As most of you probably know – or have probably read about – there seems to be a shortage of equine veterinarians. It’s not for want of demand, apparently – there are still plenty of horses in need of veterinary care. It’s just that, according to, oh, just about everyone (clients, the American Association of Equine Practitioners, the American Veterinary Association), there don’t seem to be enough people interested in becoming veterinarians who take care of horses.
It’s a legitimate concern. I think that there are a lot of reasons for it. Some of the challenges are going to be difficult to address, I think. In no particular order, here goes.
1. YOU CAN’T SEE AS MANY PATIENTS
The fact is that, as a horse doctor, you can’t see as many patients as you can if you’re a small animal doctor. Most small animal hospitals schedule 4 – 6 patients an hour. The veterinarian receives the animal, but then sends it on to technicians who will generally do the tests and procedures. There’s a lot of work going on behind the scenes.
You can’t work as quickly in horse medicine. It might take me 30 minutes to drive to see a horse, 30 minutes to examine and/or treat the horse, and 30 minutes to drive to the next horse. There are only so many hours in the day. Even large hospital facilities can’t approximate the volume of a busy small animal practice.
This ultimately means that small animal veterinarians make more money than horse veterinarians. Money isn’t everything, but it’s something. Add to that the fact that young graduates are coming out of veterinary school with mountains of debt and it makes all the sense that you’d want to get the best salary available to you, and, what with the corporatization of small animal medicine, the benefits are usually better, too.
2. PRICING PRESSURES
Let me start by saying that I completely understand that no one wants to pay more for something than they should absolutely have to. That being said, veterinarians can make their money in one of two ways: selling products or selling services.
The veterinary world is now full of on-line pharmacies competing for a piece of the veterinary pie. It’s easy to do a quick internet search and find prices for items that are usually less than the price for the same item charged by a veterinarian. Heck, sometimes the prices on-line are less than what I can purchase them for from my supplier!
When, after trying to come up with a reasonable mark-up on a product, you are told by someone who is wearing a pair of $700 blue jeans, that he or she can get the product you prescribe cheaper on-line, and how can you sleep at night selling that same product for more, it does get a bit disheartening.
The competition is fine, but it’s not a level playing field for the horse veterinarian. Even the biggest horse practices can’t compete with the bulk purchasing power of internet companies. If you can’t make money selling products, the cost of services has to go up, which doesn’t make clients happy, either. Having such stiff (and somewhat unfair) competition makes it harder to make a living – and it’s more incentive to do something else.
3. PERFORMANCE vs. HEALTH
You don’t really find small animal veterinarians who consider themselves “performance” specialists; as far as I know, no one is racing cats and now that dog racing is mostly a thing of the past, most small animal veterinarians get to focus mostly on one thing: the health of the animal.
Not so in horse medicine. Many segments of horse medicine are driven by the idea of “performance,” that is, the job of a veterinarian is to keep the horse going as well as it can (or maybe even better) for as long as it can. The horse needs to run faster, jump higher, turn quicker, etc., for as long as it can. It needs to do that to win ribbons and prizes – it needs to do that to win money for its owner, or for resale, or just for pride. If the horse can’t do their job to the satisfaction of the owner, then it may be time for a new horse. If the treatment isn’t in the best long-term interest health of the horse, that may not really be that big of a deal. The time is now.
Trying to “optimize” a horse’s performance is not why most of us get into horse medicine, I think (or at least I hope). Sometimes, focusing on a horse’s performance seems like more of a medicine show than real medicine. I went to veterinary school for two reasons. First, I real like being around horses. Second, I just wanted to help them if they got sick or hurt. The idea that your job is to merely to get horses to perform at their “best” regardless of any long-term consequences can be a bit soul-sucking.
4. LOTS OF OTHER “EXPERTS” KNOCKING AT THE STABLE DOOR
I’m not saying I know everything about horses, even after 40+ years working on them, countless hours of CE, writing and researching, lecturing, etc. I don’t. However, I would like to think that perhaps I know something.
But apparently not, at least according to some. Not to lay “dentists,” who may assert I don’t know anything about the teeth (and thereby try to take another chunk out of practice income), not to unlicensed “chiropractors” who are the only ones who apparently know when various parts go “out” (and when they’re back in place), not to massage therapists who say they’ll “improve circulation” or magnetic or laser therapists who may assert they’re doing the same thing, not to farriers or body workers or even psychics, who may not even need to see the horse to know what’s wrong with them (I’ve had to discuss such over-the-phone “diagnoses” more than a few times).
Small animal veterinarians usually don’t have to put up with competition from unlicensed “experts.”. You usually have to take your dog to the small animal veterinarian – the horse veterinarian often comes to you. And, since you’re so readily available, being at the stable and all, just about anyone else can come, too: and often does.
5. REQUESTS FOR TREATMENTS
It’s not uncommon in the horse world for someone to opine from outside the arena that a hock or stifle “needs” to be injected, or a particular substance needs to be prescribed. There’s apparently not need for those folks to be bothered with actually having to learn anything at all about what those substances do (or don’t do), much less spend years learning about the inner workings of the horse himself. Being expected to simply deliver some treatment without actually considering what (if anything) might be going on with the horse can pretty discouraging.
There’s also a dark side. If you don’t respond to some requests, there’s a decent chance that you’ll be replaced by someone who will. It can be hard to work under such circumstances, fearing that you’ll lose your job if you don’t do something you think isn’t right. This isn’t something that really happens in small animal medicine, at least not that I know of.
I don’t think it happens much in human medicine, either. I cannot ever recall going into any one of my doctor’s offices with a specific agenda. I can only image what my doctor might say if I came into the office saying, “You know, doc, I’d like to have gall bladder surgery.”
NOTE: Equine clients would probably never say that their horse needs gall bladder surgery – at least they’ve never said that to me – because horses don’t have gall bladders.
SECOND NOTE: The lack of gall bladders in horses has not prevented them from having “gall bladder meridians,” as per acupuncture acolytes (of which I am not one).
THIRD NOTE: One time I had a trainer ask me to inject a horse’s hocks. I said I would be there to look at the horse on Tuesday (I wasn’t just going to inject). Tuesday came and, because of emergencies, I got nowhere near the horse, much less the barn. Plus, I forgot to call. Two days later, on Thursday, I came out, and was greeted with a big hug, and thanks for making the horse so much better.
Anyway, this request to perform specific procedures in the absence of making any sort of diagnostic effort gets rather trying. I don’t believe I, or any of my colleagues, like to think of ourselves as veterinary automatons, who perform services on demand. Most of us (at least I think most of us) would like to think that our opinion in the matter might be worth something, as opposed to merely being the bobblehead doll who nods meekly at any request.
As a veterinarian, you’re supposed to examine the horse, find out what’s wrong with it, and then treat the problem: you’re not supposed to just give something on demand. It’s exhausting if you try to push back, and pushing back generally isn’t well-received anyway. Sometimes, it may just feel like trying to do what’s best for the horse isn’t worth the fight.
6. YOUR WORK IS OUT THERE FOR EVERYONE ELSE TO SEE
Horse medicine is done out in the open. Everyone can see what you’re doing and, apparently, pretty much everything thinks they can do it. It’s really not that hard to give a horse a shot in the muscle, or even the vein (it just takes a bit of practice). And, of course, everyone has their own opinions on how the job should have been done. I’ve been criticized for restraining horses in a way that a client felt inappropriate, or I’ve lost a client because I failed to notice a spot of blood on my arm when cleaning up after the last laceration. Living up to someone’s unspoken expectations is a problem in all branches of veterinary medicine, I think, but it’s really hard in horse medicine, when people are watching and commenting on your every move.
7. HOURS (and hours)
Working hours as a horse veterinarian can sometimes seem interminable. For example, if you’ve chosen to work at large breeding farms, you’re literally on call 24:7, for at least half the year. In a one- or two-person practice (which is about 45% of all of the horse practices in the US), means you can find it really hard to make plans, and, if you do make plans, they can be quickly and easily interrupted. That sort of instability in your personal life isn’t for everyone. When you’re offered the opportunity to work defined hours and the rest of your time is to yourself, you might just jump at the opportunity.
8. IT’S PHYSICAL (and a bit dangerous)
It’s just a fact that horse work is more physically demanding than working on dogs or cats. It’s also more dangerous – in fact, in a survey in the UK a few years back, being a horse veterinarian was the most dangerous profession surveyed (more than prison guards or policemen, for example). That’s not necessarily and enticing combination.
Now, all that said, being a veterinarian who works with horses has been the perfect choice for me. Practicing horse medicine is as much of a lifestyle as it is a profession, I think. The two reasons that I got into doing this – because I love horses and because I wanted to take care of them when something went wrong – are still as important to me today as they were when I started down this path. Still, not all practices are the same and there are, honestly, lots of good reasons why someone might choose not to be a horse vet. But there are also plenty of reasons to love being a horse veterinarian, too. I’m glad I did.
