Although veterinary practice can be very specialized, similar to medical practice, most veterinarians work within one of five spheres: private practice caring for "companion'' animals, agribusiness, institutional veterinary practice, government veterinary service, and research or industry (e.g., pharmaceuticals). Each sphere has different pursuits, responsibilities, and objectives. There are approximately 60,000 veterinarians working within the United States. Most work in private practice, but the federal government employs more than 1,100 veterinarians. Other large employers are state departments of agriculture, universities, research laboratories, agribusiness, and pharmaceutical companies, (U.S. Department of Labor Bureau of Labor Statistics, 2005).
Private Practice Caring for Companion Animals. One sphere of practice involves the care of companion animals (i.e., pets). These practitioners generally work in private clinics and hospitals and provide individual animal medicine and surgery services to clients. Many companion animal veterinarians specialize into particular fields of medicine or surgery. Often, individuals develop expertise with rarer forms of pets, including reptiles, birds, small rodents, and aquarium fish. These veterinarians provide a valuable resource in interpreting the health of these less common species. There are approximately 60 million dogs, 70 million cats, 10 million birds, and 5 million horses kept as pets in the United States (Euromonitor, 2000; American Veterinary Medical Association, 2002). Of the households in the United States, approximately 36% have dogs, 32% have cats, 5% have birds, and 2% have horses.
Livestock Farming. Veterinarians within this sphere work with production animals, which are animals kept for profit. These animals include cattle, swine, poultry, race horses, and racing dogs such as greyhounds and Alaskan "mush" sled racing dogs.
Many production animal veterinarians provide only a management consultancy service—offering nutrition, production system, disease management, etc. This is advice without also providing a basic clinical service to treat sick individuals. These veterinarians combine their knowledge of animal physiology and disease with an ability to observe change within animal populations, to gather and analyze data. For example, commercial farmers often hire veterinarians and nutritionists to help them optimize their yield of animal product (e.g., beef, eggs).
Disease diagnosis and control at the population level is the major emphasis of food animal veterinary practice. Evaluation of disease in a food animal emphasizes symptomatology. Veterinarians dealing with food animals may not undertake a complete physical examination on individual sick animals (with dairy veterinarians providing notable exceptions to this rule). There are far too many animals to survey, and it would not be cost-effective. Frequently "examination'' is undertaken only to rule out a specific disease. However, the clinical examination of sick animals is undertaken in the event of evidence of an outbreak (multiple animals with similar signs are observed), or if the signs observed fit diseases of particular concern (e.g., exotic diseases such as foot-and-mouth disease). Veterinarians will readily perform necropsies on dead animals (often abbreviated). On occasion, the veterinarian and the producers will agree to sacrifice an affected animal in order to undertake necropsy.
If a carcass has an unusual appearance or the veterinarian suspects the presence of a particularly virulent pathogen, he/she will undertake a full necropsy. This may require the shipment of the body to an animal hospital of government veterinary laboratory to allow for a more extensive pathological examination than is possible in the field. A government veterinary officer is immediately contacted if an exotic disease is suspected; movements onto and off the farm are prohibited until a complete investigation has been completed.
Production animal veterinary medicine emphasizes the economics of intervention (e.g., cost/benefit analysis) to a much greater degree than does human medical practice or private companion animal veterinary practice. This is because the veterinarians are supporting food safety, economic, and animal welfare goals: growers want to maximize profit given the constraints of protecting animal welfare and the environment. Highly skilled veterinarians contribute to the profitable farming of animals by developing systems that maximize growth rates, feed conversion efficiency, reproduction and production, as well as disease control within the population. The tight profit margins common within agriculture generally limit the use of expensive veterinary skills and pharmaceuticals on the individual animal. However, systems that control or reduce the level of disease within the population generally provide a significant return on investment to the rancher when multiplied across large herds. Veterinarians typically develop these populationlevel disease management systems.
Institutional Veterinary Medicine. Another avenue of veterinary pursuit is institutional veterinary medicine, which includes zoos, wild animal parks, aquariums, and aviaries. Veterinarians working in these areas develop skills in health of nondomesti-cated animals and in ecology. These skills complement their traditional veterinary medicine and surgery skills, and the veterinarians use these skills together to maintain the health of animals within their care. The skill crossover is such that, often, these veterinarians become involved in work directed toward the preservation of species. These veterinarians also often examine injured and sick wildlife found by members of the public. They are, therefore, an important interface to animal diseases in wild populations.
Public Practice. A third sphere is public practice, essentially composed of government veterinarians working for the state and federal departments of agriculture. Veterinary duties include enforcement of the regulations to control certain stock diseases, farming practices, animal movement (interstate as well as international), animal welfare, and quarantine. They can also work to control organisms of relevance to governmental public health (e.g., birds and mosquitoes) if an animal disease of interest is involved; however, the control of specific pests, such as mosquitoes, is performed by local municipalities.
Government veterinarians' responsibilities extend to the investigation of potential exotic disease events, unusual disease events, and the gathering of disease surveillance information. They predominately work with agribusiness (cattle, swine, poultry); however, an increasing proportion of their time and resources are used for companion animals, especially hobby farm animals (such as pet cows, sheep, poultry, goats, and the increasingly popular Vietnamese pot bellied pig).
Primary responsibility for inspection of food animals at the slaughterhouse rests with the USDA. Within USDA, the Food Safety and Inspection Service (FSIS) employs well over 1,000 veterinarians for this purpose. These veterinarians perform both antemortem and postmortem examinations of animals at commercial slaughterhouses, such as those operated by the large meat processors Cargill, ConAngra, and Tyson. The USDA inspectors screen animals and divert any that raise suspicions to a holding pen, where an FSIS veterinarian examines them for evidence of disease. FSIS inspectors cover cattle, swine, sheep, and poultry; they also examine minor species such as goats, rabbits, and bison on request.
The USDA's jurisdiction includes animals intended for interstate shipment. State agriculture departments inspect food animals that are raised and processed and with food product that is sold within their respective states. The goals of state inspection programs mirror those of the USDA (California Department of Food and Agriculture, 2005; Iowa Deparment of Agriculture and Land Stewardship, 2005; New York State Department of Agriculture and Markets, 2005). Disease surveillance duties often involve trapping and monitoring of vectors. For example, culicoides insect population monitoring for blue tongue virus and mosquito monitoring for the surra try-panosome occurs in Australia (Animal Health Australia, 2004).The National Australian Arbovirus Monitoring Program uses the information from vector monitoring to predict the annual distribution of key agricultural arboviruses, such as blue tongue within northern Australia (Australian Government Department of Agriculture et al., 2003).
Nonclinical Veterinarians. Many veterinarians work outside of clinical practice in universities, research, the pharmaceutical industry, business, or their own farming enterprises. In some countries (e.g., Australia), the geographical spread of veterinarians who farm instead of practice veterinary medicine is extensive. These veterinarians provide an informal network of sentinel farms. However, there is often no system in place to capture the observations of these practitioners.
The number of veterinarians who undertake research is increasing. These professionals are in universities (where they often also have a teaching role) and research establishments. Animal health research includes areas such as ecology, diagnostic test detection, and wildlife. Many veterinarians manage the animal houses within research organizations that, for example, require expertise in rodents and primates.
Veterinarians within pharmaceutical industries generally are involved with the development, marketing, and product support for veterinary pharmaceuticals. These veterinarians observe changes that occur at an industry level: for instance, a reduction in the use of respiratory disease treatments within the beef feedlot industry, an increase in the demand for chicken vaccines, or a change in the prescribing behavior of small animal clinicians for antibiotics. Often the information that they obtain is commercially sensitive and therefore is unavailable for disease surveillance purposes.
These distinctions between spheres of veterinary pursuit are important, because each category of pursuit uses, what we will call, electronic veterinary records (EVRs) very differently.
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