I have had a pretty good relationship with my vet since the day she was born. The first time I called her for vet services, the bill had already accumulated to about $200,000 (maybe more as my accounting is not that good). And the total is still going up. But I can call her day or night and she will answer or soon return the call. Though, I do have to cut the grass, maintain the computers and do the repairs at the clinic in order to get that level of service.
There seems to be a shortage of large animal vets here. There is a cycle with new vet graduates here that want to do large animal work. They start out and everyone is thrilled that there is a new large animal vet that they can call. But they are mostly only called for emergencies. Cow down or calving problem. The new vet is happy to have the work and responds to every call. The new vet is asked to speak at the local cattleman's meeting. People like everything, except the price seems high. Pretty soon, the new vet realizes they are not making much money given the cost of their education and have only accumulated a new truck, a calf puller, some ropes and some drugs. They work out of their home and truck. The farm calls each take a good amount of time, the facilities are OK to non-existent, and most were not built for speed. Each call is for one or only a few animals. In a few years, they decide to move where there is better opportunity or they decide to include small animals in their practice which requires them to get a building and employees. When they get the building and employees, they are busy with small animal work, have more money and are hard to find for any large animal work. They might still do some large animal work for a few favorite clients. The cycle repeats.
There are other areas of the country where large animal vets thrive. Those are where there are more cows than people or at least lots of cows. Even though the vet may serve several counties and travel quite a distance, there is a lot of work to be done at each stop, the facilities may not be the new, but they are built for speed and the owner and help are experienced cattle movers. The vet can process a lot of animals at a fairly low cost per animal, but comes out OK due to the volume. The vet clinic has multiple vets doing large animal work. They share the large animal load and someone is available for vet service or at least a phone consult pretty quickly. If they do any small animal work, it might be only one vet that mostly does the small animal work.
I think the issue is related to supply and demand. The underserved areas just don't have enough demand to justify the exclusive large animal vets. Vets are licensed and regulated by the state, not the feds. The state laws differ state to state. Technically in most states, only licensed vets can perform and charge for veterinary procedures. Depending on the state, it may be technically illegal for a non-vet to AI a cow, insert embryos, dig out a foot abscess, and such. The owner can do those things since he is not offering services for pay. Otherwise, the law may require a vet. Many/most of these tasks do not require a vet since they can be performed by people with the experience, except for state laws. Perhaps what is needed is a change to those regulations to allow a non-vet person to do some of that work. Perhaps a capable person could work under the direction of an overworked vet that is mostly doing small animal work. Working mostly independently, but associated with a vet to allow vet level oversight and consultation as needed and access to drugs that may be needed. This would still require changes to the laws in most or all states, but might be a solution. The current regulations are in place to allow state oversight/control in hope of ensuring competence of the provider. As well as eliminate non-vets from taking work from licensed and qualified vets. The issue in some areas is that the vets don't want this work as it is not financially attractive and any quality of care concerns become secondary if there are no providers available to do the work. In the meantime, some areas of the country are underserved with the situation becoming worse each year. Even getting health papers for large animals is difficult in many places. Government rules are slow to change, are bureaucratic by definition, and usually require loud voices to get any changes started. If my thoughts have merit, large animal owners will need to make some noise to get something started.
Anyone within driving distance of a vet school can probably get cattle service there at a low cost. And they usually have very good facilities.