The cost of empathy
I was deeply disturbed by findings in the recent Merck Animal Health Veterinary Wellbeing Study that “just 41 percent of veterinarians would recommend the profession to a friend or family member” and that “24.9 percent of veterinarians have considered suicide at some time in their lives.”1 A variety of stressors associated with working in private veterinary practice are contributors to burnout, compassion fatigue, lack of job satisfaction, and low self-esteem and can lead to an erosion of professional expectations and aspirations. That many members of the veterinary profession have mental health issues is, I believe, part of the price of empathy associated with providing animals the best possible care.
The finding that food animal veterinarians scored higher in well-being than did individuals in other segments of the profession was interesting.1 Animals raised for food are likely easier to objectify as commodities and seem less likely to raise the sorts of emotional dynamics associated with companion animal patients and their owners, dynamics that call for greater degrees of empathy and understanding. The greater the empathy, the greater the burden the suffering of others becomes. If not addressed, this empathetic burden may lead to compassion fatigue, burnout, and other mental health problems. As is the case for other caring professions, mental health issues will continue to be an occupational hazard for veterinarians.
Economic factors also play a role in mental health. Economically secure veterinarians in the United Kingdom, for example, describe themselves as “completely unstressed.”2 But surely, a sense of purpose and value to society is just as important to one's feelings of self-worth as financial remuneration. As new openings emerge, veterinarians may well find opportunities to work with humanitarian, public health, animal rescue, and conservation organizations that provide value to society at perhaps a lower empathy cost because of a balancing sense of purpose and value.3
Michael W. Fox, bvetmed, phd, dsc
Golden Valley, Minn
1. Nolen RS. Mental health, well-being problem serious, not dire: study. J Am Vet Med Assoc 2018;252:392–393.
2. Salaries and stress: how are they linked? Vet Rec 2018;182:65.
3. Fox MW. Holistic veterinary medicine: veterinary challenges and opportunities in a changing world. AHVMA Journal 2016;45:12–19.
How do we determine value?
I am disheartened that so many veterinarians in clinical practice appear to be determining their own value on the basis of average client transaction or gross income, or are using end-of-day sales totals to determine how good or bad their day was. Clearly, incorporating sound business practices into the management of veterinary clinics has been a positive thing. However, I worry that in the process we may have lost the meaning of what we do and why we do it. My hope is that we can find ways to hold onto that meaning or to regain it if it has been lost. Sometimes, the most value we can bring to our clients, and thus to our patients, clinics, and staff members, is to empathize with them when they need it most and do all we can to help them.
I personally have had multiple instances when what I did for a client's pet was perhaps not the ideal approach or the most expensive. I have seen clients who had been to other veterinarians and were told they either had to pay for extensive testing and treatments or euthanatize their pet. In response, I have offered a modified approach that was perhaps less ideal but more affordable and didn't result in euthanasia.
So, tell me, how should we determine our value? On the basis of average client transaction? Or, more qualitatively, on the basis of the number of animals and owners we were able to help with the fewest resources?
Leslie Sadeghi Brooks, dvm, mph
Indianapolis, Ind
