Veterinarian Tom Furman is a dying breed.
With no conventional work schedule in place, he may spend one day dressed in a white lab coat, neutering dogs and tending to vomiting cats in an office. And the next day, he's dressed in a pair of green coveralls driving 120 miles in a dusty gray Dodge Ram pickup truck to perform an emergency C-section on a cow and test the semen of a two-ton bull.
"When you sprinkle the small-animal medicine in with the large-animal medicine, you can get a big variety of responsibilities for the day," Furman said.
As both the emergency and primary caregiver of all breeds of animals in the area, Furman, 33, is the lynchpin of Alliance, Neb., a small town on the western edge of the Sand Hills with a population of just less than 8,500 people. But he could be the last. Furman is among the ever-shrinking pool of rural veterinarians.
"This has been bad and getting worse for a number of years," said Dr. Ron DeHaven, CEO of the American Veterinary Medical Association (AVMA). "There has not been a time when it was worse than it is now."
Today, more than 1,500 counties in the U.S. are without a single veterinarian to treat animals, estimated by the AVMA. That amounts to 44 states with at least one shortage area, designated annually by the U.S. Department of Agriculture (USDA).
The shortage is most acute in states with the most food-producing animals, such as cows, chickens and pigs.
In Idaho, 33 of its 44 counties are in need of rural veterinarians; in South Dakota, more than a dozen counties have more than 25,000 food-producing animals but no food-animal veterinarians.
Last year, Secretary of Agriculture Tom Vilsack designated 187 veterinary shortage areas nationwide. Colorado, Iowa, Kansas, Nebraska and Texas top the list.
The problem extends beyond protecting animals. Nearly 70 percent of human diseases have an animal origin, DeHaven said, and are often caused by bacteria such as salmonella and E. coli transmitted to humans from animals.
Gary Sherman of the USDA's National Institute of Food and Agriculture (NIFA) said rural veterinarians are the eyes and ears of today's farms.
"Ultimately, to keep the food supply healthy and safe, it must begin with healthy animals." he said.
In one county in Iowa, there's only one veterinarian to care for more than half a million head of livestock, according to Dr. David Schmitt, the state veterinarian.
The numbers are similar in Texas. And Dr. Dee Ellis, the state veterinarian, attributed the shortage to cold hard economics.
"A vet charges what he thinks the animal is worth, but because a producer doesn't think treating a chewed-up sheep is worth $2,000 an hour, he can't make enough money to stay in business," Ellis said. "Either lower your fees or don't practice."
Fewer Rural Vets Threatens Animals, Farmers and Food Supply
That explains why Furman in Nebraska has a mixed-animal practice, treating both farm animals and house pets.
In all, only about 17 percent of the country's veterinarians work exclusively in food-animal medicine, compared to the more than 70 percent of vets who work with companion animals, such as dogs and cats. And that number is expected to drop. Recent studies indicate the amount of food-supply veterinarians will likely fall by about five percent every year, according to the AVMA.
That news is unsettling to Hilary Maricle, 32, a farmer in Albion, Neb., who said she needs veterinarians to come to her farm most often during emergencies with her livestock.
"And that's always when they're busiest," she said. "It's in middle of the night, it's on the weekend, it's when we need them now."
But that's not always possible when the veterinarians she works with are stretched too thin.
"We start to see the real challenge when vets are already on a call, working with other animals," she said. "They'll say they can meet us as soon as possible, but that might be in four hours. They want to be everywhere, but they just can't."
The shortage has even lead Maricle and her husband to consider treating their farm animals on their own.
"We spend a lot of time worrying about our animals, so the concern for not having a vet when I need one is huge," she said. "We ask ourselves, what are the things we can learn from the vet to do on our own if that shortage is there?"
Explaining the Shortage
A declining rural population, debt of up to $140,000 for veterinarians starting out, and an irregular schedule nursing thousand-pound animals in sometimes grueling conditions are factors that can easily lead a recent graduate of veterinary school to choose against the life of a large-animal vet.
"We still have this rural population farming, yet we don't have the concentration where it's economically viable for a rural veterinarian to set up a practice there," DeHaven said.
In 2010, only 12 percent of new veterinary school graduates sought employment in rural practices, as opposed to the 33 percent who went into companion-animal practices, earning on average almost $10,000 more per year, according to the NIFA. About half of graduates went into areas of advanced study, such as internships and residencies.
For Ellis in Texas, it's no wonder then why many of today's students choose to work with companion animals, instead of being "notoriously underpaid" as a food-animal veterinarian.
"Rural vets are often faced with the dilemma of, 'I can neuter a dog in my clinic for $100, or I can drive a hundred miles to sew up a sheep for $50,'" Ellis said.
Plus, added Ellis, more importance is routinely placed on companion animals.
"Even farmers think, 'I'll pay anything to save my cat, but I'm not necessarily going to pay anything to rescue my goat.'"
Another lure of a companion-animal practice is the standard workday schedule that accompanies it.
"It's 10-hour days as opposed to 12-hour days in a climate-controlled room," said David Kirkpatrick of the AVMA. "That's probably much more practical than working in excessively high or bone-chilling temperatures with animals weighing thousands of pounds."
This shortage of rural vets, in turn, "contributes to a lack of rural vitality because without veterinary support, the needs of animal health operations, ranches and farms oftentimes can't be profitable," Sherman said.
Assistance from the Government
The federal government has stepped in, making available millions of dollars in incentives to encourage new veterinarians to work in rural practices. One solution has been the introduction of a variety of loan-repayment programs. The Veterinary Medicine Loan Repayment Program (VMLRP), sponsored by the USDA, offers graduates who have pledged to work in designated shortage areas for three years $25,000 a year in veterinary school loan repayment.
In 2010, the USDA awarded 63 of these grants, totaling about $6 million. Because of these awards, 34 states will fill at least one shortage area in their state.
"These are trained applicants who have always imagined going into large-animal medicine but could not do so financially," Sherman said.
In October 2010 the AVMA's Food Animal Veterinary Recruitment and Retention Program awarded $100,000 to each of its first five recipients who pledged to practice in underserved areas for four years.
In March 2011, U.S. Senators Tim Johnson (D-SD) and Mike Crapo (R-ID) introduced the Veterinary Medicine Loan Repayment Program Enhancement Act of 2011, which provides a federal income tax exemption for payments received under the VMLRP, allowing award recipients to collect more money. The bill has 14 cosponsors and is currently in committee hearings.
Many states -- Connecticut, Georgia, Kansas, Kentucky, Louisiana, Minnesota, Missouri -- have implemented similar programs to make it economically viable for veterinarians to practice in rural areas.
DeHaven said that while these programs are not a silver bullet in eradicating the shortage, they are a step in the right direction in support of emerging food animal veterinarians, and consequently food safety.
"We need to get the public to understand that food safety encompasses everything from the food they eat, to the animals that produce that food, to the practitioners that take care of those food-producing animals."
Likewise, Sherman said the programs are critical to the needs of people not only in rural areas, but people everywhere.
"Our national herds are our treasures," Sherman said, "and they need to be protected because they make up an agriculture that America is dependent upon."
ABCNews.com contributor Andrew Mach is a member of the University of Nebraska ABC News on Campus bureau.