Musings on vet mental health, past and future.

 

 

 

 

 

 

 

Although I’m happy for others to read it,  this post, nay blog, is aimed largely at my veterinary friends both on and off social media.

I’m on the point of hanging up my stethoscope after 39y, and I’ve been in a reflective mood of late. Much is currently being said and discussed regarding the mental health of vets in practice, worldwide. There is great disquiet about the working environment in practice and how young vets are not adapting well to it.

I have no evidence beyond my 39yrs experience, and my opinions are no more than that. However I do think that some of them are worthy of further investigation or even research. So here goes…

My 39y was split into 2 discrete parts, with the hinge just after the millennium. It’s the contrast between my 2 eras which gives rise to this piece. My first 21 years was spent in mixed practice, largely my own practice in N Wales. We did all our own OOH. There were no alternatives. We grew the number of vets in the practice not out of profit, but out of the need to improve this rota. The Rota was at worst 1 in 2 nights and weekends, at best 1 in 4, but mostly 1 in 3. There was no time off in lieu as there was no manpower to cover it. Working hours were enormous. I never measured but I guess we’d have averaged 70-80 hrs/wk. We were exhausted physically. Sleeping was wonderful! Holidays a luxury. Weekends off all too brief. On the upside, clinical experience came rapidly, but clients were the same as ever, and really had little appreciation or understanding of our lifestyle, despite Herriot’s best efforts. But we did have a warm inner satisfaction of being a small, intrinsic part of something rather wonderful.

Post millennium, I’d had a partnership falling out scenario, and I found myself in  purely SA practice in Wirral. It was solo vet pretty much but we had an OOH night and weekend service to support us. I never did another night on call! Weekends were morning consults only. I got a life back. First reaction was one of unbelievable bliss. I felt like I’d awoken in vet’s heaven. Mind you, it wasn’t as good for the patients. As we didn’t do nights, almost all overnight cases were transferred to OOH, and an element of professional satisfaction disappeared. As the practice grew, by growth and acquiring another 3 locations, our vet numbers grew. But this time we weren’t growing numbers to give us a less insane OOH. We were growing to cover surgery daytime hours. Working days were 10 hrs start to finish, and there was usually a break or two of some sort. A 5 day working week was rapidly heading towards 40 hours. Furthermore, the practice rapidly feminised. And with it came the request for part time hours. We swiftly moved to vets who only worked 2,3 or 4 days a week. The rota became a patchwork. Case continuity depended on superb case notes and overall, we delivered.

What a different world it was to the pre millennium era.

Was I still physically exhausted? Absolutely not.

Was I mentally exhausted? I was drained. Why? Well that’s the huge question and is the crux of the matter. I didn’t work every day. But the day before I worked, and especially the evening before, was horrible. My anticipation of what was to come the next day would bear no connection to reality. I’d overthink everything. This seemed to be exacerbated by endless discussions over every detail of work and personal lives. Thinking was and is draining!

 

At this point I’d like to step outside the vet world. I’ve spent my life working between the goalposts of vet practice life. I saw the world outside purely as an observer. But what I observed, particularly in my kids and other young working people, was that our young vets are not in a unique position. There is nothing particular here to the vet profession. I believe that the workplace post millennium has changed. It has involved less hours. More systems, wretched systems. More zero hour contracts. More jobsworths abusing their tin-god power appetite. More debt. More comminications. And more time to reflect. To worry. To anticipate.

So, in a nutshell the young workers pre millennium were more often physically tired and worn out. And post millennium they have become mentally drained.

Which is better? Personally I think man is more suited to physical tiredness. I don’t think we have evolved enough yet beyond the Hunter gatherer who had to work all hours to keep the dependents fed and watered. Our politics and social conscience may have moved on. Our bodies haven’t. We simply don’t have the evolutionary adaptations yet, across society, to cope with the modern, reduced hours, over systemised workplace. And we are deprived of the solutions. We work less, we get paid less, we owe more. We need to pay off debt and work more. But work isn’t available to fit our over systemised lives. We can’t fit it in! Vets are actually lucky….there is far more work available to us than to most young workers. But does it fit with all the other elements of our complex lives?

What’s the answer? I don’t know. But here’s the suggestions.

1.We need to work longer hours, with less frequent, longer breaks – I’m not talking lunch, tea breaks, days off or weekends! Consequently we will have less random, disorganised negative thought time. We need less days off. More work consistency.

2.We need less social media (!!) because it winds up the negative thought process far more than the positive ones.

3.We need more small business opportunities. The Great Corporate has taken over the world of employment.  And many young workers just don’t fit in. So we need real and adequately lucrative alternatives. And we need to keep small business simple. If there is one huge opportunity of the dreaded Brexit, it is to reduce regulation. Please please…

4. Go carefully with Employment law. The human being takes badly to being treated by process, tick box, system. Invoke it and we naturally feel that we are just a number. A commodity. A lump of meat. Nooooo! We are REAL people. Individuals. Talk and listen. Discuss. Have meetings, phone calls, conversations. But cut the formality until you absolutely have to use it. So much can be worked out and around. Once due process starts, the battle is called and lost. Teams need great morale. Due process is a moralecide.

5. We need sabbaticals! Rather than constructing life around weekends and holidays, take fewer, extended breaks. Leave and start over if necessary. And be constructive. When you work hard, you really shouldn’t be able to dwell on what to do next in life. Instead aim to earn enough to give yourself a real break. Several months. A year maybe. Time enough to totally log off ….and to log on again later under a new entity. Nothing lasts for ever in any life, but in the 21st C the lifespan of a job, a business, a role is shorter than ever before. I believe there is no choice but to adapt fast to this one. I know other things in life get in the way. Kids! But sort it. Do something great with your kids while you can. Then do something different in life.

6. Money. That which makes the world go around. Or not. An estate agent told me recently that homes for first time buyers must have a new kitchen and bathroom. The young won’t fix up anything. They want it all done and will borrow more to pay for it. BORROW MORE?? So much debt. Debt really, really causes worry. And rightly so. Did the banking crisis do nothing? Did we not learn that debt has to be affordable? Student loans worry me. They are clouded in the mysteries of taxation and ultimately don’t have to be repaid for those on low earnings. What a way to live. If you earn enough you have an extra significant tier of tax. If you don’t earn that much your debt/loan spirals with interest. Then one day it will disappear! No wonder there is a generation struggling to handle money!

We can’t escape that real debt has to be affordable. It should be minimised and leveraged for maximum benefit. If it can be avoided…avoid it. If you can stay at home for Uni….do so! It will save a fortune in REAL money. We have a stark contrast nowadays of students with debt and hard working apprentices without. I’d wager that the apprentices sleep better! My gross generalisation is that I think they are a happier lot, both during and after training. Go prove it somebody please! They work long hours, learn from a real person, hands on, and learn to pay their way from a young age. Man is adapted to suit.  

7. Unique individual or just a number? As the Great Corporate grows incessantly – I speak globally here rather than just veterinary – profitable business opportunities are gobbled up and the world of small business gets ever more competitive and difficult.

So do we stay within the Great Corporate? Well how is the stress of being just a number? Are you happy there? 

Or do we look beyond for that small niche which creates an opportunity?

Whilst it is undoubtedly getting ever more difficult to do so, paradoxically we all share the very same USP opportunity  We are all unique – and don’t let anyone tell you that you aren’t! Joe Public loves a service consistently provided by the same person, day in, day out. Provide something needed, do it yourself, be yourself, build your client bonds, make everybody feel special, and you too can build a small and successful business. Do you want to go large, Sir? Avoid!! Small is beautiful and you are too.

 

So there’s my proposition 1-7.  We are better adapted to full time work for a season, than to part time work for ever. And after a season, we need a sabbatical so we can migrate to better feeding grounds.

 

Thoughts please?

11 Comments on “Musings on vet mental health, past and future.

  1. Wow. This makes a lot of sense to me. The kind of approach you describe here has undoubtedly been key to my recovery from severe MH problems, though only having read your blog does it now make sense! Having said that, mine is a personal experience and there’s no one size fits all solution to wellbeing.. though I do think we overemphasise “work-life balance” these days, and often it is counterproductive, for the reasons stated.

  2. I agree with you completely. I’ve only been at it for 31 years, but what you say has been my experience as well. When I stopped doing out of hours, even though I still working 6 days a week, it felt great, like I had so much more free time. Maybe its the contrast that’s important. How do you know you’re warm if you’ve never been cold. How do you know you’re happy, if you’ve never been sad. Some point of reference is needed to make a comparison. From my own experience of dabbling in other areas, it might help if people were to spend some time outside the profession in another business? They may find it is in fact easier and more fun being a Vet than they originally perceived? I’m in an independent practice.

  3. Hi Tim, I agree with a lot of this. It is late at night now but here are my musings….
    Small is beautiful. Continuity of care important and THE big difference between corporates and independents. If we can keep the same ethos, a good environment and a group of like-minded, committed vets though, part time hours can work for our clients . I totally agree that physical exhaustion is preferable to mental exhaustion. But is the increased stress and mental exhaustion a symptom of client expectations increasing? And being stuck in a consulting room as opposed to out on the road with time to think between clients?
    (I certainly fared better with time to switch off on the drive home rather than the walk through a door from practice to house and then the immediate onslaught of children, laundry etc.)
    Let’s not forget that nowadays both halves of the marriage partnership have to usually go out to work to pay a mortgage so there’s not normally someone at home also covering the house jobs.
    I agree practice has changed a lot and as I said, I agree with much of what you said. In addition, I was just talking today about how now there are so many specialists, insured patients and increased litigation that the stress of “should i refer” vs “I’ll give this a go” has changed massively in the 16 years I’ve been in practice and I think that has a bearing too.
    Reached the point where I’m waffling and brain dumping now so will end here.
    There’s a massive debate to be had though and the more voices added the better as we all have different viewpoints but the profession certainly needs help!

  4. Hi Tim. Thanks for that perspective, it’s worth thinking about.

    My experience hasn’t been the same. I’ve only been at it for 11yrs, which is probably not an accurate comparison, but for me, the best thing I ever did was to move from a mixed practice with a 1 in 2-3 call rotation to a smallies only, owned by a corporate, with no call at all.

    I now work every second weekend but still only do 5 days each week (with only the occasional change). The daily hours are pretty much the same, still on salary so only get paid for 38hrs (but that’s my choice) but my work life balance is far healthier.

    When I used to do call I didn’t sleep, because I couldn’t switch off. I would spend entire nights/weekends at work watching an animal on a ventilator, with several others in hospital, sleeping on the floor in 15-30min allotments, then putting in a full day/week afterwards (no time in lieu, paid a set fee for being on call, not hourly). I was tired all the time, my memory was terrible, I was always cranky and I hated going to work. I was hard on the staff under me. It was not fair on my colleagues.

    Now there’s no a/h, critical patients are sent to an emergency service and I sleep soundly knowing they are getting the very best of care. I have far more responsibility in my new job, but am less worried – working for a corporate has its challenges, and it can be slower getting things done but they have clear guidelines and goals for my role which is incredibly reassuring. My paycheck is the same at the end of the week (but money has never motivated me, its a means to an end) with less worry. For the first time in years, doing further study seems feasible.

    I’m still a perfectionist but for some reason it’s not as important anymore. 🙂

    1. Thanks for your thoughts and comments Rachel. Isn’t it great that we now have more career options and variety than ever? We are such a varied bunch, with differing reactions and we don’t all suit the same environment. The main thing to get across to people is that sometimes we think we are in a comfort zone, when actually we are totally stressed out. A different environment that we may not have considered appropriate may however suit us far better. Discussion rules!

  5. Tim
    How well I recall you and I speaking – yes actually SPEAKING – on the old dog and bone back in the very early noughties. Something I had written or pronounced about had triggered a response within you – and because it was 15++ years ago I cannot remember what!

    I enjoyed your exposition in this blog, BUT I need time to reflect upon it prior to responding. We are similar in age and have had some matching experiences in life (apart from your complete focus upon gardening which leaves me shuddering at the thought of soil under my fingernails!LOL) so I need to dig up feelings and memories from what I recall as a satisfactory and fulfilling professional existence – even now at 46 years since graduation and 5 years after I should’ve hung up my rubber gloves (for A/Gs).

    I will return, and engage with you. Here. (PS It was Al who suggested I read this – so blame him!)

    1. Al Wilson – he of the quirky humour and sideways view on life and the universe. Frequent contributor to Veterinary Voices, the closed and expansive FaceBook page, where 7000+members give vent together, weep together, laugh together and hopefully learn together – even at our great ages Tim!!

  6. George
    Ah that Al! See first comment above.
    Our great age….don’t rub it in George! Admire how you keep going.
    Back to the garden. We fortunately missed the 2 storms but the garden did not. So come home to an extra dose of work. I should add that my gardening approach adheres to pareto: I select the 20% of the possible garden tasks which will give me 80% of the results. The rest is left to nature. It gets me by! TTFN.

  7. Right on Tim! I have enjoyed a 44 year Vet life. I then stopped abruptly and retired. I wa often asked do you miss it. I do not. I enjoyed almost all of it. Had some great colleagues,and a variety of work. I first joined a great mixed (very mixed) practice . It had a wonderful variety of work in East Yorkshire.
    We did everything that Vets could do. L A , SA, MAFF (remember them) , there was a regional office in the town. We did Work for A large Pharmaceutical company in Hull. (Disprin to Immobilon). Teaching at Bishop Burton Agriculture College. (I got to write the Vet part of a textbook for them ) , for the Local Authorities and Port Health (Hull). (Exports pigmeat /Imports ) I got Brucellosis during the scheme to eradicate it. (not nice). The Practice expanded twice so was involved in planning the new practice twice, with a talented Architect who had specialised in Vet premises. We were next to the Cattle/pig/sheep Market so saw clients regularly, and collected their cheques too. I got to go abroad to Hong Kong in the 70’s. I did 5 years there. (Horses (500), a Dairy Herd (500) , Small Animals , Exotics with an American Specialist. I did a lot of Sailing and made friends from all parts of the world. I returned to Beverley as a Partner, and I hope I encouraged another generation of Vets . I volunteered to help with the last FM D outbreak as I had seem many cases in the abattoir in HK. Got sent to the front line straight away. A harrowing experience. I retired and did some export work for while . Then retired for good at short notice when the exporters got a better quote from a group of EEC Vets, I hope UK still uses these EU Vets after Brexit as they are good and much needed. I am currently without a pet (for the first time) as my Flatcoat died last year. Do I miss Vet work? Not now, My advice to young Vets – aim high, don’t be put off from any opertunity. You have a great education and can use it in a variety of ways

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