured to keep their prices unsustainably low to retain business.

Veterinarians, including equine veterinarians, tend to be empathetic perfectionists. Dr. Cilinski admits that after years of practice, she still goes to bed wondering if she could have done something better. “I struggle with my clients’ expectations. I want to please everyone, and if they want an appointment right now, I really want to make that happen. But, sometimes all my vets have a full day and we can’t squeeze them in. I see it as a personal challenge to get that horse seen and fixed as soon as possible.”

Mentorship is becoming more common in veterinary medicine, but guidance and psychological safety are sometimes lacking in the equine field. “This isn’t unique to equine medicine, but a culture of shame and blame can be another source of stress and demoralization for newer veterinarians and ultimately is a detriment to patient care,” said Dr. Luby. “I feel like many practices could benefit from regular morbidity and mortality rounds to establish a culture of psychological safety and allow veterinarians to learn from their mistakes and near misses.”

New equine veterinarians also face financial strain. Starting salaries for equine veterinarians are significantly lower than those of companion animal veterinarians, and many new graduates leave veterinary school with more than $200,000 in student loan debt.

Addressing the problems

So, what can be done to ensure the number of equine veterinarians doesn’t continue to dwindle? While progress is slow, the equine veterinary industry is improving the quality of life for equine veterinarians and their support staff. Some practices have implemented a four-day work week, so veterinarians work overlapping schedules, which helps improve their work-life balance. Dr. Cilinski’s team works a four-day work week, and the veterinarians rotate on-call on holidays and weekends to optimize quality of life. “And, on long days, we provide pizza and sandwiches, so our team knows hot food is waiting for them when they get back to base,” she said.

Dr. Luby thinks the equine industry needs to take a few lessons from the small animal field. “Working long, unpredictable days, and then having to cover emergencies during nights and on the weekends is just not sustainable,” she said.

Emergency strategies

A common stressor among equine practitioners is finding solutions for emergency coverage. Some potential strategies include:

• Forming an emergency cooperative. Providing emergency care for clients can be especially difficult for solo practitioners and those in small practices. One solution is to team up with other veterinarians and share on-call duties, with the understanding that they will not perform routine work during the emergency visit and clients return to the original veterinarian the next business day.
• Emergency-only practice. In some areas, interested equine veterinarians have the opportunity to start an emergency-only practice. This would allow them to be free during the day, while providing emergency coverage for participating practices.
• Client-only coverage. Some practices provide after-hours emergency coverage only for current, active clients, which can cut down on the veterinarians’ burden.
• Haul-in emergency service. For practices with a hospital or clinic, requiring clients to haul in their horses for emergency treatment can reduce travel time and costs for hourly workers.
• Relief veterinarians. Relief veterinarians can also benefit many practices. They can help practices to continue offering emergency care while allowing their veterinarians to take time off for vacations, maternity leave and continuing education.
• Referral practices. If your area has a referral practice, your clients can contact them for after-hours emergency care.

Client education

Client education is another important factor in improving the equine veterinary industry. “If owners hear about the struggles we face, maybe they’ll soften their expectations a little,” said Dr. Cilinski. Educating clients about what constitutes an emergency can also help, so they don’t call in the middle of the night for an issue that can wait until normal business hours.

Veterinarians should also set boundaries with clients to preserve their time, energy and mental health. This improves communication by clarifying what clients can expect in terms of availability and response times. Clients who understand these limits are less likely to make unreasonable demands or feel frustrated when they don’t receive an immediate response. This leads to better, more respectful interactions and a more positive client-veterinarian relationship.

Distributor representatives can also help equine veterinarians. Offering discounts and rebates for practices, especially small practices, helps alleviate some of their financial burden. Client education events are also great opportunities.

“These events show the client the value of a product and get potential new clients in the room with the practice,” said Dr. Luby. “They can give me talks all day about a new product, but that information doesn’t help me if I can’t sell it.”

Technical skills labs offered by distributor representatives also benefit practices. “We are fortunate to have great reps,” said Dr. Cilinski. “The BAL and gastroscopy labs that they set up have been really helpful for our veterinarians and support staff.”

Equine veterinary sustainability is an important issue that AAEP is currently working to improve through its Commission on Equine Veterinary Sustainability. Veterinarians can also attend the Sustainability in Equine Practice Seminar and Retreat to learn more strategies for improving the quality of life for equine veterinarians.

Survey on Salary and Lifestyle

In 2022, the AAEP conducted an Equine Medicine Salary and Lifestyle Survey of its U.S.-based members to determine the average salary among those practicing equine medicine, with a specific interest in exploring the salaries of recent graduates. Among all those surveyed, the average (mean) salary was $154,217. The salary among those who have graduated in recent years (2016-2019 graduates) was $88,973. To read the full results visit aaep.org/resource/2022-equine-medicine-salary-lifestyle-survey.

Photo credit: Iryna Inshyna/fotoedu, istockphoto.com/fotoedu