Introduction

Two alternatives to the most common roles as associate, partner, or owner for clinical practitioners include relief (locum) or mobile positions. Full-time relief veterinarians are typically employed at multiple hospitals, often filling in for the permanent staff member or utilized during staff shortages. Their presence allows associates and owners to take time away while still meeting the demand for services.¹ Relief veterinarians typically work independently, functioning as a small business, but some work as employees of a relief company, hospital group, or corporation.^2,3

The number of relief veterinarians has grown from approximately 1,800 in 2008 to about 2,300 in 2018, an increase that matches the overall increase in actively working veterinarians.⁴ For some, the decision to work as a relief veterinarian is a career choice, while others use it as a temporary position until they become a hospital associate, partner or owner.¹

There are numerous touted benefits of working as a relief veterinarian, as discussed in various trade magazines and veterinary websites: control over one’s work schedule; a variety of environments, colleagues, and clients; better pay; and opportunities to explore different hospital settings.^2,3,5 However, there are also purported disadvantages of relief work, including less job stability (relief veterinarians are dependent on shift availability) and a lack of established client relationships or colleague interactions.³ Moreover, relief veterinarians are typically responsible for many business-related tasks and expenses that are managed for full-time associates as part of their contractual agreement. These include taxes, insurance (health, dental, vision, disability, etc), professional licensing, veterinary association dues, retirement contributions, and continuing education. Relief veterinarians must be able to create a budget that adequately accounts for these additional expenses to determine the minimum number of hours they are required to work.

Another alternative to traditional clinical positions is a mobile practice. While mobile practices for large animal veterinarians have long been the norm, small animal mobile practices have only recently increased in popularity.⁶ And although there is scant research on this career option, non–peer-reviewed sources suggest that some veterinarians are attracted to mobile practice because of the relatively low startup costs, estimated to be approximately 25% of starting a brick-and-mortar practice.⁷ In addition, mobile services offer pet owners the ability to receive services within their home, removing the stress of a hospital visit, and often offer flexible hours to better accommodate pet owners’ schedules.^6,8 Most mobile veterinarians function as small businesses, providing many of the same services as a brick-and-mortar hospitals, including physical examinations, vaccinations, blood work, euthanasia, surgery, dental work, diabetes management, and senior health.^7,8 Other mobile veterinarians contract to provide or refer certain services (eg, radiography, surgery, dentistry) through brick-and-mortar hospitals or work for corporate mobile businesses. Regardless of services provided, many states require mobile practitioners to coordinate with a local stationary clinic. This requirement means that animals requiring emergency care, hospitalization, or surgery can be referred when such services are deemed necessary.⁹

Mobile practices share many of the same benefits and challenges associated with a relief position, including the ability to set one’s own schedule.¹⁰ Yet, similar to those in traditional practice, some mobile veterinarians find it difficult to set boundaries with clients. This can lead to difficulty separating work and personal time.⁷

Despite the number of relief and mobile veterinarians, and the purported benefits and challenges, there is a dearth of research about this population. To address this, we designed this study to better understand how relief and mobile veterinarians feel about their positions, including the benefits and drawbacks, as well as the reasons for choosing one of these career options. We were also interested in the perceptions of veterinarians thinking about making a career change to either relief or mobile work.

Methods

We created an online, anonymous survey (Supplementary Material S1) and distributed the link via the Veterinary Information Network (VIN) data collection portal to all members of the VIN, an online community for veterinarians (n = approx 43,000 members). The survey invitation was sent to all VIN members because VIN does not track which members work as relief or mobile practitioners, but in the email invitation we indicated we were surveying only veterinarians who were currently working as a relief or mobile veterinarian or were considering a career change to either of these options.

The survey was open May 11, 2023 through May 30, 2023. A reminder email was sent 2 weeks after the initial invitation. We included screening questions asking if participants worked as a relief or mobile practitioner or were considering either of these types of positions. Analyzed data consisted of respondents who stated they were currently working as a relief or mobile veterinarian. The study was categorized as exempt by the Colorado State University Institutional Review Board.

The body of the survey consisted of demographic questions, including gender, year of veterinary school graduation, and current type of practice (eg, relief, mobile, or considering either of these options). Those working as relief veterinarians were asked what type of practice they provide services for (eg, first opinion, emergency, specialty, shelter, other). Both relief and mobile veterinarians were asked to indicate their most recent previous position (eg, corporate-owned practice, privately owned practice, shelter medicine). They were asked if they chose to leave their previous position and, if so, were asked to indicate to what degree several factors affected their decision to leave using a 4-point Likert scale (1 = did not affect at all to 5 = strongly affected). Examples of these factors included health benefits, administration, personal case load, and feeling their voice is heard by management/owners. They were also asked, using a 4-point Likert scale (1 = not at all to 4 = very) how several potential pressures in their previous position factored into their decision to leave. Examples of these stressors included pressure to generate practice revenue and pressure to work longer shifts or work beyond contracted shifts.

Relief and mobile veterinarians were next asked to describe their satisfaction with several aspects of their current position with a 5-point Likert scale (1 = very dissatisfied to 5 = very satisfied). Examples of these factors included available for elderly family or family with medical needs, work-life balance, and ability to travel. They were then asked to indicate which factors apply to their current position from a potential list of items (eg, little support from colleagues, new hospital protocols each time, lack of job security). For each indicated item, they were then asked to report how each of these factors made them feel, using a 5-point Likert scale (1 = this aspect bothers me a great deal to 5 = I like this aspect a lot).

To ascertain what business-related items they have in their current role (eg, business website, financial advisor, disability insurance), relief and mobile veterinarians were asked to indicate those they currently have, those they don’t have but plan to get, and those they have no plans of obtaining.

Relief veterinarians were asked if they have a regular client base (ie, regular hospitals or shelters), how easy or hard it is to find relief work, where they get their prospective clients from (eg, personal introduction, state veterinary medical association list, personal connections). They were then asked to rank these methods in terms of usefulness. Similarly, mobile veterinarians were asked to indicate how easy it is to find mobile work, the methods they use to find prospective clients, and the ranking of these methods in terms of usefulness.

Both relief and mobile veterinarians were then asked to indicate how well a series of potential reasons to pursue a position as a relief and mobile veterinarians applied to them using a 5-point Likert scale (1 = does not apply at all to 5 = totally describes me). The reasons were adapted from Trice’s list of types of relief veterinarians.¹ Examples of reasons included wanted to run your own business/be your own boss; wanted/needed flexibility for child or elder care, hobbies, other businesses, etc; and felt burned out and chose relief/mobile work as a way to get a break (Supplementary Material S1).

Results

Discussion

There are numerous reasons that veterinarians may choose a career as a relief or mobile veterinarian. We found the most common reasons for leaving their previous position included schedule concerns (number of hours worked per week, ability to create a flexible personalized schedule, and the ability to leave work at the scheduled time) and hospital dynamics (eg, administration, culture, leadership, feeling their voice was heard). Previous studies have found these reasons (including the inability to get through their workload on time, not enough time per patient and the perceived negative impact on patient care, and personal fatigue) are all associated with decreased productivity and increased turnover and burnout.^11–13 In contrast, control over work conditions, including workload, autonomy in clinical activities, and flexibility in work schedules, appear to improve veterinarians’ job satisfaction.^13,14

Despite the recent attention given to burnout among veterinary professionals, its prevalence continues to increase.^15–17 One recent study¹⁸ found that 40% of veterinarians are considering leaving the profession, with one of the top reasons cited involving a lack of work-life balance. Similar results highlighting the importance of work-life balance have been found in studies conducted in the US, UK, Australia, and Germany.^19–24 In addition, the percentage of veterinarians resigning or choosing to work in nonclinical roles has increased,^25,26 with reported reasons including number of work hours, workload,¹³ perceived stress and anxiety,^{19–21,27,28} and conflicts with home and caregiving responsibilities.^19,29,30 In our study, both relief and mobile veterinarians reported high levels of satisfaction with work-life balance (mobile, 78%; relief, 91%) as well as availability for children (mobile, 84%; relief, 84%) and other family members (mobile, 85%; relief, 87%). Furthermore, only 15% of mobile and 5% of relief veterinarians reported feeling dissatisfied with their income.

In addition to asking why current relief or mobile veterinarians left their previous job, we also asked them to indicate why they choose relief or mobile work. We found the most common reasons given for choosing mobile work included wanting to be one’s own boss, schedule flexibility, and wanting to escape an unhealthy work environment. For relief veterinarians, the most common reasons included schedule flexibility, escape from an unhealthy work environment, and feeling burned out and wanting a break. Both mobile and relief positions are typically entrepreneurial positions that offer the ability to set one’s own schedule and be one’s own boss, thereby improving work-life balance, which has been found to positively impact well-being and retention in the field.^19,22,28

As of 2009, female veterinarians outnumber males, and 83.2% of US veterinary students are female.³¹ As the field becomes increasingly feminized, schedule flexibility and work-life balance will likely increase in importance. One reason for this may be the number of household tasks and amount of care that women provide.³² Women spend substantially more time on housework and childcare than men (on average 24.4 hours per week³³), regardless of work status and education level.^34,35 In addition to childcare and household tasks, many women also care for an older adult, a need that can arise more suddenly and intensely than childcare needs, making it harder to prepare for and therefore potentially more stressful than other caregiving demands.^33,36–38 These “sandwich generation caregivers” (those who care for both an older adult and children³⁹) are typically employed females between 40 and 59 years of age^33,40 who struggle with work-family conflict that negatively impacts their well-being.^41,42

Combining employment with household chores and caregiving responsibilities can be stressful because they compete for limited time and energy.³⁹ Yet doing both can also be beneficial,^39,43 and jobs that allow for the blending of these roles can reduce the stress associated with home and caregiving responsibilities.³² Having flexibility and control over one’s work schedule can help people juggle their work and family/home responsibilities, especially home tasks that have limited flexibility like cooking or caregiving, and, as a result, improve overall well-being.^29,44 One recent survey⁴⁵ found that 64% of female veterinarians and 42% of male veterinarians reported that they would take less pay for more flexibility in working hours. Scheduling flexibility, however, must be paired with schedule control; employees need predictable schedules and control over their working hours to effectively balance home and work responsibilities.^46–48

In terms of potential drawbacks, relief and mobile veterinarians reported being most bothered by new hospital protocols, little support from colleagues, and a lack of job security. These are important factors to consider when contemplating either of these types of positions. Those who thrive in familiar, comfortable settings with a consistent team and a steady, reliable paycheck may find these positions challenging.

While many relief and mobile veterinarians in our study report high satisfaction levels with work-life balance and availability for family members, only a minority of practitioners pursue these alternative career options. We hypothesize that 1 reason could be that traditional clinicians overestimate the negatives and underestimate the positives of these positions. Providing resources and education to associates interested in moving into relief or mobile work may help some veterinarians seeking better work-life balance and well-being stay in the field. For example, the importance of planning for the future and unforeseen accidents or illnesses should be addressed. We found that approximately 50% of relief or mobile practitioners reported having no disability insurance and more than 25% reported having no retirement plan. Training that addresses these topics, in addition to tools pertaining to business structures, contracts, insurance, and bookkeeping, are recommended. There are a limited number of current options, including companies that employ relief veterinarians. In addition, we suggest that veterinary organizations are ideally suited to offer business-related resources for those wanting to pursue relief or mobile career options.

There are several limitations to our study. Our sample consisted of a small percentage of VIN members, so caution is suggested when generalizing to other veterinarians. Nevertheless, our survey is larger than any others we identified that have surveyed relief or mobile practice veterinarians. Another limitation, given the small number of responses from all those eligible, is response bias. It is possible that individuals who feel strongly about relief or mobile work may have been more likely to respond to the survey. However, the invitation to participate in the survey was nondescript, only inviting those in mobile or relief practice to participate. Additionally, it is unknown whether participants who reported not having benefits (eg, health, dental) obtain these through another source, such as spouses. Further research to determine whether lack of benefits for relief and mobile work is a problem and a potential barrier to these types of positions is needed. Research pertaining to relief and mobile work could also benefit from a better understanding of other barriers for those seeking these types of positions, what resources they need to be successful, and whether these positions are more beneficial to some veterinarians, based on demographics and personality types, than others. Future studies that involve mixed methods or qualitative analysis would be helpful to further understand these alternative positions and those who choose to move in these directions.

In conclusion, there are several societal and demographic trends that suggest mobile and relief positions might become a more popular choice for veterinary associates. First is the current shortage of associates,^27,49,50 making many hospitals open to exploring alternative options to traditional associate positions. In addition, the fact that many pet owners are looking for veterinary care options that are logistically easier and less stressful for their pet^7,8 than taking them to a veterinary clinic means that a growing number of owners might be open to the concept of mobile clinicians.

Mobile and relief positions allow veterinarians to take control of their career in ways often not permitted in traditional associate positions. Improved work-life balance and flexible hours, whether through changes for associates or a shift to relief or mobile work, offer a way to address current retention struggles within veterinary medicine.^46,47 A focus on these areas may be especially timely, as both male and female millennials and Generation Z veterinarians have a different perception of work-life balance than previous generations.⁴⁶

Although mobile and relief positions come with more financial risk than traditional associate positions, and while it should be noted that this was a small sample and may not be representative of all mobile and relief practitioners, most respondents in our study reported no difficulty finding work and reported minimal financial concerns. In addition, they reported high levels of job satisfaction with the very work-related elements they were seeking when they left their previous job.

Relief and mobile veterinary positions appear to offer increased autonomy over one’s schedule, allowing for better work-life balance and the availability to provide care for children and/or other family members. It would appear that for many relief or mobile veterinarians, the decision to leave their previous position in search of one that offers better work-life balance paid off.

Supplementary Materials

Supplementary materials are posted online at the journal website: avmajournals.avma.org

Disclosures

The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this manuscript.

Funding

The authors have nothing to disclose.