Rural Missouri Magazine

Filling the rural vet vacuum
Missouri’s veterinary profession struggles to keep docs on the farm

by Bob McEowen

Veterinarian Dan Goehl medicates a cow after treating her in a farmer’s pasture. Although the veterinary profession sees a shortage of food-animal doctors, Goehl, who serves clients in northeast Missouri as well as Iowa and Illinois, questions whether rural areas can actually support more large-animal vets.

Dr. Dan Goehl’s day starts in the bed of a pickup truck, where he dissects a calf to determine why it died. After checking e-mails, he’s off to a nearby farm where he palpates two dozen heifers, measuring each cow’s pelvis and advising his client which animals are likely to breed successfully. Next, he attends to a cow with complications after giving birth.

After a quick carry-out lunch, the Canton-based veterinarian hauls a trailer-mounted chute to a farm 25 miles away where he’ll examine 100 head of cattle, vaccinating each and castrating the young bulls.

It’s a typical day for Goehl, a large-animal veterinarian whose 2007 GMC pickup already shows more than 70,000 miles from visits to clients in at least five northeast Missouri counties, as well as Illinois and Iowa.

“Most veterinarians in a mixed-animal practice, their day consists of technical work like castrating animals, preg checking, giving vaccines, pulling calves, doing necropsies,” he says. “You do a lot of manual, technical work — what we call chute work — and you give all your information away.”

Although the work is often physical, the conditions harsh and the hours long, Goehl says his practice fulfills his desires to live in rural Missouri, work in agriculture and earn a steady living.

Increasingly, though, food-animal vets are hard to find. According to the American Veterinary Medicine Association, 15 Missouri counties have no large-animal veterinarians. In 22 other counties, there is just one large-animal veterinarian each.

“There definitely is a shortage across all industries and across all facets of large-animal practice,” says Dr. Linda Hickam, Missouri’s assistant state veterinarian. “There just seems to be not enough large-animal students coming out to fill those voids.”

Hickam, an employee of the Missouri Department of Agriculture, says shortages are felt everywhere from sale barns and processing plants, where veterinarians are required to certify the health of food animals, to the family farm, where producers often can’t find a veterinarian to perform the kinds of services that Goehl provides every day.

Fair Grove veterinarian Ellen Ratcliff performs surgery on a Great Dane puppy. Ratcliff graduated vet school with the intention of treating horses and food animals. Now injuries sustained on the job force her to concentrate on small animals.

But Goehl, a member of the Academy of Rural Veterinarians, says numbers don’t tell the whole story. The lack of veterinarians to respond to producers’ occasional needs, especially emergencies, does not necessarily imply that an underserved county could support a full-time veterinarian.

“There’s a shortage of veterinarians that will get up in the middle of the night and go pull calves,” says Goehl, who operates the Canton Veterinary Clinic with his wife, small-animal vet Rachel Goehl. “One, you don’t make any money doing those services; and, two, that’s what ruins your family life. That’s why we have a hard time getting veterinarians to come back to rural practice.”

Initial results of a University of Missouri Extension study show that 19 percent of cattle producers had difficulty obtaining veterinary services in the past year. But Beef Veterinary Specialist Dr. Craig Payne, who authored the survey of 541 producers, says 52 percent of cattlemen expect to have difficulty hiring a vet within the next 10 years.

Any effort to address future shortages must begin at the state’s veterinary school, experts say. Each year, the MU College of Veterinary Medicine in Columbia graduates about 75 new animal doctors. Of those, roughly one-third will find work in a mixed practice, where they treat horses and food animals as well as pets. Just 5 to 10 percent of graduates will treat food animals exclusively.

While many students are lured away by research or specialty practices, others simply opt for the regular hours and comfortable environment of a small-animal clinic. A food-animal practice typically only appeals to students with backgrounds in agriculture. With fewer young people raised on farms today, the prospects of an adequate large animal veterinarian core does not look good, says Dr. Jeff Tyler, director of strategic program initiatives at Missouri’s vet school.

“When I was a kid, approximately 2 to 3 percent of the U.S. population lived on a farm. Today that same percentage is 0.7 percent. At a time when we have fewer people growing up on farms, livestock numbers are the same and the roles for a food animal veterinarian have become bigger,” Tyler says, adding that modern regulations and livestock production practices require more intensive veterinary care and management.

Another factor is skyrocketing tuition, which puts college out of reach for many rural students. These students also often come from smaller, poorer schools, where the lack of advanced placement courses creates an academic disadvantage.

Dr. Darren Loula tends to a calf at the Fair Grove Veterinary Service. Loula joined the practice after graduating in 2008. Less than one-third of vet students pursue careers in food-animal medicine.

In recent years, the state of Missouri has created programs to attract students to vet school generally, and large-animal practice specifically. The university’s AgScholars program identifies promising high school students and places them on a fast track to vet school. A new loan forgiveness program — funded for the first time last year — reduces the cost of a veterinary education in exchange for large-animal service in an underserved area of the state.

“It was very attractive to me,” says Jason Wooderson, a fourth-year vet student and one of six students to receive $20,000 as part of Missouri’s Large Animal Veterinary Student Loan Program. “I’ll come out of school owing over $100,000. If I can knock down a fifth of that, it greatly helps.”

Wooderson, a non-traditional veterinary student with a wife, two children and a previous career as a schoolteacher, will return to his hometown of Bolivar and join a successful, exclusively large-animal practice owned by a retiring veterinarian.

While the loan program is ideal for a student joining an established practice, it’s less clear whether it’s enough to convince a graduate to open a new practice in an area not otherwise being served.

“Bottom line is everybody has to make a living,” says Michael Stafford, whose Fair Grove Veterinary Service employs two additional vets, including a recent graduate. “Average starting salary is about $50,000 a year and if you have $150,000 in debt, that barely covers that.”

Although, salaries for food-animal vets are equal or greater than those of small-animal docs, most practitioners agree the hours are longer and the work harder. Furthermore, clients who measure the value of services based on the market price of livestock often can’t afford to pay veterinarians a wage that accurately reflects their time and effort. Those realities often cause large-animal vets to make sacrifices small-animal vets don’t have to consider.

“I don’t have kids because of my student loan debt,” says Dr. Ellen Ratcliff, 32, who joined Stafford’s practice after graduation in 2001. “It would be impossible to have kids now unless I worked part time. I can’t work part time and make my student loan payments.”

Dr. Dietrich Volkmann, right, a veterinary professor at the University of Missouri, prepares students for extracting a stillborn calf from its mother. Students, from left, Kira Moore, Lydia Cook and Jason Wooderson treated the cow during a two-week rotation in veterinary reproductive science, or theriogenology. At one time, MU vet students spent eight weeks practicing theriogenology, the bread and butter of a large-animal practice. Wooderson is one of six students currently benefiting from a loan forgiveness program directed at food-animal veterinarians.

Ratcliff, who serves on the board of the Missouri Veterinary Medical Association, also says what many others are reluctant to admit. The preponderance of women in vet schools contributes to a shortage of large-animal practitioners. Female veterinarians, she says, often choose to work part time once they start a family. They also are less willing than male vets to suffer the bumps and bruises that come with treating farm animals.

Although Ratcliff graduated vet school intending to spend her career treating large animals, she now devotes most of her time to caring for dogs and cats.

“All I wanted to do when I got out of school was horses and a little bit of goats and cows. Eight years later, all I want to do is small animals,” Ratcliff says. “Mostly, it’s the injuries. I’ve had two back surgeries. I’ve been kicked so many times I can’t even count. I’ve had one of my fingers bitten off working on a horse’s teeth.

“It’s just tearing me up,” Ratcliff says. “In the interest of being mobile when I’m 50 years old, I’m going to try to do more small animal stuff.”

Ratcliff’s experience provides a sobering reality check when she addresses incoming veterinary students at MU. It probably won’t be her words that will steer future veterinarians into other areas of animal medicine, though. There are already plenty of other forces at work.

Dr. Goehl prepares to palpate a herd of heifers for a client.

Declining farm populations, the attractiveness of specialized veterinary medicine and the relatively simpler demands of a small-animal practice all portend shortages of large-animal veterinarians for years to come. Finally, castrating bulls and palpating cows doesn’t hold much allure for many students exposed to high-tech medicine in vet school.

“In small-animal medicine, there’s more opportunity to use advanced technologies and advanced surgical techniques because people will spend a thousand dollars on their dog. With a sheep or a goat or cow, it’s like the animal is worth this much, so that’s what I’ll spend,” says Dr. Darren Loula, a 2008 graduate who now handles most of the large-animal work at the Fair Grove clinic.

Financial incentives — loan forgiveness programs and statistically better earning potential, among them — may help, but even recent graduates say that may not be enough to attract a student who wasn’t otherwise inclined toward food-animal practice.

“You can throw a lot of money at someone, but if they don’t enjoy the job, if they don’t like doing cattle work and going on chute runs, it doesn’t matter how much money you make,” says Dr. Seth Shirey, a 2008 vet school grad who began working at Goehl’s clinic when he was in high school.

Instead, it appears that most future large animal veterinarians will come from the same place they always have: the farm. Like others in agriculture who choose their profession in spite of challenges, large-animal veterinarians don’t need anyone to convince them of their choice.

“Most of us that came out of vet school wanting to do large animal, came into to vet school wanting to do large animal,” Loula says.

For more information about the MU College of Veterinary Medicine’s AgScholars program, call 573-884-6435 or log onto

Rural Missouri | June 2020 Issue

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