In the trenches

NATIONAL REPORT — Is a female majority in veterinary medicine exacerbating the shortage of rural, large-animal veterinarians? Or is it just a sign of the times?

Rural areas are clamoring for veterinarians, prompting universities and governments to find new ways to attract new blood to large-animal medicine. At the same time, family farms are disappearing. But whether the increase of women in veterinary practice, the changing attitudes of a new generation or a changing rural landscape play a greater a role in the decline of rural veterinarians is an answer even those on the front lines have a hard time agreeing on.

"They keep blaming that because there are more women, there are less veterinarians in rural areas, and that's not true," says Dr. LuAnn Dorman, who started her small-animal clinic in Pratt, Kan., after more than a decade in large-animal medicine. "I think there's just a decline in the rural areas. The trend is changing that if you have to farm, you have to farm big. There are less family farms, and I think that's a lot of it. The kids going to veterinary school nowadays are coming from more urban areas."

Some rural areas have open-minded populations, but there are many more that make it difficult for women to practice in large-animal medicine, Dorman says.

"There were some pretty good guys up there who didn't have problems with it, but there were a lot who thought women just couldn't do the job," she says. "If you proved your ability, they might come around. To others, it wasn't a woman's place. There were some who got in my face and said women belonged barefoot and pregnant in the kitchen, and there were some who said they would rather have their cow die than have a woman (veterinarian)."

Not all female, large-animal veterinarians share Dorman's experiences but might agree that the rural landscape is changing, and it takes a special kind of person to be a large-animal vet.

"You took every call that came, and it was all hours of the day or night. Part of me loved it, and part of it was extremely difficult. It's physically very draining, which I actually liked, but I think some people — men and women — don't like that," says Dr. Donna Stafford, whose 30-year veterinary career began with a decade of solo practice primarily on Indiana swine farms. She now works at a mixed-animal practice in Litchfield, Ohio. "It's emotionally draining because of the hours, but I really miss it a lot at times."

Forewarned being a solo, large-animal practitioner would be difficult, Stafford says she actually had fewer problems with rural farmers than she does now with suburban transplants that care for the occasional goat.

"I liked having rapport with farmers. Everyone said I would have trouble because of the area, but I didn't because you just go out, you do it and you prove yourself," Stafford says. "If you act like Miss Priss and you're not dressed appropriately, you might have a problem. But if you just go out, and you do your job, it's no problem. People give the farmers a really bad name that they're not used to women doing this, but look at the farmer's wife. They do stuff more than men in the city do."

Where Stafford practices now, most family farms are being sold and backyard livestock make up the bulk of her large-animal patients. Over the last decade, her large-animal clients have dropped from about 50 percent of the clinic's business to about 10 percent.

"I miss the true farmer day-to-day, where this is their livelihood versus the hobby farmer," Stafford says. "More and more people are selling out. As the farms go out, they lose their services. There aren't nearly as many farm stores and services."

Some women do leave rural practice because of difficult clients or practice atmospheres, though, and Dorman says it's a hard enough job without adding that kind of stress. But the rural atmosphere seems to be adapting with the times.

"A lot of those guys, older ones, can't accept change. But at some point they retire or die and the next generation is more accepting of women. I think it's going to be more accepted," Dorman says, adding that she thinks moving forward, a lack of interest in large-animal practice will become the bigger problem. "The people going into vet school just don't want to do large animal. Incentives might help the ones that are interested but don't have finances."

Stafford agrees that the new generation brings new attitudes, but says those attitudes may also be holding rural practice back.

When she left Indiana and her primarily large-animal practice, it was to be closer to family and to give her children a better life, Stafford says.

"I couldn't find anyone, male or female, to join the practice because the money wasn't big. You just can't make enough," says the mother of two. "It was kind of a cluster of things, but it wasn't because I couldn't do it or because I didn't like it."

"I think there's a real problem with veterinarians coming out of school now, period," Stafford says. "There isn't the commitment, and that doesn't work with farm vets. In the city you can do that, but when you're out in farm country, you don't have a referral clinic to send to. You just do it."

As a young mother, Stafford says, her life "didn't revolve around kids' birthday parties" and her own needs —not that it was "right or good." Younger generations demand more work-life balance and have different financial needs, she says.

"There's a huge difference now, especially financially. Right now vet school is so incredibly expensive that these people get out of school owing $150,000 to $200,000, and they're making a mortgage payment on their loans. You're not going to make that as a large-animal vet in a rural area."

The incentives being put in place by the federal and state governments might help, but there are no guaranteed solutions, Stafford says.

"I think incentives are a good idea. Whether they will be able to stick it out, I don't know," she says.

"I never expected anybody to do any special favors for me, I didn't want anybody to," Stafford explains, adding there are times when a woman's smaller size can be a help or a hindrance. "But I think it's an excuse a lot of times. I think it's the hours, the lack of financial reward, and it is brutal at times physically. But I wouldn't go back and trade it. It just comes with the territory."

Dorman agrees that the physical nature of the job may be a problem for some, but says gender isn't the defining line in the sand.

Injuries play a big role in the lifespan of large-animal veterinarians — regardless of gender, Dorman says.

"You're more at risk for injury and end up getting hurt," she says, remembering a male classmate who left large-animal practice after five years because he hurt his back. Neck, back and shoulder injuries are primary concerns, but the general physical stress of the job is what gets to large-animal vets in the end.

"It's nice when you have the great facilities to work cattle, but a lot of times, somebody didn't even have a stock trailer or a chute, then you're more prone to getting hurt. One of our equine instructors said 'If you get a 1,000-pound horse that wants to get in a pissing contest with you, it doesn't matter how strong you are,'" Dorman says. The key is knowing how to handle larger animals. "Ultimately, even for the biggest, strongest guy, the animal is still a lot bigger and stronger than they are. I'm almost regretting having done large-animal because of the problems I have now, but I do miss it."

But for some, even in the younger generation, the hard labor of large-animal practice is an attraction, not a deterrent. Taking criticisms based on gender isn't something younger generations may take in stride, either.

"For me, it is not really an issue and never has been. Maybe there are clients who choose to go other places because I am female, but that is their problem, not mine," says Dr. Nora Ditmars, 30, who works at a mixed-animal practice in Fairbury, Neb. "We are plenty busy. I have yet to find a time when size and strength prevented me from getting the job done. I suppose there may be at some point...that I have to do a C-section because I needed six more inches on my arm, but I have yet to encounter (that situation). One advantage to being small is that the wear and tear on my arm from pregnancy checking heifers is significantly less."

"I don't even know many 250-pound guys who will mess with a 2,000-pound bull," Ditmars adds with a laugh.

Working under the tutelage of a seasoned rural practitioner and having had many mentors who taught her "how not to get hurt," helped Ditmars embrace her chosen career with fervor.

"People have to go into rural practice because they like it and not for any other reason. To quote a friend of mine, 'It's a lifestyle, not a job.' The less people there are, the happier I am. I definitely prefer open spaces, and that's just my personality," she says. "I think there's a big difference between being in rural practice and being a solo practitioner. I have the big advantage of having every other Sunday off during calving season and every other weekend the rest of the year. Sometimes, people confuse the issue of being a solo practitioner with being a rural practitioner."

One challenge in rural practice, Ditmars believes, is making enough money — and the increased availability of animal drugs from third-party sellers doesn't help, she says.

"I can't tell them to buy it from me when they can buy it $3 cheaper somewhere else," Ditmars says. But if a practitioner isn't making money off drug sales, they need to make it up with higher charges for their services.

"Long-term, it doesn't matter how many people you recruit who want to practice, if it doesn't work economically, it's not going to happen," Ditmars says.

But these days, it's hard to make a living working in rural America, especially with the student debt load many new veterinarians carry.

"You can't afford to go into a rural practice and pay that debt back," Ditmars says, adding she worked through school and was able to graduate with minimal debt, but many of her classmates were not so lucky.

"I think the only way to increase the number of people in rural practice is to give students experience working in a rural setting," Ditmars says. "Some are going to like it and some are going to hate it."

"I really don't think I'd be happy doing something other than this. Every time I look at a practice that's less than 50 percent large animal, I don't think I'd like it — I know I wouldn't like it. I'll probably do this forever, provided I'm able to."