Production medicine is part of every-day veterinary medicine. As the veterinarian, you should always be thinking about the clients total operation. Are you a cow fixer or a herd health veterinarian. There is a big difference.” — W. Mark Hilton
Wes Ishmael | May 25, 2013
Production medicine—melding animal health and veterinary care into animal production management—is beyond infancy, but it’s far from losing all its teeth.
“The concept of cow-calf production medicine is still relatively young and still evolving,” says Terry Engelken, DVM, a professor of production medicine at Iowa State University, focusing on the cow-calf and feedlot sectors. “It requires paradigm shifts on the part of the producer and the veterinarian. The producer has to come to the realization that their veterinarian has more to offer than just being a ‘cow mechanic’ and the veterinarian has to understand how to collect and analyze economically important factors that impact profitability.”
Though Dr. Engelken sees slow, steady growth over time, it seems acceptance and use of production medicine is scattered, more client-dependent than size-dependent.
In California, for instance, John Maas, DVM, Extension Veterinarian at the University of California-Davis says it’s a mixed bag. There are progressive practitioners working with progressive cow-calf producers to improve profit potential. There are also producers who view veterinarians as folks who douse emergencies, and veterinarians content to provide only those fire-engine practice kinds of services.
“It’s been one of those things you would think common sense and good business suggest we would have evolved to by now,” Dr. Maas says.
Figuring out the business model of providing production medicine services continues to stall some.
Russ Daly, DVM, Extension Veterinarian at South Dakota State University, believes producers recognize the value of veterinarians and the information they provide. He also knows veterinarians who want to provide production management service to clients. For the most part, though, he says, “In this state, I’m not sure that we’ve found a good way for veterinarians to capture that value, which works for the client as well.”
As for W. Mark Hilton, DVM, it’s impossible to think about production management without considering the animal health side of it and vice versa. Dr. Hilton is a clinical professor in food animal production medicine at Purdue University. He also founded and owns Midwest Beef Cattle Consultants, which many regard as a poster child for how to work with clients in partnership rather than a buyer and seller of specific services.
“Growing up, our veterinarian helped us. He fixed things, but he’d also show us something else that could help us,” Dr. Hilton says. “Production medicine is part of every-day veterinary medicine. As the veterinarian, you should always be thinking about the client’s total operation.”
Dr. Engelken concurs.
“I disagree with those who say that production medicine skills are separate from individual animal medicine, surgery, or palpation skills in a cow-calf practice,” Dr. Engelken says. “I think they are very intertwined in that unless you can exhibit a high level of competency in these areas, you probably won’t build enough trust with the producer to provide consulting services. These skills are also absolutely critical to being able to collect the baseline production numbers that you need to be able to provide consultative services to the client.”
“Are you a ‘cow fixer’ or a ‘herd health veterinarian’?” Dr. Hilton asks, “There is a big difference.”
Herd-Specific Data is the Foundation
For one, Dr. Engelken explains, “Record keeping and data analysis must come into play if you are ever going to get this type of service off the ground. You can’t benchmark performance if the appropriate numbers aren’t being recorded, and that first step can be a real challenge. You have to think about what output parameters you want to evaluate and then make sure you are getting those numbers captured. Then, it becomes a question of identifying the magnitude of losses and what areas the client needs help with. Are those losses associated with cattle disease, herd management, or a combination of both?”
“Production medicine is more of a mind-set of how you do things, and the most important thing that we can do is find the weak links in the production chain,” Dr. Hilton says. “We want to find the most important factors that are hindering a farm’s success.”
In that effort, Dr. Hilton encourages veterinarians to focus on four production goals: decrease production cost; increase the value of production sold; doing both of these with less labor; and maintain or enhance animal welfare.
“I’m a fan of individual cow records,” Dr. Hilton says. “Producers are surprised how consistent individual cow production is from year to year.” With records, clients can see that a cow weaning a calf 25 percent lighter than the herd average this year will likely produce one of similar caliber next year, and the year after. Dr. Engelken points out that the records portion of cow-calf enterprises is less standardized and more challenging to ferret out than in other sectors like feedlots, stocker operations, dairy and swine.
“Your opportunities to generate production or economic numbers are really driven by specific events that occur during the annual production cycle,” Dr. Engelken explains. “These events include calving, calf processing, going to grass, weaning, pregnancy check, etc. You aren’t typically generating input/output numbers on a daily basis like producers in other animal enterprises. These events may be separated by several months (start of breeding until preg-check) or they may occur over a relatively long period of time (the calving or breeding season), which makes data collection and interpretation more difficult. Secondly, in cow-calf practice, veterinarians are often the ones collecting the data since they will be the ones on the ranch as these production events occur. This data may take the form of reproductive information, calf performance numbers, and animal health performance.”
The next step is at least as essential.
Once this data is collected, the important thing is that it is economically relevant to the operation and that it is converted into information that the practitioner and client can use to identify problems and make corrective management decisions,” Dr. Engelken says. “I believe that’s when information has economic value to the producer. This value is improved over time as economically important management changes are continually identified, documented, and benchmarked.”
Areas Of Impact
Any area of production that drives a substantial amount of production output or input invites examination.
For Dr. Engelken, three key areas jump to mind: data based evaluation and the benchmarking of reproductive performance over time; nutritional management to control the cost of supplemental feed; herd health design and maintenance.
“Reproductive performance drives the bus on the income side of the equation and has to be closely monitored,”
Dr. Engelken says. “However, when you look at the differences in profitability between beef operations, you will find much more variation in input costs than you do in revenue generated. Since the largest component of cash costs deals with supplemental feeding, it is only natural that our profession should be involved in evaluation of the nutritional program and cattle feeding practices.”
Likewise, Dr. Hilton says, “Nutritional consulting has provided our clients with the best return on investment. Feed costs are up tremendously over the past five years and our herds that have kept feed cost from rising at the national average are doing much better financially than those that are average or above. I have heard from veterinarians who have saved clients $30,000 in feed cost versus what they would have fed. Even simple ideas like allowing cows only 4-6 hours daily access to hay can save a producer over 30 percent of his hay cost, according to Purdue research.”
As for design and maintenance of the herd health program, Dr. Engelken says, “We are constantly bombarded with new ‘miracle cures’ that come from a syringe, in the form of antibiotics, vaccines, or mineral supplements. I think the practitioner plays a key role in helping producers understand what they need, and maybe just as importantly, what they don’t need. This also requires that diagnostic information be collected from both live animals and necropsies so that disease patterns on the farm can be monitored and herd health programs changed as needed. This is still at the heart of veterinary medicine.”
“Every herd has strengths and weaknesses, but if health is one weakness, it’s nearly impossible to have any real strengths,” Dr. Hilton says. “Think of all the problems that may occur subsequently if calves get sick at a very young age—increased death loss, lower weaning weights and rates, increased sickness and decreased growth in the feedlot, less replacement heifers for the herd, etc. Health is surely a huge impact on the total herd.”
Wrap it all together and Dr. Engelken says, “In our case, we continue to be involved in nutritional management, ration analysis, electronic record keeping, and evaluating reproductive performance. We also spend a fair amount of time evaluating options for our clients and using partial budgets to play ‘what if’ games and look at alternatives.
“Providing impartial science-based information is part of our job. Just simply due to the huge impact that reproductive performance has on ranch profitability, I guess it’s inevitable that we continue to look at estrus synch options, bull selection parameters, and the potential uses of gene markers. Having said that, we still do the traditional things such as palpations and disease management.”
It’s Hard To Pigeonhole Client Interest
As mentioned at the outset, producers of a particular size or in a particular part of the world aren’t necessarily more or less likely to be interested in a production medicine relationship. But there are indicators.
Where he sees successful production medicine relationships, Dr. Maas says, “Number one, the ranchers are business people, no matter the size of the herd. They’re 110 percent vested in the cattle business for their income or they have come to ranching from another business. They understand inputs, outputs, shrink, all of the things that affect their bottom line.”
When Dr. Engelken was on faculty at Mississippi State University, he worked with folks in the agricultural economics department to survey beef producers in the state. The aim was trying to identify practices, demographics and characteristics that defined various levels of management.
“Obviously herd size made an impact. The larger the herd, the more time the producer devoted to herd management. These producers also utilized their veterinarian more often,” Dr. Engelken explains. “However, factors such as client age, education level, the number of extension meetings attended, serving as an officer for a cattlemen’s group and participation in seedstock production affected their level of herd management, as well as how they interacted with their veterinarian.
“That is a point that I try to drive into our students: If you want to come into contact with producers who would be willing to use consultation services, then you need to understand the characteristics of those producers. Our graduate veterinarians need to be involved with the local cattlemen’s groups, extension programs, as well as organized veterinary medicine. They need to be able to identify larger operations (especially seedstock) that are being operated by younger individuals who have an animal science or ag economics degree.
“Those are the producers who understand the impact that our profession can have on their bottom line. However, there are also smaller operations that want to do things the right way and will actively seek out this type of service, even though their cow herd is not their primary source of income.”
Conversely, Dr. Maas believes veterinarians willing to proactively forge new relationships and strengthen existing ones tend to have the most success providing consulting that goes beyond fixing problems.
“Clients call to ask questions. That’s the point at which veterinarians need to begin relationships,” Dr. Maas believes. “Maybe someone calls to ask about a particular vaccine. Also tell them how to handle it and how it should be administered. Ask them if they’re BQA certified.” Dr. Maas says.
“Then, figure out a way to follow up to see how they got along, at no cost to them. Maybe that leads to a chat about how they develop their heifers or what genetics they use and why,” Dr. Maas says. “Invest your time and energy into follow-up, so they understand that you’re the kind of veterinarian who is interested in their operation, not just someone who’s there when there’s an emergency or when they have a question.”
Some will grab the invitation immediately and do their part to establish the relationship. Others never will.
“Dedication to relationship is the important thing,” Dr. Maas says.
“The bottom line is that there may only be 15-20 percent of clients that will be willing to pay for a complete consultative type of program (nutritional management, record keeping, breeding season evaluation, economic analysis, etc.),” Dr. Engelken says. “But, they have been my best clients because without fail, they have all made me a better veterinarian.”
How You Go About It
“The key is to establish credibility and gain trust,” Dr. Hilton says. “The client has to trust the veterinarian to do what is right for the client’s business. That trust comes from time spent working together and having some successes along the way. If I can solve a client’s calf scours problem then I have earned some credibility. Once I have credibility I get asked more questions about the beef business. I want to be the ‘go to’ person in their beef business. Half the time they have a question, I won’t know the answer, but that’s not a deal breaker. I know the people who can help answer that question. They are already on my ‘team’ because I have asked them questions before.”
Likewise, Dr. Engelken says, “It takes time and trust. We work for a client base that tends to be very conservative and risk averse. They want to feel comfortable that you can treat a sick animal and have it get better, that you can handle a dystocia and end up with a live cow and calf, that you have accurate palpation skills, and understand the importance of reproduction to their bottom line.”
A common characteristic Dr. Maas notes in the practitioners involved in these kinds of relationships is their passion for sharing information.
“These veterinarians are educators. They love what they’re doing. They love to educate, to teach, and they don’t feel like they have to do everything themselves. They’re happy to share their knowledge and don’t feel like they have secrets to guard,” Dr. Maas says.
If you’re looking for a more specific game plan, Dr. Hilton suggests, “Go to the client who asks you the most questions. Tell him or her you want to make a deal. You want to do more production medicine and want their herd to serve as the pilot. You’ll charge less because you’re learning, too.”
Then, Dr. Hilton says, “Let’s look at the goals for your herd, identify something I can help you with in the next year, a problem I can solve or help prevent, something that will make your life easier.”
For example, maybe the client says winter feed costs have gotten out of control. Even if you don’t feel like you have the nutritional expertise to solve the problem, Dr. Hilton stresses you know folks who can.
At the same time, don’t sell yourself short.
“Some of our veterinarians have tremendous expertise in nutrition. Others are very savvy on added value marketing programs,” Dr. Daly says. “They might not realize they have enough expertise to provide advice to clients, but they probably do.”
Incidentally, Dr. Daly sees genomics as an area where there is currently a void of understanding that veterinarians could help clients bridge.
Getting Paid For What You Know
None of this works, of course, unless veterinarians are paid enough to make production medicine worth their while. As alluded to earlier, some folks feel uncomfortable charging for information they’ve likely given away in the past.
Plus, it can be difficult for producers to assign value to information when it seems to be everywhere for free.
“You can get information from your neighbor, from the Internet, from university extensions,” Daly says. “I try to impart to producers that local, farm-specific information is more valuable than information they can get anywhere else.”
One step Dr. Daly sees some veterinarians making in such a transition is charging clients by the hour rather than for providing a particular service.
That’s how Dr. Hilton has long charged clients.
Rather than be tempted to try selling a client another product or service, by charging hourly, Dr. Hilton says you can try to talk them out of buying things to save money and add value.
“You do not have to sell something to someone to make a living,” Dr. Hilton says. “You do not have to do a procedure on an animal. Our most valuable asset is our brain. You have to charge for your knowledge.”
“We could argue about the definition of consulting as it applies to a cow-calf practice,” Dr. Engelken says. “I guess maybe the simplest definition is getting paid for what you know. That payment could take several forms such as a per head fee, a retainer, an hourly consulting fee, or even enjoying a high degree of client loyalty because you offer a higher level of service than other veterinarians in the area.”
Of course, there are few buyers for anything that dampens rather than grows the bottom line.
Veterinarians Must Bring Value
“In consulting, the goal is to always give the client value for the money they spend. If I charge someone $1,000 for consulting and it saves him $5,000, that is a win-win. If I charge $6,000 for that same result it is win-lose and the client will never spend money with me on consulting again,” Dr. Hilton says.
“The way that we marketed our program is that we explained to the owners that, really, this program was free,” Dr. Hilton says. “If, for example, the program was going to cost $8 per cow, per year, to be on the records and consultation part of our program, we would show them how they could make at least $8 more per cow in increased income. Then we would also show them how we would be able to save them at least $8 per cow in reduced expenses. We guaranteed the program would be cost effective to the owners IF they gave us their short and long term goals AND they implemented the changes we suggested.”
The program Dr. Hilton is referring to is the Total Beef Herd Health Program (TBHHP). He began it in 1988 when he started Midwest Beef Cattle Consultants. The program cornerstones are herd health, records, fertility, environment, marketing, genetics and nutrition.
“We examine the herd from a total herd view and make recommendations based on financial return,” Dr. Hilton explains. “Common concerns of herds I have visited in the past include: inadequate herd fertility, cows that do not fit their environment, lack of hybrid vigor, pasture conditions that are not optimum for production, excessive calf morbidity, etc. Although we see recurring trends in herds, each herd is quite unique in its strengths and weaknesses.”
Back to the beginning of the program.
“After looking at financial figures, many times the first year on the program produced significantly more than twice the client’s investment. We had herds that increased revenue up to eight times what they paid us for one year of the program, so that was very exciting,” Dr. Hilton says. “If you want to be a hero with your clients, in addition to helping them decrease their cost of production and increase the value of their product, have them do both with less hours of work devoted to the enterprise. Tell me who else has these goals for the producer? The answer is no one.”
Dr. Hilton cites other examples of veterinarians bringing added value to clients:
- Vets host an annual calving clinic to remind clients about when to call for assistance(progress every hour), what supplies they should have on hand, and provide a review of techniques on how to assist in delivery.
- Clinics help clients precondition calves with a uniform health program, then sort them into uniform load lots so client calves command higher prices.
- Vets assist cow-calf owners in formulating rations, utilizing corn and soybean coproducts to stretch winter feed resources and save significant money on winter cow feeding.
One vet organized some of his very best client herds to sell bred replacement females. After pregnancy check, the secretary at the clinic records all data in a spreadsheet and provides this to producers looking for heifers. The spreadsheet gets updated throughout the fall and winter as heifers are sold and others are added to the for sale list.
“Recently, a beef producer had some calves for sale. Last year he received a horrible price, given the quality of the calves. He asked another producer where he sold his calves. That producer told him, ‘My vet lined up a couple of potential buyers for me and I got top dollar.’”
The producer who received the lousy price contacted the veterinarian. The veterinarian stopped by to see the calves and called two buyers. The producer received a price he felt his calves merited.
“The producer then called the veterinarian about his calf scours problem. Long story, short, the veterinarian proposed a very good solution to the scours problem, started asking about nutrition and will be formulating all of that producer’s rations now,” Dr. Hilton explains. “The same producer also wants to enroll his herd in the veterinarian’s records program. The veterinarian has become the ‘go to’ person for that producer’s beef herd.”
Dr. Hilton asks students the most effective way to have success with clients in the future. He tells them it’s having success with clients today.
“You have to provide value,” Dr. Hilton says. “It’s got to make money for them. I want to be an asset to the client, not a liability.”
Moreover, Dr. Hilton emphasizes clients must drive.
“Clients have to tell you what they want. You can’t tell them what to do,” Dr. Hilton says. He learned that lesson the hard way early in his career. “I give them recommendations, the owner makes the decision. If they want to keep a late-calving cow, for instance, that’s their business.”
“You really have to pick and choose your opportunities to start production medicine programming,” Dr. Engelken says. “Rarely do you institute this massive consulting type relationship at one time; at least that has not been my experience. It seems like I have been more successful in starting with an obvious weak point such as heifer development or an animal health issue and then working in the rest of the program over a number of years. Some herds are more willing to adopt this type of relationship faster than others, but it takes time to build that trust account with the client.”
Though none of this is necessarily quick or easy, Dr. Hilton emphasizes that’s it’s not complicated.
“Let people know what you can do. Do it. Follow up. Keep asking clients what their goals are and then help them reach them,” Dr. Hilton says. “Veterinarians need to be more proactive in asking clients what they need from them. Clients need to demand more from their veterinarians than fixing problems.”