My name is Jasmin Klocker and I have been a veterinarian in mixed practice in NSW since January 2000. I am writing this letter today as I am very concerned about the future of our profession.

I feel that with 20 years of experience, a significant amount of this time spent running my own practice, raising 4 children while working full time and losing my husband—also a veterinarian—to suicide 3 years ago that I am in a fairly good position to reflect on some of the major issues affecting us.

THE PROBLEMS

The SUPPOSED Issues

We keep looking at vet fatigue, lack of support for new graduates and fellow vets, the lack of respect towards veterinarians shown by the public and remuneration as issues causing the poor veterinary retention rates we are seeing. These issues are also being flagged as the leading causal factors in the declining mental health of our members.

The PRIMARY Issue

I think we need to turn this around and focus on what is now—and what has been for the past 16 years, —the primary issue facing us.

That is the veterinary shortage seen in Australia. My husband and I wrote an article which was published in The Veterinarian in 2006 about the rural vet shortage.

Unfortunately, nothing has changed in the past 17 years and here we are with an even bigger problem in 2021.

Today, we no longer have a shortage merely in the country, but it has now hit the cities and coastal towns as well.

When we are short on veterinarians it places an enormous strain on the team in the clinic. It makes it hard to take leave, it stretches everyone’s time, making support for new grads more difficult.

Overtired and overworked veterinarians are not as resilient as they would be if they were well rested. We have a harder time coping with the day-to-day stress of the job, the public and coworkers when we are exhausted.

Rethink ways to increase veterinary wages

I think most vets are aware of the expectations on work hours (i.e. this is not a 9-5 job) and are also aware of the award wage before they begin their studies.

For us to be able to increase this wage, we need to find a way to help those animals belonging to people who cannot afford what we are offering them.

At the end of the day, we are not a high earning profession as we are dealing with animals and not people.

Unaffordability of ‘Best Practice’ for all clients

There is no Medicare for animals, and we are constantly raising the bar on expensive testing and best practice. Realistically, when 1 in 5 Australians do not have $200 in the bank, most people cannot afford this best practice standard that is now on offer at most practices—often as the only option.

‘Cherry-picking’ by Mobile Veterinarians

I feel that there should be restrictions placed on mobile veterinarians, linking them to a base clinic where they help share the load of hospital care and after-hours work.

The mobile services take the easy work, the work without the ongoing medical or surgical care given in a clinic.

They have low overheads and less stress. It was OK when there were a few veterinarians practicing in this way; however, we are seeing more and more vets who no longer want the headache of general practice moving down this path. Leaving fewer vets in the general clinic settings.

Explosion in Paperwork

The expectations on paperwork for veterinarians has tripled in 20 years.

From pet insurance forms to fill out, to extensive histories for fear of litigation. If we spend 2-3 times the amount of time on admin duties, we need more veterinarians to be able to get the cases seen in a day done. The problem is there are continually more patients to see and fewer veterinarians to employ.

No Experienced Veterinarians to Fill Full- Time Job Vacancies

We have had advertisements on Kookaburra, the AVA (very expensive), Facebook vet groups, Locum agencies, Erika at Vet and Pet Jobs.

Our advertisements are now a permanent fixture as we have not managed to be fully staffed at any point in time since 2011. We are employing any locum we can get our hands on; basically, if they are registered and have a pulse, they have a job.

We have not had 1 experienced veterinarian apply for the position in the past 18 months and a total of 3 new graduate veterinarians in this time. Also, a Romanian veterinarian who has no qualifications here.

Poor Calibre of Most Locums on Offer

The quality of most (but not all) of the locums is atrocious. Young vets who are sick of the responsibility of a full-time job are switching to locum work far too soon in their career. They have greatly reduced responsibility, generally refuse to participate in after-hours work and earn twice the money.

The problem is they are not experienced veterinarians, and often are quite incompetent at simple tasks.

For example, we have in the past year had 3 animals spayed by locums which had ovarian tissue left behind. In 20 years, I have not had this happen with any of my full-time vets.

The locums are long gone, and we clean up the mess.

We have had locums who do not know which vaccine to use, and other locums who are unable to perform any surgery at all as they do not have this skill.

One locum recently could not flush a blocked fluid line. They are basically veterinarians who need close supervision.

When I graduated a locum would come and run your practice for you while you were able to go on holidays.

Emulate the Human Medicine Screening Process for Vet Students

The mental health of the profession is declining due to the veterinary shortage. A combination of fatigue, a stressful job, lack of holidays and veterinarians with an unrealistic idea of what a veterinary job involves is leading to this decline.

Medical students pass several exams which profile them as suitable for the pressures of their chosen career. We need this to happen with veterinarians. We need new graduates that:

• can perform under pressure
• are resilient when the inevitable difficult week arises
• communicate with the public at a high level thus making their job easier
• know that they have not chosen a 9-5 career. There are not many neurosurgeons who expect to go home at 5pm every day.

Neurosurgery is a job you choose to do knowing full well you may have some very long and challenging days at times, as is Veterinary Science.

Now that there is such a shortage of vets, I as a practice owner am torn and nearly at the point of completely selling up shop. In the past 6 months I have closed a branch and am selling my main clinic. I am considering turning my mixed practice clinic which has serviced our rural community for 18 years

into a 9-5 small animal clinic for ease of staffing. The big problem is that I have a moral issue with this and feel that it is difficult to let down the people who have supported both myself and my family for 20 years.

Problem is, there is no one to take up the slack. There is not another clinic down the road; this will leave yet another community without a large animal service and will stretch the next vet 40-60 minutes away to the brink of insanity also as they try to pick up the slack without enough staff to do so.

Who steps up?

In our area in the Lower Hunter, we are one of the last clinics offering a 24-hour emergency service.

Multiple (approximately 5) clinics within 1 hour of us have stopped performing large animal work or after-hours work in the past 24 months. We have been overrun with work and will now be in a situation where we cannot do it anymore either.

The question is—WHO WILL?

It also alarms me that an area as large as Newcastle can send all the local clinic after-hours cases to the one emergency centre: NAREC. This clinic set up to take other clinics’ after-hours work. It is run primarily as a business and was from the outset.

They actively came and asked for clinics to give them this work. In the past 2 years this has also become a significant problem.

They no longer have enough staff either.

Many veterinarians are leaving mixed practice to take on a small number of emergency shifts with higher pay and better work-life balance.

With the help of Google search and the key words of ‘emergency service’, clients who live over an hour away are finding us and driving to us for this service when they cannot get into the emergency centre as they are overrun with cases.

These are not our clients.

We are not open 24 hours a day but have a vet in bed who can get up and service our own patients in a true emergency. We should not need to take up the slack again.

Excessive Bills & Over-Servicing by Emergency Centres

The next issue I have with the emergency centre is the prices they are charging. Remember also that they have no competition in the area at all.

Imagine a loyal pensioner client of a small suburban clinic with a sick dog being directed by their veterinary clinic’s after-hours phone message to call this emergency centre. Once they arrive it is all about money.

Excessive bills and often over-servicing, which their normal vet would not charge and money which they cannot afford.

We have recently seen a patient quoted $6,000 for a pyometra surgery. They could not afford this and came to us instead. Again, not our client. This is also not a specialist procedure and a procedure that a general vet can easily perform in a short period of time at a greatly reduced fee.

Financial Constraints Balanced with ‘Gold Standard’

I suggest that these emergency centres need to offer clients more options from gold standard through to basic care.

I also feel that the referring veterinarian should have some responsibility for their clients and patients also when they are unable to afford the service offered at the specialist centre.

It would be very interesting to gain some statistics on the number of pets euthanased due to financial constraints at general clinics and at 24-hour emergency clinics.

SOLUTIONS

#1 – There should be a certain amount of experience a veterinarian needs to acquire before they can be classified as a locum and charge locum rates.

Due to the vet shortage, they can all get jobs and natural selection no longer occurs. way the veterinary boards deal with mental health needs to change.

#2 – The way the veterinary boards deal with mental health needs to change.

People need to feel able to declare that they are unwell without the board placing many restrictions on them.

A vet will pretend to be fine to have restrictions lifted, even when they are not fine.

If a vet in this position tells the psychologist that they are suicidal it will almost definitely lead to further restrictions and hoops to jump through.

These are hoops that those already struggling cannot manage to jump through.

#3 – Facilitate Overseas Vets to Work in Australia

We do not have enough veterinarians to fill our positions, yet we make it near impossible for overseas (OS) vets to become accredited here. I can guarantee that the overseas vets. I have worked with are all 10 times more competent than our current locums.

Let us allow them to work under supervision and if a registered Australian practitioner certifies as to their abilities, register them without having to make them take exams that are ridiculously onerous, stressful, expensive, difficult (way more exacting than routine undergraduate exams) and not necessarily applicable (e.g. does an experienced small animal practitioner in Australia have to remember the ins and outs of piggery management they learnt 20 years ago?—No—and nor should an OS small animal practitioner.

An undergrad degree is merely a basic starting point—it should not define whether a good and experienced (or even specialist) vet can work in this country.

Or we could look at making the exams reasonably priced, with new content and passable.

#4 – We need 2% more vets than there are jobs.

We need some vets to be unable to find a job.

This would stop vets from leaving if they have had a bad week as they could not merely walk into 15 new jobs tomorrow.

It would also mean that the vets who truly are incompetent and negligent would no longer be able to hold down a job unless they lift their game.

#5 – We need:

* A test for new university place applicants to establish resilience and mental toughness

* Vet Student Interviews (as in Charles Sturt University, Wagga).

* A lower entry mark, as what we need are hardworking vets happy to be on farms, not just the high achievers who are often better suited to research work.

At the end of the day, someone who scored an ATAR 98 or above may not want to spend the next 60 years pregnancy testing cattle and pulling calves.

We have found the Wagga new graduates to be 10 times more resilient, hardworking, and more likely to work in the country and stay in the country than their city counterparts. We have seen this over many years now and feel that the model Wagga is using should be more broadly implemented.

Of course, there are exceptions to every rule and some of the graduates from other universities are fantastic as are some of the high achievers.

However, I have noticed a pattern developing over time.

* More men in the veterinary work force, or double the number of women (i.e. two for each Full Time Equivalent job).

Realistically, half of the women I have employed in the past 15 years are no longer a full-time employee by the time they are 30.

They often do not want to participate in after-hours work due to the challenges of doing this with children. If they do participate in after-hours work it often places a strain on them, leading to decline in mental health and wellbeing.

This is not a sexist comment but just a fact.

#6 – I believe that:

All clinics greater than 40 minutes from an emergency centre should have to do after-hours work.

There needs to be an option for reasonably priced vet care for the community. We need to realise that a homeless lady living in her car with her corgi (who happens to be all she has) has as much of a right to be treated as the corgi belonging to the psychiatrist with a 6-figure income. In my opinion, the best practice in these 2 scenarios is worlds apart, but both are OK. I do not feel that we as a profession still see this distinction.

Before a clinic can stop doing after-hours work, they need to find another clinic who is happy to take on their clients. This is especially the case for large animal work in rural settings.

Dial HELP!

A telephone number should be established that vets can call when they are so short-staffed that they can no longer cope. Maybe it would be possible to have a pool of veterinary locums who are happy to be placed in positions where the situation is becoming dire.

This may be a service the AVA could help organise.

I am at this point myself.

I ensure that all my vets get their time off, look after their wellbeing and needs, but no one does this for me.

I know that if I do not look after their needs, they will find another job tomorrow and I will be even more short-staffed. This is the situations owners are finding themselves in. I have not had a break in 3 years.

I cannot do this for much longer.

Unlike my husband, I will walk away before it kills me.

However, this will leave yet another hole in a profession that cannot afford to lose anyone else.

“I would love to speak to anyone who would like to discuss these issues further”

Dr Jasmin Klocker

The long and short of it is that we needed more vets 15 years ago and still do today. We need to stop talking about this and find a way to make it happen now. Otherwise, there will be no profession, no-one to look after our country’s animals and we will still be talking and planning.

I am also not alone.

Every veterinarian I speak to, every pharmaceutical rep I speak to, every recruitment agency I speak to, it is all that anyone is seeing. It is the fundamental problem facing our profession.

Thanks for your time,

Jasmin

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NOTE: Jasmin has been awarded a CVE$500 voucher in recognition of the time and effort taken to write this insightful appeal

Note: The CVE will invite comments from the AVA and the Veterinary Boards for publication in Issue 303, June 2021.

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