My career has come to an end. After some 47 years of practicing veterinary medicine, I have hung up my stethoscope, sold my practice, and now have only the memories to keep me company. I look back upon a career that saw me treating large and small animals, owning 2 different clinics, employing scores of employees, volunteering and leading many different veterinary groups, writing a self-help book, and serving on veterinary college committees. Did I wake up each morning and jump out of bed, heading off to work in total ecstasy, exhilaration, and enthused anticipation? Absolutely not! However, there was rarely a day when I doubted my choice of profession and my undeniable gratitude for having received that acceptance letter from Cornell University on April 25, 1973.

With this as a preface, it is an understatement when I state that a recent American Veterinary Medical Association (AVMA) Chart of the Month,

 whose source is 2023 Merck Animal Health Veterinary Wellbeing Study IV,

 grabbed my full attention. The topic was veterinary team job satisfaction and indicated that 56% of the surveyed veterinarians expressed an “extremely/very satisfied” rating for their job, 11% gave their job a “not too satisfied” rating, and the remaining 33% rated their job as “somewhat satisfied.” Frankly, to give your job a “somewhat satisfied” opinion is not what I call a ringing endorsement. That being said, if I add the 33% and the 11% responses, I now have 44% of our veterinarians stating that they are not terribly excited about their chosen profession. The survey noted that younger veterinarians (those aged less than 34 years) have the lowest level of satisfaction. The Merck study goes into further detail on some of the topics, which define job satisfaction and lack thereof: burnout, well-being, mental health, coping skills, clinic culture, work-life balance, income, career pride and positivity, and student debt.

These statistics caught me by surprise and should be great cause for concern for anyone who cares about the health and future of our profession. It is discouraging to recognize the years of preparation and planning that each veterinary school applicant has experienced, not to mention their hopes and prayers for their own letter of acceptance, and then read these findings, which detail a profession under stress. Correcting these significant challenges to career satisfaction requires a multidimensional approach. Financial, career, and mental health counseling would all serve a positive role, as would guidance for a healthier work-life balance. Or perhaps a change in location or even a totally different branch of veterinary pursuit. Personally, my stress levels plummeted the day I started at a new practice where the large animal work did not include equine medicine. And we all know classmates who switched their employment from clinical to nonclinical, and that can make all the difference. Although these approaches are available and warranted, there remains one more therapeutic piece that might fill the greatest need when striving to increase this level of job satisfaction: mentorship.

Mentorship is nothing new. I would even argue that our profession has relied more than most others on its utilization and delivery. This concept brings with it the ideals and aspirations associated with a variety of characteristics. Perhaps the most shared word when referencing this term would be guidance. For me, however, it goes much deeper. A mentor is one who offers the irreplaceable wisdom of experience, the knowledge of what works and what fails, the learned lessons of confronting and solving the same repetitive dilemmas, the genuine ability to instill confidence and positivity, the coaching that turns the obscure into the obvious, and the sound reasoning that bolsters and restores strength and hope for a successful career.

Our profession and its leadership have already developed a variety of mentorship programs. They are digitally designed and delivered. A few examples would be the AVMA-endorsed MentorVet Connect program, Ready Vet Go, Veterinary Information Network’s Veterinary Mentorship Academy, and a variety of programs offered in-house by corporate practice groups. However, I still see a significant void, which when addressed, might very well boost that “very satisfied” percentage. That would be face-to-face mentorship.


We, as a profession that cares seriously about its own, need to create more opportunities for our students and our most recent graduates to converse in person with those who have survived and flourished. Our baby boomers, Generation X, and even Millennials have a wealth of knowledge, experience, and sound advice that surpasses any online auto-tutorial, costs nothing, and is infinite in value. There truly is no replacement for such a one-on-one opportunity. Just as we all had that extra set of guiding hands on our very first spay or the astute advice and support of a senior clinician for treating that first diabetic cat, I see no better option for confronting the woes, fears, and challenges facing our youngest members and prospective members than sitting down in the same room with one of the many who have already been there.


To accomplish this hands-on mentorship I suggest the following:

Create space in the veterinary school curriculum to allow frequent mentoring sessions with alumni and invited practitioners. These occasions may be organized as part of the business courses offered or simply as stand-alone events.

Do the same for our national, state, associations at their conventions, meetings, and continuing education (CE) gatherings as well as other CE conventions and events held by veterinary college alumni associations.

Our larger veterinary facilities, which have a staff of 20 or more veterinarians, should hold and encourage frequent in-house mentoring events.

The guidelines for veterinary school externships should encourage mentoring, internships, and residencies. Postgraduate veterinary medicine is not all about diagnosis, treatment, and surgery.

The format of these mentoring events should be structured as small groups of 1 to 5 attendees per mentor. Depending on the attendance there are several different paths at this point. Where the number of mentees is small it might work best to have groups of 1 or 2 who sit down with a mentor and converse for an hour or longer on numerous topics. Where the turnout is larger, a preferred option might be to have a number of tables, each with a different topic posted, and have the mentees rotate every 15 minutes to a new table of their choice, limiting the number per table to 4 or 5 individuals. The mentors will need to decide among themselves how to delegate the topics. Examples for discussion might be stress, family and work-life balance, staff issues, feelings of incompetence, career transition, practice ownership, finding a mentor, mental health, client disputes, and so on.

Prior to the event, it would be advisable to have some guidelines provided to the mentors. These might take the form of a handout, online education, or simply a sit-down presentation. There are many excellent guides for best practices in mentorship. A recommended example would be found in the 2023 American Animal Hospital Association Mentoring Guidelines.

 I will add, however, that from my experience mentoring is more an art than a science. There is no single format that would serve as the gold standard. What is universal are the key words and phrases which each mentor should express during their conversations. The mentee needs to hear: “How are you doing?” “What are your challenges?” “How might I help you?” “I understand,” “I know what you are feeling,” “There is a solution,” and “Here is my advice.” As these events conclude, they must not end. It is important to exchange contact information and encourage continued communication and support. During the sessions there will be questions that need some form of follow-up. The mentor should anticipate this occurrence and assure the mentee that he/she will send along the proper answers in short order. This usually takes the form of a link to a website or the email address of someone who may provide the requested information.

What about the online approach to mentoring? Wouldn’t this work just as well? I cannot dispute the convenience of such a format. And, yes, digital delivery allows true professionals in this field to participate. However, for online mentoring to succeed, you must rely upon the prospective mentee to take that first step and assume the experience, and sound advice that surpasses any online auto-tutorial, costs nothing, and is infinite in value. There truly is no replacement for such a one-on-one opportunity. Just as we all had that extra set of guiding hands on our very first spay or the astute advice and support of a senior clinician for treating that first diabetic cat, I see no better option for confronting the woes, fears, and challenges facing our youngest members and prospective members than sitting down in the same room with one of the many who initiative for searching out such programs. On the other hand, when face-to-face events happen at veterinary meetings, other organized veterinary events, in-house veterinary facilities, and veterinary colleges, we have the ability to reach out directly and individually to our prospective mentees. Those in charge at these gatherings should make every effort to grab these younger attendees by the hand and personally persuade and encourage them to attend. We have the opportunity to truly extend happiness and career satisfaction to so many through mentoring. We just cannot wait and hope for them to take the initial step. We must be proactive.

Another obstacle that some of the online courses cannot avoid is a fee. We must keep the face-to-face mentorship cost-free. Additionally, the in-person events allow the mentee to converse and learn from a number of different mentors during the same hour or two. Advice takes many forms. The ability to gather a variety of opinions from a single session only boosts the value and advantages of this personal experience.

There are challenges to any mentorship program. Signing up the participants on both sides of the table will take time and effort. The value and rewards for each group must be advertised and promoted. The mentors should be knowledgeable, energetic, generous, and supportive. The mentees should be excited, curious, and receptive. The time commitment for mentee and mentor may pose an obstacle. Fortunately, our profession is one steeped in the tradition of giving and supporting our own. It is also one which finds its members constantly striving for improvement and seeking answers. These qualities should serve to bring both groups together.

Early in my career I worked as an associate at 2 different animal hospitals. They were quite representative of the 1970s and 1980s in that they both were small, independent facilities and each was owned by a solo veterinarian. The environment was warm and friendly. All the employees regarded each other as family. As I was new to the profession, the owners of these hospitals continually went out of their way to bolster my confidence and instill a sense of positivity and fulfillment. They were always by my side offering advice and wisdom. You could tell that they were genuinely interested in my well-being and my professional growth. They were true mentors. Perhaps they wanted to nurture my success and hope that one day I would buy into ownership. But there was more than that. I honestly felt that they each had experienced their own local, and affiliated veterinary fragility and insecurity upon graduation and now felt obligated to foster my happiness and success.

But that was then. Our profession is changing. We need to ensure that as the corporate sector grows, so does this same personal and supportive mentorship. Regardless of the practice type, the problems facing the recent graduate remain the same. In fact, the present growth of corporate ownership provides a new opportunity and an additional pathway for delivering in-house and hands-on mentorship.

One final observation. Another look at the Chart of the Month reveals that the percentage of “unhappiness” for our support staff is even greater than that of the veterinarians. Our technicians, receptionists, and administrative employees are experiencing their own set of challenges. Our support staff is vital to our profession and cannot be overlooked. Although I have not addressed this deficiency, we must not forget them either when it comes to mentoring and support. We need to include the whole workforce in this process.

In summary, our profession is fortunate in that so many of us have the wisdom and experience to advise and support others who might be struggling and who might be questioning themselves and their choice of this dream career. The 56% of individuals in our profession who have obviously figured it out, and who have expelled the demons, are an untapped potential that we must bring on board if we are to pass on and bequeath to others the well-being and happiness that so many of us have already found.

Chart of the month: veterinary teams and job satisfaction. American Veterinary Medical Association. Published August 20, 2024. Accessed November 11, 2024. https://www.avma.org/blog/chart-month-veterinary-teams-and-job-satisfaction

Volk JO, Schimmack U, Strand EB, et al. Work-life balance is essential to reducing burnout, improving well-being. J Am Vet Med Assoc. 2024;262(7):950-957. doi:10.2460/javma.24.02.0135

2023 AAHA mentoring guidelines. American Animal Hospital Association. June 27, 2023. Accessed November 11, 2024. https://www.aaha.org/resources/2023-aaha-mentoring-guidelines/

Articles

Discover the ways that mentor support can lead to better staff well-being

Mentorship may help improve job satisfaction

 editorial team is counting down our Top 20 news stories and articles of the year, from January 1, 2024, to November 15, 2024. Rank was determined by measurable audience interest and engagement.

A spotlight is shining on 1 article each day through New Year’s Eve, when the No. 1 dvm360 story of the year will be shared. The following article is No. 6 on this list:

Veterinarian files whistleblower and retaliation lawsuit against former employer

Veterinarian Mariana Pardo, BVSc, MV, DACVECC, and her attorneys filed a federal whistleblower and retaliation lawsuit against Animal Surgery Center of Long Island (ASC) and its founder Tomas Infernuso, DVM, DACVS. According to the complaint filed in the United States District Court Eastern District of New York,

 Pardo accused Infernuso and ACS of medical misconduct as well as discriminating against staff.

In 2022, Pardo was recruited to join ACS as its emergency and critical care medical director but was reluctant to do so based on the proposed terms of her employment that the clinic initially offered. However, Infernuso later promised Pardo that a new contract would be finalized eventually while assuring her that she would receive all the benefits and compensation she had sought as terms of her employment. According to the complaint, Infernuso had not delivered on any of the promises made to Pardo.

Shortly after starting her career at ACS, Pardo noticed medical misconduct and harassment of other staff members, according to the complaint. Pardo also stated in the filing that she became aware that the clinic was using unlicensed veterinary technicians for procedures, providing substandard medical care, and engaging in unsafe administration of controlled substances, while Infernuso engaged in mistreatment of fellow staff members. Pardo also stated, through the complaint, that she advocated for better treatment and conditions for employees at ACS continuously with Infernuso. When Pardo brought the issues to Infernuso’s attention, he was allegedly reluctant to address the issues which led her to create a spreadsheet where she wrote down in detail all that she witnessed or became aware of.

For more on this story, including references, view the full article here: 

https://www.dvm360.com/view/veterinarian-files-whistleblower-and-retaliation-lawsuit-against-former-employer

dvm360 is counting down the Top 20 news stories and articles from 2024 with this series of spotlights

2024 veterinary news in review: #6

Merry Christmas dvm360 readers! As a present to you, we are dropping this Christmas episode to bring you into the world of exotic medicine. Our host, Adam Christman, DVM, MBA, welcomed Rachel Siu, DVM, to share what it is like to be an exotic veterinarian, debunking some myths about costs and care, and providing tips to help professionals be more comfortable when treating an exotic pet in their clinic. 

What would you say to those that are tuning in that say, like, Oh, I'm still a little leery about it. I don't know if they say, oh my gosh, are rabbits coming down? I don't know, you know. Like, what would you say to some of those listeners out there?

I would say your critical thinking and research skills are super important. If you know, you have a rabbit coming in, for instance, make an hour long appointment, or even hour and a half you're really uncomfortable with them. Make sure you have enough time to really do your exam very slowly if you nee, do your research on which drugs are safe to give, and I know have the resources available, whether that be, you know, exotic textbook or VIN, or, you know, there's like the favorite, the Carpenter's Exotic Animal Formulary is, you know, one of the exotic Bibles. So make sure you have those resources available to you and really research, you know, things through before you just go prescribing things willy nilly, because I have seen other veterinarians prescribe, you know, antibiotics to rabbits and Guinea pigs that have killed them because it wasn't a safe medication. 

So, you know, I want people to be comfortable and start seeing exotics, if that's what they're passionate in, but make sure you you research things either ahead of time or, take the time during your appointment to to really make sure you're comfortable with what you're doing. 

Podcasts

Enter the world of veterinary exotics with our host Adam Christman, DVM, MBA, and Rachel Siu, DVM

The wonderful world of exotics

A spotlight is shining on 1 article each day through New Year’s Eve, when the No. 1 dvm360 story of the year will be shared. The following article is No. 7 on this list:

Federal bill aims to help make veterinary care more affordable for pet owners

A bipartisan bill—the People and Animals Well-being (PAW) Act—that would expand the use of tax-advantaged health care spending accounts to include veterinary care expenses has been introduced in Congress. The legislation seeks to amend Internal Revenue Code Section 213(d), and would increase animal health eligibility in programs that include Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs).

According to Congresswomen Deborah Ross (D-NC) and Claudia Tenney (R-NY), who both introduced the bipartisan bill, the PAW Act would allow pet owners to have up to $1,000 in veterinary care expenses or purchase an animal health insurance plan paid using their HSAs or FSAs.

 “Pets are more than just animals–they’re beloved members of families who bring joy, comfort, and even health benefits into our lives,” said Ross in a news release. “However, rising veterinary costs often make it challenging for families and veterans to provide care for their pets or service animals. As a dog owner, I’m proud to introduce the bipartisan PAW Act, which will include veterinary care and pet insurance as eligible expenses under HSAs and FSAs to help ensure every animal lover can afford care for their pets. I’m grateful for the partnership of Congresswoman Tenney and will keep working to see this bill signed into law.”

The legislation would also provide for limitless veterinary care expenses for service animals that assist individuals with mental and physical disabilities by ensuring the Internal Revenue Service continues to rely on an updated definition of “service animal” for health care spending accounts.

 "Our pets and service animals are cherished members of our families, and it's essential that owners have the ability to pay for quality care,” Tenney said in a news release. “The PAW Act offers greater flexibility to pet owners by allowing them to use HSAs and FSAs for pet care expenses. This legislation will help veterans, and all pet owners afford veterinary care for their beloved pets and service animals."

The bill was applauded by MetLife pet insurance provider, the American Veterinary Medical Association (AVMA) and the Human Animal Bond Research Institute (HABRI) in news releases issued by the offices of both Congresswomen.

https://www.dvm360.com/view/federal-bill-aims-to-help-make-veterinary-care-more-affordable-for-pet-owners

2024 veterinary news in review: #7

A spotlight is shining on 1 article each day through New Year’s Eve, when the No. 1 dvm360 story of the year will be shared. The following article is No. 8 on this list:

written by Mélanie Perrier, DrMedVet, DACVS, DECVAS, CERP

The presentation of horses for wound evaluation following trauma is a frequent occurrence and one of the most common emergency presentations in equine medicine.

 Horses can sustain wounds over any part of their body, with the distal extremities and head region being common locations for injuries. Like in the distal extremities, there is little soft tissue coverage in the head region, and in up to 80% of cases head lacerations can be accompanied by a traumatic fracture of some part of the skull, making them slightly more challenging to manage.

In one study, fractures involving a horse’s head following a kick from another horse comprised 12% of all incidents and were the second most common type of fractures, following splint bone fractures.

 A thorough knowledge of the horse’s anatomy is needed when addressing trauma and lacerations in the head region. Vital structures found in a horse’s head include the eyes, cerebrum, paranasal sinuses, and nasolacrimal duct.

The equine skull is complex and composed of bones including the incisive bone, nasal bone, frontal bone, maxilla, lacrimal bone, zygomatic bone, interparietal bone, parietal bone, temporal bone, sphenoid bone, occipital bone, ethmoid bone, palatine bone, vomer, pterygoid bone, and mandible.

 The most common bones injured in skull fractures are the nasal, frontal, and maxillary bones with the zygomatic process of the frontal bone.

 Additionally, lacerations to the face and subsequent facial bone fractures can be complex and involve various structures such as sinus compartments, the lacrimal duct, orbit, and cerebrum.

Last year, investigators, including this author, analyzed 13 cases that were presented in our practice over the past 4 years.

 Cases were included if they underwent CT diagnostics of the head with a history of facial trauma and had a fracture of at least 1 of the facial bones comprising the skull. We only included cases that were treated without internal fixation of the skull fracture.

For more on this story, including references and how to navigate bones and vital structures requiring knowledge of the horse’s anatomy, view the full article here: 

https://www.dvm360.com/view/equine-head-wounds-and-skull-fractures

2024 veterinary news in review: #8

Dr Natalie L. Marks discusses how HT Vista Heat Diffusion Imaging can be utilized by general practitioners to screen canine dermal and subcutaneous masses.

Take the AI out of WAIT: A Proactive Diagnostic Approach to Masses

During Fetch Long Beach 2024, Natalie L. Marks, DVM, CVJ, CCFP, Elite FFCP-V, an internationally renowned veterinarian, veterinary educator, media expert, and angel investor based in Chicago, IL, presented a session on utilizing newer technologies, like HT Vista’s Heat Diffusion Imaging tool to screen for canine dermal and subcutaneous masses and differentiate between benign and potentially malignant tumors. "This isn’t a replacement for FNAs or biopsies," she emphasized, "but a decision-support tool to help us screen which masses need further investigation." By offering a middle ground between watchful waiting and invasive testing, HT Vista empowers clinicians to make more informed, proactive decisions during point-of-care visits.


The HT Vista device operates by heating tissue for 10 seconds and analyzing its cooling patterns over the next 30 seconds. Malignant tissues cool faster than benign ones due to differences in vascularity, metabolism, and tissue structure. The device generates a heat diffusion score from 1 to 10, with scores of 5–10 indicating a high likelihood of benignity, and scores of 1–4 suggesting malignancy, prompting further diagnostics. "The negative predictive value is huge," Dr. Marks explained. "It means 98% of the time, when this tool says a mass is benign, it really is. That’s the kind of confidence we need." Results are delivered in just four minutes, making it an efficient and valuable addition to veterinary practices.

Cost-Effective Screening & More Informed Decision-Making


Dr. Marks underscored the tool’s importance in addressing long-standing challenges in veterinary oncology. Traditional approaches, such as cytology, can be cost-prohibitive for many clients, leading to delays in diagnosis. "Unfortunately, for many veterinarians today, the recommendation is to watch and monitor," she noted. "Thirty years ago, that might have been fine, but we can and should do better now." HT Vista bridges this gap by offering a proactive and affordable screening solution that enhances access to care while providing clients with the peace of mind they need to make informed decisions.
Real-life cases highlighted the practical impact of HT Vista. Dr. Marks described a senior dog with 14 masses, a situation where aspirating all lumps would be financially and logistically challenging for most clients. "How many clients can afford to aspirate 14 masses?" she asked. "With HT Vista, you can screen them all and focus your diagnostics where it’s most needed." In another case, the device could have expedited the identification of a mast cell tumor, allowing for earlier intervention.


While acknowledging some current limitations, such as inapplicability to ulcerated or reproductive masses, Dr. Marks emphasized the potential for growth as HT Vista’s AI technology evolves. "The more data we feed it, the smarter it gets," she explained. She urged veterinary teams to embrace innovations like HT Vista, which complement traditional diagnostics rather than replacing them. "This is about preserving the bond between families and their pets," she said. "It’s why we became veterinarians—to improve the quality and quantity of life for our patients." By incorporating HT Vista into their practices, veterinarians can provide comprehensive, compassionate care while enhancing client trust and patient outcomes.


Videos

Dr. Natalie L. Marks discusses how HT Vista Heat Diffusion Imaging can be utilized by general practitioners to screen canine dermal and subcutaneous masses.