Why did you want to be a vet? There’s a good chance that it was your calling, or you just always wanted to be a vet in private practice (1). Alternatively, you may have found yourself with a high enough score to get into the course but with no real idea what you wanted to be when you grew up. Academically gifted people could choose to do Medicine, or Law, or Dentistry, or any other number of better-paying, more prestigious, more glamorous vocations. So again, why vet?
It most likely comes down to your underlying values. Perhaps you feel compassion for animals, you value the kindness of helping, or you love the idea of making a difference for pets and their people. You get into Vet and off you go. You survive, or thrive at university, avoiding any non-assessable Professional Studies lectures because who really needs those?
So, now you’re a vet. There are particular traits that veterinary employers prefer in their employees that will mean the business runs more smoothly – agreeableness and conscientiousness being high on the list, meaning employees who do their work to a high standard, get along with people, communicate well, and know their limitations (2). Employers would also like their employees to have business acumen however it is telling that students don’t see as much value in this (3).
Reality hits. Responsibility is heavy. In clinical practice, the agreeable vet is now off-balance with the impossible task of trying to keep everybody – clients, co-workers and the boss – happy. The vet who likes to make a difference has to choose between euthanasing the dystocic bitch, or knowingly running up a likely bad debt for the caesarean. While the financial responsibility for the dog lies with the owner, the vet is emotionally blackmailed by the scenario playing on their values.
The kind vet can choose between dealing with unhappy clients for charging appropriately for the work done, or dealing with an unhappy boss for not charging appropriately. The conscientious vet has to cut corners to get through the caseload in the time available, or try to use their crystal ball powers to diagnose and prognosticate in cases of limited funds.
The values and traits that draw people to the profession and make them good employees now begin to create stress once the reality of clinical practice sets in. And herein lies the values conflict. The dichotomy of clinical work is that those values and ideals are often opposed to what is required for a business to be profitable.
I clearly remember the sadness and powerlessness of my new graduate days as the realisation dawned that it didn’t matter if I was skilled enough to fix something, it mattered if the owner would pay. It took a few bad debtors to break my trust in people’s goodness. Ultimately successful clinical work seems to require a hardening or repression of some of the values that drew us soft-hearted types to the profession originally. However, it’s also worth keeping in mind that losing idealism isn’t unique to the veterinary profession and challenges exist to finding worth and meaning in work regardless of the industry.
Later career experiences can also hold their challenges. The forward-thinking vet with excellent communication has few client complaints but develops depressive realism (4) and a general erosion of positivity and joy. Wealth as a value may become more pronounced as people age and become more aware of the difficulty of servicing a mortgage or affording the lifestyle of their non-veterinary peers. Fear of failure has consequences beyond not meeting one’s own expectations, with the potential for client complaints, board investigations, or litigation.
Add other workplace stressors to the mix (5, 6) and you have a melting pot of personality and environment factors waiting to bubble over into psychological distress and its dire consequences.
Where to from here? How can we improve things?
In any discussion about mental health challenges in our industry, the point is made that universities should select for resilience rather than solely on academic merit. Additional entrance requirements to test for existing resilience, empathy and communication skills are already occurring in some Australian universities in order to gain accreditation for the US. If applied harshly the criteria may exclude people who could otherwise make great vets if taught the required strategies. (Disclaimer – 100% projection occurring!).
If the vet industry is going towards ‘business’ should the profession be trying to attract more business-oriented brains, bidding farewell to the ‘they don’t care how much you know until they know how much you care’ paradigm? Can we have it both ways? Perhaps we can if we continue to accept the caring types and teach them how to cope early on, or somehow attract entrepreneurial types and encourage empathy, or find the elusive creatures who naturally do both.
It has been identified in the literature for many years that students need to be taught these skills at university (7-11). They already are but their relevance and importance can be lost amongst the workload and the information is not always well received. Further work is needed to implement ways for students recognise the importance of, and prioritise learning these strategies in order to develop a professional identity congruent with both their values and what is required of them in life after university (12, 13).
Once in practice, there are self-development strategies for learning boundaries and assertiveness, how to value your skills, assigning responsibility where it belongs, an imperviousness to emotional blackmail, and self-confidence. Luckily there are excellent resources available to do this in a healthy proactive way rather than figuring it out in desperation as you go along (14-18). Many workplaces, and the AVA, have Employee Assistance Programs available which link to non-vet-based psychologist services.
Workplace stressors are a contributing factor to mental health issues in clinical work. Good work is being done to address this with some employers now prioritising employee wellbeing by implementing workplace wellbeing programs, focussing on team dynamics, having mental health advocates in the workplace (e.g. the AVA Mental Health First Aid certificate holders), ensuring lunchbreaks and on-time finishes are available, and providing easy access to resources for personal development, amongst other strategies. The leadership and profitability of a clinic will determine how wellbeing strategies are practically implemented. There is hope that one day it will become the industry standard.
Public education about the costs of animal ownership and the financial responsibility involved is needed. Who should provide this and how? ‘If you can predict it, you can prevent it’ is regularly thwarted. What other than lack of awareness leads to the Border Collie in a small suburban backyard with a time-poor family? Or the anxious rescue dog adopted by a sociable family? Or the itchy Wolfhound puppy in a financially constrained home?
We see the problems coming, and many could be avoided if people initially made informed decisions rather than having a nasty shock when they learn the effort and costs involved. Our professional fees are not the issue, the lack of awareness in the pet-owning public is the issue. Having to justify our fees to clients by valuing our skills and equipment is a daily occurrence. It’s part of the grind and can really start to rankle if you let it. How do we go about increasing awareness, not just about why vet care should cost what it does, but of the factors people need to consider before getting a pet?
We need to care about the pets and their owners, but not so much that we feel frustrated and powerless. It’s a tricky balance but many vets seem to strike it well, finding joy and worth in long careers in private practice. The trend towards wellbeing and positive psychology is destigmatizing mental health struggles and opening up conversations about how best to address our industry challenges from both a personal and organisational level.
The vet industry provides many opportunities for its people to have satisfying, fulfilling roles and it’s up to us to make it work, either in or out of private practice. The information is already out there (19-23) but between juggling work hours, cases, family, health, and life in general it’s not obvious unless you go looking for it. I hope this article helps bring hope and understanding to those in clinical practice, and furthers the discussion of how we can address our industry’s challenges.
Dr Haidee Gray
Dr Gray has spent two decades working in small animal veterinary practice and is pursuing further study in psychology and philosophy.
References:
- Heath, T., Lynch‐Blosse, M. and Lanyon, A. (1996), A longitudinal study of veterinary students and recent graduates: 1. Backgrounds, plans and subsequent employment. Australian Veterinary Journal, 74: 291-296.
- Schull, D., Morton, J., Coleman, G. and Mills, P. (2012), Final‐year student and employer views of essential personal, interpersonal and professional attributes for new veterinary science graduates. Australian Veterinary Journal, 90: 100-104.
- Henry, C. and Treanor, L. (2012), “Exploring entrepreneurship education within veterinary medicine: can it be taught?”, Journal of Small Business and Enterprise Development, Vol. 19 No. 3, pp. 484-499.
- Kristi Reimer Fender quoting Elizabeth Strand, PhD, LCSW, in ‘Veterinarians more likely to be neurotic than regular folks’ February 20, 2019, retrieved from www.dvm360.com on 26/06/2020.
- Hatch, P., Winefield, H., Christie, B. and Lievaart, J. (2011), Workplace stress, mental health, and burnout of veterinarians in Australia. Australian Veterinary Journal, 89: 460-468.
- Meehan, MP. (2014) Psychological wellbeing of veterinary professionals. Veterinary Record 174, 142-143.
- Cake. M, Veterinary Professional Life – supporting the veterinarians mind. Proceedings of the AVA Annual Conference, Perth, 2014 Page J1.4b.5
- Meehan, M. (2019) Practical strategies to manage work-related stress in the veterinary profession, Veterinary Record 184, 585-587.
- N Hamilton (2019) Coping with Stress and Burnout as a Veterinarian, Australian Academic Press Group Pty Ltd.
- www.loveyourpetloveyourvet.com.au/veterinaryprofessionals
- www.makeheadway.com.au
- www.highperformancevets.com
- Stoewen DL. Veterinary happiness. Can Vet J. 2016;57(5):539-541.
- Dr Cheryl Fry. Bouncing back after tough days (5 keys for cultivating veterinary wellbeing and building resilience) Proceedings of 2020 NSW Division Conference
- Overfield, R. Ideas for creating emotionally-healthy workplaces and staff wellness programs Proceedings of the 4th AVA/NZVA Pan Pacific Conference, Brisbane 2015
- Wallace, JE. (2019) Meaningful work and well-being: a study of the positive side of veterinary work. Veterinary Record 185, 571.
- Martin A. Cake, Melinda A. Bell, Naomi Bickley, and David J. Bartram (2015) The Life of Meaning: A Model of the Positive Contributions to Well-Being from Veterinary Work. Journal of Veterinary Medical Education 2015 42:3, 184-193.