Flower Dog

Photo courtesy of Dr. Lisa Tanner

A bouquet of carnations shaped into a dog were given by a client to a veterinary technician working at the Crabapple Animal Hospital in Alpharetta, Georgia. Celebrating gifts from clients is a good way for veterinary professionals to receive pleasure from their work, psychologists say.

Celebrating a successful surgery with colleagues. Savoring a thank you from an appreciative client. Cuddling a kitten.

There are countless ways for veterinarians to derive pleasure from their work. Yet they could be forgiven for often feeling their chosen career is more a miserable ordeal than a satisfying journey.

Headlines abound in journals and newspapers about relatively high rates of suicide and attrition in the profession, pinned on everything from long hours and abusive clients to hefty student debt (particularly in the United States) and compassion fatigue.

Now, a growing body of veterinarians and psychologists is arguing that while recognizing those negatives is important, the literature is too heavy on gloom. Could practitioners' mental health, they ask, benefit from taking a more balanced approach to professional development — one that promotes factors that make veterinary work satisfying and pleasurable?

"When veterinarians burn out and become demotivated, it's not just due to an excess of bad things," said Dr. Martin Cake. "It's related to an absence of good things, too."

Cake is an associate professor in veterinary anatomy at Murdoch University in Perth, Australia. He has led or contributed to numerous papers on workplace psychology and teaches professional skills to veterinary students. The university's approach, he said, is rooted in positive psychology, a concept that started gaining traction among psychologists at the turn of the century and challenged a traditional focus on dysfunction.

Cake is among the first researchers to apply positive psychology specifically to veterinary medicine, alongside like-minded practitioners in the United Kingdom and North America. Among them is Dr. Susan Matthew, professor and associate chair of veterinary medical education at Washington State University in the U.S.

In foundational work, Matthew and Cake, collaborating with Adelaide, Australia-based psychologist Michelle McArthur and Caroline Mansfield at Murdoch University School of Education, coauthored a study published in 2017 that uncovered a wide discrepancy in the scientific literature. After analyzing 59 papers on veterinary mental health published over the previous two decades, they found that problem-oriented terms such as "stress," "suicide" or "depression" appeared about twice as many times as positive terms, such as "well-being" or "resilience." Some papers, they observed, conveyed an almost war-zone setting; one literally compared veterinarians to troops deployed in Iraq.

Building on that research, Matthew has since teamed up with McArthur and another Adelaide-based psychologist, Madeleine Clise, to identify sources of pleasure in veterinary work. Their paper, published last month in the British journal Veterinary Record, found its 273 veterinarian respondents derived pleasure from multiple sources, such as successful treatment outcomes and bonding with clients.

"There's so much to love and find rewarding in veterinary practice," Matthew said. "Yet it can so often get buried in the everyday."

Flow states and messages in medicine bottles

When pressed, veterinarians don't appear to have great difficulty identifying sources of joy. On message boards of the Veterinary Information Network — an online community for the profession and parent of VIN News — a discussion titled "What is the best thing to happen to you today?" started in 2013 remains active, garnering 5,038 responses and counting.

Pleasurable experiences recounted on the thread include celebrating a colleague's birthday with a "squirt gun fight and a Star Trek cake"; a client taking an entire practice's order for Starbucks; and a clinic receiving a surprise $1,000 donation to a rescue fund.

Researchers such as Cake, Clise, Matthew and McArthur are trying to codify such weird and wonderful sources of joy, and work out how they can be systematically recognized, promoted and reinforced.

They agree a good starting point might involve recognizing that well-being drivers exist in two channels: the eudaimonic and the hedonic. Eudaimonic happiness comes from experiences of purpose and meaning, so it often is recognized following thoughtful consideration. Hedonic happiness is achieved from more immediate experiences of pleasure and enjoyment — in other words, stuff that just makes us feel nice.

Of the minority of papers that focus on the positive aspects of veterinary work, most concentrate on the eudaimonic sources of happiness of which Cake advocates. "Happiness and enjoyment in their own right aren't enough," he said. "You need to find a sense of deeper purpose to what you're achieving in life."

Finding meaning, he posits, is especially important for veterinarians because they dedicate so much of their lives to helping others. Regular reminders of their raison d'être can therefore help them weather stress. In a simple exercise he calls "quite powerful," Cake has students write on a slip of paper why they want to be a veterinarian, and put the paper in a medicine container, such as a pill bottle. They students are encouraged to carry the bottle with them and read the message whenever the going gets tough.

Cake also recommends using so-called gratitude apps on smartphones. For instance, one called Three Good Things has users record three positive things that happen to them each day. "You would think that is such a nothing exercise, but it's been shown in multiple studies to have surprisingly good outcomes, basically on par with drugs in terms of mental health," he said.

Again gravitating toward the eudaimonic, Cake reckons that one of the strongest motivations for veterinary work (alongside helping animals) is a desire to solve problems. "[We know] these are intelligent people because of the academic hurdles they cleared to get into the course," he said. "Vets love a challenge." To be sure, he adds that getting the level of challenge right is critical. "Too little challenge is bad and too much challenge is bad. So it's all about finding the sweet spot that matches perfectly with peoples' skills."

Locating that sweet spot can help veterinarians enter "flow states," which Cake said is another classic example of a positive sensation that is not overtly pleasurable. "A flow state is like when you're in the zone, so it's common in sport, but it can be anything that you're intensely focusing on... a long surgery perhaps, or when you're doing consults that are running really well."

It's healthy to feel good

Other researchers say that the hedonic side of happiness shouldn't be overlooked. In that vein, the Adelaide-based psychologists Clise and McArthur have just completed another paper, entitled: "Is veterinary work more than satisfying? A critical review of the literature." In it, they acknowledge that while eudaimonic sources of happiness are important (and often overlap with hedonic sources), the hedonic element in veterinary work is vastly underappreciated and should be researched more extensively.

"Hedonia is often written off as fluffy and unimportant," Clise said. "But there's actually a huge amount of research that's come out since the early 2000s showing how important positive emotions are for long-term well-being."

Specific pleasure-giving experiences for veterinarians could include cherishing positive interactions with clients by recognizing those as wins. When she visits clinics, McArthur, a clinical psychologist, always checks the lunchroom to see if it has a "recognition board" that displays thank-you cards and letters.

"Veterinarians have a profound and positive impact on the community," she said. "But it's just human nature for us to focus on the really challenging client interactions. That's why I think overt recognition is really important, just to remind us of the positive impacts that we're having on peoples' lives."

Celebrating achievements, the psychologists say, could occur during regular team meetings that allow veterinarians to tout their triumphs and those of colleagues. Models of peer support that aim to look after people regardless of their age or experience level also should be encouraged, they said — and on a regular basis, not just when things go wrong. When things do go wrong, such as arguments with clients, McArthur recommends holding "hot debriefs" to support practitioners and staff immediately after those difficult moments, rather than relying on ad-hoc water-cooler conversations for comfort.

Overall, satisfying veterinarians' need for a challenge ranks high among the things that make the profession fulfilling. In a quick poll last week that asked what aspects of veterinary practice they enjoyed most, 2,114 respondents from VIN most frequently selected "patients" (18%), "resolving complex medical or surgical problems" (15%) and "the constant learning and challenges" (13%).

In McArthur's and Clise's research with Matthew, the 273 participants provided up to 10 responses to the prompt: "I derive pleasure in my work as a veterinarian when …" The researchers categorized their answers by theme, and found "professional expertise" referenced most often, at 22%. That theme encompassed responses relating to veterinary know-how, such as "I make a challenging or unusual diagnosis" and scholarship, such as "I am involved in research."

Coming in a close second, at 20%, was the theme of "positive outcomes," which encompassed successful treatments. A further 19% related to pleasure from "job characteristics," predominantly about workload and organizational culture, such as "the workplace is happy." Relationships came next at 16%, followed by recognition at 10%, helping at 7% and personal resources at 3%.

Matthew — who, for her part, takes delight in playing with puppies and kittens and enjoys fostering bonds between humans and their pets— says further work could explore those themes in practice. For instance, she said, the qualitative research in the paper could be used to create quantitative survey items that would scale the extent to which individuals report experiencing particular forms of pleasure. Low scores could be used to identify where more could be done to enhance individual veterinarians' well-being.

"Everything you put into building your well-being is like filling a glass with water," Matthew said. "All the things that sap your energy and joy at work are like draining the glass. Savoring the pleasures that exist in veterinary work can be part of filling your glass and helping to create a buffer against future negative experiences."

Clise, the psychologist, hopes any buzz generated by her and others' research will contribute to changing the tone of conversations about veterinary work."It's nice to give vets some positive publicity about their amazing specialized skill sets. They have to be experts on so many species; they're a specialist, a generalist, a surgeon — they can be so much in one person," she said. "Giving them more credit for the good things they do will only help how they're perceived by clients and could attract more newcomers to the profession."