Caring-Killing: the suicide crisis among veterinarians in the US
It’s the last job anyone would consider hazardous.
A veterinarian is often associated with caring for animals in a calm, friendly environment. Many people imagine a vet appointment going the way a pediatrician appointment would: a tickle here, a temp check there, and the most stressful thing that can happen is a crying fit following a vaccine shot.
Unfortunately, nothing could be further from the truth.
Over 70% of veterinarians in the United States have had a colleague die by suicide, and male veterinarians are twice as likely as females to take their own lives. In all, those in the profession are four times more likely than anyone in the general population to succumb to it. While the medical profession as a whole is known for its stressors, veterinarians are in a special class.
Financial Pressure
Veterinarians are faced with many unique stressors, with money being chief among them.
On top of the emotional strain of having to work with an animal in dire straits, the pet owner’s ability to pay for treatment is a daily issue. In 2022, pet owners spent approximately $36B in veterinary bills. General appointments and emergency procedures alike require upfront payment, with or without pet insurance. In some cases, a 50% deposit is required before the animal can be treated. And while there are payment plans or credit-based programs like Scratch Pay and CareCredit, any amount of cost buffering comes in a step too late.
When the owner can’t pay, the pet is euthanized. Depending on the state, there is also the option of the vet holding the animal under the state’s veterinary lien law until the owner can pay. Of course, neither option is an ideal solution when you just want your sick companion to get better and come home.
The owner is left in severe distress as they try to figure out how to cover an enormous vet bill, facing high emotional stakes and other financial responsibilities they may already have on their plate. Meanwhile, the veterinarian is left in a morally difficult position—all the training and personal/emotional investment in becoming a veterinarian must take the back seat to payment. Human medical costs are not handled in the same way, and despite the sometimes outrageous totals they usually offer more flexibility around breaking up the costs.
Things can get heated and even dangerous between pet owners and vets on the issues of cost before care. Some find it easy to accuse a veterinarian of being greedy but the harsh financial reality is at once simple and complicated.
Inflation during and since the COVID-19 pandemic has increased costs in every sector, and the cost of medical supplies and clinic overheads have reached unprecedented levels. If you consider that most veterinary clinics perform their services on-site, from dental care to x-rays, lab work to minor or major surgeries, the operational costs become incredibly high.
Although veterinary clinics have the tradition of being locally owned, a new development in the vet world is that modern clinics are increasingly under the influence of private equity. More corporations and multi-national companies are investing in veterinary clinics, putting additional pressure on vets to turn a profit. The costs to stay open, pay their ownership and pay themselves aside, vets must also deal with the issue of debt.
Veterinarians are saddled with extreme student debt after graduation, some as high as $460,000 including interest.
Psychological Strain
Some cases are simple check-ups, allergy treatments, medication renewals. Many more feature long-term illness or emergencies. Long shifts demand vets to be proactive and supportive during emotionally draining situations, especially if the animal’s wellbeing doesn’t improve. After going through this day in and day out, compassion fatigue sets in, and the vet may not be able to be as emotionally present as they would like.
Even after failing to save an animal after working as hard as they can, a vet faces the fallout of not being able to live up to their oath on that day, or perhaps for several days in a row. The pet owner might be understanding despite their grief, but they may also be angry at the vet for not being to do something that, really, was medically impossible to do. Something as “simple” as leaving a bad review about the vet’s business can eat at the doctor’s frame of mind and confidence, not to mention their online reputation.
This opinion vlog by Dr. James Cellini, a veterinarian in Rhode Island, goes further into the common psychological pressures faced by veterinarians.
When it comes to suicide rates among veterinarians, ready access to euthanasia drugs is another concern. The “caring-killing paradox” is prevalent among those who care for animals in medical or shelter environments. When they have to euthanize an animal if medical treatment or rehoming isn’t possible, the vet is at risk for experiencing trauma and pronounced psychological distress. Whether it’s a single cat or an entire herd of cattle, vets come with the deepest intentions of helping their patients. If all that work is repeatedly for naught, the negative effects can jeopardize the vet’s mental health. Poisoning is the leading suicide method among veterinarians, according to a 2019 study by the CDC.
Support for Veterinarians
It may be an unconscious idea born of stress, or just a human tendency, but for some reason people who are in the position to save a life are seen as superhuman. That is, that against all odds they should be able to save every life, do every thing perfectly and correctly. Love must live to fight another day. The brain surgeon with miracle hands, the cancer specialist with a miracle cure, the therapist with the perfect solution, the veterinarian with your beloved pet’s life in their hands.
No matter how great our technology, nothing is perfect and no one is infallible. While everything is a two-way street, there needs to be a shift in the work culture and in the things we expect from the people who help us.
Not One More Vet (NOMV) is a San Jose-based non-profit focused on supporting veterinarians through all these stressors and so much more. Created in 2014 following the death of Dr. Sophia Yin, the organization provides mental health support, resources, community, and outreach to those in the veterinary field. Vets can also find help through the American Veterinary Medical Association, who provides suicide prevention training alongside their standard career membership and education tools.
The Vet Show, and other events, have talks on client management and self-management in times of high stress.
