“That was the first time a client threatened to kill me,” the keynote speaker said before pausing for effect as the veterinary students in the audience frantically took notes. I was attending an event for veterinary students that had kicked off with a lecture about personal boundaries and resilience. The speaker was excellent. He was energetic, dynamic, and funny. He included a good mixture of research and anecdotes, and he was speaking directly to fears and concerns common to veterinary students.
The only problem: The lecture was horrifying.
In 45 minutes, the speaker cycled through a greatest-hits list of terrible things that can happen over a 20-year career. He shared stories of feeling belittled, bullied, and threatened. He talked about racist or hurtful things clients and co-workers said. He talked about nasty customers, patients, and employers.
Don’t get me wrong: All of this was coming from a good place. This speaker was honestly trying to protect these students and prepare them for the worst things they might encounter in practice. But the lecture made it sound like these students were going to graduate and be loaded onto boats so they could participate in the opening scene of “Saving Private Ryan.”
After 18 years of practice, sitting in that lecture made me anxious to go back into the clinic. Despite knowing exactly what practice is like, my palms were sweating. I found myself asking, “Who the hell would ever be excited to graduate into this?”
The speaker was telling the truth. The examples he gave were real, and the lessons he learned have value. But, while his lecture was truthful, it wasn’t entirely accurate. The facts were correct, but the story about what it’s like in the exam room was wrong.
If I told you about every case that went badly for me, I would speak the truth, but I wouldn’t give you a realistic picture of what my clinical days are like. The same would be true if I told you about every client who was upset with me, every argument I’ve ever had with my spouse, or every time I’ve dropped the ball as a parent. While true, these stories alone wouldn’t provide a correct representation of who I am as a clinician, spouse, or father.
We have a problem in modern veterinary medicine. People share true things, but they don’t accurately reflect what’s happening. Yes, veterinarians have a challenging job. We deal with bullies, pain, death, stress, debt, and limited resources, but those represent a tiny percentage of our time in practice.
I have no idea what percentage of appointments the average veterinarian would say are “bad,” but for most of us, that number is not particularly high. This doesn’t mean we shouldn’t focus on wellness or making our mental health better. It does mean that we shouldn’t give people the impression that we fight for our lives from the moment we walk into the clinic until we walk out of it.
Why We Emphasize the Pain Points
People want to avoid pain much more than they want to reflect on things that are working out. There’s an evolutionary basis for this: Focusing on danger and pain increases our chances of surviving, while focusing on how nicely things are going can hasten our removal from the gene pool. Also, we like to believe that focusing on problems moves us forward in productive ways.
This is why we talk so much about pain points in veterinary medicine and highlight specific examples of shortcomings. Most of us do this because we want to make the profession better — to fix things or help others avoid hardship. Owning mistakes and challenges is the first step to overcoming them.
There are others, however, who have a different motivation for fixating on the problems of the profession. There are entrepreneurs, investors, and private equity groups that would like to make a case that veterinary medicine is fundamentally broken and needs to be reimagined. Their financial success depends on a public perception that veterinarians and veterinary institutions cannot be trusted to look out for the public interest, and that veterinarians wield too much power and are too out-of-touch. These groups look to profit from the role of veterinarians (who are expensive and tend to insist on prioritizing care of patients over revenue) being reduced, and customer convenience being prioritized far above patient care.
I don’t want us to stop talking about problems in veterinary medicine. I do, however, believe that it’s time for us to begin putting the problems of our profession into perspective and context. Yes, we have challenging and stressful jobs. For most of us, these jobs are also meaningful and rewarding. For every rude or aggressive client, there are 20 more who are kind and reasonable (and at least one that’s wonderful).
We need to continue to be honest about challenges, but we also need to be accurate about where we are. There are real risks to us in having the general public believe that working in a veterinary clinic is basically a horror movie with people screaming at us and our coping mechanisms crumbling under the weight of death and pain. It’s true that our jobs have hardships. We do not, however, need to have our patients seen by an AI bot instead of a human for the sake of our mental health. (Apologies to the tech bro whose dreams were just stepped on.)
Veterinarians Are in Touch With Accessible Care
I attended a lecture recently that was hosted by a prominent pet-focused charity. In this lecture, shared survey data revealed that there are potential treatments for patients that pet owners want, that are objectively affordable, and that veterinarians are not comfortable recommending.
In some instances, I know there are conservative approaches to therapy that veterinarians are probably being too dismissive of. For example, in the last few years, we’ve seen good evidence of the effectiveness of outpatient treatments for conditions like parvovirus and feline urinary obstruction. Prior to the publication of these positive treatment outcomes, I was among the veterinarians who were uncomfortable with these conditions being managed at home. That doesn’t mean I didn’t treat them using exactly this approach, but I was much less encouraging of outpatient therapy than I am now that we have data to support it.
The lecturer did not mention these or any other examples of cheap, popular, non-vet-approved therapies. Instead, the lecturer spoke in broad generalities about the entire category of “things pet owners want but vets aren’t comfortable with.” The narrative seemed to be: “See, veterinarians need to get on board with therapies they don’t like if they are cheap and pet owners want them.”
In the specific case of complicated medical therapies where data is being used to validate more conservative approaches to care, I think they are right. It’s true that we need more research on affordable care, not just on cutting-edge advances. However, veterinarians are already working to provide care that pet owners can afford. It’s not as if there is a pile of cheap and effective treatments that veterinarians just need to get on board with.
For every instance of a good treatment option that veterinarians are not yet comfortable recommending, there are probably 100 — or 1,000 — treatment options that veterinarians are not on board with because they do not work or can actively cause harm. After all, the majority of “treatments” that pet owners tell me they want — and are more affordable than what I’m recommending — have included things like antibiotics they can keep “just in case,” nonanesthetic dentistry, homemade flea preventions, tea tree oil cancer treatments, and pet psychics.
I’m not trying to be snide. These are actual treatment approaches clients have taken seriously with me. I love it when pet owners do their research, advocate for their pets, ask questions, and communicate clearly about their needs and capabilities. I never want anyone to feel dismissed or unheard. Unfortunately, while there are real opportunities for veterinarians to find new conservative ways to treat patients, it’s misleading to suggest these methodologies are everywhere or that vets are out of touch because they don’t support every inexpensive option that excites pet owners.
The “Vet Industry” Doesn’t Exist
In the previously mentioned survey presentation, we were shown a question where veterinarians were asked to choose which statement most closely aligned with their personal view:
- “People who cannot afford a pet should not have one.”
- “The veterinary industry has a responsibility to support all pet owners in providing care, regardless of their financial situation.”
There were no other options, and veterinarians were required to choose before moving on with the survey. The results: 18% agreed with statement No. 1, and 82% agreed with statement No. 2.
This question really bothers me. A good survey asks questions that do not guide respondents but instead seek to understand what people actually think. The wording of this question seems to intentionally elicit strong emotions around one choice, and to provide a vague and consequence-free “safe” alternative answer. After all, raising your hand for “people without lots of money shouldn’t have pets” feels like the right answer if you’re auditioning to be a comic book villain. Answering that “the vet industry (whatever that means) has a responsibility to help people” makes us feel generous without having to actually commit to anything.
I pulled the survey result for this specific question using Google Gemini, and the AI conveniently let me know why this matters:
“This 82% majority marks a major turning point in how veterinarians view their role. For a long time, there was a ‘gatekeeping’ mentality in the industry (the idea that pet ownership is a privilege for the financially stable). These results show that the vast majority of modern vets now view pet ownership as a fundamental human-animal bond that the industry should protect, regardless of the owner’s bank account.”
It’s undeniable that the majority of veterinarians do not believe that only people who never experience financial hardship should have pets. Veterinarians value the human-animal bond and desperately want to keep pets with families and provide care to them. These are the truths of our industry.
Also, because of how it’s worded, this question doesn’t give us any actual insight into how veterinarians feel about providing care in the absence of the ability to pay. I reject the idea that veterinarians today are more committed to getting pets care than veterinarians in the past have been (although access to care is a bigger issue today because of significantly higher costs). Veterinarians are not coming around to the idea that they should help out pet owners, and it is damaging to our reputations to act like this is so.
For all the talk I hear in the industry about how veterinarians need to stop focusing on the “gold standard” and try to meet clients where they are, I still haven’t seen this disconnect in practice. When I look at the history of veterinary medicine, I see countless doctors who have paid themselves and their staff pitifully because they wanted to keep care affordable. I remember the early 2000s, when the biggest piece of practice management advice being given was that veterinarians should not be allowed to make estimates or create invoices. Why was that the big revelation? Because veterinarians are notorious for skipping steps, discounting services, and simply not charging for services rendered.
Are there veterinarians who get frustrated trying to treat patients when the pet owners have little or no resources? Of course. Do we have veterinarians who don’t yet have the clinical experience to know where they can be more conservative than they were taught in vet school? Also yes. But think about the veterinarians you actually know. Are these people holding tight to the gold standard of care instead of doing all they can to help the person in front of them? Are they just waking up to the idea that access to veterinary care is important? No, and portraying veterinarians in this way is not accurate.
Veterinarians are not heartless, and they are not out of touch. The sad truth is that there is no “veterinary industry” coming to support all pet owners. When the single-mother practice owner has a client whose pet needs surgery at 6 p.m., the AVMA is not going to send a veterinarian to do it. Mars Petcare is not going to pick up the tab. The state VMA is not going to reimburse her for the cost of her drugs. Right now, when you say to this practice owner, “Don’t you think the veterinary profession has a responsibility to support all pet owners in providing care, regardless of their financial situation?” what we are really asking her is, “Don’t you have a responsibility?” That is the truth inside our clinics.
Veterinarians have a moral responsibility to care for pets and to try to help pet owners. We all need to recognize that this must happen inside a reality where there is no government support, no social safety net, and no megacharity making this care possible. Veterinary practice owners are still small business owners who have to pay their staff, buy their supplies, and keep the lights on. Associate veterinarians don’t get to set the prices, make the rules, or change the protocols. Access to care for pets is vital. It also has little to do with what veterinarians want or their unwillingness to rely on the “veterinary industry” to get care done.
The Blind Men and the Elephant
There’s an old story about four blind men who are asked to describe an elephant. The first blind man grasps the elephant by the trunk and says the elephant is similar to a powerful snake. The second man feels an ear, the third a leg, and the last grasps the tail. All four truthfully describe what they encounter, resulting in radically different yet individually correct descriptions. None of them is remotely accurate about what the beast before them is.
Veterinary medicine is an elephant. It’s made up of good days and bad days, challenges and victories, advocacy for patients, and collaboration with pet owners. Veterinary medicine is a cash-based business with a huge heart, a lot of student debt, and no societal safety net. It has a noble history of sacrifice for animal welfare and a future of opportunity for improvement and innovation. It has doctors who want the best for patients and who also face harsh practical and financial realities that can’t be waved away, but that often seem invisible to the outside world.
Those of us in the exam rooms possess the distinct, holistic perspective necessary to understand the true nature of veterinary medicine — “the elephant” — in its complexity of challenges and rewards. It’s time for us to push the conversation about access to care in an actionable, positive, and realistic direction. We need to define our realities before those with partial views — or possibly self-serving agendas — convince the world we are something that we are not. We need to tell the facts and the full story of what’s happening in veterinary clinics.