New Perspectives on Veterinary Burnout | Episode 49 | Reviving Vet Med

Recent veterinary research reveals that as many as 50% of veterinary team members may be experiencing burnout. Tackling burnout in the veterinary profession requires a deeper understanding of its complexities. In this episode, we explore innovative ways to measure and address burnout, drawing on recent research and insights from Dr. Andria Jones, a researcher at the Ontario Veterinary College.

We discuss the four burnout profiles identified in veterinarians: engaged, ineffective, overextended, and burnout, along with a brief look at the disengaged profile. Each profile highlights unique challenges and opportunities for intervention, emphasizing the importance of personalized approaches to wellbeing.

Listen in as we delve into effective strategies for fostering engagement, reducing overextension, and implementing systemic changes to combat burnout. Whether you’re a veterinary professional, manager, or leader, this episode offers valuable insights to help create a healthier, more resilient workplace for everyone.

Resources
How do you measure burnout among veterinarians? (blog): https://revivingvetmed.com/measure-burnout-among-veterinarians/

Latent burnout profiles of veterinarians in Canada: Findings from a cross-sectional study (article): https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.2281

Burnout symptoms and workplace satisfaction among veterinary emergency care providers (article): https://onlinelibrary.wiley.com/doi/10.1111/vec.13271

Episode 9: How finding meaning improves wellbeing (podcast): https://revivingvetmed.buzzsprout.com/2011463/episodes/10874179-how-finding-meaning-improves-wellbeing-episode-9-reviving-vet-med

Thank You to Our Sponsor Scribenote
Book a Demo: https://calendly.com/d/4zm-dsr-wfh/scribenote-demo
Try 100 Notes for Free: https://app.scribenote.com/auth/register?referralCode=Reviving-VetMed

Newsletter
For more practical pointers and tangible tips related to veterinary mental health and wellbeing, subscribe to our e-newsletter: https://revivingvetmed.kartra.com/page/newsletter

Online Programs
To learn more about our 4- and 8-week online programs approved for CE credit in jurisdictions that recognize RACE, please visit: https://revivingvetmed.com/programs/.  

Questions, Suggestions, or Sponsorship Opportunities
Email: podcast@revivingvetmed.com 

Scribenote
The first AI-powered veterinary SOAP creator that builds accurate medical records effortlessly.

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Transcript

Still writing medical records manually? Imagine reducing the mental load of a full day's patient care. With Scribe Note, the AI-powered veterinary soap creator, you can streamline recordkeeping effortlessly, as if you had a personal scribe. 

I recently used Scribe Note during a hectic string of emergency shifts, when I managed over 20 cases in twelve-hour days. It drastically cut down my medical record completion time, letting me focus more on patient care and less on paperwork. Scribe Note has truly transformed my workflow. Born from a desire to help, Scribe Note now supports veterinary clinics across North America. It is dedicated to improving veterinary wellness and reducing burnout. 

Try it now at scribenote.com. With a free trial of 50 records for reviving vet med listeners use the link in the show notes for 100 free notes, 50 more than the trial. Book a no-obligation demo call and see how Scribe Note can simplify your day. 

In today’s episode,we’re diving into an important topic: new ways to measure and tackle burnout. We all know that burnout is a significant concern in the veterinary profession, but today, I want to share some cutting-edge insights from recent research, including fascinating work by Dr. Andria Jones from the Ontario Veterinary College.

Burnout is no stranger to those of us in veterinary medicine. In fact, veterinarians around the world—whether in the UK, Australia, the US, or Canada—are consistently found to be at increased risk for mental health challenges like stress, anxiety, and depression. While we often focus on these mental health outcomes, burnout, though less frequently studied, is a serious problem that we need to talk about more.

Today, we’ll discuss how burnout is measured, the impacts it has on our profession, and explore some new ways to think about and tackle this growing issue. This is a fascinating new area of research, so let’s get into the episode. 

This is the Reviving Vet Med podcast, and I'm your host, Dr. Marie Holowaychuk. My mission is to improve the mental health and wellbeing of veterinary professionals around the world. 

Before we dive into newer approaches, let’s take a step back and define burnout clearly. Burnout arises from chronic workplace stress, particularly when the demands of the job far exceed the available resources. According to the World Health Organization, burnout is defined as an occupational phenomenon which emphasizes that it's caused by stress at work rather than being a medical condition. 

We know that burnout has three components. Those are emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment.  Now it's important to recognize that you don't need to have all three of these things to experience burnout, and we're going to dig into that later on in this episode. 

So when it comes to emotional exhaustion, this is the depletion of your energy reserves. where you feel completely drained or like you have nothing left to give. So I think a lot of us can relate to this sensation in vet medicine where we come into practice and we just feel like we have nothing left to give to our clients, our patients, or our team. 

Depersonalization, on the other hand, is when you start to feel mentally distanced from your work, whereby you might develop a sense of cynicism towards your job and the people and animals you're trying to help. So some people will refer to this as cynicism. And again this is just where you really don't see your pet owners as humans, you don't see the animals as patients, you just see them as pets. 

just something that you're supposed to be working on, but not necessarily feeling connected to them.  And then a reduced sense of personal accomplishment is when you feel like nothing you do matters. as if your work is ineffective and you're just not achieving the outcomes that you want. So this might be feeling like none of your cases turn out the way you want them to, or no matter how many people you try to help you feel like you're spinning your wheels, or that what you're doing on a day-to-day basis has no real impact on your veterinary patients or clients. 


It can have serious consequences for both mental and physical health, leading to insomnia, depression, fatigue, and more severe conditions like heart disease or type 2 diabetes. Burnout also affects workplace dynamics, leading to job dissatisfaction, absenteeism, presenteeism, high turnover, and ultimately attrition.

So these three components, emotional exhaustion, depersonalization, and a lack of personal accomplishment, all combine to create what we call burnout. And as I said, you don't need to have each one of these, but each of these can be a symptom of burnout. And burnout really has a lot of consequences for our mental and our physical health.

In fact, research shows that burnout can lead to insomnia, depression, fatigue, and even more serious health conditions like heart disease or type 2 diabetes.  We also know that burnout can impact dynamics in the workplace because team members who are experiencing burnout can have job dissatisfaction.

They will have more absenteeism, maybe even presenteeism, meaning they show up to work but are not actually fully engaged. They might leave the job, resulting in high turnover and, ultimately, what we've been experiencing a lot in vet medicine, which is attrition, where we just have a lot of people leaving the industry altogether.

When it comes to traditional measurements of burnout, the most widely used tool that has been used is the Maslach Burnout Inventory, or the MBI, which basically assesses the three components that I just mentioned. This is a psychometric scale made up of 22 items or questions that are highly reliable across a lot of different populations, including healthcare providers.

There are actually different MBIs that are available. There is one for the general population, and then, as I said, there is one for specifically healthcare providers, one for educators, and some other subpopulations as well. I'm going to link to a blog that I wrote a few years ago regarding how to measure burnout that talks about this scale.

But essentially how it works is that there are statements related to emotional exhaustion, which ends up being measured on a scale of 0 to 54, with higher scores indicating higher levels of emotional exhaustion. Depersonalization has a series of statements that are scored between 0 and 30, again with higher scores pointing to increased risk.

And then personal accomplishment is scored from 0 to 48, but with this score, lower scores actually are more indicative of burnout. So what that means is that the lower scores for personal accomplishment are more likely to indicate burnout. The more accomplished you feel, the less likely you are to be experiencing burnout.

Now, I mentioned that there are these statements that the MBI uses. They don't actually give a simple yes or no answer in terms of whether you're burnt out. Um, instead, you are answering the question on a scale of how frequently you feel that way. And that ultimately gives that score. And really when we look at these different sub scores or the three different components of potential burnout, It allows us to really understand how burnout is affecting that individual based on each one of these different ways that burnout can show up.

So I want to discuss how Dr. Andrea Jones work in recent research proposes new perspectives on understanding burnout. I think that traditionally we have tried to use the MBI and other scoring tests. to view burnout as something you either have or that you don't have. And a few years ago, I measured the MBI specifically among emergency and critical care providers.

And it was very challenging for me and the statistician to determine how we were going to characterize individuals as having burnout or not. And we ended up instead looking mostly at sub-scores in terms of looking for associations between different variables like working hours and workload and that sort of thing and scores such as emotional exhaustion, depersonalization and personal accomplishment to really get a sense of which of those workplace variables might have been contributing to burnout.

But when it came to determining how many emergency and critical care providers experience burnout or what the quote unquote incidents or rates of burnout were, that was a little bit more challenging. And this is something that researchers like Leder and Maslach have started investigating, which really suggests that burnout exists more on a continuum and not simply on a yes or no spectrum.

So instead of asking, "Are you burnt out or not?" we can actually look at where people fall on the continuum ranging from engaged to burned out. This is what Dr. Jones did in her research that was performed based on survey studies that measured the MBI amongst veterinarians in Canada. And they were able to identify that Canadian veterinarians fell into one of four burnout profiles.

First, we have the engaged profile, which was identified in about 10% of the participants in the study. These are the folks who are energized, involved, and feel a sense of accomplishment in their work. While only 1 in 10 of veterinarians in this study fell into the engaged category, these individuals represent the benchmark for what we want to feel when we come into work each day.

So these veterinarians had low levels of emotional exhaustion, low levels of cynicism or depersonalization, and high scores in the levels of personal accomplishment.  So how do we increase engagement in the veterinary profession? Well, it's important that practices create a positive team environment, with strong interpersonal relationships, good communication, and a sense of autonomy for all team members. 

Research shows that mentorship programs, regular team-building events or social gatherings, and informal check-ins throughout the workday can help create these environments. We've talked about this before in some of our episodes on reducing workplace toxicity.  We also know that opportunities for professional development play a big role in engagement.

Veterinarians who are given the tools and opportunities to grow in their careers, whether by taking on challenges that align with their personal and professional goals, are more likely to stay engaged. This might mean giving team members a chance to pursue additional training, attend workshops, or take on new responsibilities in a way that makes them feel like they can progress in their careers. 

The second profile that was identified is the ineffectiveness profile, which represented about 20% of veterinarians or 1 in 5.  So this group struggles with feelings of low personal accomplishment, and yet they have normal emotional exhaustion and  depersonalization scores.  What this group really represents is those who feel negatively about how well they're doing their job.

So, if you've ever felt like you're not good enough or that you aren't making a difference despite your best efforts, you might relate to this group. So how do we help individuals in this profile? Well, one of the most important strategies is helping them rediscover meaning and purpose in their work.

This is something I've talked about on the podcast before and I will also link to that episode. But sometimes it's about realigning job duties to match those personal values and interests. something that individuals refer to as job crafting. So, for example, if a veterinarian is passionate about community outreach or mentoring young veterinarians, we want to make space for those activities in their work to enhance their sense of purpose and purpose and self-efficacy.

Once again, if we have values incongruence, where a person maybe really values those long, deep client interactions, and they're being forced into a situation where they're having to go from appointment to appointment to appointment, that is also going to create this sense of ineffectiveness.

So again, it's crucial that we have this job crafting that allows people to work within their values. And it's also crucial that employers offer opportunities for continuing education and skill development. We know that when veterinarians feel like they're growing and progressing in their careers, their sense of efficacy will improve. 

The third profile that was identified among these Canadian veterinarians is the overextended profile, which is particularly common. Actually, about one-third of participants, or 30%, fell into this category. These veterinarians report high levels of emotional exhaustion, but they're still moderately effective and involved in their work.

In other words, they're just doing too much, and I think a lot of people can relate. Overextension is primarily driven by a lot of work demands, often without the resources to manage those demands. This is really relevant today as many veterinary practices are increasingly overburdened due to staff shortages and rising demand for care.

So what can we do to mitigate the overextended profile? Well, first and foremost, we need to look at ways to reduce workloads. So that might mean adjusting caseloads. offering part-time or flexible schedules, ensuring there's enough administrative support in place. These changes, even just implementing AI software for medical records or other ways to streamline tasks, can show that they can make a big difference in reducing exhaustion.

Research also shows that interventions focusing on controlling the length and intensity of shifts are particularly effective in alleviating overextension.  Work-life balance is also key here. Veterinarians, especially women in the profession, report high levels of work-life conflict or imbalance, which significantly contributes to their emotional exhaustion.

So we want to make sure that we're giving female veterinarians more control over their schedules, which will help them manage the balance between their work and personal responsibilities. 

Finally, among the Canadian veterinarians who participated in this study, we have the burnout profile. This is the most severe form of burnout, where participants report high levels of emotional exhaustion and depersonalization, along with a lack of personal accomplishment.

This is the most concerning profile because it suggests a complete depletion of energy, along with feelings of detachment from both the job and the patients. So unfortunately, the largest number of veterinarians fell into this category, which was approximately 40% of those who participated in the survey.

So for vets in this category, individual interventions like stress management, cognitive behavioural therapy, or mindfulness can be helpful, but they aren't enough on their own. We need to have structural and organizational changes to address the systemic issues that drive burnout. Things like excessive workloads, lack of support, poor leadership, and unclear job expectations. All of these things to burnout, especially among individuals in this category.

So, I want to emphasize that the research really does indicate that individual-level interventions alone don't work long-term. As much as I am a proponent of encouraging individuals to control what they have control over, which is themselves, we also need organizations to step up and make the necessary changes to work environments to prevent burnout from happening in the first place.

As we've seen during the COVID-19 pandemic, organizations that build a strong, resilient team culture are better equipped to manage workplace stressors and navigate unforeseen challenges. This came out quite consistently in the veterinary literature on resilience during the pandemic.

I also want to mention a profile that was not identified in the research study among veterinarians but is still relevant to understanding burnout. This is the disengaged profile, and it represents individuals who are neither emotionally exhausted nor feeling ineffective, but they're simply disconnected, and their depersonalization scores are high.

People in the disengaged profile might experience boredom or a lack of enthusiasm about their tasks. They don't show a lot of emotional involvement or personal investment in their job, which leads to a feeling of indifference or cynicism. So, they might not show really severe symptoms of burnout, such as emotional exhaustion, but their lack of engagement can still negatively impact their productivity and job satisfaction. 

We want to address disengagement by rekindling that sense of purpose and connection to work. Once again, this could mean revisiting the alignment between personal values and job roles. It could be creating more stimulating or variable tasks for the veterinarian or fostering a sense of belonging within the team. 

No matter what we do, we want to provide opportunities for skill development and ensure that team members feel recognized and valued so that this can help reengage those who might otherwise drift into disengagement. So, I am definitely fascinated by this new research and this new way of looking at these burnout scores.

I definitely have a desire to go back and look at my raw data from the Emergency and Critical Care Providers Study and just see how we can better characterize those individuals. I love that we can look at burnout more on a continuum, you know, with engagement on one end, and then ineffective overextended and disengaged in the middle and then burnout on the opposite end.

This really allows us to look at ourselves and our team members to see where a person might fall on this spectrum and hopefully tailor our burnout interventions more closely to where that individual is, what they're experiencing and therefore what their needs are, and also, you know, catch them early before they get to the end of that engagement burnout continuum. 

Again, whether it's fostering engagement by promoting professional development and team cohesion, or addressing that feeling of overextension by creating more sustainable workloads, there are concrete steps that we can take as leaders, organizations, and individuals to improve wellbeing in the veterinary profession.

At the end of the day, the message is clear. Burnout is not just an individual problem Yes, there are things that we can do to manage our burnout, like setting boundaries, getting sleep, taking care of our mental health, managing the things that we are saying yes to, and those types of things. It is also a systemic issue, and that means it's one that requires organizational interventions as well to truly make a difference.

So, together as individuals, organizations, and leaders, we can tackle burnout and move toward a healthier, more engaged veterinary profession, which I think every single one of us listening today would like to see.

So that’s it for this episode of Reviving Vet Med. 

I hope that you took away some helpful information related to how we measure and mitigate burnout. 

If you do one thing after listening to this episode, I hope that it’s to forward this episode to a colleague or coworker who you think would benefit from it. 

We would also appreciate it if you subscribe to the podcast, so that you are sure to get the new episodes as soon as they drop. 

If you’re interested in the resources from today’s episode, please check out the show notes. You can also follow us on social media @RevivingVetMed for more tips and strategies for wellbeing in veterinary medicine. 

If you have questions about today’s episode, suggestions for future topics, or inquiries about sponsorship, please email us at podcast@revivingvetmed.com. 

I’d like to thank Asia and her team at BearBeat Productions for producing this episode and I’d also like to thank you for listening. 

I hope you’ll tune in next time - in the meantime, take care of yourself.