Episode 66 | The Veterinary Care Cycle: Stay In Your Lane & Improve Your Career

In this episode I share about the categories of Vet Med Stress and explain how trying to control facets of the veterinary care cycle outside of our control contributes to frustration, anxiety and burnout.



  • Categories of Vet Med Stress
  • Veterinary Care Cycle
  • Responsibilities of veterinary professionals, clients and patients
  • What falls outside the scope of responsibility of veterinary professionals


Vet Life Academy


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So if they decline what you recommend, that doesn't make them bad pet owners and that doesn't make you a faulty veterinary professional for not being able to talk them into it. That's not your job. I'm Dr. Cari Wise, and this is The Joyful DVM Podcast. Hey, everybody, welcome to episode 66. And this episode, we're going to talk about the veterinary care cycle and specifically how,

if we stay in our lane, we will improve our overall career experience. Before we jump into that, I want to take just a second to talk about the things that tend to stress us out in veterinary medicine. There are a group of stressors that really everything else that happens can fall into. So a group of categories, if you will, those categories include human interactions,

unexpected events, personal inexperience, prior decisions. And then on top of that, our belief systems, our personal narrative and our sense of hyper responsibility, those things together account for all of the stress and anxiety that we experience in this career field. If we take a look, then at the veterinary care cycle, we can start to see how a lot of this comes to be.

The veterinary care cycle is simply that relationship between the client, the doctor, or veterinary staff and the patient, and what happens with any given appointment that is the cycle of care. So the client makes an appointment. They come in and they see the veterinary care team. The ambient of the animals evaluated. There is a plan made a plan implemented, and then eventually the pet goes home one way or the other.

That's very broad sweeping, but that's what happens within an appointment cycle. If you will, there are three main players in the veterinary care cycle. Those players are the veterinary health care team. So the veterinarians, a veterinary technicians, the receptionist, the assistants, all of the people within the organization, that's the veterinary healthcare team. That's player. Number one,

player. Number two is the client. So the pet owner, and sometimes there's more than one, right? And then player number three is the patient itself. Those are the three pieces in the veterinary care cycle. When we start to overlap responsibility between these three pieces, that's when everything gets really hard. The client is kind of in the middle. When we look at these three players,

the client's the one taking in the information that we provide and making the decisions. Then for the pet, the client can't make the pet better any more than we can make the pet. It's the pet's job to respond or not to the treatment that is provided. We don't control physiology. This is one of the areas that we tend to step out of our lane.

We think as veterinary professionals, that what we do makes a pet get better or get worse, but friends, weren't just not that powerful. Our role as veterinary professionals in this veterinary care cycle is simply to make a medical evaluation, to provide information and options. And then to let the owner decide the decisions are not ours to make. That can be really hard for us.

And this is where it all gets a little muddy and gray because as veterinary professionals, most of us are also pet owners. And so we come into these interactions with our clients, with our own personal opinions and agendas, what we would do if it were our pet, and when the clients decide differently for their pet, that has an opportunity to create a lot of drama and frustration for us.

You know, that gap between expectation and reality popping up again, if we'll just remember to stay in our lane, by reminding ourselves that the decision is not ours to make, nor is it hours to judge, then this part gets easier. Just focus on what you're there to do to, to make a medical evaluation. So good physical exam, good history,

and then to make a medical recommendation. This is that treatment plan. The estimate, all of that kind of stuff goes into that. You're going to make a recommendation for care, and then you just have to step back and let the client decide because that part of the veterinary care cycle, where the decisions get made on how to move forward with treatment,

those decisions are not decisions where the veterinary health care team to make. Those are the decisions that lie in the responsibility of the client. Now, for sure, sometimes clients are going to ask you, well, what would you do if it were yours? And you can answer that question, however you want to. There's no right or wrong answer here,

but ultimately they get to decide, and we only create suffering for ourselves. When we judge their decisions, we also create suffering for ourselves. When we have an opinion of the outcome of the patient, through the lens of the client's decision, if they had chose differently, the pet would have gotten better. That's something that many of us think, but it's not true.

We have no way to prove that the way that an individual animal is going to respond to treatment or even lack of treatment is not something we can control. There are tons of animals in the wild that survive illnesses every single day, the body is an amazing thing. It has an amazing capability to heal itself. We step in and we intervene because that's our job,

but is it always necessary? I don't know. Sometimes it seems like it really is. And other times it just really isn't, we've all had those cases where the owners have declined everything taking the back home, and then we've seen the animals six months later. And it's completely fine. Makes no sense. We probably were pretty frustrated at the time when the owner left AMA I guess medical advice,

we probably had a lot of conversations around that and our judgment of their decision. But then lo and behold, six months later, he comes to the pet. So who was right and who was wrong? My point here is that nobody is right and nobody is wrong. There are three players in the veterinary care cycle. There is us as medical professionals who are going to make an evaluation and make a recommendation.

And that's where our responsibility really ends. We're going to make a recommendation and we're going to let the owner decide. What's the owner decide how they want to proceed. Then yes, we stepped back in. We implement their wishes and of course there's opportunities for us to make mistakes there, to be human. And that's why we have liability insurance and things like that.

But as we do our part, we have to then together the client and the veterinary healthcare team step back and just wait. The response to that treatment is not something that we as veterinary professionals or they, as pet owners can control. It is simply the individual physiology of the animal that responds to treatment or doesn't. And as we wait to see how it's going to respond,

that period of time can be really uncomfortable. And we amplify that discomfort when we layer on judgment over the prior decisions. So when we judge the clients or what they decided to do or not do, when we judge ourselves for the way that we cared for the pet, or we judge our coworkers for the way that they interacted with the case, that's where we create a lot of suffering and struggle for ourselves.

But once that time period has passed and we have the opportunity to evaluate the pet. Again, we get new data and the whole cycle starts over. When we're evaluating that pet as a recheck or right back at the beginning, we're making a medical evaluation, we're making, we're providing information and we're making a recommendation. And once again, there's the part where the client gets to decide how they want to proceed for their pet.

We then implement their wishes and we all wait and see again, the veterinary care cycle does not have drama, innately, woven into it. That's the part that we create for ourselves. And so we look at the things that tend to create a lot of stress and anxiety and veterinary medicine. We notice that it's a human interaction and a decision and a belief system,

and our own sense of hyper responsibility that really amplifies the frustrations for us that amplifies the discomfort in negative patient outcomes or negative client interactions. How the client responds to what you recommend is irrelevant. They get to do whatever they want to do. They get to believe whatever they want to believe, but that doesn't make your medical any less valid. It's simply their opinion.

Their decision is also their decision. So if they decline what you recommend, that doesn't make them bad patterns, and that doesn't make you a faulty veterinary professional for not being able to talk them into it. That's not your job. Her job is not to talk people into doing stuff. Our job is to give them all the options. And I mean,

all of the options, a lot of us have so much discomfort was what we would label as confrontational conversations that we try to guess what they're going to agree to before we ever present them with their options. Many of us would actually start to pull things off of a treatment plan and decrease prices because we anticipate a conversation about money. That's going to be an uncomfortable conversation.

We think we know what they will and won't pay for. That's not our role. Our role is to give them all of their options and then to let them decide. Oftentimes there's some back and forth as we work with their budgets, but we don't need to start out carving things away to try to make the conversation go easier. When we do that,

that's just an indicator for us that we aren't willing to feel uncomfortable, that when we believe other people are uncomfortable, that makes us uncomfortable. And we're trying to control their emotions with our actions. But friends think, feel, act the way that they react to your treatment plan is based on their thoughts. And that's not something that you are ever going to control.

So don't try to control it. Don't try to create a perfect treatment plan. That's going to create a perfect reaction from your client. It's just not possible. That's not our role, our role isn't to make sure that the clients are always happy. Our job is to make sure that we give the options to the client and let them to decide. When we start to tango in the client interaction piece,

to the way that we do our job, our job gets way more complicated, but if we'll just step back and stay in our lane, if we will just allow ourselves to do the part that we're actually there to do, which is to make a medical evaluation and then make those recommendations to the clients, then everything gets easier because we only need to do that part.

And then we can work on our own stuff. We can work on why it is that we feel so uncomfortable when people don't choose the things that we would recommend. We can ask ourselves, why is it that we are really avoiding conversations that we think are confrontational. There's actually no confrontation at all and presenting a treatment plan, but our mind would have us believe that it's a dangerous situation.

Let's work on that. Let's work on the parts that we can control, because until we're willing to go into those conversations, to lay out all the options for our patients, to what the clients react, however, they're going to react until we're willing to do that. We're never going to serve the patient at the highest level possible. The patient does not benefit when we carve away our recommendations for fear of the client's reaction.

We've got to remember, we're there to serve clients and treat patients. And the only way that we can get to the patient is through the client. And even though there are going to be times when those clients are not going to agree to the things that you recommend, it's still your job to recommend them. That's how you can sleep better at night.

If your mind wants to grab onto that and start to tell you that if you had done a better job, that they would have agreed to more, that's just nonsense. There are things that we can do individually to work on managing our mindset so that that lower brain doesn't pull us down into the, that downward judging spiral. That's a dark and really frustrating place to be.

It certainly fosters the imposter syndrome that many of us suffer with, but it's not true. Your job isn't to make the client happy. Your job is to simply evaluate their pet and to give them recommendations, and then to follow through on what they decide to do in that moment, when they come around again, that whole cycle starts over. So just stay in your lane.

Remember you're there to serve clients and treat patients in the way that you do that is by making a medical evaluation, providing information and options, and then taking a step back to let the client to decide. Then you step back and you implement their wishes. And then everybody has to wait and see how the patient responds, stay in your lane. And remember that the boy,

the patient responds to treatment is something that you will never control, that you can do everything right, and still have a patient crash and burn, or you can do nothing at all and have a patient rally and survive that we aren't that powerful. And it's not our job to fix anything. It's simply our job to give recommendations and to implement wishes and then to wait right alongside the pet owner.

As we wait to see how that patient responds, I hope this helps as far as clarifying what our job is in veterinary medicine, so that you can have a little bit of relief and the responsibility that you may feel about patient outcomes and the way that clients interact with you. Those things are things that you won't ever control my friends. So they do not deserve the attention that we often give it.

And the looping thoughts and the anxiety that we create as we remember that we're there to simply evaluate, provide information and implement decisions. Then I promise you the relief that comes starts to come quickly, and you will actually start to enjoy your job again, because you'll start to release that hyper responsibility over the things that you'll never control. Keep this in mind as you go into next week.