When I applied to the Purdue School of Veterinary Medicine in the mid-70s, there were roughly 9 applicants for every spot. There were only 72 students accepted every year. Some students that were not able to gain entrance to a veterinary program turned their efforts towards medical school instead. This article, written in 1978, discusses the surge in interest in becoming a veterinarian. Interestingly enough, it also mentions a shortage of veterinarians, especially those willing to treat large animals.
Recently an article from Veterinary Advantage appeared in my inbox. Mitigating Pain Points For The Shortage Of Equine Associate Positions, written by Graham Garrison, contains information shared by Amy L. Grice VMD, MBA. Grice spent 25 years practicing as an equine veterinarian, and was a managing partner in a large equine referral practice. Currently, she serves on the board of the American Association of Equine Practitioners (AAEP). The article opens with the following statement:
In May 2021, there were over 450 job postings on the AAEP Career Center website. Grice cited industry statistics that well under 2% of new graduates enter equine practice each year, with just 1.5% in 2018, 1.0% in 2019, and 1.4% in 2020. With about 4,000 graduates each year, that translates to less than 50 newly minted veterinarians entering the field each year.
“The AVMA estimates that there are about 60 equine veterinarians retiring each year, a figure they expect to grow 3% per year,” Grice said. “When examining AAEP members, 44% are more than 50 years old, and 27% are more than 60 years of age! In addition, about half of the new graduates that start their careers as equine practitioners are not still working with horses by the fifth year after their graduation.”
Did you catch that last sentence? In addition, about half of the new graduates that start their careers as equine practitioners are not still working with horses by the fifth year after their graduation.
I am on a myriad of Facebook groups related to horses and dogs. Every so often, a thread pops up where someone is either praising or blasting their veterinarian, or the veterinary profession as a whole. I totally understand that there is a range of competency out there, as there is in any profession. However, I suspect that very few people really understand all of the dynamics involved with being a healthy and successful veterinarian, leading a balanced life and making an adequate living.
Is there really a shortage of veterinarians?What the AVMA thinks…
Last August, two higher-ups in the American Veterinary Medical Association, or AVMA, wrote an article questioning whether there really was a veterinary shortage? It was a very data-driven article, showing statistics that there really wasn’t a pandemic pet boom (which is actually supported by other data as well) and discussing the loss of efficiency that occurred in veterinary practices during the pandemic.
The article addressed and essentially disected the following potential contributors to whether or not clients had adequate access to veterinary care.
Was there a pandemic pet boom necessitating the need for more veterinary services? (The article says there was not.)
What role does staff attrition and practice productivity play? (The pandemic significantly decreased practice productivity. Staff attrition could be addressed by making employees feel more valuable and increasing pay.)
Should we add more veterinarians? The article begins this section by stating, “It’s important to be clear: There is a need for more food animal and public health veterinarians, especially in underserved rural areas.” However, the article disputed that adding more veterinarians in general would “fix” the issues currently experienced by the veterinary profession.
There was some discussion in the article about an idea apparently floating around the veterinary community and veterinary schools… should there be another role created between the veterinary technician and the veterinarian? Something like a Physician’s Assistant? That is a topic for another day…
The conclusion drawn by the authors of the article was that existing practices need to improve their efficiency, more adequately utilize their technicians, take advantage of technology, and practice team building. Well guess what? That conclusion was poorly received by the veterinary community as a whole.
Is there really a shortage of veterinarians? What the veterinary community thinks…
Today’s Veterinary Business published a response letter to the AVMA, written by a couple of dozen of the movers and shakers in the veterinary business world. I am going to drop a significant portion of it right here… although you are welcome to follow the link above and read it in its entirety yourself. I just can’t say it any better…
We are chief medical and veterinary officers working in support of our colleagues, most of whom are your members. We work proudly every day to grow, coach, mentor and retain great colleagues. As you can see from the signatories, we represent thousands of practices, tens of thousands of veterinarians and industry partners. Our veterinarians practice in all corners of the U.S. We are writing to offer our help in graduating more veterinarians.
We were disappointed to read in a recent JAVMA article of our associations questioning the workforce shortage as a ‘temporary cyclical economic factor’ and that ‘adding veterinarians to the companion animal sector is unlikely to address the profession’s current workforce issue.’
We see the effects of a workforce crisis every day, including delayed and denied care, suffering pets, [and] veterinarians and their teams struggling emotionally, mentally and physically. It’s clear to us that the shortage is real and growing. There are few things more difficult for veterinarians than turning away pets in need. It challenges our purpose as well as our oath.
Recognizing that adding seats, classes, new schools and additional class cohorts is no easy task, we are offering our assistance. We are eager to partner in providing internships, residencies, clinical rotations, summer job opportunities, visiting faculty, mentors and scholarships in support of training additional future veterinarians.
We see the current workforce crisis as acute and growing. We encourage you to acknowledge the workforce shortage [and] support additional programs, increased class sizes and the addition of new classes to existing programs.
The health of our colleagues, pets, the public and our profession is at risk. Together we can help more animals, promote the wellness of your members, and build an even brighter future. We look forward to future collaborations.
The signatories on this letter include but are not limited to executives associated with Mars Veterinary Health, VCA Hospitals, Blue Pearl Hospitals, Royal Canin, Thrive Pet Hospitals, Banfield Hospitals, and Animal Policy Group senior adviser and consultant Eleanor Green, DVM, DACVIM, DABVP, the dean emeritus of the Texas A&M University College of Veterinary Medicine.
The suicide rate among veterinarians
Early on in my career when I attended continuing education workshops, there were never any topics that addressed the veterinarian’s mental health. Fast forward 30 years to the 4-day conference I often attended in Kansas City. There were entire tracks dedicated to mental health.
An article published in the New York Daily News and written by Indu Mani, DVM, states that one in six vets have contemplated suicide, and vets are as much as three times more likely to die by suicide than the general population. That is a staggering statistic. I must add that veterinary technicians also suffer from an inordinately high suicidal ideation and suicide rate. They experience most of the same stresses. Sadly, there are too many drug options available in a veterinary practice that have the potential to end life… animal OR human.
Incredible debt, long hours, low pay
There are many articles and studies addressing why veterinarians are so prone to suicide. Most graduate from veterinary school deeply in debt. This article in Time says,
Veterinary students in the U.S. graduated in 2018 with an average of $150,000 in debt, according to the AVMA. Yet data from the Bureau of Labor Statistics shows the median annual wage for veterinarians in 2018 was $93,830, and starting salaries are significantly much lower.
Here is a very recent article detailing the salary compensation for companion animal, food animal, and equine veterinarians. Horse vets make the least amount. Remember that statistic I shared at the beginning of this post? About half of the new graduates that start their careers as equine practitioners are not still working with horses by the fifth year after their graduation.
Clients expect their vet to be available 24 hours a day. No one wants to adequately compensate the guy or gal who spent 60 minutes or more getting to and from their farm. Spending a significant amount of time addressing a colic or stitching up a horse that impaled itself on a fence should be appropriately compensated, both for the time involved and the expertise that was hard-earned… but no one likes a big vet bill.
Severe emotional stress
Dr. Mani, author of the previously linked New York Daily News article, writes a very clear description of the emotional stress that veterinarians encounter on a daily basis. Again, with a clear link to the original article, I can’t say this any better than she did:
Our canine and feline patients typically live anywhere from 12 to 20 years, and we transmute from pediatrician into gerontologist during that time, observing the senescence and death of our one-time pediatric patients. It’s been estimated that we lose five times as many of our patients as physicians do. We are legally authorized to humanely euthanize companion animals for sickness and suffering, but also for human-directed aggression, pet overpopulation and the egregious “convenience euthanasia,” when a healthy pet is euthanized due to personal reasons of the pet owner. Encounters with death are routine in veterinary practice.
Next, Dr. Mani discusses moral distress. This term relates to what happens to an individual who is asked to do something that goes against their personal moral compass and core values. Moral distress has been shown to significantly increase burnout and psychological stress. Dr. Mani says,
Veterinarians dwell in moral distress. We provide subtherapeutic care for pets with wholly treatable diseases. We are requested to perform excessive and clinically unrewarding treatment in the face of a poor prognosis. We have few ethics consultation groups to lean on. We are often asked to perform painful cosmetic and convenience procedures on our patients. We are challenged by individuals who question our Aesculapian authority as veterinarians. We are asked to relinquish, help re-home or euthanize healthy patients. These just encompass a fraction of the ethical dilemmas that induce moral distress in veterinarians.
Dr. Mani is a fellow at Harvard Medical School’s Center for Bioethics and an associate veterinarian at VCA Brookline Animal Hospital.
Lastly, I’d like to discuss one more factor that creates significant burnout in the veterinary profession… cyberbullying. Yes, you read that correctly. Veterinarians, struggling to do everything discussed above, asked on a daily basis to waive fees, end up being blasted online because they didn’t make a client happy. Or perhaps, the end result was not what the client wanted, regardless of whether or not that result was realistic.
When a veterinarian is doing everything possible to maintain their mental health, provide state-of-the-art medical care without spending a nickle more than necessary, paying off veterinary school loans, working long hours, dealing with rising fuel prices… and yet a client complains, and does so publicly… is it any wonder that fewer and fewer people want to sign up for that?
Tell your horse vet that you appreciate them. Pay your bills with a smile. Understand that an incredible amount of time, energy, and sacrifice went into getting that education. Recognize that they are, by no means, “making a killing” on what they are charging you.
I wrote a blog series about my days in veterinary school.
