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Several factors lead to overall shortage of veterinary services in smaller communities

Several reasons led Gary Pearson, a doctor of veterinary medicine and owner of Prairie Veterinary Hospital, to close his practice.

The rising costs of providing services and a shortage of veterinary technicians and veterinarians have led to an overall shortage of veterinary services in smaller communities, according to an owner of a veterinary practice and an official at the University of Saskatchewan in Canada.

Prairie Veterinary Hospital in Jamestown closed on Oct. 1 due to many factors, said Gary Pearson, 82, a doctor of veterinary medicine and owner of the veterinary practice. He said rising costs of supplies, the impact of a road project near his practice, the increasing difficulty of hiring qualified staff necessary and the inability to find a veterinarian to purchase his practice led him to close Prairie Veterinary Hospital.

From January to August of last year compared to this year, the cost for supplies increased by more than $31,000, a 36.5% increase, Pearson said. He also said state and local taxes increased by more than $3,600, a 26.7% increase, during that same timeframe.

“How do I absorb that or how do I pass that on to a client in Jamestown,” he said.

Pearson’s practice offered orthopedic services, which he said very few veterinary practices offer in North Dakota.

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He said it is difficult to provide the service for a price that people in the Jamestown area can afford. He said his overhead expenses were much more than other small animal practices because he offered a level of service that was “unheard of” in a town the size of Jamestown.

Pearson has supplies for orthopedic services that range from a few dollars to thousands. He said providing orthopedic services requires having specialized equipment on hand.

“We need a whole assortment of bone plates for different-sized bones for example at $50 to $100,” he said.

He said he did an orthopedic surgery called tibial plateau leveling osteotomy for a little less than $2,500. However, the cost would be around $4,000 to $5,000 if someone went to Fargo for the same surgery, he said.

“But if I charge $5,000 very few people in Jamestown can afford that,” he said. “ … In Fargo, there are enough wealthy people to support that level of practice at that price. There are some people in Jamestown that can afford that, but not enough really that I can charge those fees and still be able to do it.”

Pearson documented the history of Prairie Veterinary Hospital. He wrote in a paper titled “Prairie Veterinary Hospital July 1983-October 2021” that the income at his practice was barely enough to cover the $1,800 per-day expenses and the net income for the month was a little more than $216.

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“I had applied for a COVID Payroll Protection Program loan in April of 2020, and by not taking a salary for myself for 16 months, we had managed to ‘cash flow’ so I had been holding that money in reserve in case something happened in the future,” he wrote. “But by the end of the second week of September we had gone through the regular substantial balance in our checking account and had to tap into the PPP funds. If that continued, we would run out of money in another three weeks.”

He wrote that fees would need to be increased, which would require time to make a difference, or more appointments would need to be scheduled to increase income, which would also take time because Prairie Veterinary Hospital had to counter widespread perception that it was closing.

He wrote that he proposed to staff to concentrate appointments more rather than having them scattered throughout the day so some employees could go home early or not come in some days in order to reduce payroll hours until the income increased.

“However, both our associate veterinarian and our technician said that they could not accept any reduction in their pay,” he wrote. “So the only alternatives I had were either to take money out of my retirement savings to keep the hospital open, or close it.”

Veterinarian shortage

Phone calls and emails requesting comments about veterinarian practices closing in smaller communities to the American Veterinary Medical Association and Sarah Lyons, executive secretary with the North Dakota Board of Veterinary Medical Examiners, were not returned.

A combination of factors has led to an overall shortage of veterinarians, said Chris Clark, associate dean academic at the University of Saskatchewan, who has had discussions with veterinarians and veterinary medical associations in Canada.

Clark said pet ownership has increased and pet owners are demanding and requiring a much higher level of service for their pets.

“So each veterinarian can only see so many animals in a day,” he said. “As you spend more time with an animal, you can see less animals in a day.”

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Clark said veterinarians in smaller communities used to handle everything that came in and that meant those veterinarians had to be proficient in orthopedics, soft tissue surgeries and reproductive surgeries among other services. Now, advances have been made in veterinary medicine and more specialists are working in specialty centers.

“As new graduates are coming out of a veterinary program, they don’t get the opportunity to practice their orthopedic skills because there are orthopedic specialty practices that clients prefer to go to,” he said. “These older veterinarians who really sort of honed their skills because there was no one else to do it, when they retire those skills are lost and the only replacement are the truly highly-trained specialists who are generally only found in large urban centers.”

Pearson said a project to rebuild the East Business Loop highway and the adjacent frontage road in front of Prairie Veterinary Hospital in 2011 and 2012 deterred people from going to his practice.

“People couldn’t even get here,” he said. “They couldn’t even get in the door.”

Pearson wrote a case study about the East Business Loop reconstruction project that said the frontage road reconstruction was not done a block at a time.

“Not only was access not provided through the alley to our business, but the alley was barricaded to prevent access to or from our business; no signs were provided directing people to our business during the first six weeks of the eight-week frontage road reconstruction period; and access frequently was obstructed even after a small sign (“Prairie Vet” with an arrow) was put up on a barricade a block away at 14th Avenue SE,” he wrote.

He said the problem was that his clientele builds over time and depends on developing long-term relationships with clients and providing long-term care for their pets.

For example, he said if a dog has heart failure that dog will be taken to the same veterinarian for a long time. Another example is if a client’s pet receives a rabies vaccination, he or she will receive a reminder card from that veterinarian.

“They go back to that veterinarian rather than to the previous one,” he said. “So it takes a long time to build a small animal veterinary practice and it is very difficult to get clients back once you lose them.

“That is what the road project did. It basically shut us down, and we never have gained full level of profitability.”

Clark said the goal of every veterinary practice is to keep a committed clientele by providing the best quality service available. He said keeping a committed clientele requires a veterinarian being available for routine and emergency services, which Prairie Veterinary Hospital provided.

“Certainly things like sending out vaccine reminders and that sort of thing is a part of that provision of service,” he said. “Every veterinary practice does different things to attract new clientele and keep their current clientele.”

Pearson also said it was difficult to find veterinary technicians and veterinarians who want to move to Jamestown.

Clark said it is difficult to attract veterinarians to smaller communities.

" Having spent years working in a city, studying and honing their skills, it is a particular type of person that wants return to a rural community, typically someone who has really strong ties to a community and is able to put down roots and sort of absolutely revel in that rural community," he said.

Clark said there has been a generational shift where rural veterinarians used to work really long hours -- about 60 to 70 hours per week -- but recent veterinary graduates are looking for more work-life balance where their schedule is more like other professions would be at.

“The reality is if you have someone who is working a 40-hour week and they are trying to replace someone who was working a 70-hour week, you almost need two people to replace that person,” he said.

Because of the shortage of veterinarians, salaries increase to attract new graduates which increases the cost of providing veterinary services, he said. He said it is difficult to overcome the advantages of living in larger cities, and rural communities need to attract a veterinarian in a slightly different way.

“So just trying to think in a much bigger sense on how to attract and keep an individual beyond just the practice building and beyond the practice in terms of the clientele,” he said. “That is where I think the community can sometimes be helpful too.”

Pearson said he used to get “spontaneous” applications from veterinary technicians looking for a job but he hasn’t received one for 10 to 15 years.

He said veterinary fees in North Dakota are generally lower than in the rest of the country so wages for veterinary technicians are low.

“It is a problem for the veterinarian to pay his technicians more, what they are worth, when other veterinarians aren’t,” he said. “That means you have to up your fees to pay for the higher wages of the technician.”

Pearson wrote a case study about providing high quality veterinary services in a smaller community. In order for him to provide services such as orthopedic, X-rays, surgeries and endoscopy, he provided them for a price where his practice "barely broke even" and even lost money on most of the advanced services that were offered, he wrote.

"But that is the trade-off that was necessary in order to practice high-quality small animal veterinary medicine and surgery in a small town in North Dakota," he wrote.

Veterinarians cannot practice in an efficient way without the support of good veterinary technicians, Clark said. He said the shortage of veterinary technicians can be attributed to the same issues as the shortage of veterinarians.

Pearson said it was difficult to find a veterinarian who provided the same level of service he is providing and wanted to own and operate a small animal veterinary hospital in Jamestown.

Clark said veterinary practices in small communities aren’t attractive to a new graduate. A smaller veterinary practice does not have the ability to attract another veterinarian to buy the building and supplies to pass it on to the next generation.

“We are starting to see the disappearance of some of these practices, and one of the knockoff effects of that is that communities are starting to lose their veterinarians,” he said. “The distance between veterinary practices is becoming greater, which sort of impacts people looking for care for both their pets and their livestock.”

Related Topics: JAMESTOWN
Masaki Ova joined The Jamestown Sun in August 2021 as a reporter. He grew up on a farm near Pingree, N.D. He majored in communications at the University of Jamestown, N.D.
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