Profession challenges – At present’s Veterinary Enterprise

Student debt, the practice environment and well-being are among the top issues facing veterinarians and veterinary technicians, an NAVC-commissioned study discovers.

When asked which career-related issues were frequent stressors in their life, 76% of veterinary professionals put student debt at the top.

Only about half of veterinary professionals — 55% — report high levels of satisfaction with their careers, a new NAVC report finds, with the rest lukewarm about their jobs or outright dissatisfied. Plus, more than 1 in 4 veterinarians and 1 in 3 technicians say they’re likely to leave the industry within the next five years.

The North American Veterinary Community’s Voice of the Veterinary Community survey is the latest in a series of reports, including the most recent well-being study from Merck Animal Health, that indicates the profession faces an uphill climb in solving challenges such as high student debt, unhealthy practice environments, and less-than-average levels of mental and emotional well-being.

The survey was conducted in late 2019 by the market research firm LRW on behalf of the NAVC, publisher of Today’s Veterinary Business. More than 600 veterinary professionals — about 300 veterinarians and 300 technicians/nurses — participated.

Besides reporting on job satisfaction, the researchers explored issues that might contribute to how individuals feel about their chosen profession. Here’s a closer look.

Personal Finances

When asked which career-related issues were frequent stressors in their life, 76% of veterinary professionals put student debt at the top. Among those with student debt, veterinarians reported an average balance of $174,122 and technicians/nurses said $27,610.

The experts interviewed by Today’s Veterinary Business weren’t surprised.

“It’s no secret that the pathway to and through veterinary medicine does not often expose you to robust financial education,” said Tony Bartels, DVM, MBA, who runs the VIN Foundation’s Student Debt Center. “So, in some respects, it’s expected that people are stressed out by financial things, particularly student debt, which can be quite large for some people. Even if it’s not large, having debt at all can be stressful.”

Of course, large student loan balances would be less of a stressor if veterinarians were paid more. Veterinarians earn an average $105,240, which is higher than much of the U.S. workforce, according to the Bureau of Labor Statistics. But heavy debt burdens mean they still feel tremendous financial pressure. As one anonymous survey respondent put it, “There is an extremely poor debt-to-income ratio” in the profession.

Compensation was an important issue for technicians/nurses as well. When they were asked in open-ended fashion which part of their job they struggled with the most, low pay was the top answer.

“I feel like I earn too little compared to how much of my life is spent at work, no matter how much I love my job,” said one anonymous respondent. Another said: “I love being an RVT but the pay is just not substantial enough for the cost of living.” (Side note: Technicians/nurses used the word “love” seven times more often than veterinarians in their responses, perhaps indicating that they’re expected to be compelled by a love for their profession rather than financial compensation.)

 

So, why are veterinarians not paid enough to service their debt in a way they’re comfortable with, and why are technicians/nurses not paid enough to make a decent living, at least according to many of the respondents? Arguably, a line can be drawn to another issue explored in this research: clients’ unwillingness to provide needed pet care. Among veterinarians, 56% said that issue was of highest importance to them, second only to balancing work and family. Their comments focused on unrealistic client expectations coupled with resistance to treatment costs.

Theoretically, if clients were willing to pay more for pet health care and the veterinary team’s expertise, or if more pet owners were willing to pursue regular veterinary care, incomes and staff compensation would both be higher. On the other hand, if the costs of veterinary and technician schools were lower, corresponding student debt levels would be lower, too.

The profession has struggled to find ways to both raise demand for veterinary services and lower the cost of education. In the meantime, the question arises: Do these complex and interrelated issues even have a solution?

“Sure, and maybe we can we can stop COVID and cure cancer next,” Dr. Bartels joked. “Unfortunately, there’s just not a good link right now between the market for veterinary education and the market for veterinarians and what they’re paid. That’s not an indictment on anything. That’s just the situation that currently exists.”

One positive is that even though many high-level professional and societal issues are beyond their control, individual veterinary professionals can take steps to combat financial distress and career dissatisfaction. The best way to do that is to arm themselves with information, especially in regard to student debt, Dr. Bartels said.

“Having more comfort around financial principles and your own options can provide relief from some of the stress,” he said. “It can help reframe your perspective.”

Practice-Related Challenges

The survey results suggested that stresses related to the practice environment might contribute to job dissatisfaction. Fewer than half of the respondents felt they work well with others on their team, with just 44% saying their practice had “very good” or “excellent” teamwork.

When choosing from a list, technicians/nurses, in particular, selected “dealing with compassion fatigue/burnout in my practice” as the most important concern they faced, while staff turnover was the stressor they dealt with most frequently. Lack of uniform titles, veterinarians not utilizing their skills, and lack of respect from veterinarians also were high on the technicians’ list.

“There is still a lot of disrespect towards [veterinary technicians and assistants] in the field and my practice,” one technician responded. “The DVM and managers don’t want to use us to the fullest. It’s very frustrating.”

Mary Berg, RVT, VTS (Dentistry), who has held leadership positions with the National Association of Veterinary Technicians in America and other organizations, saw all those factors as connected. In fact, they’re a major reason why many technicians want to move into other industries, usually human medicine. At the very least, she said, technicians often leave for veterinary practices that have healthier work cultures.

“Turnover happens because of toxic work environments,” Berg said. “People are not happy where they’re at, they have bad management, they have someone in the practice who’s bullying or negative, and they’re not being allowed to utilize their skills.”

While there’s no magic bullet, Berg said, communication is a key to breaking the cycle of toxic practice environments that drive burnout and staff turnover. Owners and managers need to confront rumors openly, hold regular team meetings, maintain open-door policies and not tolerate recrimination against whistleblowers, she said. An employee manual clearly spelling out what is and isn’t permitted is important along with consistent enforcement.

“You can’t say, ‘Well, we know Suzy doesn’t always follow the rules, but she’s been here forever,’ ” Berg said. “It has to be the same for someone who started two months ago as it is for someone who’s been there for 20 years.”

Berg also said that if more veterinarians better understood a credentialed veterinary technician’s skills, those technicians would be utilized more effectively, which would drive job satisfaction and increase revenue, and that in turn could increase technician pay.

“Having veterinarians who leverage their technicians and teams to the best of their abilities is immensely important,” she said.

Well-Being and Mental Health

The survey found that many veterinary professionals struggle with their well-being and mental health. Some 44% of veterinarians and 53% of technicians/nurses rated their mental well-being at a 1, 2 or 3 out of 5.

Survey participants responded to a depression scale question regarding how often they had trouble sleeping, felt lonely or fearful, felt like they couldn’t get out of bed, and so on. The responses indicated that 36% of veterinarians and 46% of technicians had a high likelihood of suffering depression, which is much higher than the general population.

Kimberly Pope-Robinson, DVM, a certified compassion fatigue professional, created her 1 Life Connected consulting business to help veterinarians and their teams achieve greater well-being. Dr. Pope, who has written about her experience with depression, said she often encounters veterinary professionals who struggle with disillusionment and regret early in their careers because their expectations don’t match the reality of their life after graduation.

“As veterinarians, we have this idealistic vision of what we’re going to do and how we’re going to honor the human-animal bond,” she said. “We sacrifice so much to climb all these mountains to achieve our dream. And then we get to the top and think, ‘OK, I made it, so now I’ll be happy.’ But then we realize it’s really hard and really sucky sometimes, and all we see is more mountains in front of us.”

Younger veterinarians battling discouragement might be driving the statistics that point to dissatisfaction and poor well-being in the profession, Dr. Pope said. But the good news is that they often find a way through the barrier, whether by taking a break from veterinary work, finding a position they enjoy or learning to live with altered expectations.

“Most people find a way to make it work,” Dr. Pope said. “Because you don’t find happiness; you create happiness.”

Hilal Dogan, BVSc, founder of the Vet Confessionals Project, is a younger veterinarian who found herself in a dark place after graduating from veterinary school. Early in her career, she said, she encountered bad medicine, questionable ethics and bullying from senior management.

“It was absolutely terrifying to even think about protecting myself or speaking up for what’s right,” Dr. Dogan said.

Despite regularly engaging in self-care practices such as yoga, meditation, exercise and healthy eating, Dr. Dogan became more and more unhappy — and eventually desperate as she faced physical and emotional problems. So she quit.

“The environment was so toxic that I knew if I didn’t leave, it would kill me,” she said.

Dr. Dogan now lives in Denver and does relief work, which she finds personally and professionally supportive, and she focuses on emergency care, which she loves.

Drs. Pope and Dogan agreed that while issues like student debt, difficult clients and unhealthy teams can all contribute to dissatisfaction with a veterinary career, everybody’s “thing” — the driving force behind their unhappiness — is different.

“I can tell you that when I was suicidal and really not in a good place, I had no debt and I wasn’t directly working with clients,” Dr. Pope said. Her “sinker,” the term she uses to describe what drags a person down into unhappiness and poor well-being, was fear that she would make a mistake and lose her veterinary license.

But no matter the challenge, she said, the solution — and what she teaches veterinary teams — involves both figuring out what someone needs in life to combat the weight of personal burdens and losing the stigma attached to depression and other mental health issues.

Dr. Dogan, a certified clinical trauma professional, said supportive relationships and interpersonal connectedness act as antidotes to stress and unhappiness.

“Your relationships with other people, whether in work or life or wherever, ultimately determine how happy you are,” she said. “They’re also what determine how likely you are to be affected long term by a traumatic stress situation.”

Dr. Dogan experienced this when she encountered a doctor who disparaged her abilities as a relief veterinarian. She told her employer and the practice owner that she would no longer work at the clinic. To her surprise, the practice supported her and confronted the doctor who made the remarks. Her employer backed her up.

“I was shocked,” she said. “I thought I was going to have to leave this place, that I was going to play out the old story of what happened to me before.”

Instead, all the parties worked to heal the breach. That included the doctor who criticized her, with whom Dr. Dogan now has a productive and healthy relationship.

“This is what people need, because no matter what, we can’t stop people from being horrible to each other,” she said. “But we can protect each other. We can stand up for what’s right. If you have support and you feel safe, you can overcome anything and you can be happy.”

Kristi Fender is a freelance writer and editor in Shawnee, Kansas, with a long history of covering animal health and veterinary medicine.

WHY THE SURVEY WAS DONE

Last year, the North American Veterinary Community set out to conduct original research designed to understand and measure the state of veterinary health care from the perspective of veterinarians, veterinary nurses and technicians, and pet owners. While surveys abound in our field, what makes this study unique is the depth and breadth of the research in comparing how those three groups — the shared custodians of our pets’ overall health and well-being — feel about their relationships with each other and their priorities for veterinary care.

Many of our findings validate concerns we have long acknowledged in the veterinary field. What is new are the insights gained regarding the stresses veterinary nurses and technicians experience as compared to those of veterinarians, the interpractice relationship challenges, and the disconnects between pet owners and veterinary professionals on critical issues pertaining to pet health care.

In addition to our desire to learn, the NAVC commissioned the study with a big goal in mind: to bring the veterinary community together to address the challenges our industry faces and help shape the future of the veterinary profession. At the NAVC, we will use the findings to guide the development of new programs and inform our strategic approach to supporting the veterinary community. Undertakings we will continue to drive include the Veterinary Nurse Initiative and other workplace/organizational changes we are proposing through the Veterinary Innovation Council. We will also seek new initiatives that directly address and support mental health challenges and create new forums for learning.

When we set out to conduct this research, no one could foresee the catastrophic impact that COVID-19 would have on the global economy, society and our own veterinary community. But the study’s findings confirm the need for our industry to take action that is more timely and urgent than ever.

— NAVC CEO Gene O’Neill

WHAT PET OWNERS SAID

The NAVC’s Voice of the Veterinary Community survey checked in with about 500 pet owners. The results uncovered some good news for veterinary professionals.

  • The respondents identified strongly with their pets, with 87% saying their pet is a core part of their overall happiness and well-being.
  • Most pet owners — 83% — were satisfied with their veterinarian.
  • 72% strongly agreed that their veterinarian is caring toward their pet.
  • 70% said their veterinarian recognizes how important their pet is to them.

NOT SEEING EYE TO EYE

Several findings in the Voice of the Veterinary Community revealed a gap in understanding or opinion between veterinary professionals and pet owners. Here they are:

  • Only 36% of veterinary professionals said they discuss the human-animal bond regularly with pet owners. But 72% of pet owners said they’re familiar with the benefits of the bond. This raises a question: Could discussions of the bond drive a better connection between veterinary teams and clients?
  • According to pet owners, the top quality of an excellent veterinary team is a passion for helping animals. Veterinary professionals rated this sixth on the list, with their top priority being a well-staffed practice. Pet owners and veterinary professionals did agree that communicating effectively with clients was the second most important quality of a good clinic team.
  • While 98% of veterinary professionals agreed that preventive care is an important aspect of a pet’s health and well-being, 62% of pet owners who didn’t visit a veterinarian in the past 12 months cited the belief that their pet was healthy. That might indicate a lack of understanding of the value of preventive care.