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Take Note: Jason Doll on the increased suicide risk for veterinary professionals

TN Jason Doll
Jason Doll
Dr. Jason Doll

Dr. Jason Doll is a veterinarian with a special interest in end-of-life and palliative care. A native of Happy Valley, he worked at VCA Metzger Animal Hospital as an associate after graduating from Tufts University in 2020 with a dual degree in doctorate of veterinary medicine and masters of public health. He currently lives in Portland, Maine, after relocating with Lap of Love Veterinary Hospice. Dr. Doll talked with WPSU’s Lindsey Whissel Fenton about the suicide crisis in veterinary medicine, about the stressors that contribute to it, and about the organizations working to provide education and support.

During the course of the interview, Dr. Doll mentions several resources:

If you are in crisis, the Suicide Prevention Lifeline is available for free 24/7; text or call 988.

Here’s the conversation with Dr. Jason Doll:

Lindsey Whissel Fenton: Welcome to Take Note. For WPSU, from my home studio, I’m Lindsey Whissel Fenton. For many people in caring professions, their work is more than a job; it's a vocation. Unfortunately, vocations in veterinary medicine can carry a significant risk. One out of six vets has considered ending their life. Compared with the general public, male veterinarians are 2.1 times more likely to take their own lives, while female vets are 3.5 times more likely. Our guest, Dr. Jason Doll, is a veterinarian with a special interest in end-of-life and palliative care. A native of Happy Valley, he worked at VCA Metzger Animal Hospital as an associate after graduating from Tufts University with a dual degree and Doctorate of veterinary medicine and Masters of Public Health. He currently lives in Portland, Maine, after relocating with a Lap of Love Veterinary Hospice. We'll talk with him about the suicide crisis in this industry, about the stressors that contribute to it, and about the organizations working to provide education and support for veterinary professionals. A couple notes: first, throughout this interview, we may say the word vet, and in this context, we are referring to veterinarians rather than veterans. And second, this conversation does include talk of suicide, so please take care while listening. Jason, welcome to Take Note.

Jason Doll: Thanks for having me. I'm so excited.

Lindsey Whissel Fenton: A lot of kids express a desire to be a veterinarian when they grow up, but not all of them follow through with it. Why did you choose to make the dream of working with animals a reality?

Jason Doll: Because I love people. Attached to every animal, whether it's the dog laying next to you, or a wild pelican, there's a human that really cares about them, and is sort of in charge of their health, even with those wild species. And so, just working with and trying to help those people that care about the animals the most, that's such a big honor. And of course, I mean, that that's what makes it messy. I think that's why we're talking today is the people are the best. But then they can also make situations the worst.

Lindsey Whissel Fenton: Bad situations are unfortunately, not all that unusual for those working in veterinary medicine. We're going to delve into what some of these challenges are, and how they contribute to the increased risk for suicide among this population. It's estimated that one out of six veterinary professionals has considered ending their life. How does hearing that statistic affect you?

Jason Doll: It makes it very, very scary. And very real. And honestly, I didn't realize sort of the impact that that has, until one of my classmates died by suicide a few months ago. He was in the class above me. And I knew him relatively well that my biggest memory was been on large animal rotation. It was like my second rotation. And I appreciate horses from afar. And he was just so supportive. So, to hear, hear that just made it so much more real, even though while making connections throughout vet school, and you get to see unfortunately, that this is not a unique situation. And I'm honestly so worried about when it's going to be someone in my class proper.

Lindsey Whissel Fenton: I'm really sorry to hear about your classmate. May I ask their name?

Jason Doll: His name was Peter Trip. He was great. And his partner, Chelsea, is also a veterinarian. And she's been doing amazing things trying to really celebrate it and try to make a positive out of such a, such a tragic thing as well. So, I definitely want to give a shout out to Chelsea because she's doing amazing and has really been trying to keep us informed of all the great things that she's doing in his memory.

Lindsey Whissel Fenton: This is a complicated issue, and there are many layers to it. What are some of the stressors that veterinarians or vet techs face that people outside the profession might not be aware of?

Jason Doll: So, some of the contributing factors include accessibility to care of the family, the emotional toll of that accessibility of care of allocation of resources, the debt-to-income ratio for both veterinarians and for veterinary technicians, as well as euthanasia being a completely acceptable form of treatment, and especially as of late, COVID restrictions can be can all contribute to the emotional toll of a veterinarian. And thank you for acknowledging the veterinary tech population as well. For those that aren't familiar with that term, we don't have nurses, we have superheroes. But we can't put that on a job description. So, we call them a technician. So, these are the people depending on the practice, they're the ones that pick up the phone first, because not every practice, it has the luxury of having receptionists or veterinary care coordinators. But they do, literally everything that a nurse can do, plus a social worker, plus radiology technicians, plus behaviorist plus, like working in labs like working with blood tissue, things like that, plus education, they do so, so much. And I think that that is a big, big part of why the veterinary field is in trouble, not just because there's a lack of veterinarians, but because that there is a lack of support staff as well. And that's something that I certainly dealt with at some of my former positions. We had enough doctors, but oftentimes, I would only have one technician or sometimes I'd be by myself, that was that was I think the toughest part is it wasn't just being a veterinarian, but it was being a veterinarian in a situation where you just don't have the support staff. And that's not good for you. Not good for the family, and certainly not good for the most efficient medical care.

Lindsey Whissel Fenton: One of the charges that is often levied at vets, for any variety of reasons, maybe you're booked and you aren't able to take a new patient or the family can't afford a treatment, is, “You don't love animals,” or “If you did love animals, you would treat them for free.” How does that affect you when someone says something like that?

Jason Doll: That's a that's a super that's a good question. That is tough when wyour sort of morals are questioned or are called slanderous things, which I have, it does affect you. But that's why I love veterinary medicine because the other parts of your team, the techs, the receptionists, even the custodial staff, like really are supportive of you. I remember the first time that happened when I was in practice, one of the technicians like I saw that I was at a car for a long time. And I mean, I have no poker face. And I, even though I was wearing a mask, and she like came over and said like, “Oh, you're needed inside for an emergency,” and like sort of saved me from the sort of emotional blackmail that I was getting from this family. And luckily, I was able to go inside compose myself, and then go back out there once I did that, and so I'm thankful for her. Thanks, Kayla, if you're if you're listening, and I just will always remember that.

Lindsey Whissel Fenton: Tell us about the costs associated with treating an animal. What kind of constraints are you up against as a provider?

Jason Doll: I think because a lot of humans and human medicine have insurance. They're like, “Oh, it's a $20 copay.” It's like, “No, you need to pay either 100% at service, or if they're being hospitalized or need a surgery, even 50%.” Again, every clinic is different of what if they allow payment plans, or if they accept other payment methods like care, credit, things like that, if they have an Angel fund, which are all questions that I implore people to ask, before you get a pet, but I think pet insurance is something that's becoming a lot more popular. That's something that I think folks should consider, but especially if you adopt an older pet, or one with a known health condition to have like sort of a pet safety fund. And, that I think is super, super important.

Lindsey Whissel Fenton: You mentioned older pets. That brings us to euthanasia, which is a unique aspect of veterinary care that other professions don't have to grapple with. I can say, from personal experience, that the decision to put a beloved pet down is excruciating for the pet owner. And I imagine it's also tough on the care provider. I heard one vet say, “When we put an animal down, we know that it's one of the pet owner’s worst days ever. We see everyone's worst day ever, over and over and over again.”

Jason Doll: And that's honestly my reality of every day. People ask me all the time, “Does it get easier?” Of course it doesn't. But I am so honored and lucky to be with someone on that worst day, too, as a family told me once to make a sucky day suck less. And that's honestly what I'm there for. And to experience every flavor of grief is just really humbling. And for me too. I mean, if we break down the word euthanasia, that means it could die. If and a big thing for me, as somebody that I asked almost every family that I visit is, how do you want their last days to be like, is it important for you to be there with them? And 10 out of 10 family say yes. So to have something controlled, especially in conditions, where you're saving them from respiratory distress, or complete paralysis, or, or becoming unconscious, because they're becoming anemic due to a bleeding mass, it's just knowing their reality, especially for my hospice families, I literally draw out timelines of each condition they're living with, whether it's diagnoseable, like whether it's formally diagnosed, or whether it's a symptom, it's like this is how the end would be, what would have them pass away, or what would warrant an emergency visit. And then again, we sort of put like, where we think, again, it's a continuum of where we think they are. And then sometimes we're on two sides of sheets of paper. And then at the bottom, like, I don't care where they are in here, but then I put like a big equal sign at the bottom. What does that mean for the quality of life? At the moment, and then we talked about as we're going up there, because a lot of the time just like we can't go the other way, we can only go this way. So that's something that I always try to talk to them about. And I think just seen all that they're doing. When I talk about at least the founders of Lap of Love, Dr. Dani and Dr. Mary, they talk about sort of the expenses that the family doesn't, that's just not just not monetary. I, I created this little acronym called like taking the TEMPof the family, which it's like, like, it can be a little more painful than most people realize. So T is time. E is sort of the is the emotional toll, the emotional expense that you're doing is monetary. And then P is physical; if you have 100-pound curvy lab that is having difficulty getting up, are you able to sling them to take them outside are able to shift them over so they don't get ulcers or develop a urinary tract infection? And again, every family is different. And that I think is what is beautiful about veterinary medicine. But I think that we have the luxury, that an acceptable treatment is euthanasia is just so, so wonderful that we can really give them the final moments that they deserve. That's peaceful with their family in their favorite place. I've helped families helped angels transition under a trampling twice. So, it's really wherever is most comfortable for them, even if it's just in their arms or in their lap. I mean, that's why we're called Lap of Love is because Dr. Dani, when she was in the ER a woman said, like, “Oh, I don't want my, my angel to be on a cold table. Could could they be in my arms?” And she's like, “I don't see any reason why not. If that's where she's most comfortable and you think she's most comfortable, absolutely.” But to have something controlled. In an instant, I would rather have it be a day, a week too early than a moment too late.

Lindsey Whissel Fenton: If you're just joining us, this is Take Note on WPSU. I'm Lindsey Whissel Fenton and our guest is veterinarian Dr. Jason Doll. We're talking about mental health among veterinary professionals and about the increased risk of suicide for people working in this field. Jason, we talked about some of the intense emotions that can be involved when treating a sick animal, and how those feelings can get projected on to the veterinary care team. In this day and age, emotional responses can live on beyond that initial interaction. Many of us use the internet to help us decide which service providers we want to use. So, if someone feels anger toward their vet and goes online and writes a negative review that lives on in perpetuity, what kind of impact does that have on the veterinary community?

Jason Doll: It it's very destructive. It's I always find like leaving reviews for medical professionals on a non-medical professional site to be really tough. I mean, obviously, like you're dealing with people so things all honestly always aren't going to be perfect. But I think too. I think this goes for Anything for anything that you're reviewing, if you don't address the person directly or the team directly, how are they going to get better? So, saying slanderous things I think on either side. I know the veterinary community is not immune to this either for doing it, but I think for a family to say things like that, again, emotional blackmail, like, “Oh, they don't care.” You don't know that. Or, “It was too expensive.” Like, I mean, the veterinary medicine, unfortunately, is expensive, and that you're the responsibility of the pet owner, to be aware of that. So, I think careful planning before that, is really, really important. But I also think the veterinary profession is important for that to honestly, itemized lists are good, like, this is where everything was going into. And then you can clearly see oh, this is for the drugs, this is for, to keep the lights on to keep the machines working. Because in terms of the salary, veterinarians and vet techs are well below any other professions, the debt-to-income ratio of veterinarians is, is astounding. And that's, that can be daunting. Yeah, the top veterinarian, like highest paid veterinarians, like barely match up to the lowest paying human physicians. And vet techs, that's, it's not sustainable. And that's why a lot of them are leaving the field, even the ones with formal training, are leaving the field because it just is not sustainable at all, and a lot of them are, are barely making minimum wage, if that.

Lindsey Whissel Fenton: When you go back to these online reviews, a lot of clinics, veterinary clinics are really small businesses.

Jason Doll: Well, and that's what I feel like that's the quagmire is that families want, “Oh, like, we want a vet that really listens to us and doesn't just see us as a checkbook and everything.” But then you're not supporting small businesses. There's especially during COVID, there is a big movements, like support local. And, but they're not that a review, like that is not supporting local, you know how inflammatory that can be to a small business. Or even if it is part of a big corporation, those are your neighbors.

Lindsey Whissel Fenton: If a pet parent is not happy with the care their pet is receiving, how can they communicate that feedback to their veterinary team in a compassionate, respectful way?

Jason Doll: I think the way that you would for any other conflict in your life, I think to say, “Hey, could we have a follow up call?” And I mean, the conflict management says like to create a time and to like a discrete time and to and to stick to that to just because in the moment, the busyness or I mean, you're dealing with a sick pet as well. So, it's like, you need to do that. But I think to say, “Hey, could we talk to, to the vet, like at a different time, like a call or even something sit down as well?” Just to just to mention that just since I think in the moment, it's gonna be really, really tough. So, I think to talk to them directly to understand why this happened. Why it costs this much, and sort of what what the what we're on both ends, the expectations, because that's the biggest thing of why conflict is like that. It's not that there's a right or a wrong usually, but it's just the expectations are coming from two different standpoints.

Lindsey Whissel Fenton: How open are people in the profession with each other about mental health? Is there much support?

Jason Doll: There is. Luckily, I mean, it's a small community. But there's been a lot of organizations that have sort of popped up even throughout my sort of journey through veterinary medicine. I think one of the most well-known is called Not One More Vet, that was established in 2014, after the passing of a wonderful behaviorist, Dr. Sophia Yin, who died by suicide. And one of her veterinary friends and colleagues started this. So, it's been it's very supportive. I joined their group after I graduated, and it's been a nice sort of pocket of resources, but then also hearing stories to an experiences of that as well. I've become more active in a couple other organizations, one called Pawsibilities that a poultry veterinarian Dr. Valerie Mercado started. And then MentorVet that Tennessee based veterinarian named Dr. Addy Reinhardt. And that's been very helpful. For me. Pawsibilities is more based on diversity in the veterinary field. So, being an being in the LGBTQ community has been very nice to have that support as well. And then MentorVet, that's more taking newer grads, we're on a Zoom call once a month, to talk about different readings or ethical dilemmas, things like that. And then you're paired with someone that's already been through the program. So, I mentor and I talk about once a month, and I'm excited to be on the other side of that, since that program is ending from there. And that's funded by Merck Animal Health, which is really, really cool to see one of the big laboratory organizations were the big stakeholders that provide a lot of the veterinary pharmaceuticals testing, things like that to be so supportive about veterinary mental health. So, we're going in a, in a good direction, it's just I don't know, the field itself, how sustainable, it's going to be, especially with COVID, how many pets were adopted. And because of the backlog of vaccine schedules or being able to establish the regular vet or socializing, we're seeing a lot of a lot of issues, unfortunately, with that, and I just I don't know, which were the direction of the field. Hopefully, it's sustainable. I'm very happy where I am right now. And so, I'm very thankful.

Lindsey Whissel Fenton: What is something or maybe even a couple of somethings, that someone listening to this, who doesn't work in veterinary medicine, but interacts with those professionals—what's something we can do to support those superheroes in our lives, who are caring for our fur babies?

Jason Doll: Be patient and proactive. I think are the two big things we always love. Just like dogs, we love surprise treats. Whenever you can, again, that's not a necessity. But I think to take those moments to be like, “Hey, you're doing a great job,” or “I really appreciate what you're doing.” A little of that can go such a long way. And again, I think being proactive to, again, we're happy to take calls. Just because it's hard, an emergency to have a pet owner sometimes does isn't congruent to an emergency visit at the moment. But I think any veterinary hospital would be happy to take the call to help guide you into a time when it would be or if they really think that, hey, you should come in now this is the situation that we're dealing with, again, set up those expectations. And doing that, too. Honestly, my favorite thing is when family members type out, like questions like I saw, like I had a puppy visit where they literally had a packet of probably 40 questions and I was like, “I will return this to you. And the next day or two because I can't do it right now. But I'm not going to like not fill it out.” And I was just like this is helpful, because this shows me where you are. This is the all the googling you could be doing. Again, Dr. Google did not go to veterinary school. No formal training. And I think that that's the tough thing and providing those resources to or I would, upon discharge be like, “Hey, I know you're going to Google this or you've already Googled this as we were taking care of your angel and giving them meds or what not. Here's the resources that I use.” And again, there's so many wonderful family accessible resources. I mean, I've printed out scientific papers for families, because that's something that that helps them process all of this, too. But I think to again, have expectations on both sides is so important. And for yourself, too. This is a tough world we're in this is a tough profession. But don't be tough on yourself.

Lindsey Whissel Fenton: So, you said proactive and to clarify what I think I'm hearing is you mean proactive in terms of planning and scheduling appointments as much in advance as possible, proactive in preparing for those appointments, and then earlier, you talked about savings, so proactive with financially factoring in you're animal’s care.

Jason Doll: Proactive like that, taking the TEMP that I talked about before. So being proactive about that is like, Okay, I mean, obviously, no one can plan for an emergency. But it's like, okay, if I have a vet visit, like, again, normally, they're 15 minutes to an hour depending on it. So, when they make that be like, “Hey, what does the day look like so far?” Like when they say like, “Hey, you have an appointment for Wednesday. It's Monday now,” I'd be like, “Hey, how does that look so far? Obviously, I know things can change. But how much time? Should I do that?” And also to be like, “Oh, are you doing curbside right now?” Just to, again, set those expectations. And again, the person answering those calls, will probably not be the veterinarian. But I think even to be like, “Hey, could I have a five minute call with them or an email or, or whatever,” you're like, I give families my work cell phone number, which I know is not something that they do. And I text them sometimes, especially weeks months afterwards to check in of how they're doing. But I think that setting those expectations is important.

Lindsey Whissel Fenton: What message would you give to someone who is working in veterinary medicine and might be struggling right now?

Jason Doll: You're not alone. You have a community. And there are bodies here that can help you. But you're not alone. And you matter. And we're here for you.

Lindsey Whissel Fenton: Jason, thank you for talking with us.

Jason Doll: Oh, thank you for having me, Lindsay. I really, really enjoyed it.

Lindsey Whissel Fenton: Dr. Jason Doll is a veterinarian with a special interest in end-of-life and palliative care. To learn more about the suicide crisis in this industry, to seek support or to find out how you can help visit wpsu.org/takenote. If you are in crisis, help is available. You can call or text the Suicide and Crisis Lifeline at 988. It’s available for free, 24/7. From my home studio, I'm Lindsey Whissel Fenton WPSU.

Lindsey Whissel Fenton is a senior producer/director at WPSU. An award-winning storyteller, she has explored a wide range of issues through her work in public media. Most recently, she produced and directed Speaking Grief, a multi-platform public media initiative that works to create a more grief-aware society; she continues to produce content for the project's social media presence.