In terms of methodology, the qualitative survey was based on ethnographic observations carried out in practices and interviews of rural veterinarians working in these practices. To vary the sample of fifteen practices surveyed, I focused on two cattle farming areas: one based on suckling cattle in Deux-Sèvres, and the other on dairy cattle in the region straddling the south of Bretagne and Pays-de-la-Loire.
Fourteen of the practices surveyed are mixed veterinary practices, meaning they combine livestock activities with pet care (dogs); only one practice focuses solely on livestock. It is important to note that the veterinary practices visited were larger than the national average, likely due to the choice of the survey areas, which are still heavily dominated by livestock farming, and the availability of veterinarians to answer the survey.
In order to analyse how veterinarians are organised professionally, it is essential to understand their daily activities. Although veterinarians openly support preventive and collective medicine for livestock, this survey shows that the boundaries between curative and preventive medicine, and between individual and collective medicine, are blurred as these activities are closely linked during farm visits. However, for the sake of clarity, I have chosen to distinguish three categories: general medical procedures, product sales and monitoring services.
Based on my field observations, I classified rural veterinary consultations into two categories: general medicine and regulatory procedures. General medicine represents the day-to-day activities conducted by veterinarians. These are usually same-day visits, for example for milk fever, mastitis, and respiratory or rumination problems. Surgery, whether emergency or non-emergency, are also part of these basic procedures. Euthanasia also is performed, since this is, as one veterinarian emphasized, a "profession in daily contact with death and disease”. Regulatory procedures are activities regulated by the State, mainly for the export and import of animals, but also relating to certain diseases monitored by the State. They include, for example, prophylaxis treatments, blood tests and appointments with livestock health protection groups (GDS). The rural veterinary profession consequently revolves around a wide variety of activities, and this was one of the elements of job satisfaction most frequently cited in the interviews.
The vast majority of rural veterinary practices rely on the sale of products. This represents between 65 and 85% of the turnover of the rural activity of a practice, the remainder corresponding to medical procedures. The bulk of this activity involves the sale of medications (antibiotics, vaccines, parasite prevention, hormones, etc.). However, due to the recent regulatory changes concerning the sale of these products (in particular the EcoAntibio plans), veterinary practices are expanding their product range, selling an increasing number of food supplements and hygiene products.
In addition, alternative medicine is on the rise in veterinary practices. In our sample, five practices offer herbal medicine, five aromatherapy and six homeopathy; four practices offer all three approaches. It should nonetheless be noted that, according to statements collected during the survey, veterinarians seem to be more in favour of phytotherapy and aromatherapy treatments than homeopathy.
Although the daily routines of veterinary practices continue to revolve around emergency management on livestock farms, the emphasis in recent years has been on preventive health care limiting the consumption of inputs. This prevention objective is leading to the development of services that are billed by veterinarians. To use the most commonly used term, veterinarians are trying to sell farmers "monitoring" services, proposed at the herd level and focused on overall health objectives. However, there is no uniform model; the practices each have their own names, their own content and their own billing systems for these services.
These services are therefore "contractualized" activities, meaning subject to a contract with a reciprocal commitment from both parties. This is where the difference with general veterinary medicine lies. How the contracts are formalized depends on the veterinary practice, for example they can signed or unsigned. In addition, veterinary practices offer a range of services, from one-off checks to regularly scheduled farm monitoring. The implementation of contracted services always starts with an assessment to diagnose the farm’s problems, then the veterinarian proposes solutions, and the contract is established depending on the range of services selected.
These monitoring services, which reflect the commodification of advice, revolve around medical procedures and/or the prescription of products, both medicinal and non-medicinal. Therefore, although there is an attempt to compartmentalize different monitoring activities according to the farm’s problems, all of these areas are closely interrelated.
Reproduction monitoring is the most common and most established type of monitoring service on livestock farms (fourteen practices). This type of service was set up about twenty years ago to better manage cow reproduction, in particular through ultrasound scans. Since then, other services have been introduced:
- milk quality monitoring (four practices), where the veterinarian’s role is to ensure good milk yields while guaranteeing the health of the animals, in particular by avoiding mastitis;
- parasite monitoring (three practices) allows the use of parasite prevention to be supervised and managed rationally on farms;
- feed monitoring (three practices) where the veterinarian works directly on the animals' rations based on the farm’s production objectives;
- herd monitoring (four practices) includes the others mentioned (feed, milk quality, parasitology, etc.) in a systems approach to health.
With the exception of one structure, all of the veterinary practices surveyed offer at least one type of monitoring service (reproduction monitoring), and some may offer up to five different types.
This first post helps throws light on the activities of veterinarians. While the legitimacy of preventive medicine has risen in the context of the fight against antimicrobial resistance, prevention does not negate the use of drug products, particularly vaccination. Continuing to prescribe medicines appears to be vital for the internal organization of veterinary practices. We will see in an upcoming post how this organisation and the resulting working conditions play a decisive role in the integration of monitoring services in the range of services offered by veterinary practices.