Rural vet practices challenged with investing in staff retention
This is the first in a four-part series, “On Call: Vets Under Stress”, that explores the pressures and overwhelming challenges facing those who choose a career in providing care for our animals.
Some experts say rural vet clinics in shortage areas may not be investing enough in keeping their staff in the community due to limitations on mentorship opportunities and work-life balance.
Brad White, a professor in the Kansas State University College of Veterinary Medicine, said there's a lot of factors in job satisfaction that lead to higher turnover rates of veterinarians at rural practices. He said handling high turnover rates can be especially challenging for these clinics because it's difficult to develop a business from the ground up where the client pool is limited.
"Good, healthy businesses are going to have less turnover," White said. "Most veterinarians are not doing this solely for the compensation, but you have to have a healthy business to be able to stay in practice in that area. And I think that's one of the challenges that we look at with rural practice, is developing that business aspect of it and making that work."
However, White remarked that some state and federal programs – like the US Department of Agriculture's Veterinary Medicine Loan Repayment Program and the State of Kansas' Veterinary Training Program for Rural Kansas – can help increase retention. They incentivize vet grads to stay in rural communities by offering large, but varying, degrees of student loan debt repayment in exchange for helping shortage-designated areas.
White said research revealed that between 2010 and 2020, 43 of 55 participating vets remained at the same practice they started at under the Kansas program, while 48 out of 51 remained in the same county, calling it a "tremendous success rate."
Located in the dairy dense eastern Wisconsin, Al Martens is one of 11 vets employed by Waupun Veterinary Service. The 43-year veteran of the veterinary medicine field says fewer and fewer vets want to be involved in small rural practices.
“They’d rather be involved in a large rural practice like ours that covers a big area. Because we have so many vets we’re able to provide a big palette of services that one or two vets can’t provide,” Martens said. “Our applicants come from all over the country.”
More than money
Compensation plays a big role in turnover rates and overall job satisfaction, but that's not the most important factor across the board – happiness with what you're doing and who you're working with tended to be most important to respondents, White found. He explained that compensation was not one of the top factors because student debt is not uniform for vets.
MORE: How to save a life
The top factors in job satisfaction were interaction with clients, interaction with coworkers and interaction with animal patients.
"We have some students with high levels of debt and some students with lower levels of debt, so the compensation that's required to service that debt differs by individuals," White said. "Then once you get to that baseline compensation level that can service your debt, it may not be the highest thing on your list."
Martens says the culture in his practice goes all the way back to the man that hired him out of college.
“We try to make everyone that works here a partner, which helps to make their job economically feasible,” Martens said. “If we like you and you’re contributing to the business, we want to share. This makes it easy for me to attract good people. It’s kind of a like a payback for us.”
White said the important thing for clinics to focus on is creating a healthy business that has good relationships with its staff. That could include better benefits, shorter work hours, employee bonding opportunities and regular pay raises. Recruitment is also an aspect of the business, but White said some clinics spend too much time on recruiting a new vet but not enough on convincing them it's worth staying for the long haul.
Vet grads also look for mentorship opportunities that give them feedback on their work, White said. They also seek out training opportunities under highly experienced vets, which are not often available in rural areas because of larger workloads and overall smaller practices.
"Providing feedback was critical in several areas. Having the ability to say, 'How am I doing along the way?' All of us appreciate that in our jobs, especially when it's positive," White said. "It certainly led to less job satisfaction if you didn't get adequate feedback. I'm going to make a tie that job satisfaction is going to be related to turnover, although we didn't specifically ask that question."
Gabyrelle Gilliam, a former graduate student in veterinary biomedical sciences who worked with White on the research, said she thinks small, rural communities are often centered around their local vet clinic. Shortages have affected those communities deeply.
"My projects stemmed from both my desire to have a statistical and communications focus within the livestock industry. One thing I've realized growing up in the agricultural industry is that many small towns are centered around their local vet clinic," Gilliam said in an email. "With an emphasis being placed on rural veterinary shortages in recent years, we felt that understanding what impacts all aspects of retention for a practice to be key."
Gilliam said offering competitive salaries, providing mentorship opportunities and working to include employee needs are important parts of successful recruitment and retention.
Crying out for mentorship
Brian Aldridge, a professor at University of Illinois' College of Veterinary Medicine, said one attractive thing about rural practices is that it's much easier to become a partial or total owner of a practice, which can be desirable to vet grads. However, he said it's becoming less desirable to brand new vet grads, who instead want to spend their introductory years training under experienced vets before trying to start up their own clinic.
"I think they're crying out for mentorship, and within mentorship, coaching and training. So we say to them, don't pick your job, pick your boss, because it's who you work with. Your growth and your ability to flourish in that job depends more on the people you work with," Aldridge said. "Pick some colleagues who are going to not just mentor you, but coach you, pick you up when you fall, be patient with you."
Vet grads who don't receive any mentorship opportunities often get discouraged and leave the practice in search of something more satisfying, Aldridge explained. In this way, salary is not as much of a driver as is lifestyle, like being able to work shorter shifts or have a weekend with no emergency calls. While some people who move to rural areas find their passion, others realize they may not even enjoy working on food animals, he said.
Meg Mueller says her rural veterinary clinic in northwest Wisconsin is a true mixed practice.
"I've treated a hedgehog and a horse in the course of the same day," said Mueller who became a partner this year after 10 years. Her clinic is located in one of the state's underserved areas.
Mueller also serves a district representative for the Wisconsin Veterinary Medical Association and has been vocal about providing training opportunities to veterinary medicine students and new hires.
"When you come out of school you're not going to know everything and that's ok. The employer and the mentor's job is to help them navigate through it," she said. "The knowledge is there but they need the experience and there's no way to get that other than going out and doing it. And with a small mixed practice in the rural area you're going to have experiences that run the gamut."
Aldridge said clinics in rural areas need to include small companion animals in their practice because otherwise it's not economically viable, unless you have some sort of specialized skills for large animals. And while entrepreneurship is not something found in every vet student, he said it can be a point of ambition for those going into rural areas, especially where many retiring vets are looking for someone to take over the clinic.
"Let's open the door to them being able to buy into practices in some of these rural areas, I think that would be fantastic," Aldridge said. "What we've learned is ... vet students don't want that. Business ownership isn't on their mind when they come into school. So I think we have to ... inspire them while they're in school. I think those years are really formative in which direction they're gonna go."
Colleen Kottke of the Wisconsin State Farmer contributed to this report.