Clinton Neill, PhD, assistant professor at Cornell University College of Veterinary Medicine’s Center for Veterinary Business and Entrepreneurship, joins Dr. Andy Roark to discuss the economic impact of burnout on the veterinary profession.
LINKS
Burnout’s Economic Toll on Veterinarians Calculated (JAVMA): www.avma.org/javma-news/2021-12…4&dlv-mlid=3330547
Uncharted Podcast on iTunes: podcasts.apple.com/us/podcast/the-…st/id1449897688
WORKSHOP – Loading the Bus w/ Dr. Andy Roark & Stephanie Goss:
unchartedvet.com/strategic-planning/
UNCHARTED APRIL CONFERENCE:
unchartedvet.com/uncharted-april-2022/
Charming the Angry Client On-Demand Staff Training: drandyroark.com/on-demand-staff-training/
What’s on my Scrubs?! Card Game: drandyroark.com/training-tools/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr. Clinton Neill is currently an Assistant Professor in veterinary economics for the Cornell Center of Veterinary Business and Entrepreneurship. Dr. Neill’s research primarily focuses on the broad scope of issues that face the veterinary industry. He also has grant funded research projects in food policy, labeling, and the integration of producer and consumer decision making. Before coming to Cornell, Dr. Neill was an Assistant Professor in Food Systems Economics at Virginia Tech. Dr. Neill completed his bachelor’s and master’s degrees in Agricultural and Applied Economics at Texas Tech University, and received his Doctorate in Agricultural Economics from Oklahoma State University. In addition to his research Dr. Neill focuses on bringing his academic research to real solutions for the veterinary and food industries. Email: cln64@cornell.edu
EPISODE TRANSCRIPT
This podcast transcript is made possible thanks to a generous gift from Banfield Pet Hospital, which is striving to increase accessibility and inclusivity across the veterinary profession. Click here to learn more about Equity, Inclusion & Diversity at Banfield.
Dr. Andy Roark:
Welcome everybody to The Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guy, I have a good episode for you today, super interesting. Look, we all know that burnout is a problem in vet medicine, but how big of a problem is it? Can we put a number on that problem? Can we put a dollar figure on that problem? That’s what we get into today with my guest, Dr. Clinton Neil. Dr. Neil is currently an assistant professor in veterinary economics for the Cornell Center of Veterinary Business and Entrepreneurship. Dr. Neil’s got some new research out and I want to go through it with him on what is the economic cost of burnout in vet medicine? Let’s get into this episode.
Kelsey Beth Carpenter:
This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to The Cone of Shame with Dr. Andy Rourke.
Dr. Andy Roark:
Welcome to the podcast Dr. Clinton Neil. Thanks for being here.
Dr. Clinton Neill:
Thanks for having me Andy.
Dr. Andy Roark:
Oh man. My pleasure. So you and I met about two years ago in the before times at the Women’s Veterinary Leadership Summit, and you were doing some presentations there and you were doing some research. You do a lot of research with AVMA correct? And their economic summit?
Dr. Clinton Neill:
Yep, I’ve been doing work with AVMA since when I started my PhD actually back in 2014, and that has evolved time on different topics and things. And so when we met a couples years I was doing a bunch of work on gender wage gaps, which I had a big JAVMA article come out early this year, and then now we’re moving on to new things.
Dr. Andy Roark:
I guess your main job is at Cornell, right? Can you tell me a little bit about that?
Dr. Clinton Neill:
Yeah, so I’m at Cornell now and before when we met a couple years ago I was at Virginia Tech, and I was actually getting ready to interview for this position at Cornell. So my job here at Cornell now is working for the College of Veterinary Medicine, and specifically through their brand new center or Veterinary Business and Entrepreneurship. And so it’s a big center, we’ve got a big research component which is what I’m leading, a big education component to give every veterinary student that comes through Cornell business education so that they know what’s going on in the industry and things like that. Then we have an outreach and entrepreneurship and an entrepreneurship piece as well to help with innovation, both inside the university and the college, as well as outside with our partners.
Dr. Andy Roark:
That’s fantastic. I love it. I’m such a big fan of business education in vet schools, and out of vet schools, but business education for vet professionals is hugely important. I wanted to talk to you today, I saw last month in JAVMA there was an article that came out and it was talking about burnout’s economic toll on veterinarians. And so you had done the lions share of the research on that, and putting forward a pretty strong case about the economic damages that are done by burnout and I think this is really important. Obviously burnout is something that I care a lot about, and I think it’s a real problem in our industry.
Dr. Andy Roark:
But I do think that digging into the economic implications and ramifications of burnout could be a really good tool for motivating some of the corporate practices, practice owners in general to prioritize, wellness and burnout prevention strategies. And so I want to unpack that with you a little bit, make an economic case for me for preventing burnout, I guess is where we’re going. And so just start with that, let me toss you a softball, I guess, just to start with. What is burnout in an economic context? Let’s start by defining terms.
Dr. Clinton Neill:
Yeah. So I like to take that back a step slightly to what burnout really is, because understanding what burnout is in that context of how it’s actually defined by the World Health Organization and those types of things has a really big meaning and then we extrapolate to what are the economic outcomes of that.
Dr. Andy Roark:
Sure.
Dr. Clinton Neill:
And so according to World Health Organization, WHO, it’s a phenomenon that happens at work, it is all about work. It’s not necessarily about what’s going on personally, it’s about work having a really big impact on the amount of stress you’re getting, and that affects how well you’re able to work. And I’m trying to put my thoughts together, but it’s really about these feelings of energy depletion and exhaustion, and just really cynicism towards your job. And that’s where burnout is defined, and when we take that and we think, okay, well, I don’t like my job, right?
Dr. Andy Roark:
Okay.
Dr. Clinton Neill:
What tends to happen? We maybe don’t do all this tasks that we’re supposed to be doing, right? And this is across all fields, right?
Dr. Andy Roark:
Yeah, sure.
Dr. Clinton Neill:
We don’t want to go to work, we may call in sick more, we may try to reduce how much we’re working, and if it gets bad enough we want to leave, right? And find a new job.
Dr. Andy Roark:
Yeah.
Dr. Clinton Neill:
And so those are the economic outcomes of that, which is what’s happening to the labor force, right? Which is reducing those work hours, leaving their jobs, or even retiring early for some people which we see has an effect as well. Is that they’re at their end of their careers, they’re burned out and they just don’t want to be there anymore so they retire early.
Dr. Andy Roark:
Yeah. I would push into that a little bit and say one of the things when you talk about work output, our job as veterinarians is patient advocacy a lot. We’re advocating for patients and people who are burned out just don’t want to do it. You know what I mean? When you’re burned out the idea of getting up and really trying to be persuasive to get people to do what they should do, it’s monumentally hard. And so the idea that someone who’s burned out would have a significant drop in their productivity in the practice, that makes perfect sense to me. Even if they don’t change jobs, even if they’re not reducing their hours, they’re just working much less effectively. I mean, we’ve all probably gone through periods of that where it’s just hard to get up to do the flea talk yet again.
Dr. Clinton Neill:
Yeah. And that’s the other that you’re pointing straight to, right? Which is there’s some cases in the human medical world, burnout leads to increased medical errors, and these other types of outcomes that just aren’t good for medicine in any sort.
Dr. Andy Roark:
Not good for anybody.
Dr. Clinton Neill:
Yeah.
Dr. Andy Roark:
Okay. Cool. So I think it’s pretty easy to grasp the idea and go, okay if that’s how you define burnout and you see how burnout interacts with people showing up and doing their job, it’s not hard to believe that this is going to have an economic impact. How do you actually calculate any… Okay, so walk me through the math, because I think up until this point it was really easy. I have no idea how to calculate lost wages, economic impact from burnout like this. So give me a mile high view of how do you even start to look at a problem like that?
Dr. Clinton Neill:
Yeah. The methodology I follow here in this larger article and the work we’ve been doing is called a cost consequence analysis. And so that’s purely really comes from this medical, human medical side of literature, we follow a bunch of stuff in JAMA and those types of things, but the big thing is understanding two key components. Which is how much revenue is the person bringing in to a business or practice in this case and vet med, right? And we can back out okay so if they’re working this many hours a year and they’re bringing in $300,000 for the practice, right?
Dr. Clinton Neill:
You can figure out what an hourly cost is if they’re not working that hour. When we think about turnover which is the other… The two big pieces we look at are reduced working hours which I talked about, and then turnover. When somebody leaves your practice, right? You’re revenue because they’re no longer there, and when you have to fill that position, right? You have to spend money to try and find somebody. When you find somebody, you have to train them.
Dr. Andy Roark:
And they’re not insignificant. I think people blow that off, right? Bringing in someone new into your practice, they’re not going to be at their maximum product level the first day. Anyone who’s had a new person come in knows that. It’s going to be three months before they really start to get up to where they’re going to generate revenue that’s comparable to what they’ll probably generate going forward.
Dr. Clinton Neill:
Right. And so the way we look at that is look at what is it, search costs is how we call it, or which is all the money that goes into posting a job, and where are you posting it all those costs, and recruiting, and interviewing, and the time spent by other people to do all of that. And then looking at just training and all of that. And so replacement costs, there’s a lot of estimates for this and we vary what we do here, but it’s about two thirds to three quarters of an annual salary for vet.
Dr. Andy Roark:
Okay.
Dr. Clinton Neill:
And so that’s what we use as a mark as we look at average salary, or not salary in this case, but average income because people are in production, and then back out that two thirds to 75% of that. And then add all this up and look at the probability of you being burned out and those types of things. So the complicated part really is just figuring out people who are churning over, reducing work hours, those types of things, how much of that is actually due to burnout? And we have some data to help back all that up, but getting those costs is really just about understanding what revenue are you missing when somebody’s not there, reducing work hours, or leaving, and you have to hire somebody. Those types of things.
Dr. Andy Roark:
Talk to me a little bit about the probability of being burned out, because that’s an interesting statistic, right? So in order to calculate this, we have to know what percentage of veterinarians are burned out so talk to me about those numbers a little bit.
Dr. Clinton Neill:
Yeah. So all this work in conjunction with AVMA, and you brought up a point earlier that I just want to touch back on. All of this work about calculating the economic cost was to motivate and give us something tangible to address the problems. And so when we started talking about this, Dr. Matt [Soloy 00:10:41] and I with AVMA economics division, this actually happened before times. And we were trying to build up and trying to understand people are burnt out, the issue of burnout in vet has been growing for a while and has been increasingly talked about. And so what they did, they as in AVMA when they do their annual surveys through the economics division, one of them is I think they do a census it’s called the census of veterinarians that they do every year, which is just a random sample.
Dr. Clinton Neill:
But within that, they ask a set of questions from the professional quality of life scale that actually has questions about burnout, and compassion fatigue, and these types of things. And from that, we can construct a measure of whether somebody is burned out or not. And so that’s how we get that data, and then we also are observing through that survey data do they want to reduce their work hours? Why do they want to reduce their work hours? Did they leave their job? And those types of things. And so that we grabbed that measure of burnout through these types of questions, and then used that to create these probabilities and these calculations.
Dr. Andy Roark:
Did you see different probabilities in different segments of practice?
Dr. Clinton Neill:
Definitely. So we broke it down into four categories, and we look at the overall. We look at companion animals, we look at equine practitioner, food animal, and then mixed practices. And we see that burnout was really high among the mixed practice associates. So we don’t really look at practice owners because they actually don’t have a lot of burnout.
Dr. Andy Roark:
Really?
Dr. Clinton Neill:
That was very few, it was very low probability of having burnout if you’re practice owner.
Dr. Andy Roark:
That’s fascinating to me. Okay. And you buried the lead there, I was like, wow. Really? That’s crazy. I mean, as a business owner, I’m like, “Oh man, this is stressful as heck for me.”
Dr. Clinton Neill:
Yeah. I think it’s part of it is that practice owners have a little bit more say about when they work, and how much they’re working, and those types of things and so-
Dr. Andy Roark:
Yeah, no, I think that’s a good point. I think autonomy is a big part of it, right? Even though bear the responsibility, they maybe have some more levers in work life balance that associates don’t have.
Dr. Clinton Neill:
Right. And so when we look at associates with this work, mixed practices I think had ended up having a higher level of burnout. Well, companion animal actually had the highest level of burnout, and then it was mixed and equine were about equal. I’m looking at my numbers here. You saw about 62% of companion animal associates were burned out, at least a moderate level of burnout, and then it goes down to 56% for equine, mix and food animals had the lowest at 51%.
Dr. Andy Roark:
Okay, hold on. Wait, the lowest is half the people are burned out?
Dr. Clinton Neill:
Yeah.
Dr. Andy Roark:
Oh my God. All right. Huh. It’s one of those laughs to stop from crying things. Oh my God. Okay. Yeah. That’s that’s enormous. Okay, I’m processing.
Dr. Clinton Neill:
That’s again, moderate level of burnout. So there’s a scale of I think I can do this.
Dr. Andy Roark:
Yeah, I think that’s a good point. Burnout it’s not a zero sum binary thing you’re burned out or you’re not, there’s definitely levels to that.
Dr. Clinton Neill:
Yeah. And this is moderate, and this is people who score at least in the middle of range and upwards. If we get into those upward ranges, so you’re still talking like 48%, 30 to 40% of vet med so not an insignificant change.
Dr. Andy Roark:
Hey guys, I just want to hop in real quick with an update on a couple of things over on the Uncharted Veterinary Podcast, that is a podcast I do with Stephanie Goss on veterinary business. We got a question from the mail bag, it is what do I do about my cowboy technician? This is a technician who takes risks, they put themselves in harm’s way, they’ve been bitten recently. And when they’re talked to about taking risks with their body and themselves, they act like it’s not a big deal. They don’t see a problem, they act like taking risks is what makes them good at their job. That’s not true. How do we reach this person? How do we change their behaviors? Because guys, you can’t put yourself at risk like this. Hard conversations that’s what we do, that’s what we talk about on the podcast.
Dr. Andy Roark:
So anyway, wherever you get your podcast, Uncharted Veterinary Podcast I’ll put a link directly to the episode in the show notes. Check it out. In education news, guys on March the 9th we are having our last in our to strategic planning series. Stephanie Goss is taking the lead and leading her workshop called if you can’t measure it, you can’t manage it all about the metrics. If you need to get your head straight and get a dashboard so you can look at your practice and see what is going on, and know how you’re doing, and know how to make some decisions, and have some hard numbers to back up the choices that you have to make you need to be in this workshop. It is free to Uncharted members, it is $99 to the public. That’s all it is. It is a fantastic deal. If you need this, you need this. It is March 9th, it is at 5:00 PM Pacific Time, 8:00 PM. Eastern Time. Jump in, get registered, I’ll put a link in the show.
Dr. Andy Roark:
The last thing is the April conference, it is the April Unchartered Veterinary Conference. It is in person in my hometown in Greenville, South Carolina. If you’ve never been to an Unchartered Conference, it is magic. It is not a conference, it is a community. It is where we come together and we build relationships and we support each other. And you get to meet positive, excited, enthusiastic people who are doing cool things and new things, and who see possibilities in the future, and who are excited about that medicine. If that sounds like you and you’re like, “I want to be around people like that.” This is how you make it happen. You should get on the plane, you should come to Greenville, you should meet these people, you should be a part of uncharted. And when you come the Uncharted Conference you’re not there for two or three days, oh, no, no, no, no you’re in for a year.
Dr. Andy Roark:
You’re going to come in, you’re going to do the live event, and then you’re going to stay in our online community and you are going to get support and encouragement throughout the whole year. It is the conference that does not end. It is truly different and unique. Ask anybody who’s been in Uncharted and been a part of it, it is something truly special. Anyway, if that sounds exciting to you, if you’re like, “Gosh, that sounds like it would fill me back up. I’ve lost my passion. I’ve lost my spark. I need something to get me reignited.” That’s what we do at Uncharted. Come and check it out. Don’t miss this. Take the gamble, come and see if it’s for you. It might just be the thing that you desperately need. Anyway, guys that’s enough of that. Let’s get back into this episode.
Dr. Andy Roark:
Talk to me a little bit about support staff here, right? So we’re talking a lot about veterinarians, right? You do have information on support staff as well, right?
Dr. Clinton Neill:
Yeah. Specifically veterinary technicians/nurses, depending on where you’re at and how you define that. When we look at those, their burnout rate some of that work had been done by NAVDA, the North American Vet Tech Association, or I can’t remember-
Dr. Andy Roark:
No, you nailed it. Yeah. North American Vet Tech Association.
Dr. Clinton Neill:
Yeah. They did some numbers and these are a little bit older numbers, but they’re looking at like 41% of vet techs are burned out, or have compassion fatigue of some sort. But that rate of turnover for them is still pretty high as well so that’s a big piece of that as well. And I don’t have any numbers on that different perspectives of different practice types, but it’s a problem across both support staff as well as the doctors themselves and that’s a big piece that, well, I can’t dig into those numbers as much as I want in the data.
Dr. Andy Roark:
Yeah.
Dr. Clinton Neill:
It’s important to know that and to take into account this matters to the whole industry, not just one piece.
Dr. Andy Roark:
Yeah. So in your research, you put forward that if you look at the economic impact of burnout in veterinarians, we’re talking about $1 billion a year in lost revenue attributed to burnout. And then you said, if you add in veterinary technicians, it goes up to basically two billion, right? It’s like 1.9 billion. So I was really struck by if we go with these numbers, basically the economic impact of the veterinary technician burnout is almost equal from a revenue standpoint to the doctors. I think it’d be easy to say, well, a burned out doctor is a greater financial liability than a burned out technician. And I don’t know, I assume that comes a lot from there are more in a practice than a doctor. Maybe having a smaller financial impact individually, but when you add together, burned out technicians across the practice you end up with almost the same economic impact as burned out doctors. Is that true?
Dr. Clinton Neill:
Yeah. I mean, you hit the nail on the head with that. You’ve got over a 100,000 vet techs working across all of these different practices, and then you’re also probably have about 60 to 80,000 actual veterinarians that are associates and not practice owners. So it’s a pretty big number. The other big piece here is that the cost of a vet tech leaving your practice is more than what you’re paying that vet tech, is what we actually find, and that’s a key component to that as well.
Dr. Andy Roark:
Break that down for me a little bit. Why is that the case? How could it possibly cost me more to have a vet tech leave than to keep a vet tech and continue to pay them?
Dr. Clinton Neill:
Right. Well, I mean, think about it when you have a vet tech leaving, right? How much work are they actually doing keeping that practice running?
Dr. Andy Roark:
My vet tech, like all of it.
Dr. Clinton Neill:
Yeah. I was going to say, and think how many vet techs do you have per doctor in a practice?
Dr. Andy Roark:
There’s a variation across the industry, but it’s probably three to four in my practice.
Dr. Clinton Neill:
Yeah. And so if you have one person down, that’s 25% of the work is having to be distributed across other people, which means they’re doing less work, and so it compounds. It’s not just that vet tech leaving, it’s the fact that they’re leaving, other people have to pick up the slack, which means they can’t do as much work or they’re doing too much work and burning themselves out, right? And so a lot of that comes from the fact that vet techs help bring in that revenue that a doctor’s bringing in just as much as the doctor itself. And so when they churn over, they’re not able to help contribute to that revenue generation, and that’s the important piece that we find there.
Dr. Andy Roark:
Yeah. So the opportunity cost basically is what we’re talking about, right?
Dr. Clinton Neill:
Yeah. Exactly. Which is the big economics term that economists like to throw around., is Opportunity costs is what can we be doing with that time?
Dr. Andy Roark:
Yeah, that does make sense.
Dr. Clinton Neill:
What’s the next best alternative to our time, right? Which is not trying to hire another person and then not trying to do other people’s work.
Dr. Andy Roark:
What does that number mean when we say $1 billion in lost revenue or or $2 billion if we factor in vet techs? Is that a lot? Is that a little? I think if we look at the whole industry, I honestly don’t have a good… We’re talking about imaginary money at this point to me, this is theoretical money and so it’s a bajillion dollars. And what is that money actually? What are we talking about?
Dr. Clinton Neill:
And I think it is important to say that all these numbers are really the opportunity cost, right? That even if we didn’t have as much turnover and these types of things, right? Is it really going to be $2 billion? Maybe. There’s also other things we’re not taking into account in the work that I’ve done, but taking that number and moving that forward.
Dr. Andy Roark:
Well, even what we were talking about before is say we’re looking at lost hours or job turnover. Oh, I don’t know how you calculate decreased effectiveness communicating with pet owners, but to me that’s a significant driver. So all this is going to be a little bit of shades of gray. Yeah, some got us some hand waving, can you just squinch your eyes a little bit and you can see it, but it’s important to get a general perspective of what we’re talking about.
Dr. Clinton Neill:
Yeah. And so when we look at $1 billion let’s start there, that’s 2% of the total revenue for the whole industry in the US.
Dr. Andy Roark:
Okay.
Dr. Clinton Neill:
So not a large percentage of the industry, right? You’re talking about a 2% gain just from veterinarians. If you add vet techs, right? It’s probably another almost 2% of that, so 4% of the whole industry when we round up. So it doesn’t seem like a lot, but if you put that in perspective and you look at what I enjoyed doing was taking the amount of debt from the 2020 graduating class from all the vet schools. And if you look at that, the amount of revenue that you’re not generating say if we take that number as given, could pay back all that debt twice over. And I think that’s the number that is a little more tangible than going, “Oh, it’s 2% of an industry that generates $46 billion in revenue, right?”
Dr. Andy Roark:
Yeah.
Dr. Clinton Neill:
There’s these different pieces of how we can think about it, but $500 million in debt for the 2020 graduating class of vet med, that’s a lot of revenue that could help pay back debt and reduce that stress and those types of things as well.
Dr. Andy Roark:
Yeah. I wonder whether that break down it at an individual practice level, right? So if you say companion animal practices generally have the highest level of burnout, and you’re talking about say 4% productivity loss, what does that translate to as a practice? Would that be a 4% increase in overall gross revenue? Probably more than that if you’re looking at companion animal. And then I’m sure it’s also very practice type specific, geography specific, all those sorts of things. If you have a practice that doesn’t have a lot of burnout, then you’re probably not that negatively affected, but that means that somebody else has probably got a burnout problem and they’re probably significantly more affected.
Dr. Clinton Neill:
Yeah. And I won’t say I don’t have those exact numbers I think to the question you’re asking, but for companion animals that’s where most of the cost is coming from, right? Because that’s also the largest part of the industry. You’ve got almost 56,000 companion associates.
Dr. Andy Roark:
Yep.
Dr. Clinton Neill:
And so if you look at what their numbers, total costs for the companion animal part of the industry and break down just averaging across everybody, those burned out or not, you’re looking at like $17,000 a vet.
Dr. Andy Roark:
Okay. Yeah, that’s what I was looking for. So $17,000 per vet give or take, rough math. Man, that’s not insignificant.
Dr. Clinton Neill:
No. And if you take that number and you take out all the people who aren’t burned out, right? So that number’s just going to go up, you’re talking probably more around 25 to 30,000.
Dr. Andy Roark:
Oh yeah, so when you remove the non burned out vets, which is 30, 40% of them, maybe when they come out and you just look at the impact on the burned out vets, you’re looking even higher than that. Yeah, that’s significant. That makes sense to me. And again, we’re fudging the numbers here just for conversation’s sake, but looking at a burned out doctor and saying that person’s burnout is $25,000 a year, that seems right to me. I’m not blown away by that number, I could 100% see how that would shape up into that level of lost revenue, right? And I’m not saying this as a way of increasing more revenue, but rather as a way of looking at the price that burnout takes on a practice.
Dr. Clinton Neill:
Yeah. And so even if you think about, so say you’ve got a 10 doctor practice and three of them are burned out, right? That’s almost a $100,000 in revenue, that’s $75,000 that you’re missing out on, right?
Dr. Andy Roark:
Right. Oh yeah. And that’s also bottom line money too, right? You’ve already probably covered your hard costs, this is practice profitability, this is staff salary money, this is bonus money, this is profitability on the practice money. This is money that you could actually use to affect the life of the people who work there, and to make significant changes because this is all gravy, right? This is the profitability of the practice that’s being eaten away, not the hard costs.
Dr. Clinton Neill:
Right. I mean, because vet is profitable overall in general. I mean not every practice is, but most practices are and the industry itself is producing 12% profit over cost.
Dr. Andy Roark:
Are these numbers significantly different from other professions? Are we a burned out profession compared to other professions, I guess? And there’s a lot of narratives that are thrown around, especially online people say the burnout in vet medicine is worse than anything. I don’t know that I’ve ever seen any numbers to that, is there anything comparable in other industries that we can look at? Even from a financial perspective and say, “Oh man, the toll here is significantly greater than is in other service type industries?”
Dr. Clinton Neill:
Yeah. So I mean, everything I was doing was based off of studies done in human health positions and those types of things, and so the study I did was pretty much comparable to what they were doing for human health physicians. And I’m trying to remember what the cost is, I want to say the per doctor cost is higher, but the industry cost isn’t because there’s a lot more human physicians, right?
Dr. Andy Roark:
Right.
Dr. Clinton Neill:
But it’s pretty high. We have a higher level of burnout as compared to human physicians based on… It’s not exactly comparable measures because they’re measuring it slightly differently just using a different scale, but it’s not an insignificant amount, and vet med is probably slightly more burned out than everybody else. We have higher turnover rates than most of these other industries as well, and I think that reflects that as well.
Dr. Andy Roark:
That’s fascinating when you look at turnover rate, especially when you think of the amount of training time that goes into getting a medical professional up and going in vet medicine. Or you think about, so you’re talking about credential technicians or veterinarians that ended up sinking a lot of time and effort into their training. And then oftentimes there’s non-compete…. Oh, I forget the term for it, the contractual term, but the non-compete clauses that we have that make it hard to leave, and then the fact that you would still see turnover. That’s pretty significant.
Dr. Clinton Neill:
Yeah. When I was looking at these numbers, 2020 turnover numbers you would know which was pandemic and everything else, was 20% for companion animal veterinarians. And I think AHA, the Animal Hospital Association was stating 15% the year prior, or something like that.
Dr. Andy Roark:
Yeah.
Dr. Clinton Neill:
So it’s much, much larger. And I don’t have the physician numbers right in front of me, but I’m trying to think off the top of my head, but I’m pretty sure I know turnover rates are higher.
Dr. Andy Roark:
Gotcha.
Dr. Clinton Neill:
And then just overall rate of burnout is higher as well.
Dr. Andy Roark:
What do we know as far as root cause? So when we look at this, where does burnout come from? I mean, if we know the impact that it has, we start to look at then immediately to where’s it coming from?
Dr. Clinton Neill:
Yeah. I think when I was digging into this, and I’ll say I have some data, some anecdotal data about this, just because I haven’t done any [crosstalk 00:30:03].
Dr. Andy Roark:
Yeah. Anecdotal data.
Dr. Clinton Neill:
It’s not me asking people what’s going on, there’s actual data behind this. When we would look at why people wanted to reduce their work hours or why they left, a lot of it was because the expectations of what they were told when they were hired or they were told that they were to expect for that year were much lower than what they were actually doing. In terms of how many hours they were working a week, how many emergency days they were working, or things like that. And that tended to be when they said, “I want to reduce my work hours because I’m working more than I was expecting to work and now I’m burned out.” And all those things always came up together.
Dr. Andy Roark:
That’s interesting. So one of my favorite sayings is that, “People don’t get upset about what you give them, they get upset about the difference between what they expected to get and what they got.” And yeah, expectations are important. So just for me to say this back to you, one of the continued trends is not just how much people work, but what they expected to work versus what they actually work. Is that true?
Dr. Clinton Neill:
Yeah. And I think that’s spot on. And the way that vet med’s going, right? I don’t think anybody can work less hours at this point. I think all practices are busy, I think they need people to work and that’s either hiring more people and everybody works less hours, right? Which isn’t always feasible. Or everybody needs to continue to work the amount of hours they’re working. I think just bringing that expectation up front and being like, “The need is I need somebody to work 60, 70 hour weeks. I’m not going to tell you you’re going to work 40 and then work 60, right?” I think that’s where the conversation needs to lead a little bit, and not misalign people’s expectations with reality.
Dr. Andy Roark:
Therein lies the rub, right? My wife and I are still waiting on a package for Christmas, and so we’re recording this the week after Christmas, but it did not show up in time. And she’s quite frustrated at me because we sat down together and we decided to order this thing, and we looked at a number of different places that were selling it and we went with the place that said they could deliver it by Christmas. And they totally did not and now we’re miffed, but we still placed the order with those guys.
Dr. Andy Roark:
You know what I mean? And it’s almost like one of those things, I completely agree with you, expectations are key and we should be honest about what people are getting into. I think the fear that a lot of people have is if I’m the only one who’s honest, then everyone else is going to tell a fairy tale and we’re going to lose people, but I think that transparency is the answer to that. Don’t you agree? Of saying, “This is what you can expect when you come to this hospital.” And having other people to say, “Yes, that is true. This is what you’re getting into.”
Dr. Clinton Neill:
Yeah. And I agree with the transparency piece, and I agree with that piece across a lot of different topics. I think I argued that for within the gender wage gap work that I had done and all of that, because just being honest with people, and I think that’s especially important for these younger generations when you get into the millennials and now the gen Zs are starting to get into vet school and coming out of vet school. What they care about is honesty and about being upfront and just telling them what they are to expect. And I think that’s… The transparency piece, I’m a huge advocate for, I guess is what I’ll say.
Dr. Andy Roark:
Well, no, I’m a big advocate for it. I also think it’s reality, right? It’s a force of nature, which is in the world we live in where social media is a thing and people have a voice and we’re all way more connected than we ever were in the past, right? I’m still Facebook friends with the vast majority of people I went to vet school with, and I can reach out to them and say, “Hey, you work in this area. How much do you work? And do you mind me asking what your salary is?” And generally people are very willing to share that information privately. That didn’t used to be the case, right? In vet medicine of old, everyone they graduated, they went to work in their little practice. What? Are they going to write a letter to an old classmate?
Dr. Andy Roark:
That didn’t happen, but now it’s wide open. And so now we’re starting to see pay scales, which I think are great, just wage transparency of this is what you get paid at this level, and this is what you get paid at this level. And this is how compensation is done. I think it’s been painful for a lot of clinics in vet medicine that we’re not set up that way, maybe that means a good pain. I think it’s a transformation people go through, but I think that that type of transparency is really good and it’s just interesting now to see. I think we are resetting expectations, and I think a lot of it is in schools, in vet schools. New graduates come out and I’ll talk to vets that are out looking for their first job, and they’re not dim, they’re well prepared as far as what is my life going to really be like when I get here?
Dr. Andy Roark:
When can I expect to leave the building? Not when is my shift in? Not when is the last appointment for me scheduled? When do I really leave this building? And how am I going to be contacted when I’m gone, and when I’m at home? Are you going to be calling me? Am I going to be doing those things or not? I don’t think most of us had the wherewithal to ask those types of questions. They were just unheard of in the past, but I think that that’s the new world, and so I think probably ultimately it’s going to be really good.
Dr. Clinton Neill:
Yeah. And now you have people like me working at vet school, teachings vet students to ask these type of questions.
Dr. Andy Roark:
Yeah, exactly right. Hey guys, so at best 50% of you are going to be mildly burned out in a few years. Let’s talk about that. Yeah, those are not conversations of old. Dr. Clinton Neil, thanks for being here. Where can people learn more about your research? If they want to look more into this topic, where can they go?
Dr. Clinton Neill:
Yeah. I mean, feel free to email me, my email’s public through Cornell anyways, but we can post it here and now.
Dr. Andy Roark:
Sure, absolutely.
Dr. Clinton Neill:
Feel free to email me directly, but a lot of the burnout stuff in vet med is especially new, and so I’m trying to build that out and have those resources in a place we’ll hopefully have some stuff out on the Cornell website and things like that. Working on publishing the stuff as well, so we’re working on that, but I mean, look into the position literature, research burnout in physicians you’ll find a lot of stuff there. But it’s all the same things, it’s just trying to apply it to vet med and trying to figure out what are the actual solutions to that? And that’s the next steps where we’re going.
Dr. Andy Roark:
Thanks. Guys, I’ll put a link down to the original article that we discussed in the show notes. The term I was thinking of earlier is restrictive covenant, that’s the do not compete clause that came to me later, things like that. I’m sure there’s a million other things that we messed up along the way, but man, what a good conversation. Thank you. Thanks for being here, Dr. Neil. And guys take care of yourselves, I’ll talk to you later on.
Dr. Clinton Neill:
Thanks.
Dr. Andy Roark:
And that is our episode. Guys, I hope you liked it. I hope you got something out of it. Guys, I got to give a quick shout out right now to Banfield the Pet Hospital. Listen, Banfield has given us a generous grant to have transcripts for the podcast. That’s right, you can find transcripts of both the Cone of Shame Podcast and my other podcast the Uncharted Veterinary Podcast, which is a business podcast. If you haven’t checked it out for vet medicine, check it out you might like it. If you like this one, you might like that one. Anyway, in effort to increase accessibility ,inclusion in the veterinary space, Banfield has made these transcripts possible. It’s a wonderful gift to my team, it is a wonderful a gift to our audience.
Dr. Andy Roark:
We’ve gotten emails that says, “Hey, when are you going to have transcripts so that people who are not able to hear can enjoy this content and can get information from it?” And thanks to Banfield, we’re able to make that possible, and so I just have to thank them for what they do. It was above and beyond, they didn’t have to do this, but man, it means the world to me. And I am so glad to have these transcripts to put out so that everybody can take advantage of what we’re doing here. Click the show notes, if you want to find the transcripts. And again, thanks to Banfield. Guys, take care. Be well. Talk to you later. Bye.
Editor: Dustin Bays
www.baysbrass.com
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