Thursday, September 1, 2016

It isn't just high school anymore. Veterinarian Bullying and Veterinarian Suicide. How the vet clinic is the new homeroom.

There are a few key concepts to pet care that vets just intuitively get. Something about our ability to provide empathy, our understanding of biology, psychology, and determination of sheer will in the face of adversity. It is why we know to not give up on a sick kitten, parvo puppy, or judge a short coated wide nosed bully breed as automatically being guilty of the label "dangerous." We can sniff out disease, diagnose via one sentence in a chart without ever seeing the pet, and make spot-on assessments in whip cracking time. We are an intuitive deeply sensitive organic bunch.

Many of us chose medicine because we like a challenge.  A list of incomplete clues and playing detective. We also like gambling on gut feelings... we all do it. It is the fun of having little access to all the big expensive diagnostic tools that give you neatly packaged answers and remind you to always be humble. We also chose to study and practice this craft for the benefit of pets as the cuter cuddlier alternative to the humans we would rather avoid.

For too many vets the situation is this; One on one, vet to patient, we are incredibly adept and skilled... BUT, one on one vet to client, OR, vet to superior vet, we are falling apart. We are unable to voice concerns, stand up for ourselves, our patients, our integrity, our self respect, our emotional well-being, or the others around us as they are being bullied. We are victims of abuse in our own places of work and we don't provide ourselves a short term, long term, or even a differential plan to improve it. We are abysmal doctors in caring for our own disease.

Some of us live daily in a quiet self-imposed crippling torture. Some of us are leaders like practice owners, relief vets, self-employed, or practicing and living based on our own needs and desires. It is often the simple fact of the "haves" and the "have-nots" and the delicate piece of earth that remains in between. Status, titles, empowerment, entitlement, whatever the case, the "haves" decide and the "have-nots" put up with it. Many are associates living by a play book someone else directs and dictates. I have become increasingly aware of this group through my blog and a few secret Facebook groups dedicated to providing support and a safety net to those of us who are in danger or intimately aware at how high the suicide rate in our profession is. It is heart breaking to hear how many people feel trapped and desperately unhappy.  As this profession shifts hands to the next generation of intelligent compassionate women it seems to have also shifted into treacherous waters full of mental anguish. Veterinary medicine is replete with emotionally embroiled overabundance. The problem seems to be where to manage the excess when you have learned helplessness.

I usually try to not alienate anyone by providing generalizations, BUT, this is a plea for those who need it to get their own SELF HELP so I am going to be as direct as possible.

Why do vets allow themselves to be bullied? Studies show it is that they feel one of the following;

TRAPPED. People will die internally, or kill themselves if they feel trapped. Chew your paw off to get out of a leg hold trap. Put a bird, gorilla, elephant, whale in a cage too small, deny them love, stimuli and a healthy happy environment and they will unravel. We have all seen it. We recognize it, we diagnose it, and now we need to start treating it. We need to do this reflectively. We are no different than the dogs, cats, and caged beasts our clients have inadvertently messed up to the point of needing professional intervention.

CONFLICTED. We are asked, expected, or ordered to do things we do not agree with. Add a pathetic patient whose fate literally lies in our hands into the mix = recipe for disaster, lying, self loathing, and emotional heartbreak.

EXHAUSTED. We have this ludicrous idea and expectation that your self worth is directly proportional to your self destructive obsessive compulsive work ethic that denies and promotes not eating, not sleeping and not using the bathroom. In less civilized times it was termed "slavery." Except now it is viewed as "self-imposed and expected." Perversely it is rewarded to work to past the point of exhaustion. Who wants an exhausted doctor?

FINANCIALLY BOUND. OK, we are in debt up to our eyes. Some are drowning. Naive, blindingly stupid, immature debt because we absolutely had to go to vet school. (Starting to see a pattern of self-perpetuating stubborn behavior here?).


The "haves" hold this false counterproductive belief that if you work or reside in a profession built on a pyramid of power the minions at the bottom need a reason to stay complaint and stay quiet. The history of dynasties is built on this premise. You either "have" or you are a "have-not". High school meets real-life and still the same drama persists.

Women out there who are unhappy I offer this advice;

Try to understand what the most basic source of your discontent is.

  • Is it finances? Is it due to debt? If so is digging deeper, working harder, and sacrificing the balance that keeps you able to work in a healthy manner worth it? If you feel tied to a bottom line you will inevitably make poor decisions and perhaps even cost your patients the options that might cost them their lives. I know of associates who are requested to maintain an average client transaction that starts at a number. Client options therefore include those above the ACT or euthanasia. It is both criminal and unethical. There are "embedded costs" in services that inflate the basic service fee. Does an x-ray include a mandatory radiologists review? Why? You will in many cases be paying for something added that you don't need. You are financially bound.
  • Is it a boss or co-worker who makes your life hell? Do you take it? Do you ever ask yourself if you have to? If you want to? Or if the consequences are worth the courage it takes to stand up and demand something different? I will be the first to admit that I live on the other side. On the side that makes me incapable of being civil at times. In the face of cruelty, neglect and bullying I am quick to drop an F-bomb, and I am not picky about who I drop them around. I am that cat in the cage who always chooses to hiss, claw, and fight. It is as basic and primal as the feral cats response to fear of being eaten. I realize there are Cocker Spaniels out there. Everyone loves a Cocker Spaniel. We vets expect that their lowered ears and cowering submissive tail wag all say "Please go away, I am too afraid.. But I am paralyzed to do anything about it." "Oops, I think I just piddled on the floor...." You are exhausted and trapped. We know that some dogs will resort to biting via deeply seated redirected aggression, or a submissive dog pees. Cats, well, we all know they are smarter. They haul ass for a new home, or claw your eyes out. Be the cat.
  • Is it emotional disconnect from who you thought you were? The healer you wanted to be and the vehicle of lack of options that you have become? I would argue that this is a myth. I am living proof. I can't explain to you exactly how it happened, but at some point I decided I was going to live by and be true to the core of who I am. I save from suffering, I protect and provide happy healthy lives. I most importantly refuse to believe or accept the commonly broadcast brainwashing bullshit that "we can't save them all." We can, we merely decide to not be the one who plays God, determines life or death short of death shrouding above our patients. We ease suffering and we don't speculate for an easy convenient death. Yield your pink sword for only the battles already lost, not those being fought. You are conflicted.

Donatella and Raphael
I did some research on bullying on the adult level. I was particularly interested in this at the level of the military's response to intimidation tactics shown to subordinates. I think it is relevant for a few key reasons;
  1. Most vets work under another vet by reason of rank, length of employment, or experience.
  2. Most have binding contracts that dictate terms and conditions that must be met to insure continuance of said employment.
  3. Most vets are in debt and need to maintain continued employment to break even. Getting ahead is a dream way down the road.
  4. Most vets have learned, or been instructed to, keep their mouth shut in the face of adversity or confrontation. I know lots of vets who are instructed to stay in the exam room repeating treatment options and allow verbal abuse from the emotionally AND financially strapped client to get a treatment plan estimate signed and deposit placed.
  5. Most vets avoid job searching like it is water boarding. We loathe the hunt for a new home.
  6. Most vets cannot, yes, simply cannot, muster the little voice buried deep down that allows them to stand up for themselves. Ever. We are taught to take it. We take it to get into vet school, we take it once we get into vet school, and we keep on taking it. You practice what you are taught.
  7. Most rationalize the bullying. They learn when to avoid the bully, what the triggers are, and rationalize that they can minimize the hurtful altercations if they only can do..... The maneuvering to avoid the tickling down of nastiness is a dance that wastes your time and diminishes your ability to do your job of helping your patients.
  8. The options out are either insurmountable, inaccessible, or unfathomable. So people stay trapped.
How does the military address bullying? It provides outside resources. Is honest in its advice to not seek help within the team and add further dissension, and it reminds us that managements assistance in providing a safe workplace is critical. But what happens if management is the bully? And what happens if you, as next in command, are expected to both take the crap coming downhill, and figure out how to live by example, maintain your own code of ethics and want to protect those beneath you?

The military resemblance is solid.. So lets move onto a topic we all can relate to; dog training and behavior issues.

I found these 4 week old kittens on one early morning run in a tire on the side of the road.
In 1 day they transformed into marshmallow-love-muffins.

If we are so adept at identifying the source of the problem and making a diagnosis without most of the fancy expensive human medicine equivalents at our disposal then why is it that we can't fix our own problems? Why don't the skills and lessons we have already learned and mastered translate into the veterinary office bullying dynamics? Why aren't we rewarding only the good and ignoring the bad? Wouldn't things change if you just shut off your ears and walked away every time the boss started barking, growling, hissing or trying to spray/pee on you to mark their territory?

We know better, but we can't ask for, or demand, or even role model better? Reward the good. Smile and say "thanks" when you do something amazing. Miracles happen everyday in practice. Give yourself a gold star! Post on social media your favorite feel good moments. Empower and recognize yourself daily.

Remember that there are people who work for you so lead by example. We are all conditioning each other to act appropriately. Keep training your staff. Teach them new things, share the wealth of your experience and expertise. We all need and deserve praise, empowerment, a shoulder to lean on and a trusted co-worker as much as you do. It isn't about picking sides and building a team against your boss it is being the shining example of how to raise a healthy human in a dysfunctional family. This is every behavior puppy exam we see. We know how to do this. Train the parent to see the world through the pets eyes to enrich the bond and avoid the biting behavior case down the road. We do not condone yelling, punishing, hitting or being harsh to a puppy, or anyone in our care. EVER. 

Try to see yourself as the person you want to be? How can you get there? Is behavior modification needed? Do you need a trainer, mentor, or secret Facebook friend/group to help you muster the courage to keep yourself alive?

Staying in a toxic environment is detrimental to your quality of life. How many times a day do we discuss "assessing quality of life" with our clients? How many pennies are in your "bad day" jar? Choosing to stay is a behavioral learned condition. "How do I train my cat to go back to using the litter box?" To which we reply back, "We always treat the medical condition first, and then begin behavior modification training." If you are not feeling well please ask your doctor for help.

We are acutely skilled at understanding and categorizing the behaviors and responses our patients display. We assess and prescribe our reactive behaviors and treatments to these. Are you the "get out the drugs" when the frightened cat starts fighting back, girl? Or, do you act like the Cocker Spaniel with paralyzing fear and either ignore or be calmer/more gentle? We empathize with our patients and adapt accordingly. If your boss is using a newspaper to emotionally swat you into submission, rubbing your nose in your own excrement, bullying/intimidating you, or in any way making you feel anything other than valued, my best honest advice is to salvage yourself, guard your own self esteem, and walk. It is not lonelier, scarier, or worse on the other side of a hard decision. There is nothing more important to you than your life.. your own destiny in your hands. You made it through vet school. Most of us thought  that was almost impossible. It wasn't, you did it. You walked in, and you walked out, and the rest of your life is yours. Never surrender that. It is yours.

found in a dumpster emaciated, tail tip deglove, parasites-galore!

A very good friend and associate described her struggles with her emotional well-being in her previous practices as this: "I knew I was in need of help. I called the State Board and was told they couldn't do anything. I called a lawyer to ask for help with my abusive boss. She told me "it sounded awful and that she was sure she could assist and then asked me if I had $400 per hour to pay for her help?" I didn't know where to go. So I moved from one bad practice to another." Sounds like so many of us who get stuck in bad relationships, doesn't it?

There is this huge move in veterinary medicine to provide a Fear-Free (trademarked) practice. Essentially it is a certification to train the staff to provide fear free care, handling and services to the patients who are under our care. Why isn't this being taught to the staff and superiors at the clinic? Perhaps Fear-Free needs to start at the top and trickle all the way down?

Maybe its time to address our own health with our own advice?

Pray what you preach. Learn how to incorporate a healthy workplace into your life and as an extension of it. If you can't muster that voice follow your advice and decide your own destiny.

Here are some of my favorite training tips; How many could you incorporate in your life to improve it?

1. Get outside. Everything is better under a tree, in the grass, or bathed in sunshine.

2. Find something to hug. The toughest days are always easier to tackle with a kitten hug or a beagle kiss.

3. Remind yourself whose life you made better today. (PS the number of legs they walk on is not important).

4. You are a caretaker. Take care of yourself. Happy people have happy pets.

5. Dig deep until you find that treasure. Be the JRT! Work passionately and let your passion provide the answers to the tough questions.

6. Never surrender the bone. Hold onto to your soul and don't let anyone take it.

7. Retractable leashes are dangerous and self-deprecating. Walk side by side enjoying each others company, or go leash free and let the adventures of the unknown be your guide.

8. Reward a good day with a healthy snack and a long rest. Dx yourself with bilious vomiting syndrome,, have a snack before bed!

9. Collars, like monogrammed white coats, can be resized, redesigned and replaced. No one owns you.

10. Cancer, disease, and death are far more likely if you don't care for the whole package. Protect your life and be the  best friend to your best friends by taking care of yourself for the long haul. We know how to tell our clients how to do this. It is never easy to implement a change for long term benefit but that is not an excuse to not try.. you made it through vet school after all. You can do anything!


Walk into every situation, every patient and every dilemma with the attitude of "what can I do to help?" If the answer is "get the hell out!" listen. You are an amazing healer with an adept skill set even without all of the fancy expensive diagnostics to back your diagnosis up.

If I can help please find me on Facebook, at this blog, or at my vet clinic, all are listed at the end. I will really try to not sound like a Drill Sargent and I really will be on your side, no judgement, no harassment, no consequences, just love, support and encouragement on your terms.. no one is trapped.

Resources for vets;
AVMA Wellness and Peer Assistance support.

List of compassion fatigue resources via Jessica Dolce blog.

Compassion Fatigue blog. Krista Magnifico, DVM

About me;
Still wandering around in rose colored glasses. Still loving being a vet. Still filling my cup at every chance I take. And, still trying to save the world one wet nose at a time. I started as a way to help provide a safety net to those in need and those who can provide help. It is a free to use site intent on inspiring and empowering. Please join us in saving the pets of the world.

I am a small animal vet in northern Maryland. Jarrettsville Vet is in Harford County MD. A busy 7 day a week, 6 DVM practice where care is never denied and happy endings are always on the To-Do list.

I am also on Twitter @FreePetAdvice, Facebook, YouTube and in the yard/couch with my own four legged kids. If you need me, or you need help you can leave me a phone call, comment, or email. I will help in whatever way I can.