Preventing burnout at the organizational level

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Challenges surrounding mental health and burnout within the veterinary industry have been a growing area of research and discussion over the past decade. During the first part of her 2-part session, “Self-Care Isn’t Selfish: Essential Skills For Success,” presented at the Fetch dvm360 Conference in Atlantic City, New Jersey, Kate M. Boatright, VMD, an associate veterinarian at Penn Ohio Veterinary Services, and founder of KMB Veterinary Media, provided an overview of the current state of mental health in the industry, and advised practice managers how they can address the situation.¹

Mental health and burnout

Boatright shared the results of the Merck Veterinary Wellbeing Study Series, which provided a detailed account of the state of mental health within the industry, over the past several years. In the 2017 study, 79% of veterinarians reported feelings of anxiety, burnout, and compassion fatigue over the course of the previous year.² The next study, from 2020, demonstrated increased levels of awareness of mental health in the veterinary profession, though wellbeing remained largely unchanged.^2,3

The 2021 study found increased signs of psychological distress in veterinarians, which Boatright attributes—at least in part—to the COVID-19 pandemic. The most recent Merck data, released in early 2024, showed a stable level of psychological distress in the industry.⁴ Among those at higher risk for psychological distress are veterinarians who are new to the field, female, minorities, and younger than 35 years old.^3-5 In her session, Boatright emphasized the important role that practices play in the industry’s mental health.

“[If you are experiencing burnout], you can stay in this profession, and you can still recover from burnout, you just have to recognize it and make the space and time for it,” Boatright said in her presentation. “But it’s even better if we can prevent people from getting into that state of burnout in the first place. So, prevention of burnout really has to happen at the organizational level.”

Approaching clinic managers

Boatright addressed the concerns of individual team members who recognize burnout within their clinic but fear their clinic’s management won’t care to take action. She recommends that, when starting that conversation with management, team members should “go with the money.”

“A lot of the time, especially when you’re talking to business-minded people, [mentioning money] could be helpful,” Boatright explained. “First of all, we have the impact to the veterinary team members. If you are burned out, then you are going to be less effective at your job. Other people are going to have to pick up your slack [if] you get to the point that you need to take a break and leave the clinic.”

She drew attention to a perpetual burnout cycle, which occurs when 1 team member takes time off because of burnout, other team members take on more in their relief, which results in them experiencing burnout, as well. “[If you’re experiencing such high burnout] that you need to leave the clinic, now you’re down a person as a veterinarian. That’s going to [lower] the number of appointments that you can see, unless you expect your other veterinarians to take over that same caseload, which [would] just perpetuate that burnout cycle.”

She points out that an alternative solution would be for managers to hire someone new, although that would involve cost to hire, which she says is about 50-75% of the annual salary of a position to replace that person. In total, burnout costs the veterinary industry an average of $1.93 billion in losses each year. In addition to the economic costs, she points out that burnout can come with emotional costs to the clinic, damaging preexisting relationships with patients or clients, and preventing the formation of new ones.

What practices can do

“Programs focused on changing individual behavior are much less effective than programs focused on teams,” Boatright said. She identified 6 main points to address burnout form an organizational level:

• Lack of control: Team members may feel that they lack control over their careers, including a lack of control over scheduling, which patients come into the clinic, or the volume of patients that come into the clinic.
• Insufficient reward: It’s important for team members to feel celebrated and appreciated. Some clinics hold a weekly reading of 5-star reviews, and others implement “kudos jars,” which offer small prizes to celebrate efforts that go above-and-beyond. 
• Lack of community: People should feel like team members within the workplace, and there should be a sense of community, team culture, and good connections. Otherwise, as Boatright cautions, team members could be on their way to burnout.
• Unfairness: There shouldn’t be members of the team that receive special privileges. Specifically, she provides the example of veterinarians who need to leave early to pick up their children from school. How can a practice make this fair to non-parents? “Are we asking only our non-parents to work on holidays?” Boatright asked. “Well, guess what? They have family and lives too.”
• Mismatched values: If someone’s personal values don’t align with the clinic’s, that could serve as a trigger for burnout.
• Work overload: Working too much can be the biggest contributor to burnout. Boatright explains that, while this is the only 1 of these factors that individual team members do have control over, managers need to proceed cautiously and ensure that team members are not being overworked.

Psychological safety

“[Psychological safety] is a term that we’re hearing more and more in the profession,” Boatright said. “…and it’s multifactorial. Part of it is creating a safe space to have these discussions about mental health, creating an environment where you’re comfortable [expressing concern for a colleague’s wellbeing], and also comfortable coming up with new ideas.”

Team members should be able to admit their mistakes without fear of retribution. It’s not uncommon that admitting a mistake ends up as the difference between life and death for a patient. The workplace should also be a safe space for the discussion of mental health. The knowledge that your team has your back can go a long way in preventing burn out or other mental health challenges.

“Our team members right now are our highest risk individuals,” Boatright said. “Our younger veterinarians, technicians, younger professionals are at higher risk. We have to remember the significant impact that burnout has in the profession, and that we need to look at organizational change to prevent burnout.”

References

1. Boatright K. Self-Care Isn’t Selfish: Essential Skills for Success Part 1. Presented at: Fetch dvm360 Conference; October 14-16, 2024; Atlantic City, NJ.
2. Volk JO, Schimmack U, Strand EB et al. Executive summary of the Merck Animal Health veterinary wellbeing study. J Am Vet Med Assoc 2018;252:1231-1238.
3. Tomasi SE, Fetcher-Leggert ED, Edwards NT, Reddish AD et. al. Suicide among veterinarians in the United States from 1979-2015. JAVMA 2019;254(1):104-112. https://doi.org/10.2460/javma.254.1.104
4. Volk J, Schimmack U, Strand E, Vasconcelos J et al. Merck Animal Health Veterinary Wellbeing Study II. Available at www.vetwellbeing.com. First accessed May 15, 2020.
5. Volk JO, Schimmack U, Strand EB et al. Executive summary of the Merck Animal Health veterinarian wellbeing study III and veterinary support staff survey. J Am Vet Med Assoc 2022;260(!2):1547-1553.
6. Volk JO, Schimmack U, Strand EB et al. Work-life balance is essential to reducing burnout, improving wellbeing. J Am Vet Med Assoc 2024;262(7):950-957.