30 Nov Lunch Time Bonus – Bridging the ‘Pet vs. Profit’ Paradox
The veterinary industry is transforming in terms of corporatisation, competition, commoditisation, client compliance and public perception. These changes are accompanied by concerns about vets’ mental well-being, new graduate support and preparedness, as well as attrition from the profession. Much of this comes from the fact most vets work far too hard, for far too long and for far too little return due to inefficiency, frustration and poor profitability in their businesses. They labour under the induced fear, guilt and obligation of the false public and professional myth of expected altruism, social contract and non-commercialism that is at the heart of the Pet vs. Profit Paradox.
These issues raise questions about how veterinary professionals are aligning ‘who they are’ with this new world and raises questions of self and professional identity.
Veterinary professional identity is (in contrast to other career identities) stable over a very long time (from adolescence), global in that it affects all domains of life (not just work) and highly internalised through a very strongly held set of sub-conscious values and beliefs.
Their are three main identity themes in veterinary professional identity:
- Self as Technically Competent – “Doing the thing RIGHT” is linked to Mastery. This is the most important element of veterinary professionalism among students and academics. This is central to professional identity from an early stage. An inflexible thinking style means this can cascade into perfectionism and micro-management
- Self as Dedicated and Resilient – “Doing all-RIGHT” is linked to Autonomy. This is the ability to cope with hard work and stress, being resilient under pressure and perceived by others as dedicated to their work. Inflexibility in this area can lead to fear of failure and heightened sensitivity to criticism and mistakes.
- Self as Ethical and Moral – “Doing the RIGHT thing” is linked to Purpose. Vets have to reconcile their own values with the expectations that are placed upon them and to be seen by others to behave in a moral and ethical manner. Inflexibility can lead poor decision making and unreasonable behaviour (because they are right!).
We need to ask: Do we really have a recipe for successful professionals?
- Early fixed mindset that could lead to an inability to cope with change
- Extreme regard for technical expertise that could lead to perfectionism and inflexibility in all areas of life
- A high need for autonomy and perceived resilience that could lead to control ‘freakishness’ and micro-management
- Poor ethical and moral reasoning skills that could lead to poor decisions because of conflicting ethical reasoning
There is no doubt that these norms associated with veterinary professional identity can cause stress, anxiety and undermine wellbeing and self-esteem.
These issues have three very important implications:
1) Fixed Identity and a Challenging Reality – Unfortunately, from day one of being in practice vets are faced with the stark reality of dealing with clients and patients in a commercial world – things go wrong – exposing then suddenly to a catalogue of real and perceived threats to technical competence, dedication and resilience, as well as ethical and moral challenges such as:
- Complaints and mistakes
- Anaesthetic deaths / treatment failure
- Rejection / questioning of treatment options
- Rejection / questioning of competence
- Clinical perfectionism vs. pragmatism
- Appraisals and feedback
- Disciplinary proceedings
- Job dissatisfaction or loss
- Illness and stress
- Accountability and targets
- Commercial accountability
Research shows that technical competence threats, in particular, can have catastrophic psychological effects for individuals who have invested heavily in their identity as professionals. (Mellanby and Herrtage 2004) Other studies have shown that other professionals (doctors) who had experienced a current or recent complaint were at increased risk of moderate/severe depression, anxiety and suicidal ideation. (Bourne et al 2015)
2) “Who am I” and “What do I do” Mismatch – These three identity themes are completely at odds with the widely held ‘Veterinary Myth’ held by the public, vet students and academics and espoused by the profession at all levels. The myth says that vets act out of Altruism – that veterinary professionals should put the interests and welfare of others before their own; and Social Justice – the veterinary profession should, in the interest of fairness, provide equal opportunities of care to all clients. Nearly all veterinary students start their training with these beliefs intact and these are reinforced by their academic training. However, they struggle to survive in the commercial real-life world of veterinary practice but the need to conform to the myth is still there.
As a result, vets are robbed of their primary purposeful belief in who they are and what they do. Student vets enter the profession with a distorted view of the professions expectations, an incompatible professional identity and a fixed mindset. This can be psychologically damaging and undermine resilience.
3) Veterinary career choices – Self-identification with the veterinary profession is far stronger than identification with either a particular organisation or their own values and beliefs,they seek organisations where their identity is a good fit andmakes it less likely that veterinary professionals will adopt organisational rules, participate in activities or promotions or act ‘as the organisation’ they don’t believe in.
With the increasing corporatisation of the veterinary profession, and trends towards employment rather than self-employment, individuals will increasingly need to work within organisational values.
Can Commercialism help?
The same research suggests that ‘Commercialism’ is of least importance to vet students in terms of desirable character traits and of low importance to their academic tutors. Veterinary professionals equate being a commercial organisation with being unethical. However, the reality of veterinary practices puts commercialism centre stage as a pragmatic necessity of business. This is why the fundamental pets versus profit paradox issue is so hard – it is an ethical problem of identity.
Practices and the profession have a significant challenge to manage the pets versus profit paradox. The veterinary profession has at its core a moral and purpose vacuum and a battle raging as Commercialism tries to replace Altruism and Social Justice as our sense of purposeful identity at the very beginning of our careers.
However, Commercialism can be a pathway back to Purpose. We need to find a way to be commercially successful that is ethically acceptable to the profession. One way to address this is to redefine and expand the definition of commercialism to include balancing 4 conflicting outcomes of clinical care, financial viability, client experience and team harmony. Once the practice is commercially viable you can get back to the Purpose.
Stories of congruence lack the discomfort of the stories of tension and give the feeling of an enriched position. Independent veterinary practices have an opportunity to generate competitive advantage through their people by working towards organisational and individual identity congruence. If veterinary professionals can achieve validation and enrichment at work, this in turn leads to employee retention and attraction.
- Have the ‘Commercial’ discussion at recruitment
- Make ‘Financial viability & sustainability’ one of the practice and personal KPIs along with Clinical, Client and Team KPIs
- Give practice financial information on a regular basis
- Be aware of ‘Fixed Mindsets’ – yours and others
- Get comfortable with commercial reality
- Play with your identity ‘act as if…’
- Get other staff to understand;
– Why profit is important
– How profit is generated
– What you can do with profit to improve patient care, client experience and team harmony
- Lead by example
- Reward on congruence – not turnover
Mindset – Carol Dweck
Drive – Daniel Pink
Mans Search for Meaning – Victor Frankl
By Alan Robinson