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Some South Dakota professionals in short supply

From the November 2008 South Dakota e-Labor Bulletin

As our working population ages and nears retirement, South Dakota is facing the loss of a wealth of experienced people. Having a shortfall of workers is of even more concern in rural areas of the state, especially in certain occupations.

Veterinarians

Veterinarians is one such occupation. According to the first quarter 2008 South Dakota Quarterly Census of Employment and Wages data there are 141 establishments classified within the North American Industry Classification System (NAICS) code entitled "Offices of Veterinarians." These offices employ 845 people. The bigger question is: are these offices evenly distributed around the state to provide good health to our companion animals, health and profitability to our farmers and ranchers, and safety to our food supply? The distribution actually proves to be uneven, which can cause distress for some farmers and ranchers in more rural areas. In the event of an outbreak of disease in larger animals, veterinarians, in partnership with food inspectors, serve as the first line of defense in controlling the outbreak.

Examination of the distribution of veterinary offices shows Pennington County and the Sioux Falls Metropolitan Statistical Area (MSA) are home to most of these offices. As these areas are home to the state's two largest cities, this is not surprising. Thirty nine percent of the veterinary offices, which employ 42 percent of the workers in this industry classification, are located in these areas. Recent studies by the American Veterinary Medical Association indicate the national demand for veterinarians will increase by as much as 14 percent by 2016. South Dakota employment projections indicate employment of veterinarians will increase 32 percent during the 2006 to 2016 time period, from 235 workers to 310. The nation's 28 veterinary schools graduate about 2,500 veterinarians annually, a number that has remained stable for at least a couple of decades. The reason the number of graduates isn't increasing is simply a matter of space, which does not allow for larger classes.

In recent years, more of the graduating veterinarians have been women, who tend to practice in small companion animal clinics in the more metropolitan areas. Large animal doctors face long hours, hard physical labor and often long drives to worksites. These are seen as drawbacks to a young woman veterinarian who is trying to balance a career and a family. Being a large animal veterinarian is probably the most physically demanding job of all the areas of practice. Another factor in recently graduated doctors going into predominately small animal practices is that owners of companion animals are more likely to spend hundreds, if not thousands, of dollars on their care. For owners of larger animals, economics plays a bigger role in decisions about treating the animal.

Students also come out of school with a large debt and are looking for the fastest way to pay off that debt. A clinic for small animals is usually more lucrative than a practice for large animals.

As a nation, we are being drawn away from our rural roots and into urban areas. This leaves fewer people on the farm and a diminished pool of candidates for veterinary school, as it has been found students who grew up on a farm around large animals are more inclined to be interested in practicing veterinary medicine with large animals. Another draw to urban areas for veterinarians is the likelihood a spouse will find better job opportunities.

For all of these reasons it has been noted large animal veterinarians are, on average, older than small animal vets. With an aging workforce and baby boomers starting to retire, it is becoming a critical issue more graduates of veterinary medicine focus their practice on larger animals. Several states, schools and national organizations are brainstorming ideas to address this issue. Some schools are trying to add classes and enlarge facilities. South Dakota State University has a pre-veterinary medicine program and tries to immerse students in large animal work at an early point in their studies. South Dakota, along with several other states, has programs in place to reduce the cost of veterinary school for students in return for agreeing to practice in rural areas with large animals. There are national plans in the works to provide grants to schools for use by students who are willing to go into large animal practice, but the structure and funding are not yet established.

Attorneys

South Dakota is facing a similar situation with attorneys in rural areas. There are currently 439 law offices which employ 1,564 employees. According to the first quarter 2008 Quarterly Census of Employment and Wages data, there are nine counties which do not have any lawyer offices; only two of these counties are in the East River area. The Sioux Falls MSA and Pennington County account for 45.8 percent of all law offices in the state. The counties which house the two interstates which cross South Dakota account for 86.3 percent of all lawyer offices in the state. This leaves some large areas underserved by legal representation. Research indicates this is a global problem. Articles in trade journals and newspapers from Japan, England, Australia and the Middle East address the dire need for lawyers in rural areas.

As is true with veterinarians, unless a recently graduated law student has ties to a rural area, he or she is likely to settle in the more populated areas of the state where a spouse can find work and a steadier income allowing for the repayment of student loans. The cost of malpractice insurance and dues are the same no matter where you practice, although the cost of setting up a practice would probably be lower in a more rural area. Studies have shown since the early 1990s about 60 percent of law school graduates have been women, many of which take a hiatus from the profession when they start raising families and find it difficult to balance work and family obligations.

One option to alleviate the shortage of attorneys in rural areas is to make more use of video conferencing. As technology and access to these services improves, it becomes easier to utilize. A web cam mounted on a rancher's computer to communicate with a lawyer is almost as good as sitting in the attorney's office, and much more economical than traveling a hundred miles and at least a half a day for a meeting.

Another option being endorsed by paralegal assistance organizations is to make greater use of this profession; much like is being done with physician assistants. These individuals can do much of the preparatory, consultation and information gathering before an attorney becomes involved with a case. They draft court documents, wills and correspondence. They can interview the individuals involved and do research. All of these tasks help free up an attorney's time for more pressing issues. There was a time when paralegals were not seen as having the right or knowledge necessary for these undertakings, but times are changing and these practices are becoming more accepted.

Healthcare Providers

The aging population and the desire of individuals to stay as healthy and active as long as possible are the primary reasons the healthcare industry is expected to grow. For the 2006-2016 time period, it is expected there will be 11,190 jobs added to the healthcare industry in South Dakota. The demand for these workers exists across the state, but especially in the rural areas. The demand for healthcare workers includes several occupations, such as doctors, nurses, physical therapists, physical therapy assistants and pharmacists. Healthcare establishments in South Dakota often use temporary help agencies to assist in meeting staffing needs, sometimes even workers from other states, to help staff rural clinics and hospitals. These workers serve an area for several weeks up to several months before being transferred to their next assignment.

A solution to help address the demand for pharmacists is the utilization of telepharmacy centers. North Dakota uses this program to help alleviate the shortage of pharmacists; South Dakota is looking at the program as well. Telepharmacy centers allow pharmacy technicians to validate prescriptions with licensed pharmacists using remote cameras. When the prescription is approved, the patients use the same electronic link or remote video to have a consultation with the pharmacist at the "hub pharmacy," after which the pharmacy technician fills the prescription. At this time several states are considering making use of the same system. This means it is no longer necessary for patients to travel long distances, sometimes in winter conditions, to fill prescriptions or to plan far enough ahead to order them by mail.

South Dakota is feeling the pain of understaffed occupations in rural areas, and only a few have been examined in this article. Many, if not all, states and even foreign countries with rural or isolated areas are feeling the same pains. Partner agencies involved in the Workforce 2025 initiative are developing strategies to help alleviate the situation. Ideas such as adding space in college programs to graduate more professionals, loan forgiveness or reductions for working in rural areas, internships and programs to encourage high school students toward these fields of study are being examined. Continued technological advancements coupled with South Dakotans' ingenuity and resourcefulness will no doubt be invaluable in developing and implementing these and additional solutions to challenges of occupational supply in our rural areas.

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