Happy in the Country

While the rural veterinarian shortage is real, some small animal vets are thriving in their country settings. Here are some of their stories. Part 1 of a 2-part series.

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Veterinarians Thriving in Small Towns Across North America

by Constance Hardesty, MSc

ROLLING FIELDS. A DOZEN CATTLE. The weary but kind large animal veterinarian rattling down country roads in a beat-up pickup truck.

Well, not quite.

The countryside covers most of North America. In some areas, the local farm may count more animals than the surrounding towns have people, and the shortage of rural veterinarians is serious and real.

Alongside it, however, there’s another story to be told. The countryside is speckled with small towns serving colleges, tourists, inland shipping, mines, mills, or factories. To get a better view of practice in today’s America, Trends reached out to veterinarians in rural and small towns. Some planted roots early. One returned home after decades away. All are thriving in place.

These are their stories.

Farrah Austin, DVM, and Tom Austin, DVM

Owners, Grace Animal Hospital, Bridgeport, West Virginia

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On a satellite map, Bridgeport, West Virginia, looks like a real-estate dream: location, location, location! The nearby crossroads of two major highways puts the town within easy reach of Morgantown and Charleston, West Virginia; Pittsburgh, Pennsylvania; Washington DC; and Columbus, Ohio.

In a way, location is what drew the husband-andwife team Tom and Farrah Austin to Bridgeport from Southern California.

Tom was born in Charleston and grew up in Ripley, about 110 miles from Bridgeport. Most of his family still lives in the area. He began his veterinary career in Ripley as a mixed animal practitioner, and for a while, it looked as if he might stick close to home, too. Then opportunity called.

“I moved to California in 1982, when Orange County was still mostly rural,” he says. “I had a very good opportunity to work in a large, multidoctor practice, gain invaluable experience, and advance my career.” The area’s rural character allowed Tom to continue his mixed animal practice until circumstances changed.

“I started there doing small animal and equine practice. However, the area was growing rapidly and the horse population got squeezed, so I went to strictly small animal practice,” he says. “After only a couple of years I was able to become a partner in the practice, which rooted me to the area for almost thirty very enjoyable years.”

Farrah followed a different career path. Born and raised on the west coast of Congo, Africa, she attended college in California and earned her veterinary degree from the University of California, Davis. After graduation, she chose small animal practice, working in Southern California.

You might think a couple of southern California veterinarians might retire to the beach, but the doctors weren’t ready to dig their toes in the sand just yet. With Tom’s special interest in orthopedic and small-tissue surgery and Farrah’s interest in holistic medicine (she’s a certified veterinary acupuncturist), they decided to open Grace Animal Hospital in Bridgeport in 2011. “We named Grace Animal Hospital after God’s amazing grace to us,” she says.

“Selling the practice in Southern California and returning to my West Virginia roots has been a very positive move,” Tom says. “I see it as a new chapter in my life and career with more to come.” In addition, they note that “we have an amazing team of individuals who all share in our vision and who are proud to be a part of our hospital family. This gives me great happiness and makes the job that much more meaningful and rewarding.”

This is Farrah’s first foray into practice ownership, and she’s found it a fruitful experience. “Having the freedom to make our own decisions for how we want the hospital to run, what services we offer, and the standard of medicine and care we provide to our clients and patients are some of the reasons I really enjoy practice ownership,” she says. Farrah adds that she and Tom “knew from day one that we wanted the hospital to be AAHA accredited.” That helped with the start-up.

“It didn’t seem as though we had to worry about gaining new clients or advertising,” Tom says. “We have always relied on word-of-mouth referrals, and our practice has continued to grow. Our AAHA membership, the AAHA standards, and member benefits helped with that, and it also helped us to put into place good practice and financial management systems.”

“I love that I can take my lunch break outside and look at the river landscape in my practice’s backyard.”

—GUYLAINE CHARETTE, DVM, PEMBROKE, ONTARIO

Holistic medicine and acupuncture are very well received in the area, Farrah is happy to report. “We have clients who drive from all over the state to have these services performed. I think more and more people are seeing the value in integrative medicine and there is a demand for it. Most of the patients I see for this are either from word-of-mouth or recommendation from their regular veterinarian as part of a treatment plan.”

There is also little competition, she notes. “There are only a couple other practices in our state that provide companion animal holistic and integrative medicine. There are a few local vets that do acupuncture, but I am the only certified acupuncturist in our area.”

So, what would the doctors say to veterinarians considering a mid-career move?

“There are a lot of good things about living in a small town, too many to list them all here,” Tom says. “But there are advantages to living and practicing in larger metropolitan areas as well.”

Farrah agrees. “Each veterinarian must know his or her own self and choose what is right for them.”

Guylaine Charette, DMV

Owner, Pembroke Animal Hospital, Pembroke, Ontario

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Pembroke, Ontario (population 15,000), is nestled between the Ottawa River and the enormous Algonquin Park. A hobby farm near Guylaine Charette’s home has horses and llamas, and she often sees wolves, moose, and turtles. As work-from-home allows people the flexibility to choose a rural lifestyle, Pembroke is growing.

Charette came to Pembroke directly from veterinary school. “I am a city girl, and I was not looking for life in the country,” she says. “I was looking for an AAHA-accredited practice close enough to my family (two hours away), and the opportunity to become fluent in a second language appealed to me. I am French-speaking and studied veterinary medicine at Université de Montreal, in French.” Pembroke offered opportunities that would be hard to find in a large city. “As a rural vet, I have had so many opportunities to develop a wide expertise in surgery, internal medicine, dermatology, and behavior,” Charette says.

Another plus: collaborating with area hospitals in sharing on-call services, helping local animal shelters, and working together for better patient outcomes. And the setting can’t be beat. “Our hospital is located directly beside the Ottawa River,” Charette says. “I love that I can take my lunch break outside and look at the river landscape in my practice’s backyard.”

But a rural companion animal practice has its challenges, too. After a long day at work, a doctor and veterinary technologist remain on-call to handle emergencies. And, with the closest referral hospital at least 80 miles away, referring a patient to a board-certified specialist means a full-day commitment for the client.

On the other hand, “less access to veterinary specialists affords us the possibility to offer broader services, including surgery, dentistry, internal medicine, some oncology treatments, and behavior counseling,” Charette says. The hospital even has a training center for puppies and adult dogs.

But “because the cost of living is lower here and our clients’ disposable income may be lower than in other areas, we may charge less for similar procedures than we would if we were in a big city,” Charette adds.

As AAHA president (2019–2020), Charette met veterinarians from urban, suburban, and rural practices. All veterinarians share certain opportunities and challenges, she notes. “The entire profession is under great pressure from the shortage of staff,” she says, adding that all practice owners must “provide the best management structure to ensure that our workplace culture fosters employee wellness, that we can provide decent compensation, and that we reinvest in our hospital.”

“As veterinarians, we are all equally motivated to stay current with new medical and surgical trends as well as provide wellness medicine and the best quality care. We are advocates for our patients and their human families,” she adds.

Charette credits accreditation for helping her practice meet high standards. “AAHA accreditation evens out the playing field. We may practice in a small community, but thanks to the AAHA standards, our hospital provides the high quality of care that is typical of an AAHA practice,” she says. As proof, she can point to her own experience. Pembroke Animal Hospital was AAHA Practice of the Year in 2016.

To veterinarians considering rural practice, Charette says, “Yes, you can have a well-managed and profitable hospital!”

Saundra Robinette, DVM

Owner, Escanaba Veterinary Clinic, Escanaba, Michigan

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Escanaba, Michigan (population 12,108), is a port city on Lake Michigan’s Little Bay de Noc in the state’s Upper Peninsula (UP). The town is named for a nearby river, and Escanaba was the name of an Ojibwa village in the area. It’s a great place to chill: In winter, the average high hovers below freezing and the average low is 6 degrees. (The coldest temp on record is -28 degrees!) It’s not the snowiest city in the US (that’s Syracuse, New York, at 128 inches per year), but it averages a respectable 52 inches per year.

Saundra Robinette, DVM, owner of the AAHA-accredited Escanaba Veterinary Clinic, was raised in the area. When she graduated from veterinary school, her husband already had a teaching job in Escanaba, and for several years, the couple maintained a long-distance marriage.

After working as an associate in small animal medicine, Robinette took charge of her career by pursuing a rotating internship. “I was burnt out, and the internship was my out, my way of changing things up,” she remembers.

The internship at Michigan Veterinary Specialists changed her professional life. “It really allowed me to build my confidence and become so much better: better with differentials, more comfortable with interrupting diagnostics, more comfortable with recommendations for advanced diagnostics and treatments.”

A later stint at Fox Valley Animal Referral Center in Appleton, Wisconsin, was another great learning experience, thanks to specialists who “loved teaching and allowed us to grow as doctors,” she says.

Pregnant with her second child, she was ready to close the gap in her long-distance marriage, “so I set out to buy the Escanaba Veterinary Clinic and start watering the roots I had in this town,” she says.

Her AAHA-accredited practice provides the quality care that both Robinette and her clients expect.

“We may not have a specialist next door or just down the road, but they are really only a few hours away and an easy trip if our clients want to use them. We have a good support team, are well supplied, and have great diagnostic tools.” In addition, she says that “good communication with the client explaining what you can and cannot offer is key. Then, expectations are not left unmet.”

Her practice faces the profession’s most pressing challenges. “I think most of the veterinary field faces many of the same issues. We are challenged with price points. Wanting to be affordable for our clients but also wanting to offer our employees a good life,” she said. “We are all struggling with too many client needs and not enough time. I could hire another full-time veterinarian and still not have enough appointments in the day for pets in need.”

Robinette also stresses the importance of vet techs. “The truth is, more than a veterinarian, we need trained help. I don’t know of a hospital right now that is not in need of more licensed veterinary technicians. We could get so much more done with more technicians. They seem to enter into the field, but they do not stay. It is a hard job, both physically and emotionally, soul-sucking sometimes. If veterinarians feel underpaid, how do our LVTs feel? They really struggle to make ends meet as well. It seems they come into the career just to turn around and find a new profession. It is very sad.”

After-hours care can also be a strain, even though her practice uses Guardian teletriage service. “Prior to using Guardian, people would be upset about finances or having ER fees, and we would have to hear about how we don’t care about pets or are letting their dog die,” she says. “This service has eliminated these conversations, which has been a huge relief.”

But, with specialist services a few hours away, even teletriage can’t solve the problem. “If I could make one thing go away, it would be on-call. Let’s be honest: it is the hardest part of practicing where I do. In the month of May, I was called in 28 times,” she says.

“I am happy to have cared for the pets, but it is challenging after working all day to be up late or in the early morning and then again working all day. You cannot be good for anyone when this happens. You are not a good doctor, a good wife, a good mom, a good pet mom, a good coworker. You get burnt out, and it is a struggle to do a good job functioning with normal life,” she says.

“We need more trained veterinary technicians. That should be a goal for our profession. We are all in need of them, and rural areas are struggling even more than the cities.”

 

Constance Hardesty
Constance Hardesty, MSc, tells stories about the people, medicine, and technology serving our animal companions.

 

Photo credits: Photo Courtesy of Grace Animal Hospital, Photo Courtesy of Grace Animal Hospital, Photo courtesy of Guylaine Charette, DMV, Photo Courtesy of Escanaba Veterinary Clinic

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