Why are veterinarians unhappy?

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If you ask 10 children what they want to be when they grow up, there are sure to be some aspiring veterinarians in the group. However, the veterinary field is difficult to break into, despite its high desirability. According to the American Association of Veterinary Medical Colleges¹, veterinary schools turn away almost 10 individuals for every open seat. Once they are accepted, veterinary students happily put their lives on hold to focus on the rigorous academic schedule and fulfill their lifelong passion.

Fast-forward 5 years. Many of those same veterinary students, now working at their first practice, are unsatisfied with the career they wanted so badly and have lost their zeal for veterinary medicine. In fact, according to the 2020 Merck Veterinary Wellbeing Study², only 33% of veterinarians would recommend a career in veterinary medicine. The American Veterinary Medical Association (AVMA) reports³ that 40% of veterinarians are considering leaving the profession. The Merck study also revealed that well-being is lowest among younger veterinarians, with 54% of those younger than 35 years suffering or barely getting by. This brings us to the question being asked with increasing frequency: Why are veterinarians, and particularly young associates, so unhappy?

Many factors likely contribute to this complicated equation, including the following:

• Workload: In 2016, AVMA⁴ reported that small animal veterinarians saw an average of 76 pets per week, which seems an appropriate workload. However, an increasing shortage of veterinarians⁵, along with the exploding pet population, has pushed the workload to an unmanageable burden. Add inefficient curbside protocols to the mix, and veterinarians are reaching their breaking point.
• Salary: According to AVMA statistics⁶, the starting salary for new graduate veterinarians is roughly $85,000, and an American Animal Hospital Association⁷ survey of 600 veterinary practices reports an average salary of almost $108,000 for all veterinarians. However, veterinary salaries fall short when compared with those of other medical professionals. The 2018 Medscape Physician Compensation Report⁸, which evaluated salaries of human medical doctors and specialists, reported that primary care physicians earned $237,000 on average, whereas specialists earned $341,000. Although veterinarians may not expect to earn as much as human physicians, the disparately high debt-to-income ratio is a sticking point. A study published in the American Journal of Pharmaceutical Education⁹ reported that veterinarians graduate with the highest debt-to-income ratio compared with dentists, pharmacists, optometrists, and physicians. Physicians often graduate with a debt-to-income ratio less than 1, meaning that their starting salary is typically more than their debt load.
• Age profile: According to AVMA¹⁰, millennials make up the largest proportion of veterinarians. The current veterinary population falls into the following age groups, and this generational shift brings significant change, particularly in what motivates millennial veterinarians and makes them feel fulfilled and happy:
  • Millennials (ie, those born between 1981 and 1996): 35.1%
  • Generation Xers (ie, those born between 1965 and 1980): 34.6%
  • Baby boomers (ie, those born between 1946 and 1964): 29.9%
  • Silents (ie, those born between 1928 and 1945): 0.4%.
• Pandemic-related changes: The pandemic has resulted in new consumer and employee behaviors. Although a larger pet population has increased veterinary business, more veterinarians are looking for ways to work from home.

With an increasingly unhappy veterinary population, finding and retaining talented associate veterinarians has become the overriding challenge for practices.

What motivates veterinarians?

To determine why veterinarians are unhappy, business leaders must first figure out what motivates them. Motivation results from an individual’s passion and purpose. Veterinarians obviously do not lack passion. They have wanted to save animals since childhood—and still do—but are often unhappy about other areas of their chosen field. Many veterinarians do, however, lack purpose. They struggle with a sense of belonging and may not feel they fit in with their workplace culture and values. In fact, they may be completely unaware of their practice’s values and business goals.

Do money and benefits motivate veterinarians?

Many practice owners assume money will motivate associate veterinarians, and veterinarians’ large debt load supports this assumption. However, a study¹¹ conducted by the Center for Health and Wellbeing at Princeton University in New Jersey indicates otherwise. The study found that although low income correlates with unhappiness, emotional well-being does not progress beyond an annual income of $75,000. In other words, a veterinarian who makes $100,000 is unlikely to be happier than a veterinarian in similar circumstances who makes $90,000.

Job ads tout other benefits, such as more vacation time and a continuing education allowance, but these benefits do not provide purpose or belonging. Continuing education increases skill and expertise, but it is a legal requirement rather than a personal goal and often does not bring a sense of completion or fulfillment.

Maslow’s hierarchy of needs

The psychologist Abraham Maslow proposed a widely accepted theory about human motivation in the 1940s. According to Maslow’s hierarchy of needs, human motivation is based on 5 core needs (shown in Figure 1).

(Figure 1).

• Physiological: Physiological needs include basic human survival needs, such as food, water, sleep, clothing, and shelter. A typical veterinary salary adequately covers these needs, which are necessary to move to the next level. Once these needs are met, additional resources (eg, a higher salary) do not necessarily equal more happiness and usually do not serve as strong motivators.
• Safety: Physical, mental, health, and financial safety, which provide security, are the next lower-level needs.
• Belonging: Relationships with family, friends, and coworkers form the last lower-level need. In practice, veterinarians need to feel a sense of belonging to a “tribe,” or people with similar values. As a lower-level need, acceptance is critical to an individual’s happiness and motivation.
• Esteem: Higher-level needs are not essential but can provide greater motivation. Esteem needs include self-respect (ie, believing one is valuable and deserves dignity) and self-esteem (ie, confidence in one’s potential for personal growth and accomplishments). Esteem is based on respect from others and self-assessment, which can lead to self-confidence and independence.
• Self-actualization: Also referred to as self-fulfillment, the highest motivating factor involves reaching one’s full potential. Self-actualization needs include education to refine talents or reach an expert level, caring for others, and expanding one’s horizons through ventures such as travel or culture.

So, why are veterinarians unhappy?

Maslow’s theory provides significant insight into veterinarians’ motivating factors, which can help business leaders understand why they are so unhappy.

Veterinarians lack a sense of belonging

According to Maslow’s hierarchy of needs, all 3 lower-level needs must be met for veterinarians to be minimally happy. If veterinarians make an average salary and have their safety needs met, the first 2 levels are covered, leaving the need to belong. However, if a practice has an unsupportive—or worse, toxic—work culture, or simply makes no effort to encourage team relationships, this need will be lacking. People are naturally motivated by close relationships with their work family. Achievements, such as mastering a new surgical technique, are more exciting when shared, and a tribe mentality can make the bad days more bearable.

If a practice cultivates a culture of belonging, associates will have their lower-level needs met, which should equate to reasonable happiness. However, reaching only the minimal happiness benchmarks likely will not satisfy goal-oriented veterinarians. For higher-level motivating factors to kick in, veterinarians must also meet their needs for self-respect, self-esteem, and, ultimately, self-actualization. Without clear opportunities for veterinarians to meet these needs, practices will continue to struggle with unhappy associates.

Veterinarians lack clear goals

Each step of a veterinarian’s journey—a bachelor’s degree, veterinary school admission, veterinary degree, and perhaps specialty certification—is a clear objective that helps them to reach their ultimate goal. Veterinarians have been achieving goals their entire lives. But once they achieve the career that has been their long-term focus, they no longer have a clear goal. Most people would assume that new veterinarians would relax and enjoy their success. But many veterinarians are goal junkies who always need a challenge, and they may feel let down if they do not have another goal.

How do younger veterinarians fit into the picture?

Now, consider the current generation of millennial veterinarians—overachievers who desire instant gratification. Millennials are not used to long-term planning, become impatient without immediate reward for their efforts, and feel frustrated when they do not have clear goals to work toward. Many millennials work in practices where they do not feel appreciated or do not have a sense of belonging. Veterinarians are burning out (or worse) at an alarming rate, partly because the reality of veterinary practice does not match their expectations. This theory was confirmed by a recent burnout study by Veterinary Integration Solutions (VIS), which revealed¹² that professionals younger than 30 are more vulnerable to burnout; respondents in the younger age group were found to be less enthusiastic and more physically exhausted than their older peers.

When you apply Maslow’s hierarchy of needs, millennials clearly are lacking low- and high-level needs that contribute to their motivation. This goal-oriented generation needs to be motivated differently.

How can veterinary business leaders develop happy veterinarians who are motivated to succeed?

Applying Maslow’s hierarchy of needs to veterinary leadership, owners and managers can ensure their associates’ needs are met by doing the following:

• Offering competitive compensation, so that basic needs are covered
• Cultivating a culture of belonging, so that associates feel part of a “tribe”
• Sharing core values with team members, so they understand the practice’s mission and their purpose
• Helping associates set measurable, rapidly achievable goals
• Fostering a culture of continuous improvement, rather than waiting for corporate change management
• Creating a positive and immediate feedback loop, practicing radical candor for giving and receiving feedback

Many frontline staff are unaware of their practice’s high-level business goals or do not understand how their work contributes to those goals. Veterinary leaders can incorporate goal stacking to help their associates set clear goals that align with the practice’s business goals. Goal stacking includes helping associates identify goals in the following categories:

• Clear short-term goals, which can be achieved daily
• Operational chunked goals, which can take weeks to months to achieve
• High-level, more difficult goals, which may take from 1 to 10 years to achieve
• Transformative goals, which may take a lifetime

Practices can also help associate veterinarians to set personal goals, such as financial or educational goals, which may increase motivation.

Creating an environment of purpose and belonging and helping veterinarians to identify clear goals can provide the motivation and foster the happiness that veterinarians desperately need.

To watch the full-length webinar on this topic, go here.

Dr Ivan “Zak” Zakharenkov has earned multiple accreditations in veterinary medicine. After graduating, he worked in 35 veterinary hospitals across Canada, where he was inspired to create Smart Flow, a first-in-the-industry workflow optimization system. Smart Flow was subsequently acquired by Fortune 500 company IDEXX, where Ivan became General Manager of the Software division. After consulting 500+ practices worldwide on workflow optimization, he dove into studying the psychological triggers of burnout and business methodologies that veterinary organizations can apply to eliminate them. Ivan obtained an MBA degree in International Healthcare Management and wrote a dissertation “Implementation of lean thinking to improve the employee experience.” Today Ivan is leading VIS, helping veterinary groups systematize acquisition, integration and improvement of practices while preserving the employee experience.

References

1. The Association of American Veterinary Medical Colleges. Admitted student statistics. Accessed June 15, 2021. https://www.aavmc.org/becoming-a-veterinarian/what-to-know-before-you-apply/admitted-student-statistics/
2. Merck Animal Health. Merck Animal Health Veterinarian Wellbeing Study 2020. Accessed June 15, 2021. https://www.merck-animal-health-usa.com/offload-downloads/veterinary-wellbeing-study
3. Salois M. Supporting well-being during COVID-19 and beyond. dvm360. November 2020; (11): 28.
4. American Veterinary Medical Association. 2018 AVMA report on the market for veterinary services. Accessed June 15,2021. https://www.avma.org/sites/default/files/resources/2018-econ-rpt3-veterinary-services.pdf
5. Larkin M. Veterinarian shortage or salaries not keeping up? JAVMAnews. November 25, 2019. Accessed June 15, 2021. https://www.avma.org/javma-news/2019-12-15/veterinarian-shortage-or-salaries-not-keeping
6. Larkin M. Good news, bad news for educational debt, starting salaries. JAVMAnews. December 15, 2019. Accessed June 15, 2021. https://www.avma.org/javma-news/2019-12-15/good-news-bad-news-educational-debt-starting-salaries
7. AAHA Updates ‘Compensation And Benefits’ Guide. Today’s Veterinary Business. January 2020. Accessed June 15, 2021. https://todaysveterinarybusiness.com/aaha-updates-compensation-and-benefits-guide/
8. MedScape Physician Compensation Report 2019. Accessed June 15, 2021. https://www.kaptest.com/study/mcat/doctor-salaries-by-specialty/
9. Chisholm-BurnsM, Spivey C, Stallworth S, and Zivin JG. Analysis of educational debt and income among pharmacists and other health professionals. Am J Pharm Educ 2019 Nov; 83(9): 7460. Accessed June 15, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920640/
10. Generational shift: What does it mean for the veterinary profession? AVMA@Work Blog. January 25, 2021. Accessed June 15, 2021. https://www.avma.org/blog/generational-shift-what-does-it-mean-veterinary-profession
11. Kahneman D, Deaton A. High income improves evaluation of life but not emotional well-being. PNAS September 21, 2010; 107(38): 16489-16493. Accessed June 15, 2021. https://www.princeton.edu/~deaton/downloads/deaton_kahneman_high_income_improves_evaluation_August2010.pdf
12. Zakharenkov I. Younger veterinary professionals are more vulnerable to burnout. Veterinary Integration Solutions. Novemeber 2, 2020. Accessed June 15, 2021. https://vetintegrations.com/insights/veterinary-burnout-age/