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Yes, There Is a Problem

Yes, there is a problem today in veterinary medicine.

No, it is not hopeless.

It’s not the situation, but how we decide to view and think about it, that makes all the difference.

After one of my recent talks, a veterinarian (DVM) came up and told me she had just been to a seminar where they were discussing all of the stressors in veterinary medicine, how hard our field is, and how detrimental it is to mental health. She said she felt as if they were telling her “she should be feeling very bad and sad” about being a DVM and practice owner. She said she walked out of the talk and shook it off, saying to herself, “I have an amazing profession, an awesome practice, and a wonderful life” – and she was pretty annoyed that the message of the seminar was so very negative. I love that she pushed back on this idea of victimhood and burnout. I agree with her. But it’s unfortunate that she, and many other DVMs, are regularly having this messaging pushed on them at some of our biggest conferences. It’s up to those of us with strong management skills to help out and mentor those who want to find this same place of love for our profession, for ourselves, and most definitely for our teams. We can do this.

We are navigating some difficult challenges and worrying trends in veterinary medicine today.

Of course, there’s a significant shortage of veterinarians and trained technicians, with many DVMs retiring, and too few joining the profession to take their place.

Mental health and wellness concerns are being raised constantly. Even if you were not feeling particularly stressed before, the information you’re seeing in most places is telling you that you are stressed, and that you are a victim of the current circumstances.

All of this is leading to an epidemic of “powerlessness” among many in our profession as Kogan and Rishniw1 have found, which is creating many negative downstream effects – not the least of which is the corporate takeover of our industry – which does not appear to be to our benefit. But if you’re in this profession, you don’t need me to tell you this. You’re already living it – or at least reading about it.

It’s my personal mission to help change this current narrative and bring us back to seeing veterinary medicine as the amazingly fulfilling and wonderful career that it should be.

I believe veterinary medicine is more of a “calling” than a career. We are so lucky to have this opportunity to combine science, nature, and the beauty of the human–animal bond all into one career. I feel there has been far too much time dedicated to telling us what’s wrong with our profession, and that we should all feel like victims. I would like to help change this narrative by sharing another way of looking at things – a way to elevate the circumstances of our workplaces and help more people have a fulfilling career in veterinary medicine. I believe our field is full of smart, caring humans who together can continue to make veterinary medicine one of the best ways to spend your professional life. I hope I can contribute to making a career in veterinary medicine a great one.

In this chapter, I’m going to address some of the key factors that I believe are actually leading to the difficulties in our profession today, and what I think underlies these issues. Then, in the remaining chapters, I will take you through what I’ve done to take on these challenges and build a successful practice – and I’ll show you how you can do something similar in your own practice.

The Talent Shortage Meets the Pandemic Puppies

We’ve been shorthanded in Registered Veterinary Technicians (RVTs) and DVMs in some areas for a long time. But things got exponentially worse during COVID as a perfect storm converged:

• We all saw a tremendous increase in the need for our services during COVID. Different sources gave different reasons for this. I believe it was mostly that people were home 24/7 with their pets, and thus were more focused on the well‐being of their pets and more likely to notice potential issues. This is a good thing – but it created an unexpected surge in demand.
• Dog breeders accelerated the pace of breeding, and many people looked to breeders and shelters to adopt dogs and cats to fill all of their free time.
• Older DVMs accelerated their retirement due to the challenges of delivering services during the pandemic.
• Managing the crush of the pet owner's needs and reduced staff availability was stressful.
• Enhanced unemployment made it difficult to retain entry‐level staff, who could earn almost as much by not working.

In short, COVID drove a decrease in people available to work and a simultaneous increase in demand for our services.

Corporate Influences

The shift toward corporatization is also reshaping the landscape of veterinary care, as corporate groups often prioritize private equity returns and profits over quality of care. The animal care and pet industry has boomed over the last decade, with the industry now valued at nearly $150 billion,2 and private equity firms and corporate investors have taken note. Research estimates that corporate veterinary practices account for approximately 10% of general companion animal practices and 40–50% of referral practices in the United States veterinary services market.3 This problem has increased greatly as practice valuations have escalated, and very few associates (who usually carry significant student debt) are able to put together the capital needed to buy their practice from the original owner. In addition, most associates I’ve met are not interested in the lifestyle required of an owner. When you add in the fact that many practice owners are struggling with the current conditions – and all the propaganda saying practice ownership is stressful and ruins your mental health – you can’t really blame an associate for not wanting to go down that path.

M&A Has Changed the Industry

Also, remember that corporations in our industry have gained more access to us by way of mergers and acquisitions. For example, many of our “industry media” and conferences, which were founded by DVMs or others not primarily motivated by profit, are now owned or controlled by commercial interests. So it can be difficult to ascertain who is actually speaking to us and what their motives may be. It can be hard to determine who their messaging and content really benefits.

Many of these corporate interests are regularly pitching us new products, services, or technologies that we now “must have.” Being a leader means knowing what to say “no” to – even if just a “no for now.” As a small business, you should choose your projects carefully, knowing what you and your team can manage well. And, remember, take “baby steps.” You cannot do everything at once.

Data‐driven corporations and technology platforms are aggressively pushing to marginalize the role of DVMs in the veterinary care process. They are skilled at leveraging financial capital with targeted marketing, public relations, and regulatory lobbying, all aimed at sidelining the veterinarian and making technology the center of pet healthcare. Legislation and lobbying efforts have been aimed at eroding the veterinarian–client–patient relationship (VCPR). Much of this legislation appears to be guided by corporate interests in order to monetize veterinary medicine by reducing the veterinarian’s input into patient care.

Pet owners increasingly get pet care information online,4 but the online environment is dominated by corporate players who are focused not on delivering quality information and steering pet owners to their local DVM, but rather on selling their raw food diets, Cannabidiol supplements, or telemedicine consultations to generate profits.

Care and Service Are Suffering

Poorly managed hospitals with weak leadership lead to unhealthy working environments for staff. Shorthanded teams mean longer wait times for clients. Overworked staff means more mistakes and risks to the well‐being of our pets. Unhealthy practice environments lead to unhappy, stressed, unsupported staff. All this is legitimately frustrating for pet owners. Unfortunately, they often take out their frustrations on the very people who are trying to help them – DVMs and their staff. Whether through verbal abuse, one‐star reviews, or social media rants sent around the world in an instant, these behaviors harm the hard‐working and well‐meaning people in veterinary medicine.

We need to do better. And we can.

Burnout and Wellness Challenges Have Escalated

If you were, or are, working in a poorly managed practice, all of the above issues have contributed to burnout. Burnout has become a common topic in every discussion in every veterinary forum.

But that’s actually the problem: Too many people in veterinary medicine have accepted the idea that “this is how it is” and have stopped seeing this as irrational and wrong. Many have started to believe that burnout is a function of our industry.

It is not.

We need to change our perspective. We have an amazing profession where we...