Alarming suicide rates reflective of stresses felt by veterinarians

This is the third in a four-part series, On Call: Vets Under Stress, that explores the pressures and overwhelming challenges faced by those who choose to care for our animals.

Burdened by the eradication of student debt, the heightened effects of compassion fatigue, and grueling work schedules, veterinarians are committing suicide at an alarming rate, often using the same drugs they use to end the suffering of their animal patients.

According to the American Medical Veterinary Association (AMVA) statistics, one in six vets has thought of suicide. According to a report released last year by AMVA in partnership with Merck Animal Health, veterinarians are 2.7 times more likely to die from suicide than the general public.

These dire stats became personal to the Wisconsin veterinary community when 36-year-old colleague Josh Smith, DVM, took his life on March 2, 2021. Smith had worked as an intensive care nurse in Madison at VCA VESVSC for five years before moving on. in October 2020 an academic position as Assistant Professor at UW Madison, which trains and trains veterinarians in intensive care medicine.

The organizers of a GoFundMe account set up in memory of Smith and in support of his surviving fiancée and their children indicated that Josh’s head was in financial difficulties.

“The surge in vet suicides was particularly on the forefront with the loss of Josh,” said Meg Mueller, veterinarian at Osseo-Augusta Veterinary Clinic. “Everyone thinks about how we take care of ourselves and each other. The question is how do we best deal with it? “

The pressure to become a vet starts long before your first paycheck. The competition for entry into veterinary school is almost as intense as there is competition for entry into medical school.

“Most of us who step into veterinary medicine are Type A people, very driven perfectionists,” said Becky Krull, who has practiced veterinary medicine in the Green Bay area for 16 years.

Buried in debt

With most new vets blessed with six-figure debt straight from veterinary school, the AMVA estimates that one in five graduate graduates leaves school with more than $ 200,000 on loan. When compared to veterinarians starting salaries that range from $ 60,000 to $ 70,000, the debt-to-income ratio can be a tough mountain.

“Unfortunately, students don’t have a great understanding of the debts they’ll have after school, and then there’s the reality of what they deserve and what they actually deserve,” said Mueller.

The pressures of this debt-to-income ratio slowly builds with additional job stressors – long hours and sometimes a demanding clientele.

“We often hear that we do this job because of the money. This is far from the truth. But compared to human medicine, we are a cash-based, uninsured industry, ”said Müller. “Unfortunately, many of our customers don’t understand this aspect of our industry. But we have to keep the lights on and pay our employees.”

Because some pet owners are unable or unwilling to pay for medical treatment for their animals, many veterinarians are forced into moral dilemmas – a difficult situation for someone who wanted to help animals rather than kill them.

“Often times we know we can save an animal’s life, but instead someone chooses not to, and now I’m forced to do things that I can’t do morally. It’s hard to take mentally,” said Krull, partner at Green Bay and Allouez Animal Clinics.

Online attacks

And disgruntled pet owners can launch online attacks on the clinic or the vet themselves via the internet.

Vets are more likely to be victims of cyberbullying than their counterparts in dental or medical practices. A 2014 AVMA survey found that one in five veterinarians was either bullied by online pet owners who posted harmful reviews online, or knew of a colleague who was attacked.

“(The Internet) has opened a route of attack that is unprecedented in other professions. Since we are a company, we are often ridiculed for our prices or employees,” said Krull. “(Online attacks) have destroyed businesses, and if you are already in a fragile mental state it can really bring you down. It has made veterinarians quit business or even kill themselves.”

Krull says veterinarians may see death differently because they have the euthanasia gift and easy access to these drugs.

“We see it as a way to end the suffering. And based on mental health, vets know how to end it,” she said.

Work-life balance out of whack

Krull says workload expectations were unrealistic in the 1980s. It is not uncommon to work seven days a week and to be on call 24 hours a day for emergencies – even on Christmas Day, she says.

“We called it the old man’s game. Those expectations were so high, and they set that standard and eventually burned themselves out. Nobody can keep performing at that level,” said Krull. “Even if you are passionate about your job, you have to refrain from it.”

When Krull came to the practice, her male business partner worked daily and took emergency calls after work and on weekends.

“There was an emergency call center in the Green Bay area, so he eventually agreed to back off a bit and not take after-hours and weekend 911 calls, but we were still open Monday through Saturday,” said Krull, the 70th At that time worked 80 hours a week.

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The pressure continued to grow, especially as Krull became a mother and worked until the day of delivery. Three weeks after the birth of their second child, Krull returned to work and brought her daughter to the clinic.

“My receptionist looked after her while I saw patients and when she was ready to eat I would stand aside and feed her, then give her back and move on,” said Krull. “While I wouldn’t recommend it, as a business owner I felt like I had to be back to help the business run and be profitable.”

Krull said her customers had no idea about their victim.

“I got so good at wearing a mask that my clients had no idea I was having trouble until I talked about it publicly on my Facebook page,” she said. “They were nothing but supportive and started telling their stories. Here I was, suffering in silence, not knowing that other people around me had the same problems.”

Krull says she approached her partner about her burnout fears, only to have him admit it happened to him too. But he never talked about it, she said.

“That’s where the stigma is greatest. I don’t like standing in front of complete strangers and saying I had a mental crisis in 2016, but when I did, others started talking about it,” she said. “We shouldn’t be ashamed. And the more we share these stories with one another, the more it begins to heal us. “

As Krull began her personal path to regain a foothold and regain her joy and passion for her job, she discovered a new role as a motivational speaker: helping veterinarians to bring their professional and private lives back into harmony.

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“My executive coach said it was obvious that I have a passion for this topic and one thing leads to another,” she said. “I reached out to my drug reps who wanted to take me out for lunch or a clinic and it snowballed. And now I’m often asked to talk about workplace wellbeing. I love meeting other vets and Staff struggles over conquering the and stresses that it entails being a compassionate caregiver. “

As a practitioner, Krull says that she is only interested in prevention. And the time to focus on that is long before a crisis arises.

“People have really woken up for the past five years, but awareness should start as soon as we go to veterinary school. We need to learn the tools that will help us cope with the very stressful profession we have chosen, ”she said. “Had I had these tools much earlier in my career, I don’t think I would have hit the bottom that I had.”

Mueller says one skill veterinarians must embrace and enforce is setting boundaries.

“This work-life balance is something that is really important and, as the givers we are in this profession, many find it difficult to say no. Some of my classmates no longer practice quality of life and for many of these reasons Stress was just too much, “said Müller. “It’s sad when that happens because burnout is real. And as an industry, we need to start working towards change. We can’t keep repeating that we have always done it this way.

Mueller is honest with students about the rigors of their job.

“I tell them this job is tough and you need everyone to do it. This job is more to your life than just a job, whether we want to admit it or not. And sometimes it is harmful to ourselves if we do not refrain from it, “said Müller.” I have had conversations with former classmates and colleagues who say that sometimes you have to be ready to go away and find the right situation, that’s out there. “

Time for a change

Both Krull and Mueller say it’s time for change … and not too soon. Since the job is increasingly dominated by women and women are more likely to think of suicide than their male colleagues, this gives what is happening in the industry a whole new dynamic – and urgency.

Most of the positions in the respective clinics are occupied by women, many of whom are raising families.

“I want to be the entrepreneur who changes the business model that we may have to adjust a few things so we all – including dads – can make it to a baseball game, have time to breastfeed, or celebrate their children’s birthdays. “said Krull.” But just because you have no children doesn’t mean you have fewer opportunities to lead a life or be free, have time or go on vacation ‘looks very different today. But it’s okay, that to change to suit our needs. “

A year and a half ago, says Krull, she convinced her (now retired) partner to close the clinic on Saturdays.

“I finally convinced everyone that 40 hours a week is enough. Now all doctors only work four (albeit long) days a week, but something amazing has happened: We did not get much headwind from our customers and our productivity has increased, ”said Krull. “There are a lot of studies that suggest that happiness equals productivity. And by reducing our hours, we’ve actually made more money and are happier people.”