Dr. Julie Buzby — Veterinary and Mental Health Advocate

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If you have researched mobility products for an aging K-9 companion, you may have come across Dr. Julie Buzby’s name. What you may not know, is that outside of founding ToeGrips, Dr. Buzby is a staunch advocate for mental health support and awareness within the veterinary professionals community.

With a suicide rate 3.5 times higher than the general population, veterinary professionals have been battling a mental health pandemic within their profession that has flown under the radar for years. ABILITY Magazine’s Jennifer Woodall sat down with Dr. Buzby in a virtual interview to discuss the potential causes for the increased suicide rates, experiencing loss, breaking down mental health stigmas and how to come together as a self-supporting community.

Jennifer Woodall: How are you today?

Dr. Julie Buzby: Hi, I’m great. How are you?

Woodall: Good. Thank you. So, my brother actually works as an advisor at a private college, and part of his position in his job is to prep people for graduate school. He was saying, surprisingly, that veterinary school is extremely competitive. The requirements for the program are even more strenuous than medical school, and he was a little surprised by that. Is that something that you have found to be synonymous with the schooling programs for veterinary in medicine?

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Buzby:  Yes. And I think it really comes down to supply and demand. I applied for veterinary school in 1990. No, that’s not true, because I went to college in 1990. So it would have been 1993, maybe, and there were only 20 some veterinary schools in the US. Now, there are over 30, and we have US students who go internationally as well into the Caribbean to try to increase their chance of getting in. I think that’s the main issue. There’s a lot more medical schools in the US than veterinary schools. So that’s one issue, just a supply and demand to get a position in those schools, and the class sizes tend to be small. The other issue is this change in the dynamic of the workforce. Many schools have over 80% females coming into the incoming class. So that’s another interesting change in what we’re seeing for the profession and the future of the profession.

Woodall: Yeah, absolutely. I think the statistic that I read was 70% of the veterinarians are women. So, yeah, that is interesting. Have you seen or are you aware of any connections between the reported level of depression in veterinary students versus practicing veterinarians? Do you see a discrepancy in those numbers?

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Buzby: So to be quite honest, I don’t feel equipped to speak about that. I’m not sure what the number… I haven’t personally looked at data for students only. I do care very much about the data for veterinarians, and particularly female veterinarians, because that’s the circle in which I run. I spend a lot of time socially online with colleagues and different Facebook groups and community groups. There’s one statistic out that says female veterinarians are 3.5 times more likely to take their life by suicide than the general population. I really got a deeper understanding on this recently. Every year, Merck and the AVMA (American Veterinary Medical Association) I think, work together to put out data. NPR has recently been talking about this. People Magazine recently did–when I say recently, in the past couple of years–highlighting veterinary mental health. It’s coming to light for those of us who are in the profession. It’s something we think about a lot because in these online groups, it’s not uncommon for there to be posts about a colleague who we’ve lost. There’s been weeks where we’ve lost two colleagues in the same week to suicide.

And it just rips your heart out because you feel this attachment, right? As veterinarians, we’re in this circle together, whether I knew them or not, where our lives are parallel enough that it just really hurts. My heart–all of our hearts–go out to the clients and staff and certainly their family who are affected. My son, this past spring, for his AP research class had to pick a topic to do research on and present it. The topic he chose was specific to veterinary mental health, and the angle was how debt, student loans and debt affect mental health. He put out a survey and had I think just a couple shy of 400 veterinarians take that survey. I read through the data because a lot of it was like you could type in the answers, so really good for hearing people’s hearts as they typed out the things that are causing mental health issues and stress. Student loans was way more significant than I expected in the way that they described it.

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I’ve always seen student loans listed as a risk factor for veterinary mental health in the list of eight things that cause depression and put veterinary mental health at risk. I’ve always seen it in the list, but I’ve never seen it isolated and discussed. Because that’s an issue that’s also very much on the mind, I’m sure, of veterinary students who are racking up that debt, I’m sure there’s parallels there. And it was eye-opening for me.

Woodall: Yeah, that’s definitely an aspect that I hadn’t considered before, but once you say it, it makes so much sense. A lot of school loans, the prospect of paying them off can be very bleak sometimes, so that makes sense that it could be a contributing factor.

Do you have any personal opinions on why you think there’s a disparity between the rate of suicide with women and men within the veterinary medicine field?

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Buzby: Well, I don’t know if the percentage takes into account that there’s just more women. I don’t know if that’s factored in or not. I think it’s truly just a number that’s higher in women. Veterinary medicine tends to attract Type A perfectionists who are very hard on themselves. We don’t need anybody–I’m sure this is true for most humans, but I can certainly speak to our profession–we don’t need anybody bashing us on social media, telling us what a horrible job that we did, although in absolutely almost all cases, it’s not true. We’re doing our best. I always say animals are living systems, they’re not mufflers, and so we can’t guarantee that it’s going to work perfectly every time. These are living systems that it doesn’t always go the way that we want it, even despite our absolute best efforts. But we’re very hard on ourselves. There’s a meme going around in veterinary medicine that says: “I wake up at 3:00 AM and think about your pet and I don’t charge you any extra for that.” That’s the gist of the meme. It’s so true. When I owned my veterinary hospital, we were in a rural area, and so I couldn’t just easily send patients off for overnight emergency care because we were in a really rural area.

I would literally just sleep on the floor of the hospital next to a patient who might need a higher level of care. I’m not saying that to draw attention to myself and my dedication, that is the level of commitment that we have as a whole. I’ve been a vet for 27 years, and the people that I’ve worked with in all different situations as an emergency vet, as an associate, as a practice owner, this is the conscientiousness and the degree of extreme commitment that the profession exemplifies. So, you take that and you multiply that over many years and many, many situations, and then you add to it for females also feeling the pressures of being responsible for family life and kids and success at home. It just adds up to be a lot of pressures that I think people try to be perfect in, and that’s too much for humanity to bear. I was at a veterinary conference years ago where a speaker who had struggled with depression and suicidal tendencies spoke, and she was a veterinary technician, and she did such an amazing job. It was really my first deep dive into this aspect of our profession.

She said, “People don’t die by suicide because they want to die. They die by suicide because they want to escape just pain, just immeasurable immense pain that they feel like there’s no other way out from.” I’m not saying that men don’t feel pain, but I think women just internalize that maybe differently and just process it differently. That aspect of perfectionism and just trying to be all things to all people, professionally and personally, and wear all the hats and find the work-life balance. I think it just is too much. Like I said, too much for a human.

There’s all this discussion about your superpowers and you’re a superstar, and you’re a superhero. I know those are all said as compliments–and certainly well-deserved compliments, I’m sure, when they’re said–but I really feel like I’m going to–in my own circle of influence, even my family–I’m just going to take it a step back and say, I think it’s enough to be human. I think if you can be human and with that, forgive people, forgive yourself, fail and forgive yourself and understand that’s a part the journey and be civil to those around you, just the aspects of just being human. I think that’s enough. Maybe we should just take it a step back and work on allowing ourselves to be human and not striving to be superhuman.

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Woodall: Yeah, absolutely. Also, I think, too, when you get the label of being a superhero or superhuman, even if it comes from a source of good intention, you get put on this pedestal, and the pressures that come with that get magnified to uphold these expectations. So, yeah, I definitely like that. Let’s just be human. I like that thought process for sure.

 I was reading a couple of statistics, and one of them was coming from the National Library of Medicine, talking about the differences of rate of suicide in different professions, and talking about how the veterinary profession is close to twice that of the dental profession, twice that of the medical profession, and 3.5 times the rate of the general population. I know we mentioned some of the risk factors briefly. Can you go into a little bit more detail of why you think that is? What risk factors are there that caused that increased number?

cindy barnes at a vaccine clinic in south africa organized by the nonprofit community vet clinic. the village children were responsible for bringing their pets in
Cindy Barnes at a vaccine clinic in South Africa organized by the nonprofit community vet clinic. The village children were responsible for bringing their pets in

Buzby: Right. So, I’ll just touch briefly on debt since we’ve already said it. It’s very hard to get an eight-year degree without going into debt, there’s very few people that are going to accomplish that. In my son’s survey, there were people that had funding from an outside source, typically a family member or inheritance or something, but what I didn’t realize was there was a large number of people in the survey, I want to say a quarter to a third, who were going to take 25 or more years to pay off their debt. That was mind-blowing to me. They described it as a chain around their neck, something that they constantly thought about, something that they constantly felt guilty about because they were either working all the time to pay it off and not with their kids, or they didn’t really have money to do things that they wanted to do with their family, like vacations, et cetera. I think it’s not just the burden of “I got to pay this off”, but it’s also how that debt affects the way you live and even contributes to guilt–mom guilt–specifically.

There’s this term, compassion fatigue, which I think is a little bit of a misnomer. I don’t think veterinarians get fatigued to being compassionate. I think truly, back to the human aspect, I think we often work a lot of hours. A lot of hours and fatigue itself takes a toll on mental health. I just know that when I’m fatigued, I don’t cope as well. I’ve also heard a lot of people say, “Oh, I could never euthanize an animal, that’s got to be the worst part of your job.” I think I speak for our profession when I say that’s not the worst part of our job. It’s actually a privilege and an honor to be there with people during that time, giving that animal a peaceful painless transition and giving the people peace of mind and really scripting ‘the good death’ if you will. That’s a really beautiful place to be, and we’re honored to be there. What’s hard is that we often go from that appointment to the next appointment, which is the 10-week-old puppy who’s there for his puppy shots, and we don’t have time to grieve and process that. Because I can’t, I’ve said this before, but I can’t break down and start crying in the exam room with the people as much as my heart is breaking.

For a lot of us in this profession, we’ve been with that puppy their whole lives, and now they’re 16, and it’s time to say goodbye, and those people and that pet is just as much a part of family as theirs. I won’t say just as much, but we truly love these pets. So, I can’t start weeping with the people in the room because I’ve got to hit the vein, and in order to make this perfectly smooth, I can’t be blinded by my own tears. Then you come out of that room and then you go to the next appointment. It’s just all part of the flow, which you need to hold space for in your heart, but there’s not time in a busy appointment schedule. I don’t know that other professions deal with that whiplash.

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Certainly, during COVID, we did curbside appointments for the most part because most states were requiring that. We were considered essential but there was a lack of contact. During that time, a lot of people got pets, as you probably know. Then there was this whole thing of, “Is there a shortage of veterinarians?” We saw veterinary emergency hospitals who didn’t have enough staff to care for the pets. Veterinary hospitals were maxed out caring for their own clients, and now what do you do with new clients who obviously need to be seen? We care just as much about those animals, but logistically, how do you make all this work? One of the joys of being a veterinarian is that every day is different–that’s great–but one of the hardships of veterinary medicine is that every day is different and very fast paced and a lot of whiplash.

buzby group photo from the veterinary encouragement conference
Group photo from the veterinary encouragement conference

I think there are certainly other medical professions that deal with that, but maybe not to the extreme we do. If you think about most MDs, if you’re a dermatologist, you’re seeing dermatology cases, and there’s not really emergencies. If you’re a cardiologist, you’re focused on your thing. Most veterinarians–we do have specialists, thank heavens, and they’re brilliant and save a lot of lives–but most veterinarians are general practitioners. So, one appointment can be a puppy, the next appointment is euthanasia, the next appointment can be a hit by car where every second counts, and the next appointment can be a dog with an ear infection and multiply that the course of the day, so the days can be really intense. Veterinary medicine is changing to respect boundaries and to understand that we have to prioritize the health of the veterinarians and their staff just as much, but for all the years that I was in practice, it was normal that you’re never going to get out the door on time, you’re never going to have a lunch break–that was just what was expected. That is shifting, but that’s an important shift to happen for veterinary mental health. Again, back to humanity. We’re not robots. You can’t just go 24/7 and not take a break.

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Then there’s, sadly, the issue of social media, the Keyboard Cowboy, the Yelp Review. There are very hurtful things said in veterinary medicine. Most always, I will say the cases that I know about, most always unjustified. Certainly, mistakes can be made, but for the most part in the situations I’ve seen blow up on social media, it’s because of a person who’s grieving and chooses to take it out in this way on a person. Maybe there was not the best communication, possibly, and the person didn’t really understand that animals aren’t mufflers, and this isn’t a guarantee, but I personally know of veterinarians who’ve been driven out of the field by a mob of people who can’t express their own anger, and then rally other people on social media to get involved and create a lynch mob. I do know of cases of veterinary suicide where this was a contributing factor, so that’s another big one. Even the American Veterinary Medical Association has a cyberbullying department. That’s crazy that the AVMA needs a cyberbullying department. So that’s another real issue.

buzby hillary mcmanama dvm with patient 1729
Hillary Mcmanama DVM with patient 1729

Woodall: It sounds like there’s a lot of repressing of your emotions throughout the day. That’s what it sounds like when you’re describing having to go from a puppy to a euthanasia to a medical emergency, and having to have this even tone of demeanor across it. It sounds like there’s a lot of repressing of these really intense emotions which I can totally see how that can contribute to depression. Do you have any ritual self-care that you do when you get home or a way that you process through having to tamp down how you feel throughout your work day?

Buzby: It’s a great question, and I’ve never thought about it as repressing emotion. It seems so obvious when you say it. I think we just call it being professional. I mean, we have to be professional. To answer your question, I think you have to find a coping mechanism. For me personally, I just love God, and he is my source of strength, so I am always praying in the background of my head. Even in euthanasias, I will ask the client, “Do you mind if I pray with you?” and for me, that brings me a lot of peace. I hope for them as well. I’ve never had anybody say no in all the years. So that’s my source of strength and encouragement. Always there, always steady.

I can’t speak for other people, but I agree with you that we have to find a way to process that, and maybe that’s really the bottom line of what’s missing. There is an organization that started within the past couple of years called the Veterinary Hope Foundation. They do small group sessions with people that are like-minded in the profession. I think they try to put the practice owners with the practice owners and people in common life circles together, and they just talk through things, which I think has been really helpful. I just finished hosting the third annual Veterinary Encouragement Conference. During COVID, I just thought, “We’ve got to get together. Isolation is a big issue for all of us right now, but for our profession with everything else going on with mental health, what if we got together in person?” The goal was really encouragement and community–and we have to get a certain number of continuing education hours every year to keep our degree–let’s meld the two, but put more emphasis on support and community. We just did our third annual one, and the Veterinary Hope Foundation was there doing 20 minutes sessions with a licensed social worker who has an emphasis in the veterinary profession. Her sessions filled up so quickly, and I think she dealt with a lot of really heavy stuff just in these little 20 minutes sessions. I guess my point is there is a need for–we would call it a pop-off valve, a piece of the anesthesia machine that has to be able to open to allow everything to properly circulate and not explode the lungs–I think veterinary medicine needs to do a better job of finding the pop-off valve.

Woodall: Sort of touching on how you mentioned isolation a little bit. I was reading a study from Bartram and Baldwin that suggests that professional isolation is one of the potential contributing factors to increased suicide rates among veterinarians. Can you tell me a little bit about the aspects of the job that tend to be isolating? What that looks like?

buzby liz neveau dvm doing acupuncture and laser therapy on goldie the 20 year old quarterhorse
Liz Neveau DVM doing acupuncture and laser therapy on Goldie the 20 year old Quarter Horse

Buzby: I will say that I’ve seen an improvement in this over the course of my career, which makes me really happy. When I graduated from vet school, I thought of myself inappropriately as competing against all the other veterinarians. I mean, I wouldn’t have been able to consciously verbalize or explain this, but you get out there, and especially because I open my own practice, I’m a competitor. I mean, of course, I wish my colleagues well, but somewhere deep inside of me was this idea of I want to be great and I want to be the best, and that means I have to be better than other people, so that in and of itself, I think, is isolating that mindset. I have seen a shift, and certainly I’ve been blessed to be a part of it. I certainly feel it at my soul, but I think I’ve seen a shift in our profession where we realize that veterinary medicine is not an individual sport. It’s a team sport. I don’t mean that only within a hospital itself, I mean collectively, we’re a team sport. I’ve heard this said at conferences, but I know it to be true, no one’s going to come from the outside and rescue us from our mental health crisis. The government’s not going to fix this. The NIH (National Institutes of Health) is not going to fix this. We’re going to have to fix this ourselves, and I think we recognize that. I think it just brings more camaraderie and compassion and empathy as we practice. I actually feel much less isolated than I did initially when I first got out of school and then opened my own practice. I was a solo practitioner and that’s super isolating since I was working by myself. I think this is a good place for social media. Social media can be dangerous, or at least any tool, I think, can have the potential for harm, but a good thing about social media is I think it’s been used to bring veterinarians together. Back to your question as to why the profession is isolating. What comes to mind, again, is who is in the profession. It’s these type A perfectionists that hold themselves to such a high standard and beat themselves up so relentlessly for the slightest thing that doesn’t go perfectly, that I think we just isolate ourselves by our own perceptions.

Woodall: Yeah, that makes sense. Absolutely. Especially when we’re talking about even from the get-go when you’re going into veterinary school, it’s immediately competitive. So it does make sense because you’re just thrown into the fire from the beginning competition-wise. It puts you in that mindset before you even graduate.

Buzby: And we talked about how hard it is to get in, so you’ve already competed hard to get there. And, yeah, your mindset doesn’t instantly change. You’re still striving.

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Woodall: Yeah, absolutely. It’s something to prove for sure. I couldn’t find any information about this, so I was just curious if you had any professional insight on it. Do you see any difference between the mental health and quality of life situation between rural vets or city vets? Do you see any differences there related to suicide rates and mental health?

Buzby: I don’t know. There is an organization called Not One More Vet that specifically exists to prevent veterinarians taking their life by suicide. In my son’s research paper, I think he found that over the past 40 to 45 years or something, 400 veterinarians have lost their life to suicide. I would say that quality of life is going to make a difference. So, I think there’s so many factors. Is that city vet, $300,000 in debt, working all the time, feeling the pressures? I think city practice may be expected to be less James Harriet, for lack of a better word, than country practice, so maybe the pace and the expectations are different. Not that the reality of saving animals’ lives isn’t the same in both, but yeah, I wouldn’t be able to answer that question. I think it all comes down to quality of life.

buzby michelle meyer dvm with cat reign
Michelle Meyer DVM with cat Reign

Woodall: No, that makes sense, like an individual case-by-case situation. What we see time and time again, when we talk to really anybody about mental health in what they’re doing, regardless of what sector it’s in, we see that there’s so much stigma against mental health still. Do you feel like stigma against mental health issues plays a role in veterinary professionals seeking treatment or not?

Buzby: For sure, and I feel like I’m a broken record, but I think it goes back to that perfectionist type A personality. You can’t show weakness. You have to be perfect. So to say, “I’m struggling”, we just don’t say it. That’s just not in our DNA. I think it’s something that there are a lot of people and organizations working to break that down and say, “No, it’s okay. It’s okay to be human. It’s okay to struggle, and we want to come alongside you and help you in those times.” In my conference, the Veterinary Encouragement Conference, what I say at the beginning of every conference is, “If you need help, if you are hurting, if you are not in a good place, I beg of you to be vulnerable, to be honest, and to reach forward, to reach out to those of us who are. If you’re in a good place and you’re stable and you’re strong, then you need to be—we need to be—reaching back for those people who are reaching forward.” And you know what? We’re constantly switching position, right? I mean, there’s days where I’m reaching forward–maybe even changes hour by hour–and times when I have it in me to reach back. I want to help others. And it’s a dynamic relationship.

Woodall: When you were mentioning your conference before with the Veterinary Hope Foundation bringing the social worker there and the general consensus that veterinarian professionals need to initiate the change towards a more supportive mental health structure themselves, what do you feel needs to be in place to promote mental health awareness and support within the veterinary community? What do you think needs to happen to see a change?

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Buzby: One of the things that breaks my heart, and really haunts me is when you see a veterinarian who’s taken their life, almost always there’s a post about it on social media. Here’s this picture, here’s this veterinarian, here’s their story. They always look amazing. They’re kneeling down, they’ve got six puppies on their lap, they’re laughing hysterically with their team surrounding them. They never look like hurting, and that’s that thing that bothers me. To your point before about the stigma of mental health, we’re really good at putting on masks. In veterinary medicine, cats are known to not show pain. They won’t show pain. They’ll mask pain, and they just won’t show weakness. Veterinary medicine is filled with a bunch of cats that are not going to show weakness. They are going to mask it. I think the more we can break down stigma and the more resources we can provide, especially from within because there’s this empathy that we have having lived this life together, I think the better off we’ll be and the more of a place we’ll create for people to be honest and open. Now we’re talking about it, so we’ve moved from never talking about it to now it’s out there. In the profession, I think everybody’s well aware of it now. I still think the general public doesn’t really know, so I appreciate what you’re doing because even though there has been some limited discussion here and there, if it comes up when I’m talking to a relative or if I’m in a place where for some reason this comes up as a discussion, 9 times out of 10, that person who’s not related to the veterinary field is shocked and that says, “I had no idea.” So, I still think people don’t know. Awareness is important. The root thing is making it okay to not be okay and then finding ways for us to support those people who are reaching out for help. But step one is just making it okay for them to reach out and not be blacklisted, and for us to realize that it’s not a weakness, it’s being human, and it’s to be expected–it’s not a failure.

buzby michelle meyer dvm with a mountain of laundry
Michelle Meyer DVM with a mountain of laundry

Woodall: Yeah, absolutely. One of the parts of breaking down stigma that I think is really important is to be able to break it down within the professional sector, not just general population, but in the workplace. A lot of times, especially when you’re a doctor, a veterinarian in a position of–authority is not really the right word, but it’s the best one I can come up with right now–you’re always expected to maintain a certain decorum. Then when you start talking freely about mental health, a lot of people can be like, “Oh, well, can you even do your job at this point?” And that’s such an unfair connection to make. I would love to see some way to break those walls down and make it a more comfortable space to realize, yeah, you can definitely have mental health issues and still be so great at your job. Those things aren’t the same.

Buzby: Right. That’s a great point. It’s a great point.

Woodall: Is there anything else you would like to talk about that we haven’t covered yet today?

Buzby: I really want the world to know that veterinarians are heroes, and they care so deeply. They care so deeply for their patients and their clients. There’s been all kinds of stuff that goes around online like veterinarians are in it for the money. That’s absolutely not true. There’s shockingly little money in veterinary medicine. I’m sure the corporations that own some of these hospitals, that’s not true for, but in 27 years, I cannot think of a veterinarian that I met that I was like, “Man, there’s a bad apple who is just in it. I don’t know how he got into this profession.” They’re in it because this is a calling, really, and there’s so much goodness. I would love for people to just know that and give their veterinarian just space to not be perfect and show appreciation when it’s appropriate. And like I said, I think that’s true for probably all of us, not just the veterinary profession.

Woodall: Thank you for taking the time to speak with me today, have a good day.

buzby whitney brown dvm with a litter of kittens
Whitney Brown DVM with a litter of kittens

Buzby: Thank you so much. Take care.

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