Getting to the root of overworked and burned-out veterinary practices

Veterinarians have a hard time.

For many, the dream job of caring for animals is becoming less and less of a dream. Many veterinarians feel that they are working more hours than ever in low morale, high turnover jobs to meet the increased demands of their current customers. Practices have difficulty recruiting staff and vet technicians – important roles in keeping the practice up and running.

“The practices and veterinary care teams are very busy, and burnout and stress are real problems that many people go through,” said AVMA Chief Economist Matthew J. Salois, PhD. “We are in a very tight job market and it is currently very difficult to recruit and retain talent – and undoubtedly contributes to a feeling of burnout.”

Dr. Salois opened the AVMA Veterinary Business and Economic Forum, held virtually October 14-16, discussing the causes of the hustle and bustle and burnout attacking veterinary practices these days. Its general message is that there are a complex set of factors that need to be understood if the profession can effectively address the very real-life problems that practices and veterinarians face.

“A very common story told in our industry goes something like this: The demand for pets grew during the pandemic with an epic rate of pet adoptions. At the same time, the veterinary practice experienced an exploding demand for services, which led to a crisis for the workforce as the supply of veterinarians and veterinary services could not meet the demand. “

And although there is “quite a bit of truth” in this view, Dr. Salois, it is an oversimplification.

The reality, as Dr. Salois stated is that the so-called pandemic “pet adoption boom” is a little exaggerated. New customers may contribute to increased business, but in fact it is higher expenses combined with the pent-up demand of existing customers that account for the majority of the growth in sales and visitors. This was confirmed in a later presentation by VetSuccess. Finally, inefficiencies and staff turnover exacerbated by the COVID-19 pandemic have escalated problems with busy schedules and staff burnout (see story).

“We have a very challenging personnel dilemma,” said Dr. Salois, “which has a significant impact on well-being and staff turnover.” And the practices feel it.

Dive deeper into the data

A review of transactional data collected by 24PetWatch and the Best Friends Animal Society shows that the total number of pets adopted from animal shelters in 2020 was the lowest in five years.

Animal shelters made a concerted effort to get the animals out of the shelter and into foster families. The adoption processes were longer during the pandemic. Shifting adoption visits to virtual appointments, and later to allowing a limited number of physical visits, meant fewer adoptive animal children could be treated in a given week. And successful castration and neutering programs have also been shown to be effective in keeping populations down.

“Simply put, fewer animals in the shelter meant fewer animals had to be adopted,” said Dr. Salois.

Animal adoptions in 2021 look very much like 2020 so far, added Dr. Salois added. Tracking data shows adoptions are 1.6% below 2020, with cat adoption outpacing dog adoptions. Compared to 2019, the current adoptions are almost 20% lower. While animal shelters aren’t the only source of new pets, they remain a leading source alongside pet shops and breeders (see story).

Why so busy?

Monthly clinical appointments per practice increased by an average of 4.5% in 2020 and in 2021 they are currently 6.5% ahead of the previous year, which of course is positive news, said Dr. Salois, adding that it raises important questions: is 4.5% to 6.5% growth epic? This growth is healthy – and perhaps even unprecedented – but is it enough on its own to bring practices and employees into a tailspin? Is that enough to plunge our workforce into a crisis? Or do additional factors play a role?

Such inquiries are not intended to dismiss the reality of overcrowded practices and exhausted veterinarians, emphasized Dr. Salois. Rather, it is an appreciation of the real and tangible challenges veterinary practice teams face and, importantly, a way to better understand the root causes of those challenges so that the profession can implement strategies that are effective in relieving stress.

Dr. Salois stated that the increase in business was not due to new patients. In fact, the average annual share of new patients in total appointments has decreased in recent years from 17.1% in 2019 to around 15.8% in 2021. The practices are picking up the backlog of canceled or postponed appointments due to a consequence of the pandemic, together with current customers and pet owners who are paying more attention to veterinary care.

In addition, many problems are due to declining productivity in veterinary practices and inefficiencies in practice operations that have worsened during the coronavirus pandemic, said Dr. Salois. A measure of veterinarian productivity is the average number of patients a veterinarian treats per hour. In 2020, U.S. veterinary practices saw the average number of patients a veterinarian could treat per hour by 25%.

With a 4.5 percent increase in appointments and a 25 percent decrease in the number of patients a veterinarian can see in an hour, that feeling of overwork makes sense, said Dr. Salois.

“Let me be very clear. This doesn’t mean you work less. It means that the efficiency with which you are working has been hindered, ”he explained. “It’s like running a mile on a treadmill or running a mile on the beach. The distance is the same, but of course you need a lot more effort and maybe even more time. In other words, to see the same number of patients as before COVID-19, you have to work a lot harder now, try harder and maybe even work longer. “

To make matters worse, a sizeable and growing number of veterinarians would actually prefer to work fewer hours and do so for lower pay (see story). In addition, there is high staff turnover. As Dr. Salois explained that the average turnover rate for veterinarians is around 15-17%, which is twice that of a general practitioner, and the average turnover rate for veterinary technicians is over 25%, which is compared to the highest in various health professions.

“Staff turnover is costly, time-consuming and also has a negative impact on productivity,” explains Dr. Salois. “From an economist’s point of view, a high turnover is a symptom of a bigger problem.” Salois continues, this is a warning sign that veterinarians are feeling overworked and overwhelmed, which is one of the factors that can affect any business’s productivity as well.

What now?

Dr. Throughout his talk, Salois emphasized that oversimplifying a problem can lead to oversimplified solutions.

It is not enough to increase the number of vets by graduating more vets or creating a new class of vets that some have termed intermediate or intermediate extenders. They neither close the productivity gaps, nor do they remedy the high turnover rate.

“We don’t need a five-year plan, we need a plan for now,” said Dr. Salois. “Like a patient who is bleeding, you need blood, but the first priority must be to stop the bleeding.”

There are several solution-oriented strategies that can help in the short term, explained Dr. Salois, such as telemedicine and other technological innovations, a better utilization of the veterinary technicians and the creation of a sense of purpose and belonging for all members of the animal care team.

“We can now take action to leverage technology, empower talent, and engage the team,” said Dr. Salois.

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