Is the Equine Veterinary Profession Up for Something New?

‘New’ is what’s needed to firm up the ranks of equine veterinary practitioners. 

The newest generation of equine veterinarians has different ideas about professional and personal satisfaction than those who came before them, and today’s practice owners should consider re-evaluating their business models to accommodate them. This is particularly true as the profession and the industry worry about a shortage in their ranks.

Justin High, DVM, a veterinarian and partner in Reata Equine Hospital in Weatherford, Texas, put the issue succinctly in the 2023 spring issue of Quarter Horse News: “The expectations, standards and history within equine veterinary medicine were built by hard-working, task-oriented perfectionists who laid the groundwork where few people these days care to walk.”

Statistics tell the story

According to the AAEP, approximately 1.3% of new veterinary graduates enter equine practice directly each year, and another 4.5% pursue further training in equine internship positions. Within five years, however, 50% of all these veterinarians leave for small animal practice or quit veterinary medicine altogether. The primary reasons are burnout due to the personal demands of the profession and personal struggle due to the lower starting salaries in equine practice when compared to those in companion animal practice, according to AAEP. Many new veterinarians begin their career with more than $200,000 in student loan debt.

“Finding our way forward as an industry will require innovative ideas, flexibility, family-friendly cultures, shorter work weeks, better boundaries, capturing all revenue, improved efficiency, and higher fees,” wrote veterinary business consultant Amy Grice, VMD, MBA, in the 2021 AAEP Proceedings. “In addition, improved internships, collaborative emergency services, better support and mentoring for new graduates, client education, and competitive salaries will be needed. Fostering connection, minimizing injury, and modifying restrictive covenants are also important.” Dr. Grice is a co-founder of Decade One, a network of regional peer groups for equine veterinarians.

Sustainability

In 2022, the AAEP formed the Commission on Equine Veterinary Sustainability to develop strategies to retain and recruit more veterinarians to equine practice. The Commission is led by AAEP-member volunteers with work focused in five key areas: compensation, strategies for effective emergency coverage, veterinary practice culture, internships, and supporting the growth and development of the equine veterinary student. While developing solutions to these five key factors, the Commission intends to ensure that the needs of one- and two-doctor practices are carefully considered. Approximately 50% of AAEP members operate practices of this size. Outreach to horse owners and equine industry partners will create expanded awareness and yield additional perspective.

“The feedback we’re receiving from equine veterinarians about the Commission’s work so far is very encouraging,” said AAEP Executive Director David Foley. “AAEP members are sharing that they are using the new tools we’ve developed in practice, and positive change is happening. This includes, for example, practices deciding to offer more flexible work schedules for their team and changing how they distribute emergency fees to ensure that the on-call veterinarian receives better compensation for their time. Former equine veterinarians who left for small animal practice are encouraged about the culture shift happening and are interested in returning to equine practice.”

One of the biggest pain points for small practices is emergency coverage, he said. The AAEP Commission’s Emergency Coverage Subcommittee has developed several models to help ease the burden of after-hours care for small practices. These include pursuing emergency cooperatives with other equine veterinarians in the same geographic area, setting clear limits on who receives emergency service from the practice, requiring clients to haul-in their horse for after-hours care, and using the services of an area referral hospital for client care after hours.”

But implementing new methods of compensating veterinarians and staff, accounting and scheduling won’t be easy. “These tactics all involve changing an aspect of the current business model, and it presents a culture shift for both the equine practice and their clients,” said Foley.

“Equine veterinarians are very dedicated to their clients and sensitive to any changes that may create a hardship,” he continued. “However, equine practices who have already made changes are sharing with us that clients are presenting very little pushback. The horse industry is aware of the shortage of equine veterinarians. Many have experienced it firsthand, and they want to see their veterinarian have an improved quality of life, which involves change. It can be a leap of faith for an equine practice to change a long-standing policy, but we are seeing many, many positives when they make a change that prioritizes their personal and professional well-being.”

Collaboration

To help retain experienced equine veterinarians, some independent practices have banded with others to share the load of some of the most demanding facets of equine medicine, including emergency calls.

Cavalcade Management Group was co-founded in 2017 by three upstate New York practices: Millbrook Equine, Rhinebeck Equine and The Equine Clinic at OakenCroft. “There is a strong cohesion between our practices through which our veterinarians frequently collaborate on cases through our referral network, which is a huge asset to our clientele,” said Miranda Gosselin, DVM, partner at Millbrook Equine and member of the Cavalcade Education Board of Directors. Cavalcade members look for ways to share expenses to minimize costs for all three practices, and “we try to work together to minimize redundancy and improve the experience for employees, clients, and patients.”

Cavalcade also aims to support and offer educational initiatives for horse owners, veterinary professionals and equine veterinary students. “The collaboration between our independently owned founding practices enables us to host events that are more robust and relevant for all three of those groups,” she said.

First hosted in 2016, Cavalcade’s Future Equine Practitioners Weekend offers equine veterinary students in all years of study two days of wet labs, discussion and networking opportunities. The event culminates in an Intern Fair. Said Dr. Gosselin, participants say they appreciate the opportunity to get experience using various pieces of equipment, such as ultrasound; enjoy the practical applications of what they’ve read in a book or learned in the classroom; benefit from networking with vets, other students and industry members; value candid conversations with practicing equine vets; and come to understand/ experience that practices and practitioners can be collaborative and collegial.

“We’ve found that focusing on the positive aspects of equine veterinary medicine has been tremendously well-received. While our veterinarians don’t sugarcoat their experiences, a lot is achieved through proactive management of expectations. We are hopeful that through experiences like FEPW, we can help foster a positive experience and provide examples of how equine practice can be rewarding and sustainable.”

Mentoring

Another networking event – the Opportunities in Equine Practice Seminar – is designed to encourage students to enter equine practice upon graduation, said event organizer Craig Lesser, DVM, CF, of Rood and Riddle Equine Hospital, which has locations in New York, Kentucky and Florida. The most recent OPES occurred in September 2023 in Lexington, Kentucky, after a 10-year hiatus. More than 250 students met industry partners, toured equine hospitals and local horse farms, visited Keeneland racetrack and participated in workshops.

“It was long overdue,” said Dr. Lesser. “We have been in a shortage of equine veterinarians for the past few years and historically this event has helped with recruitment of veterinarians into equine practice. It was incredible to see the outpouring of support from equine practices and industry.

“We were able to open the opportunity for students to discuss with practitioners their experiences in equine practice and have an open dialogue about the rewards along with what they have done to conquer the challenges we face as practitioners. We also exposed them to a variety of niche types of practice that fit with different practitioners, interests and lifestyles.” The seminar’s career management format offered practice and financial management information for students as well as opportunities for practitioners to establish long-term mentoring relationships.

“Some practices were on hand to discuss how they are fighting against an equine veterinary shortage,” said Dr. Lesser. “Some practices are switching to four-day work weeks and have noticed through efficiencies that they are actually producing more in a shorter period of time. Some practices are starting to think outside the box on how best to compensate veterinarians so they can live the life they want to live both financially and socially.

“Equine veterinary medicine is an extremely rewarding career; it has taken me places I never dreamed possible,” he said. “While it does have challenges, practitioners are coming up with creative solutions to combat them, from four-day work weeks to call-sharing. However, at the end of the day, the relationships I get to build with clients and patients are unmatched compared to any other aspect of veterinary medicine.”

Easing the strain of emergency coverage

Solo equine practice allows veterinarians to shape the business into their unique vision of professional success. But it also presents downsides, including the absence of a team to share after-hours emergencies. To begin regaining control of personal and professional schedules, the AAEP Emergency Coverage Subcommittee advises equine veterinarians to consider how the following actions may benefit their practice.

Provide after-hours care only to current clients. Be sure to define what a “current” client means to you and communicate this to horse owners.

Require clients to bring horses to you. Providing treatment at a central haul-in location can increase your efficiency and alleviate drive time. Some emergencies can’t be trailered, but this option shares the responsibility for acquiring care with the client.

Limit hours of emergency coverage. Dr. Meggan Graves of the University of Tennessee College of Veterinary Medicine found that only 2.6% of equine field ER calls occurred between midnight and 6 a.m. Providing instructions on how to proceed to a referral center during these hours decreases the burden on the practitioner.

Charge appropriately. After-hours care is overtime work, and veterinarians should be compensated as such.

Educate clients about true emergencies. The more your clients understand when to call you, the fewer non-emergency calls you will receive.

Use a third-party triage service. A triage service can address clients’ concerns and allow the veterinarian to follow up during normal business hours. Typically, these services – staffed by veterinarians – charge the client, not the practice.

Don’t respond to client convenience messages after hours. Use an auto-reply message to provide instructions for true emergencies and acknowledge you will respond during regular hours.

Take care of yourself first. Recognize when you are getting overburdened and schedule some time off – the same as you would any other appointment. But make sure to keep it! Hiring an assistant is the No. 1 way to increase efficiency.

Source: “Emergency Coverage in Solo Practice: Solutions to Ease the Strain,” AAEP Emergency Coverage Subcommittee

Flexibility for a changing workforce

Females comprise more than half of equine veterinarians, and forward-looking practices are adjusting accordingly, wrote veterinary business consultant Amy Grice, VMD, MBA, in the 2021 AAEP Proceedings. Those adjustments begin with maternity leave policy. “Having a collaborative plan in place in advance for maternity leaves is smart business,” she said. “The alternative is often losing talented associates.”

Instituting a maternity leave policy is just the beginning, though. “Veterinarians with young families generally cannot work long hours each day, six or seven days per week, as has traditionally been the norm in equine practice,” wrote Dr. Grice. “Having a ‘hard stop’ to the day is often necessary to allow children to be picked up at daycare or from after-school activities. Household necessities such as grocery shopping and doctors’ appointments must be attended to as well. Many female veterinarians are married, with spouses that are employed full time and often not available for these responsibilities, and many young families don’t have relatives nearby to provide help.

“Practices that offer shortened workdays and work weeks will attract and retain associates more successfully. A four-day work week with no routine appointments scheduled to begin past 3 or 4 p.m. can help provide time that current associates need.”

Source: The New Paradigms Needed in Equine Practice: AAEP Proceedings

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