Understanding the moral injury facing veterinarians

One thing I hear a lot in passing conversations, social media comments, or review forums — is frustration directed at veterinarians because people perceive the prices of medical care for their pets as exorbitant, and unfair.

This misperception goes as far as people thinking a veterinarian contributed to their cat or dog’s death because they could not afford the life saving treatment that was being recommended for their pet. I can empathize with the anger and pain of an emotional or grieving pet owner, but I also understand the challenges facing the veterinary industry and the devastating impact this has on wonderful people working in the profession.

Very few people realize that it’s harder to get into veterinary school than it is to medical school. Despite a similarly rigorous and competitive program, veterinarians stand to make, on average, half as much as physicians. According to the Bureau of Labor Statistics (BLS) published on Indeed, doctors make an average of $208,000 per year, while veterinarians make an average of $99,250 per year. Veterinarians pursue this field because THEY LOVE ANIMALS, but the pressure on these professionals financially, physically, and mentally is significant

Depression, compassion fatigue and burnout are common with veterinary professionals, even in the early years of their careers. A survey conducted by the American Veterinary Medical Association (AVMA) indicated that approximately 1 in 6 veterinarians had considered suicide at some point in their careers.

The veterinary profession can be highly rewarding, and more and more hospitals are working to protect their staff from stress and hazards by investing in their mental health and wellbeing. But if you’re struggling to imagine why a career dedicated to pets, puppies, kittens and other animals could be so difficult, here are a few of the reasons why being a veterinarian can be so difficult.

• Emotional and Ethical Challenges: Veterinarians often deal with life-and-death situations involving animals. They may face difficult decisions related to euthanasia, end-of-life care, and delivering unfavorable diagnoses to pet owners. The emotional toll of these situations, coupled with the responsibility to provide ethical and compassionate care, can be challenging.
• Long Work Hours and Demanding Schedule: Veterinarians often work long and irregular hours, including evenings, weekends, and holidays. The demanding schedule can disrupt work-life balance, making it challenging to find time for personal commitments, relaxation, and self-care.
• High Workload and Time Pressure: Veterinarians often face heavy workloads and time pressure due to the need to attend to multiple patients and handle emergencies. This can lead to long working hours, limited breaks, and a constant need to make quick decisions, increasing stress levels.
• Emotional Investment in Patients: Veterinarians develop strong connections with their animal patients and their owners. Dealing with pet illnesses, injuries, or loss can take an emotional toll. Additionally, managing client expectations, communication challenges, and difficult interactions can add to the stress of the profession.
• Financial Pressures: Veterinarians may face financial pressures, especially if they own or manage a veterinary practice. Balancing the provision of quality care with the need to maintain a viable business can be demanding and stressful.
• Compassion Fatigue and Burnout: The constant exposure to animal suffering and the demands hospital staff face can contribute to compassion fatigue and burnout. Over time, this can lead to emotional exhaustion, decreased job satisfaction, and a higher risk of mental health issues.

Lately I have been thinking about how the terms ‘compassion fatigue’ and ‘burnout’ may actually undermine the profession. These labels can imply a weakness or lack of grit on the part of the individual, instead of employing the people, communities and educational institutions to rally around a cause or recognize how our actions can contribute to a crisis.

A recent New York Times article about ‘The Moral Crisis facing American Doctors’ is profound, challenging our society to understand and support the ‘moral injury’ employees in many industries and professions face — including veterans, physicians, farmers, slaughterhouse workers, and more. Understandably, in professions where employees are more likely to have financial insecurity they may be subject to more moral injury for fear they can not voice objections or refuse the direction or demands of employers.

In 2022 Dr. Andy Roarke hosted Dr. Indu Mari, DVM and a fellow in Bioethics at the Harvard Medical School, on his veterinary podcast, The Cone of Shame. In the episode, Dr. Mari describes “moral distress is when you have to perform an action you either feel compelled to perform or you perform an action which is the opposite of what you feel is right.” She then discussed the contrast between veterinary medicine and pediatric medicine. Dr. Mari explained that “Pediatricians have the right to advocate for their patients in their patient’s best interest even if it supersedes what the parent wants to do… or the ‘harm principle’ that if you elect a certain procedure it will result in harm to your patient. It occurred to me that we (veterinarians) don’t have any of those protections in our shared decision making models.”

The science of the Human-Animal Bond is still relatively unknown, but Dr. Mari and a wonderful TedX talk by Dr. Melanie Bowden, DVM help explain its implications on how we love and medically care for pets. Bowden describes, in inspiring and heartbreaking detail, what it really takes to be a veterinarian today. Her Ted Talk is a must-listen for any pet parent or animal lover, as it compels us to understand the challenges facing our pet’s veterinarians, and what we can do to be better pet owners and clients.

Dr. Bowden explains how kindness, candor and communicators can empower us to be better guardians of our pet’s lifelong health and wellbeing. Lastly, both she and Dr. Mari help remind us that until the world catches up to the moral obligation and individual commitment we have to our animals — the best thing we can do is prepare ourselves financially for the care our pets may need. Yearly preventive care and check-ups, a healthy diet, and pet insurance or plan to afford unexpected vet bills can all help ensure we can be there for our pets when they need us most — and help support the medical professionals who have committed their lives to the Veterinary Oath, and to the animals we love so very much.