Flourishing In Veterinary Medicine And Beyond

 

Flourishing In Veterinary Medicine And Beyond

 Amelia Knight Pinkston, VMD

Mentorships have the power to be the catalyst for positive change that the veterinary profession desperately needs, but first we need to unlearn the deeply ingrained unspoken lessons that have led us to where we are. Together, we can make this happen starting today.

Here’s a snapshot of where we are according to Merck’s Veterinary Well-Being study:

• Less than half of vets would recommend the profession to a friend or family member
• Almost 1 in 5 vets regrets becoming a veterinarian
• Almost a third of vets and half of vet support staff are classified as having high burnout
• Almost 1 in 10 veterinarians and 1 in 5 vet staff are suffering from serious psychological distress

 

These statistics are getting worse not better, and it’s not surprising. In order to become a vet, there has to be a passion and desire that supersedes the hard realities of the profession. Logic alone isn’t a good reason to become a veterinarian when you look at the high student debt, compare our salary to MDs who get to focus on one species and often body part, and the moral dilemmas we are sure to encounter on a daily basis.

No one becomes a veterinarian by accident. We are determined and follow our hearts. So where do things go wrong?

In vet school, we learn what every species needs to survive and yet we are rewarded for ignoring the basic necessities our brains and bodies need to function. We have been taught and rewarded to self-sacrifice.

We operate on a false belief that once we achieve it, it will be better. Easier. Worth it. We will have “made it”. The problem is that “it” continues to remain in the future no matter how many achievements are reached. First it’s graduating. Then it’s once you’re comfortable with spays. Then it’s once you’ve been practicing for a couple years. Then once your hospital isn’t understaffed. Or once all your student loans are paid. When you operate on the belief that the future will be better, it makes it easier to grin and bear it in the present. Yet the longer we operate in that mindset, the more we dismiss and sacrifice all that we could enjoy in the present. This approach of always pushing against the friction without rest creates an uncomfortable callus over the compassion and passion that once drew us to the profession.

The veterinary profession is so focused on clinical skills and doing our job that it has tragically ignored the skills that are most important for a sustainable and fulfilling career in veterinary medicine. You can have the most incredible clinical skills in the world, but if you’re overwhelmed, stuck in survival mode, and ready to leave the profession that doesn’t matter.

Now, this isn’t a “vet med is screwed” kind of article. Quite the contrary. According to Merck’s study, 56.7% of vets are flourishing compared to the remainder who are just getting by or suffering. Flourishing! What a delicious word. It’s a word that sounds light, inviting, energizing, uplifting, and sustainable.

 

According to Oxford Languages, the definition of flourish is, “to grow in a healthy or vigorous way, especially as the result of a particular environment”.

We have proof that it’s possible to flourish in the veterinary profession. There are two important parts of that definition:

• To flourish is to GROW. It’s not stagnant. It is a journey and experience not a destination.
• Flourishing is influenced by its environment.

 

Things go south when we forget what is required to grow. Growth requires basic necessities like food, water, rest, and sunlight. How many of those are treated like a luxury in vet med? It is really hard to enjoy the journey or to support others when you feel like a withered flower.

 

The point of mentorship in vet med is to provide support and guidance to help a vet flourish. Teaching clinical skills without also teaching how to prioritize basic necessities is like dropping a seed on the floor and expecting it to grow.

 

Vet school curriculums have been using the drop-a-seed-on-the-floor-and-hope-it-grows approach because of the belief that there’s too much to learn and not enough time. True, there is too much to learn! That’s what makes vet med rewarding. We get to be life-long learners, and there will always be new advancements, cases that stump us, and clients that challenge us. That does not mean something has gone wrong. That’s when we get to use our curiosity, problem-solving, and connections to GROW. Imposter syndrome and anxiety arise when growing pains are interpreted as proof of not belonging and failure rather than a journey of growth and self-discovery.

 

Our profession WANTS things to be better and this is frequently reflected in devoted mentors determined to provide new grads with the positive experience and support they never had. Yet in an effort to provide the best experience possible they unknowingly teach a detrimental unspoken lesson that perpetuates the very reason they didn’t have a good mentorship: self-sacrifice. It’s these sneaky scenarios that are holding the profession back from the true change that’s possible.

 

Here are some examples:

• A mentor encourages their mentee to leave the hospital and take a lunch break yet the mentor always works through lunch
  
• The mentor wants their mentee to feel supported, so they respond to texts at any hour even when they’re not at work instead of empowering the mentee with tools and skills to think critically and build confidence on their own or to provide other sources of support after hours
  
• The mentor is so devoted to helping their mentee have a positive experience that they pile on extra cases to accommodate the mentee’s lighter schedule telling themselves it will be worth it if their mentee is happy and able to help in the future

These scenarios send mixed messages that lead to unease and guilt in the mentee. Are they actually supposed to take a lunch break? It creates an invisible debt they carry in their unconscious feeling like they need to pay it forward by self-sacrificing in the future. The message is that rest and nourishment are dispensable luxuries.

If the goal of mentorship is to provide guidance and support as a role model, the first thing we need to ask is “how is the mentor?”.

 

This isn’t a simple question to answer. I was in denial about being in burnout for a long time. At work, I appeared pleasant, cheerful, and calm. If someone asked me how I was doing, I would have said “good!” with a smile on my face. If I was being “honest”, I might say “things have been busy/stressful, but good!”. My brain wasn’t ready to accept the reality that I was miserable in a career I had worked my entire life to achieve. But my body knew. The exhaustion, constant anxiety, brain fog, stomach aches, and stress colitis were signs that my approach to the profession wasn’t working for me. It wasn’t until a functional medicine doctor asked if I liked being a vet that I started to connect with the emotions I had kept suppressed deep inside me. I was caught by surprise when tears immediately flooded my eyes, and even then I listed the reasons I loved the profession.

 

When we are taught to self-sacrifice, we become disconnected from the valuable lessons are bodies and heart are trying to tell us. The veterinary profession as a whole needs a new mentor, and every single member of the veterinary team has the power to be a role model and lead by example. 

 

We must start being proactive about how we can prioritize and support the basic necessities of every member of the team. How can every member of the team be ensured a lunch break? How can everyone have moments to decompress and give their brain a break during the day? This is something that has to be learned, because it goes against everything we’ve been taught. For many vets, resting is more uncomfortable than a big dog spay. It doesn’t feel safe.

 

That leads to the second part of flourishing: the environment.

 

The environment needs to feel safe and there are two aspects that influence that:

1. The way the individual experiences and perceives the environment
2. The environment itself

 

How An Individual Interprets Their Environment

Stress has a huge impact on the way we experience life and it’s the leading concern when it comes to veterinary well-being. Effective stress management techniques should be a core component throughout the veterinary curriculum, and yet it’s often completely absent.

 

The nature of the job means that veterinarians encounter a huge spectrum of emotions throughout the day ranging from joy when a recovered sick patient wags their tail as they get to go home, sadness when a sweet elderly man sobs during a euthanasia sharing that it was the only family he had left, and rage when a client accuses you of only being in it for the money when they don’t have the finances to pay for the recommended care of their purebred dog.

 

All of those emotions could very well happen within minutes of each other. When vets aren’t taught appropriate techniques to process and release emotions throughout the day, they accumulate inside of them like a pressure cooker or weigh them down.

 

When the body experiences more stress than it can process in the moment it shifts into survival mode where everything is perceived as a threat and negative emotions (like stress, anxiety, anger, shame, frustration, self-doubt, etc.) take over in an effort to try to keep you protected and safe.

 

Examples:

• Feeling resentful about the hours you have to work and underappreciated and complaining that things will never change despite never actually having a conversation expressing those feelings and what you need
  
• Suffering from Imposter Syndrome because your brain points out all the things that don’t go well rather than seeing all of the cases that do
  
• Ruminating over conversations with difficult clients
  
• Not being able to sleep at night despite being exhausted because you’re worrying about cases and second guessing decisions you made

 

In these cases, it is the way the brain is interpreting the environment that is leading to the negative emotions rather than the environment itself. This is good news, because rather than changing jobs or leaving the profession the brain just needs to shift out of survival mode and have a filter change. In these scenarios, the brain is seeing everything from a negative and threatening filter and making up worst case scenarios that aren’t reality.

 

These negative thoughts and patterns are common and need to be discussed and normalized in the profession, so they don’t fester inside us. Self-directed neuroplasticity (the ability to change and re-wire your brain) needs to become a core part of the veterinary curriculum, which is why I teach the basics in the “Anti-Anxiety Tools That Actually Work” masterclass that’s part of the free “Beat The Burnout: What We Should Have Learned In Vet School” series available to all members of the veterinary team.  

 

When The Environment Is Unsafe:

In vet med, sometimes the workplace truly is unsafe and stunts growth. A chaotic environment is linked to higher rates of burnout. As a relief vet, I have experienced first hand just how much the culture impacts my energy by the end of the day and how much revenue I can generate for the practice even between two hospitals that look the same on paper.

 

Signs of an unsafe workplace include:

• Tolerating verbal abuse from clients because of fear of losing a client
• Saying “yes” to more appointments even when fully booked because you want to help every animal and don’t want upset clients
• Man-handling stressed patients because there “isn’t time” for fear-free techniques
• A culture where staff are pressured to come to work even when sick and where asking for time off is treated like a burden

All of those are examples of what happens when a practice is stuck in survival mode. In survival mode, you are only focused on staying safe in the moment. The hospital operates on a set of false assumptions that these behaviors are key to success. Yet, when you zoom out to look at the big picture, it’s actually the exact opposite.

 

Let’s take a closer look.

When rude clients are tolerated, the concern is that the client will leave and may even leave a bad review causing loss of other existing or potential clients. That’s an unlikely worst case scenario, but tolerating toxic clients is guaranteed to send the message that the hospital is prioritizing the happiness of their clients over their own veterinary team.

 

Here is a much more realistic scenario: a staff member is pressured to tolerate verbal abuse and to cater to a rude client. In an effort to appease the client, a bottle neck is created: management needs to get involved, lines start to build up, staff members become flustered and ruminate over the client and become distracted from their jobs, and appointments start to run behind. Numerous respectful clients end up having a bad experience, overhear staff complaining, and start to search for new clinics as they wait in the appointment room. Staff members dread going to work and eventually quit because they feel undervalued, disrespected, and lack control in their workplace.

 

What is a greater profit loss: one toxic client or a valuable staff member? Hint: the estimated cost of losing a veterinary technician is $59,000 and it’s $104,000 for a veterinarian.

 

Practice taking a step back and thinking about the ripple effect and long-term consequences for the other unsafe workplace scenarios above. I’ll be diving deeper into the topic in the “Beat The Burnout” series.

 

Where Do We Go From Here

All of this must stop. In an effort to provide the best care to our patients, the profession ironically forgot the basics of sustainable life. We forgot to put our oxygen masks on first. Rather than trying to build on a foundation made of self-sacrifice and survival mode that is crumbling before our eyes, we need to work together to create a sustainable ecosystem that thrives.

 

It’s time to pause and take a deep breath so we can shift out of survival mode and look at the big picture. We need to inhale energy, fresh perspectives, and curiosity, and exhale tension, judgment, and the old stagnant ways that are weighing down the profession. We are all in this together.

 

Tension, conflict, and burnout arise when one team member feels like they’re carrying more than their fair share. An ecosystem is resilient and thrives when there’s a natural symbiotic relationship where everyone supports each other with a natural give and take. Every single member of the veterinary team has the power to be a role model and mentor by first prioritizing their safety and basic necessities. Veterinary community, we can do this. We can flourish.

 

Here is where I suggest we start:

1. Shift out of survival mode. Listen to the “Anti-Anxiety Tools That Actually Work” replay to learn techniques that can be done anywhere to signal to your body that you are safe. You’ll also learn the basics of how to use those to start rewiring your brain. These techniques should become as routine as core vaccines in every hospital. 
2.  Starting today, every hospital should pledge to institute a zero tolerance for bullies policy. You will be shocked how many rude clients become perfectly reasonable when their behavior is called out and no longer gets them what they want. For those that remain rude – good riddance! You will notice a huge shift in the health, happiness, and success of your practice when you release and let go of toxic clients. This is a simple and powerful message that you can send to your entire team showing that they are respected and a priority.
3. Apply the “zero tolerance for bullies” policy in the way veterinary team members are treating themselves. The positive intelligence assessment is an easy way to identify the different judgmental voices creating a negative filter in your brain. Have honest conversations sharing what those voices are saying and how everyone can support one another in overcoming them. More on this topic in my Beat The Burnout series.
4. Share this article with your hospital, mentor, or mentee and use it to spark productive conversations around how to create a sustainable ecosystem. When thinking of new ideas make sure not to switch your “things will never change/that’s not possible” filter to “things are changing/we can do this”. Ditch judgment and embrace curiosity when brainstorming.
5. Start observing how many basic necessities are being ignored during your day or at your hospital. Start leading by example and having conversations about how they can be treated like a priority in the hospital. For example, institute mandatory recess.
6. Find a community where you feel safe and supported and where there is a natural ecosystem of giving and taking. Utilize online communities like Facebook groups and VIN. Create a group text with veterinary friends to discuss challenging cases and to be seen and supported after really hard days. I’d love to see a Bumbl-like veterinary app that helps mentors and mentees find the right match. Anyone want to help make that happen?
7. Educate pet owners on the realities of the profession. Recently, parents who lost their veterinarian daughter to suicide launched a “We’re Only Human” campaign in Australia to raise awareness among pet owners about the challenges of the profession. Hospitals are putting up posters and pet owners can pledge to be kind to the veterinary team. Consider sharing this on social media to spread awareness throughout the world or start your own conversations around the topic.

 

Amelia Knight Pinkston, recovered burnt out VMD, certified integrative health and life coach, and change worker

Ways to connect:

•     Instagram (@lifeboostwithamelia), Facebook, LinkedIn, or by email at amelia@lifeboost.today.  
•     Join the conversation in the “Beat The Burnout” Facebook group open to all vets and vet students.
•     Sign up for the free “Beat The Burnout Series: What We Should Have Learned In Vet School” series. You’ll receive the replay for the “Anti-Anxiety Tools That Actually Work” masterclass.
•   Learn more about my programs at www.lifeboost.today

 

Sources:

Merck Animal Health. 2022. Veterinary Health and Wellbeing And How To Improve Them. Accessed 28 May 2023.  https://www.merck-animal-health-usa.com/wp-content/uploads/sites/54/2022/02/2021-PSV-Veterinary-Wellbeing-Presentation_V2.pdf

 

Neill CL, Hansen CR, Salois M. The Economic Cost of Burnout in Veterinary Medicine. Front Vet Sci. 2022 Feb 25;9:814104. doi: 10.3389/fvets.2022.814104. PMID: 35280150; PMCID: PMC8913590.