Leaving Vet Med
Equine veterinarians face especially daunting stressors. While some choose to leave the profession entirely, others become so overwhelmed they feel suicide is the only way out.
Veterinary medicine has many unique characteristics that make it both a rewarding and challenging profession. However, in the past 15 years, veterinarian suicide has risen exponentially—it’s now three times higher than the national average suicide rate. While this is something everyone in the equine industry should be concerned about, Jen Brandt, Ph.D., director of Wellbeing and Diversity Initiatives with the American Veterinary Medical Association, notes rates of suicide are increasing nationally in all age groups and among various professions.
What stressors might veterinarians endure that makes weathering their particular storms so difficult?
THE FINANCIAL PRICE
Amy Grice, VMD, formerly an equine practitioner and now a business consultant for veterinarians, notes that like human medical doctors, the financial strain placed on young veterinarians can be
astronomical. However, unlike many medical doctors, the majority of equine vets work at practices that employ two veterinarians or fewer; small practices mean less ability to weather a decrease in revenue.
The average salary for an equine vet’s first job is about $55,000 a year, says Grice. However, the average vet school student loan debt in 2018 was $143,000 (this number includes the 20 percent who graduated with zero debt as well, so the true amount owed per graduate is actually higher). The debt-to-income ratio far exceeds what financial advisors say is reasonable for a professional.
Because most practices are so small, there is not a lot of flexibility to take time off—even if the vet is unwell or injured.
“The injury issue is a huge one in equine practice,” says Grice. “It’s terrifying how many [vets] I know who were injured, sometimes severely, and went back to work before their doctors advised them to.”
This rapid “return-to-work” mentality is also prevalent when female vets have babies. About 80 percent of vet school graduates are female, Grice notes, and many of them can’t afford to take maternity leave because they have student loan payments due.
THE NEED FOR APPROVAL
The need for approval and acceptance isn’t just part of the social-media-loving younger generation’s culture; it permeates the world of veterinary medicine, as well. Associates in larger practices may crave acceptance from older colleagues, often to the detriment of their own health.
The old-school mentality of “suck it up, be like the big, strong guys” is often portrayed to women. Like their male counterparts, female vets want to be seen as individuals and be respected and valued by their bosses, colleagues and clients.
While setting boundaries is essential throughout one’s career, the early years of a veterinarian’s career is often when most experience systemic barriers. For economic survival and to build a professional reputation, they may feel forced to place their own needs on the back burner while they sacrifice in order to gain—and keep—clients. While giving their cell phone number out and answering clients 24/7 may support better financial security early on, it’s an unsustainable way of life.
“It never feels like work until it does,” says Grice. “When you have someone needing you all the time and there is never a hard stop to your day, it can get overwhelming quickly.”
As a member of a small or solo practice, these doctors are responsible for both routine care and emergencies for all of their clients, she points out. It can be utterly exhausting.
Vets also are not immune to the effects of cyber bullying. Brandt notes that a displeased owner may take to social media to make allegations about a vet instead of speaking to
the vet directly. This blasting on social media often doesn’t include all of the facts, yet it can have a significant impact on the veterinarian’s bottom line and emotional health.
However, the vet often isn’t in a position to ask the client not to write a review or to respond to an inaccurate review once it has been posted, Brandt notes.
The pressure To perform
Jeremy Shaba, DVM, director of the Mental Health Initiative at Hagyard Equine Medical Institute in Lexington, Ky., says that one intense stress some of his peers have encountered is the need to create a treatment plan for a horse based on a budget rather than what may be best for the patient.
Unfortunately, it’s easy for a client to assume the veterinarian will do something for free or for a deeply reduced price if they’ve had a relationship for multiple years. Often the horse owner forgets that the vet has their own bills to pay, and possibly practice owners who oversee their work.
The client then has their feelings hurt and becomes angry if they feel their vet isn’t “doing all they can” (even for free) to help or save their horse.
“One of the most painful weapons an owner can use against a vet is to accuse them of solely being in veterinary medicine for the money,” says Brandt. “It’s referred to as an emotional blackmail technique. Even though you recognize the client is going through a difficult time and may be lashing out, it still hurts. And four or five of those interactions in a day make your soul weary.”
The flip side of this equation is also stressful for vets: Having to euthanize an animal for the owner’s convenience. Though sometimes this request is made as a bluff to see if the vet will pony up a discount or offer services for free, sometimes the ask is a truly selfish request and not one motivated by the animal’s health or owner’s financial means.
This situation can escalate rapidly. The best way to avoid being placed in this position is for the vet to set boundaries of what they will and will not do while withholding judgement.
With all of these stressors in mind, it shouldn’t be surprising that a lot of equine vets burn out rapidly. But it’s particularly heartbreaking to think some see suicide as their only option.
The latest American Association of Equine Practitioner’s (AAEP) membership survey showed that 50 percent of vet school graduates who enter equine practice have left the profession within five years.
This means that someone who went to school for nine years (a four-year bachelor’s degree, four years in vet school, and a one-year internship) and racked up nearly $150,000 in debt is ready to throw in the towel in less than the time it took them to get through school. Scary, isn’t it?
opeN liNes of CommuNiCATioN
What can make vets’ lives a bit easier? Plan ahead for emotionally intense situations, Brandt recommends. Oftentimes horse owners are forced to make decisions when they’re at their most stressed, she notes.
“While the horse may be healthy now, some day he won’t be,” says Grice. “It’s important to discuss with your vet what that looks like and what you as the owner feel is the most important value.
“Know your non-negotiables. It’s much easier to say what quality of life looks like when the animal is healthy. It may be harder to define what quality of life looks like, from a neutral perspective, after the horse is already ill. I encourage owners to write that information down now, when the animal is healthy, and then put it aside until they need it.”
This can be hard when we live in a deathdefying culture, according to Brandt.
“It can be hard for vets to use the word death,” she says. “While this is understandable, [both
vets and owners] need to do our part to approach a situation with compassion and grace.”
In a perfect world, both the vet and the owner of a horse that is facing euthanasia would come out feeling supported.
Shaba notes a common misconception is that having to euthanize animals is a major factor in veterinary burnout. While this is part of it, he notes, euthanasia is just a small piece of the puzzle. It is often compounded by issues like the vet’s debt-to-income ratio, a lack of work-life balance and financial restraints when dealing with clients.
The resourCes Are ouT There
In recent years, a wealth of professional development courses have been added to vet school curricula to address mental health. Brandt says these can include communication classes geared toward dealing with emotionally charged situations, managing finances, how to handle compassion fatigue, and self-care.
Support doesn’t stop the minute a vet school student walks across the graduation stage. Many clinics and practices have begun programs that focus on mental health issues in an effort to stave off burnout and reduce the risk of suicide among their staff.
Shaba is deeply passionate about the mental health of veterinarians. Hagyard Equine Medical Institute works diligently to create philosophies to support each vet’s well-being, professionalism and collegiality, he says.
Hagyard has a plethora of mental-health initiatives in place designed to ensure employees know that they have somewhere to go, someone to talk to or someone to call when they are in a crisis. Shaba schedules numerous stressrelieving activities and social events throughout the year, as well as holding events that raise awareness around mental-health issues.
Online resources are also available. The AVMA’s Workplace Wellbeing Certificate Program is comprised of multiple modules that can be taken individually or completed as a unit. The program is designed to empower veterinarians and team members with the knowledge and skills to create a culture of wellbeing in the workplace.
“Not One More Vet” is the name of a Facebook group with more than 22,000 members and nearly 200 posts a day. The page is a place for vets to discuss their feelings, receive support and know they are not alone.
As a horse owner or caretaker, one of the most important things you can remember is that veterinarians are doing their best. They may not respond to a text or a call right away because they’re caring for someone else’s sick horse.
“Having supportive and grateful clients makes a huge difference,” says Shaba.