Burnout is an ongoing concern in the veterinary profession, and can lead to catastrophic consequences. The suicide rate among veterinary professionals is almost double that of dentists, more than twice that of human physicians, and four times the rate of the general population. According to the 2020 Merck Animal Health Veterinarian Wellbeing Study, veterinarians experience a higher burnout rate than physicians, despite working fewer hours, and only one third of veterinarians would recommend their profession to a friend or family member. Over the past year, veterinary professionals have experienced a mix of unprecedented stressors, including job uncertainty, COVID19 pandemic, and increased veterinary demand.
My recent study confirmed that the veterinary industry is beyond burned out. Survey respondents reported being emotionally and physically exhausted at work, lacking enthusiasm, and feeling a sense of dread when thinking about work. While most veterinary professionals report that they find their work meaningful and have generally high job satisfaction, the degree of burnout from work demands is increasingly high. The survey included veterinary professionals of all age groups, and non-veterinarians, including technicians, assistants, managers, and front desk staff.
Unexpected research findings
The survey revealing the high burnout rate among veterinary professionals was no surprise, but some results regarding the age group and staff members most affected by burnout were unexpected.
Younger veterinary professionals are more burned out
Older veterinarians might be expected to become physically and emotionally worn down over time, and to experience more burnout than their younger, more eager colleagues, but the study found the opposite to be true. Survey respondents under 30 years old, who comprised 27% of participants, reported the highest burnout level and the lowest happiness at work. The same age group reported less enthusiasm and more physical exhaustion than their colleagues in other age groups. Why are younger veterinarians, who are expected to be enthusiastic and happy about their jobs, experiencing the highest burnout? Some possible explanations include:
- Impatience — The younger generation is more likely to expect instant gratification, and become burned out when they don’t see instant results and obvious appreciation of their hard work.
- Overachiever mentality — Most veterinarians are overachievers throughout school, and are used to success. When a patient dies, or a client becomes angry, they are not prepared to deal with the perceived failures.
- Frustration — Newer veterinarians have become accustomed to working toward short-term goals, such as finishing college, and then veterinary school. They may feel ill-prepared to plan for the decades-long career ahead, and become frustrated about the lack of clear short-term goals and achievements.
- Work-life balance — Many younger veterinary professionals don’t want to work long hours, and feel guilty about being away from their families.
Possible solutions for younger veterinary professionals to enjoy their career include helping them set short-term goals, recognizing their achievements, and preparing them for possible failures. Veterinary schools can implement mindfulness coaching to give students tools to cope with daily stress.
Veterinary technicians are more burned out than veterinarians
Veterinarians seem to shoulder the most responsibility, and would therefore be expected to suffer the most stress and burnout, but my study found that veterinary technicians reported surprisingly low job satisfaction, compared with veterinarians and management staff. Possible reasons include:
- Long hours — While all veterinary staff work long hours, technicians typically arrive before veterinarians, and stay longer, working 50 to 60 hours per week in some cases.
- Low pay — According to the NAVTA 2016 Demographic Survey, an average veterinary technician salary is $15 to $20 per hour, which is only slightly above the national poverty line, after tax deductions.
- Underappreciation — Pet owners rarely recognize veterinary technicians for their role in helping their pet recover. Veterinarians typically receive their appreciation, which they may not pass down to the entire team.
- Professional ceiling — Veterinary technicians have few higher level jobs to work toward, without further education or changing careers.
- Compassion fatigue — Veterinary technicians often grow weary of dealing with sick and injured patients day after day, and assisting with euthanasias.
Frustration, disillusionment, and burnout lead most veterinary technicians to leave the field after five years, on average.
Help veterinary technicians battle burnout by making them feel valued and appreciated, recognizing their contributions, offering non-monetary incentives, and helping them find ways to evolve in their career paths.
A rigorous workload obviously contributes to burnout, particularly during the pandemic, but most burnout stems from external factors, such as lack of respect and appreciation, that can be resolved by veterinary hospital management. The Maslach Burnout Inventory, which is the most widely used tool to measure burnout in various professions, identifies six easily identified burnout triggers in the veterinary profession:
- Lack of control — A lack of control over hospital policies and procedures, and being expected to follow guidelines without having a say, can cause veterinary professionals to become disillusioned with their job.
- Conflicting values — Performing convenience euthanasias, turning away clients who are unable to pay, and providing less-than-ideal care can lead to burnout.
- Insufficient rewards — Many veterinary professionals, particularly support staff, feel undervalued and under-compensated for their efforts and long hours.
- Work overload — In addition to working too many hours, work that is too complex or urgent in nature can be overwhelming.
- Unfairness — Hospitals often have a favoritism culture, where promotions are based on relationships instead of effort, and clear advancement criteria are lacking.
- Community breakdown — Without clear, regular feedback and established conflict resolution protocols, different personalities are likely to cause conflict that leads to a negative workplace culture.
Using lean thinking management strategies to prevent burnout
Veterinary burnout is a widespread problem, and managers need to go beyond assessing the burnout level, and work toward identifying solutions. While encouraging self-care is helpful, managers must also take responsibility to create an environment where employees don’t burn out. Lean thinking, originally proposed by John Toussaint from Catalysis a nonprofit education institute, has been widely used to successfully reduce burnout among human healthcare workers. With a focus on purpose, processes, and people, lean thinking can also be used to transform veterinary hospitals. Lean thinking applies six main principles:
1. Lean is an attitude of continuous improvement — Managers must always work toward maintaining a positive, healthy work culture. When certain goals have been achieved, the bar should be set higher, to encourage continuous improvement.
2. Lean is value-creating — Lean thinking should ultimately increase value for the patient—processes that are inefficient and do not create value should be revised or eliminated.
3. Lean is unity of purpose — An organization’s purpose should be well-defined, understood, and shared by every team member.
4. Lean is respect for people who do the work — Lean leadership empowers front-line staff members to make decisions, allowing them control in difficult situations.
5. Lean is visual — Visual displays placed in central areas help reinforce core values, application of lean methods, and staff communication.
6. Lean is flexible regimentation — Procedures should be standardized, but protocols should be flexible to allow for improvements that optimize workflow and increase performance.
A lean operating framework entails having clear policies and systems that cultivate a culture of purpose, appreciation, and respect, and ultimately eliminate burnout triggers.
Cutting the problem at its roots by building a system that works against the burnout triggers
The veterinary industry has undergone significant corporatization, with more than 20% of U.S. veterinary hospitals currently part of larger groups, and further consolidation on the horizon. Because of their large size and available resources, veterinary consolidators are in a unique position to significantly impact veterinary burnout industry-wide. By adopting lean thinking principles, implementing specific business methodologies and operating framework, corporate consolidators can shed their “money hungry” image, create a positive work environment, and continuously attract and retain top talent.
Veterinary consolidators can apply the following principles to build a culture of excellence and ultimately a burnout-proof enterprise.
Burnout assessment pre-acquisition. Most consolidators assess a practice purchase from financial and legal standpoints, but understanding the culture, burnout rate, and acceptance of new management practices is as important.
Clarifying core values — Consolidators should ensure a practice’s staff understands and shares the corporation’s mission, vision, and core values.
Carefully handling change management — Different cultures, workflows, and systems are merged when a veterinary consolidator acquires a hospital. If the transition is not managed carefully, frustration and uncertainty can lead to significant staff turnover.
Focusing on wellbeing — Veterinary consolidators must recognize that front-line staff are their most valuable asset, and focus on their wellbeing. A Gallup study found that disengaged employees miss 37% more work and have 18% lower productivity, compared with happy employees. That means an employer receives no return on approximately 34% of an unhappy employee’s salary.
Leading, not managing — Lean thinking can help veterinary consolidators differentiate leadership from management to improve the employee experience and achieve organizational excellence.
Respecting frontline workers — Frontline staff should be empowered to make decisions, which will help them feel in control and valued.
Clarifying protocols — Implementing clear policies, processes, and systems will eliminate burnout triggers, such as frustration and work overload.
Regularly assessing staff wellbeing — Veterinary consolidators should use a wellbeing assessment tool, such as the Professional Fulfillment Index, to regularly measure employee wellbeing and head off early stage burnout.
While veterinary burnout is a significant problem, veterinary consolidators can take advantage of their unique position and lead the charge on creating a respectful, supportive industry that empowers frontline staff. An operating framework, with clear policies, processes, and systems, can be used to make these positive changes in veterinary practices, and ultimately empower the healthcare team to live their passion.