When Michelle Stokes noticed a necrotic wound on her cat, Jellyfish, last July, she and her husband had to call about 50 vets before they found one to squeeze them in.
The local emergency veterinary clinic was so supportive that they said the wound — serious but not yet life-threatening — was not a true emergency. Jellyfish didn’t have a regular vet because Stokes and her husband had just moved to the Cleveland area. They called up Google Maps and went through the list of offices found. The reaction was always the same: no vacancies, no admission of new patients until August or even September. Meanwhile, Jellyfish was getting sicker and more lethargic. “We just kept trying and trying and trying,” Stokes told me. “We’ve called pretty much every single vet office in the Cleveland area.” A week later, they finally had a stroke of luck. They managed to speak directly to a vet at a practice and when Stokes sent a photo of the wound, the vet said to take Jellyfish to the surgery. The cat is fine now.
Stokes’ scramble to find veterinary care is not uncommon. Hospitals, clinics and veterinary services in the US have turned away animals over the past year because they are understaffed. This crisis has hit all levels of the system, from general practitioners to specialists, but animal emergency rooms — where the job is most stressful — are having it the worst. Veterinary staff told me of emergency hospitals closing overnight, owners being evicted hundreds of miles away for an elusive vacancy, and dogs with broken bones, a real emergency, waiting for hours to be seen. “If I have 17 patients in the hospital and I and a doctor are there 15 hours, I can no longer take pets. Because I can’t physically do it,” Kristi Hulen, a Seattle-area veterinarian, told me.
Staffing shortages have gotten so bad in some areas that Maureen Luschini, an emergency vet in central New York, told me bluntly, “Emergency care for your pets cannot be guaranteed at this time.” There just aren’t enough people to care to take care of all the sick animals.
Veterinary medicine has struggled with staffing issues for years, but the pandemic has made things worse. After COVID struck, The demand for vet appointments increased– for newly adopted pets and for older pets where owners observed new health problems after being at home all day. COVID precautions like curbside service also caused offices to operate less efficiently. Everything just took longer.
Meanwhile, veterinarians and veterinarians began to leave the field. “All my friends who were of retirement age — early 60s — just retired right away,” Carrie Jurney, a Bay Area veterinary neurologist, told me. Staying in the job wasn’t worth the risk of catching COVID. Also the veterinary sector distorted quite feminineand mothers without childcare are quitting or switching to more flexible remote work.
As the pandemic progressed, those who stayed saw their jobs deteriorate. Owners stressed by lockdowns became more angry and unruly towards veterinary staff. “During the pandemic, people forgot how to be human,” says Melena McClure, an emergency vet living in Austin. And the overworked staff no longer had the time to sit down and explain to distraught owners what was happening to their pet, which wasn’t helpful in these volatile situations. “Yelled at, threatened, called every horrible name ever written or spoken,” Hulen said. Jurney said she’s fired more clients in the past year and a half than at any time in the last 20 years of her career. Receptionists bore the brunt of this bad behavior. “We’ve had a much higher turnover rate than ever before,” says Gary Block, who runs a veterinary clinic in Rhode Island with his wife. He estimates they lost about 80 percent of their receptionists last year.
Low wages in veterinary medicine have only exacerbated the problem. “McDonald’s pays $15 to $16” an hour, Block says. “I’m sure there are still veterinary techs making less than that amount in Rhode Island.” He and his wife recently increased the salary, but have had to offset it by increasing nursing fees.
“This is a slow-moving tsunami,” Liz Hughston, a veterinary technician and president of the National Veterinary Professionals Union, told me. “The true magnitude of the staffing crisis was not felt at this point because I think we had an endless supply of bright-eyed young people who wanted to work with puppies and kittens all day.” Historically, if people who worked in the industry have burned out, new ones have taken their place. The turnover rate for veterinarians was high even before the pandemic: 23.4 percent per year, according to a January American Animal Hospital Association Survey 2020. Many experienced veterinarians eventually go into medicine, where many of their skills come into play and the pay is better.
Vets also deal with burnout and broader mental health risks. Her turnover rate is 16 percent, much higher than she is doctors in human health care. Female veterinarians are 3.5 times more likely to die by suicide than the general population, and male veterinarians are about twice as likely. according to a 2018 CDC to learn. Jurney, the neurology specialist, is also president of the nonprofit organization Not One More Vet, which operates a crisis hotline and provides emergency grants to veterinarians who need help. In the past two years, she says, “demand for our services has increased tenfold.”
Lisa Moses, a Harvard veterinarian and bioethicist, attributes burnout to the “permanent and cumulative impact” of moral strain in the workplace. People who decide to become veterinarians, veterinarians and support workers usually do so because they love animals. But it is also part of seeing many animals suffer: some owners have to let their pets die because they cannot afford care, others refuse to put them to sleep and instead subject the animals to futile medical treatments. in one Survey 2018 that Moses conducted, 62 percent of the vets said they sometimes or often encountered cases where they “couldn’t do the right thing.” More than 75 percent said these cases caused them moderate or severe distress. In understaffed hospitals and clinics, overworked veterinarians find they cannot provide every animal with the level of care and attention they desire. “It’s kind of self-reinforcing. The fewer people and staff there are, the more everyone gets overworked,” Moses told me. And the more stressed and overworked they are, the more likely they are to quit.
In the midst of this staffing crisis, animals sometimes get worse care. Some 24/7 emergency hospitals have had to reduce hours and turn patients away. Luschini, the emergency vet in central New York, had to send patients all the way to Philadelphia. Whenever a large ER fills up, Block said, it’s like “musical chairs” to find another one with an empty seat. And emergency hospitals constantly operate in an “orange” tier, where wait times can exceed 10 hours and staff have to turn away all animals except those with immediate life-threatening injuries or illnesses.
When Emily Knobbe’s pup, Hazelnut, was bleeding from a six-inch laceration on her leg, the Portland, Ore., emergency room was so full Knobbe had to sit on a nearby stairwell to wait. It took 14 hours to connect Hazelnut. The vet said the cut, while severe, had not caused any injury to the tendon or bone. But in the days that followed, Knobbe noticed that the dog didn’t put any weight on that limb. It took several days to get an appointment from Hazelnut’s regular vet, who referred Knobbe to a specialist, requiring another week of waiting. Eventually, she learned that Hazelnut’s Achilles tendon was 80 percent ruptured. The injury had worsened in the time it took to get a proper diagnosis, giving Hazelnut a 50/50 chance of losing her leg. Knobbes wonders if the busy hospital missed the tendon damage because the vets were so overworked. Hazelnut ended up having surgery and is doing fine on all four legs now. However, for Knobbes, the waiting and waiting was a truly terrifying experience. “We felt very powerless in that moment,” she told me, “just knowing that she was in pain for weeks and we just had nowhere to put her.”
For hospitals, understaffing means constant screening. When a pet needs to be taken for surgery, said Hulen, the Seattle-area veterinarian, she needs to take her attention away from all other patients. “Things get overlooked. Medications are omitted. Walks are missed. Feedings are skipped,” she told me. “That is not right.” Certain labor intensive procedures are also set aside. For example, Block’s veterinary clinic in Rhode Island is the only one in the state with a ventilator. However, using the ventilator requires the dedicated attention of a technician and a veterinarian. When things get hectic, the hospital has to announce that it is no longer accepting ventilation cases. “These animals literally have trouble breathing,” Block told me. “We have the equipment and the skills to provide care, but we have to make a choice”: will the vet stay with the one patient who needs a ventilator, or should he look after five or six other ICU patients in the same number? Time?
When GPs are too busy, pets they can’t see for routine or preventative care end up needing emergency care. “We have seen tons of parvoviruses in dogs. There has been an increase in calicivirus virus in cats,” Luschini said, referring to infections that any vet can be vaccinated against or treated early on. Even specialists are overbooked. Jurney, the veterinary neurologist, said a normal, fully booked day before COVID might have included an operation or two plus five appointments. The day before we spoke, she told me she had surgery and 12 appointments. And that wasn’t even her busiest day in two weeks.
The vets and veterinarians I spoke to saw no improvement in the short term. Wages have risen, although not always as fast as inflation. Company veterinary practices have been offering this for a short time Bonuses up to $100,000 to veterinarians who enter into a three-year contract. But there is a fundamental supply and demand problem. More Americans are get pets, while the number of people entering the veterinary profession has not kept pace. By 2030, the US will need almost 41,000 additional vets and almost 133,000 certified veterinary technicians, according to a new Mars Veterinary Health report. Any solutions are probably years away. The current chaos will not be resolved any time soon.