Dr. Christina McRae realized her solo practice had gotten out of hand when the depressed and over-stressed veterinarian found herself contemplating the ease with which she could steer her car off the road while driving one wintry night.
That frightening pull toward oblivion galvanized the small-animal practice owner in Whitby, Ontario. She confided in her husband that night and got help from an understanding doctor and a business consultant.
McRae's long, slow journey toward better balancing her time at work and at home is a story that she willingly shares to help others. It is why her heart ached recently when a colleague on the Veterinary Information Network (VIN), an online community for the profession, expressed feeling overwhelmed by the dual demands of work and motherhood.
"I dwell," the VIN member who posted anonymously explained. "I am constantly thinking about work: the potential for angry clients, did I explain enough for informed consent, did I push those people into euthanasia too soon, did I miss something on the rads, etc? I dread going in to the clinic in case there are messages from previous cases. I cannot sleep well. Some days I have no appetite."
McRae responded with encouragement for the veterinarian and mother of a young son. Her advice: Delegate as much as possible to support staff, from call backs to surgical admissions. And consider getting professional help.
“I felt so sympathetic,” McRae says. “I don’t have children, but I could really identify with the tone in her writing.”
It seems others do as well. VIN, for instance, is teeming with acknowledgments that veterinary medicine can be a demanding and high-stress profession. Many practitioners report being overworked, pulling evening and weekend hours, some in isolated settings. Veterinarians often deal with the pressures of running a small business while handling difficult clients and making life and death decisions. Compassion fatigue and anxiety compounded by high economic indebtedness have been known to bring on depression.
At least 14 studies from around the world have found a higher suicide rate among veterinarians than the public. A study published in Occupational Medicine last June indicated that suicides among veterinarians in the United Kingdom are three times the general population rate.
In countries such as Finland, Belgium and Australia, veterinarians have confided to researchers that they struggle with job strain, stress and burnout. One New Zealand study found that female veterinarians suffered more work-related stress and depression than their male counterparts.
If such results hold across broader populations, it could be a concern as veterinary demographics continue to shift. More women now practice veterinary medicine than men in the United States, and roughly 80 percent of all veterinary students at U.S. programs are female.
Considering that the responsibilities of raising children and family life traditionally fall more to mothers, McRae believes that work-life balances for veterinarians will be more strained as older veterinarians retire and new graduates take their place.
“I think there will be a lot of women who work part time, and there will be a lot of women who will be burned out because they decide to do too much," she says.
Job stress can eat away at both genders and all ages. Dr. G. Robert Weedon, an adjunct professor at the University of North Carolina Wilmington, recalls that in his early years in a rural practice, he could barely sleep during his on-call weekends because he was constantly braced for the phone to ring.
About half the calls that come in to Shawn McVey, owner of Phoenix-based McVey Management Solutions, involve workplace stress. One of his most recent was from a male practice owner who confided that he no longer looked forward to going to work because employee conflicts were sapping his happiness.
“Veterinarians can be in denial for many years,” McVey says. "They’re really not used to asking for help. They’re supposed to be the expert.”
Dr. Micaela Shaughnessy, who works full time and is a divorced mother of two girls, ages 7 and 9, characterizes her job as a veterinarian as "tough."
“I deal with people. I make sure I stay upbeat and happy and encouraging and continue to explain things gently and kindly, and in the back of my mind all I want to do is cheer my daughter on the swim team.”
As a relief veterinarian in Maryland and Virginia, Shaughnessy works lengthy hours when others long to be off: summers, holidays and school breaks. When she can vacation, she pulls her daughters out of school so they can have family time together.
“In my experience as a full-time working mother, there is no such thing as work-life balance,” she says. “I think that’s a misnomer. I think it’s something that sets us up for failure. We work every day, every week, every month to get us closer to the center, but every day one trumps the other.”
Work-life juggling in any field, not just veterinary medicine, tends to be an impetus for burnout, say clinicians and management consultants. It's important for those feeling the strain to recognize it, they say. Warning signs can differ from person to person but often include becoming uncharacteristically emotional, prone to tears or anger and snapping at clients or colleagues.
Many overstressed veterinarians dread work or dwell on the job long after going home, haunted by possible mistakes. Some might turn to alcohol or drugs to depress their feelings.
Veterinarians on VIN say there's a way to mitigate such stresses: delegate, delegate, delegate.
“You really can’t do it all,” says Dr. Michelle Vitulli, whose Caring Hands Animal Hospital in Virginia started with one site and has expanded to four. She says growing her business taught her to let go.
“Going from one practice to two practices was a huge challenge. I didn’t have a lot of procedures in place to handle that 100-percent growth,” she recalls. “That initial expansion … forced me to find what people are good at and delegate more.”
Some tips on delegating include using licensed veterinary technicians to prep animals for surgery, having assistants in exam rooms to update patient records and training office staff to handle a wide range of client interactions such as providing test results, summarizing treatment plans and giving estimates.
When delegation is humming along smoothly, it can be a real eye-opener, Vitulli says: “I just remember going away on vacation, coming back and the revenue was up and everything was going great, and they were having a really strong month. I remember thinking, 'Wow, they really don’t need me.'”
Other suggestions for optimizing time at work include computerizing records, bringing in practice managers who can suggest ways to streamline workload and generate new business, and taking continuing education courses to improve efficiency or business leadership.
Karyn Gavzer, a veterinary practice management consultant in Springboro, Ohio, advises making daily to-do lists that bring with them the satisfaction of crossing off tasks once completed.
Some veterinarians choose to work part-time to hold down their workload, but that can have its own challenges, according to Dr. Suzanne Brown of Houston, another VIN member.
Switching from full time to part time once her twin daughters were born “did take some adjustment,” Brown says, “in terms of learning how to handle my cases and make sure I had everything done either by the end of the day or by the end of my scheduled time to be on.”
Brown chooses to work three days consecutively to greater ensure the continuity of care, as opposed to working every other day.
It also helps, Brown says, that she is able to occasionally make calls from home even though she now has three little girls under 4 years old. “I’ve been pretty happy with the balance I’ve worked out,” she says.
While optimizing the time spent at work can take some of the stress off busy veterinarians, it is only part of the equation in avoiding a downward spiral toward burnout. Experts believe that having a happy, fulfilling life away from the job matters enormously, whether that means exercising more, spending time with friends and family or just savoring small moments.
“Get three daily doses of pleasure,” consultant McVey advises. “Reading, a cup of coffee, a glass of wine, a run, whatever it is.”
The American Veterinary Medical Association, while cautioning that no one formula works for everyone, posts a list of stress busters on its website that includes getting enough sleep, eating a balanced diet, drinking in moderation and playing with pets.
Dr. Lisa Miller, associate dean of academic and student affairs for the Atlantic Veterinary College at the University of Prince Edward Island, says healthy conversations can also work wonders. “I’m a big believer that if you can tell one person your problems, it reduces stress immensely,” she says.
Several veterinarians recommend alleviating stress by focusing on top priorities and learning to let go of the rest.
“The most important thing for me is to keep my boundaries. 'No' is a complete sentence,” says Shaughnessy, the relief veterinarian. “When my work day ends, I am very clear about that with my employers. … Everyone knows that upfront.”