One day during a routine ovariohysterectomy, an assisting technician made a comment on how clean I was with the handling of my surgical equipment and gauze.
It turns out that she was used to working with doctors that littered the surgery floor with bits of used gauze and other perishable materials, and I immediately knew the type of doctors she was talking about. They were the efficient pragmatic types that knew exactly what they were supposed to do in the surgical suite and solely focused on their task alone, with little regard for the aftermath of their work.
I, however, have always struggled being a pure pragmatist in my practice with medicine and the way I navigate life.
The way I see it, it doesn’t take much effort to simply leave the used gauze on the surgical table so I can reuse them as needed, and not bother someone to clean up after my own mess. It also allows me to keep track of how much material I have already used.
I’m not sure how many are like this, but it seems pragmatism is highly regarded in my field — but what’s the repercussion for pragmatism when it does not take into consideration the aftermath of unintentional consequences?
It feels the veterinary industry has been pragmatic for a long time and we are now at a time of reckoning.
Embracing One Welfare
As members of the veterinary community, we are uniquely positioned to protect the health and welfare of animals, human beings and the environment.
The concept of One Health, recognized by the WHO and CDC, is a largely familiar concept in the veterinary field. But there is an even more inclusive concept – One Welfare – which states that human welfare, animal welfare and environmental conservation are all inextricably linked.
We are all fully aware of the interconnection of living beings on this planet. For many of us, the very reason we chose this profession is because of our love and awe for nature and creatures both big and small. And yet I am seeing very little effort in the veterinary community, and almost none in most veterinary practices when it comes to sustainability efforts.
The challenges of thinking sustainably
To be fair, running a practice is a huge challenge. Not only do we have to juggle practicing quality medicine, compassion, and maintaining a profitable business, but we are also facing the new challenge navigating the current COVID-19 pandemic.
Mental health is a significant concern in our field as well, and practices must be mindful of the wellbeing of their staff. Considering these factors, adding on another layer of practicing sustainability may seem too much for a practice to handle.
But there is beauty in the concept of One Welfare. The COVID-19 pandemic, the mental health crisis and the recruitment/retention of new talents can all be addressed by implementing sustainability into a practice by addressing the interconnection of these seemingly unrelated problems.
Sustainability in vet med: 3 strategies
Responsible antimicrobial use
One way veterinary professionals can work toward great sustainability is by advocating for responsible antimicrobial use. This includes educating clients on the need for routine stool tests to control parasitic infections in the community and the use of responsible preventative prophylactics.
Responsible antimicrobial use is also about questioning and being mindful of what we were taught. A recent British study found that over 20 English rivers were contaminated from fipronil and imidacloprid, key ingredients in topical flea/tick preventatives. It was suggested that this was due to owners applying topicals on their pets and then allowing them to go for a swim, or showering them when the product was still left on their coat.
While it’s important to protect our patients, it should not be done so blindly with no consideration for our local environment and the animals that live there.
Client education doesn’t stop with antimicrobial use. Rather, as veterinarians, we are in a position to encourage sustainable behavior in every aspect of animal care.
One such aspect is the Raw meat diet. Despite warnings from the FDA and the CDC, some clients still prefer this diet to commercialized diets.
Raw diet is not only a huge zoonotic health risk, but it is also an unsustainable diet choice for pets. In fact, a study from UCLA in 2017 found that US dogs and cats can cause 25-30% of environmental impact from meat consumption in this country — an equivalent of about 64 million tons of carbon dioxide a year.
There are investigations being done on whether dogs could be placed in a more plant-based meal. And while cats cannot maintain on a plant-based diet (and as veterinarians we cannot recommend a diet that could lead to significant malnutrition), we can protect the immediate environment by educating clients on the need to house cat indoors to protect wild birds in the area.
There is so much that both individual veterinarians, veterinary staff and veterinary practices can do to implement sustainability practices. Veterinarians in Australia have set up Veterinarians For Climate Action and in the UK a group of like-minded veterinarians started Vet Sustain to help veterinary professionals and practices build awareness and implement sustainability into their practices. Their Greener Veterinary Practice Checklist is a good start.
Getting involved also means enacting change at a higher level, such as reaching out to veterinary schools to include more sustainability teaching in their curricula.
Some vet schools, particularly in the UK, are already working on including sustainability classes in their curriculum in the coming years. This will mean that the new grad vets will graduate with expectation for how practices are implementing sustainability efforts, and will gravitate towards those that align with their values.
Sustainable practice = Happier vets
Incorporating sustainable practices into your clinic is important to reduce waste and help preserve our planet. But it also has added benefits — namely, creating happier vets.
Reducing compassion fatigue
Consider, for example, the effects of compassion fatigue, which are known to lead to burnout. We often assume compassion fatigue a is due to tragic cases we deal with at work. While this is certainly true, compassion fatigue can also come from the daily news of environmental damage, another species added to the endangered species list, another oil spill in a marine coast, another evidence of dying coral reefs…and so on.
Because we naturally care about our environment, all of these add on to our fatigue. What if practices implemented sustainability in a way that would allow empowerment for causes other than the next case we see?
Being prepared for the next pandemic
It is not a stretch to say that we are also experts in zoonotic diseases, and COVID-19 is certainly one we are acutely aware of.
While infection rates in animals have only been rarely documented, judicial practice of PPE even after the pandemic calms down is certainly a wise move from a One Health and sustainability standpoint so that practices will be even more adequately prepared for when — not if, but when — the next pandemic hits. Part of implementing sustainability is about being aware of the undesirable effects of climate change and being proactive and well-prepared for the next big hit.
Attracting top talent to your practice
Forbes released interesting research in 2018 that showed that millennials in particular have higher expectations on values — both as consumers and as employees — for businesses. As a (slightly older) millennial, I can attest to this sentiment a lot. Naturally, a vet practice working on sustainability efforts would therefore have a higher likelihood of attaining and retaining new talents.
We are part of one of the most highly regarded and influential professions, and sustainability should be at the center of what we do.
Veterinary medicine is about looking at our patients holistically, constantly checking in on their quality of life, encouraging preventative care instead of reactive care, and always being on the look-out for underlying systemic issues to address the surface problems. There is no reason why we cannot expand our skills and influence as leaders to protect and promote the health and welfare of our animals, our fellow human beings and our planet we all live in.
It’s time to be mindful of the single-use materials we use. It’s time to ease on the pragmatism and widen our horizon. It’s time to take a proactive change and respond to the voiceless voices that seeks our attention.
Dr. Yui Shapard is an Associate IndeVet practicing in New York City.