Dr. Bill Wagner
There are a lot of unhappy veterinarians in clinical practice today. Within my personal and professional circle I see many social media posts celebrating moves out of clinical roles citing general dissatisfaction with the career path that these veterinarians had originally planned on. While clinical practice isn’t for everyone and it is a good thing for those who don’t find happiness in clinical practice to explore other ways to build a career as a veterinarian that they’ll enjoy, this new exodus from clinical practice sounds and feels different. The ground has shifted, and many veterinarians seem unhappy with their jobs despite having a genuine passion for clinical practice. This week we’re taking a dive into trying to understand the root of this widespread dissatisfaction and what needs to be done to address it.
Veterinary clients have changed
The rise of “pet parents”, pet owners who treat their pets as members of the immediate family, has resulted in a cascade of changes in the way veterinary clients expect to get care for their pets and access to their veterinarians. Veterinary clients being more engaged with their pets’ health has many benefits: higher engagement generally results in pursuing more care and better compliance with medical recommendations. However, higher engagement is a double-edged sword. Engaged clients hold their veterinarians to higher standards of relationship-building, trust-building, time, and energy. Simply answering the “what” is not enough for a pet parent, they will also expect the “why” and to be treated as peers in decision making who are coming to veterinarians for expert opinions with which to shape their own decisions, not mandates or orders for what should be done. Managing the modern veterinary client who wants a pediatrician-like relationship with their vet is a more mentally and emotionally draining process for veterinarians, and veterinarians do not benefit from much of the gated access that pediatricians have learned to build around themselves (imagine calling your pediatrician and having a demand to speak to the doctor humored without question).
Rising student loan debt rightfully translates into higher expectations
The cost of entry into the veterinary profession has grown astronomically over the last couple of decades. This hasn’t just led to higher expectations for compensation among veterinarians, but also higher expectations of job satisfaction. Simply put, if a job is less financially rewarding then it needs to be more rewarding in non-financial factors in order to attract talented individuals. Even with associate salaries climbing in recent years, after-debt inflation-adjusted income for the average associate veterinarian is still significantly reduced relative to previous norms before the student debt crisis. It is (at least in this author’s opinion) entirely valid for veterinarians to have higher expectations for job satisfaction after pursuing 8 years of higher education for a career that has become less financially rewarding. With a quarter of a million dollars in student loan debt, it is fair to expect to enjoy your job.
Non-clinical and non-traditional roles are great for those who want them, but aren’t a sustainable answer to widespread GP dissatisfaction
It is this author’s opinion that it should always be celebrated when a veterinarian discovers their personal best expression of their career as a vet, whether that is in a clinical or non-clinical role. However, it is concerning that so many veterinarians are fleeing clinical practice for non-clinical or non-associate roles not because they’re being genuinely called to other work but because they’re unsatisfied with the clinical work that they originally set out to do and are seeing non-clinical/non-traditional roles as an escape. There’s a finite supply of non-clinical and non-traditional roles in veterinary medicine and ultimately most of the available jobs in the profession are clinical. Telling unhappy clinicians to pursue a non-clinical job works as an individual solution but isn’t viable as a profession-wide answer to widespread job dissatisfaction among clinical veterinarians.
Disruption of access to primary care services is an existential threat to the profession
Pet owners expect us to be there. Whether it is addressing illnesses or injuries or providing preventative care, the expectation is that there will be a veterinarian that pet owners can seek out to provide that care. We lose credibility as veterinarians to tell clients not to consult “Dr. Google”, not attempt to treat issues themselves, or fail to comply with preventative care options while also telling them that they’ll have to wait a month or more to get an appointment with their primary care vet. ERs have long been the “exhaust valve” for spillover GP caseload. However, a shortage of access to GP services has used and abused this outlet and has driven many emergency and referral teams to the breaking point, disrupting their ability to serve critical and urgent cases by flooding their waiting rooms with non-urgent cases. Any veterinarian who decides to leave clinical practice or entirely from the profession due to job dissatisfaction is extremely difficult to replace due to the finite educational pipeline. We need to find a way to stop the bleeding of talent lost from clinical practice before the veterinary healthcare access crisis worsens. The only way to do this is to address the reasons why so many vets are unhappy in clinical roles and raise the bar for the quality of GP jobs.
Don’t blame the pandemic
A variety of factors converged during the pandemic which led to a deluge of caseload for most small animal general practices around the country. However, the shortfall of clinical veterinarians predates this wave of increased demand, and the tide of need for clinical veterinarians has been rising for many years now. Even after the “pandemic puppy” craze quiets down, the baseline of need for vets is still going to be set higher than it was pre-pandemic, and all signs point to demand continuing to grow. It would be a mistake for the profession to treat rising demand for veterinary services during the pandemic as a one-off event rather than the tipping point of longstanding trends of increased pet ownership, the evolving role of pets as part of the immediate family, and a new generation of “pet parents” who seek more access to care.
The responsibility falls on employers to make GP jobs desirable
This is the burden of having your name on the door! If the market states that flexible scheduling and 40 hour-max weeks are the prevailing expectation, that’s what you’ll need to provide in order to be competitive in hiring. Associates want to be protected from abusive clients or clients who have poor boundaries about access to their vet? That shouldn’t be a question. Associate compensation needs to be sufficient to reasonably service their student loan debt and support a decent living? Of course. Managers and administrators should be effective and competent leaders who facilitate rather than interfere with the work of the medical team? This is a fair expectation.
The flip side is that employers need to have honest, respectful, and transparent conversations about what the cost is of providing those things. More pay for fewer hours worked means that more revenue needs to be generated per hour by the practice in order to make the math work. That likely means matching prices for services better with their true value, a team effort to improve operational efficiency (including a concerted effort by the employer to provide sufficient and properly trained support staff), and a commitment by the medical team to improve charge capture to ensure that all services that they provide end up on patient invoices.
The primary takeaway is that no employer is entitled to having great employees. Building a great team takes both up-front and ongoing work. If veterinary employers want to ensure that good veterinarians stay in clinical practice, we need to provide them with jobs where they're going to be satisfied and supported. Finding and keeping the right people means listening to their needs and investing in their success. The general sentiment of dissatisfaction among veterinary associates suggests that, collectively, most veterinary employers are still struggling to develop the right work environment that will appeal more to clinically minded veterinarians than the call of relief, non-traditional, and non-clinical roles. For practice owners who are struggling to find and retain the right team to drive your practice to its greatest potential, please reach out to me to find out more about how AVP can help.