Dr Gary Turnbull on the veterinarian shortage

Gary Turnbull
Photo of Dr Gary Turnbull by Jeremy Rogers

There are claims the veterinary profession is on the brink of a crisis, but the Steering Committee from the recent Vet Shortage Think Tank believes they may have the solutions. By John Burfitt

There’s something about the present numbers within the veterinary profession that do not stack up, and as the situation has failed to improve in recent years, some of the key players are more than concerned.

On one hand, the supply of new vets entering the marketplace has “increased substantially in recent years”, according to the 2017 Department of Employment’s veterinary labour market survey. It detailed that seven Australian universities now produce an estimated 500-550 vet graduates a year. And yet, the same report also stated that Australia continues to experience a serious shortage of qualified practitioners, revealing, “the proportion of vacancies filled and the average number of applicants per vacancy falling substantially from [2014’s] peak levels”. 

Ask any practice owner who has attempted to recruit a new vet in recent times and be prepared for a flood of tales on the problems of doing so. According to the Lincoln Institute’s Vet Shortage Think Tank report, nearly 90 per cent of veterinary business owners reported unprecedented difficulty in filling vacancies, with 41 per cent waiting longer than six months to fill positions.

Attrition levels of those leaving the profession—from recent veterinary graduates to veteran practitioners—was one of the main areas of investigation of the Vet Shortage research. It concluded the main reasons for the exodus ranged from high stress and mental health issues through to excessive client expectations and poor financial remuneration.

Dr Michael Powell is one of the directors of the Lincoln Institute, and says the findings of the report offers a revealing insight into what is happening in the profession. 

“I would agree that based on the data we’ve produced along with the other data available about the profession from other organisations, alongside amounts of anecdotal reporting, we may be on the brink of a crisis,” Dr Powell says. “What concerns me most is where our profession will be in the coming years unless we take action on attrition rates, and the causes behind them.”

Gary Turnbull
Dr Gary Turnbull with Dr Priscilla Turnbull (his wife and business partner) and senior veterinary nurse Alex Wilson, performing abdominal surgery on a cat. Photo: Jeremy Rogers

Dr Gary Turnbull is a veterinary practice owner and fellow director of the Lincoln Institute, and agrees there are major problems ahead unless the findings of the Vet Shortage report are acted upon. He says Australia needs to look no further than to New Zealand for warning signs.

The problem of attrition

“Dr Jason Lowe is a New Zealand veterinarian who recently completed an MBA thesis on leadership in the veterinary profession, and his research suggested that with current trends, by 2029 the profession would be unsustainable in New Zealand and no longer meet the demands of the marketplace,” Dr Turnbull says. “That is only a decade away, and it doesn’t take long when you look through the data to realise the same thing could happen here, and we simply can’t allow that.”

In November, a meeting of the Vet Shortage Think Tank took place in Sydney, involving all major stakeholders of the veterinary profession—universities, representative and registry veterinary bodies, corporate and privately owned practices—to discuss the attrition problem. In the weeks leading up to the event, the Lincoln Institute circulated two vet industry surveys, and a total of 407 veterinary business owners and 685 employed vets responded.

Among the key data results were that 81 per cent of business owners indicated longer-than-normal vacancies place them under greater than usual hardship meeting the needs of clients, and 63 per cent indicated it negatively impacted their economic performance. 

More than 70 per cent claimed they are experiencing greater than normal stress in their role as well as having concerns about the sustainability of growth due to the vet shortage. Around 64 per cent are working more hours than they would like because of the shortage and 22 per cent indicated they do not intend to continue to operate their business due to it. 

Most concerning of all, 37 per cent were considering leaving clinical practice all together within the coming year, 44 per cent experience anxiety in performing their role and only 41 per cent would become a vet if they had their time over.

These numbers struck close to home for Dr Turnbull, who says he was familiar with such attitudes within his own team. “One of our young associates who’s been with us for 18 months told of three people from her graduating year who are already looking to get out of veterinary practise,” he says. “That is shattering, as these are young vets who have committed five or six years of study but have already had enough.”

Dr Powell says the specific details revealed in the Think Tank report are what need to be focused on, particularly the issue of attrition. “So rather than saying this is all about a shortage of supply of graduates, this data suggests this is far more an issue of a serious upswing in attrition of vets from the industry,” he says.

Eight-point action plan

An important outcome of the Think Tank meeting was the creation of a steering committee, consisting of senior members from various industry groups representing Australia and New Zealand including the Australian Veterinary Association, Veterinary Practitioners Board of NSW, New Zealand Veterinary Association, veterinary schools, registry boards and veterinary industry representatives from both corporate and private practice groups. The steering committee met in late March and created a comprehensive eight-point action plan working paper.

“When we see a suicide rate as a profession that’s four times that of the average in Australia and twice that of any other medical or paramedical profession, then that is the urgent issue.” 

Dr Gary Turnbull, director, Lincoln Institute

Those eight points cover demand management, mental health management, selection criteria for vet degree candidates, the perception of vets within the general community, gender equality, enhanced remuneration, leadership training and coaching and the support of postgraduate vets.

Accompanying each of the eight points are detailed action plans for the various sub-committees to act upon, involving a wide range of partners throughout the industry.

“There’s no way we can address all these issues and affect real change without a huge multi-pronged, coordinated change in approach in a number of aspects of the profession,” Dr Powell says. 

“But I believe change is possible, providing we leverage the support of all these key organisations and the people we have on board. We’ve already started to make headway on some of the action steps and have the support of contributors with a high level of expertise and industry connections to achieve our goals.”

Tackling mental health 

Of the eight issues on the Steering Committee slate, addressing mental health issues within the profession must take priority, Dr Turnbull believes. In the Lincoln Institute survey data, the number one reason cited by veterinarians for planning to leave the industry was stress and anxiety.

“When we see a suicide rate as a profession that’s four times that of the average in Australia and twice that of any other medical or paramedical profession, then that is the urgent issue,” he says. “I’ve seen veterinary team members personally suffer with mental health challenges associated with work, and it’s only now that I’ve stepped back from clinical work that I recognise the impact compassion fatigue has had on me across my career. We have the opportunity to change people’s lives, so I think we need to do something about this right now.”

Among the mental health initiatives planned are more training for undergraduates in resilience, self-care and reducing the stigma of mental health issues; an industry self-care code of conduct; and business guidance on improving mental health. The committee also plans to work with the AVA’s Mental Health First Aid program which offers workshops and online learning exploring depression and anxiety within the profession, and also a 24-hour telephone counselling service.

Remuneration of vets

The financial realities of the profession were also explored. Compared to those in other professions with similar levels of skill and specialised training, vets are underpaid. The median starting salary of a general medical practitioner in Australia is $115,422 a year. By contrast, the average entry-level salary for vets is around $50,563, with some new grads on as little as $40,000.

Gary Turnbull
Dr Gary Turnbull examines Stella, the Cavalier King Charles spaniel, assisted by practice manager Stacey Theofanou. Photo: Jeremy Rogers

“This is undoubtedly one of the key factors playing into the attrition,” Dr Turnbull adds. “And sadly, industry experts would suggest the average profitability for a vet practice is only seven to eight per cent before tax, and those margins are getting squeezed even further, so there’s not a lot left at the end of the day.”

Dr Powell says it is not a dramatic overstatement to claim the profession is currently at a crossroads, and the best way to point it in the right direction is for important discussions to be had.

“My concern is about attrition, and so my mission and that of the committee is to help turn that around, but that is going to take an industry-wide effort,” he says. “We will need stakeholders at all levels, business owners and clinic managers, practicing veterinarians and their teams to get involved and invest time, energy and some education into addressing this.”

What is needed, he states, is to effectively embrace a movement of change within the profession, to ensure a sustainable future. “We need to bring those issues to the surface and speak out about matters like mental health, finances, workplace flexibility and gender equality—the very facets that are contributing to the exodus taking place,” he says. “The more we address them, and commit to action, the sooner we can create a change not just for the future generations of Australian vets, but the ones already in our community who we risk losing.”

Dr Turnbull concludes: “This change is not going to happen organically. If the profession wants to continue, then it’s going to take the people currently in it to take charge of where we are heading. And we need to do this now.”


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4 Comments

  1. Something smells a bit fishy with this rather over emphasis on anecdotal data.

    Why is no-one looking at the statistics:
    NSW vet board: 20% rise in vet numbers over last 5 years
    AVA membership: 40% rise over last 18 years
    QLD registrations: massive rise as shown by graph on p2 of below government report

    There has also been some research done by AVA that shows Australia has one of the highest number of veterinarians per capital in the world.

    So actually it seems like we have a veterinary oversupply issue rather than attrition problems. Perhaps the people being used for anecdotal information doesn’t account for a lot of other factors.

    https://www.ava.com.au/about-us/annual-reports/
    https://www.vpb.nsw.gov.au/annual-reports
    https://www.daf.qld.gov.au/__data/assets/pdf_file/0003/93009/2547-vet-surgeons-act-review-background-paper.pdf

    1. Everyone dancing around the issue that women vets don’t want to work in rural areas, don’t want to work with large animals, don’t want to work outside and don’t want to work full time…

  2. Generally a good article.
    It is indeed a multi factorial issue that we have all seen coming and brewing for many a year.

    The profession has many positives and many/most of us are passionate about our profession.
    There are however, like any profession/ career/ trade, aspects of it which are negative.

    From where we sit, some possible reasons we see for the disparity between numbers of graduates and poor vacancy filling rate might be…

    Graduates leaving the country permanently
    A proportion of the increased number of yearly graduates are **full fee-paying overseas students** who (naturally) return to their country of origin on graduation. As a result a significant proportion of those annual graduates, although still maintaining their registration in Australia, are not practising here and thus leave the Australian Vet pool ->thus the number of graduates “available” is artificially high-> less available to fill the vacancies.

    Graduates leaving the country temporarily
    As has been the case for a long while, a healthy number of recent graduates take off overseas to work, the well known OE, either for the increased remuneration or the experience itself or both. Anecdotally many colleagues feel that this trend may be increasing in accordance to the characteristics of the more recent generaltion. This therefore leaves less practising Vets here at home and athough still maintaining their registration in Australia, are not practising here and thus leave the Australian Vet pool -> less available to fill the vacancies.

    Working hours
    For many employed practitioners the working hours are 38hr /week. However, by the time the hospitalised patients are checked and treated, the messages and phone call backs, lab results, referral letters, insurance forms, controlled drug book etc are done plus the odd case that turns up at the door at 5:30-6PM, a significantly large proportion of practitioners work another few hours a day jumping it to 50hrs+/week. What then further rubs salt into the wounds is that many employed Vets are on a salary and are not remunerated for these extra hours.
    There are many strategies that clinics can (and do) put into place to minimise/reimburse for this but they are not always easy to implement or follow and it continues to be a major negative for many.
    For sole practitioners this may be even worse, they may have staff/account/maintenance/management issues also to deal with, such that these additive extra hours may be far more, further adding to their load.
    So working hours continues to be one of the reasons as mentioned in the article as contributing to those moving out of clinical practice thus creating more vacancies.

    Remuneration
    I think that has been well covered in the article, and it is, without a shadow of a doubt, very low considering education intensity/ duration, hex debt, hours worked, number of species requiring knowledge of, scope of disciplines required to be mastered, responsibilities involved, compassion issues, financial restrictions imposed on the work (and inherent internal conflict thereof), dealing with the public as well as patients etc etc.
    Certainly many vets have expressed difficulty in meeting the cost of living with the remuneration they receive and with the level of wages they often receive, one can understand why.
    Interestingly, those vacancies offering remuneration on the higher end ($110,000 upwards) which would seem “more fitting” to the education and skill possess by a Veterinarian, are not finding as much difficulty in being filled. Of interest a few weeks ago my nurse sent me a “Seek or Indeed” positions-vacant snippet for a dog groomer at $60,000 and for a vet nurse at $75,000. Below these were a number of advertisements for vets at $50,000 and many at $60,000 and $70,000, we all shook our heads as do probably most Vets.
    For many, what is even worse than the inordinately low remuneration, is in fact the widely-held (and voiced) view of the public that vets are inappropriately highly paid. Most members of the profession have endured those comments at some stage which, for many, cuts deep when the remuneration is less than many tradespersons who have not had to undergo the arduous tertiary training and costs thereof not to mention the lack of income and hex debt accumulated during the lengthy training to achieve that qualification.
    For practice owners, there are some who would like to remunerate higher but the balance sheet makes that difficult, or there may be other “more pressing’ callings on the clinic purse or, perhaps, more commonly in corporately owned clinics, do you all think that the Vet (and vet nurse) remuneration is kept as low as possible in order to maximise the return to investors (which increasingly are USA investors with large numbers of clinics now being owned by the US owned TPG investment giant).
    So definitely, I agree low remuneration continues to be one of the reasons as mentioned in the article as contributing to those moving out of clinical practice.

    Changing times?
    In the “old days’, to many a practitioner, the long hours, afterhours call outs, the poor remuneration and sacrifices made thereof, were often termed a lifestyle “choice” of belonging to the profession. In other words, you accepted this lifestyle, and any negative affects it had on your family, your health, psyche, relationships and general QOL, all as part of the career choice, or plainly put, this was your penance for choosing this career, and just get on with it. There is no doubt for city colleagues who are fortunate enough to have afterhours clinics available nearby (or at least shared AH rotors between clinics) this lifestyle is a whole lot better than it used to be. However, as pointed out in the article, although reduced, a veterinarian in clinical practice still has many negatives and the younger people/graduates of today have a wish/expectation to live/enjoy life more fully and as such perhaps are less likely to tolerate the negatives of clinical practice and either do not choose the profession (as an increasing number of males do) or move-on once the reality of life within it is realised.
    So definitely, wanting a more balanced work/ life ratio is an additional reason contributing to those moving out of clinical practice, especially for those early on in their careers who are still young enough to retrain into a less stressful + better remunerated career.

    Time-Out for having a family / temporary break from the profession
    As you know, the profession is undergoing dramatic gender change with a predominantly female graduation balance. Many mum-vets (and the odd dad-vet although there are decreasing numbers of these with there being fewer males entering the profession) naturally take a chunk of time away from the work force to dedicate time to pregnancy, child-birth and child raising. Naturally, this time away from the workplace creates more vacancies (most temporary some permanent) to be filled and thus contribute to the increased vacancy rate.

    Job-Sharing/ Job-splitting/Part-timing
    This concept has enjoyed major growth, again boosted to no insignificant degree by the gender change we are experiencing in the profession.
    When I left my last full-time small animal clinical position, there were few applicants to fill the position. In the end it was filled by 2 very skilled mum-vets who job-shared the position. As is the case with school teachers, another profession with a significant gender shift, job sharing is becoming more and more common. I note a Vet clinic nearby also has no full time employed Vets but 4 part-time Vets splitting the 2 full time positions. All 4 are youngish Mum Vets which is great. Many young mum-vets that I speak to/engage with, mention to me that they find the reduced hours allow them to..
    a) keep their hand in with the veterinary world (and not lose skills),
    b) have more time to devote to family issues, life admin & their own physical and emotional wellbeing,
    c) “dilute” the negatives of clinical practice somewhat with only working 2-3 days/week (they have 4-5 days with no work stress) but still get the opportunity to enjoy the positives
    d) continue to earn so that they can contribute to the household income, although they mention it is somewhat embarrassingly low. A few said that they would have been forced to go back working full-time if it were not for the significant main income of another enterprise or their spouse in another profession earning significantly higher income allowing the family to survive.
    From the client point of view, some clients do say they are a tad frustrated, often not being able to see the same Vet for their pets health continuity, but hey at least there are Vets in attendance.
    So what has happened, increasingly the one job is filled by 2 practitioners thus halving the number of available Vets to fill further vacancies.
    Also there are numbers of younger graduates who simply “want a life” and choose to only work 2-3 days a week as a practitioner, who perhaps do not have the financial liability of a mortgage or a family and thus still have the option of doing so.
    I also know several Vets who work 2-4 days a week in non-Vet fields which are less demanding / with far greater remuneration, and practice 1-2 days a week because they enjoy it or do not want to “waste” their qualification and hard work in gaining it.

    Just a few thoughts and interested to hear the view of others…

    1. I think your response and the original article identify and address the issues very succinctly. I have seen articles which identify the veterinary degree as being the worst investment in tertiary education that you can make. Fees parallel those of the medical and dental students and the course duration can extend to seven years. No interest loans or the ability to offset your loan payments could eases the financial pressures and cash in the bank can certainly help work life balance as you may be able to afford a life.

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