0:06

Hi everyone, I'm Anne Helen Peterson

0:08

and this is Work Appropriate.

0:18

So I just want to make this clear right now

0:21

that I love vets and vet techs

0:24

and everyone who works at veterinarian offices.

0:26

I have had more dog trauma in the last

0:29

decade than most and

0:31

vets and vet techs and vet receptionists

0:33

have made it bearable. But

0:35

over this past decade, I've also come to understand

0:38

how working in vet medicine has become

0:40

incredibly difficult. Some

0:42

of it is just the reality of talking to people

0:44

day in and day out about their precious

0:47

pets when they're suffering. But

0:49

that's just the baseline. It's even harder

0:51

when pet care has become even more expensive

0:54

and pet insurance is essentially a scam

0:57

and so many vet practices have been acquired

0:59

by private equity. It's never been more

1:01

expensive, student loan-wise, to become

1:04

a vet and basically every vet

1:06

clinic is understaffed. It

1:08

is really, really hard to work in veterinary medicine

1:10

right now

1:11

and the suicide rates amongst vets really

1:13

reflect that.

1:15

I've been wanting to write about the vet industry for some

1:17

time now and then I heard about Karen Fine's

1:19

new book, The Other Family Doctor, which

1:22

addresses both the essential role of vets in our

1:24

pets' lives, but also so many

1:26

of the ways that the profession as a whole is

1:28

in crisis. In this episode,

1:30

you'll see that she provides some really lovely

1:33

and empathetic answers to questions from

1:35

listeners who are in the veterinary medicine

1:37

field. But I also want to note that

1:39

we talked, Karen and I, back

1:42

in early May when my beloved tripod

1:44

mutt, Peggy,

1:45

was in the midst of a gastrointestinal

1:47

crisis that would just a few days later lead

1:49

us to make the truly heart-wrenching decision

1:52

to put her down at the age of 8.

1:54

That's part of why we've delayed this episode

1:56

for a few weeks. It was really just too

1:58

much for me to even write about. this intro,

2:01

but I want to say that when I was talking to the

2:03

emergency vet at 1am, making

2:06

that incredibly difficult decision, I held

2:09

Karen's words in my mind and felt nothing

2:12

but deep waves of appreciation for

2:14

the work that this vet was doing,

2:17

soothing both us and our dog

2:19

whose suffering needed to end. I'll

2:22

also say that even though this intro

2:24

is a little bit dog-sad, the

2:26

rest of this episode is not, but

2:28

it will give you a lot more empathy for the people who

2:31

make our pets best lives possible. I'm

2:33

so grateful for it.

2:39

My name is Karen Fine and

2:42

I'm a veterinarian and I just wrote

2:44

a memoir called The Other Family Doctor.

2:47

So tell us about writing The Other

2:50

Family Doctor. So what was your goal for

2:52

writing it? Why did it feel like a book that you had

2:54

to write?

2:55

It felt like a book I had to write

2:57

because I see so many

3:00

people that are so upset when

3:02

their animal dies

3:05

or at the end of their animal's life

3:07

and I think a lot of people feel that they're

3:09

alone in their grief and

3:12

perhaps that it's unusual to have such

3:14

a close relationship with an animal

3:17

and not only have I had those relationships,

3:20

those close relationships myself, I've

3:22

seen them in so many people

3:25

and I wanted to write a book to

3:28

kind of talk about that and it's also

3:30

pretty rare to have a book that talks

3:32

about euthanasia in veterinary

3:35

medicine so a lot of books will sort of touch

3:37

on it and you know the end of an animal's life

3:39

but not really go into detail

3:42

about what it involves

3:44

and how how difficult

3:47

it can be for people and also some

3:49

of the things, some of the narratives

3:51

that people have that I think are not

3:54

helpful. I think a lot of people

3:55

feel very guilty before

3:58

and afterwards. People feel that

3:59

there's this huge choice they have to make and

4:02

they don't feel qualified to make it. So

4:04

even though I'm helping people with that decision,

4:07

I still feel from them and often

4:09

see a lot of this real anxiety

4:12

around the decision, as

4:15

well as the grief that's inherent.

4:17

You're losing this animal

4:19

family member, but it's also around

4:22

this making the decision. And then you're

4:24

also feeling like it's called a

4:26

disenfranchised grief. It's a grief that

4:28

not everybody recognizes. So

4:31

it's hard to say to your workplace, I need

4:34

a day or two off because my animal

4:36

died. I'm having a hard time

4:38

focusing, I'm crying all the time.

4:40

And it's hard. Some

4:43

people have a type of workplace where

4:45

they can say that and many people don't.

4:48

Yeah, I find that actually with stress

4:50

over my dog. I have a

4:53

three-legged dog that was

4:55

in an accident and over

4:57

the course of it was paralyzed and then had to have an amputation.

5:00

And she's great now, this was several

5:02

years ago, but it just created

5:04

a fraught emotional relationship with

5:07

this dog. I feel very, very

5:09

connected to her. And when things

5:11

happen, like right now she's on hunger strike

5:13

because we're away from home. You're like, what's

5:16

gonna happen? Is this happening because I'm not

5:18

there? And it's hard to explain

5:20

to people who don't have that sort of relationship

5:22

with their pets and what it

5:24

feels like, but it's very real. And I

5:27

love that phrase, just disenfranchised

5:29

grief to talk about

5:32

what it feels like when you can't talk about your grief. Very

5:34

much. And I'm fortunate being in the

5:36

veterinary field because I'm surrounded

5:39

by people who do understand. And

5:41

even any people in my life who don't

5:43

feel that way themselves understand that I'm

5:45

a veterinarian. So I get a little bit of leeway.

5:49

But I think a lot of people don't have as

5:51

many people in their life who

5:54

really get it, especially potentially at

5:56

work. And another thing

5:58

you brought up is when you were saying, you know, that your

6:00

dog has three legs, and we call that a tripod,

6:03

P-A-W-D, is that

6:05

when you have a special needs animal, and

6:07

a lot of animals at the end of their lives

6:10

become special needs. So especially with

6:12

some of these older animals that people

6:15

are sleeping downstairs because they can't go

6:17

upstairs anymore, or they're giving them medication

6:19

multiple times a day, they're helping

6:22

them go in and out of the house,

6:25

all these things that we do that sort

6:27

of build up until we may not realize

6:29

how

6:29

much we're doing. And

6:32

that bonds you even more with that animal. You're

6:35

so in tune with them and what their

6:37

needs are. I think you're bonded even

6:39

more than if it's sort of a healthy

6:42

animal that doesn't need as much care

6:44

from you. You

6:46

know, I think that people don't often think

6:49

of veterinary medicine as

6:51

an industry, but it very much is. It

6:53

is an industry that makes money, that

6:56

has industrial changes, that have changed

6:58

the character of the work. And

7:00

so I'd love to hear from you how you've

7:03

seen the industry change over

7:04

the course of your career. Yeah,

7:06

it's very much an industry. And it's

7:08

very interesting too, because there've been so

7:10

many changes since

7:13

I graduated, which was about 30

7:15

years ago. And,

7:18

you know, I'm sort of considered possibly

7:20

old school, and I would say people that are older

7:23

than me say 10 years older,

7:25

that's probably pretty old

7:27

school. And the changes have

7:30

just been phenomenal. So say 40

7:33

years ago, most practices were one

7:35

doctor, maybe two doctor practices.

7:39

And there wasn't nearly

7:41

as many options as there are now

7:43

for care. There weren't as many specialists.

7:46

And when I was first in practice, if I suggested

7:49

a specialist to somebody, a

7:51

lot of times they would look at me like I was

7:53

crazy. You know, you want

7:55

me to take Fluffy to an ophthalmologist,

7:59

a veterinary ophthalmologist.

7:59

and now it's

8:02

rare that people laugh. They

8:04

may or may not go, but most

8:06

of the time they do. And just knowing

8:09

that there are specialists, most

8:11

people are much more knowledgeable

8:13

about that. They're much more savvy and they know

8:15

that there are specialists for different things. I think

8:18

what people don't realize cost-wise is that

8:20

we don't have a lot of control over a lot

8:22

of the costs. The costs keep

8:24

rising from our suppliers and

8:28

also veterinary medicine, it takes

8:29

as long to become a veterinarian as

8:32

it does to become a human physician.

8:35

And veterinarians often have hundreds

8:37

of thousands of dollars in student

8:39

loans with a far

8:42

lower salary than a physician.

8:46

So that's one reason

8:48

why I think many veterinarians are under fairly

8:50

significant financial stress.

8:53

And then we'll hear people complaining

8:55

about prices and saying, well,

8:57

you people are, you should be doing

8:59

this

8:59

for free if you care about animals, which

9:02

pretty much every veterinarian and staff member

9:04

has heard. So we're going to talk

9:06

a lot about mental health in

9:08

the veterinary medicine field, but before we do that,

9:10

I kind of want to just

9:12

think about some of these structural challenges that

9:14

I think a lot of people aren't aware

9:16

of. So what are some of

9:19

the trends, business or otherwise that

9:21

are really challenging right now in

9:23

particularly the American understanding of how veterinary

9:26

medicine works? Yeah. So it used to

9:28

be you'd have a one or maybe

9:30

a two doctor practice that would be sort of local

9:33

in your town. And if there

9:36

weren't really a lot of specialists and it was sort

9:38

of, if you could do it, you did it.

9:41

And a lot of

9:42

those veterinarians were really good at a

9:45

broken leg, fixing a fracture, that

9:47

kind of a thing, but something more

9:49

complicated medically or diagnostically

9:53

were much more difficult to

9:55

treat. And then what happened

9:57

is we had corporations coming in. and

10:00

starting to buy up these large practices,

10:02

partly because veterinarians coming

10:05

out of school can't afford to

10:08

purchase these larger

10:10

clinics. I think it was easier when it was

10:12

a one-doctor practice for someone to

10:14

say, okay, I'm going to take out a bank

10:16

loan. Having a practice is

10:18

incredibly expensive because we have

10:21

the same surgical equipment for

10:23

human hospitals. So opening

10:26

a practice is not just like putting your name

10:28

on a shingle and opening your

10:29

door and having a table and a stethoscope,

10:32

it's far more involved.

10:35

So for someone to come out of school

10:38

with heavy student loan debt, and

10:40

then to think about purchasing a practice

10:42

with all of these things going into it,

10:45

you're talking about an enormous, someone

10:48

would have to have a huge deep

10:50

pockets to do that, and a lot of veterinarians

10:53

don't. I mean, that's one thing I think most people

10:55

don't think of at all, is that if you start a

10:58

veterinary practice, you are also starting a small

10:59

business. And so like you said,

11:02

you have to have an enormous amount of capital either through

11:04

a loan or through private funds, which

11:07

not most people, if they come from normal

11:10

means, don't have that. So there

11:12

are other businesses that are taking

11:15

advantage of this

11:16

situation. We're going to get more into this. So

11:19

I think this is a perfect segue into a

11:21

question about one of these business trends.

11:23

It's from Christie.

11:25

I am a mid-level manager at a private

11:27

equity-backed veterinary consolidator.

11:30

Consolidation of privately owned vet practices

11:33

is a rapidly increasing, and in

11:35

my opinion, scary trend. I

11:37

stayed this job because of the great pay and schedule,

11:40

and because I know that my team and I genuinely

11:42

work every day to advocate for higher pay

11:45

and better working conditions for the people in

11:47

our practices.

11:48

Is consolidation in the vet med industry a

11:50

foregone conclusion we should accept and

11:52

lean into how to make it better? Or

11:54

am I totally kidding myself that fighting from

11:57

the inside will make any difference at all? Why

11:59

aren't you? unions more popular in Vet Med. So

12:02

can you explain this consolidation thing for people

12:04

who aren't in this world? How does this work?

12:07

I think what they mean by consolidation is private

12:10

entities, these corporations buying

12:12

up clinics. I don't think there's a whole lot

12:14

of consolidating like two clinics

12:17

into one clinic. So

12:19

it's more that

12:21

the clinics are owned by these corporate

12:24

entities who can,

12:26

they'll set the prices. They can

12:29

set the salaries, raises,

12:32

those

12:32

types of things. But

12:34

I think from the perspective of the industry,

12:37

it's become very, very challenging.

12:40

And especially with COVID, it was sort

12:42

of a trifecta just to kind of get into

12:44

COVID because that's been also a huge

12:46

shift in the industry. Many more

12:49

people got puppies. Many people

12:51

left the industry or were unable,

12:54

they were either sick or home taking care of kids

12:57

and people were curbside,

12:59

which took a lot longer. So when

13:01

we weren't letting clients into the building.

13:04

So that's sort of a history of veterinary medicine. You've

13:06

got these small clinics and now you're getting

13:09

bigger clinics. And it

13:11

would be great if there were unions, but I think when

13:13

you have these really small businesses, that's

13:15

not really something that you

13:17

picture unions. Maybe

13:20

that could be the future of veterinary medicine. It

13:22

would be great. I

13:24

am an optimist and I do think advocating

13:27

from the inside and this writer

13:29

sounds lovely. I love the

13:31

way that there's working

13:33

with others to advocate for higher pay

13:36

and better working conditions. I

13:38

would sure much rather have somebody with that

13:40

attitude working in that field

13:42

than someone who says, well, why should I care?

13:45

Or thinks we make a lot of money or

13:48

something like that.

13:49

Do you think that this sort of ownership

13:51

consolidation. So companies buying

13:54

up various practices in various towns.

13:56

So like you said, it's not necessarily like the practices

13:59

themselves are joint.

13:59

it's that the owners are owning

14:02

more veterinary practices. Do you think

14:04

that this is kind of inevitable? Like this is

14:06

the way things are going to go unless there's a huge

14:08

shift in the way that we train

14:11

and fund and think about

14:13

debt for veterinarians? I

14:16

do. I guess I can't see it going

14:18

any other way. I think there

14:21

are still some small one

14:23

to two doctor practices, but more

14:26

and more of them are these larger practices.

14:29

They're pros and cons, but

14:33

I think having being able to be open more

14:35

hours and then if that one veterinarian

14:37

gets sick or takes a day off, you

14:39

have somebody to cover. If you're

14:42

a one doctor practice, then

14:43

you're closing. If

14:45

you want to go to your kid's

14:48

concert or whatever

14:50

it is or you're sick, it's

14:52

very difficult. It does

14:55

give people more wiggle room

14:57

when there are more doctors. Also, you can bounce

14:59

things off different people and different

15:02

practitioners have different skill sets. Somebody

15:04

may be really good, say with ophthalmology

15:07

and someone else may be really good at surgery.

15:09

I think it's a good model to have

15:11

multiple doctors, but it's just unfortunate

15:13

that it sort of prices out

15:15

many veterinarians. Not to

15:17

say too, I never wanted

15:20

to own my own clinic just because of the

15:23

huge overhead and responsibility,

15:25

I would say. Financially, it was out of

15:27

reach, but it also felt

15:30

overwhelming to me responsibility wise.

15:32

Yeah. As far as any sort of advice

15:34

that we can give this question asked her, Christy,

15:37

I wonder the

15:39

company that owns

15:41

the practice would also presumably

15:44

be in charge of benefits and that sort of thing. I

15:46

know that

15:48

therapy is something, just having

15:50

a therapist, having someone that vets

15:52

can talk to, that that's something that you've talked about

15:54

a lot in terms of just being

15:56

really conscious of mental health when

15:58

it comes to vets.

15:59

Maybe it would be even something like advocating

16:02

for affordable access

16:04

to mental health care for all

16:07

employees. Yes. I'm really glad you brought that

16:09

up, because there is a fairly new field

16:11

called veterinary social work. And

16:14

a lot of the big hospitals, like

16:17

at the veterinary schools or Angel

16:19

Memorial in Boston, have

16:21

veterinary social workers on staff.

16:24

But other than that, they're not really

16:27

out in the veterinary world. And I think

16:29

it would be a great model if

16:31

some of these consolidators or big

16:34

corporations

16:34

employed veterinary social

16:37

workers. And maybe they would go and spend

16:39

each day at a different practice. So

16:41

then if there was a social worker

16:43

at your practice one day a week to

16:46

talk to the doctors and the staff,

16:49

also to talk to some of the clients

16:51

who are really struggling with

16:54

decisions or with loss or

16:56

whatever. And then also the veterinarians

16:59

and the staff. We go through really

17:01

difficult situations very

17:04

regularly. So that would totally

17:06

be on my wish list for the veterinary

17:09

corporations to do. Because

17:12

I've thought of that before as a model. And you don't know

17:15

who would pay for it. Would it be

17:17

people's private insurance? And then that would

17:19

be difficult. It would be clients. It would be staff.

17:22

But if you had it paid for by

17:24

the corporation, then one

17:27

veterinary social worker could do five practices

17:30

if they were one day at each.

17:32

Yeah. I mean, it strikes me as good

17:34

business sense too, just because you have

17:37

someone who is providing an outlet

17:40

for the

17:41

people within the profession who need someone

17:43

to talk to and to kind of outsource some

17:45

of those emotions. But then it also is providing

17:48

someone who is incredibly skilled at

17:50

those sort of soft skills of dealing with patients

17:52

and patients' owners that makes

17:55

it just all around a better experience,

17:57

a more sustainable experience. So that's a thing.

17:59

I think that's our great specific

18:02

advice is start talking

18:05

about veterinary social workers and how

18:07

that could maybe work within the larger scenario

18:10

of a private equity backed veterinary consolidator.

18:13

I would love to see that.

18:25

Our next question is from someone who has been in the

18:27

business almost as long as you have but

18:30

is making a change. This is from

18:32

Lowell and Matt, Crookets VP of

18:34

production

18:34

is going to read it for us. I've been

18:36

in the veterinary field for almost 20 years and

18:38

I'm getting ready to go back to school for a tech

18:40

career. I make decent pay but I live in

18:42

the Bay Area and everything is very expensive.

18:45

About half of my tech classmates are still in the

18:48

field and the rest either went into vet school

18:50

or left the field entirely. Why is my

18:52

field struggling so much to keep long term

18:54

nurses and will it get better or should

18:56

I warn the younger nurses to get out while they can?

18:59

All right, so first, Karen, can you give us

19:01

some insight into the different roles? What

19:04

is the difference between a tech and a nurse

19:06

and what's the schooling like, that sort of thing?

19:09

Tech and a nurse would be the

19:11

same thing. Some people want

19:13

to call them nurses and

19:15

some people say technicians. Historically

19:18

in the field, we've always said technicians

19:21

but also historically, techs

19:23

have been trained. They may have been

19:25

high school students that were trained

19:27

by the local doctor

19:30

and had not had any

19:32

specific education in the veterinary tech

19:34

field. That has changed dramatically

19:37

over the last, say, 10 to 20

19:39

years that now there are technician

19:41

programs where people go to school

19:44

and they really have many, many skills

19:46

that are learned in school, not sort of learned

19:49

on the job according to that one person's

19:52

training them on the job. That's

19:54

kind of the history of it and that may be

19:57

why there is this history. Well,

19:59

there's a history of...

19:59

bad pay, veterinarians don't make much, technicians

20:02

aren't going to make as much as veterinarians. Which

20:05

is a shame because you have people that are

20:07

very knowledgeable and very

20:10

dedicated and it's a

20:12

poor paying field in

20:14

general. So I'm impressed that the person

20:17

says they make decent pay. But

20:20

I can understand it's a challenging

20:22

field and I think many people can make

20:24

more money or less

20:27

hassle if you will or less

20:29

maybe emotional stress

20:32

in different fields. And

20:35

again I'm an optimist and I also

20:37

there's a shortage of veterinarians. So

20:39

I would say looking ahead

20:42

there's a lot of talk in the field about how

20:45

we don't utilize technicians

20:48

as well as we should. So when I for

20:50

instance what that means is if I look at say

20:53

my afternoon in practice how many things

20:55

am I doing that I

20:57

need my doctor skills

21:00

to do versus how many

21:02

things am I doing that I don't. So if I'm

21:04

inputting charges into the computer well

21:06

someone else could do that. And

21:08

technicians have these higher skills like they

21:10

can be drawing blood from an animal, doing

21:13

all the treatments to the animal. Sometimes

21:15

I'm drawing blood, well that's time

21:17

that I could be spending doing

21:20

more doctor things whether that's

21:22

talking to clients writing in the record stuff

21:24

like that or doing procedures that are

21:26

more like you need a doctor to do them

21:29

say aspirating a lump or

21:31

something else like that. So

21:34

there are definitely people saying you know

21:36

we need to use technicians more

21:38

widely especially because

21:40

there's a veterinarian shortage.

21:43

So I'm hoping that that will become the

21:45

case and technicians will for

21:47

instance putting in an intravenous catheter

21:50

I learned how to do that in school and when I was

21:52

a new vet I was the one responsible

21:54

for doing that and now it's just assumed that

21:56

the technicians are going to do that just

21:59

sort of like in human

24:00

Your book, The Other Family Doctor, has a whole chapter

24:02

that's just about veterinarians in crisis.

24:05

And you write that, quote, veterinarians are

24:07

so involved in helping others with their narratives that

24:09

they often neglect their own. And the

24:11

failure to separate from the stories of clients and

24:13

patients can lead to burnout and compassion fatigue.

24:17

This is a version of a story that I've heard for

24:19

so many people in helping professions, you

24:21

know, whether they're teachers or social workers.

24:24

Like, it's just, it's a real problem.

24:26

And I wonder if you can

24:29

talk a little bit more about how you've recognized

24:31

this in your own practice. I

24:33

know that you have a policy that you

24:35

will be the vet for your friend's pets, but

24:38

only to a point. Can you talk about that?

24:40

It's something that I kind of struggled with

24:42

for a long time without realizing

24:45

it in terms of the difficulties of

24:47

the profession. And euthanizing

24:50

an animal, a lot of people think, oh, okay,

24:52

euthanasia must be the hardest thing you do.

24:55

And at first it was, you

24:57

know, just the giving of the injection

24:59

that was a little overwhelming to

25:01

me. And then now, you know,

25:03

usually I feel that, you know, the animal

25:05

is suffering. I'm doing a kindness

25:08

to that animal, but it's a

25:10

huge, you know, it can be the worst day of

25:12

that person's life. And that person's

25:14

in the room with me. So I'm very conscious

25:17

of facilitating this event to

25:19

be as good as possible for the

25:21

animal. And for the person

25:24

or people, oftentimes there's multiple people

25:26

in the room with me. And

25:29

that's challenging. And

25:31

sometimes it goes, you know, mostly

25:34

it goes well. Sometimes it doesn't go as

25:36

well as I'd hoped. There's a lot of things that

25:38

are not in your control. So

25:41

I realized a long time ago that it was hard

25:43

for me to euthanize my friends and

25:45

families animals. If I've been

25:47

to a home socially and, you know,

25:50

eaten dinner there and, you know, it's

25:52

people I know really well to facilitate

25:54

that moment on one of the hardest days

25:56

of their lives. And I can

25:57

understand why they would want it to be.

25:59

me doing it. But the thought of

26:02

me, you know, doing that for

26:04

all of my friends and family

26:07

is something that felt overwhelming

26:09

to me when I thought about it sort of, you

26:12

know, in advance going down the road. So

26:14

I told people and friends

26:17

and family have been very respectful of that.

26:19

Certainly in an emergency I would, but

26:21

that's something that's been difficult

26:24

for me. And then I think just

26:26

the difficulties of the profession, I

26:28

feel like in vet school, we were really trained

26:30

to be very stoic. And

26:32

there was no discussion

26:35

of emotions or ethics

26:38

and our feelings. There was none of that.

26:40

It was sort of, and I talk about it in the book, that we

26:42

had to do non-survival surgical

26:44

labs where for each student a dog

26:47

died that we did surgery on

26:49

and then they were euthanized. And

26:51

there were no discussions of

26:53

how we should feel about this. And

26:56

if we didn't, you know, if we struggled with

26:59

this, there was no place to kind of

27:01

go with that. So I feel like that really trained

27:03

me to be very stoic. And

27:06

I didn't really think about myself

27:08

in terms of feeling some

27:10

of the difficulties until I heard

27:12

that there was a high suicide rate in

27:14

the veterinary profession. And then

27:17

it really made me stop and think. And I have

27:19

not been suicidal, but I think

27:21

every veterinarian knows people or

27:24

knows of people who have died by

27:26

suicide in the profession.

27:28

But it also made me hearing about this

27:30

high rate, made me think, well, there's

27:32

a lot to struggle about. And I'm not the

27:35

only one who's sort of tamping these feelings

27:37

down and ignoring them

27:40

and just saying, oh, yeah, well, I'm tough. I

27:42

can deal with this. And I think

27:44

from my perspective, and I wrote about this in the book,

27:47

there's not there's not really a place

27:49

for us to reflect on these things

27:51

and talk about it if we have a difficult

27:55

case or a case that maybe

27:57

didn't go the way we wanted to or did. difficult

28:00

conversation with someone. Sometimes

28:02

I've just felt really enmeshed with certain

28:05

situations and people and

28:07

animals, and I had a hard time kind of separating

28:09

myself from them. And

28:11

I think probably every veterinarian

28:14

would say there's times where they wake up at three

28:16

in the morning and they're thinking, should I have done this,

28:18

should I have done that, that kind of a thing. But nobody

28:20

talks about that. And in the profession,

28:23

it's more been focus on

28:25

wellness. So, you know, well, we

28:28

all need to make sure we're eating right and sleeping

28:30

right and exercising. And I

28:32

think that that's good, but that really ignores

28:35

the whole fact that this is a really

28:37

challenging profession and these are hard things that

28:39

we do and we need to recognize that. And

28:42

then there's also the concern that that

28:44

can be blaming the practitioner.

28:47

So if you are struggling and then it comes

28:49

like, well, are you eating right and sleeping right and exercising,

28:52

well, who is doing all those

28:54

things optimally and odds are if

28:56

you're depressed, you probably aren't. So

28:58

then you don't wanna feel,

28:59

you know, you wouldn't want someone to then feel that,

29:02

you know, oh, okay, well, it's my fault. You

29:04

know, if only I could be exercising

29:06

more then I wouldn't be having these struggles.

29:09

I think that's not helpful. Yeah,

29:11

I love that you brought up the stoicism

29:14

that's really like ingrained

29:15

in veterinary students.

29:18

And I think that that's one of those things that if

29:20

you wanna deal with this problem, you

29:22

have to go back to the root causes, which is

29:25

oftentimes in the training, in

29:27

the attitudes that we say are ideal

29:30

when dealing with problems in these sorts

29:32

of situations.

29:33

Instead of saying like, oh, you have this problem,

29:35

maybe you should meditate, right? Like you

29:37

said, that is ascribing the

29:39

failure to deal with this problem.

29:42

That is basically like you said, blaming the

29:44

person for not being good enough at

29:47

dealing with their own problems instead of saying,

29:49

oh, look, maybe we created an entire

29:51

scenario where like, this is very

29:54

common for people to feel like they're struggling and

29:56

like that it's somehow not okay to

29:58

reach out. So my question is, If you

30:00

have a colleague who comes to you

30:02

and is struggling, you know, there's a lot of

30:04

really great resources in your book, but

30:06

what would you tell them? Is there a

30:09

hotline? Like, is there a really great

30:11

book? Like, what sort of advice would

30:13

you have if they were really struggling with their mental health

30:15

within the field? Well, I would definitely tell

30:18

them to talk to a therapist. And

30:20

I've talked to therapists, you know, many

30:22

times over the years, and I think therapy is really

30:24

valuable to getting to the

30:26

root causes of certain things.

30:29

And there are some really good, also,

30:31

resources in the veterinary community.

30:34

There is something called Not One More Vet,

30:36

which is basically, we want not one more

30:39

veterinarian lost to suicide. And

30:41

there's also something called Vets for Vets,

30:44

which is a program to help veterinarians

30:46

with situations like this. And

30:49

I think they even have like small groups to

30:51

talk about things. So there are a lot

30:53

of resources now in

30:55

the profession, which is really good. And

30:57

that was not the case 10 or 15 years ago. There

31:02

were not really those resources.

31:03

Yeah.

31:13

So our last question comes from Maggie, and it's

31:15

such an important one. I'm so glad that this person wrote

31:17

in. My sister is a veterinarian

31:20

and often talks about the mental health crisis in

31:22

her field. She has a single parents during the

31:24

week while my brother-in-law travels for work. In

31:27

her social media, she presents a happy life. While

31:30

I know she loves much of her life, I know she's

31:32

exhausted too. How should people

31:34

outside the field support and recognize possible

31:36

signs of suicidal ideation and depression,

31:39

especially since the veterinary world

31:42

is so dominated by women who face additional

31:44

pressures to be and present as perfect

31:46

parents, in addition to the extreme

31:48

emotional demands of veterinary work?

31:52

All right, so I want to address this in tears.

31:54

So if you have a family

31:57

member or a close friend in veterinary.

31:59

medicine.

32:01

How can people listening

32:03

right now, how can they support them?

32:05

Yeah, what a great question. So yeah,

32:08

I've already talked about some of the

32:10

wellness and why this is such

32:12

hard work. And to some extent

32:14

too, there's a history, this

32:17

has been talked about in the profession too, that

32:20

the profession has a lot of perfectionists.

32:22

Perfectionism is a problem with veterinarians

32:25

and we sort of have high achievers that

32:27

are, you know, we're not always good at saying no.

32:30

You know, if the receptionist says so-and-so

32:32

is on the phone and fluffy's really sick

32:35

and you know, what can we do? It's

32:37

hard for me to say no. And I think it's hard

32:39

for a lot of people to say no. And part of it is

32:42

because you want to take the best care of that

32:44

animal, even though your schedule is full and

32:46

you might be better off saying, you know, well, they need to go to urgent

32:48

care. And part of it is

32:50

you really want to help that animal. Maybe you know that animal

32:53

and their client. And maybe

32:55

part of it is that it's just hard to say no in

32:57

general. And I think that's definitely the

32:59

case for me. And I felt

33:02

for a long time, I thought I have a great

33:04

life, you know, and I do and I did,

33:07

but it was also very challenging.

33:09

And I think how to support somebody

33:12

specifically might be saying, you know, it's

33:14

okay to talk about stuff with me. I think

33:17

to some extent when people say, your

33:20

job must be so hard, I don't know

33:22

how you do it. That can

33:24

feel very isolating. And that's

33:27

something I've been thinking more about.

33:30

And I kind of wrote that, you know, in

33:32

the in the book, that's something we often hear all

33:34

the time. And it's it's a very isolating

33:36

feeling. You know, I, I always wanted to be

33:38

a veterinarian, but I knew I could never euthanize

33:41

animals. We've all heard

33:43

that countless times. And

33:45

it just makes you feel separate from other people.

33:48

So I would not say something

33:50

like that. But to say something like,

33:52

you know, I'm here, if you want to

33:54

talk, have you had any hard cases this

33:56

week? What's that like? Maybe

33:59

being able to be the there for that person

34:01

to open up with and just vent to

34:03

some extent about a difficult client or

34:05

a difficult case or even

34:07

a difficult co-worker whatever it is you know

34:09

I mean we're not immune to those stresses

34:12

as well so I think that could be helpful

34:15

and then maybe other single parent

34:17

stresses as well like you know you're also

34:19

thinking what's for dinner you know you're trying

34:21

to think through a difficult case

34:23

you've got phone calls to make how are you gonna

34:25

pick up your kids it's a very

34:28

challenging time situation

34:29

I think it potentially can

34:32

be where you're trying to get all your

34:34

stuff done by a certain time

34:36

frame if you have to pick up children and

34:38

different every workplace has its own culture

34:40

so I hope Maggie's sister is at

34:42

a place where the culture is that it's

34:45

okay for her to leave and that she doesn't

34:47

feel like she's you know

34:49

leaving stuff undone at the end of the day

34:52

and that you know it's it's it's a

34:54

hard situation so I think

34:56

just probably being there as a support

34:59

would

34:59

be the main thing and then listening I think

35:02

for any you know I'm not an expert on

35:05

suicide prevention but any things

35:07

that would be worrisome just

35:10

asking if if she needs any help

35:12

or sometimes you know a lot of people and I think veterinarians

35:15

too you know if someone says do you need help

35:18

people are gonna say no no I'm fine but if someone says

35:20

hey I'm cooking dinner and I make it a whole

35:23

ton can I come by with

35:25

food you know that

35:27

is a lot easier to say yes to than

35:29

someone saying you know I'm here if you need me

35:32

then that's you know then it's that's

35:34

a little bit harder to to reach out

35:36

absolutely what about people who

35:40

have pets and interact with vets in

35:42

any sort of business relationship

35:44

like basically anyone who has a pet

35:47

what are things that people can do

35:50

to make people who work in the

35:52

vet's office easier

35:55

one thing I said in the book was if you're

35:57

buying heartworm and flea and tick

35:59

preventative to buy it from your local

36:01

veterinarian because those things

36:03

can be pricey and a lot of people buy them

36:05

from online companies and that way

36:08

the money does not stay in your community. And

36:11

even if your vet clinic is owned by

36:13

a corporation, that

36:16

money is still going to come in as, oh, that

36:18

money was earned by this clinic. They may be able

36:20

to hire another receptionist, so your hold times

36:22

aren't as long. They may be able

36:25

to hire another technician so that they're able

36:27

to get through more appointments and

36:29

things

36:29

like that, they may be able to buy more equipment

36:32

so that you won't have to go to a specialist. You

36:34

can get some tests done in

36:36

house. So those things

36:38

really affect

36:40

the local clinics.

36:42

So I would encourage people to think about

36:44

buying their, you know, if they're

36:46

buying medication, whether it's, you

36:48

know, over the counter stuff, try and purchase it through

36:51

your veterinarian. I think that's a helpful thing to

36:53

keep your money and your support. That is such a good point

36:56

and a very actionable thing. I

36:58

think to understand that

37:01

everyone at the clinic a lot of times is

37:03

in a stressful, potentially a stressful

37:06

situation. So if they call

37:08

and then, you know, they think, well, the receptionist seems

37:10

short with me. Well, maybe they just got done

37:13

checking somebody out for

37:15

a euthanasia and it'd be someone

37:17

they'd known for 10 years and with an animal

37:20

and they're just, you know, struggling to maintain their

37:22

composure after that. You just, you

37:24

just don't know, you know, we see everything

37:27

a huge spectrum on a daily

37:29

basis. And I think when people are calling and

37:31

they're worried about their animal, that's all that's on their

37:33

mind is their animal, which is understandable.

37:36

But I think trying to understand that many

37:38

times in the vet clinic, we're all being

37:40

pulled in many different directions. And

37:42

that also because of the veterinarian

37:45

shortage, the huge amount of people

37:47

that got pets during the pandemic, it

37:49

is now more common for veterinarians to

37:51

say, we're already double booked for

37:54

the rest of the afternoon. And,

37:56

you know, and then you may have a doctor who has to leave at

37:58

a certain time to go get their

37:59

children. And then

38:02

to say, you know, we have to send you to urgent

38:04

care. And people don't want to hear that

38:06

they don't want to go to another facility where

38:08

they don't know the doctor, they may have to drive further,

38:11

they may have to pay more money. But that's

38:13

going to be more and more common, just

38:15

like in human medicine, because

38:18

we can only do so much.

38:20

Yeah, I think just having that empathy and that understanding

38:23

that the people that you're dealing with are people, and

38:25

they are deserving of our respect.

38:28

And even though we

38:29

ourselves might be going through moments

38:31

of crisis or anxiety, that we

38:33

owe others our respect as well. I think that's really

38:35

important. Karen, I'm just so

38:38

grateful that you came on the show today and really

38:40

elucidated this world for us and gave

38:43

us a lot of amazing advice. So where

38:45

can people find you if they want to hear more from you? Thank

38:48

you so much for having me. This was great.

38:50

And I really appreciate being on the show. You

38:52

can find me at Karen fine dvm.com.

38:56

Thanks for listening to work appropriate. If you've

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40:01

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