Rural veterinary shortage caused by retention issues, not attraction

NATIONAL REPORT — Two companion studies that delve into the motivations to enter and leave rural veterinary practice could provide key insights for recruiters and veterinary colleges trying to sway incoming veterinarians into practicing in underserved areas.

The key points made by the studies are that most veterinarians who enter rural practice make up their mind to do so long before entering veterinary school. They are attracted more by the lifestyle of the rural veterinarian than the salary or other incentives. However, the lifestyle of the rural veterinarian often plays a part in many leaving rural practice as they mature.

The studies, "A survey of reasons of veterinarians enter rural veterinary practice in the United States" and "A survey of reasons of veterinarians leave rural veterinary practice in the United States," were published through a combined collaboration between veterinary college researchers in Oregon, Ohio, Michigan, Colorado and Iowa.

Why choose rural practice — and when?

More than 92 percent of 1,126 respondents in the first survey reported an interest in rural practice. Those uninterested in rural practice primarily consisted of women, members of generations X (born between 1964 and 1978) and Y (born after 1978), veterinary students and those with urban backgrounds.

Nearly 40 percent surveyed say they developed an interest in rural veterinary practice before eighth grade, about 28 percent while in high school, 17 percent during undergraduate studies and about 13 percent while in veterinary school.

More than half interested in rural practice say having relatives with a farm background played a big role, while less than half had rural veterinarians as mentors. Fewer veterinarians cited exposure to rural practice in veterinary college or through clubs as factors in choosing rural practice. About 23 percent of those DVMs surveyed said that the stories of James Herriot cultivated their interest in rural practice. Men more frequently cited family farming backgrounds as reasons for being interested in rural veterinary practice, while more women cited influence from the works of James Herriot. More Generation Xers cited James Herriot stories than any other generation, and generations X and Y showed less interest than Baby Boomers (born between 1946 and 1964) and those from the Silent Generation (born before 1946).

More men than women reported an interest in rural practice, but 45 percent of women chose their path before eighth grade and only about 19 percent in veterinary school, compared to about 34 percent and 9 percent of men, respectively.

Veterinarians who chose rural practice placed a high value on rural lifestyles, followed by herd-level animal care, as major factors in their decision. Men were more likely to express an interest in herd care. Salaries and benefits did not play into the equation, and the study notes that recruiters for rural practices perhaps should focus efforts on emphasizing personal and professional features of the job, like rural lifestyle and herd medicine. However, salary proved to be a growing factor in the decision making of younger generations, the study notes.

Middle-America states like North Dakota, South Dakota, Texas, Kansas, Nebraska, North Carolina, Virginia and Indiana have some of the greatest food-animal veterinarian shortages — with some 1,300 U.S. counties reporting no veterinary service for more than 25,000 food animals, according to data compiled by the American Veterinary Medical Association (AVMA). Other states reporting less drastic shortages — counties with no veterinarians for 5,000 to 25,000 food animals — are located primarily in the Southeast and up the East Coast, according to the map.

Why leave rural practice?

The shortage of rural veterinarians may be more influenced by a lack of retention than attracting new people to the field, the study authors note, adding that recruiters might do well to focus efforts more on keeping rural veterinarians in practice than in trying to draw them to it.

The second study focused on why vets left rural practice. This survey polled 805 rural veterinarians — 246 of whom had abandoned the field. About 94 percent of those who left did so after less than five years of practice. Most who left were from urban backgrounds, though rural veterinarians without previous livestock experience did not leave their positions any more than those with prior experience.

There was not a significant difference between the number of men and women who left rural practice in general, or because of time off or emergency duty. More women, however, did report leaving the profession because of the practice atmosphere than compared to men. Similarly, Generation Xers ranked practice atmosphere as a factor in leaving much more frequently than the Silent Generation. About 23 percent of women, and no men, ranked gender issues in rural practice as being a reason for leaving.

Men and women both cited potential for practice ownership and family concerns as highly important in their decision to take jobs in rural practice. Members of generations X and Y cited salary, benefits and time off as factors for leaving.

"It is possible that because veterinarians focused on personal qualities in accepting a first job in rural veterinary practice, they also placed less emphasis on factors such as salary, time off and emergency duty, which eventually became important issues as time passed," the study states. "To promote retention of personnel in rural veterinary practice, these positions may need to evolve over time to meet the changing needs of veterinarians."

Those who left rural practice most often went to urban practices, followed by jobs in academia.

The studies were conducted by: Aurora Villarroel, DVM, MPVM, PhD, Dipl. ACVPM; Stephen R. McDonald, DVM; William L. Walker, DVM; Lana Kaiser, MD, DVM; Renee D. Dewell, DVM, MS; and Grant A Dewell, DVM, PhD. The full studies were published in the April 15 issue of the Journal of the American Veterinary Medical Association.