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Culture shift needed to enhance veterinary well-being

Well-being Isn't just an individual effort—it takes a village. Workplaces can play a substantial role in promoting health and well-being by reducing barriers to emotional and physical health.

In addition, a collaborative and inclusive approach is essential for promoting healthy work environments that welcome all members of the team—not just those within the majority group. All individuals need to be accepted for who they are versus how well they fit in, said Jen Brandt, PhD, director of well-being and diversity initiatives at the AVMA.

“It's up to teams, practices, and organizations to actively create space for individuals and groups who have traditionally been marginalized,” she said. “Creating inclusive environments requires intentional organizational commitment. It can no longer be the sole burden of the individual who has been marginalized to attempt to carve out a space where they can be accepted.”

These were the central themes that came out of the 2019 Veterinary Wellbeing Summit, held Nov. 17–19 in Rosemont, Illinois. The event attracted 263 attendees, who heard from industry experts and colleagues how to make individual and organizational well-being an everyday part of their personal life and professional practice.

The event, now in its sixth year, was hosted by the AVMA, Association of American Veterinary Medical Colleges, and Zoetis, with additional support from Hill's Pet Nutrition and Banfield Pet Hospital. The first four years of the well-being summits were aimed primarily at those who work in academic settings. For the 2018 and 2019 summits, the AVMA expanded the scope to include practitioners as well. The summit brings together veterinarians, veterinary students, educators, and mental health professionals to explore and identify individual, community, and systemic actions that can be taken to foster well-being and inclusivity in the workplace.

A number of sessions also focused on best practices in suicide prevention or post-vention, including a talk from Christine Moutier, MD, chief medical officer of the American Foundation for Suicide Prevention.

She mentioned that stigma reduction is a core component of any successful suicide prevention program, with a particular focus on vulnerable populations.

“You might be in the most enlightened school or practice, where you're shedding stigma and talking about mental health, but when you become distressed, your perception changes,” Dr. Moutier said. “Whether it's cognitive distortion or shame or fear or primal instinct of withdrawal, when we're not feeling ourselves or are weakened in some way, we have to keep in mind that it's OK to seek help.”

The summit builds on the AVMA's Workplace Wellbeing Certificate Program, which comprises five modules that connect veterinary team members with critical resources for group and individual problem-solving focused on creating a culture of well-being.

Participants in the certificate program must complete the first module—“Creating a Culture of Wellbeing”—before moving on to the remaining modules, which may be completed in any order. Participants who complete all modules will earn an AVMA Workplace Wellbeing Certificate of Completion in addition to four continuing education credit hours. The certificate program is free to all AVMA and Student AVMA members; the cost for other veterinary professionals to register is $75.

See the AVMA's other well-being resources at avma.org/Wellbeing.

Condensed from Jan. 15, 2020, JAVMA News

Access to lethal means looked at to lower veterinary suicide rate

Veterinarians have a higher rate of suicide than does the general population, research says. But according to the most recent study, if suicides associated with pentobarbital, a drug commonly used for euthanasia of animals, were not counted, veterinarians would mirror the general population in terms of suicide rates (J Am Vet Med Assoc 2019;255:595–608). Further, 89% of the pentobarbital-caused deaths did not occur at work—most of the time they were at home (72%).

Tracy Witte, PhD, a professor in the Auburn University psychology department and lead researcher of the study said: “This gives credence to the idea that if we made it a little more difficult for veterinarians to die by suicide, we could prevent suicide, not just make them switch to something else. Moreover, our finding that most of the suicides involving pentobarbital occurred outside the workplace suggests any new policies should consider guidelines for when and how pento can be removed from a clinical setting.”

Limiting access to lethal means is effective, as the data show that most people don't opt for another method. A 2017 study in the online journal BMC Psychiatry found that people in jobs with access to firearms, medicines or drugs, or carbon monoxide more frequently used these methods to end their lives than those without access to lethal means.

Dr. Witte's research group is planning to get feedback from practitioners on a variety of ideas on how to implement better controls on pentobarbital and seeing whether they work.

Condensed from Jan. 15, 2020, JAVMA News

Prioritizing well-being at the institutional level

Makenzie Peterson, well-being program director at Cornell University College of Veterinary Medicine, said working toward better well-being for all requires culture change. That's because individual efforts can't take root if the culture isn't open to them in the first place.

She gave the talk “Developing a Strategic Organizational Plan for Wellbeing” during the 2019 Veterinary Wellbeing Summit, held Nov. 17–19 in Rosemont, Illinois.

And while intimidating, culture change is necessary for many parts of the profession, Peterson said, citing results from the Merck Animal Health Veterinary Wellbeing Study, which showed that overall only 40% of veterinarians would recommend the profession. And of those with serious psychological distress, only 17% would recommend the profession (J Am Vet Med Assoc 2018;252:1231–1238).

She outlined the following five steps to create a culture of well-being at any workplace.

  1. 1. Establish enough leadership buy-in.

  2. 2. Conduct a needs assessment, including resource allocation and the current culture, and data analysis.

  3. 3. Determine which change management and well-being approaches to take. Culture change should touch everything from recruiting, hiring, and orientation to performance evaluations, staff training, and support.

  4. 4. Conduct a stakeholder assessment.

  5. 5. Address barriers to change, which can involve closed attitudes, not accounting for differences among departments or divisions, unclear culture goals, bias or stigma, poor communication strategy around changes, or lack of employee engagement, expertise, or data.

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Makenzie Peterson, well-being program director at Cornell University College of Veterinary Medicine, gave the talk “Developing a Strategic Organizational Plan for Wellbeing” during the 2019 Veterinary Wellbeing Summit, held Nov. 17–19 in Rosemont, Illinois. (Photo by R. Scott Nolen)

Citation: American Journal of Veterinary Research 81, 2; 10.2460/ajvr.81.2.96

To manage resistance, addressing it formally, identifying the root causes of resistance, and being able to answer “What's in it for me?” can all go a long way, Peterson said.

Condensed from Jan. 15, 2020, JAVMA News

Allergic to work

Dr. Jessica N. Graves didn't think about her allergies when she was growing up in Canada, but she started to do so when she moved to Illinois to pursue a preveterinary degree.

“I had an asthma attack when I was working with some pigs, but I didn't realize what was happening, and I didn't tell anyone because I was self-conscious,” said Dr. Graves, an associate veterinarian at Critter Care and Sandwich Veterinary Services in northern Illinois.

More than 50 million people in the U.S. suffer from allergies and nearly 24 million have asthma, according to the American College of Allergy, Asthma, and Immunology. Some veterinary professionals start their careers already allergic to animals, while others become allergic to their patients after entering the profession.

According to a 2009 study from the University of Saskatchewan Western College of Veterinary Medicine in Canada, about 38% of responding veterinarians reported developing an allergy during their career, and 41% said they altered the way they practiced in response to the allergy. The study used a questionnaire to examine exposure of veterinarians to occupational health hazards.

Animal-related allergies can include symptoms such as sneezing, runny or stuffy nose, red and itchy eyes, nasal congestion, skin reactions such as hives, coughing, and other asthma-related problems including shortness of breath. And yet, these professionals persist in treating animals—despite the chronic symptoms and extensive treatments—to pursue what they say is their life's calling.

Condensed from Jan. 1, 2020, JAVMA News

FDA describes legal limits of drug compounding

Federal authorities plan to affirm that veterinarians and pharmacists can compound animal drugs from raw active ingredients, which the Food and Drug Administration refers to as bulk drug substances, but only under narrow circumstances.

They also plan to focus enforcement efforts against those who sell copies of approved drugs.

In November, FDA officials published draft guidance that describes which animal drug compounding methods are legal, illegal and subject to enforcement, or illegal but allowed by policy because they benefit patients. The guide, Compounding Animal Drugs from Bulk Drug Substances, is available at jav.ma/Guide256.

Citing the Food, Drug, and Cosmetic Act, agency officials said an animal drug compounded from raw active ingredients is a new product that needs FDA review, whether that's reflected in full approval, conditional approval, or the indexing that allows administration to non-food-producing species with small populations. But they acknowledge some animals benefit from exceptions.

A cat allergic to a drug ingredient may need a specially compounded formulation. Cattle that have eaten poisonous plants may need a compounded antidote.

Veterinarians and pharmacists still should dispense an approved drug when possible and, when none is, should consider extralabel use of an approved or indexed animal-use or human-use drug, the draft guidance states. If none meet the patient's needs, a compounder should try to use an approved drug, a conditionally approved drug, or an indexed drug as the source of active ingredients before resorting to raw active ingredients.

Condensed from Jan. 15, 2020, JAVMA News

Interested in veterinary anesthesia? This organization may be for you

North American veterinary professionals who want to know more about anesthesia and analgesia but don't plan on specializing in the field now have a home: the North American Veterinary Anesthesia Society.

The new nonprofit organization was established through a partnership between the American College of Veterinary Anesthesia and Analgesia and the Academy of Veterinary Technicians in Anesthesia and Analgesia. The two groups saw a need to elevate standards of care and practice for veterinary anesthesia and analgesia, as well as support those providing anesthesia and analgesia to animal patients.

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The North American Veterinary Anesthesia Society was created with every member of the veterinary team in mind. (Photo by R. Scott Nolen)

Citation: American Journal of Veterinary Research 81, 2; 10.2460/ajvr.81.2.96

The NAVAS mission is akin to that of the Association of Veterinary Anaesthetists, which partners with the European College of Veterinary Anaesthesia and Analgesia. Given the common missions, the NAVAS and the AVA have mutually agreed to share information and opportunities to promote anesthesia care globally.

The society debuted last September at the International Veterinary Emergency and Critical Care Symposium in Washington, D.C. In addition to members of the ACVAA and the AVTAA, who receive membership in the society, the NAVAS has grown to roughly 60 members who aren't affiliated with either organization.

Members of the NAVAS have access to an array of resources on the organization's website, including a library, a calendar of continuing education events, and a forum for talking with colleagues. The website content is available to all members of NAVAS and, to a limited degree, nonmembers.

“Members of the veterinary and aligned professions will be able to look to NAVAS as a resource for education, research, and scientific progress in veterinary anesthesia and analgesia,” said Dr. Khursheed Mama, founding member of the society.

Condensed from Jan. 1, 2020, JAVMA News

More pets, more debt?

Early research shows a potential link between the number of pets a veterinary student has and that student's financial behavior and outcomes.

A small study found a statistically significant correlation between educational debt and the number of pets veterinary students reported taking care of. Students with nine pets accumulated over $70,000 more debt during veterinary college than did students who had no pets while attending veterinary college, according to research presented by Bridgette Bain, PhD, during the AVMA Economic Summit, Oct. 22–23, 2019, in Rosemont, Illinois. However, only 0.2% of responding students had nine pets.

“How many animals have you been financially responsible for during your matriculation during veterinary school?” was a question included in the 2019 AVMA Senior Survey, which gathers information from fourth-year veterinary students prior to graduation.

The data show that over half of responding students had one or two pets while attending veterinary college and accumulated between $140,000 and about $155,000 in educational debt during that time.

“I don't think necessarily that more pets translate into more debt, but I think this may be a proxy for financial decision-making and overall financial behavior,” said Dr. Bain, associate director of analytics in the AVMA Veterinary Economics Division. “This is a preliminary analysis, so we have a lot more work to do in terms of understanding this relationship.”

Dr. Bain said there is more analysis to be done in this area. She plans to continue this line of research in 2020.

Condensed from Jan. 1, 2020, JAVMA News

Contest puts students’ animal welfare knowledge to the test

A record 244 participants representing 25 universities competed in the 19th annual AVMA Animal Welfare Assessment Contest, Nov. 23–24, 2019, at Colorado State University.

Participants must conduct live and computer-based assessments of the welfare of animals in various settings. Those decisions and how well the participants present and justify their positions are scored by a panel of judges. The event included keynote addresses from Temple Grandin, PhD, professor of animal science at Colorado State, and Ruth Woiwode, PhD, a livestock auditor with Food Safety Net Services.

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The 19th annual AVMA Animal Welfare Assessment Contest hosted this past November by Colorado State University drew the highest number of participants since the contest began in 2001.

Citation: American Journal of Veterinary Research 81, 2; 10.2460/ajvr.81.2.96

Results of the 2019 competition are as follows:

Veterinary Student Division: Live Assessment High Scoring Individual—Brittany Senecal, University of Illinois; Live Assessment High Scoring Team—Michigan State University; Overall Individual—Caleb Brezina, Iowa State University; and Overall Team—University of Guelph.

Graduate Student Division: Live Assessment High Scoring Individual—Shannon Kelley, The Ohio State University; Live Assessment High Scoring Team—Colorado State University; Overall Individual—Emma Heuchan, University of Guelph; and Overall Team—University of Guelph.

Undergraduate Division: Live Assessment High Scoring Individual—Samantha Likar, University of Minnesota; Live Assessment High Scoring Team—Texas A&M University; Overall Individual—Ashley Dunn, Michigan State University; and Overall Team—Michigan State University Team 1.

The next two Animal Welfare Assessment Contests will be held at North Carolina State University, followed by contests in 2022 and 2023 at the University of WisconsinRiver Falls.

Condensed from Jan. 15, 2020, JAVMA News

Canadian veterinary colleges teach access to care

Students at two Canadian veterinary colleges will graduate with a better understanding of how to remove barriers to clients accessing care, thanks to funding meant to revolutionize veterinary education and services.

Last November, the University of Guelph Ontario Veterinary College announced it had received an $11 million donation from Kim and Stu Lang through their Angel Gabriel Foundation.

The donation will create the Kim and Stu Lang Community Healthcare Partnership Program, the first academic program of its kind in Canada. It will expand initiatives such as OVC's community outreach and spay-neuter programs that provide veterinary services for shelters and underserved and remote communities.

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Dr. Shane Bateman, associate professor of emergency and critical care medicine at the University of Guelph Ontario Veterinary College, works with veterinary students at the Guelph Humane Society. (Courtesy of University of Guelph)

Citation: American Journal of Veterinary Research 81, 2; 10.2460/ajvr.81.2.96

The program will include graduate training and specialization in community or shelter medicine to educate future specialists and help establish evidence-based best practices. Previously, such training was available only outside of Canada.

The University of Prince Edward Island Atlantic Veterinary College in November announced it had received a $50,000 grant from the U.S.-based Stanton Foundation's program for developing courses on canine care.

Dr. Michelle Evason, an associate professor of small animal internal medicine, is using the funding to develop a new third-year elective course that will teach veterinary students to identify and define the spectrum of care and give them the tools they need to address the issue.

The spectrum of care is defined as the availability and accessibility of veterinary medical care regardless of the socioeconomic status of the pet owner.

The course, thought to be the first of its kind to be taught at a veterinary college in Canada, will be offered in the winter 2020 semester.

Condensed from Jan. 15, 2020, JAVMA News

Education council schedules site visits

The AVMA Council on Education has scheduled site visits to nine schools and colleges of veterinary medicine for 2020.

Comprehensive site visits are planned for the University of Georgia College of Veterinary Medicine, Feb. 9–13; the University of Illinois College of Veterinary Medicine, March 29-April 2; the University of Glasgow School of Veterinary Medicine, April 26-May 1; the University of Missouri College of Veterinary Medicine, May 17–21; the University of Melbourne, Melbourne Veterinary School, Aug. 9–14; Tuskegee University College of Veterinary Medicine, Sept. 13–17; The Ohio State University College of Veterinary Medicine, Oct. 18–22; the University of Nottingham School of Veterinary Medicine and Science, Oct. 31-Nov. 6; and the University College Dublin School of Veterinary Medicine, Nov. 15–19.

The council welcomes written comments on these plans or the programs to be evaluated. Comments should be addressed to Dr. Karen Martens Brandt, Director, Education and Research Division, AVMA, 1931 N. Meacham Road, Suite 100, Schaumburg, IL 60173. Comments must be signed by the person submitting them to be considered.

From Jan. 1, 2020, JAVMA News

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