As Mental Health Awareness Month ended last week, the staff at Rock Veterinary Clinic, Luverne, have a simple request: Be kind.
Two of their five veterinary doctors recently left the clinic, and the remaining three are working overtime to meet the needs of farm clients and pet owners.
“It’s been rough,” Dr. Erin deKoning said. “And it wouldn’t be so bad if people could be nice. … I just think ever since covid … it just brought out the most impatient behavior.”
She points to the high rate of suicide among veterinary professionals — one in six have thought about it, and female veterinarians are 2 ½ times more likely to die of suicide.
“We take stuff home with us,” she said. “When we can’t fix something or we can’t help someone, we take it home. There are nights I don’t sleep because of things we’ve seen or done, or things we tried to work on that we can’t make better.”
According to the Journal of the American Veterinary Medical Association, veterinarians in the United States are three to five times more likely to die by suicide than the general population.
And a 2019 JAVMA study showed 80 percent of all veterinarians suffer from clinical depression at some point, and about 50 percent report feeling unhappy in their careers.
DeKoning said various stressors are unique to veterinary medicine that make vets more vulnerable. Among them are emotional toll, long work hours, perfectionism, unfair client expectations and — especially among younger vets, debt and financial pressures.
Dealing with humans is the hard part
The three remaining vets at the clinic are leaning on each other’s strengths to run the business. DeKoning has been there 15 years, Dr. Jason Johnson has been there since 2004, and Dr. Michelle Engen started in 2018.
And they’re working smarter — like utilizing a call service to handle overnight on-calls and screen actual emergencies.
“We lost Dr. Paul (Sylliaasen) because he didn’t want to be on call anymore. That’s why we went to an on-call service,” deKoning said.
“With the three of us taking call, … we were trying to weed out what was truly an emergency versus people thinking they can call and leave a voice mail, and they wake you up to ask how much it costs to spay a cat.”
And it’s helping to address sleep deprivation, which is a chronic problem among most veterinarians.
“When the client comes after you, that’s your sleep issue,” Johnson said. “You lay awake and ask, ‘What could I have done different?’ 100 times. That’s what gets you.”
Generally, the three local veterinarians agree that caring for animals is the easy part; it’s the humans who make their jobs difficult.
“When you have clients who get mad about something that went wrong and they come after you … We care, and we tried all day, and they said you didn’t do enough. That’s the hardest part of this job,” Johnson said. “Because we care.”
DeKoning said farmers understand losses better than small animal clients who often view their pets as family members.
She described a 14-year-old dog who ate a foreign body, and the staff in Luverne wasn’t equipped to remove it.
“People are being unpleasant about it,” she said. “The emergency clinic is the only way to do it safely. … We’re trying to be accommodating as best we can, but it wears on you.”
She shared another example of a dog that had been hit by a car last fall.
“Paul ended up taking the leg off and it died in recovery. The owner told him, ‘You f---ing killed my dog, you a—hole.’ The fact that your dog is running in the street and gets hit by a car is our fault?” deKoning said.
Engen said people’s expectations are often unrealistic.
“As a general practice we are well-equipped, but we don’t have the things that the Sioux falls ER would have,” she said. “And fancy equipment comes with cost; you have to have the expertise to use it and that would mean hiring.”
Chasing perfection
All three Luverne vets agree that veterinarians tend to be Type A personalities and choose the profession because they’re driven to perfection.
And this leads to stress, Engen said.
“No matter how perfect you are with a case, you may be financially limited by the owner on what you can diagnostically do to fix the problem, and if you can’t do that, it’s just a crap shoot on what you can try,” Engen said.
“Personally, I want to have the pieces to do the best thing, but I’m not allowed to do that in a lot of cases because of cost, or surgical limitation (like an older pet), or you might be out on a farm call and something is in dire need and you have zero facilities to save it or accomplish any part of what you need to do.”
Johnson said veterinarians are acutely aware of the value of living things.
“It has a heartbeat. It isn’t like fixing a car where, if I put in the wrong part and it doesn’t work, I can fix it again,” he said.
“When you put all that in, and the animal dies, you’re already traumatized enough, but when the owner comes back with a complaint. … I can understand it’s their pet. They have emotions, but vets have emotions, too.”
DeKoning said veterinarians have to pivot daily between happy and sad.
“If you think about the emotional swing of things we do in a day, from birth to death … We can have a euthanasia in one exam room and it’s very sad and emotional, and there’s a new puppy next door and you have to walk in there and you have to act like nothing happened next door,” she said.
“We’re experts at masking our feelings. We have to be.”
They said the difference between veterinary medicine and human medicine is often defined by the separation of medicine and business.
“Obviously in human medicine – there’s insurance, and medical doctors don’t necessarily deal with the billing and the burden of that,” Engen said.
When people’s pets have emergencies that they can’t afford to pay for, it adds another layer of stress.
In Luverne the veterinarians are the business owners and operators, something they weren’t necessarily trained for in veterinary medical school.
“We’re more deeply immersed in it,” deKoning said. “The economy is changing, and I think there are more people struggling financially than we realize.”
‘No one wants to live this lifestyle’
They’re realizing how difficult it is to attract new veterinarians.
“We’ve tried to get vets to come here, but no one wants to live this lifestyle,” deKoning said. “Our only shot is people who grew up here.”
And younger vets are feeling the pinch of debt load.
Most fresh-out-of-school veterinarians carry $300,000 or more in student loan debt with interest rates at 7 to 8 percent. With the average veterinarian’s national starting salary at $90,000 to $100,000, financial pressures mount.
“Now you have a house payment and if you don’t like your first job, you’re handcuffed,” Johnson said. “With the new vets coming out, the burnout is bad, because of the financial pressure.”
Engen said this likely contributes to suicide rates.
“You put a lot into getting here; it’s entirely your life now, and when people treat you badly … and all that loan debt …,” she chokes back tears.
DeKoning hands her a tissue. “It’s been a tough week here.”
She said the Rock Vet staff are doing what they can to help each other and lean on professional support in their industry. What would be especially helpful, she said, is client compassion.
“I even ordered signs that say, ‘Please be kind to our staff.’”