Report pinpoints heavy veterinary shortage in Appalachia

Veterinary students at work at Lincoln Memorial University's College of Veterinary Medicine. Courtesy of LMU.A report out of a newly launched veterinary school in northeastern Tennessee makes the case that the need for veterinarians in rural areas-specifically, in this case, rural Appalachia-is much greater than previously thought. What's more, officials say, this report has the potential to increase federal spending through the Veterinary Medicine Loan Repayment Program.

The 2015 State of Animal Health in Appalachia report was released in mid-October during a conference put on by the Center for Animal Health in Appalachia (CAHA), a newly created institution affiliated with the College of Veterinary Medicine at Lincoln Memorial University (LMU) in Harrogate, Tennessee.

Part of LMU's stated mission is to improve the breadth and quality of healthcare services in rural Appalachia, and two years ago university officials decided to study both the need and opportunity for veterinary medicine in this region of the country, officials say. With the help of analysts from the National Center for Healthcare Analytics in Blacksburg, Virginia, they determined the distribution of livestock, pets and veterinarians in 420 Appalachian counties in 13 states.

The region defined as “Appalachia” by the Appalachian Regional Commission, a federal agency established to help improve the conditions of this region of the United States, includes all of West Virginia and parts of Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia.

The Appalachian footprint. Courtesy of the Appalachian Regional Commission.

The region is “bound geographically by the footprint of the Appalachian Mountains, bound culturally with a fierce sense of self-sufficiency, and bound by poor infrastructure, poor health metrics, and little access to healthcare,” says Jason W. Johnson, DVM, MS, DACT, executive director of the center, in the report.

The goals of the study were twofold, Johnson says: to quantify the need for veterinary services in Appalachia and to analyze the economic impact of existing veterinarians on their surrounding communities. “Veterinarians are out there-on the hills, in the valleys-and are important to advancing Appalachia,” Johnson says.

To conducts its analysis, the Center for Animal Health developed a modeling system to estimate county-level need for large and mixed animal veterinarians within Appalachia. It found that there are 7,178 actively practicing veterinarians within the Appalachian footprint, and these veterinarians support an estimated 13.8 million companion animals and 13.7 million large animals. They employ about eight people per practice, the report says, and their practices contribute an estimated $2.3 billion total to the Appalachian economy.

Based on the study's modeling, there is an overall excess of 264 full-time veterinarians within Appalachia as a whole. However, when the data is examined on a county level, it shows that 75 percent of rural Appalachian counties have a veterinary shortage, estimated to be 1,907 veterinarians, which translates to an economic loss of $621 million and 15,256 jobs, according to the report.

Gary Sherman, PhD, national program leader for veterinary science with the U.S. Department of Agriculture, says the report has tremendous implications for the Veterinary Medicine Loan Repayment Program (VMLRP), which his agency administrates. The VMLRP provides up to $25,000 in student loan forgiveness annually to veterinarians who work in designated U.S. shortage areas.

“The nuanced shortage information you have developed in the Appalachian footprint is going to be, I think, key to the success of the future of the VMLRP,” Sherman told those assembled at the LMU College of Veterinary Medicine for the release of the report. “We [at the USDA] are realizing after six years of running this program that's actually the level of information that we need in order to properly identify shortages.”

Sherman says state officials in Appalachia are fortunate to have such strong data to use going forward when they nominate areas for consideration when the USDA allocates VMLRP funds.

Joe Kinnarney, DVM, president of the American Veterinary Medical Association (AVMA), agreed, urging those gathered to lobby Congress for passage of the Veterinary Medicine Loan Repayment Program Enhancement Act. If that bill passes and removes the 39 percent withholding tax recipients must pay on their forgiveness funds, the VMLRP will be a viable way for veterinarians to pay down their student debt, Kinnarney says. “The data you have collected will help us make decisions, help veterinary colleges make decisions. To me, this is amazing and I applaud you on it,” he told CAHA leaders.

Michael Dicks, PhD, director of the AVMA's Veterinary Economics Division, says he would like to see the center's work replicated across the United States. “This is the kind of thing we need to have done so that we can better understand what the needs are for veterinarians across the country,” he said during the conference.

Applying CAHA's work nationwide has the potential to increase VMLRP appropriations from five million to tens of millions of dollars a year, says Mark Cushing, JD, founder of the Animal Policy Institute and LMU's vice president for public affairs. “My friends in Congress say that $5 million does not constitute a real problem,” he says. “They say, ‘Call me when you have a $50 million problem.' This has the power to do that.”