Discharge Notes columnist Dr. Andy Roark is a practicing veterinarian, international speaker and author. He founded the Uncharted Veterinary Conference. His Facebook page, podcast, website and YouTube show reach millions of people every month. Dr. Roark is a three-time winner of the NAVC Practice Management Speaker of the Year Award. Learn more at drandyroark.comRead Articles Written by Andy Roark
I recently observed a few of my Facebook friends updating their profile pictures with an image and the line “Check on Your Vet People” across the bottom. Above those words was a veterinary caduceus alongside the silhouettes of a despondent woman and a concerned dog. I spotted this trend around the same time I noticed that one of my friends had posted public pleas to pet owners, asking them on social media for kindness and understanding, saying veterinary professionals are “abandoning our families … to save yours.”
Obviously, I became concerned. The people sharing these messages are my friends. I respect and appreciate them very much. I also love that they, like so many in our profession, have such tremendous empathy, compassion and desire to help others. I knew their concerns were genuine and deserved to be addressed. But, at the same time, I found myself asking: Is this a wise way to present ourselves to the public, and more importantly, is it a healthy way to see ourselves?
As I reflected on those questions, I thought back to talks I gave at veterinary schools in recent years. Regardless of the topic I present, when I open the floor for questions, the students always ask about the stress of medicine and how to manage it, the demands of pet owners, the risk of burnout and how we might address “the mental health crisis.”
All those are great questions that warrant more exploration, not less. However, what concerns me most is how the questions are asked — the sad faces and tone of distress when the students wonder what their lives will be like after graduation. I worry that they are coming to see themselves not as the best and brightest students in America who are about to take on a challenging and stressful (but ultimately rewarding) career, but instead as near-powerless victims in a mental health horror film. Increasingly, when I lecture at conferences for practicing veterinarians and veterinary technicians, I get the same feeling from people who have been in the business for years.
If you’ve read my work for any time, you know I prioritize mental health and am passionate about solving the problems that stand in the way of veterinary professionals’ health and happiness. But lately, I’ve wondered: Are we going about this a little wrong?
Cognitive Behavioral Therapy and What We Believe About Ourselves
How we see ourselves and our position in the world matters at a deep level. We all know that a positive self-image is an integral part of creating healthy personal boundaries and having confidence in ourselves and our abilities. Still, I don’t think most of us consider how much the way we view ourselves affects our daily lives.
Modern cognitive behavioral therapy tells us that when a situation arises, our brain instinctively responds with conditioned thoughts. Those thoughts then trigger an emotional reaction, and that reaction motivates responsive behaviors. This is how we generally go through our day: situation, subconscious mental response based on previous and repeated thought patterns, emotional trigger, behavioral reaction.
My concern is this: If veterinarians see themselves as sacrificial lambs laid on the altar of relentlessly demanding pet owners, incredible workload pressure and inevitable compassion fatigue, then their emotional reactions to stressful situations might manifest from that sense of identity.
We understand the power of suggestion, right? If we come to expect something to happen, we might consciously or subconsciously help bring that expectation to reality.
Imagine a veterinarian who planned all week to attend her child’s evening basketball game but encounters an angry pet owner who wants to be seen at closing time and could be reasonably scheduled for the next day. If the veterinarian gives in to the client, she will miss the basketball game, and if she doesn’t take the appointment, the client will be upset.
If the veterinarian identifies as someone who is always being bullied by pet owners, sacrificing her family and receiving no respect from the community she serves, it’s not hard to imagine that she will be more likely to sink into a feeling of predestined hopelessness and stay at work, acquiescing to the client and missing her child’s game. But, conversely, if she sees herself as an unarguably kind, strong and smart doctor who has a stressful job that she handles by setting and maintaining firm personal boundaries, her emotional response and subsequent decision might be different.
I once told a technician I work with, “Oh, I can’t believe I left my laptop at home. I’m such an idiot!” I said it in jest (mostly), but she stopped the conversation to protest, “Please don’t say that about my friend.” I heard her state that phrase to others many times since. She believes that words matter, even if we are just saying them to or about ourselves. I think she’s onto something.
Knowing this technician as I do, I suspect her belief in the importance of positive perspective comes in part from her spouse. Her husband was born with cystic fibrosis and had a double lung transplant a few years ago. He is insulin-dependent, takes pancreatic enzyme supplements and regularly drives 3½ hours each way to the nearest CF treatment facility.
If you ask this man about his situation, he will not describe his daily struggles or the unfairness of life, although such thoughts surely must occur to him. Instead, he’ll talk about how fortunate he is to be alive as an adult, the miracle of modern surgeries and treatments, and the joyful fact that he is married and has a fulfilling life decades after doctors told his parents he would die as a child.
My colleague’s husband knows something important: Choosing how we see ourselves is within our power, even as we simultaneously work to overcome external challenges.
We make our mental habits, for better and for worse. While we should not delude ourselves about our challenges, we should shape our conditioned thoughts carefully and hold them in our minds, ready to guide us.
The Struggle Is Real
I’ll be honest. One of my greatest concerns as I write this column is that someone will interpret my call for a more positive perspective on ourselves and our profession as an invalidation of the personal challenges and mental health struggles that so many of us face. Allow me to say outright that veterinary medicine is, without a doubt, a stressful and challenging profession. I experienced a period of burnout and depression while practicing veterinary medicine. Mental health challenges are real, and we need not act like it’s not true in order to create a better narrative for ourselves.
At the same time, I feel moved to share that one of the key pieces in overcoming my burnout was deciding that I could address the condition without being defined by it. I could be a person managing burnout rather than a burned-out person. I found such power in that perspective shift that I want others to find it as well. I’d like to see my friends and colleagues choose to be empowered people who knowingly address challenges rather than helpless people destined to be chewed up by a destructive job.
It’s Not One or the Other
The life of a veterinary professional is not for the faint of heart, and it requires that we do a better job of taking care of ourselves and others than we have in the past. The correction won’t be easy and won’t come from a single fix. But I think we would all benefit by holding a more nuanced conception of the relationship between veterinary medicine and mental health and by choosing our actions from a position of empowerment.
For example, rather than posting public pleas for understanding on social media — it might not do much good and could do harm by creating a self-perpetuating cycle of sacrifice — we could work to improve our situation. We can make clear our needs and expectations to pet owners by using in-clinic tools similar to the patient rights and responsibilities documents seen today in human health care. We also can enforce these expectations through clear communication and kind but firm boundaries without being cold or uncaring.
We can choose to make taking care of our teams a top priority of our business — and not to the detriment of patients and clients but because a healthy, happy team will serve clients better than one that sees itself as a victim of a brutal profession. We can offer one another support shame-free and in the spirit of lifting each other. We can remind ourselves, each other and those around us that we are doing something amazing.
Who Are We Then?
Everyone wants to vent on Facebook from time to time; I get it. But before you share a meme that depicts all of us in this business as helpless and hopeless, stop to think: Is it really who we are? And what kind of self-fulfilling prophecy do we put in motion by telling the world that we’re here to be sacrificed?
It’s up to us to decide how we see the veterinary profession and how we present it to the rest of the world. So, let us remember that we are strong, smart and determined people who have challenging and stressful jobs that matter greatly. We make hard choices every day, often with incomplete data and finite resources, which is impressive. We manage humans, animals and forces of nature beyond our control. We have studied, trained and worked very hard to be here.
Do we face challenges? Absolutely. And no one is more qualified than we are to tackle them.