Introduction to Herd Production Medicine

Version 2.7    Updated March 23, 2018

What is veterinary production medicine?

General Discussions:

  • Beyond traditional veterinary services: 'It's not just about the cows!' - Van der Leek, ML (2015) Journal of the South African Veterinary Association 86(1), Art. #1221, 10 pages - pdf   http://dx.doi.org/10.4102/jsava.v86i1.1221
  • Cow Fixer vs. Herd Health Veterinarian: Beef Vet examines production medicine - Beef Magazine 5/25/13
    (Dr's. Ross Daly, Terry Engelken, W Mark Hilton, John Maas)
  • Grumpy Old Vets: The 1960's practice hits the 21st century. K Nordlund (1999), Bovine Practitioner 32:58-62 - local pdf
  • The use of modern marketing strategies for the promotion of preventive medicine and herd health. CS Ribble (1987), Can Vet J 28(7):406-412 -pdf
  • What I've learned about veterinary medicine since becoming a dairyman. WM Guterbock (2001) The AABP Proceedings - local pdf
  • Whom do we really work for? JF Lowe (2013), AASV SHAP 21(1)
Definitions:

The following are definitions of veterinary production medicine extracted from selected sources appearing over the years, alphabetized by author. Note the common themes across authors and species.

DC Blood (1985)

Dr. Blood, originally at the University of Guelph and later Dean of the School Veterinary Science at the University of Melbourne, was one of if not the primary originators of the concept of the herd approach and production medicine. In a conference held in honor of his retirement, it was stated that "he has provided leadership to the scientific and farming community by expounding the concept that sub-clinical disease was of greater economic importance than clinical disease and that major financial gains for the farmer could accrue through planned animal health and production programs which identify and limit the effect of subclinical disease in livestock." (KL Hughes, ed. (1985). Proc First Intl Conf Vet Prev Med Anim Prod, Univ Melbourne, Melbourne, AU, Nov 25-29, 1985. Aust Vet J). He was the lead author of the first editions of Veterinary Medicine, a textbook for large animal medicine, and of Herd Health, a textbook of production medicine, and others.

  • The serious deficiency in (the traditional) approach of disease management as the sole contribution of veterinary science to animal agriculture is that it fails to recognize adequately the strong relationship between disease management and production management, especially the effects of disease on management programs and the contribution to disease that particular production management programs can make.
  • The principal objective of (production medicine) programs is the reduction of wastage due to diseases which have management errors as major components of their cause.
  • The secondary objective of production medicine programs is the reduction of wastage due to failure to attain optimum production, optimum in the sense of being most cost-effective.
  • The principal thrust of any attempt to promote production medicine programs must be to change the behavior of farmers; change behavior in the sense of having him/her actually modify his/her management practices rather than simply become aware of the need to change them.

Over-riding all of these complexities is the need to consider the cost-benefit relationships at all levels of interaction.

The only worthwhile advice is that based on profitability.

Preferred terminology: Animal Health and Production Management

A Brand, C Guard (1996) (Herd Health and Production Management in Dairy Practice)

The complex of integrated veterinary and animal husbandry activities, centered around regularly planned farm visits, and based on a protocol approach.

  • This role is in addition to and not a substitute for traditional practice activities.
  • Instead of being focused solely on the clinically diseased animal, the comprehensive concern is for the herd and the entire farm enterprise.
  • Requires broadening beyond the traditional boundaries of thought and practice.

The primary objectives of herd health and production management services are aimed at the optimization of:

  • The health status of the herd by prevention of health, reproductive, and production problems.
  • The productivity of the herd by improving management practices.
  • The production process in relation to animal welfare and ecological quality of the environment.
  • The quality and safety of dairy and meat products.
  • The profitability of the dairy enterprise, either by increasing farm income or reducing costs.

Preferred terminology: Herd health and production management

RA Curtis (1985)

(Production medicine) is concerned with determining the distribution and causes of the status of health in animal in animal populations, and with the development, implementation and evaluation of programs for the purpose of maintaining health and for optimizing production and quality of products under humane circumstances.

To be able to offer (production medicine) programs to their clients, by graduation we want our graduates (of a residency program, I presume) to be able to do the following:

  • Clearly outline priorities and objectives for the farm
  • Draw up targets of production and action plans to achieve them
  • Predict the effect of a suggested course of action in both physical and financial terms
  • Monitor the effects of these plans and assess progress
  • Investigate shortcomings in performance compared with planned objectives.

Preferred terminology: Health management

T Fuhrman (1993 Western Large Herd Management Conference)

Production Medicine in Large Dairy Herds (pdf - edited below)

"Dairymen are in business for profit. So are veterinarians. When dairymen and veterinarians work together to manage animal production for profit, their mutually beneficial working relationship is called production medicine."

  • Production medicine is an outgrowth of preventative medicine but is not the same.
  • Preventive medicine is characterized by reproductive programs in which veterinarians routinely palpate cows for two purposes: 1) to identify postpartum uterine infection and treat it; 2) to verify pregnancy after insemination.
  • The production medicine approach toward reproduction has the objective of developing the most profitable means for providing future replacement animals for the dairy herd while maximizing milk production for profitability now.
    • The veterinarian still palpates fresh and bred cows, but does so to monitor people and animal performance rather than identifying which animals require treatment.
    • Monitoring assures that fresh cow care, heat detection, breeding, dry cow nutrition and fresh cow feeding are done correctly to maximize herd reproduction.
    • Reproductive records are also analyzed to assess the fertility status of the herd as a unit and to track the status of individual cows.
    • Programs and staff performance are modified when results dont meet targeted goals.
  • Production medicine is comprehensive herd health integrating all areas of health and productivity on the dairy farm, focusing on whole herd profitability by maximizing outputs from efficient inputs.
    • Outputs are the expression of each animal's genetic potential. For lactating cows, this is pounds of milk, butterfat and protein per day of lactation. For calves, rate of gain, livability and disease resistance. For growing heifers, height and weight growth rates.
    • Inputs are the resources provided for animals to enable them to produce including facilities, equipment and feed.
    • Inputs are almost always controlled by people; their stockmanship is a critical input which may either limit or magnify each animals' productivity,
    • Management causes problems by failing to establish clear requirements and perpetuates those problems by not setting and maintaining a clear performance standards
  • In production medicine, the veterinarian assists the owner/manager in determining the most profitable (not necessarily the greatest) animal output from the correct and most efficient use of resource inputs by:
    1. Organizing a management scheme
    2. Establishing performance goals for each subunit of the dairy
    3. Providing farm staff with programs and resources to achieve the goals
    4. Monitoring animal and people performance
    5. Responding to performance assessments appropriately

CE Gardner (dairy practitioner; column in April, 1996 DVM News Magazine FA section)

Quoting (bolding and italics mine):

My best client does almost all of his own palpations, toggles his own displacements and treats 98 percent of his sick animals without any professional intervention. So what do I do for this particular client to earn my fee when he has decided he doesn't need me or other practitioners for the routine services? The following is a list of what he and I agreed summarizes my role on his farm:

  • Monitor and review herd performance
  • Help determine changes needed to correct deficiencies found above 
  • Provide input on job descriptions, goal setting and labor management 
  • Provide traditional veterinary services as needed 
  • Be a source of new ideas 
  • Provide input on financial planning and debt management 
  • Prescribe and supervise use of prescription drugs

... I spoke on practice management at a state veterinary association meeting. Afterwards, a young man approached and identified himself as a veterinary student. He stated that he had managed a dairy farm for five years and decided to attend veterinary school in part because he was frustrated with the level of service he received from veterinarians. "All they had to do was treat. They never spoke of prevention, or tried to teach us better methods of management. My nutritionist taught us a whole lot more about disease control and good management than the vets ever did."

Our background in veterinary medicine gives us some of the skills we need, but we must continue to learn new ones. We must change our approach to how we serve clients. Future opportunities will likely involve more time teaching and less time doing. I truly believe we have a bright future, if we can set aside old paradigms and approach each farm by creatively asking, "What can I do to help this client in a valuable manner?"

CE Gardner (column in January, 2003 DVM NewsMagazine - index of all his columns)

. . . . production medicine services are those that impact herd management vs. individual animal management. In general, reproductive exams are not production medicine, as the results of a palpation usually impact that cow, but not overall management. The same principle applies to sick animals, surgeries, dehorning, etc. By contrast, record review, discussions of timed insemination programs, ration balancing, milking equipment evaluation and housing discussions impact the entire herd, and fall under production medicine.

CE Gardner (column in February, 2004 DVM NewsMagazine)

The trend to larger, more efficient farms continues its relentless march. This trend represents both a threat and an opportunity to dairy practitioners. Whether it is the former or the latter depends mainly on our willingness to change.

Winds of Change: All dairy farms have needs which veterinarians are uniquely suited to meet. In some cases our training and experience make it easy for us to meet those needs. In other cases, we must add to our existing knowledge, but we are still the best candidates. The key to remaining involved with today's dairy client is to recognize his or her unmet needs, and do what is needed to meet them. In most cases, this requires changing from "hands-on" mode to teaching, evaluating, reporting and communicating.

Herd 1 . . .  has learned to perform traditional veterinary service internally . . . they are very interested in outside input on herd management. At this time, no private veterinarian is offering that type of service to them. So, the net result is that our profession is losing them, as they pass private practitioners by in terms of having their needs met. 

Herd 2 . . . had a training session scheduled with their veterinarian, where he would be teaching protocols for treating clinical mastitis. . . . they depended heavily on this doctor to work with them on management, even as they used him less and less to do routine procedures. Clearly, this practitioner has learned how to meet the needs of a farm that will be part of the dairy industry for a long time.

Herd 3 . . . a key member of his management team was his veterinarian, and that his veterinarian did his ration balancing. . . they still used their veterinarian to do reproductive exams and to perform surgery. This doctor was successfully serving them in both traditional and production medicine roles. In other words, he was meeting their needs on several fronts, and in doing so ensured himself a role on the farm and revenue from the farm.

No two herds are alike, and there is no one set of veterinary services that will meet the needs of all dairy producers. The challenge and opportunity that faces every practitioner is to identify each clients needs, and then to be proactive in meeting those needs. There is plenty of opportunity to survive and grow if we take that approach.

CE Gardner (Cargill Animal Health, practice consultant, column in February, 2006 DVM NewsMagazine)

    Teacher or technician: exploring the DVM's changing role (edited, bolding and italics mine):

  • As herds get larger, lay staff carry out many of the duties performed by veterinarians. Many farms now do their own pregnancy exams, with or without ultrasound.
  • Like it or not, lay people can learn to competently perform many routine tasks that once were our responsibility. The veterinary role has changed. We are the teacher instead of the doer when our clients perceive an advantage to performing procedures internally.
  • Communication is important to attaining a positive outcome, and I suggest being pro-active. Ask clients if they have interest in doing more procedures that you currently perform. Most will decline, believing they are stretched too thin already but they will appreciate you for asking.
  • For the few clients who are interested, have a more extended discussion sharing the pros and cons of paying you to perform the procedures versus farm staff doing them. Recommend the best choice for their operation, but let them know you will support whatever decision they make.
    • With this last group, you are now the teacher. Schedule a time to meet with the relevant staff, and review how to accurately diagnose the condition, teach what complications need to be considered and when the procedure is not indicated. Finally, review the actual procedure, stressing the do's and don'ts.
  • This places you in the role of an ally who is trying to help them succeed rather than a disapproving authority figure from who they must keep secrets. Which role is more appealing to you?
  • Once a client decides to perform procedures, there are at least three possibilities:
    • The role simply diminishes.
    • More commonly, clients become frustrated with their performance and turn the job back over to you. The client has new respect for your abilities, enhancing your position of importance to the operation.
    • The most satisfying outcome is spending just as much time with the client and earning as much or more income, but spending time in a consulting role rather than a technician role. Hours previously devoted to palpating cows are now spent reviewing records, rations and protocols. Staff meetings or training sessions are on the agenda instead of three displacements. This outcome represents the true win-win scenario we should seek.
  • The real key to a secure future with all of your clients is to know their needs, but more importantly, know their wants. They will make decisions based on what they want. They might want to avoid writing you a check for repairing displacements, or they might want to see their calves dehorned at an early age. They might have to rationalize to convince themselves that their wants are truly needs.
  • Our challenge is to learn what they really want, and then be the resource that fulfills it.

CE Gardner (column in January, 2007 DVM NewsMagazine)

. . . technology decreases the producer's dependence on veterinarians. This continues a long-standing trend that began with lay sales of animal health products many years ago. Larger herds have typically been better positioned to replace veterinarians with lay staff . . .. In any case, the dairy practitioner continues to face challenges as he or she seeks to remain a valuable resource to clients.

I believe the best response is to serve the best interests of your producers. If using blood testing to identify open cows will help your clients, then you should be the one who tells them about it. Keep yourself in the loop. Tell them the pros and cons, and let them make the decision.

. . . there is a world of opportunity for private practitioners to be more proactive in herd management consulting. This is often referred to as production medicine. . . . review herd records and discuss herd performance . . .. be involved in the nutrition program . . . look at the rations, look at the feed in the bunk, evaluate manure, cud chewing, body condition, bunk space, . . .  help your client assess udder health, herd fertility, transition cows, calf health, heifer growth, ventilation, stall comfort and vaccination programs. . . make suggestions that improve performance or reduce costs and have a positive impact on the bottom line.

Sell yourself. Will all of this be easy? No. The best way to begin is to work on your listening skills. Learn to find out what things are of concern to your clients. Then position yourself as the best source of solutions.

WM Guterbock (2001) (former dairy practitioner, large dairy manager)

What I've learned about Veterinary Medicine Since Becoming a Dairyman (Full PDF- 34th AABP Convention Proceedings, 2001)

  1. The cows are the most important creatures on the dairy, but there is a lot more to running a large dairy than managing cows
  2. Veterinary emergencies are not really emergencies
  3. Veterinarians need to stop thinking about per cow averages
  4. On large dairy farms most traditional veterinary tasks are not being performed by veterinarians
  5. The cases we brag about generally have bad outcomes
  6. Its a lot easier to give advice than to take it
  7. We aren't the only smart people out there

Smart producers will make use of services that help them and their employees improve performance and profit. The question is not whether the services are needed but who will provide them.

WM Guterbock (2010) (former manager, Columbia River Dairies on Threemile Canyon Farms)

. . . I believe that the sustainable model is the full service practitioner who knows the client and the employees, knows local conditions, and lives close so s/he can drop in and check on how things are going and fine tune the program. This means that the practitioner needs to expand his/her knowledge base beyond what s/he learned in school. S/he needs to understand the industry and the economic constraints faced by the client, understand the production system, understand nutrition, and realize that recommendations ultimately have to pay for themselves in more milk (or beef) or lower costs. Routine work, be it emergencies, preg checking or chute work, gets you on the place so you can observe, builds the client's trust in your abilities, and gives you a chance to talk to the client. But if you give the routine stuff priority and don't take the time to delve into your clients' problems (at first you may have to do this for free!) don't be surprised if all they call you for is the routine stuff. If they are having calf raising problems, you have to make the time to observe what is going on and help them improve. You can't just tell them to send a calf to the dx lab and drive off to your next call. Or use it as an opportunity to sell medicine or vaccines without addressing the real problem. On most big dairies there are huge opportunities in improving the calf program and the diagnosis, treatment, and management of the hospital and fresh cows. But you will have to "give away" part of your knowledge by training the dairy people to do their work better, maybe even teach them the right way to roll and toggle a DA, and you may have to write protocols that seem like you are reducing sick cow work to a formula.

The Wife of Bath, in Chaucer's Canterbury Tales, defended her infidelities by saying that your candle does not have any less light if you allow another to light his candle from it. The same applies to client education. Your knowledge does not lessen if you share it. On the contrary, you only learn something well when you have to teach it, and you only understand a problem when you work at trying to solve it.

. . . many of the visitors seem to have a mental image of the ideal dairy and proceed to ask questions and make recommendations based on the image, rather than on the bottlenecks on my farm.  It is easy to come up with a list of 101 things you need to do to be a great dairyman.  The hard part is prioritizing the list and then helping the client see how the goal can be accomplished.  As producers we get tunnel vision and sometimes think that we are unable to change things until someone shows us the way to do it.  The consultant, to sell the idea, needs experience of past success, understanding of the constraints on the farm, knowledge of the people involved, and the ability to persuade without hurting the producer's pride.

JB Herrick (1989)

Before his retirement, Dr. Herrick spent many years as the beef extension veterinarian for Iowa. He was one of the early promoters of preconditioning programs for beef calves going to feedlots. Dr. Herrick is a tireless advocate of agricultural animal veterinary medicine and has written a great deal on the subject.

The food animal veterinarian must change his image in the mind of the producer from one who diagnoses ailments and offers treatment to one who is an integral part of the overall management program.

A veterinarian's goal is to make his client successful.

"Production medicine is the utilization of many facets of production, e.g. nutrition, environment, genetics, and health, into a well-managed program monitored by records" (Herrick 1990, UCD-VMTRC)

DF Kelton (2006) Epidemiology: A foundation for dairy production medicine. Vet Clin Food Anim 22(1):21-33.

Dairy production medicine . . . whereby we strive to optimize production through the elimination and control of disease and the implementation of management practices that promote animal health, welfare, productivity, and profitability.

programs . . . include the setting of performance goals, the gathering of data to assess current performance relative to those goals, the development and implementation of actions to move the herd closer to the goals in instances where they are not being met, and the continued assessment of continuously available data to verify that progress is being made.

Dairy production medicine is ultimately concerned with identifying problems or bottlenecks on dairy farms and developing strategies to relieve those bottlenecks.

S Kenyon(2010) Ross slide presentation

Traditional medicine is focused upon diagnostic and therapeutics of the individual animal with the assumption that if all the sick animals are handled properly, a healthy herd will result

If a group of cows are examined, pregnancies recorded, abnormalities treated, heats predicted, and left at that point, the reproductive program is traditional medicine directed at correcting the problems of many individual animals

Production medicine is focused upon the underlying herd management system with the assumption that if the production system that produced the problem is fixed, a healthy herd will result

If herd performance is summarized and charted, allowing management to make herd-based decisions, the reproductive program is production medicine

Goal of production medicine:
  • Have the producer see the veterinarian as veterinarian as an asset to the operation
  • See us as someone to ask about ANY aspect of their business. (We don’t have all the answers, but we know who to ask for answers to their questions.)
  • Primarily dealing with cattle owners that see themselves as running a business

Business attitude:

  • Where are we?  ->  Records
  • Where will we go?  ->  Targets
  • How do we compare?  ->  Benchmarking
  • How will we get there?  ->  Analysis

"How will you and I know when I'm doing the job you expect me to do?"

Production medicine:

  • Comparison of actual performance with agreed performance targets
  • Importance of subclinical disease and production inefficiencies
  • Importance of collection and analysis of production and health data
  • Importance of integration of advice (e.g. disease, nutrition, economics, housing)
  • Evolved from health programs for control of specific diseases (1960's) to integration of health maintenance with production management (1980's) to integration of food safety (antibiotic residue avoidance, injection site abscesses, . . .), animal welfare and environmental management

Nomenclature: Herd health, preventive medicine, population health, production medicine, herd health and production medicine

JL Kleen, O Atkinson, JPTM Noordhuizen (2011) Communication in production animal medicine Ir Vet J 64(1):8

Production animal medicine is focused on:
  • decreasing disease incidence and prevalence, increasing the proportion of healthy animals
  • reducing losses and production costs and increasing farm income
  • activities such as:
    • monitoring and early diagnostic warning
    • problem analysis, intervention and prevention
    • monitoring of feeding regimes and advice on ration composition
    • analysis of fertility data and management
    • counseling on milk-quality and milking technique
    • consultancy on planning, constructing and organizing farm buildings
Terms for this integrated approach to herd health and productivity are:
  • Herd Health Planning
  • Herd Health and Production Management
  • Veterinary Herd Health Management
  • Veterinary Quality Risk Management

JF Lowe (2013) Who do we really work for? (JSHAP 21(1))

. . .we have transitioned from individual animal care to farm health advisors and information providers. In a farm-centric food-supply chain, this was an effective model to leverage our talents and skills over more animals.

With the migration of the food-supply chain to a “technified,” integrated model, it is common to use multiple streams of information to make operational decisions, thereby decreasing the value of each piece of information. Value is no longer created by supplying information, but by synthesizing the multiple streams of information into useful knowledge.

. . . we must have a strategic change in our knowledge base. This means that we not only have a deep understanding of production operations, production economics, and human-capital management, but we also must gain a working knowledge of the rest of the food-supply chain, its economics, and the customer’s perceptions of value. In our traditional health-management role, we must value evidence-based solutions and devalue opinion-based methods of health management.

We also need a significant strategic shift in how we address problems. We must be creative, fact-driven problem solvers with a keen ability to separate symptoms from problems. Treating symptoms has been acceptable in the farm-centric model, as the local decision maker “felt better” about the situation. However, short-term resolution of symptoms without resolving the root problem in an integrated model will degrade our credibility and marginalize our role in the chain.

AJ Nelson (1989) (former dairy production medicine clinician and organic dairy owner):

An individual with a special interest in dairy cattle management who assimilates and organizes essential dairy management information from several sources and then efficiently and effectively conveys to the owner or herd manager the management performance and its economic implications.

PURR production medicine program (ranked by time to benefit)

  • Production management
  • Udder health and milk quality
  • Reproduction programs
  • Replacement management

Without question, the most critical factor to the success of the program is the dairyman. The most sophisticated, technical information in the world, with the most competent veterinarian in charge of the program, will not make one iota of difference in the management performance of a herd if there is not an interested, competent, motivated dairyman to make the necessary management adjustments to effect positive results.

If the client lacks the motivation to alter his or her management habits and procedures, the records information is useless, and program will not succeed. ... Changes in dairy management must be consistent with the owner/manager's self-image or they will not be permanent.

1999 Note: Some have extended PURR to PURRDEA

PURRDEA:

  • Production management
  • Udder health and milk quality
  • Reproduction programs
  • Replacement management

KV Nordlund (1989) Food Animal Production Medicine Program, University of Wisconsin emeritus faculty

Dr. Nordlund was for many years a dairy practitioner in Minnesota before moving to the faculty of the University of Wisconsin.

Production medicine programs include the following components:

  • Production record analysis
  • Reproduction management
  • Nutrition assistance
  • Parasite control
  • Animal environment counseling
  • Mastitis control
  • Vaccination programs
  • Genetic selection
  • Replacement rearing programs

When judged by their impact upon production, the component programs are seen to be interdependent. This interdependence is the inherent cause of weakness when a single component program is pursued by itself. Yet this same interdependence is the inherent cause of strength of a production medicine program.

... none of (this) is executed by the veterinarian. Success is dependent upon our ability to take complex ideas and make them so clear and compelling that they cannot be ignored by the client.

We become motivators, not doers.

... it is important that everyone who works at the dairy understand it - this includes the lowest paid labor. ... Failure to recognize in each person his potential for good almost guarantees that we will someday acknowledge his potential for harm.

Many of the components of production medicine programs fall outside of state veterinary practice acts, and they may be delivered in competition with other businesses and agencies.

KV Nordlund (1998) (Bovine Practitioner 32:58-62. - Full PDF)

During the previous decades, veterinary services for dairy cattle differed little from services to companion animals, which are focused on animal care. Now there are three concurrent and sometimes conflicting goals: Animal care, owner profit and consumer safety.

Three factors become paramount on large dairy farms: Specialized labor, purchasing and marketing clout due to volume, and an emphasis on schedules and constancy. With specialized labor, the guiding principle is that each task will be delegated to the lowest-paid person who can competently perform the task.

This includes tasks traditionally performed by the veterinarian.

Cow health problems that were seen twice a year on a 50-cow dairy are now seen weekly on a 1,300-cow dairy. This routine observation of now common problems gives managers and farm labor the confidence to diagnose and treat most dairy cow health problems that were once the province of the veterinarian.

Traditional medicine is focused upon diagnostic and therapeutics of the individual animal with the assumption that if all the sick animals are handled properly, a healthy herd will result. Production medicine is focused upon the underlying herd management system with the assumption that if the production system that produced the problem is fixed, a healthy herd will result.

If a group of cows are examined, pregnancies recorded, abnormalities treated, heats predicted, and left at that point, the reproductive program is traditional medicine directed at correcting the problems of many individual animals.

If herd performance is summarized and charted, allowing management to make herd-based decisions, the reproductive program is production medicine.

[Note the many scoring systems and  forms Nordlund's group has developed to perform the assessment and monitoring tasks]

Dairy management assistance services include any informational services that assist the herd manager in analysis, control, and decision making. Opportunities for providing these services include:

  • Training and monitoring of the performance of sick pen personnel
  • Nutrition management including ration formulation, inventory management and feedstuff price monitoring
  • Mastitis management including milker training and milking system analysis
  • Reproductive monitoring and projecting replacement heifer, lactating cow, and dry cow inventories based on reproductive records.
  • Consultation on facility design and maintenance
  • Expansion advice

RG Ovrebo (2010) Get more comprehensive value from your vet (Progressive Dairyman 24(9), 2010)

  • How a veterinarian works with a dairy is based on whatever return on investment the dairy owner thinks he or she is receiving from the use of that veterinary practice
  • Larger herd sizes allow dairy owners to employ skilled personnel who handle day-to-day cow treatments and care. These skilled employees can make observations of cow behavior and animal health and perform therapy protocols developed by the herd’s veterinarian. . . . Routine animal care – vaccinations, obstetrical procedures, foot trimming, dehorning, castrations and so on – has shifted from the veterinarian to employee technicians.
    • Jobs traditionally done by veterinarians on small dairy farms (reactive manipulation-based services) are not being done by veterinarians in any of the medium-to-large dairies. . . 
    • A reproductive program succeeds or fails because of the way in which the employees manage fresh cow care, heat detection and adherence to timing of protocols, administration of injections, breeding technique and cow handling. . . . . The much larger payback to the dairy is what the veterinarian recommends for future programs that increase the chances of success, and the training of dairy workers in the proper use of those programs.
  •  Veterinarians . . . work in areas of monitoring performance, bringing innovations through knowledge transfer and training employees through meetings.
    • A veterinarian must first gain the confidence of a dairy by performing the necessary exam/diagnoses, routine work and emergencies proficiently. Tough obstetrical procedures, C-sections, DA volvulus surgeries need to be done successfully when required. . . .  the veterinarian is judged on the outcome of these cases, and unless successful, will not be allowed to participate on the team with any degree of credibility.
    • From the everyday sick cow or calf (as in the past) to . . . record analysis, reproduction management, milking machine performance, facility design, employee training, herd health consultation and product sales
    • To ensure satisfactory performance and animal welfare, veterinarians create protocols and flow charts that tell employees how the job they are performing should be done. The vet’s role is now one of “coach” within the concept of teamwork.

Penn State Dairy Production Medicine Certificate Program (2002)

  • Herd performance medicine, as opposed to the more traditional individual animal care that most people learn in veterinary school
    • Emphasis on such areas as nutrition, herd management, cow comfort, farm personnel, and herd profitability.
  • To make the greatest impact on animal health and farm profitability, veterinarians need to be more proactive and prevent problems or eliminate production-limiting conditions. Typically, these involve interactions between the animals and their environment, nutrition and management.
  • Dairy producers reported fewer unscheduled veterinary visits and reported the greatest progress in forage evaluation, milk quality analysis, records analysis and improvement in animal environment.

DO Rae (1989) (U Florida Beef Clinician)

The veterinarian will continue to be the producer's front line resource for health management services and information. How can we best serve the beef producer? Traditional delivery of services has included: 1) care of the sick cow or calf; 2) emergency intervention; 3) elective procedures; and 4) regulatory procedures. Fire-engine medicine and surgery! Can the veterinarian offer a service which will help the producer better meet his needs, pressures and goals? Can we do it at a price that is bearable or preferably cost effective and income producing for the producer and veterinarian? Can we accomplish these things by offering the traditional veterinary services alone? I think not.

What type of service are we going to see then? 

  • Key: One with a more purposeful involvement in health and production management, not just an occasional fix-up or patch-up.
  • Aim: Help the beef producer optimize his profit!

CS Ribble (1987) (U Saskatchewan Herd Medicine, U Guelph Population Medicine, U Calgary Epidemiology Professor) Can Vet J 28(7): 406-412

 Depending on the producer's goals and values, a complete cow-calf herd health service program may consist of:
    Technical Services:
  • General: Clinical and routine necropsies of all animal, reproductive exams of cows and bulls
  • Health Accounting Services: Routine nutritional monitoring, routine production performance monitoring including comparison with performance targets, quarterly health management reports
  • Routine Electives: deworming, dehorning, castration, foot trimming and vaccination
  • Emergency Service: Individual animal emergencies

  • Pharmacy:
  • Drugs supplied wholesale with 5% handling fee to eliminate veterinary "conflict of interest" delivered directly to farm. Veterinarian has complete control over which drugs are used on the farm.

  • Consulting Services:
  • Information: Regular electronic and in-person information exchange, anonymous between farm information exchange and benchmarking, continuing education program for farm staff
  • Preventive Medicine Procedures: Regular analysis of validity and specific application of preventive medicine techniques
  • Science / Research Services: Investigation of disease outbreaks, regular performance of on-farm field trials to assess different management techniques and pharmaceutical choices

CA Risco (2011) Dairy Production Medicine Preface

Milk production is under constant economical, societal, and environmental challenges, which constrains dairy farmers responding to the increasing demands of an growing world population for a wholesome and economical milk supply. To meet these challenges dairy farmers must continuously adapt their milk production systems by relying on specialists to provide guidelines. Dairy production medicine integrates veterinary medicine and animal science into a system to produce milk profitably. The design, implementation, and management of this system is multidisciplinary, including clinical medicine, economics, epidemiology, food safety, genetics, human resource management, nutrition, preventive medicine, and reproduction. To be profitable without neglecting animal welfare and food safety, these specialties must work in concert to harmonize management.

MW Sanderson (2005) Beef Practice: Cow-calf Production Medicine

Production medicine is largely about using records, and proper analysis and interpretation of them, to make rational decisions based on production and economic reality. . . .  measuring production levels and subclinical disease, indentifying risks for increased disease and decreased performance, and identifying sources of revenue and cost. All of these data are needed for optimal decision making.

UCD VMTRC Faculty (1999)

What is Dairy Production/Performance Medicine?

Production medicine is the utilization of many facets of production, e.g. nutrition, environment, genetics, and health, into a well-managed program monitored by records (Herrick 1990).

The five main areas where a veterinarian can interact to help the dairy farm become more profitable are:

  1. Reduction of somatic cell count (SCC) through mastitis control and prevention
  2. Increase dry matter intake (DMI) through nutrition and improved cow comfort
  3. Improve reproductive efficiency of the herd
  4. Decrease the age at first calving through heifer management programs
  5. Advise on management to improve effective labor and facilities utilization

[Return to Contents List]

What specialized skills and knowledge are required?

Extracted from various sources, the following identify the skills and knowledge beyond the traditional individual animal curriculum that are required for successful veterinary production medicine. Again, note the common themes across authors.

D Bechtol, S Lewis, A Hentschl (Bovine Veterinarian, 10/98) Feedlot Consultants

Participate in continuing education for knowledge and contacts to maintain a cutting edge advantage in the industry. Our feedlot managers are becoming more knowledgeable so they're right behind us in the information. If we left some of these (professional) organizations (e.g., AABP, Academy of Veterinary Consultants) and didn't get the information, our clients could pass us up.

  • Understanding the culture of the industry.
  • Latest in diagnostics and treatment of disease.
  • Understanding of the basics of business practices, accounting, cash flow.
  • Understanding cattle industry risk management and economics.
  • Computer skills
  • Understanding manure management, human resource management, financial evaluations, quality control, farm gate food issues.

DC Blood (1985)

Education for veterinary production medicine:

  • Epidemiology
  • Nutrition
  • Genetics
  • Breeding Management
  • Economics
  • Veterinary Information Management
  • Production Monitoring
  • Systems Analysis

A Brand, C Guard (1996) (Herd Health and Production Management in Dairy Practice)

Veterinarians practicing herd health and production medicine should have:

  • The skills to implement and to operate herd health and production management protocols.
  • A broad knowledge and interest in:
    • The functional structure of dairy farm management and the convergence of operational farm management functions in relation to health, productivity, economy, animal welfare and environment.
    • The pathophysiology, dynamics, diagnosis and prevention of diseases and production deficiencies at the herd level to distinguish the abnormal from the normal and the suboptimal from the optimal.
    • The utilization and interpretation of diagnostic tests.
    • Basic computer handling and data processing techniques.
    • Communication and client education that enable the veterinarian to stimulate and motivate the farmer in record keeping, improvement of management procedures, and adoption of recommendations.
  • A basic understanding of epidemiologic principles, including test characteristics and observational surveys.
  • The skills to interpret not only clinical and subclinical disease but also production data and environment related observations in an epidemiological way.
  • The skills to serve both as a source and a critic of new information delivered to the farmer.
  • The ability to be a sentinel and advocate for the welfare of cattle.
  • The ability to intermediate between primary farm production and public health interests.
  • Computer facilities.
  • A farm file of reports, analyses, conclusions and recommendations.
  • A strong and current base of scientific information on dairy farm management and on the sciences related to herd health and production medicine services.

PJ Chenoweth, MW Sanderson (2005) Beef Practice: Cow-Calf Production Medicine

  • beef cattle production, management and economic strategies
  • nontraditional veterinary areas including:
    • critical thinking
    • business and financial management
    • statistics
    • risk analysis
    • epidemiology
    • applied animal breeding
    • nutrition
    • data management and analysis
    • communication skills

RA Curtis (1985)

  • Epidemiology
  • Animal production
  • Animal nutrition
  • Applications of the computer

Although 25% to 30% of the curriculum should be devoted to the health management stream, it is not intended to weaken the foundation on which our profession is built. Our graduates must be able to examine an individual animal, make a diagnosis, institute proper treatment and, if necessary, develop a control program. Veterinarians who do not have this expertise will never gain the confidence of their clients - the confidence so necessary for a sound health management program.

RO Gilbert (1998)

  • nutrition
  • housing
  • farm economics
  • industry economics
  • decision analysis
  • product quality assurance

JB Herrick (1989)

... A veterinarian involved in food animal production must learn as much as he possibly can about:

  • Production management
  • Environmental engineering
  • Genetics
  • Nutrition
  • Business acumen in profitability analysis

This will not be part of a veterinary student's training; it must be acquired after graduation [or before and during - JMG]

The greatest damage to a practitioner's reputation can be caused by making recommendations that are not in concert with those made by resource people in other disciplines. (Nutrition PhD's, dairy scientists, ...)

S Kenyon (2010) Ross slide presentation

Not expected to be the herd nutritionist but:
  • Need to know enough nutrition and feeding management to be able to troubleshoot nutritional management
  • Need to be able to lead the management advisory team
  • Need to be able to take forage samples correctly and interpret results of forage analysis
  •  Need to know enough nutrition have an intelligent conversation with the farm nutritionist
  • Useful to be able to run trial rations on a computer program

JL Kleen, O Atkinson, JPTM Noordhuizen (2011) Communication in production animal medicine Ir Vet J 64(1):8

Production animal medicine skills:
  • interpretation of production data
  • feed ration calculations
  • assessment of herd health status
  • communication processes different from those typical of individual animal focused services:
    • shift from "problem-oriented communication" associated with acute problems needing immediate solution to "solution-oriented communication" associate with long-term management decisions associated with prevention and quality management
    • broaden client's knowledge of herd health, including perception of "normal" and reducing "anchoring"
    • up front definitions of status quo, of goals, of success, of priorities and of collaboration methods without which discrepancies can lead to friction and client resistance
    • application of the "SWOT" technique
    • discussions of emerging problems related to the herd
    • discussions of long term strategies to improve herd health and performance

R Morris (1995) (Prev Vet Med 25:77-92)

Expanding on Herrick's note above:

". . . we still have important educational goals to meet in ensuring that veterinarians understand the epidemiological viewpoint. This is very difficult to achieve with undergraduates, who lack the experience of complex problems which are necessary to appreciate the value of epidemiological methods for solving such problems."

AJ Nelson (1989)

Competence and expertise must be developed in the basic areas of:  Competence and expertise must be   developed in the adjunctive areas of:
  • Nutrition
  • Mastitis control
  • Reproduction
  • Replacement raising
  • Epidemiology

 

 
  • DHIA record analysis
  • Computer skills
  • People skills
  • Goal setting
  • Psychology
  • Statistics
  • Economics

K Nordlund (1998)  (Bovine Practitioner 32:58-62.)

To serve as a herd management advisor, the veterinarian will need knowledge of:

  • dairy record and monitoring systems
  • disease management including some statistical and epidemiological analysis techniques
  • dairy finance including cost of production determinations and of partial budgeting

WR Pritchard (1989) (JAVMA 195:171-174.)

  • Economics of production
  • Clinical epidemiology
  • Nutrition
  • Housing and environmental management
  • Reproductive performance
  • Control of infectious diseases
  • Marketing aspects of the industry

OM Radostits, KE Leslie, J Fetrow (1994) (Herd Health: Food Animal Production Medicine)

Becoming  a species specialist with a comprehensive understanding of the industry is the only hope of mastering the knowledge and skills required to provide a health management service to a livestock producer.  . . . a thorough understanding of a particular livestock species or class of livestock, and the industry with which they work.

  • Animal production
  • Animal disease
  • Production economics
  • Systems analysis
  • Information management (computer literacy)

Veterinary epidemiology has become a major influence . . . . Epidemiological techniques have become important tools for developing health management programs. The collection and analysis of farm data for the implementation of health plans and actions, as well as the ongoing monitoring of performance outcome, inherently imply the use of these tools by veterinary practitioners. In order to accomplish these activities, the computer has become a major factor in the application of epidemiologic principles to herd problems.

Problem-solving skills are a major asset. Be able to:

  1. Identify the problem. (He who identifies a problem usually gets to be first in line to solve it)
  2. Access a body of relevant knowledge (personal, fellow professionals, printed, computerized databases).
  3. Apply the information to the solution of the problem.
  4. Evaluate the response.

DO Rae (1989) (U Florida Beef Clinician) Beef Health Management Prospects for the 1990's

This will require a change in philosophy and education. The beef practitioner will be better trained to meet the needs of the producer. This will include not only surgery and medicine, but also:

  • health management
  • production
  • nutrition
  • environmental engineering
  • economics
  • marketing
  • statistics
  • computer literacy
  • epidemiology. 

More importantly, the development of sound problem solving skills and client interaction skills

CS Ribble (1987) (U Saskatchewan Herd Medicine, U Guelph Population Medicine, U Calgary Epidemiology Professor) Can Vet J 28(7): 406-412

Understand modern marketing and sales theory to develop a comprehensive marketing strategy for one's products and services
Formulating a marketing strategy involves integrated the answers to three questions:
  • Which producers to target
  • What desires of those producers to satisfy
  • What marketing mix to use in satisfying the target producers, which has four components:
    • produce and service planning
    • pricing
    • physical distribution
    • service promotion via personal selling that includes discovering each producer's goals, values and needs so that a herd health plan can be tailored to their needs
  • R Saltman (2001) Dairy technical services veterinarian

    "Dairy Production Medicine" involves developing skills in multiple areas of dairy practice. Of the many challenges faced by the dairy practitioner, the need to positively influence dairy producers for change can be pivotal. Among other traits, the ability to listen and to clarify ideas is critical if the production medicine practitioner hopes to make much of an impact.

    RA Smith (2007) Veterinary Research and Consulting Services in July 07 Bovine Veterinarian

    . . . management is more valuable than what comes in bottles, so today’s veterinarian must be well-versed in:

    economics animal welfare
    animal husbandryimmunology
    beef quality assurancepathophysiology
    food safetymedicine

    We must be good trainers, educators, and motivators so that feedlot employees know their job, and have fire in their belly to ‘get ’er done,’ even when the days are long and the weather severe.” The veterinarian must also know enough about cattle feeding to communicate with the nutritionist, as nutrition and health go hand-in-hand.

    Alberta Feedlot Management Guide, 2nd ed (2000)

    Feedlot production programs, although now prevalent throughout the industry, vary widely in the services delivered and the degree of ongoing veterinary involvement. Areas that may be addressed in a health management program include:

    • diagnosis and treatment protocols for sick animals
    • vaccination strategies/risk analysis
    • post-mortem examinations as part of an ongoing disease surveillance program
    • assistance in managing day to day problems (e.g.) unusual medical conditions, minor surgeries
    • parasite control programs
    • implant programs
    • nutritional management
    • implementation and monitoring of health and performance records
    • employee training and evaluation
    • carcass quality issues
    • marketing strategies
    • animal welfare concerns
    • food safety/quality assurance
    • in-house research projects

    Handouts:

    • Evidence (and Opinions) on the Future of Ag Animal Practice ( PDF)
    • Basis of Marketplace Economics (PDF)
    • Ownership Costs and Capital Budgeting (PDF)
    • Veterinary Marketing and Salesmanship (PDF)
    [Return to Contents List]

    What are the basic differences between production and traditional veterinary medicine?

    Production Medicine vs. Traditional Individual Medicine:

    Veterinarian's Role:

    • Herd management adviser vs. Hands-on veterinary practitioner (direct application of technical skills)
    • Information evaluator (problem solving skills) vs. information applier ("hands-on" skills)

    Farm Visit Trigger:

    • Regularly scheduled visits by calendar date vs. Call from the producer on as-needed basis ("fire engine")

    Usual Primary Focus:

    • Health and Production (management) vs. Disease (infectious agents)
    • Prevention and Optimization vs. Treatment (Salvage)
    • Prevention of potential loss vs. Reduction of impending loss

    Unit of Consideration:

    • Whole farm system and groups of animals as well as Individual animal system
    • "Physical exam" on herd in addition to physical exams on individuals

    Detection of Problem and Initiation of Resolution:

    • Veterinarian detects suboptimal performance vs. Producer observes clinical case
    • Record-based detection of performance problem vs. Visual detection of illness
    • Sub-clinical & sub-optimal problems (earlier) vs. Clinical problems (later in disease process)

    Disease or Problem Manifestation:

    • Spectrum of problem present in group of animals (from performance affected only to clinical) vs. Single cases (usually clinical)
    • Problem defined by "barn yard epidemiology" (who, when, where) beyond physical exams of clinically affected individuals

    Application of Interventions:

    • Producer or their employees implement intervention vs. Veterinarian implements intervention
    • Producer or employees trained to treat routine cases (standard protocols) vs. Veterinarian treats the case
    • Veterinarian establishes protocols and monitors person performing protocol vs. Veterinarian does it

    Evaluation of Outcome:

    • Economic performance vs. Health state
    • Effects are most often not visibly discernable (e.g. additional 25 lbs. on 950 lbs. animal) vs. Visible difference (healthy vs. sick or dead)

    Basis of Comparisons between Normal and Abnormal:

    • Herd contemporary (Eliminates biases due to different genetics, environment, management, ...) vs. Literature or historical comparisons
    • Performance objective vs. Visible health objective

    Quantitative Analysis of Herd Data (Herd Production Accounting Records):

    • Use of numbers, rates, time trends, comparison of cohorts vs. Sample of one
    • Risk of occurrence (number affected / number at risk)  vs. Number affected (dangling numerator)
    • Opportunity for controlled within herd trials for decision making (e.g., best Rx, Px) vs. Only external (outside of herd)  information used for deciding which treatment or preventative to use

    Economic Impact of Interventions:

    • Potential for great impact (entire group is impacted) vs. Salvage value or reduction of loss from a clinically affected individual animal

    Level of Confidence in or Trust of Veterinarian that Producer Requires before Applying Intervention:

    • Very high (scope of impact is across herd) vs. Low to moderate (scope of impact is treated individuals)

    [Return to Contents List]


    How to get there from here?

    Optimize your learning ability and skill development:

    • Excelling requires investing considerable time in deliberate practice to develop skills and time on task to develop knowledge. Some 50 hours of deliberate practice are required to develop a skill set, such as rectal palpation for pregnancy or piloting an airplane, to entry level competence.
      • Ericsson, KA (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic Medicine, 79:S70-S81 (pdf - article begins on page 4 of prepublication proof on USC website)
      • Two popular books addressing this are Malcolm Gladwell's Outliers: The story of success (2008) and Geoff Colvin's Talent Is Overrated: What really separates world-class performers from everybody else.
    • Increase the power of your thinking process
      • The 5 Elements of Effective Thinking (EB Burger, M Starbird, 2012) - Amazon
      • Smart Thinking: Three essential keys to solve problems, innovate, and get things done (A Markman, 2012) - Amazon
      • Thinking in Systems: A primer (D Meadows, 2008) - Amazon
    • Understand and optimize your motivation
      • Motivation: The scientific guide on how to get and stay motivated - James Clear
      • Drive: The surprising truth about what motivates us (DH Pink, 2011) - Amazon
        • TEDTalk - YouTube - autonomy, mastery and purpose
      • Success: The psychology of achievement (DA Olson, 2017) - Amazon
    • Maximize your return on time invested in learning from coursework, particularly in increasing your retention and recall
    • Develop the important extra-curricular skills, competencies and literacies.
      • Richard St. John's "8 to be great" keys to success - video list - video
        • 8 Traits - Passion / Work / Focus / Push / Ideas / Improve / Serve / Persist
        • 6 Skills - Creative / Management / Computer / People / Analytical / Technical / Specific career & field skills
      • 10 Things Employers Want You to Learn in College: The know-how you need to succeed, Revised ( William D. Coplin, 2012) - Amazon  - skill list pdf pdf

    If you are not yet admitted to veterinary school:

    Acquire general skills and knowledge:

      Less than half of the skills and knowledge required for success in most jobs are in the specific academic domain associated with that job, whether accounting for the accountant, veterinary medicine for the veterinarian, engineering for the engineer, or medicine for the physician. Many of these other skills are not part of academic curriculums, require active learning and experience to acquire, and many of these are classified as "soft skills." Evidence of this is that outside of academia and some government positions, few potential employers evaluate transcripts or grade-point averages, relying instead on references, interviews, and internships.

      Understand and achieve:
    • Communication literacy: Excellent speaking and writing skills are essential for teamwork, reports, educating and motivating farm employees, and communicating with managers.
    • Economic literacy: Economic factors drive the trends in input and output prices and consumer and producer decisions. Understanding microeconomics is essential to understanding the consequences of supply and demand of both inputs and outputs.
    • Financial literacy: Everyone borrows and invests money; understanding risk and the time value of money are essential to both success and avoiding being defrauded. Much of agriculture involves operating loans and loans for facility investments to improve health and production.
    • Information (digital) literacy: (wiki) Obtaining information and converting data to information is critical, particularly managing and analyzing data with spreadsheet software such as Excel, accessing and evaluating the literature, and how to use your own literature database using programs such as Zotero.
    • Marketing and salesmanship literacy: Selling is a part of everyone's life, whether selling yourself, your ideas, your services, or a product but few understand salesmanship sufficiently to do it well
    • Quantitative literacy: Math is everywhere from determining drug dosages based on metabolic weight to evaluating ration adequacy to comparing performance
    • Statistical literacy (wiki): Understanding variation is essential to extracting signals (information) from biological information, for interpreting results of research studies and on-farm trials, and to avoid misleading yourself and your clients.
    • Books with general advice for undergraduates (buyer beware; this is not an endorsement):
      • How to Become a Straight-A Student: The Unconventional Strategies Real College Students Use to Score High While Studying Less (Cal Newport, ) - Amazon
      • Major in Success: Make College Easier, Fire Up Your Dreams, and Get a Great Job, 5th ed. (Patrick Combs, 2007) - Amazon

    Acquire specific animal industry skills and knowledge:

    • Major in Animal Science, production option, at a school with a strong program in your species of interest with the goal of becoming a competent manager. Problems in animal husbandry are at the root of many livestock disease problems and preventing these usually requires farm-specific interventions. Because small scale livestock clients seldom have significant animal husbandry knowledge or experience, basic animal husbandry knowledge is also critical for those intending to enter mixed practice serving small ruminant, camelid or bovine clientele.
    • Take all of the livestock nutrition classes that you can; get a Master of Science degree in it if you can. Animal feed is the major cash expense of most livestock operations and nutrition problems are a component of many livestock disease problems.
    • Take all the reproduction classes that you can and learn artificial insemination and embryo transfer skills.
    • Take upper division classes in applied farm-level agricultural economics and farm management. The really important herd-wide decisions in which the veterinarian is involved almost always involve economics and managing risk. The veterinarian who does not understand the economic implications of decision alternatives is of much less use to managers making these decisions than one who does. Veterinarians are becoming more involved in establishing procedures and in the hiring, training and monitoring of employees responsible for those procedures. To do this, veterinarians need to understand the principles of labor management including training, monitoring and motivation.
    • Become familiar with agricultural systems thinking and the emerging discipline of agroecology, particularly as it relates to soil biology. Improving and maintaining soil productivity is increasingly important and improving the integration of livestock into farming systems to improve soils is a key component of agroecology. Livestock waste management and green house gas mitigation strategies involve soils and the farm ecosystem as well as livestock nutrition and their production system. Be careful of the "silo thinking" common within academic disciplines.
    • Spend at least a summer or two working with the labor on large-scale operations in the area of your interest, such as one summer on a 2,000+ lactating cow dairy and another on a 10,000+ head feedlot. If you grew up on one, work on one in a different region or for a different species production system. For those intending to return to a family business, gaining 5 or so years of experience elsewhere first increases the likelihood of successful transition.
    • Apply to short-term, intense "hands-on" programs in the production system of your interest, such as the US Dairy Education & Training Consortium
    • Learn and practice agricultural Spanish

    While in veterinary school:

    Mentoring:
    • Student Information Sheet for Mentors (pdf)
    • Student Mentoring Checklist (pdf)
    • Mentoring Session Record Form (pdf)
    Actions:
    • Consider the points above and implement those you can.
    • Join the professional organizations for your species  (e.g., AVC, AABP, AASRP or AASV) and the relevant allied organizations (e.g., American Society of Animal Science, American Dairy Science AssociationNational Mastitis Council, Society for Theriogenology) as a student member. With student membership you gain access to the organization's professional journal and annual meeting proceedings.
    • If you have not, develop your conversational ability in Spanish as a significant component of the agricultural workforce is Hispanic.
    •  Learn how to use the production accounting systems (e.g., dairy - DairyCHAMP, DairyComp 305, beef - CHAPS, CowBoss, CowCalf5, swine - PigCHAMP) and how to do "barnyard epidemiology" on the data from them efficiently. Learn to use readily available tools such as  EpiInfo, Microsoft Excel and R to establish cohorts, to calculate risk of occurrence and relative risk between exposures, and to create summary tables and plots. For additional information in this area, see Herd Monitoring and Information Analysis (pdf) and Guide for Herd Problem Investigations.
    • Take advantage of the elective blocks offered at other schools with strong applied programs in your species of interest. Even consider scheduling some of these as part of your vacation time. To make sure they have a place for you, you will need to begin arranging these months in advance of when you would like to go. Many of these will allow you to take their blocks for free if you are paying tuition at another North American veterinary school and they have open slots.
      Some examples of 4th year clinical rotations (this list isn't complete; most schools have them!) open to veterinary students from other schools are:
    • Apply to short-term, intense "hands-on" education programs, such as the 8 week Cornell Summer Dairy Institute
    • Apply to summer experiences intended for veterinary students, such as the Iowa State B-PIKE (Beef - Production Immersive Knowledge Experience), the Iowa State SMEC (Swine Medicine Education Center) SMARI (Swine Medicine Applied Research Internship) program (pdf) or the WIMU Northwest Bovine Veterinary Experience Program
    • Consider specialized internships and residencies, such as the Michigan State University Training Center for Dairy Professionals (TCDP) or the UC Davis VMTRC Residency in Dairy Production Medicine.
    • If you didn't major in animal science and take the capstone division livestock nutrition and reproduction classes, obtain the textbooks for these and become familiar with the material. Feed is approximately one-half of farm operating cost and feed and feed program problems are a major cause of production diseases.
    • If you didn't have courses in applied farm-level agricultural economics and farm management, consider obtaining and reading the course textbooks to become familiar with the material. The really important herd-wide decisions almost always involve economics and risk. The veterinarian that does not understand the economic implications of decision alternatives is of much less use to managers making these decisions than one who does. Veterinarians are involved in establishing procedures and in the hiring, training and monitoring of employees responsible for those procedures. To do this, veterinarians need to understand the principles of labor management including training, monitoring and motivation. Finally, the veterinarian's allied industry "competition" usually has this background and level of academic training.>

    Identify the competencies expected by practitioners, your future employers, and begin achieving these:

    • Expected New Graduate Competencies (pdf)
    • Practitioner Competency Input (2008) - pdf (long)

    Obtain experience outside of school:

    • Identify progressive practitioners doing what you want to do and go see how they do it. Arrange to spend several days, preferably a week or so, with them during your school vacations. In that time, you can see how they interact with clients, ask them what their practice philosophy is and seek their advice on how to prepare yourself for that type of practice. Rather than concentrating on one region or one practice, go to different areas to see different ways of doing things, both on the veterinarians' and the producers' sides. To find these people, ask around. For example, ask the technical service veterinarians who come to your school; they make it their business to know the practitioners in an area. Ask the veterinarians you ride with to identify other leading veterinarians you might spend time with. Identify the area practitioners who have participated in certificate programs. The business buzzword for this is "networking".
    • Seek out veterinarians successfully managing large, modern livestock operations. These individuals have the unique perspective of both knowing what training you are obtaining as a veterinary student and knowing the actual day-to-day production aspects of the industry very well. If you can arrange it, spend some time with them on their operation. Large intensive livestock operations are  complex operations with large investments in facilities, equipment, feed and livestock and with employees having specialized tasks that have to be done repeatedly and well with consistency.
    • Through veterinarians and other allied industry personnel, identify progressive operations and contact the manager to ask if you could spend some time on the operation to see how it works and shadowing key personnel as they carry out their jobs. If you have not, spend one summer working with the labor on a large-scale operation in the area of your interest, such as a 2,000+ lactating cow dairy or a 10,000+ head feedlot, preferably with a veterinarian familiar with the herd acting as a mentor
    • Join the professional organizations (AVC, AABP, AASRP and AASV) as a student member and attend their annual meetings; the dues are essentially the cost of postage to mail you their meeting proceedings and other materials. Many have activities specifically for veterinary students.
    • A special source of ideas are the "Practitioners of the Year" or their equivalent that are selected annually by the practitioner organizations such as AVC, AABP, AASRP, and AASV. These individuals are usually quite active in and knowledgeable of the profession, are progressive and innovative, are highly respected and well known by their peers, and are intensely scrutinized by an award selection committee after their nomination. For example, to identify the AABP awardees, on the AABP website click "Conference" then "AABP Award Nominations" under "Annual Conference" then "View awards and past recipients" and finally click on the individual awards for a complete list of the recipients.

    If you are already in practice:

    • Consider the points above and implement those you can.
    • If you can step out of practice, consider doing a residency in a strong program that is targeted toward your area of interest. The pay isn't good but if you are a self-directed self-starter you will likely have lots of freedom (and the time) to develop deep expertise in your areas of interest, such as applied ruminant nutrition. For example, the UC Davis VMTRC offers a ABVP board eligible residency in dairy production medicine combined with an MPH or MBA and the Iowa State SMEC (Swine Medicine Education Center) offers a Swine Medicine Education Center Fellowship (pdf).
    • If you can't step away from practice, consider a specialized certificate programs that requires attendance for short periods across several years. For dairy, these include the Ohio State Ohio Dairy Health and Management Certificate Program and the Penn State Dairy Production Medicine Certificate Program. Historically, the Great Plains Veterinary Educational Center has run one for beef cattle practitioners.
    • If you can't make the time and monetary investments required for the certificate programs, consider venues such as the AABP pre-convention seminars. Taught by academic and practitioner experts, these are targeted at practitioners. Many veterinarians practicing bovine production medicine got their start in such seminars delivered by those 'walking the walk.'
    • Consider pursuing certification via the practitioner pathway in your area of interest. Just doing the suggested reading will get you a long ways.
    • For unbiased reviews of the science behind issues affecting and industry, consider the CAST (Council for Agricultural Science and Technology) publications and the National Academies of Sciences, Engineering and Medicine reports
    • Several successful production medicine practitioners have developed private seminars on aspects of  production medicine.
    • Students Note:
      1. Speakers and instructors at national practitioner meetings are selected for their applied expertise relevant to practitioners. Use meeting announcements, preconference seminar listings, and meeting proceedings to identify these individuals and their areas of expertise. Then search proceedings and reviews, such as Veterinary Clinics of North America: Food Animal Practice to find their papers.
      2. The board certification study guide / reading lists provide an excellent guide as to what leading practitioners in those specialty areas consider are the most important information sources to excel in that area of practice.
    [Return to Contents List]

    Dr. Al Leman's perspective

    (An "out of the box" thinking former academician, swine clinician and large hog producer)

    Dr. Leman grew up on his family's swine operation in Illinois, obtained his DVM from the University of Illinois in 1968 and later a PhD. After 6 years as a swine extension veterinarian at the University of Illinois, he joined the University of Minnesota in 1975 and rose to full professor of swine medicine and first director of the very successful University of Minnesota Swine Center. During this period, he mentored many graduate students, was editor of several editions of the text "Diseases of Swine", was president of the American Association of Swine Practitioners, was a member of the Board of Directors of the Society for Theriogenology and received numerous leadership and research awards. In 1987 he left the University of Minnesota to become a partner in Swine Graphics, Webster City, Iowa, and to expand his own swine operation, which became one of the dozen largest in the United States at that time. Cut down in his prime, he died in his late forties of heart disease while attending an international meeting on swine in 1992.

    Leman, AD (1988). Diagnosis and treatment of food animal educational diseases. JAVMA 193:1066-1068. (bolding mine)

    From his perspective as a former academician, a swine clinician and a major swine producer, Dr. Leman addressed what he perceived as the gap between the training that veterinary schools were delivering to veterinary students and the needs of the agricultural animal industries. Although written several decades ago, this paper is still pertinent and thought provoking. I encourage you to read the full version; the following are edited excerpts:

    • The shortage of food animal veterinarians well equipped to provide profitable services to livestock farms will grow because of the dearth of adequately prepared new graduates.
    • The "cult of coverage" in veterinary schools . . . results in graduates who are "one mile wide and one inch deep"; unfortunately the food animal clientele wants depth and often fails to find it.
    • Veterinary education and diagnostic services are largely directed at the pursuit of the germ. . . The reality is that germs have little primary importance in livestock production. With few exceptions, germs are opportunistic and cause secondary problems. . . . our graduates are not prepared to search for noninfectious risk factors that cause suboptimal production and trigger infectious disease.
    • The greatest single challenge is the need to daily question personal beliefs and assumptions about causal relationships. Because we are heavily steeped in the germ theory of disease, we almost always say the the presence of a germ is the cause of the other event. As a group, we need to exercise far more critical thinking when establishing causation.
    • In mature industries like food animal production, to survive production units must produce food at less than average cost of production for the industry because in a mature industry, the average supplier will enjoy little or no profit. Profitable producers will be those with the lowest costs. Therefore, the essential veterinary question, which the veterinarian must seek the knowledge to answer, becomes "What can I do to lower clients' cost of production?"
      • Does adding more biologic or therapeutic products reduce production costs?
      • Does adding ingredients or nutrients to the rations decrease production costs?
      • Does adding more or better labor reduce production costs?
      • Does remodeling farm buildings reduce production costs?
      • Does adding a better information system reduce production costs?
      • Does using more expensive breeding stock lower production costs?
    • Veterinary practice is largely a matter of information technology. Information and its management are revolutionizing food animal production and, thus, food animal practice.
    • Veterinary students . . . lack experience in the art and science of debate and objective scientific interchange.
    • Veterinary schools . . . fail to produce graduates who search eagerly and effectively for new information. This search may involve the library; it most certainly involves using the scientific method and the quest for farm-specific answers to production problems.
    • Veterinary students must be capable of managing and interpreting information from simple field trials. They must become critical readers of the research reports of others.
    • The curriculum should:
      • Emphasize health and production, not disease
      • Teach information systems and management
      • Offer training in farm management economics and risk assessment
      • Nurture and reward reliability, thoroughness, efficiency, critical thinking and creativity. Do not reward memorization.
    • Specific techniques for self-directed learning:
      • Veterinary support groups: With a group of 10 or fewer peers, host a meeting on a rotating basis, visiting a farm served by the host practitioner and candidly assess the farm productivity and services provided by the practitioner
      • Organize producer support groups
      • Establish training programs for hired managers
      • Join the information age
      • Rank your clients' farms. Meaningful rankings are powerful motivators for change
      • Buy a livestock farm
      • Concentrate on reducing farm costs. Partial budgeting, cash flow analysis and other economic tools are useful in making these judgments
      • Broaden disease control options beyond nutritional, biological and pharmaceutical products
      • Become a systems analyst:
        • What are the factors that limit maximal productivity of this farm?
        • Which of these factors can be most easily changed?
        • Which of these factors respond most quickly to change?
      • Develop the courage to say "The best action in this case is to take no action"
      • Become an advocate of animal welfare
      • Develop paramedical skills:
        • Read widely outside the field of veterinary medicine
        • Study literature on farm management and risk assessment
        • Learn partial budgeting and cash flow analysis
        • Learn how to manage people effectively
        • Take business courses

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    Some considerations:

    "Once a new technology rolls over you, if you're not part of the steamroller, you're part of the road."  Stewart Brand

    Successful agricultural animal veterinarians' practice styles range from the traditional called as-needed individual animal approach only to regularly scheduled reproductive program visits to consulting only. Across clients, individual veterinarian's style may cover the full spectrum with a different mix for each farm. How a practitioner balances this spectrum depends upon their interests, skills and opportunities. I've witnessed situations on large farms where one veterinarian did only the sick cow work, another did the regularly scheduled reproductive work and another did only monthly consulting with the herdsman. None of the three were in the same practice, each was very happy pursuing their style of practice and each was doing well financially.

    In the overall mix, the traditional individual animal work appears be declining and the herd production medicine work increasing, at least in the western dairy areas. Evidence of this shift is the following. Some large dairy practices that used to start new graduates on sick cow work with the intent that these individuals pick up regularly scheduled herd work as they became more confident of their skills and became established in the dairy community and the regular herd work became available no longer have sufficient sick cow work to justify this approach. Several reasons may account for this shift. As enterprises get larger, they can afford to hire and train employees to specialize in the routine tasks that used to be done by veterinarians, such as routine rectal palpation for pregnancy, displaced abomasum treatments and difficult calvings. In large herds, these employees do enough cases to become proficient and to do it at a lower cost than veterinarians. Veterinarians can have a role in training, monitoring and motivating these employees, a role that initially developed in the feedlot industry. Larger herds with sufficient replacements may be more likely to cull an animal than to attempt treatment. Finally, with better understanding of the relationship between animal management and production disease problems, improved management reduces the proportion of clinically affected animals in a herd. On the other hand, the problems that used to be sufficiently infrequent on smaller dairies that little progress could be made in understanding and thus preventing the problem now become economically significant as dairies increase in size and producers want them solved.

    For a description of the history of the transition from reproductive herd health to herd production medicine, see Noordhuizen, JPTM (2001). Changes in the veterinary management of dairy cattle: threats or opportunities? Veterinary Sciences Tomorrow, Issue 2 May 2001.

    This transition to herd production medicine is not easy for the veterinarian, particularly the new graduate. Many clients still perceive the veterinarian's package of services as falling more toward the traditional. Outcomes from traditional services are much easier for the client to judge (Did the cow recover or not?) than are herd production medicine services. Historically, veterinarians have charged piece rates for delivered "hands-on" services and recovered part of their compensation through markups on drugs sold. Moving to charge for "knowledge work" rather than hands-on skill work is difficult, particularly when the "knowledge work" of others appears to be free or low cost. For example, some nutritionists appear to charge low monthly consulting fees but recover most of their compensation by selling a ration component, such as a mineral mix, through the feed mill mixing the herd's ration where its cost is hidden in the mill's monthly feed bill. The feed mill is happy with this relationship because it helps secure the herd as a customer.

    There will always be small enterprises that require traditional individual animal services at a higher rate per cow than larger farms. In some regions, cultural and religious practices lead to the maintenance of small herds that are not subject to the economic pressures or tax benefits that drive other enterprises to increase in size. For example, a significant proportion of beef herds are established because of the rural lifestyle a "ranch" affords and off-ranch income supports the "hobby farm". Some families make the decision not to expand, knowing that the farm will cease to exist as an enterprise when the current operators retire and the offspring have left the farm for other occupations. Often, this trajectory is the consequence of a decision made decades earlier not to undertake the risk of investment in expansion. This decision is often made unwittingly at the time and the consequences are not recognized until years later after the relentless march of a commodity industry down the long run cost curve, mentioned by Dr. Leman in his paper, renders the physical plant of that farm virtually worthless for further use in that industry. In the meantime, these farms are often consumers of traditional veterinary services at a higher rate per cow than larger farms.

    Some thoughts on related issues and trends:

    • Agricultural Animal Opportunities (VM 394 - ppt pdf)
    • The Perfect Storm? (BCVMA, 1/09 - ppt pdf)

    [Return to Contents List]


    Selected Production Medicine References:

    Radostits, OM, ed. (2001). Herd Health: Food Animal Production Medicine 3rd ed. WB Saunders, 884 pp. ISBN: 0721676944. This book is on reserve in the Vet Med Library (SF745 .R33 2001)

    The classic text on the core principles of production medicine for the major ag animal species is long out of print. If you are interested in production medicine, find a library copy and read it from cover to cover. As the third edition has chapters by authors different than the 2nd ed., those same chapters in the prior edition may be worth reading for a different perspective.

    Brand, A, JPTM Noordhuzien, YH Schukken, eds. (1996). Herd Health and Production Management in Dairy Practice. Wageningen Pers. ISBN 90-74134-34-3 366 pp. pprbk. This book is on reserve in the Vet Med Library (SF239 .B73x 1996 )

    Written by 30 authors, including 10 from the US, this is an excellent book for people whose interest is limited to dairy.

    Chenoweth, PJ, MW Sanderson, eds. (2005). Beef Practice: Cow-calf Production Medicine, Blackwell Publ. Amazon

    Written by 11 authors, this text is an outgrowth of the Great Plains Veterinary Education Center's Beef Cattle Production Management Certificate Program. This is an excellent text for people whose interest is limited to beef cow-calf.

    Gardner, CE, ed. (1989). Dairy Practice Management. The Veterinary Clinics of North America: Food Animal Practice 5(3) Nov 1989. WB Saunders.

    Although dated, this issue contains several chapters relevant to dairy production medicine. Most of the chapters were written by well known dairy practitioners practicing dairy production medicine in the east and mid-west. Example chapters:

    • Herrick, JB. Marketing dairy practice. 457-469.
    • Nelson, AJ, HW Redlus. The key role of records in a production medicine practice. 517-552.
    • Nordlund, KV. Developing the production medicine practice. 501-515.

    Noordhuizen, JPTM (2001). Changes in the veterinary management of dairy cattle: threats or opportunities? Veterinary Sciences Tomorrow, Issue 2 May 2001.

    Risco, CA, R Melendez, ed. (2011). Dairy Production Medicine, Wiley-Blackwell.  Amazon

    Having 26 chapters authored by 24 authors, "This comprehensive book integrates new technology and concepts that have been developed in recent years to manage dairy farms in a profitable manner. The approach to the production of livestock and quality milk is multidisciplinary, involving nutrition, reproduction, clinical medicine, genetics, pathology, epidemiology, human resource management and economics. The book is structured by the production cycle of the dairy cow covering critical points in cow management." (publisher's description)

    Stokka, GL, ed. (1998). Feedlot Medicine and Management. The Veterinary Clinics of North America: Food Animal Practice 14(2) July 1998. WB Saunders.

    Thomson DU, BJ White, eds. (2015). Feedlot Production Medicine. The Veterinary Clinics of North America: Food Animal Practice 31(3) November 2015. Elsevier.

    White BJ, DU Thomson, eds. (2015). Feedlot Processing and Arrival Cattle Management. The Veterinary Clinics of North America: Food Animal Practice 31(2) July 2015. Elsevier.