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CHANGING HORSES IN MIDSTREAM

Maggie Gething, MVSc, MACVSc, MRCVS

PRESENTED AT THE 28TH WSAVA WORLD CONGRESS, BANGKOK, October 2003

Introduction

It was a challenge to find a suitable subject for this Award lecture which would not only be of interest to small animal veterinarians but would also reflect something of my own professional experiences. Although I have continued my involvement with WSAVA, I am no longer working in small animal practice; in fact my career has been rather mixed, having started in academia, progressed through small animal practice into the animal health industry, back to practice, and now in regulatory affairs, with a bit of politicking along the way.

Then I remembered participating in a symposium many years ago, for which the New Zealand Veterinary Association (NZVA) brought together a number of us who had changed direction in our careers, and we each talked about our experiences. It was interesting to find that though some individuals appeared to be ‘opportunists’, taking advantage of chances as they arose, others had been actively looking for a change because they were dissatisfied with their current job. We all know that being a veterinarian can be stressful, with a particularly high suicide rate which is apparently increasing. Could this be related to avoidable crises at work, which affect some people more than others? Is a high rate of career change also prevalent in our profession? Are such phenomena linked to personality types or early experiences in the profession? I decided that this subject warranted discussion and I hope to show why it is an important topic for the whole profession, not just those who might be considering a change of direction.

Abraham Lincoln told the story of an old Dutchman who remarked to a companion that it was not best to swap horses when crossing a stream. Why would you want to undertake such a dangerous and difficult task? The obvious reason is that your old horse is tired and can’t support you any more. Maybe there are strategies you can employ to keep the old horse fresh. Making the change takes planning and skill to manage, and help will make it easier. If you can accomplish the change successfully you will be able to continue your journey with renewed energy. The analogy with career change is obvious and I acknowledge stealing the rather appropriate title from that NZVA symposium.

Facts and Figures

I hoped to find some relevant background information from some recent surveys of the profession. Data from both The Royal College of Veterinary Surgeons (UK) and the American Veterinary Medical Association show that about three quarters of veterinarians work in private clinical practice and about one fifth in other areas. Similar figures appeared in other surveys. However, in the UK, 4% of the responding veterinarians in 2000 were working outside the profession, in jobs which did not require registration as a veterinarian. Worryingly, most of these people did not plan to return to the profession.

As expected, there is a trend away from large animal practice, and in the UK in 2002, most professional time (73%) was spent in small animal practice, emphasising the fact that any issue affecting the profession is particularly relevant to small animal veterinarians. The obvious decline in large animal vets (from 70% to 40%) was analysed in a survey conducted by the Ontario Veterinary Medical Society (Canada), which found that 50% of those entering large animal practice left after their 1st year, and another 10% within the next 5 years. Interestingly, the main reasons given were too much time on call, poor pay and conditions, and health problems; the pressure of an increasing small animal caseload was not a major factor.

For me, these surveys raised more questions than they answered. The expected career path of most new graduates is in practice. What happened to make some of them change – were they dissatisfied with practice? There seems to be no information on why, or at what stage of their career, people decided to change to another area or to work outside the profession. How many currently working in practice are disillusioned and perhaps approaching some sort of crisis?

Results of job dissatisfaction

While some people may be forced by circumstances to change their job, or may choose to do so in order to advance their career, all too often the decision is made because they are unhappy in their current position. In a small survey carried out in the USA by DVM News Magazine, 70% of veterinary practitioners said they would choose practice again. This was interpreted as a high satisfaction rating, but it implies that 30% would choose another career.

The results of job dissatisfaction can affect the individual’s employer, colleagues and family. There can also be a loss to the profession, and to society as a whole. But for the person directly involved, the results can be devastating. Stress related illness and depression may ultimately lead to suicide. The Mental Health Foundation in the UK found that suicide in veterinarians was 3 times more common that in the general population, and higher than in doctors, farmers and pharmacists, all considered high risk professions. This is a tragedy for everyone, that must be acknowledged and addressed by the profession.

What are the reasons?

The level of support received by new graduates in their first jobs can make or break them as confident, competent clinicians. A recent survey by the NZVA found that, while most employers met their obligations, 8-10% of new graduates did not feel they had adequate supervision or support. Comments from the participants revealed the huge importance of good staff relations and the influence of colleagues, as well as the high degree of stress experienced by some. Achieving a balance between giving support and allowing responsibility was considered to be crucial. At the other end of the spectrum, older veterinarians may experience the equivalent of the ‘7–year itch’, losing interest once they have achieved their goal of developing a successful practice. Maintaining interest by taking part in continuing education, interaction with colleagues, practice improvement and, perhaps above all, retaining interests outside work, may go a long way towards avoiding crises at this stage. Taking care of these aspects may also have a beneficial effect on other staff, helping to maintain pleasant, stable and supportive working relationships.

Personal circumstances vary. More women are entering the profession and expectations of both men and women are changing. No longer do young veterinarians want to work a 60 hour week, with every other night and weekend on call. Some need to take account of their families and so there is an increased need for part time work or job sharing. In the UK, the average full timer in practice worked 52 hours a week, and was also on call for 27 hours a week. If this is the average there must be a lot of individuals working longer hours! Similar figures were found in Australia. This must impact on personal and family life and lead some individuals to seek alternative areas of work, as was found in the Ontario survey mentioned above. Another factor mentioned in that survey was ill health, and this raises the importance of occupational hazards, including trauma from animals and car accidents, drugs, chemicals, and zoonoses. When these are put into the context of potential staff losses, the adoption of an adequate occupational safety and health plan is clearly not just a bureaucratic exercise.

The importance of personality

How does the way an individual copes with working conditions relate to his or her personality? In the NZVA symposium it became clear that some people need to be in control of their time and to structure their own day. This can be difficult to do in the average practice where the day’s work is often dictated by the cases that turn up. Perhaps these individuals would be happier working in government or industry, where the day can be often be organised to suit, and the pressures are different. But often people are only aware of a vague dissatisfaction and do not consider why this is occurring. Why people do what they do affects performance both at work and at home. Matching the requirements of a job to a person’s natural style of behaviour can help the person to be happier and less stressed, because the demands of the job correspond to the way they like to work. Other factors involving personal values can also be important; people are likely to become discontent if they don’t believe what they are doing is valuable. A sense of purpose and being appreciated is extremely important to most people.

I am told research suggests that 50% to 80% of all employed adults are in the wrong job or career. I would be surprised if this figure applied to the veterinary profession given the stringent ‘weeding out’ during our training process. But there is no doubt that some veterinarians find themselves disillusioned with their jobs, and would benefit from measures to enable them either to improve the way they deal with their current job or to find a more suitable one. Change always involves risk, and so facing up to it is often put off until crisis point is reached. The field of psychometrics enables people to find out about their own aptitudes and needs. Methods such as the Myers Briggs, Keirsey and DISC (D = dominant, I = influencing, S = steady, C = compliant) systems are used by professional counsellors and can also be accessed via the internet. They allow individuals to establish their preferred work style, identify their strengths, and find out what work environment will bring out their best.

Where to look for help

As with any problem, it helps to talk – to friends and family, employer, other veterinarians. There are also any number of self-help books and professionals such as life coaches and counsellors working in the field of career management. It may be possible to sort out the difficulties with the current job, or move to another job within the discipline. Perhaps the challenge of further training in a specialty may be an appropriate solution.

In some cases, a move to another branch of veterinary endeavour may be on the cards. Fear and guilt associated with change are to be expected, but as veterinarians we are lucky to be equipped with a range of skills by virtue of our broad training and experience. The physical, mental and emotional demands of veterinary practice and the diverse nature of the work provide further strengths. Abilities in problem solving, decision making, listening and communication, business management and time and stress management can be applied to many other careers. The American Animal Hospital Association markets a book called ‘Career Choices for Veterinarians: Beyond Private Practice’ by a veterinarian, Carin A Smith. While aimed at the US market, this book provides some very valuable information and resource lists for many different veterinary career paths, as well as some sensible advice as to how to plan and implement a change of direction.

How the profession can help

Many veterinary colleges, including UCD, now prepare their students for the path ahead, by providing seminars for final year students and reunions for new graduates to help them cope in their first few years. Perhaps some appraisal of character as well as intellectual abilities could be incorporated into the undergraduate years to assist in chanelling individuals into an appropriate veterinary field.

Veterinary associations can provide student membership to allow an insight into the difficulties faced by practitioners, and can set up mentor systems and help lines to assist veterinarians facing professional problems. As a result of its survey of new graduates, the NZVA has developed an induction programme for employers of new graduates, to help facilitate a smooth introduction to the profession. The Australian Veterinary Association has acknowledged that the employment of a new graduate carries responsibilities on both sides, and that a good grounding is to the benefit of the profession as a whole. An accreditation scheme for ‘New Graduate Friendly Practices’ has been set up, in which employers commit to a number of supportive activities in return for a commitment from the graduate to stay with the practice for a set length of time. Both these schemes are to be commended and some of their features could be adopted in other countries.

Retraining programmes for those who have temporarily spent time outside clinical practice are vital given the increasing number of female veterinarians, many of whom need to take maternity leave. Going back to practice after a break is rather like starting again, and confidence and competence must be regained. At the same time, employers should recognise that people work in different ways, and that many things under their control can influence job satisfaction.

Conclusion

Many of us have probably experienced a period of ‘soul searching’ during our career when we have asked ourselves whether we are really satisfied with what we are doing. Most will stay on their original horse, for better or worse. A few will be seriously distressed and may fall off into the stream with disastrous consequences. There are a number of ways in which we can help as individuals and as a profession. For those who want to revitalise or change their horse, there are many options which will allow a continuing worthwhile contribution to society and the profession, whatever we choose to do.

Acknowledgment

For help with preparing this talk, I am indebted to New Zealand veterinarian Juliet Cayzer who has herself changed careers to become a life coach.