Today I want to write to you about something very important: the fact that my car is loaded to drive my oldest daughter to college in about 4 hours, she’s upstairs saying goodbye to her sister who has to go to school today, and it feels like a small piece of my heart is shriveling and dying. (Because this is a medical newsletter, I’ll tell you that it feels like the caudal aspect of the left ventricle and maybe some of the Purkinje fibers.)
However, my wife has told me that I need to distract myself by writing something completely unrelated to my family situation. That’s why I’m going to tell you why veterinarians don’t get excited about research like they used to. This will have nothing to do with my daughter or the existential void that looms before me as someone who still identifies as “the father of little girls.” It’s just some good ol’ fashioned insight on how vet medicine works. Here goes.
The trust that veterinarians have in most “research” is plummeting. When I started in practice, new white papers, survey studies, and peer reviewed pieces garnered a lot of attention from me and my colleagues. Today, a lot of people are surprised at how little the average veterinarian seems to care about breaking research news. There are at least three good reasons for this.
First, the idea that “if you want vets to listen to you, you have to show them data” has become universal knowledge. Everyone who is trying to sell anything to veterinarians or convince veterinarians to recommend their product has heard this. Many of these folks (including massive pharma companies, practice groups, and food manufacturers) have learned the lesson that if you want to get a doctor’s attention, you’d better have documents that include tables, graphs, and p-values. The same is true for people trying to get attention online. In veterinary medicine, presenting “research” has historically been the most proven path to an attentive audience.
But times change. As the number of people wanting attention increases, the amount of content presented as research has exploded. In some cases, this flood has led to really good research not getting the attention it deserves. In most cases, however, it’s led to thinly disguised marketing campaigns, mountains of AI slop, clicky social media content, and validation for whatever cause the “researcher” holds in his/her heart.
There’s no quality control for the vast majority of studies that are published online, and peer review doesn’t have the clout it used to.
Imagine, hypothetically, that a large percentage of veterinarians were going to have a painful life experience like sending a beloved animal to… I don’t know… college. Now imagine that this experience is significantly painful, sad, exciting, and difficult to mentally process. Well, if someone wanted to make a research paper that just said “Sending animals you love to college is exciting!” then that would be true and the research would be valid even though all the bad parts were left out.
Even with cherry-picked data, a paper might still pass peer review. But in terms of what the real story is, that research is a bunch of crap and it is wildly misleading about the totality of the experience. This kind of opportunistic framing happens quite a lot. As more and more people want data to persuade vets and AI makes it easier to produce content, we are seeing a steady decline in the quality of research being put out into the world.
Some would say that data literacy is the answer and we should take time to look critically at studies and decide for ourselves what interpretations to make. My counter is (1) you can only look at data you are provided and there’s no reason to believe you’re being given all the information, and (2) who in the world has time for that? People using AI to “do research” can literally crank out white papers faster than they can be read.
Sadly, good research is getting buried in a sea of marketing content and AI hand waving. While some individuals and companies are making excellent products and backing them up with very good research, the sloppy actors are killing research credibility for everyone.
Researchers, platforms, and companies with established reputations can still get attention, but for the most part the golden “veterinarians will listen to data” goose has been killed. Also, sending pets to college is BULLSHIT! WHY DOES NO ONE EVEN TALK ABOUT THIS! PETS SHOULD STAY HOME WHERE THEY ARE SAFE!
Second, selection bias is out of control. A good chunk of the research being put out about things like affordability of care, burnout, and wellness in veterinary medicine comes from online surveys. One thing we know about surveys is that who gets surveyed is a big deal in determining what outcomes will be found.
Let’s say that 66% of American households have pets (because they do). If you stopped the average pet owner walking on the street and asked them how much money they spend on costumes for their pets, you would get a significantly different average answer than if you surveyed pet owners participating in the Westminster dog show. There’s nothing wrong at all with the dog show people but, when it comes to pet costumes, they don’t represent the average pet owner and shouldn’t be held up like they do.
You see a similar scenario when people do surveys on job satisfaction, wellness, burnout, or mental health in veterinary medicine. The people who are struggling in these areas are significantly more likely to stop what they are doing and fill out a survey than people who are busy and generally happy with how things are going. The people struggling are very important and shouldn’t be ignored. At the same time, the results of a survey that disproportionately attracts these folks is simply not representative of what’s happening across the profession.
Another example would be comparing a survey of all parents about the joys of parenthood to a survey of parents who have just finished dropping their freshman off at college and are starting a 10-hour drive home. I suspect the general population of parents would say parenting is a pretty great thing. The college drop off parents might feel differently and want to say things to the happy parents like: “YOUR CHILDREN ARE GOING TO LEAVE YOU! THEY’RE GOING TO TAKE YOUR LOVE AND ALSO THE TUITION MONEY YOU SAVED AND THEY’RE GOING TO LIVE WITH A GIRL NAMED JENNA FROM PENNSYLVANIA WHO ALREADY HAS A TATTOO! THAT’S WHAT PARENTING IS! *Sob* *Gasp* *Blows Nose*
But we’re not talking about that. We’re talking about pets and medicine, so I would also add that there’s a certain kind of pet owner who is much more likely to invest time in taking online surveys about caring for pets than your standard 66%-of-America pet owner. When we see survey results on affordability and preferences in veterinary care, we are not guaranteed that the people answering that survey actually mirror the population of pet owners we actually see who are only here to get vaccines done before going on vacation because the kennel requires it.
Finally, talk is cheap and people taking surveys want to feel good about themselves. People have a tendency to answer questions and behave in ways that make them look good to others instead of sharing their true thoughts. This phenomenon is called Social Desirability Bias, and it has been shown to persist even in anonymous surveys.
I bring this up because our society is pretty adamant that good, virtuous people love pets, and Instagram-worthy pet owners would do anything for their furry best friends. Think of one movie hero who opts not to save the cat from danger or to ignore the needs of the dog in the film. You can’t. In the Odyssey, you knew who the bad guys were because they put the very old dog outside to die. (Yes, they also murdered some farmers and tried to kill the prince… but it was the dog that made the audience want them killed).
Essentially, people understand that society views loving animals as a virtue, and appearing to value anything above your pets can be seen as negative. When people are answering questions about veterinary medicine and they know they will not have to actually do or pay for anything, why wouldn’t they lean into the most compassionate answer? It feels good to say “I would do anything for my cat!” without probing too deeply on what that would really mean if an emergency presented itself.
This does not at all mean the average pet owner taking a survey about veterinary care is lying or that the groups doing these surveys are trying to deceive anyone. I just need to point out that—and any practicing veterinarian will confirm this—there is often a sharp disconnect between what pet owners theoretically say they want to do for their pets and how they actually act when faced with real-world clinical choices and cost decisions.
This discrepancy doesn’t mean that surveys of pet owners should be ignored. It does help explain why veterinarians might be a little bit skeptical when those surveys indicate that if cost was just a little bit lower, pet owners would flock to take fantastic care of their pets.
So, there you have it. Yes, research is still important and persuasive. Medicine (much like my daughter) cannot be allowed to descend into the world of vibes and good stories told by handsome strangers. People doing research are going to have to work harder to get heard, and they should know that surveys, graphs, and tables aren’t going to carry the weight they once did. Those of us in practice (or going to college) should do our best to balance curiosity with skepticism, to remember our roots and where we came from, and above all, to NOT GET PREGNANT!
