Trusting relationships between veterinary professionals and clients are important for the well-being of people and the ultimate health of their animals. Yet, microaggressions pose a threat to these relationships. Defined as slights or indignities wielded against people with marginalized identities, microaggressions inflict a unique form of harm that reaffirms negative stereotypes enmeshed in systems of racism, sexism, classism, and beyond. In this article, we explore how microaggressions work and how they are applicable in veterinary settings. We also offer initial suggestions for veterinary professionals and educators to better understand and counteract their damage in the profession.
Studies in human medicine indicate that between 22,000 and 400,000 people die every year as a direct result of medical errors. In veterinary medicine, 42% of human-caused incidents caused harm to the patient, including 5% resulting in death. In a university veterinary teaching hospital, there were 5.3 errors/1,000 patient visits, and 4 of these resulted in death. Veterinary medicine falls far behind other safety-critical industries in adopting a culture of patient safety. Organizations should respond in a just and effective way when errors occur. Psychological safety for team members to identify and speak up about areas of concern must be created and the results of improvements made based on these concerns shared within the professional group. If veterinary medicine is going to embrace patient safety culture, it needs to be included in the curriculum. Accrediting and licensing bodies need to require the teaching and application of principles of patient safety culture. Faculty must be trained to deliver patient safety–oriented care. Experts in human systems engineering should be brought in to educate veterinarians on how the systems we work in impact patient outcomes. If we are going to fulfill the promise of the Veterinarian’s Oath, we must embrace patient safety culture and all the difficult changes it requires of our professional culture.
The authors propose using the National Academy of Medicine’s (NAM) National Plan for Health Workforce Well-Being as a framework on which the veterinary profession can re-envision patients and clients being cared for by a veterinary workforce that is thriving, where professionals operate in an environment that fosters their occupational well-being and longevity, strives to improve animal and population health, expands and enhances the care experience, and advances animal health equity. Adapting the NAM’s National Plan is intended to inspire collective action to improve the well-being of all veterinary professionals and focuses on changes needed across the profession at the organizational and systemic levels. The Plan focuses on 7 priority areas, many of which would require needed changes to the training and practice business models with input from all interested parties—including clients and the diverse communities our professionals serve. This collective approach and process would inevitably be complex; however, the authors believe that the veterinary profession as a community is ready for the challenge to advance the profession.
The purpose of this viewpoint is to discuss the risks associated with offering clinic-backed payment plans, with a particular focus on financial risks. We provide a financial calculator tool that clinics can use with their financial information to make more informed decisions about whether implementing clinic-backed payment plans are viable for them. Realistic but hypothetical financial information for a clinic is used to simulate financial evaluations, including cash flow budget analysis, multivariate sensitivity analysis, and risk assessment to help clinics better understand these evaluations. Our simulations show that even under high default rates, the revenue benefits outweigh the labor costs and could bring higher profitability to clinics while increasing access to care for clients and patients.
The challenge of meeting pet healthcare demands with inadequate staff resources creates legal and ethical considerations for the veterinary profession. Inadequate staffing can result in access to care issues that impact companion animal health, public health, and the human animal bond. An overburdened work environment may also result in liability issues related to standard of care, client dissatisfaction, and subsequent complaints. The following recommendations may ameliorate the legal and ethical impacts to include: a focus on how to optimize current resources (human and technology); improve client communications and medical record-keeping strategies; promote preventive care; develop and memorialize clinical standard operating procedures; and prioritize staff well-being to prevent burn out. These recommendations should be considered good practices when functioning under optimal conditions but are even more valuable to implement effectively in an overburdened companion animal medicine environment.
β-Hemolytic Streptococcus (BHS) species are important pathogens with both human and veterinary significance. In human medicine, BHS are considered universally susceptible to β-lactams while BHS of veterinary origin have been reported with up to 8% β-lactam resistance. Recently, veterinary diagnostic laboratories were made aware of significant variability of test method performance for BHS among laboratories. This article explores potential sources of error in antimicrobial susceptibility test performance and result interpretation that may have contributed to the unusual rates of resistance to β-lactams observed in this bacterial species. In addition, potential impacts to research, clinical practice, surveillance, and public health will be discussed.
Friction can occur between veterinarians and their clients when they are not aligned on the goals of care for a pet and what constitutes the best outcome of a case. Veterinarians frequently concentrate on providing the diagnostic and treatment protocol that is perceived to result in the best medical outcome for their patient. Pet owners frequently consider a myriad of factors relating to the pet as well as how different diagnostic and treatment recommendations will affect individual family members and the family as a whole in both concrete and subjective terms. This misalignment can lead to veterinarians experiencing moral distress and families feeling guilt and shame about their pet’s care decisions. In this paper we examine the interdependencies of families and their pets and the factors that pet owners may consider in making care decisions. These factors, adapted from the concept of Family Quality of Life as used in the human health field, can be divided into three domains including pet-centric factors, family-centric factors, and external factors. By better understanding that there are a multitude of considerations that influence owners’ care decisions and communicating with owners in a nonjudgmental manner, veterinarians can more holistically support families, decrease their own moral distress, and arrive at diagnostic and treatment plans that represent the overall best approach for the family and the patient.
The world is losing wildlife species at an unprecedented rate. Habitat destruction, overexploitation, and pollution are the leading causes of biodiversity decline. As a threat multiplier, climate change exacerbates these processes as demonstrated by the death of several billion wild animals in the last few years from wildfires, floods, heatwaves, and other natural disasters. In the face of these challenges, veterinarians have unique and important skillsets to contribute to wildlife conservation and the preservation of biodiversity at many levels. Veterinarians can organize and train to mobilize wildlife extraction, rescue, and rehabilitation units during natural disasters as well as build relationships with rehabilitators to provide their services for general wildlife rehabilitation needs. They can work in transdisciplinary teams to provide veterinary expertise for ecosystem health and rewilding projects. They can become sustainability champions by providing pollinator and wildlife friendly habitats at their clinics and reducing clinic waste and energy consumption, and they can engage in science communication and advocacy. When provided with the necessary information, resources, and action items, veterinarians can increase their positive impact and personal well-being through purposeful, value-driven, community-building efforts to support wildlife conservation and biodiversity.
Salaries apportioned to veterinary interns and residents have been historically low. The impact of this financial strain on the lives and career choices of young veterinarians has recently been evaluated. Subsequent effects of low remuneration are not limited to simple personal finances; rather, the implications may be more far-reaching, including playing a role in mental and physical wellness, affecting diversity in various segments of the profession, influencing career paths, creating barriers to educational and professional opportunities, and shaping decisions regarding family. We evaluated progress made in salaries offered for positions listed in the Veterinary Internship and Residency Matching Program between the previous analysis in 2021 and at present for the 2023 match. In addition to considering financial improvements, we discuss potential drivers contributing to change, including recent documentation of living wage requirements relative to salaries, labor market forces, and the increasingly competitive salaries offered through other career paths. We also consider implications for increasing intern and resident compensation; besides well-being, diversity, career path, and family factors, we discuss the potential relationship of postgraduate educational programs to hospital revenues and implications for how educational program structure may be affected. While compensation is far from the only element that drives career selection or satisfaction, understanding the effects of a fiscal overhaul to this educational experience can play a critical role in solving components of the workforce issues in our profession.
The medication misuse epidemic continues to be a major concern for both human and veterinary health-care providers. Medication misuse of veterinary prescribed drugs is contributing to the public health crisis. Education of students regarding appropriate prescribing, communication with clients about medication storage, recognition of signs of vet shopping and animal abuse, and appropriate pain management strategies are essential steps for ensuring our students are prepared for the world that awaits them outside the halls of academic veterinary medicine. This is the moment where veterinarians can make a difference in the lives of patients, students, and the public health.