Are horse veterinarians checking out early?

More young equine veterinarians than ever appear to be leaving that sector of the profession in their first five years, according to results of the 2016 American Association of Equine Practitioners-AVMA Economic Survey. Starting with the class of 2000, 20 percent of former AAEP members had dropped their membership within four years of their graduation date. That increased to 50 percent for the Class of 2008 and to 55 percent for the Class of 2012.

Furthermore, 21 percent of those who graduated from 2012-16 and 33 percent of those who graduated from 2007-11 said they would change sectors if they could, while only 17 percent of graduates from 1997-2006 said they would.

"It's important that we think about the reasons people are unlikely to stay (in equine medicine). I think financial stress is probably big," said Dr. Amy Grice, one of the survey's contributors, during a presentation at the American Association of Equine Practitioners' 63rd Annual Convention, held Nov. 17-21, 2017, in San Antonio.

Exit surveys of nonrenewing members that the AAEP conducts indicate the reasons are primarily lifestyle and salary, and the association is developing strategies to address these issues.

Dr. Grice speculated that after the Great Recession, practices contracted, and with things looking dire, students graduating from veterinary school made practical choices to put aside their dream to be an equine practitioner and go into more lucrative sectors to pay off their debt. She added that, since the economy has turned around, more wealthy people who already own horses are buying more of them. This has resulted in more jobs in the equine industry overall.

"Now we are in a situation where there are not enough equine veterinarians to fill the need for them, but all we need is an economic downturn, and that will change again. I would like to see data for the next couple of years to see if AAEP membership flattens out or there is less attrition," Dr. Grice said.

Michael R. Dicks, PhD, director of the AVMA Veterinary Economics Division and one of the survey's analysts, said it's also unclear whether these individuals are leaving just the equine sector or the entire profession, though he casts doubt on the latter.

"The veterinary profession generally has a less than 1 percent leaving rate. Once you're a vet, you're a vet for life," he said.

That said, the overall number of equine veterinarians has remained stable. According to AVMA membership numbers, those who selected their practice type as equine predominant or equine exclusive totaled 2,638 (3.5 percent of membership total) in 2006 compared with 3,026 (3.4 percent) in 2016.

The AAEP also isn't the only membership organization that has seen declines in numbers of younger veterinarians, as many allied organizations have experienced a similar trend.

A look at the numbers

The AAEP-AVMA survey looked at many facets of equine practice, from an age-earnings profile to geographic distribution of practitioners. It was sent to 5,657 AAEP members in August 2016 and elicited a 17 percent response rate. The survey report also used data from the AVMA's 2016 census of veterinarians, the AAEP membership database, and AVMA Senior Surveys.

Results showed that most equine practices are small private practices with one owner (63.5 percent) or multiple owners (34.4 percent). Thirty-six percent of AAEP members worked in ambulatory practice, followed by 34 percent working in an ambulatory practice with a haul-in facility and 16 percent working at a specialty or referral center (full-service with an ambulatory division). About half (49 percent) of equine practices are located in communities with populations of 50,001 or more residents and have a robust number of colleagues (73.5 percent had six or more other veterinarians providing services to equine species in their primary service area).

One interesting survey result, according to Dr. Dicks, is that ownership gains came later in the careers of equine practitioners than for veterinarians in other sectors.

"There's quite a difference at the beginning of a career in terms of what veterinarians make as owners compared with associates for most veterinary sectors, but an experienced vet out 20 years doesn't have the premium associated with ownership. In equine, it is the opposite. That's worth looking into. What is the difference here? In general, ownership is something you want to do early on as a companion animal practitioner to get those benefits, but in equine it looks like you want to do that around 40 years of age," he said.

Using figures from the 2017 AVMA Pet Ownership and Demographics Survey and the U.S. Census of Agriculture, the estimated equine population has leveled off to an estimated 8.97 million in 2017 after dropping to 8.8 million equids in 2012 following the Great Recession from a high of 11.6 million in 2007.

As horse numbers are expected to rebound, another area for potential growth is increasing services, as many horse care services are not currently provided by veterinarians. Charlotte Hansen, a statistical analyst with the AVMA Veterinary Economics Division and one of the AAEP-AVMA Economic Survey analysts, said over 75 percent of the pet horse population is owned by a "backyard" horse owner, according to the 2017 Pet Ownership and Demographics Survey. Nineteen percent of owners said their veterinarian gives their horses' vaccinations, and 14 percent of barn owners or horse owners say they worm their own horses. More than 70 percent responded across all preventive care categories that it was "not an issue," either meaning they don't seek out these services or they get this care for their horse from a parallel service provider, she said.

Dr. Dicks recommended that if veterinarians bundle their services, including vaccinating and worming, they can lower the price on each service in the bundle and still make a better profit and provide better care to the horses. The first step is establishing wellness care guidelines for horses in a practitioner's area and then establishing the value of that care.

Better business practices

Dr. Margo Macpherson, 2018 AAEP president, wasn't surprised by the AAEP-AVMA report's findings.

"To me, the big things were money, which is largely associated with the ability to pay back student loans, and lifestyle—that is, what is the crux of being an equine practitioner. The lifestyle piece is what we need to work on first. That is our easier path toward a solution. The money side will always be a bigger challenge. An owner probably can't offer a salary of $150,000 to a new graduate to help them pay off their debt rapidly. We as a profession need to look at ways to increase salaries for equine veterinarians. That's something that evolves over time."

She admits that horse owners not fully using veterinary services is not a new concern. Dentistry has perennially been one of those services in addition to vaccinations.

"Plus, there's the wellness exam side of it. The wellness exam is not viewed as quite the same in some areas of equine practice as (it is in) small animal (practice). I‘m trained to take my dog to the vet annually, but that's not true among horse owners," she said. "It's all about training your client. It's about your client feeling there is value in it."

The AAEP created the program AAEP Touch: Tools to Connect to Your Clients and Their Horses (http://touch.aaep.org) in 2014 to increase client compliance. The program offers web-based tools and resources that are based on a client survey and market research, such as "Top 10 Things Your Clients Told Us" and "The Examination: Creating Satisfied Clients," which give tips focused on what various clients value in equine veterinary care.

Soon, the AAEP Touch program aims to join Partners for Healthy Pets in helping members see how they can implement forwarding booking in their practices.The association also started an advertising campaign this past summer to promote the value of dental care by equine veterinarians. Ads appeared online and in print. Members can download tools to promote dental care in their practice at www.aaep.org. The campaign will shift to wellness and promoting a wellness examination once a year, starting in 2018.

Meanwhile, Dr. Dicks said the AVMA Veterinary Economics Division is still studying lifetime care data for horses. It's more difficult for this species, he said, because there is so much variation in how a horse is treated, depending on the breed of horse and how it is used.

"We really need to discover what the total market value is out there so we can have some idea of how many equine veterinarians we need and where they should be located," he said. "It's a big issue we're excited about working on. This is a long-term project."

Related JAVMA content:

​What lies ahead (Feb. 15, 2013)