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                    John Gay, DVM PhD DACVPM               AAHP                  FDIU             VCS

Introduction to Herd Production Medicine

Version 2.5     Updated February 07, 2014

Contents:


What is veterinary production medicine?

The following are definitions of veterinary production medicine extracted from selected sources appearing over the years. 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.

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.

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

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:

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."

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:

... 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)

. . . . 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):

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, currently 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) (Manager, Columbia River Dairies)

. . . 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.

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) (Dairy production medicine clinician):

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)

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:

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

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:

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:

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

Penn State Dairy Production Medicine Certificate Program (2002)

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? 

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

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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.

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:

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

RA Curtis (1985)

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:

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, ...)

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:

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

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.

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

Roger 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.

Bob 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 husbandry immunology
beef quality assurance pathophysiology
food safety medicine

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) TOC - People Management - Working with Your Veterinarian

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:

Handouts:

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

Production Medicine vs. Traditional Individual Medicine:

Veterinarian's Role:

Farm Visit Trigger:

Usual Primary Focus:

Unit of Consideration:

Detection of Problem and Initiation of Resolution:

Disease or Problem Manifestation:

Application of Interventions:

Evaluation of Outcome:

Basis of Comparisons between Normal and Abnormal:

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

Economic Impact of Interventions:

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

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How to get there from here?

Optimize your learning ability and skill development:

If you are not yet admitted to veterinary school:

Acquire general skills and knowledge:

Acquire specific animal industry skills and knowledge:

While in veterinary school:

Mentoring: Actions:

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

Obtain experience outside of school:

If you are already in practice:

 

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

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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' practicestyles 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.

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. With enough animals present, these employees do enough volume of work to become proficient at this skill and do it for a lower cost than the veterinarian. Veterinarians can have a role in training, monitoring and motivating these employees, a role that initially developed in the feedlot industry. In larger herds with sufficient replacements, it appears that the decision may be more likely to cull an animal than to attempt treatment. Finally, with better understanding of the relationship between animal management and subsequent disease problems, the herd production medicine approach 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 children 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 sale 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:

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Selected Production Medicine References:

(A more complete list is in In-Print & On-Line Production Medicine Information Resources)

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) Amazon

The best core book on the principles of production medicine for the major ag animal species but out of print. If you are interested in production medicine, find a copy of this book first 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 ) Amazon

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. (Vet Med Reserve)

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. (Vet Med Reserve)

  • Lechtenberg, KF, RA Smith, GL Stokka. Feedlot health and management. 177-197.

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