AAEP develops resources to recruit, retain equine veterinarians

Like many equine practices, Southern Equine Service in Aiken, South Carolina, sees a lot of emergency cases. In 2022, the practice saw 1,687 emergencies, or an average of 4.6 a day.

While practices usually charge more for emergency visits, 42% of equine veterinarians surveyed in the American Association of Equine Practitioner’s 2022 Equine Salary & Lifestyle Survey say they make no additional money from such visits.

With many parts of the United States experiencing a shortage of equine veterinary services, the AAEP developed a much-anticipated strategic plan to address the sustainability of the equine practice in the years ahead.

From the strategic plan, the AAEP launched its Commission on Equine Veterinary Sustainability at the end of 2022. As part of that, the association interviewed practice owners, recent graduates, and veterinary students to identify pain points and desires that impact satisfaction in practice.

Dr. Jennifer Reda, an associate veterinarian at Southern Equine Service, and her colleagues said they used to receive a portion of the emergency fee for each visit, but not all. However, after reviewing the AAEP survey, they collaborated to restructure the practice’s compensation model on emergency fees so that the full emergency fee would go directly to the doctor seeing the emergency They presented their case to practice ownership—and the owners agreed.

“Knowing that the doctor who sees each emergency will receive that whole ER fee—and ours are very reasonable—helps encourage us to get out there and see the emergencies and receive our fair compensation for the disruption it brings to our lives, evenings, nights, weekends, and families,” said Dr. Reda, who serves on the who serves on the Compensation Subcommittee of the AAEP Commission on Equine Veterinary Sustainability .

Sustainability initiative

Dr. Katie Garrett, president of the AAEP, said the organization found that approximately half of those who enter equine practice after veterinary school leave within the first five years of their career.

“That’s a high attrition rate and is obviously very concerning when we look at the future of equine practice in terms of making sure that we have enough veterinarians to serve the needs of horses and their owners,” she said.

The commission then created five subcommittees focused on the following areas: compensation, strategies for effective emergency coverage, veterinary practice culture, internships, and supporting the growth and development of the equine veterinary student.

Compensation for equine veterinarians

The AAEP Compensation Subcommittee’s first project involved conducting a salary survey since the last one was done 15 years ago. Results from the 2022 Equine Medicine Salary & Lifestyle Survey, released in October 2022, showed that the mean salary for a recent graduate in equine practice, not including internship positions, was $89,000 a year. Historically, however, that number has been much lower.

“Although incomes are increasing, low compensation relative to other sectors, high student loan debt, and long working hours remain concerning to new graduates,” said Dr. Amy Grice, former AAEP treasurer and member of the AVMA Veterinary Economics Strategy Committee.

A total of 1,378 AAEP members from all career stages participated in the survey, including veterinary school graduates from before 1976 to those who graduated in 2021.

In fact, among those benefitting from the recent increase in average income levels are also those experiencing much higher debt loads. While nearly two-thirds (65%) of survey respondents from all career stages had no educational debt, another 12% owed an amount that was less than their current annual salary.

Among those who graduated in 2016 or later, 27% owed an amount that was at least quadruple what they currently earned in a year. Given that the mean annual salary of 2016-21 equine veterinary graduates is just under $77,000 when including those who were finishing school or pursuing an internship in 2020-21, that equates to a debt of over $300,000 for more than one-fourth of recent graduates, according to the AAEP. 

Other key findings are as follows:

• Among all ages surveyed, the average salary was $154,217.
• Continuing education (CE) expenses, AAEP dues, and liability insurance were employer-provided to at least eight out of 10 respondents and were the most widely provided benefits. Dues for other associations, paid vacation leave, and CE leave were provided to at least six out of 10 respondents. Three other benefits were provided to half or more of all respondents: medical insurance, retirement with a company match, and paid sick leave.
• The average number of hours worked by respondents during the busiest quarter of 2021 was 57, while an average of 39 hours were worked per week during the least busy quarter of the year.
• Overall, more than eight out of 10 respondents reported being “very” or “somewhat” satisfied with their job. Those who had been in equine medicine the longest reported much higher levels of job satisfaction than those who graduated within the past decade, especially those who were the most recent graduates.

The latest resource from AAEP is the Equine Veterinary Fee Survey. Released in March, the survey collected data from members participating in Decade One, a formal mentorship program, and Veterinary Management Group 16, a professional membership organization for veterinary hospital owners. The data represents equine veterinarians from a variety of geographies and practice types. The survey includes a breakdown of costs for various types of examinations, regional anesthesia, radiological services, surgery, diagnostics, treatments, emergency visits, farm calls, and more.

Educating members on how to calculate fees for service, offering methods for increasing efficiency, and investigating gender differences in revenue production will all be part of the AAEP Compensation Subcommittee’s continued work.

Emergency coverage and practice culture

Surveyed practitioners reported working an average of 104 on-call weeknights and 22 on-call weekends in 2021.

“With an average of 6.1 veterinarians per practice, this suggests that on-call responsibilities are not distributed equitably,” according to the survey.

The AAEP Emergency Coverage Subcommittee is focused on identifying strategies to ease the emergency coverage burden. So far, it has created a comprehensive toolkit, “Emergency Coverage 2.0: Innovative Strategies to Revolutionize After-Hours Care” that describes a variety of successful models of emergency coverage.

“As equine veterinarians reevaluate what after-hours care looks like for their practices, innovative emergency coverage models are rapidly emerging,” according to the toolkit authors. “More solutions are available than ever before to reduce the burden of 24/7 client care: emergency service cooperatives, referral hospitals with emergency departments, restricting emergency service only to clients, restricting emergency service to those who will haul a horse to the practice facility, tele-triage services, emergency-only equine practices, and the use of relief veterinarians.”

Meanwhile, the AAEP Practice Culture Subcommittee identified seven pillars that contribute to a positive workplace culture, which has been shown to reduce employee turnover, enhance workplace environment, and improve profitability.

“We all want to work at a place where we feel valued and respected,” Dr. Garrett said.

For each pillar, the subcommittee developed a variety of resources for practices and staff members, including a practice owner handbook, “with actionable resources for owners to both evaluate their culture and then improve upon it to help make every practice a place everyone wants to work,” Dr. Garrett explained.

Additional tools include a culture transformation toolkit, “Building a Thriving Equine Veterinary Practice: A Culture Transformation Toolkit”, an employee reward and recognition assessment, and a giving and receiving feedback survey for employees.

Engaging with students and mentorship

The Student Subcommittee prioritized outreach to veterinary students and conducted a survey of veterinary students to determine their needs. They created a speakers’ bureau of practitioners to visit veterinary schools to share their positive experiences. This group visited 25 veterinary schools in 2023 and has plans to visit the remainder in 2024. 

“With an estimated 50% of early-career equine veterinarians leaving for other opportunities within five years of graduation, primarily for companion animal positions, the need for change is acute,” Dr. Grice said.

The Internship Subcommittee created documents to help students choose internships that are right for their goals, as well as materials to help mentors assess interns’ progress and build a program that attracts new veterinarians.

In 2023, this subcommittee also held webinars and produced several resource documents. These efforts include Best Practices Guidelines, a red or green flags document for internships, an internship core competencies document, a competency feedback form, and more.  

“We know how important mentorship is for all young people, but equine practice has some unique challenges,” Dr. Garrett explained. “Equine practitioners are often by themselves or with an assistant or technician on a farm. These aspects can lead to feelings of isolation.”

Mentorship can provide a source for case advice, general professional advice, as well as a sense of community. For example, early career equine practitioners who completed a formal mentorship program stayed in equine practice at a rate of 95%, Dr. Garrett said.

Putting resources into practice

Dr. Reda says the AAEP compensation survey also motivated her and her colleagues to consider changes to their work hours to achieve better work-life balance. Survey results showed that those working in practice reported working an average of 5.3 days a week during the busiest quarter of the year and 4.4 days during the least busy quarter.

Dr. Reda and three other associates asked the practice owners for a six-month trial period of a four-day workweek from July to December 2023, which they allowed. All four veterinarians who participated reported great satisfaction with the new arrangement. 

Dr. Reda said she was more productive over four days a week than she had been working five days a week in the previous year. She did not work any longer days than usual on those four days. For example, in the fourth quarter of 2023, she produced $13,000 more than she had in the fourth quarter of 2022.

“I credit the day off with allowing me to stack all my appointments and items to be done during business hours all on one day, which makes me more efficient and productive on the days I work,” she said.

“Other practitioners in our (AAEP) Compensation Committee confirmed this trend in their practice,” Dr. Reda said. “Many doctors working four days actually were producing more than when they were working five days, and even the practice as a whole was doing better.”

She continued, “My advice to other associates is: Do not be afraid to ask for the change that you need. Just because it hasn’t been done before in your practice, does not mean that it cannot be done.”