“While entrepreneurship can be exciting and invigorating, any professional pursuit can lead to burnout if we are not careful. Use boundaries to maximize your productivity and create a client or project list that gives you energy instead of draining it.”

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While I wasn’t quite sure how I would make everything work at the time, I made the move to part-time clinical practice and started my own LLC in early 2021, through which I provide freelance speaking and writing services to veterinary conferences, schools, magazines, blogs and more.

For me, entrepreneurship provided me with more time to invest in self-care and an opportunity to save my passion for clinical veterinary medicine by diversifying my career and utilizing my professional skills outside of the clinic. I am happier when I’m in the clinic because I have multiple professional goals to work toward, and I have more time for my family because I’ve created a career with flexibility. But the journey has not been without challenges. And through those challenges, I’ve learned just how important boundaries are to success and maintaining the mental health and self-care practices that I have worked hard to prioritize.

Identifying The Pressures

Entrepreneurship has presented many new pressures—both internal and external. In response, I have often found myself in situations where I am overcommitting or overworking to try to maximize success. Understanding what drives me to make those choices has helped me to determine ways to better protect my time and energy.

First, entrepreneurship comes with financial pressures. And particularly early on in the business, there is uncertainty when it comes to income. This, combined with initial investments and startup costs, can create significant financial pressure—especially for a young professional who still carries a large student loan debt. 

When starting a business, it’s best to have a plan that allows you a financial buffer. And it’s also important to realize that you might be a bit uncomfortable for a while. I’ve learned the hard way that working until I’m exhausted just to take on one more project and earn a few extra dollars isn’t worth the stress and exhaustion in the end.

Additionally, being my own boss has created new freedom in my schedule; no one tells me when to start work, but no one tells me when to stop either. If I want to sleep in on a writing day, that’s fine. If I want to stay up until 2 AM writing, the only person who suffers is me when the toddler wake-up call comes at 7 AM. It can be tempting to keep working past when I planned to if I’m having a productive day, or to put off a project until later when I’m just not motivated, but there are consequences relating to the time I have for myself and my family, or how mentally present I am during these times.

Finally, there is a deep internal pressure to succeed. I am proud of what I’ve built and the projects I produce, and I don’t want to see my business fail. When I am feeling particularly vulnerable about my success, I try to step back and consider the many things I have achieved so far; the number of articles I’ve written, the income I’ve generated and the conferences I’ve traveled to. While taking some time to be grateful for what I’ve done so far does help, I still must recognize when it is my fear of failure driving me to take on extra projects that overextend me.

Setting Boundaries

Setting firm boundaries is essential to maximizing productivity and maintaining the balance that drives so many to pursue entrepreneurship. It will take time to get it right; some boundaries may be too rigid and others too loose. Adjustments will need to come with time. My boundaries around the type and number of projects I take on have shifted as work has become more plentiful and my interests have narrowed.

The first step in successfully setting boundaries is identifying where they are needed. Consider your scheduled time to work, the number of clients or projects you will take on at a time, the type of clients you will accept, the type of businesses or people you will collaborate with and what your financial goals are. Good boundaries not only protect your individual time and energy, but also protect your brand, values and goals.

For me, setting financial boundaries has been the easiest to do. Using my personal and business financial goals, I have determined the amounts I am willing to spend and minimum fees for projects. Even though they were easy to set, they aren’t always easy to enforce. I’ve gotten more comfortable with the discomfort of naming a fee and waiting to see how the other party will respond—sometimes I negotiate, other times I decline.

I have found it harder to define clear boundaries around my time and energy, but these are the most important assets to protect if you want to find a healthy integration between your personal and professional life. When I teach personal boundaries during one of my lectures on wellness for veterinary professionals, I remind attendees that they are more than a veterinary professional…And I am more than a veterinarian and an entrepreneur. I have an identity outside of my work as a daughter, mother, wife and friend. I must remember that I am a human being. My time and energy are not unlimited so I must work hard to protect them, whether it is from the stress of being a veterinarian in the clinic or the stress of being a business owner. 

While entrepreneurship can be exciting and invigorating, any professional pursuit can lead to burnout if we are not careful. Use boundaries to maximize your productivity and create a client or project list that gives you energy instead of draining it. 

Here are some questions to consider when setting up your schedule and the number of projects you will take on:

• When do you find yourself being most productive during the day?
• When you are working, how long until you find your energy or interest waning?
• What are your priorities outside of work and when do you need to be available for them?
• Looking at your last week or month of work, how did you feel? 
• Do you find yourself feeling resentful about certain tasks or projects you are working on? 

Sticking to Your Boundaries

Utilizing tools and having a plan to help you stick to your boundaries is essential. I often use productivity apps on my phone to help keep me focused when I am working. These apps can also remind me when it is time to take a break. When creating my schedule, I enter family and social events in my calendar first. I schedule time for myself and the activities that help me recharge, then I see how much time is left for work.

Outsourcing some tasks can also help to uphold boundaries. A friend once told me, “You either have the time to do something yourself, or you have the money to pay someone else to do it for you.” I’ve fallen back on this advice many times. 

When it comes to my business, I regularly evaluate the tasks I need to do in order to continue to succeed and grow. I consider which tasks I enjoy, like writing content for my social media, and which I find tedious, like updating my website. Over time, I have taken the least desirable tasks and invested some money in hiring someone else to do them, or at least found software to make the tasks more efficient. 

Advice for Future Entrepreneurs

Setting boundaries is hard, but sticking to them and asking others to respect them can be even harder. As a young entrepreneur, it is scary to say “no” to an opportunity—especially if it comes with a paycheck. But if that opportunity requires you to defy your boundaries, it’s probably not worth the cost of your time, energy, integrity or mental health. Not every client, collaborator or project is the right fit. Saying “no” to something or someone now could mean you have time to say “yes” to something even better later.

Setting and upholding boundaries around your time and energy will be what keeps you in the game for the long term. As Brené Brown once said, “Daring to set boundaries is about having the courage to love ourselves even when we risk disappointing others.” +

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Cases like these can have devastating consequences on the mental health of the veterinary team. Learning to navigate these difficult situations is essential to maximize patient welfare, maintain client connections and preserve the mental health of all team members. 

Here are some tools that can be used by veterinary team members when faced with these challenging cases:

1. Prioritize compassionate communication.

Navigating the conversations surrounding euthanasia is considered by many veterinarians to be more stressful than the act of performing the euthanasia.¹ Prioritizing compassionate communication and a client-centered approach has been shown to improve client perceptions of end-of-life conversations in both human and veterinary medicine.² But what does this look like in the veterinary practice?

Client-centered communication involves establishing a relationship between client and veterinarian, and expanding the conversation beyond medical topics to include lifestyle and social topics. In the case of an end-of-life discussion, these conversations could include discussion of the client’s beliefs around euthanasia, their ability to provide hospice care for their pet, the role the pet plays in the client’s family and the client’s expectations for what a peaceful death looks like for their pet.

We must make every attempt to connect with the client and give them opportunities for input. Use of open-ended questions to elicit the client’s concerns, questions and feelings is essential. Combining these with expressions of empathy can strengthen their impact. For instance, you might say, “I know that this is not what you were expecting to hear today. Can I answer any questions about Lucky’s kidney disease for you?” or, “I know euthanasia is very difficult to consider when you love Lucky so much. Can you tell me what you’re thinking/feeling right now?” 

Once we have asked these questions, we must stay present in the conversation. Listening to the client’s response without being distracted by thoughts of other patients, how far behind schedule we might be or what we will say next will ensure we do not miss important information. A client may share information that can open an opportunity for connection—or at least an improved understanding—such as the fact that this pet previously belonged to their late partner or that they do not believe in euthanasia. We can build on the conversation to devise a plan that is in the best interest of the pet while respecting the client’s emotional limitations.

While we may feel frustrated when the client does not accept our recommendation for euthanasia, we must control our own feelings and avoid passing judgement. Staying aware of our nonverbal communication is especially important during these conversations as we can easily expose our feelings with our facial expressions, body language or tone of voice. 

2. Provide multiple perspectives.

For some clients, hearing the same information and recommendations from multiple sources can help them to understand the true severity of their pet’s condition. In some cases where I feel that I am missing a connection with the owner, I will excuse myself from the room by saying, “I know this is difficult to consider, and I’d like to give you some time to think, if that’s okay.” Most clients are grateful for this opportunity. 

I will often then send an experienced veterinary nurse in to check on the client after a few minutes and allow them time to speak with the client. Many clients will elicit the opinion of the nurse, especially if they have met them in previous visits. Sometimes my nurses have been the ones to guide clients to the decision to euthanize. 

I have also offered to call specialists or talk to other doctors in the practice to determine if there are any other suggestions for treatment. In some cases, owners have requested referral to the specialty hospital to meet with the specialist in person. In these cases, I try to encourage a direct transfer from my hospital to the specialty center to avoid prolonging pain or suffering for the pet. 

3. Provide resources to the owner.

Objective data can be powerful. Providing quality-of-life assessments help some owners in their decision-making. Two of the assessments I use most often for owners come from Lap of Love³ and the Ohio State University Veterinary School.⁴ Lap of Love’s website also offers excellent client information on end-of-life care that anyone can access, even if there is not a Lap of Love veterinarian in your area. 

Additionally, consider providing resources for grief counseling and pet loss support groups. Some counselors and groups are willing to provide support to the owner prior to the pet’s death and can help them process the decision to euthanize. Most veterinarians are not trained mental health specialists and should not try to fill the role of therapist for a struggling owner. Involving trained professionals in supporting the client can help ease the burden on the veterinary team and ultimately be more helpful to the client.

4. Explore hospice options.

Hospice care and in-home euthanasia services are growing areas in veterinary medicine. For clients who will not euthanize their pet, referral to a hospice veterinarian can provide more support for both client and patient. It is very important that owners understand what to expect in the death process and that they are prepared for the nursing care involved. They should also be advised of subtle signs to watch for in their pet that might indicate suffering or distress.

If there are not hospice veterinarians in your area, do your best to provide palliative care to the patient. Some hospice veterinarians will provide “comfort kits” or “crisis kits” to owners which include doses of medications including anti-nausea medications, anticonvulsants, pain medication, sedatives and other products specific to the pet’s disease process. The goal of these kits is to provide short-term support for the pet, including minimizing pain, anxiety and distress, until the owner can get to a veterinary office.

5. Debrief to protect the mental health of the veterinary team.

Finally, it is essential that team members can debrief after the conclusion of the case, regardless of the outcome. Cases where there is disagreement between the veterinary team and client surrounding patient care can lead to moral distress for the veterinary team. This was defined as “the experience of knowing the right thing to do while being in a situation in which it is nearly impossible to do it” in a 2018 study that explored moral distress in veterinary medicine.⁵ Seventy-eight percent of respondents said that not being able to do what they felt was best for a patient caused moderate to severe distress for them, and 73% stated the same effects were felt by their team members.⁵

Debriefing offers team members the opportunity to discuss the case and their feelings around it. This can ensure that anyone who is upset or distressed about the process or outcome can get the support they need and know they are not alone. 

In a profession with high levels of psychological distress and mental health struggles, having tools and resources for handling situations of moral distress, especially around end-of-life conversations, is crucial. +

References:

1. Matte AR, Khosa DK, Coe JB, and Meehan MP. Impacts of the process and decision-making around companion animal euthanasia on veterinary wellbeing. Vet Rec 2019; doi:10.1136/ vetrec-2019-105540.
2. Borden LJN, Adams CL, Bonnett BN, Ribble CS, and Shaw JR. Comparison of veterinarian and standardized client perceptions of communication during euthanasia discussions. JAVMA 2019;254:1073-1085.
3. Pet Quality-of-Life Assessment. Lap of Love. https://www.lapoflove.com/quality-of-life-assessment
4. How Do I Know When it’s Time? Ohio State University. https://vet.osu.edu/vmc/sites/default/files/import/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf
5. Moses L, Malowney MJ, and Boyd JW. Ethical conflict and moral distress in veterinary practice: A survey of North American veterinarians. J Vet Intern Med 2018; 32:2115-2122.

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When I started vet school, I planned to pursue an internship, surgical residency and ultimately become a practice owner. My career path didn’t end up going that direction, but the people I met and skills I learned through the VBMA have aided me at every twist and turn along the way.

Here are five reasons why business education is an important part of your veterinary journey:

1. Build your professional network.

You’ve probably heard that the vet profession is “a small world,” and “it’s not about what you know, it’s who you know.” I never realized just how true those sayings were until I began exploring opportunities for writing and speaking. Introductions from colleagues I knew well and reconnecting with old acquaintances smoothed my path into that world. 

Ultimately, you may think you know where your career is headed, but interests, goals and lifestyles change over time. Having a diverse network of professionals in the veterinary industry can be advantageous as you explore different options over time. This network may include veterinarians, fellow veterinary students (who will become your future colleagues), veterinary technicians, practice managers, industry representatives and other professionals such as lawyers, financial planners and accountants who can help you succeed. Business education provides an introduction to these individuals and teaches you how to network effectively.

2. Prepare for the job hunt and learn to negotiate.

I was fortunate to find a clinic with exceptional mentorship to start my career. The job search skills, resume writing workshops, interview preparation and negotiation tips I learned through VBMA events were instrumental in helping me find and land this job. Though I was nervous, I felt well prepared for my job hunt and knew how to set myself apart from other candidates during my interview. Certainly, my medical training was a part of this, but I knew how to best present myself and my skillset effectively.

The job offer is just the beginning. Negotiating for what you want and what you are worth—including pay, benefits, schedule and mentorship—lays the foundation for job satisfaction. Negotiation can be intimidating. Having the opportunity to practice these skills and gain an understanding of what industry standards are can help you succeed when it comes time to have these important conversations with your future employer.

3. Enhance your communication skills.

I love talking to clients, colleagues, staff, students…and pretty much anyone else who will listen. But even if you love talking like I do, you have to develop communication skills. There is a difference between talking and communicating. Effective communication means having a conversation, knowing when to ask questions of the other person, when to stop and listen, and when to pause to allow everyone time to think.

No matter what area of veterinary medicine you end up in, you will be communicating with other people—even if it isn’t a client in an exam room or on a farm. While communication training has increased in the core curriculum of many veterinary schools, you can never have too much. Being exposed to different communication styles and strategies for managing different situations (e.g., delivering a poor prognosis or discussing finances and making medical recommendations) is invaluable to your success as a new veterinarian.

4. Get comfortable with leadership. 

You know what comes along with your veterinary degree? A presumption of leadership. No matter where you work, you will be looked to as an expert and a leader by your staff and clients. You don’t have to work in a clinic for years or be a practice owner to be seen as a leader. I didn’t realize as a new grad how true this was until a trusted technician pointed out to me that the attitudes and decisions of all the doctors in the clinic impacted the staff’s morale and confidence on a daily basis.

Some people seem to be natural-born leaders, but everyone has leadership potential. Business education includes leadership training and helps you to understand the importance of skills like goal-setting, delegation and how to give effective feedback. 

5. Become a stronger associate by understanding business operations.

It can be difficult to accept the financial limitations of clients—especially when it restricts the amount of care you can offer a patient—but veterinary clinics are a business, and it is essential to understand this. By no means does this make our profession “all about the money,” as we are sometimes accused. Having an associate who understands these facts and who has a basic understanding of business operations (e.g., how prices are set, the impact of discounts and missed charges, and basic inventory management) is an asset to the practice owner and management team.

Additionally, by understanding business operations, you can be more effective when suggesting changes to protocols, the addition of new services, or requesting new medications or equipment. A new grad colleague of mine recently shared how they convinced their clinic to invest in an ultrasound unit because they presented a plan for how to charge clients for the service and a timeline for turning this piece of equipment into a profitable part of the practice.

The current market for veterinary associates is wide open. But, it hasn’t always been this way and presumably won’t stay this way forever. Taking steps as a student to make yourself an exceptional candidate can only benefit you. Pursue education in business, communication and other non-clinical skills during your veterinary education. And since many schools do not include much of this training in their core curriculum, externships and extracurriculars, such as the VBMA, are a must. +

For more information on the VBMA, visit www.vbma.biz

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“You will learn more in your first year of practice than in four years of school,” and “You’ll really excel after about five years in practice.”

I found both of those statements to hold a large amount of truth after my own graduation. Looking back on my first five years in practice, I’ve found that the most important lessons I’ve learned are not about medicine or surgery, but about myself and how to thrive in a profession that is full of challenge and is constantly changing.

1. Confidence takes time to develope

Every new graduate will have a different amount of confidence, shaped by clinical experience and innate self–confidence. For some, the transition from student to doctor is especially jarring and may create feelings of imposter syndrome, or the feeling of being a fraud. Over time, young veterinarians will develop confidence in their clinical and communication skills and grow into the best doctors possible.

Much of how a new veterinarian’s confidence is perceived comes from the way they communicate with clients, colleagues and staff members. I was initially nervous to admit that I didn’t know the answer to a question or a case, but I quickly learned that most clients are very open to an honest answer. It is never wrong to ask for a second opinion. 

Clients are generally receptive to statements such as, “I don’t know the answer to that, but I’ll look it up and get back to you,” or “I would like to consult with one of my colleagues on this case.” Clients appreciate a doctor who is willing to take the time to get them an answer—whether they’ve been practicing for a month, a year or even a decade.

It is also essential for staff to remember that a lack of confidence is not the same as a lack of knowledge. New veterinarians may take longer to work-up their cases or may need to rely on colleagues or other resources frequently at the beginning of their career, and this is okay. These young veterinarians have a lot of information and are learning how to apply it as each case comes along. More often than not, they know what should be done or where to find the information and just want the reassurance of an experienced colleague. 

Confidence will develop more quickly for those who are in a supportive clinic environment with strong mentorship and an understanding staff.

2. There is a spectrum of Care

One of the biggest challenges many veterinarians face daily is working within clients’ financial limitations. As compassionate veterinarians, we must find a way to care for our patients and clients within their means. Sometimes, economic euthanasia is the best option, but many times, there are numerous alternatives between this and the gold standard.

At graduation, I knew the gold standard for diagnosis and treatment of many diseases; however, for many clients, the traditional gold standard was not financially feasible. I was fortunate to begin my career in a clinic with a wide array of clientele and learned how to offer numerous options without judgment. As my clinical skills developed and my experience deepened, my comfort level with the various options grew. 

When I first graduated, the fear of missing something serious like metabolic disease or a foreign body often led me to push for diagnostics in all cases presenting for vomiting. Now, while all my vomiting patients are still offered diagnostics, I find myself reaching for supportive care options first in cases with a mild, acute presentation and unremarkable physical examination.

When looking for a place to start a career, I encourage young veterinarians to decide where in the spectrum of care they would like to practice and find a clinic that supports that level of medicine and has a clientele that can afford it. With time, each veterinarian will develop their own comfort level within the spectrum of care.

3. Veterinary Medicine is a team sport and It may take Time to Find the Right Team

Many veterinary clinics call themselves a family, and many operate like one. Just like a family, some clinic teams are more functional than others, but a good team will come together and support each other when times are tough. I was lucky to find a great team right out of vet school, and I give them a large amount of credit in helping me become the veterinarian I am today. 

While the characteristics of a good team will vary for every individual, great teams share some common traits:

They celebrate achievements and give credit where it is due to all members.

They provide support when cases don’t end well and help each other to learn from mistakes without judgment.

They create an overall positive working environment.

They allow each member to grow and develop into the best veterinarian, technician or receptionist that they can be. 

After a year of practice, I left the team and clinic I loved to relocate closer to family, and it took a while to find another great fit. Leaving my second clinic was a difficult decision, but it allowed me to find my current superstar team, who I have no intention of leaving any time soon.

While it can be discouraging to work with a team that is a poor fit, young veterinarians should remember that they can move on. They will find a better fit. And it is not unusual for recent graduates to move between a few clinics before settling into a permanent position.

4. Setting Boundaries Isn’t Selfish

Setting boundaries is essential to thriving in this profession. While these boundaries will vary for each veterinarian, there are several types of boundaries that need to be established:

Separate work-life from home-life and learn to leave concerns about patients and case outcomes at the clinic to allow for complete focus on family, friends, hobbies and self outside of work.

Set expectations with the clinic in terms of working hours and how cases are handled when the primary clinician is out of the office. 

Find a clinic that respects personal time away from the office for all employees.

Learn to say no to those who are looking for free veterinary advice outside of the office. It is certainly fine to help a family member or friend, but don’t be afraid to say no or advise them to call during office hours.

I, like many new veterinarians, found leaving my cases at the office to be a particularly difficult boundary to set. Shortly after graduation, I managed two cases of Feline Panleukopenia from the same household. I sent my patients to the local emergency clinic for continued care over the weekend, but I worried about them constantly. On Sunday, I called the emergency clinic to check in. The ER doctor was happy to give me an update, but before we hung up the phone, he gave me some advice. He told me to relax and enjoy my time away from the hospital, and that it was his job to worry about the patients on the weekend, because I needed time to recharge for the coming week. I still go back to this conversation when I’m having a particularly hard time leaving worries about a patient or client at the office.

5. Not Every Client Will Like You

There will always be clients who don’t like a certain veterinarian, sometimes because of the way a case ended and sometimes for no identifiable reason. It can be startling the first time a client makes a complaint, requests not to see you in the future or writes a negative review on social media. Sometimes, these relationships can be smoothed with time and open communication, but other times, it will ultimately be less stressful to not see that particular client again. 

But those facts don’t make the initial insult hurt any less. My first boss assured me that I’d eventually have many more clients requesting me than those who were upset with me. Thankfully, that is now true. Sometimes, it is hard to remember the happy clients over the unhappy ones, but as the successful cases, thank you cards and gifts accumulate, it does get easier to find strength in the confidence of those clients who do appreciate the work we do. 

This list only begins to scratch the surface of the things I wish I’d known at the beginning of my career. I hope that my new colleagues will remember these lessons as they begin their journey in this wild, wonderful profession that we call veterinary medicine and add their own insights to pass on in the future. +

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