Letters to the Editor

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Surviving veterinary medicine

I appreciate the recent letter from Dr. Shagufta Mulla.1 Unfortunately, there are far too few qualified mental health professionals to meet the need. And even if there were, most people do not have the funds or adequate insurance to cover therapy. For many people, therefore, the only options are friends and family, a support group, and insightful books.

I can recommend three books that I have found particularly effective for myself and many others. I have no financial interest in their purchase or promotion. They are listed in no particular order. One note of caution: if reading any of these becomes overwhelming, stop immediately and connect with a friend, family member, or qualified mental health counselor.

  • The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, by Bessel van der Kolk, MD. This book focuses on complex posttraumatic stress disorder, which is chronic and insidious in nature.

  • Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Self-Involved Parents, by Lindsay C. Gibson, PsyD.

  • Rewire Your Anxious Brain: How to Use the Neuroscience of Fear to End Anxiety, Panic & Worry, by Catherine M. Pittman, PhD, and Elizabeth M. Karle, MLIS. This book focuses on the dynamic relationship between the cortex and amygdala and trauma. It explains why our deep emotional reactions to others and specific situations are often not helped by typical cognitive behavioral therapy and why therapy needs to be targeted at both the cortex (cognitive) and the amygdala (both experiential and emotional).

The journey to wholeness can be long and arduous. But it is always worth the effort.

Rick Mills, dvm, phd, lmsw

Ames, Iowa

1. Mulla S. I survived veterinary medicine (lett). J Am Vet Med Assoc 2020;257:146.

Veterinary technician salary: consider all the factors

In their recent study, Gilliam and Coates1 examined the effect having an advanced degree had on veterinary technician salary in the United States. Although salary may be a measurable and easily comparable portion of a compensation arrangement, it seems like a disservice to evaluate and make judgments on the basis of salary alone. This is a reminder to consider the total compensation package for employees.

Variables addressed in the study such as longevity of employment, level of education, and advanced degrees are important. However, one should also consider assorted perks that provide additional benefits to employees, typically at an expense to employers. It is only when we consider variables such as bonuses, health insurance premiums, discounted veterinary services, and others that we can truly and completely understand the total compensation.

Above and beyond any differential for having an advanced degree, we offer vacation time, discounted veterinary services, health insurance premiums, registration at continuing education meetings, and membership dues (eg, the American Animal Hospital Association, local veterinary medical associations, and the National Association of Veterinary Technicians in America), which all contribute in a significant way to the total compensation package for veterinary technicians.

Robert P. Gordon, dvm, mph

Oakland Animal Hospital Oakland, NJ

1. Gilliam SN, Coates JR. Effect of an advanced degree on veterinary technician salary in the United States. J Am Vet Med Assoc 2020;257:328331.

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The authors respond:

As part of our recent study,1 respondents were asked questions regarding their current benefits (Figure 1). However, these results did not make it into the published version of our report owing to a lack of correlation with the study goal of identifying factors associated with veterinary technician salary.

A 2016 demographic survey by the National Association of Veterinary Technicians in America2 also addressed compensation in the veterinary technology profession, including wages and benefits. Because benefits are a vital part of the total compensation package for veterinary technicians, many technicians, when listing low wages as a reason for leaving the profession, are likely referring to the combination of salary and benefits. The retention rate for the veterinary technician profession is low, and this must be addressed to retain these highly skilled and qualified professionals in veterinary medicine.

Figure 1—
Figure 1—

Additional benefits reported by respondents (n = 1,289) to a survey on factors associated with salaries of veterinary technicians in the United States.

Citation: Journal of the American Veterinary Medical Association 257, 6; 10.2460/javma.257.6.588

Stephanie N. Gilliam, rvt, ms

Moberly Area Community College Mexico, Mo

  • 1. Gilliam SN, Coates JR. Effect of an advanced degree on veterinary technician salary in the United States. J Am Vet Med Assoc 2020;257:328331.

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  • 2. National Association of Veterinary Technicians in America. NAVTA 2016 demographic survey. Available at: cdn.ymaws.com/www.navta.net/resource/resmgr/docs/2016_demographic_results.pdf. Accessed Jul 28, 2020.

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The importance of discussing race in veterinary medicine

The sidebar to the recent JAVMA News story “Veterinarians talk racial discrimination”1 listed resources readers could use to become a better ally with those underrepresented in veterinary medicine and to learn about racial equity issues. Books such as those listed at javma.ma/booklist are dominating conversations in businesses, organizations, and late-night talk shows and topping bestseller lists. But, a cursory reading of these books alone is not sufficient.

For example, Ijeoma Oluo in So You Want to Talk About Race states, “if you are white in a white supremacist society, you are racist,” the idea being that racism must be backed by systems of power to be enacted. In this definition, common in the field of critical race theory, Black people cannot be racist because they do not hold enough power in society. By contrast, Ibram X. Kendi in How to Be An Anti-racist explicitly allows for Black people to be racist. In his definition, people create racist policies that lead to less equity or they create antiracist policies that lead to more equity. Which of these competing definitions should the average person use?

In practice, these definitions are important. In the 1970s, orchestras began conducting blind auditions to minimize nepotism. Scholars studied the effect of this policy on increasing the representation of women, which grew from 5% to 30% over the study period.2 Now, because of underrepresentation of minorities in orchestras, there are discussions to eliminate blind auditions in favor of race-based decisions. Which of these policies is racist, and which is antiracist? A similar dilemma was reported in a 2019 JAVMA News story3 regarding admissions at Virginia-Maryland College of Veterinary Medicine.

My most pressing critique of this strain of discussion about race is that it suppresses dissenting discussion and divides. More liberal philosophies believe in gradual progress and respectful, well-reasoned arguments. When gradual change is intentional, such as in the framing of the US Constitution, the reason given is to protect less powerful entities from the whims of powerful tyrants, or even against the “tyranny of their own passions.”4 Critical race theorists believe appeals to gradual progress and respect are veiled attempts to maintain the racist status quo and prefer verbs such as “disrupt,” “dismantle,” and “decolonize.” What tools do we have to determine which motivation is at play? A YouTube documentary5 on events surrounding the 2017 Day of Absence at Evergreen State College in Olympia, Wash, illustrates some of the aspects of this dilemma.

Although there are some points of internal contradiction, critical race theory as a whole is consistent and predictable, and understanding it can help explain some of today's cultural moments. Understanding these authors helps explain when the New England Journal of Medicine publishes an article that calls for white physicians to pay “‘majority taxes,’ comprising discomfort, energy, and capital.”6 It explains when Nature joins a movement to #ShutDownSTEM.7 It explains when the National Museum of African American History and Culture publishes and then rescinds a document that lists hard work and objective, rational thinking as characteristics of whiteness,8 immutably tying these traits to skin pigment.

I am not asking the AVMA and others in charge of policy to not take a political stance. The problem of racism is inherently political and demands a political response from all who can empathize. Instead, I am asking all to realize that the ideas that inform these authors are not politically neutral, nor should we assume theirs should be the default position. I encourage those who form policy to protect a culture that allows for discussion and, importantly, dissent based in mutual humility for all that we do not know and mutual respect in our shared humanity.

Taylor Gaines, dvm, mph

Catonsville, Md

  • 1. Larkin M. Veterinarians talk racial discrimination: advocates say action needed to make profession more inclusive. J Am Vet Med Assoc 2020;257:116119.

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  • 2. Goldin C, Rouse C. Orchestrating impartiality: the impact of “blind” auditions on female musicians. Am Econ Rev 2000;90:715741.

  • 3. Mattson K. AAVMC keeps focused on inclusion: veterinary colleges continue diversity dialogue. J Am Vet Med Assoc 2019;254;11241127.

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  • 4. Federalist No. 63: the Senate continued. Independent Journal, 1788. Available at: guides.loc.gov/federalist-papers/text-61-70. Accessed Jul 27, 2020.

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  • 5. Nayna M. Bret Weinstein, Heather Heying, & the Evergreen Equity Council. Available at: www.youtube.com/watch?v=FH2WeWgcSMk. Accessed Jul 27, 2020.

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  • 6. Mensah MO. Majority taxes—toward antiracist allyship in medicine. New Engl J Med 2020;383:e23.

  • 7. Note from the editors: Nature joins #ShutDownSTEM. Nature. Available at: www.nature.com/articles/d41586-020-01723-9. Accessed Jul 27, 2020.

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  • 8. National Museum of African American History and Culture. Whiteness. Available at: nmaahc.si.edu/learn/talking-about-race/topics/whiteness. Accessed Jul 27, 2020.

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Respect for women

I'm almost 75 years old and have seen a lot of changes in our profession over the 43 years I practiced veterinary medicine. Most of those changes were for the better.

I've known many fine colleagues who were, in their time, ladies and gentlemen. One particular colleague was a Tuskegee Airman during the Second World War and, later, one of the first black graduates of our state's college of veterinary medicine. He respected everyone and was respected by all.

One of the changes over the years has been the number of women entering the field. They have added many good qualities to our profession, such as caring, compassion, dedication, and competency. I'm retired, but my older daughter is a veterinarian who owns a business and employs three female veterinarians. They do incredible work.

That's why I was embarrassed to hear that a member of the US House of Representatives who berated a female colleague on the steps of the Capitol building in late July1 is a veterinarian. I can't imagine my old colleague ever doing such a thing. Women, whether in veterinary medicine, family life, or politics, have earned our respect.

William C. Skaer, dvm

Wichita, Kan

1. Lillis M. Ocasio-Cortez accosted by GOP lawmaker over remarks: “that kind of confrontation hasn't ever happened to me.” The Hill Jul 21, 2020. Available at: thehill.com/homenews/house/508259-ocaasio-cortez-accosted-by-gop-lawmaker-over-remarks-that-kind-of. Accessed Aug 2, 2020.

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Denounce unacceptable behavior

As members of the AVMA, past and present, we take the Principles of Veterinary Medical Ethics of the AVMA1 seriously. In an annotation to one of these principles, this code states that “veterinarians should strive to confront and reject all forms of prejudice and discrimination.…” In that spirit, we are appalled at the comments made by equine veterinarian Representative Ted Yoho to Representative Alexandria Ocasio-Cortez on the steps of the Capitol building on July 20, 2020.2 Rep. Yoho's previous congressional campaigns have been supported by the AVMA, the parent organization representing 95,000 veterinarians in the United States.

Rep. Yoho's abusive, derogatory language has no place in the workplace or any part of women's lives. These comments should never come from any member of the AVMA, but certainly not one who carries such a leadership role and has received explicit political support from the organization. We call for the AVMA to condemn Congressman Yoho's comments and make clear that his heinous words and feeble apology are not in any way supported by this profession.

Since the incident on Capitol Hill, Rep. Yoho has leaned on his 30 years in veterinary medicine as a demonstration of his character and a way to dismiss Rep. Ocasio-Cortez's version of events. Nearly two-thirds of veterinarians in the United States today are female. We ask that the AVMA denounce Congressman Yoho's words so that the profession of veterinary medicine is not used as a political prop and to show that this kind of behavior will not be tolerated from anyone in the AVMA.

Susan Cotter, dvm

Professor Emerita

Mary Rose Paradis, dvm

Associate Professor Emerita

Melissa Mazan, dvm

Lois A. Wetmore, dvm, scd

Mary Anna Labato, dvm

Kristine E. Burgess, dvm

Linda Ross, dvm, ms

Associate Professor Emerita Department of Clinical Sciences Cummings School of Veterinary Medicine Tufts University North Grafton, Mass

Florina Tseng, dvm

Assistant Dean for Diversity, Inclusion, Equity and Climate Cummings School of Veterinary Medicine Tufts University North Grafton, Mass

Mary Ann Crawford, dvm

Oradell Animal Hospital Paramus, NJ

Gail D. Mason, dvm, ma

Bath-Brunswick Veterinary Associates Brunswick, Me

Joann M. Lindenmayer, dvm, mph

School of Medicine Tufts University Boston, Mass

Upholding standards

In 2019, the AVMA Board of Directors selected Dr. Ted Yoho to receive the AVMA Advocacy Award.1 This award is given to recognize an AVMA member or nonveterinarian for advancing the AVMA legislative agenda and advocating on behalf of the veterinary profession. Politics aside, and regardless of any legislative achievements that may be viewed as beneficial to the veterinary profession, Dr. Yoho's misogynistic verbal assault of Representative Ocasio-Cortez this past July2 has disgraced not only the Congress of the United States, but our profession of veterinary medicine. Dr. Yoho then compounded his unfortunate behavior by refusing to apologize or accept responsibility and using his wife and daughters as a shield to protect him from any admission of wrongdoing.3

Veterinary medicine is a predominantly female profession, with two-thirds of all veterinarians and > 80% of new graduates being women. It is also no secret that our profession still struggles with ethnic diversity, being more than 75% white. In my 32-year career, I have been proud to witness the ascent of my female and nonwhite colleagues to the highest levels of leadership and accomplishment in what not long ago was a completely white male-dominated profession. Yet, although the profession has been predominantly female since around 2007, there have been only three female presidents in the history of the AVMA. Dr. Yoho's sexist and misogynistic actions followed by his weak nonapology and denial that he even said the words attributed to him is an affront to women everywhere, but especially to the female members of our beloved profession. Dr. Yoho's actions were a breach of civility that cannot be defended on the grounds of political disagreement. None of us should tolerate our mothers, wives, daughters, friends, or colleagues being treated in this manner.

It is beyond time for this type of chauvinistic attitude to end. It is beyond time for our profession to stand up for all of its membership and say, “No, Dr. Yoho. Not on our watch.” If the AVMA Board of Directors on behalf of the AVMA membership can bestow Dr. Yoho with awards and public accolades, then it should also hold him to a standard worthy of those honors. Ignoring this episode and continuing to honor Dr. Yoho without making a public statement condemning his actions is tantamount to accepting and tolerating this type of misogynistic behavior both in our society and in our profession.

Ray M. Kaplan, dvm, phd

Department of Infectious Diseases College of Veterinary Medicine University of Georgia Athens, Ga

Take a stand against sexism

The AVMA's feeble response1 to Dr. Ted Yoho's harassment of his colleague Alexandria Ocasio-Cortez on the steps of the Capitol this past July2 is simply unacceptable. Regardless of the words that Dr. Yoho may have uttered, his unprovoked verbal attack was at best unprofessional and at worst misogynistic. Certainly, his behavior is not consistent with the ethical standards to which the AVMA should hold its members, much less an elected official who represents the interests of our profession.

It appears that the AVMA prefers to stand on the sidelines as others lead. Of course, gender inequity is not only a veterinary problem. However, the AVMA is the voice for a profession that is approximately two-thirds female. Veterinary school enrollment is now > 80% female, and women make up the vast majority of veterinary paraprofessionals. How does the recent AVMA statement address the systemic effects of sexism and patriarchy in the veterinary profession? Actions speak louder than words.

The AVMA seems to have a blind spot when it comes to our profession's gender bias. Women in veterinary medicine are paid less for the same work, often maligned for taking family leave, and characterized by negative gender stereotypes, while male colleagues like Dr. Yoho are celebrated for their uncompromising “passion.” It is well past time that the AVMA take a firm stand that sexism is unprofessional, unethical, and unacceptable in veterinary medicine. That starts with admonishing members, like Dr. Yoho, for mistreating female colleagues.

Jim Dobies, dvm

Belmont, NC

Condemns offensive behavior

In late July of this year, Dr. Ted Yoho, the congressman representing Florida's third congressional district, made the news.1 On the steps of the Capitol, he confronted a fellow congressperson, calling her a horrible expletive. This extremely offensive behavior reflects poorly on him and, by extension, on our profession. I believe that, as a veterinarian serving in Congress, Dr. Yoho should behave in a manner that makes our profession proud. No matter what your politics may be, I hope you join me in condemning Dr. Yoho for this grossly offensive behavior. No woman should ever be called this in any situation, let alone in public in front of her colleagues and the press. No matter what his political disagreements with the congresswoman are, such name-calling cannot be tolerated.

During 2019-2020, Dr. Yoho received the highest individual contribution to his campaign committee ($5,000) that the AVMA Political Action Committee gives.2 The AVMA should disavow their support for Dr. Yoho, request that the PAC contribution be returned, and make no further contributions to his campaign committee.

He is a disgrace to our profession.

Linda Rhodes, vmd, phd

Durham, NH

The AVMA responds: affirming our values and commitment to gender equity

The encounter between Representative Ted Yoho, an AVMA member, and Representative Alexandria Ocasio-Cortez put a spotlight on the vital issue of gender equity in our society. The AVMA thanks our members for sharing their perspectives, and we reiterate that the reported language does not reflect the AVMA's values. Derogatory and abusive language undermines our progress toward gender equity.

“For many of us, the language reported to have been used is far from new,” Dr. Rena Carlson, outgoing Chair of the Board of Directors, said as she addressed the House of Delegates on July 30. “We vividly remember our own personal experiences, from small sexist comments to those that hurt us, to abuses that left us harmed and forever changed. Women should always be treated with respect and professionalism and the AVMA shares that expectation. This is even more critical for those who are in leadership positions.”

Following the July media reports, both members of Congress made statements with starkly different characterizations of their encounter. Because Rep. Yoho is a veterinarian and a colleague and because of the significance of this issue, we felt it was important to reach out to him directly. During our discussion, we conveyed to him the depth of feeling on this issue expressed by the AVMA members who have contacted us and our concern regarding the reported interaction. As he did in his public statements, he strongly denied saying the words attributed to him. Rep. Ocasio-Cortez just as clearly indicated otherwise. The differing accounts made issuing a statement about Rep. Yoho's specific actions or words challenging. What we could do is clearly reaffirm our values and what we stand for: such behavior, whenever it happens, is inappropriate and unacceptable. We stressed our expectation that our members, whatever their current role may be, will always demonstrate professionalism and courtesy to others and uphold the dignity and respect of the veterinary profession.

Some have asked about the AVMA Political Action Committee's past financial support of Rep. Yoho's campaign. To effectively serve our members, we work with legislators—Democrats, Republicans, and Independents—on issues that are important to the veterinary profession. We especially support members of Congress who are veterinarians; there are currently three (two Republicans and one Democrat), all of whom are members of the small but important Veterinary Medicine Caucus in the US House of Representatives.

Our PAC has supported these and other legislators as we work to advance the legislative goals of the veterinary profession. The PAC's campaign contributions are funded solely by voluntary individual contributions and are not funded by member dues. Federal law prohibits the use of member dues for political campaign contributions, and we follow the law. Rep. Yoho is not running for reelection, and his campaign will not receive additional funding from the AVMA PAC.

Let there be no ambiguity that gender-based insults and misogynistic behavior have no place in veterinary medicine or in society as a whole. Now, more than ever, it is important that we all affirm our commitment to gender fairness, anti-racism, and diversity and inclusion across all aspects of our profession. We underscore the right of all individuals to have work environments free from sexism, racism, bullying, and abusive language.

These are not just words on a page for us; we take this very seriously. We have developed and continue to develop resources to help promote a culture of equity and respect throughout our profession. The Brave Space Certificate Program, launching in October, will help create a culture of well-being in the veterinary workplace and includes a focus on diversity and inclusion. We offer several webinars addressing related topics, including unconscious bias, marginalization, and intersectionality. The AVMA Trust offers AVMA members anti-harassment training and, later this year, will offer a dedicated sexual harassment prevention training program.

What we can do—together—is learn from this episode and reflect on ways we should conduct ourselves and show respect to one another. On behalf of the AVMA, we commit to do all we can to foster an environment that is welcoming and inclusive and has zero tolerance for misogynistic behavior. Everyone can help by actively using resources the AVMA has developed and continues to develop to promote a culture of equity and respect across our profession.1 Our profession is strongest when it is unified, and substantive progress depends on our moving forward together.

Lori Teller, dvm, dabvp

Chair, Board of Directors AVMA

Rena Carlson-Lammers, dvm

Outgoing Chair, Board of Directors AVMA

Janet D. Donlin, dvm, cae

Chief Executive Officer AVMA

1. AVMA. Diversity and inclusion in veterinary medicine. Available at: www.avma.org/resources-tools/diversity-and-inclusion-veterinary-medicine. Accessed Aug 6, 2020.

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