It’s Never Been a Better Time to Be a Vet… So Why Is There a Shortage?

Summary:

• The veterinary shortage has put a huge amount of pressure on professionals.

• In the long term, changes in pay, work-life balance, and client expectations have driven dissatisfaction.

• In the short term, the pandemic has increased practice inefficiency, and therefore backlogs, exacerbating shortages.

• This cumulatively has resulted in deep dissatisfaction and burnout among vets.

• To aid the problem, better management of expectations (for clients, employees, and employers), a movement towards specialization, and better training could help.

On the front lines of veterinary medicine, a crisis is in full swing.

Widespread shortages of clinical staff are being reported all across the world. In the UK, new graduates are being (somewhat hysterically) dubbed as ‘lambs to the slaughter’ as veterinary practices struggle to recruit and retain staff [1]. In the US, veterinarians are calling the crisis ‘acute and growing’, with many demanding urgent actions [2]. While down under in Australia, reports of a ‘dangerous environment for both animals and practitioners’ have been published in a number of outlets [3].

But why is this happening? On a surface level, vets have never had it better. Statistically, they’re working fewer hours than ever before. Yet, there is clearly a problem that needs to be fixed fast.

In this article, we explore the fundamental causes of the veterinary shortage, looking at what needs to be done to ensure that the profession has a sustainable future.

What Are Some of the Drivers of the Veterinary Shortage?

To really understand what the underlying drivers are, you have to look at the data. In terms of the average veterinary workweek, vets have never had it so good. Examining data from the Royal College of Veterinary Surgeons (RCVS), there has been a steady decline in work hours since 1998.

Sources:[4][5][6][7]

Two decades ago, the average UK vet worked about 48 hours a week (on average). But in recent years, this has fallen to just over 40 hours. Although this excludes out-of-hours care, much of this labor is now outsourced, meaning vets do much less of this [8].

Although this data is from the UK, similar trends can be observed elsewhere. In the US, for example, in 2006 the average vet worked around 47 hours a week, but more recent reports suggest that many now work 40-hour weeks (again excluding out-of-hour work) [9][10][11].

But Has This Had a Positive Impact on Work-Life Balance?

Despite the changes in working hours, there has been a sizable increase in dissatisfaction regarding work-life balance. According to the RCVS, in 2019, 57.2% of vets wanted a better work-life balance. This is comparable to 2006 when only 37% of vets felt the same.

Sources:[12][13][14][15]

So what’s going on? Much of this can likely be attributed to cultural changes. As Dr. Gary Marshall, DVM and owner of Island Cats Veterinary Practice puts it:

‘30 years ago, the typical plan was to get into a practice that you could see yourself owning, or move to a position where you could start your own. Today, there are so many other options, and with the complexities involved in owning and running a practice, the traditional path is less desirable.’

‘That doesn’t mean that younger vets don’t have awesome goals that they are working toward. I just think they are divided. They want to spend less time as practitioners so they can be coaches, teachers, podcasters, sales reps, awesome parents, and so much more.’

‘This is not necessarily bad, it’s just different. After all, I practice differently than I did 30 years ago.’

It’s hard not to conclude that the issue either lies elsewhere or is more so related to a perception of what is acceptable rather than the reality when you compare the improvements made in this area.

Wage Dissatisfaction

There has also been growing unhappiness towards the financial rewards vets reap in return for their effort. According to Dr. Karen Felsted, the founder, and president of PantheraT consulting, money (or perceived lack of it) is a significant cause of dissatisfaction:

‘If you’re a practice that has been scraping along with paying [an] average [salary], with the large signing bonuses being thrown around nowadays- this will no longer suffice’.

This is evident in the research. According to the RCVS, dissatisfaction with pay has generally increased since 2006.

Sources:[16][17][18][19]

This is, at least in part, fueled by the increase in veterinary education costs that have impacted so many countries across the world.

In any event, with a shortage of staff and an abundance of positions vacant, it seems likely that wages are on the up. Although, naturally, there will be a point where a ceiling will be reached. Despite some of the rather inflammatory and vitriolic points expressed on social media, there is an inescapable truth. Vets are only as valuable as the skills they bring to the party. If there are to be pay raises, this will only be possible or sustainable if there are equivalent raises in production and efficiency.

Everyone in veterinary medicine would do well to remember that we are a largely self-funded care model without the widespread underpinning of insurance that funds the larger rewards enjoyed by lawyers or doctors. Comparison is thus likely to be unhelpful and fuel professional resentment/dissatisfaction. There’s also the small matter that for many families, veterinary care is already beyond them. Leaving ethical questions about how we reach the have-nots as well as the haves. All of which is not to say vets do not deserve a fair salary, they absolutely do. But there are going to have to be some reality checks- ones perhaps best installed further upstream when prospective vets are doing their due diligence on this as a career choice! The easy solution and the lowest hanging fruit is to pay doctors based on production, in doing so reward is inherently linked to tangible value. But rewarding based solely on financial performance is not without risk and requires balance. More on that to come.

Client Expectations

One of the most common complaints you will hear these days will revolve around clients. Although many veterinary professionals join this industry for the animals, ultimately, they stay (or leave!) because of the people. After all, client interaction is a major part of practice life. But there has been a change over the last two decades which is evident in the data:

Source:[20][21][22][23]

It’s striking that between 2010 and 2014 we jumped from less than 20% of vets struggling with clients to more than half! With such struggles widely and enthusiastically ‘discussed’ online.

But is this an example of the pet-owning public en-masse metamorphosing into surly curmudgeons? It’s easy to paint it as such, but there is another possibility. One far less palatable to the frothing masses of vets online queuing to bite the very hand that feeds them. This jump could just as easily be due to the collective inability of vets to care about, learn and wield the communication skills needed to work effectively with the general public.

As the old saying goes, we will rise (or fall) to the level of the people with whom we spend most of our time. With little to no space for meaningful communications skills training, emotional intelligence, or exam room skills (we could go on). And even less available post-graduation due to pressures of time, it’s hard to see this as anything other than a huge professional blind spot. One thing is certain- if we blame or label clients as ‘the problem’, we have little to no chance of being motivated or capable of effecting change. However, if we see our skills as a challenge, the opportunity becomes clear. Work on our skills and we’ll experience a much better outcome.

If further evidence was needed, in a recent study where we asked more than 150 graduates what the most energizing and draining parts of being a vet were, clients were at the top of both lists. This suggests that it’s perhaps not the clients that are the problem, but the skills in how to address them. A human handled well is likely to respond well. A human handled badly is likely to respond in kind.

How the Pandemic Has Added to the Mix

The pandemic has clearly not helped with existing shortages.

Anecdotal evidence suggests that an increase in pet ownership has further put pressure on the veterinary healthcare system, leading to more acute front-line shortages of staff. Numerous news reports suggest the public, many of whom are now working in hybrid environments, have bought pets to fill the social void created. This, in turn, has increased demands for veterinary care, increasing burnout and turnover.

It is difficult to say how true this narrative is, given that there is little to no data on pet acquisition outside of shelters. The data we do have from the AVMA suggests that 2.3 million fewer pets were adopted from shelters in 2020, the lowest number seen in five years. Which is exactly the opposite of what one might expect given we have been led to believe the shelters are empty.

This is not to say that there hasn’t been a pet boom (there are many reports in the UK, for example, stating that practices are being inundated with new patient requests), but it is hard to say accurately how much of an impact this has had on shortages [24].

Is Efficiency the Biggest Issue??

Veterinary appointments did increase during the pandemic. According to VetSuccess, an organization specializing in practice data analysis, the average number of appointments rose by 4.5% between 2019 and 2020. This, in tandem with a decrease in practice productivity (which dropped by 25% in 2020) has increased backlogs, placing huge pressure on teams [25].

It has undoubtedly exacerbated existing skill deficits as face-to-face communication was literally forbidden during the lockdown. Hardly a way to effectively bridge the communication divide between pet owners and professionals.

For many vets and veterinary nurses, the pandemic has also had a huge personal impact. It would be weird if this wasn’t the case. The impact on freedoms, certainty and social connection was always going to take a large emotional toll. And that’s not to mention those who have lost friends or family. As such, many people have gotten quite introspective and are asking whether what they are doing is worth it:

‘I think some people looked at the pandemic and thought: this has been horrible, this has upended my life, people have died… life is too short to stay in a role you don’t like,’ says Dr. Felsted.

‘And because of the demand for jobs created by the pandemic, it’s never been easier to get another one and move on.’

It’s easy to see why practices or roles that are failing to meet human needs are struggling. Higher lifestyle expectations have run into greater workplace pressures. The results are not encouraging.

What Effect Has This Had on Professionals?

All these different factors have had a huge impact on the way professionals are experiencing veterinary medicine. It’s hard to escape the gloomy conclusion that today’s vets are simply not enjoying their careers.

Since 2006, the percentage of veterinary professionals agreeing with the statement: ‘Veterinary work is stressful’ has increased incrementally:

Source:[26][27][28][29]

In a similar wellbeing study conducted by Merck Animal Hospital, researchers found that wellbeing indicators in vets were proportionally lower than those in other healthcare professions:

Source:[30]

Though these issues may have always existed, as culture changes, so do the expectations around what is tolerable and what is not. And with 4 in 10 vets looking to leave the profession, the people are voting with their feet.

The Great Generational Divide

One pervasive argument for why there is a veterinary shortage revolves around generational differences. The argument propagates that shortages are not a product of the profession, but rather of the people within it.

Anecdotal evidence suggests that younger vets are less resilient (or perhaps tolerant) than previous generations, and therefore more likely to bounce out of the profession.

Although it is true that younger people tend to be less resilient than their seniors (given their lack of life experience), it is hard to say whether this argument holds water given that there is little research in the area. This is mainly due to the difficulties surrounding the study of generational attitudes in social science. Nonetheless, it is a compelling argument that has gained a lot of traction.

It may also explain why the ‘Great Resignation’ is not limited to the veterinary profession, with similar reports from many other sectors.

Bring Me Solutions

So is this a disaster playing out in real time? Are we doomed to a slow death where our number dwindles year after year?

One thing is for sure, change is necessary, and necessity is the mother of all inventions. So what can be done to make things feel a heck of a lot more sustainable?

‘I think one major problem is that of the expectation of Autonomy before Mastery,’ says Dr. Gary Marshall.

‘I think those in charge of practices (typically offsite managers without a medical background) feel that anyone with a DVM can be plugged into a clinic and hit the ground running. They hire them, put them to work, and expect great things. This ‘thrown to the wolves’ reality for so many leads to dissatisfaction and burnout, with many young practitioners leaving the field and not coming back.’

This mentality has to stop. Better training and support (particularly as vets transition into working life), both by businesses and educational institutions will help tackle such problems. Creating more realistic expectations for both students and employees could also help.

We would also suggest that a recruitment drive is needed, an open and honest one. But as a part of this, we ask ourselves: who are the best people to carve out a career in veterinary medicine? For years it has been white, privileged individuals. Searching questions must be asked of the recruitment of future vets into schools.

Alongside better training, there needs to be a cultural shift within businesses:

‘Individual practices are going to have to make changes to create work environments where people want to stay’ says Dr. Felsted. ‘You can like this or not as an employer. You can say: I think this is crazy that I have to do this! But if you don’t do it, you’re not going to get the number or type of people that you want.’

Although Dr. Felsted acknowledges that some of these changes will be harder for rural practices, offering a better work-life balance, economic incentives, and work culture (in terms of support, etc) are all things that can improve retention rates.

At the heart of such changes are the absolute necessity to place vision, values, and effective HR systems (that value people as well as performance) into action.

The salary problem can be fixed overnight if vets are willing to embrace exam room training and drop the nonsensical need to be apologists for their process. Instead, we must all be advocates for our service. The widespread and routine discounting of bills is incredibly harmful to revenue, profit and salaries. To this end, vets have reaped what they have sown for decades.

There also needs to be expectation management on the employee’s part:

‘Some of the hours and salaries that [vet students] throw out, to me, can seem a little unrealistic’ says Dr. Tennetje Crocker, a veterinarian, and speaker from the US.

Dr. Crocker believes greater transparency regarding pay could help bridge the gap between graduate expectations and business reality. A focus on ‘skills training’ as a means to improve pay expectations should also be a priority.

A Manifesto for Better Workplaces

Something needs to be done about veterinary shortages being experienced in clinics. In the short term, a return to a more efficient working model will help practices manage their workloads. But must we not do better?

In the long term, there are several things both employees and employers can do:

Practices should provide better support for employees.

• Greater support for employees can reduce burnout, improve the skill set of the team and hence open up the possibility of pay rises (that is, if training has a positive effect on cash flow).

Employers and educational bodies should make access to veterinary degrees more widespread and actively reach previously shunned communities.

• From work experience to community outreach, it’s time we actively recruited from minority communities who in the past have not had the equal opportunity to pursue veterinary medicine.

There needs to be a much greater emphasis on professional skill training.

• Important soft skills such as communication, emotional intelligence, and resilience need to be taught to vets. Many lack these fundamental skills and may take out their frustrations on clients.

Practices need to improve efficiency.

• Pandemic-related inefficiencies need to be addressed so they don’t continue to put a strain on teams.

• Improved use of veterinary technicians and nurses will help engage, reward, and hence retain this group.

Employers need to create positive, safe, and diverse cultures that attract and retain talent.

• It’s a buyer’s market, and employees are voting with their feet. Employers must work on their leadership skills to improve their cultures and create environments in which people want to work in.

Practices need to dream up and execute more effective healthcare models.

• Searching questions must be asked of the general practice model as to how it can continue to be profitable and provide a fair wage to those who work within it. The adoption of new technologies and a better focus on who the practice exists to serve can help to generate improved margins which can sustainably improve life quality for all.

Veterinary medicine will always be an exciting and enticing career for professionals. The flow of talent and money continues to be strong which is an incredibly positive thing. But in order to continue providing fantastic animal care, there needs to be a change. There isn’t any quick fix, but any practice working towards a healthier working culture is taking the right step towards a prosperous future.

If you are a practice owner, manager, or team leader who is ready to harness the potential of your practice and want to learn 'How to Run a Successful Veterinary Practice Without all the Drama', sign up for my free masterclass here.

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