Dr. Dewey takes a closer look at common veterinary stressors and calls for an industry overhaul.
Veterinary medicine is in a crisis, but the hows and whys of how we got here are quite hazy, thus making the solutions even harder to come by.
“Blame it on Covid”
Early in the pandemic, the issues were blamed on the inefficiency of curbside medicine, combined with the apparent increase in adoption rates. There are reports of rising adoption rates during COVID, but statistics show that the overall number of pets surrendered to shelters dropped. Thus in reality the overall number of adopted pets was actually lower in 2020 than in previous years.
Yes, the demand for appointments is growing, but not by the proportion it feels like — appointments were up only 4.5% in 2020, and 6.5% for the first half of 2021. And yes, productivity dropped by ~25% in 2020 according to the AVMA.
But with most places no longer being curbside, these numbers would be expected to improve this year. We can assume there are less vets due to early retirement due to COVID and the loss of some female vets from a female-dominated field (thanks to the fact that women still bear more of the weight of child-rearing in our country, and thus took a harder hit from school closures).
Good technicians are also getting harder to find and even harder to keep, likely due to the low pay and the physical challenges of the job.
So do all of these things explain what is happening? Maybe. But I actually think the last 18 months have brought to the surface a lot of issues that have been brewing in the veterinary field for many years, and the culmination of these combined with the issues listed above and the overall stress of COVID has led to the current crisis. Hear me out.
The need for veterinary specialists
Gone are the James Herriot days where a vet could know and do all the things for all the animals and their people. Veterinary medicine, like human medicine, is evolving at an incredible pace.
But, unlike human medicine, most of us are not specialists. There is more technology and testing available now (that we have to know how to perform and interpret), more drugs and treatments, more highly educated owners (and more owners who think they are educated due to “Dr. Google”), more highly valued pets who are family and not backyard ornaments, and also more misinformation strewn across the internet for us to combat.
In this day and age, in what field of human medicine does the same doctor:
- see you as a baby,
- vaccinate you throughout your entire life,
- perform an ovariohysterectomy on you,
- take and interpret radiographs when you get hurt,
- anesthetize you and perform oral surgery/tooth extractions,
- document and potentially sample every lump and bump on your body,
- save your life and hospitalize you during an emergency when you get poisoned,
- diagnose and manage your diabetes,
- manage your chronic allergies,
- manage your arthritis,
- diagnose and manage your congestive heart failure,
- AND help get you into hospice care and make end-of-life decisions?
Yet this exact level of broad expertise is expected day-in and day-out of us as general practitioners.
And yet we are paid less than physicians (while simultaneously accused of being “in it for the money”), we have less highly trained support staff (and thus can end up doing things that a technician or nurse could and should be doing), and we are generally treated with less respect than our counterparts in human medicine (when was the last time you called and demanded to speak to your GP and refused to tell the receptionist what it was about?)
We fear the wrath of keyboard warriors on social media if we make a real or, more likely, perceived mistake, or if we make a scheduled appointment wait while we deal with a critical case, or even, god-forbid, if we direct a caller to an emergency hospital that is better equipped to handle their pets condition.
Add to this that none of us got here without being at least a little Type A. And oh yeah there’s the mountain of debt.
And let’s not forget that, to quote Cageliner, “new COVID variant causes lack of sense of smell, basic human decency” (we’re looking at you, client who berates entire staff over what was later deemed to be her own mistake).
What’s next for vet med?
In my opinion, the crisis in veterinary medicine is not just pandemic-related, nor is it something that can be easily fixed.
I think veterinary medicine is in need of a major overhaul, because the pressure and expectations placed on us are becoming unrealistic and unsustainable. Should we have more urgent care facilities? Maybe we need more surgery centers — not just for spays/neuters, but for things like mass removals and cystotomies (i.e., things that don’t need a specialist, but things not every GP should be expected to have to do)?
How do we change the public perceptions and expectations of veterinarians?
What will it take to get support staff that is better trained and better paid and willing to stay in the profession long-term?
I wish there were more answers, but hopefully posing the questions and bringing awareness to the issues is a starting point towards turning our profession in a better and more sustainable direction.
Kristen Dewey, DVM is an Associate IndeVet practicing in North Carolina.