DVM Newsmakers: Endangered in the USA

CLEARFIELD, IOWA-He sat in the back of the ambulance, sirens blaring - an odd time for reflection.

With nose and ear still bloodied, his mind darted between his 10-year-old son he left behind at the scene, and the reasons he couldn't control the hyperventilating and persistent numbness in his hands and legs.

The pain throbbed for J.D. Hensley, a 39-year-old mixed animal practitioner. It was a time that he questioned his life-long career choice of working as a mixed animal veterinarian. He was angered by the predicament and the need for a different head gate.

"When you get into these communities, you pretty much know everybody. And everybody knows who you are," laughs Dr. J.D. Hensley.

At the time, he didn't yet know that he suffered three facial fractures after a well-placed kick from a bull during a castration.

He fell unconscious; his head hit the back of the squeeze chute as he collapsed.

The look on his son's face told the story that day.

Hensley softly smiled as he recounts the story. His experience is pegged as one reason in a litany of factors fueling a major shortage of veterinarians in rural America. It's a physical job.

The apparent trend has become so problematic, veterinary officials are calling it a national security problem due to the important role food animal veterinarians play in protecting this country's food supply. (See related story,)

Despite the injury risk facing mixed animal veterinarians, Hensley believes that life in rural America has one big arrow in its quiver - it's called quality of life.

It keeps him in Clearfield, population 300.

There are no traffic jams; everyone in town knows each other, and this practice lifestyle is the last holdout to an idolized James Herriot practice experience.

"I guess the best way to describe Clearfield is that it's a friendly town. When you get into these communities, you pretty much know everybody. And everybody knows who you are," Hensley laughs.

He and his mixed practice colleagues in remote areas are becoming somewhat of an endangered species in the United States, so much so that veterinary leaders and lawmakers are scrambling to resolve the issue by funding the National Veterinary Medical Service Act, which would provide educational debt relief to graduating veterinary students if they choose to work in under-served rural areas. (See related story.)

The long-term trend is that America's rural infrastructure is aging and shrinking in numbers. Clearfield is living proof. The 2002 Census of Agriculture shows the average age of principal farm operators at 55.3, which has been steadily increasing. So has the percentage of farm operators 65 or older (more than one in four). Conversely, principal farm operators with average ages less than 35 (5.8 percent of the total) have been declining since 1982.

Hensley says people leave rural communities for the higher paying wages in cities, or sell farms to developers or consolidators because of tougher economic times. Conversely, land prices are going up due to investors plotting future bets on the next wave of urban sprawl.

The movement is taking its toll on the numbers of veterinarians practicing in rural America, too. According to American Veterinary Medical Association (AVMA) data, about 63 percent of the 63,259 actively employed U.S. veterinarians work in private practice treating small animals exclusively. The rest of the numbers stack up differently - small animal predominant, 11.8 percent; mixed animal, 8.3 percent; large animal predominant, 5.9 percent; equine, 4.7 percent; large animal exclusive, 4 percent; and other species, 1.1 percent.

Attitudes about treating large animals have changed as well. An AVMA survey of graduates says 25 percent are willing to devote at least part-time work to large animals, while 10 years ago the number was closer to 36 percent.

The shortage is so bad in rural America that some practitioners are resorting to building new clinics in an attempt to snare young veterinarians.

Hiring veterinarians to work in his area isn't measured in months, but in years, Hensley says.

He and his partner, who manages another practice in a neighboring community, have been looking for an associate veterinarian for three years. Some practices in the area have been in the hunt for the last five years.

Hensley's reality isn't uncommon; there's no one behind them to pick up slack or new work.

"I look at it in different ways. If I ever get to the point where I am a solo practitioner, I'd like someone there to service my clients. We provide quality and timely service. What worries me is what if I want to leave for even a weekend, who is going to service these clients?" While retirement is far off for the middle-aged father of three, Hensley wants a return on his investment. The reality is that if this trend isn't abated, some retiring veterinarians might be forced to simply close their doors, a worst-case scenario that would also leave a void in coverage to communities.

Challenges in recruiting veterinary students to move into the country seem almost insurmountable - lower wages, incoming female veterinary students are choosing small animal practice, not as many veterinary students have agricultural backgrounds, farms continue to consolidate, and there is a lot of drive time.

But there is freedom in the country, and it's a lifestyle Hensley is gladly giving to his children.

"This is where I want my children to grow up." He adds that many of the people in his community are also good friends - lifelong friends.

For Hensley, the toughest part of his job is not getting "run-over by cow," bitten by a dog or even stitched up by his partner on occasion; it's actually charging his clients.

"I am friends with most of my clients. It's hard for me to charge them," he says. "I try to manage people's money for them. I know that I shouldn't, but when you know everybody, you start thinking about their dollars, too. I would love to work for this community and not have to charge anything, but it just doesn't work that way."

Hensley has no regrets. While every day brings small "victories and failures," he recognizes he is a respected and trusted community member.

"Our clients trust us. They trust our opinion, and they depend on us to make their decisions. You may not find that in urban areas."