As you might know from me already, veterinary herd health and management programs are an important part of the activities of production animal vets in the Netherlands. The final presentation I gave at the Livestock Production and Health group of the South African Veterinary Assocation in Skukuza was summarizing the PhD work of Marjolein Derks (who will defend her thesis on June 26). There are some interesting findings from this work.

1. Association between farmer
participation in veterinary herd health
programs and farm performance
Henk Hogeveen and Marjolein Derks

2. • You can type your text here
•
Present day dairy industry

3. Implications
• For the farmer
– More focus on quality of production
– Importance of animal health goes beyond
profit
• For the veterinarian
– Less curative drug sales
– On-farm counseling as part of veterinary herd
health management
– VHHM is more and more stimulated

4. “a combination of animal health,
production and prevention, in a framework
of economics, animal welfare, food safety,
public health and environment. Regular
farm visits and checks of specific farm
data are very important.“
Definition of on-farm counseling
(literature)

5. • Very broad
• Interpretation is difficult
• Our definition: A regularly visit of the
veterinarian on the farm aimed at the prevention
of disease. May be combined with routine
activities
Limitations of this definition

6. Protocol (after Brand et al., 1996)

7. More specifically
• Operational
– Treatments
– Inseminatinos
– Pregnancy checks
– Claw treatments
– Dehorning
– ……
• Tactical
– Disease monitoring
– Preventive measures
– Treatment protocols
– …….
• Strategic
– New barns
– Disease eradication
– ……
Objectives
Execution
Monitoring

8. Old stuff
1500
1700
1900
2100
2300
2500
2700
Begeleid Controle
1974/75
1976/77
Difference HFl 176/cow/year
Bron: Sol et al., 1984

9. Long term effects
1500
2000
2500
3000
3500
4000
4500
Begeleid Controle
1974/75
1976/77
1980/81
1985/86
Bron: Hogeveen et al., 1991

10. A few questions
• What is the view of the farmers towards
VHHM
• What is the view of the veterinarians
towards VHHM
• How well is the VHHM performed?
• What is the effect of VHHM
• What are the economics of VHHM

11. Why VHHM (farmers view)
• Research 2007
• Questionaires for 800 farmers
• Why and why not VHHM
• 250 returned, 170 VHHM, 80 no VHHM
• Derks et al., 2012 (PVM)

12. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
fertility milk production udder health young stock nutrition claw health housing
always
regular
problems
never
Contents of VHHM

13. Reasons to (not) participate
Participation in VHHM gem Likert score
Production increase 4,32
Prevent “blindness” 3,83
Structure in work 3,08
Existing problems 3,06
Advise of veterinarian 3,01
Routine checks farm 2,94
Reasons to quit VHHM gem Likert score
High costs 3,85
Low efficiency 3,68
Unpractical advise 2,95
Not enough structure 2,89
Not adjusted to farm 2,79
Costs too much time 2,79
Reasons not to participate in VHHM gem Likert score
Expected high costs 3,75
Expected low efficiency 3,21
Costs too much time 3,11
Not interested 2,93
I do not have a computer 2,73

14. Charging
• Per hour: 69%
• Per hour (advice) and per act: 28%
• Fixed tariff per cow per year: 2%
• Specific packages 1%

15. Conclusions
• Fertility large part of activities
• Farmers like the “support”
• Reasons not to participate:
– Money
– Time

16. A few questions
• What is the view of the farmers towards
VHHM
• What is the view of the veterinarians
towards VHHM
• How well is the VHHM performed?
• What is the effect of VHHM
• What are the economics of VHHM

17. The interviews
• Semi structured interview: definition
and pressure points
• 10 randomly selected practices
throughout the Netherlands
• Recorded with a voice recorder and
transcribed in full
• After coding connections were made
• Not published

18. Practice
nr fte % dairy
Counseled
farms Dairy farms/fte % counseling
1 4 25 20 20 80
2 1 100 43 43 95
3 4 20 15 19 30
4 4 70 40 14 25
5 3 35 27 27 60
6 5 60 58 19 35
7 4 25 20 20 55
8 13 15 70 36 50
9 10 45 130 29 70
10 5 20 23 23 60
The interviews

19. Contents of advice work
practice fertility data analysis udder health feed other blood
1 v v v sometimes v
2 v sometimes sometimes sometimes
3 v sometimes
4 v v v sometimes sometimes
5 v v v v v
6 v v v v v
7 v
8 v v v v v v
9 v v v v v
10 v v v sometimes

20. Farmer is the key figure
• Depends on what the farmer wants (10x)
• There is no protocol, it is adjusted to the
farm
• I take other things into account, depending
on the farmer
• You look at what is important on that farm
at that time
• The farmer asks, and you deliver, that’s the
whole story

21. Variation between farmers
• Some farmers are active participants in study
groups, others aren’t, it varies
• Some don’t want that, they just want fertility
checks
• I have farms that really want to look into
problems, and others that absolutely don’t want
that
• Some prefer to keep their production numbers to
themselves
• And some are really obedient, they follow the
advice, and others just… don’t

22. But most important conclusion …
The attitude of the veterinarian towards
on-farm counseling influences on-farm
counseling and the way the advice is
picked up by farmers

23. Illustration: two practices
• Interview nr. 7 and nr. 8, two practices that
were situated 20 km apart
• No difference in geographical or
sociological structures expected
• Large difference in attitude towards on-
farm counseling

24. Contents of advice work
practice fertility data analysis udder health feed other blood
1 v v v sometimes v
2 v sometimes sometimes sometimes
3 v sometimes
4 v v v sometimes sometimes
5 v v v v v
6 v v v v v
7 v
8 v v v v v v
9 v v v v v
10 v v v sometimes

25. Conclusion
• Big differences between practises
• Because of farmers?
• ….. or because of attitude of the vet???

26. A few questions
• What is the view of the farmers towards
VHHM
• What is the view of the veterinarians
towards VHHM
• How well is the VHHM performed?
• What is the effect of VHHM
• What are the economics of VHHM

27. Study on advising skills
• Study in 2011
• 29 vets in 15 practises
• Accompanied during 1 VHHM visit (1 vet 2
visits)
• Questionnaire for vet and farmer (same
questions)
• Evaluation of advisory talk
• Derks et al., 2013 (Vet J.)

28. Setting goals
• 7 vets set goals together with farmer
• not setting goals because
– Not aware of wishes of farmer
– No need to commit this to writing
– Documentation is ‘too formal’
– No good reason to set goals

29. Awareness of goals
• 22 combinations of ‘farmer’ and
‘veterinarian’ goals
• 16 vets could not clearly identify a farmer’s
main goal
• most goals were not clearly defined
• none of the farmers/veterinarians used
target values in establishing goals.

30. How to do an advisory talk (Wessels, 2008)

31. Results

32. Conclusion
Vets should learn a lot about
proper consulting
The value of VHHM can be greatly
improved

33. A few questions
• What is the view of the farmers towards
VHHM
• What is the view of the veterinarians
towards VHHM
• How well is the VHHM performed?
• What is the effect of VHHM
• What are the economics of VHHM

34. Large study
• 5,000 farms (207 vet practises) from CRV
(MPR organisation)
• Questionnaire about VHHM
• 695 replies (69 % VHHM)
• MPR and fertility data available
• Analyses on MPR data in relation to VHHM
• Derks et al., 2013, 2014 (J. Dairy Sci)

35. Contents of VHHM
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
pregnancychecks
adviceonfertility
analysisproduction
parameters
milkproduction
udderhealth
nutrition
youngstockrearing
clawhealth
housing
never
when problems arise
not always, but regularly
always

36. Overzicht resultaten [2]
n
pregnancy
checks
advice on
fertility
advice on
production
numbers
udder
health
milk
production nutrition
young stock
rearing
claw
health housing
60 x x x x x x x x x
40 x x x x x x
33 x
29 x x
18 x x x x x x x x
18 x x x x x x x x
15 x x x x x
15 x x x x x x x
14 x x x x x x x
12 x x x
11 x x x x
10 x x x x x x

37. Effects VHHM
• Participation
– More milk (+336 kg/cow/year)
– Lower SCC (-8,340 cells/mL)
– Lower first calving age ALVA (-12 d)
– Lower % non return 56-d (−3.34%)
– More inseminations per cow (+0.09).
– More culled cows (+1.05%)
– Lower age at culling (−70 d).

38. Yeah but ….
• There is an association no “real” causaal
effect
• My belief: At least part of the effect is “real”

39. Two studies
• Normative
• Economic data
• Question:
If you compare the costs of VHHM with the
economic value of improvements, what is
the efficiency?
• Ifende et al., 2014 (Vet Rec); Derks et al., 2014

40. Normative study
• All farms from previous study
• Look at VHHM and estimate costs
(normative)
– Farm seize
– Reproductive performance
– Intensity of VHHM
• Calculate net returns milk production
• Calculate costs of replacement

41. Used normative factors
Variable Abbreviation Value
Call-out costs of veterinary visit (€/visit) Cv 30
Costs of time of veterinarian (€/hour) Ct 120
Time necessary for a pregnancy check (min.) Pt 2
Time necessary to discuss the first topic (min.) Tt1 10
Time necessary for each additional topic (min.) Tt2 5
Costs of replacement heifer (€) Ch 888
Table 2. Assumptions to calculate the costs of VHHM based on farm data.

42. Two evaluations

43. Results
VHHM* NVHHM
Min Max Mean Min Max Mean
NRmilk 1452 3160 2403 1173 3066 2293
Cvhhm
Startup cost vet visit 1.06 26.00 4.71 - - -
Cost of pregnancy check 0 10.00 8.09 - - -
Cost of time for discussion 0.56 40.48 6.79 - - -
Total 1.62 67 19.62 - - -
NRvhhm 1429 3138 2388 1173 3066 2293
Costs of replacement heifer 51 415 224 76 464 212
NRtot 1198 2887 2164 1018 2851 2081

44. Data study
• Bookkeeping firm (Alfa Accountants)
• Questionnaire send to 572 farms
• 187 replied (85 participants, 102 non part)
• All farm economic data available
• Stochastic frontier analysis
– Looking at efficiency of farms
– 4 models: financial data per cow/kg milk and
including/excluding farm structure variables

45. Variable Participant Mean (sd) se P-value
Total revenue/100 kg cmilk yes 35.52 (3.28) 0.36 0.16
no 34.71 (4.32) 0.43
Feed costs/100 kg cmilk yes 7.44 (1.40) 0.15 0.80
no 7.38 (1.75) 0.17
Health and med costs/100 kg cmilk yes 1.31 (0.59) 0.07 <0.01
no 1.01 (0.43) 0.04
Cattle costs/100 kg cmilk yes 2.84 (0.71) 0.08 <0.01
no 2.35 (0.63) 0.06
Land costs/100 kg cmilk yes 1.58 (0.41) 0.04 0.26
no 1.50 (0.53) 0.05
Non-operational costs/100 kg cmilk yes 39.58 (7.67) 0.87 0.99
no 39.57 (7.05) 0.72
Total revenue/cow yes 3185.39 (528.69) 57.34 <0.01
no 2949.44 (501.22) 49.63
Feed costs/cow yes 671.96 (174.43) 18.92 0.11
no 631.18 (173.88) 17.22
Health and med costs/cow yes 111.05 (48.09) 5.38 <0.01
no 11.98 (36.23) 3.72
Cattle costs/cow yes 256.56 (80.43) 8.72 <0.01
no 200.36 (62.51) 6.19
Land costs/cow yes 142.17 (42.84) 4.65 0.02
no 126.90 (46.48) 4.60
Non-operational costs /cow yes 3517.20 (830.11) 94.60 0.07
no 3314.43 (556.35) 57.08

46. No differences between groups

47. Conclusions
• Normative study:
– Clear economic benefit of VHHM
benefit/cost ratio: 4.2
• Farm economic data study
– Technical differences were equal
– No economic differences
– Farms with VHHM also spend more money on
other area’s?

48. SOME FINAL WORDS

49. • VHHM is related to better results
• Despite “not too good” advisory activities
• Room for improvement
• Vets should organize VHHM better
– Structure
– Consultancy skills

50. Develop farm specific VHHM

51. There is a future for VHHM
• Vets should learn to develop VHHM
products
• Should improve their consultancy skills
• Look critically at yourself
• Market your products and belief in them
• Create a portfolio of successes

52. Thank you very much for your
attention and the opportunity to be
here