Burnout’s economic toll on veterinarians calculated

Burnout is a top challenge in the veterinary profession, particularly during the COVID-19 pandemic because many clinics are busier than normal at the moment, said Clinton Neill, PhD, assistant professor at Cornell University College of Veterinary Medicine’s Center for Veterinary Business and Entrepreneurship.

Dr. Neill and his colleagues sought to assign a dollar value to what this occupational phenomenon is costing veterinary medicine. They found that veterinary medicine is leaving money on the table to the tune of an estimated $1 billion because of burnout.

“This will give clinics and hospitals and the entire profession a way to talk about this that is cohesive and make this an actionable item,” Dr. Neill said during his presentation, “Economic Cost of Burnout in Veterinary Medicine,” at the annual AVMA Veterinary Business and Economic Forum, held virtually Oct. 14-16.

“So it’s important to think about root problems now and change to hopefully have better long-term success for the profession,” Dr. Neill said.

Tallying the cost

The World Health Organization has defined burnout as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. Specifically, burnout has three dimensions:

• Feelings of energy depletion or exhaustion.
• Increased mental distance from one’s job or feelings of negativism or cynicism related to one’s job.
• Reduced professional efficacy.

Burnout leads to actions that reduce the economic health of the profession, Dr. Neill said, affecting both the supply and demand for veterinary services, whether through decreases in consumer confidence and perceived quality of care or through employee turnover, reduction in working hours, and people exiting the profession. Burnout can have short- or long-term effects, including potentially hampering the recruitment of future veterinarians, he added.

According to data from the 2016, 2017, and 2018 AVMA Census of Veterinarians surveys, 50.2% of respondents were classified as having high burnout scores. Controlling for other variables, high educational debt was associated with high burnout. Veterinarians who spent 75% or more of their time working with dogs or cats had a higher burnout score than did those who spent less than 25% of their time working with dogs and cats. Veterinarians with more experience and higher annual incomes had lower burnout scores. And women had higher burnout scores than men did.

Dr. Neill and his group used this data to calculate burnout rates and then looked at the probability of turnover and reduced work hours because of burnout. The researchers accounted for costs of turnover resulting from replacement costs, including job postings, training, relocation reimbursement, and bonuses, as well as lost revenue from not having a veterinarian present to perform services or from reduced working hours.

The average total industry cost is $0.928 billion to $1.005 billion annually in lost revenue because of burnout among veterinarians. That amounts to about 2.1% of the total industry revenue for 2020. Put another way, that amount could pay for the class of 2020’s education two times over.

If veterinary technicians’ burnout is added to the equation, economic losses increase to about $1.93 billion annually. Dr. Neill said, “There’s a lot of techs out there, and burnout is also relatively high among them.”

The highest realized economic costs—or lost revenue—of burnout per veterinarian were seen in mixed animal practice, while the lowest realized economic costs of burnout per veterinarian were within food animal practice.

Getting to the root of it

“If we can start solving those problems, there’s a lot more revenue to be made,” Dr. Neill said, adding that communication, workflow, and leadership are key to organizational interventions to reduce burnout. Examples include providing feedback and coaching as well as recognizing quality job performance.

Dr. Neill suggested the following action items to address burnout at the practice level:

• Hold monthly meetings to focus on work-life challenges and difficult issues in management of patient care.
• Improve workflow by offloading nonessential tasks to nonveterinarian staff members.
• Remove bottlenecks in patient rooms with regard to medication reconciliation, vaccinations, and data entry.
• Reduce time pressure with plans for future increases in visit time for primary care.
• Institute a new prescription phone line to free up veterinary technicians if the practice has a pharmacy in house or other ways to distribute food or flea and tick medications.
• Present work-life data as a platform to discuss issues within the clinic.

Dr. Neill said a calculator tool will be available in the near future for practices to determine the cost of burnout at their clinic.

Dr. Quincy Hawley, one of the masters of ceremonies for the AVMA Veterinary Business and Economic Forum, said, “Burnout may be real, but it doesn’t have to be the reality for you or your team members.”