Vets, Stress and Suicide

There’s suddenly a lot of talk about the suicide rate in vets, thanks to a new study from the USA. It’s re-opened an important conversation, but I believe also created a lot of misinformation.

For example, I saw one vet say it was because of bad debts and emotional blackmail by pet owners. That’s clearly just his experience. So here’s the evidence we have for what’s going wrong, and my suggestions for fixing it.

The New Vet Suicide Study

Vet deaths in the USA were collected from 1979 to 2015 and compared with the general population. They found:

  • Male vets were 2.1 times as likely as the general US population to die by suicide
  • Female vets were 3.5 times as likely
  • The median age of suicide was 57 for males and 42 for females

Here are my observations:

  1. The higher rate in females is a new finding and quite alarming
  2. The rate in male vets is similar to other medical professions
  3. Both rates are far too high

I have known three vet suicides, and I do think there is a problem. I also think that most observers are missing the point in what’s causing it.

I worry about poorly prepared young vets entering the profession, as I do about older vets at risk of burnout. We need to talk about why this is happening and how vets can take care of themselves. Let’s also remember vet nurses.

What might be causing vet suicides?

Here are the results of studies that examined the causes of work stress for vets:

  • Long work hours & work overload
  • Professional isolation
  • Student debt
  • Veterinary care costs
  • Lack of senior support
  • Practice management responsibilities
  • Client expectations & complaints
  • Euthanasia procedures
  • Poor work life balance

I’ll discuss each one in turn.

Long Work Hours & Overload

Although being overworked is part of the ebb and flow of veterinary practice, it has been shown that stress and anxiety in vets increases with the number of hours worked.

This can mean late nights, missed lunches and exhaustion. It can also mean feeling you haven’t done the best you could for the animals you treated. It might also cause errors to be made.

My Suggestions:

  • Look after yourself. Eat and sleep well during busy spells, and stay in touch with loved ones.
  • Take your holidays or recharge at a conference. It’s your right to do so.
  • If it continues, talk to your employer. The issue may be about hiring extra staff or other areas of HR management. For example, many practices will double book in busy periods, which all vets hate.
  • I don’t buy the ‘there’s a vet shortage’ argument. It’s up to the practice owner to set realistic workloads for the number of vets employed.  If necessary, fork out the money and hire a locum veterinarian.
  • I know from my own experience that employing a new graduate can improve the workload without any loss of quality of work.

Professional Isolation

What makes our job great also makes it hard. Unlike other professions, we look after all the health care needs for an animal. In our practice the same vet who examines your pet usually takes responsibility for their X-rays, surgery, dentistry or hospital care. Human medicine may have over ten people sharing the responsibility for the same process.

There will be times when you can look back and see how things could have been better. Even if you made the most logical decisions at the time, it can be hard to remind yourself when things don’t go well.

With chronic illnesses, sometimes the answers are not immediately obvious. I usually have at least one difficult case on the go but sometimes they come in waves, and it can feel overwhelming.

My Suggestions:

  • Use the experience and education of other vets in the practice (if you have them).
  • Recommend a second opinion or call other vets for mentoring. It’s too easy to think of other vets as competitors when what we really are is colleagues.
  • Refer to specialists whenever you feel out of your depth.
  • Only work in practices that provide real support.
  • Keep learning. This industry changes all the time. If you let your skills and knowledge stagnate it makes isolation all the worse.
  • Remember you are human.

Student Debt

I was one of the lucky generations who were educated on the cheap. However I know the sorts of debts students now face. These debts trap new vets into working when they may be better walking away or working part-time.

Of course, I know that’s not much different to being older and having a mortgage, but it’s yet another pressure. It’s also not helped by the fewer options available than other professions like medicine. If a vet doesn’t like ‘being a vet’ there just aren’t many other ways of using the training.

My suggestions:

  • Get good financial advice.
  • Don’t let debts dominate you: we live in a lucky society.
  • Get paid properly. You have the right to ask for a good salary or find it elsewhere.

Veterinary Care Costs

It’s especially hard to be right all the time when costs need to be controlled and you can’t do everything you want. That’s the nature of being a vet; there’s no Medi(vet)care.

Even worse is when clients can’t afford even the most basic tests or treatment. In larger corporate veterinary chains, price flexibility is very difficult. Although emergency care is always provided free of charge by all vets, some patients may be refused treatment if credit is not available. This can be very distressing for the vets involved as well as the clients.

My Suggestions:

  • You can’t change the world; this is a global problem. Don’t take it personally.
  • Suggest a charity program for disadvantaged clients or volunteer on days off. It’s time someone sets up a similar program to the Blue Cross charity in the UK.

Lack Of Senior Support

One of the most common causes of job dissatisfaction is unhappiness with employers. While it can take many forms, a common one is being asked to perform skilled tasks with little or no support. This is why I left the last job I had before Walkerville.

Such a situation sets you up to have to take responsibility for bad things happening. You could even get blamed for something you should never have had to do.

My Suggestions:

  • Approach a senior member of staff. They probably have no idea it’s happening.
  • If the conflict is with senior staff, try to have the problem mediated from outside.
  • Your job is not your life. Get out if you have to.

Practice Management Responsibilities

Like any business manager, vets often have to worry about a lot of extra things when they’d rather be with your pet. All the day to day equipment failures, staffing issues, computer malfunctions etc.

Many vets have financial pressures as well. The combination could be overwhelming.

My Suggestions:

  • Remind yourself why you’re in charge; so you can serve your patients the way you believe they should be. The other stuff is just detail; don’t let it take over.
  • Delegate. There are lots of great support services out there.
  • If there is staff conflict in a practice you manage, don’t ignore it. Consider using HR consultants if it isn’t simple.
  • If a business is failing or not running smoothly, seek help from a business management consultant. There are many available, including some specifically for the vet industry.
  • Recognise the signs that it’s time to acquire a business manager, partner or sell to another vet. The times I’ve seen vets go through these steps they ended up a lot happier once it was over.

Client Expectations & Complaints

We love you guys like our friends. Animal people are the best people and it’s a joy getting to talk pets all day with you. But just like anywhere, there are always a few we just don’t see eye to eye with, for a variety of reasons. Sometimes it’s just a personality clash or a problem of different points of view. Other times it could be from a genuine error.

All experienced professionals are likely to have had to deal with serious complaints at some stage in their career. A vet could be made quite vulnerable during any conflict with a pet owner. It could be many times worse if there was any suggestion that the vet had been at fault.

My Suggestions:

  • Take comfort in the respect and warmth you get from the majority of clients and accept you can’t win them all.
  • Talk to friends or workmates about your disagreements instead of dealing with them alone. A well-managed practice should be able to offer a supportive environment to staff.
  • Accept that even when you do your best, sometimes bad things will happen. This doesn’t make you a bad vet, just a human being.
  • Be honest in your explanation of a poor outcome. You will be amazed at how understanding most people will be of an honest mistake. Most people who see you care and have done your best will accept an apology, especially if they can see how it will result in improvements in the future.

Euthanasia Procedures

Euthanasing and mourning my own cat was one of the hardest things I’ve ever done. What may be shocking is that it is in complete contrast to how it is when I euthanase other animals.

Yes, it gets me down; yes it can be emotionally draining, but I joined this profession knowing it’s an important part of what we do. I can choose not to do it if it isn’t right, but usually it’s easy to see as an act of kindness when it’s not our own pet.

However, what I also see is that my approach to euthanasia is not shared by all. Some vets never come to terms with this terrible responsibility. Others are forced to euthanase animals that they do not believe should die.

My suggestions:

  • Talk to your employer about your concerns. For example, I’ve always been happy to do more than my share if I have a young vet struggling with euthanasia.
  • Flat out refuse to euthanase if you don’t think its right. If you get sacked for it you’re going to be able to find a more supportive job elsewhere.

Poor Work Life Balance

Entry to the vet courses is highly competitive, and this will select for a certain sort of person, accustomed to high standards of personal performance. This same attitude, which can be hard to carry around in the real world, puts people at risk.

It’s too easy to let being a vet take over your life completely. As I mentioned earlier, it isn’t helped by being overworked. Suddenly you find you’re working 60 hour weeks, losing touch with friends and not following your own passions outside of work.

My Suggestion:

  • Don’t accept a life of work alone or it won’t last. If you don’t look after yourself, that work rate you’re setting isn’t sustainable and you’ll burn out.
  • Keep your options open whenever possible by retaining or developing new skills.
  • Remember that experienced vets are always employable somewhere else. Being a vet is a tough training ground for any responsible job.
  • Teach! Hosting vet students on their clinical placements or mentoring a new graduate is a great way to remind yourself how far you’ve come and how much you have to give. It’s also very satisfying knowing the experience you’ve accumulated can be passed on.
  • If at all possible, find someone to talk to regularly about your work stress, either privately or professionally.

One Last Reason

There’s another reason why suicide rates are higher in vets that’s a lot harder to fix. We have an easy availability to the means and a familiarity with the technique that is unique across the professions. It’s impossible to limit access to these drugs while still providing humane euthanasia.

Here the only answer is better support of vets so that they don’t take this path in a moment of desperation.

What about the future?

I see people starting to talk about the risks and I am optimistic about the future. I also think the new generation of vets will be more likely to find supportive workplaces, and less inclined to ‘stick it out’ and not ask for help.

If you feel that issues raised in this article have upset you, or if you are having thoughts of suicide, please contact Lifeline Australia on 13 11 14 or Beyond Blue on 1300 22 4636. Though I am only a veterinarian, I am also happy to discuss work-related problems in the strictest confidence.

This article is dedicated to the friends and families of the victims of suicide.

By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These blogs are from a series regularly posted on Facebook and Twitter. We do not accept payments or incentives in return for stories. Like or follow our page or subscribe via email to read the latest.
Have something to add? Comments are welcome below and will appear within 24 hours of lodging.

Andrew

8 Replies to “Vets, Stress and Suicide”

  1. Great article, and I agree with Alix’s points too. I would like to add the following point: vets need to know what the escape avenues are out of the profession that don’t involve becoming a teacher (which seems to be the default at the moment). I would like to encourage recruitment consultants like VetLink to have a consultant whose sole role is to help vets transition out off the profession into something else.

    I am quitting the profession, almost entirely because I’m sick of dealing with the general public. This profession has jaded me and made me increasingly misanthropic. It has made me start to not care any more, and that kills me. I’ll keep my rego up just in case I change my mind in the next couple of years, but for now I am walking away. It seems that five years is the magic number as many of colleagues at this point in our career are turning our backs on it. It is a shame, because we worked hard to get where we are but the public throw out back I our faces. I find the comment “you vets are just in it for the money” particularly galling and offensive.

    Anyway, I’m looking forward to hanging my stethoscope up and walking away to a well paid office job…

    1. Thanks. The point about assisting transition is a very good one. Vets can feel ‘trapped’ by their highly specific jobs and not see another option.

  2. Thanks for the well thought-out and balanced article. Whenever I read stories like this it reminds me that vets face the same issues around the world, and suffer the same consequences.

    I found a couple of your points quite interesting, particularly your comment “If a business is failing, there’s probably not much more that can be done”. I’m not sure this is true- in fact, I’d be surprised if it were the case. If you look at your list of drivers of vet suicide they can be split loosely into 2 camps- stuff that is related to vet work (euths, tricky clients, high standards, access to lethal drugs) and stuff that is related to any poorly managed job (team conflict, over work and business management). If a business is failing I would suggest that there is a collection of problems behind the scenes- and usually it’s nothing to do with clinical work!

    I believe it is possible to address a lot of vet workplace stress through proper clinic management. I don’t know what your situation is and I’m certainly not having a go at you if you do run your own practice (good on you if you do!) but vet clinics are often poorly managed. Clinic management often takes a backseat to vet work for owner-operators and often there isn’t always a strong grip on all aspects of business management.

    We’re happy to seek advice when we hit medical issues we can’t tackle but we’re often slow to do so when it’s a management issue. If your business is failing- why not seek a business or clinic consultant? If you can’t deal with a tricky member of staff, why not ask an HR specialist what to do? If over work or bad clients stress your team, is there a way for management to mitigate that through better support? What does that ‘support’ look like in practical terms?

    Vet will always be a tough but rewarding job but too often I read articles like this where a lot of the problems are completely unrelated to vet specifically and would be stressful in any workplace. We can’t necessarily change the industry but we can change where we work- either by being agents of change within the workplace or by finding a new workplace altogether.

  3. Thanks for this intelligent and thoughtful article, I especially appreciate the solution ideas offered. Working in human health, I believe one of the most important factors in the impact of stress on worker health, physical and mental, is failing to acknowledge the sources and to problem solve solutions.

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