5:30 a.m. I am good at sensing what time it is by the way the morning light angles in through my bedroom window, by how loudly the birds sing, by how many cars rumble past on Old County Road as working folk start their day. I have been awakened by the muffled sound of my office phone ringing twice before going to voicemail. I am one of a dying breed. A solo veterinarian who lives at my home-based practice. I should have learned by now to turn off the office phone ringer at the end of the day, but I always forget. If I remember then I will forget to turn it back on tomorrow. So I just leave it on, surrendering to the fact that, with the hypervigilance born of being on call for the last 40 years, and being a mom to boot, I will never, ever sleep through those distant rings. After a moment of confusion, my mind clears enough to identify that it is Wednesday. On Wednesdays another Island veterinarian covers emergencies. A blanket of gratitude covers me as I close my eyes. Today, at least, I do not have to deal with someone’s early morning crisis.
There is a different kind of wake up call coming to the Vineyard — a problem brewing for years and now exacerbated by the effects of the pandemic: A shortage of veterinarians. This is an issue nationwide.The USDA has declared 221 shortage areas in 48 states this year. According to an article in the February 2021 issue of Today’s Veterinary Business, studies by economists and data from the U.S. Bureau of Labor Statistics reports a shortage of 3,000 to 5,000 veterinarians that is increasing annually as the baby-boomer generation of animal docs start retiring in droves. There are not enough newbies coming up to replace us old-timers.
Why? Lots of reasons. Not enough veterinary colleges. Not enough people willing to take on the huge student debt often entailed with getting a veterinary degree, especially considering veterinarians in general practice make about one-third of what our counterparts in human medicine earn. More women veterinarians, which often means more part-timers during child-rearing years. (Save the discussion about fathers for another time.) A standard of care which, in one generation, has gone from an agricultural economic-based gestalt to “state-of-the-art” human-level medical practice. An increased emphasis among the younger generations on work-life balance, which I totally support but which often means more docs who are simply not willing to burn themselves out working crazy hours. Burning out anyway. I could go on and on.
So what does this mean for the Vineyard? Simply put, there are not enough veterinarians here for the number of people and animals. In addition, many of us are approaching retirement, dealing with medical or family concerns, and/or battling various degrees of burnout and compassion fatigue. Our multi-doctor practices have been trying for years without success to hire associates. The cost of living is too high. With the absence of a local emergency clinic, few vets want a job that requires working full days then also being on call overnight, on weekends, and on holidays. If that isn’t complicated enough, few veterinarians nowadays do “mixed practice.” Most focus on small animals (i.e. dogs and cats), or equine, or livestock, or exotics. But not all of the above.
About 20 years ago, the majority of the Island veterinarians got together and worked out a system to try to provide urgent care and emergency services after hours. It has been complicated. Not all of us have the same expertise or equipment. Not all of us have the same insurance, which matters if you’re a dog doc being asked to treat an extremely expensive horse for colic. We have different styles, different philosophies. Sometimes one of us would need to drop out for a while. Someone would get injured or sick. But we made it work. Day after day. Year after year. Now we meet periodically by Zoom and wonder how much longer we can keep going. We gather in small groups for socially distanced lunches or backyard beers, debriefing and bolstering each other up to face the next on-call shift. Someone periodically sends an email brainstorming ideas of how to make this better. We are giving it our all. One of us is always on call to return urgent phone calls and help triage your pet’s situation. Call your regular vet’s office anytime and you will be referred to whoever is covering. But there is only so much each of us can do, and we’ve been doing it for a very long time.
Here are the cold, hard facts. There is no 24-hour veterinary emergency clinic on the Vineyard. Period. There has been a steady increase in both our human and pet population, which has surged even more this past year with many seasonal residents choosing to stay year-round, and many people adopting “pandemic pets.” Yet we have at least two fewer full-time veterinarians here than we did 10 years ago. That’s two fewer human beings contributing to covering after hours urgent care and emergencies.
What can you do? Work with us. Remember your local veterinarians are not specialists. Our practices are not emergency hospitals. Island life is sometimes inconvenient. You may need to take an unanticipated ferry ride to get your pet optimum care. Address any problems your pet is having promptly with us during office hours. Don’t wait until Kitty has been vomiting for days then call on Sunday. Don’t call at midnight when Fido gets sprayed by a skunk. (Just Google it.) I don’t mean to sound flip. We know you love your pets. (Honestly, we love them too, which is one reason this is such a difficult profession.) We will continue to do our best, but we need your help, consideration, and understanding. I’m going back to sleep now. Call your Island vets if you need them. Wait until office hours if at all possible.