The Vet Emergency

Jason E. Kaplan

The pandemic worsened working conditions for veterinarians, who have been pushed to the brink with increased workloads. But COVID-19 is also forcing employers to address the mental-health crisis afflicting the profession.

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If you take your pet to DoveLewis Emergency Animal Hospital, Oregon’s largest veterinary hospital, you may be in for quite a wait. The Portland ER for animals — open 24 hours a day, seven days a week — has been inundated with visits over the past 10 months. The time it takes for pets to be seen has gone up by as much as 24 hours. Pre-pandemic, the hospital aimed to prevent wait times from going above one hour.

“I used to get upset if our wait times were three or four hours,” says Ron Morgan, CEO of DoveLewis. “We are still seeing 6-, 8-, 12-, 14-hour wait times sometimes.”

0721 Vet ronIT4A6862Ron Morgan, CEO of DoveLewis Emergency Animal Hospital in Portland.   Credit: Jason E. Kaplan

The increased workload stems from unprecedented growth in pet ownership during the pandemic. With people spending much more time at home, especially because of work-from-home policies, many have adopted pets to keep them company. Nearly one in three Americans adopted a pet during the pandemic, according to an October 2020 report from the Insurance Research Council. And as more people spend time at home with their pets, they are paying more attention to health problems their pets may have had for a while but which they have been too busy to notice or take care of.

This has translated into a large uptick in vet visits. Morgan estimates that DoveLewis veterinarians will treat about 20% more patients this year compared with last.

Part of the increase in emergency vet visits is due to general-practice vets turning away pet owners. Regular vet clinics have been so overwhelmed that some stopped accepting new patients and curtailed service.

“I’d say 20 to 30 patients are coming to us a day who would see their regular vet if they could get in,” says Morgan.

This increased workload across the sector is leading to unprecedented stress and burnout among veterinary doctors and vet technicians. A profession that was already facing a labor shortage before the pandemic is now severely understaffed, pushing some veterinarians to their breaking point.

0721 vet dovelewis IT4A6922Staff at work at DoveLewis Emergency Animal Hospital in Portland.   Credit: Jason E. Kaplan

The occupation already had one of the highest rates of suicide of all types of work, and the pandemic has made working conditions worse.

Employers are starting to take notice. Many are trying to make their workplaces less stressful by providing better mental-health services for staff, enforcing breaks and reducing shifts. The pandemic is forcing much-needed change in a sector where work-life balance has traditionally been a luxury.

COVID-19 has completely changed the way veterinarians communicate with clients, and that has added to the difficult work conditions, particularly for vet technicians and other support staff.

Most clinics require clients to drop off their pets at the curb because of the lack of room inside for social distancing. As a result, communication with owners is done mostly over the phone, which can make consultations much longer.

“We are busy all the time and everything takes longer. An appointment used to take 30 minutes. Now it is almost one hour,” says a veterinarian who asked to remain anonymous.

Adding to the increased appointment times is the jump in caseloads.

“The major hospitals have had to defer cases to other hospitals or close down entirely because we can’t get cases through triage,” says Heidi Houchen, president of Oregon Veterinary Medical Association and a practicing veterinarian at VCA Northwest Veterinary Specialists. “Caseloads have doubled and tripled. We have gotten over a thousand phone calls a day. Sometimes it is just fielding advice. We field phone calls constantly — a lot of the time it is figuring out how urgent something is.”

DoveLewis was receiving so many phone calls from pet owners that it hired a company just to handle call volume. Previously, on-staff vet techs handled customer calls.

Support staff say they have faced increased abuse from clients during the pandemic. Pet owners are generally more anxious and less financially secure because of COVID-19. Support staff traditionally take payment for treatment and, because of this, they often bear the brunt of abuse from pet owners.

“To say I am burned out is an understatement,” says a Portland vet technician who asked not to be named. “People treat you horribly. The bills are so high that a lot of the time they can’t afford it. They take that emotional guilt out on the staff.”

Pet insurance still has a low take-up rate in the U.S. compared with Europe. A survey by Liberty Mutual Insurance finds almost three-quarters of animal owners do not have pet insurance. In some areas of the country, the insurance rate is in the low single digits. Treatment plans are tailored to the clients’ budget, which can make the job stressful and time-consuming, say veterinarians.

Another vet says she has seen clients try to break into the building to see their pets. Staff harassment is common, she says. “Clients are impatient and demanding. I know one clinic that had a complete turnover of staff.”

Veterinarians are also subject to abuse online from pet owners complaining about service —most of it is related to the cost of treatment. This online abuse adds to the overall frustration and disenfranchisement that employees feel.

Recognizing the stress and emotional toll that veterinary medicine is taking on staff, employers have offered more mental-health services to workers in recent years. Therapy sessions, mental-health apps and massages are some of the services that managers and human resources tout as solutions to staff burnout. But veterinarians are skeptical.

“There is no time” to use these services, says one vet. “We are so busy.”

The vet technician who asked to remain anonymous says the No. 1 change that would persuade her to stay in the profession is more pay and better benefits. She has six years of experience but earns just $17 an hour. She is two to three times busier than before the pandemic and is considering quitting the profession because of burnout.

“The best thing that could happen is if we got unionized and got a livable wage,” she says.

Over the past few years, there has been a drive toward unionization in the veterinary medicine sector. COVID-19 may accelerate that. Among labor unions representing employees is Portland’s ILWU Local 5, which has represented workers at Columbia River Veterinary Specialists since 2018. Employees at the Vancouver-based veterinary hospital, owned by PetVet, were among the first in the sector on the West Coast to unionize.

Vet employers are seeking to boost wages to attract staff. Kate Sycamore, medical director of Pacific Northwest Pet ER & Specialty Center, says the biggest change needed in the profession is to pay support staff better wages. Her employer is opening a new hospital in Vancouver, Wash., later this summer. It is hiring 90 support staff and between eight and 10 emergency doctors.

Sycamore sees the new hospital as an opportunity to start a veterinary facility that does not have the traditional workplace culture that has hobbled other practices.

0721 vet Vancouver IT4A6416Kate Sycamore, medical director of Pacific Northwest Pet ER & Specialty Center, left, and veterinarian Ashley Runey, who specializes in emergency medecine, at the construction site of the new hospital.  Credit: Jason E. Kaplan

“There will not be an ingrained culture or communication dysfunction. We get to start from scratch and set expectations,” says Sycamore.

One approach is to pay support staff higher-than-typical wages. Interviewees will be asked what type of wage they seek and be offered additional management responsibilities, which vet doctors traditionally have, to boost wages. The vet hospital has considered flexible schedules that offer staff 8- and 10-hour shifts in addition to the more typical 12-hour shift. The new facility will have an employee garden for staff to take breaks outside and a break room next to the intensive care unit to make it easier for staff caring for critically ill patients to take breaks. The employee insurance plan includes benefits for mental-health support.

Creating a culture in which staff are comfortable asking for help is also a goal for the new hospital, says Sycamore. As a vet doctor in previous roles, she says she did not receive support when she needed it. “I have gone to my manager and said I am not coping, I need help, and she said to me, ‘I don’t know what I can do for you.’”

The new hospital strives to create an environment in which employees “feel safe and supported to voice their concerns,” says Sycamore. “A lot of people in vet medicine are introverted and take that stress and hide it and don’t talk about things. I have friends who have lost people to suicide in the vet profession. Often you can’t predict that something like that is going to happen.”

DoveLewis hired a social worker shortly before the pandemic to roll out a new “vet well-being” program at the hospital. Vets can go to the social worker to talk one-on-one about emotional and mental-health problems.

Morgan at DoveLewis says the biggest complaint from veterinarians is understaffing. The hospital added 24 new positions to cope with the extra workload. But it usually has unfilled positions because it is hard to find staff, says the CEO. There are thousands more open vet positions in the U.S. than people who are able to fill them. The United States Department of Agriculture declared 221 shortages of vets in 48 states in 2021.

Compounding the problem is the large student debt that veterinarians accumulate, which dissuades young people from entering the profession. In 2020 the average student debt for a U.S. graduate of veterinary medicine was $188,000.

Morgan is concerned that his hospital, as a nonprofit, cannot compete with the larger corporate-owned clinics, which can offer higher compensation and perks like student-debt relief. “We honestly don’t have the resources to compete with that. We have to focus on other things to attract people, such as our culture, our quality of medicine.”

The Portland Veterinary Medical Association has done work to address employee burnout. It promotes wellness and well-being initiatives for its members. Every year it holds a wellness symposium that is designed to make sure people in the profession feel comfortable talking about the emotional challenges of practicing vet medicine.

Laura Lambruschi, past president of the association and general practitioner at the Northwest Neighborhood Veterinary Hospital, experienced herself how COVID-19 worsened work conditions. Safety protocols made the workplace isolating as staff spent all day alone in the exam room, says Lambruschi. The workload also “skyrocketed” with the number of clients at her hospital increasing between 25% and 50% compared with before the pandemic. The clinic had to stop accepting new clients, and appointments were booked up for two months.

The workload started to take its toll on staff. “Things got really overwhelming. Everyone was feeling overworked and emotionally drained,” says Lambruschi. Her employer started a wellness program to alleviate the stress. This includes free two-hour yoga classes a month, visits from massage therapists, and a walking group to encourage staff to take breaks and socialize with each other.

Lambruschi stresses employers have to take responsibility to ensure staff set limits on how much they work and take advantage of mental-health supports. “We are such an empathetic and driven group of people that without someone else telling you to say no, take time for yourself, it won’t happen,” she says.

The easing of COVID-19 restrictions may make conditions a little less hectic at the state’s veterinary practices and hospitals. Businesses that stopped accepting new patients are taking appointments again. New regulations allow pet owners to come inside the building if social distancing can be maintained. Most practices cannot keep this distance because of the small size of exam rooms. But a recent rule change allows clients to enter exam rooms if they are fully vaccinated.

The stress on vet practices during the past 18 months of the pandemic will be a burden on the sector for some time to come.

“There is a lot of trauma that people have sustained over the past year and a half,” says Sycamore at the Pacific Northwest Pet ER & Specialty Center.

She sees the opening of her new hospital as a good opportunity to start afresh. One big difference of the business is that its new hospital director comes from the medical profession rather than the vet sector. Her training is in psychology. “Our team has the tools to build that support network that a vet hospital needs,” says Sycamore.

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