Why do vets commit suicide?

This question is 95% depressing but has a 5% positive conclusion.

The veterinary profession is in dire need of strong, clear leadership. The British Veterinary Association is loved by veterinarians, but is viewed by the public as a vets' social club. Conversely, the Royal College of Veterinary Surgeons (RCVS) is perceived by the public as the voice of veterinarians, yet it's supported by only 18% of members who vote in elections each year. Most vets (82%) deem that whilst they must pay a fee to the RCVS to practise in the UK, they don't have to support a body that prosecutes vets. The RCVS has recently dispensed with its mission statement to promote advances in veterinary medicine, focusing instead on prosecuting vets. Vets have more suicides in the UK than any other profession. Another reason why so many vets commit suicide is that there's no central funding similar to the NHS, so vets are forced to juggle with business issues as well as being clinicians: the combination inherently produces suicides.

The two greatest expenses for vets are drugs and employees' salaries, and the last government squeezed profits that vets could make from drug sales ie. vets were forced to give free prescriptions, and agricultural merchants could also stock veterinary drugs. Some pet owners consequently poisoned their animals through inappropriate drug use, but consumers also lost out where the government forced a replacement of human drugs (previously allowed for animal use) with their veterinary equivalents, which were up to five times more expensive. The added expense arose from pharmaceutical companies (in obtaining government licences for the veterinary drugs) and these costs were passed onto consumers. Pharmaceutical companies yielded various forms of revenue for the government.

With drug revenues squeezed, vets inevitably turned to savings on employees' wages. Hence, many veterinary practices now employ animal assistants rather than trained veterinary nurses. This may or may not be a concern for the public. The RCVS reaction was to impose further conditions and regulations upon the vets (directed at veterinary premises and practice management), and the RCVS funded these extra regulations through fees levied against vets. Practices still continue to employ animal assistants.

In turn, vets have begun to wage commercial war upon one another (a distant cry from the camaraderie and cooperation demonstrated in the NHS). Such rivalry goes beyond the usual commercial competition for clients, or the stealing of employees from one another and ignoring of employment contracts - the RCVS does not involve itself in such matters. The RCVS has however instructed practices to advertise their top ten selling products, where the products are sold at cut-down prices because the clients monitor these price changes. Conversely, less familiar drugs and operations in particular (that are costed by pounds per minute), are given price increases by many practices. Whilst poor cooperation between practices isn't helpful, it can at times be common place. Unethical practices phone rivals and masquerade as clients (inquiring re prices), whilst in reality they're calculating how little they should lower their own prices, or better still, how much they can higher their own prices.

A more serious theme has begun to emerge as vets commercially wage war amongst themselves, since apart from misleading clients re pricing, warring does nothing to add to the service for clients - conversely it becomes a significant distraction. Warring often takes the form of new practice start-ups, arising from a disgruntled employee who wants to work less hours and be paid more (compared to other employees). Employers' contracts are generally ignored and confidential information is used to steal clients, whilst assessing if the divulged revenues will outstrip the calculated costs. Stolen clients represent a revenue increase to a new start-up, particularly if the start-up is a satellite site of an established veterinary group. Conversely, any clients lost to a start-up represent a revenue loss, and veterinary businesses run at about 25 per cent profit, so it only takes a quarter of clients to defect to a new start-up before a practice begins to lose money. It's well known in industry that whilst a quarter of clients will stay loyal to a business, 50 per cent will be influenced by better deals elsewhere, and the remaining quarter of clients are always looking to move. Veterinary groups use this situation to put rivals out of business. Moreover, defecting clients will inevitably harbour complaints and with a small amount of encouragement from a rival, it can cause significant damage to the reputation of an established business. Unfortunately, the cost of seeking compensation through courts invariably amounts to thousands of pounds, and the RCVS doesn't become involved in such issues. However, the RCVS always investigates a practice receiving complaints against it, even if those complaints are a result of proactive encouragement from a rival. Vet suicides are related to the destructive nature of such issues.

So if the RCVS isn't involved with practice wars and vet suicides, what is it doing besides prosecuting vets? The RCVS is proactive in attempting to encourage support for its Council elections above the current 18 per cent. Some candidates who stand for Council strive to change the RCVS from within ie. by re-emphasising the RCVS mission statement towards improving veterinary medicine, or by preventing a recurrence of historical mistakes, such as the handling of the 2001 foot-and-mouth disease epidemic. Not all RCVS candidates however, receive the same treatment. One candidate (who was advocating RCVS reform) had graduated from a European vet school, so his RCVS membership meant that legally, vets from ten more European countries could work in the UK. [This increased the workload for RCVS staff by about a third, but their line managers were unfortunately the same lawyers who controlled the RCVS elections.] This candidate was proposed by a former RCVS President and a Chief Veterinary Officer, so his chances for election seemed very good. Disturbingly, these well known proposers were presented by the RCVS with their names changed, and were left unrecognised by voters. The candidate was not elected. Another candidate and a homeopathic vet, complained of similar irregularities, but candidates who were elected had been provided with web pages to address the voters. Coincidence? When the RCVS presented its first EU member to the Press, it wasn't the Englishman whose prima facie application had taken two years, with support from the EU Commission, a former RCVS President, and two Chief Veterinary Officers. The RCVS presented a Slovakian whose application had been rushed through in two months.

So what should be made of the RCVS preoccupation with prosecuting veterinary surgeons performed under the guise of securing public confidence? A key criterion is consistency. A recent case presented to the RCVS Preliminary Investigation Committee investigated a vet who had performed a cat spey and this cat subsequently had kittens a few weeks later. The vet cited high blood pressure and memory loss as a reason for not removing any of the reproductive tract, and he emerged from the investigation with impunity. The same vet x-rayed another animal with a broken sternum but failed to identify a significant laceration to the thoracic epithelium. The animal died of septicaemia. The RCVS sought charges against the vet's boss.

An animal assistant stated in court that she had administered anaesthetic to a pet, although she had no veterinary nor veterinary nurse training. When the incident was reported to the RCVS, a RCVS lawyer stated that they 'were not in the business of prosecuting members of the public, but were only responsible for prosecuting vets'. Ironically, the RCVS was concurrently working with the Trading Standards Organisation to investigate five cases of possible illegal veterinary surgery performed by non-veterinarians. A key criterion is consistency.

The RCVS recently commissioned a university professor to investigate 'why so may vets commit suicide?' It probably doesn't take a university professor to decide that some problems lie at home. Perhaps it might be useful if someone suggested that the RCVS reads its own agenda.

Interestingly, the government was considering an alternative body to the RCVS for regulating veterinarians, primarily guided by non-veterinarians. In this alternative scenario, vets would no longer distrust other vets who prosecute them and who also levy increasing fees against them - vets would answer to a faceless bureaucracy, without hidden agendas from internal politics nor influence from power-broking lawyers. Now that sounds a rational possibility. It's perhaps the single positive conclusion from this review.