My encounter with a superhero

November 13, 2019
Melissa Detweiler, DVM

Dr. Melissa Detweiler practices full-time in rural northeast Kansas. She also has a full-time husband (whom she practices with) and three full-time kids. In her spare time, she feeds the creative side of her brain by writing, blogging and podcasting. She also enjoys running, gardening, fishing and travelling to warm, sunny beaches. Dr. Detweiler can be found online at thisvetsvoice.com and dvmdivas.com or by email at melissa@dvmdivas.com.

I stumbled into a moderation job for Katherine Goldberg, DVM, LMSW, and inadvertently opened my eyes to a big need in the veterinary profession.

Christin Lola/stock.adobe.comeI glanced through my room assignments as moderator at an upcoming Fetch dvm360 conference, and one of the tracks threw me for a loop: Veterinary Social Work?

Huh. Interesting.

In my unenlightened state, I envisioned cases of pet abuse and animal hoarding, home visits for neglected children and drug abusers, because that's what “social work” meant to me. My assumption? Veterinary social work must be for those clinics in big urban areas with a much different caseload than mine.

Imagine this scenario: An animal is left at your practice by the pet owner for a routine procedure. You do everything “right.”  All pre-op screens are normal. Dosing and monitoring are perfect. The procedure is performed flawlessly. But the pet doesn't wake up. It codes during recovery, and you have to make that phone call.

Now you're faced with an angry and confused client. They're beyond consoling, screaming malpractice. They recruit the internet army and blast you on social media. You recognize that their behavior is 100% based in grief and that their loss is the motivator. But you're a veterinarian, not a therapist or counselor. Your feeble attempts at defusing the situation only make things worse.

There must be a better way. So … what if there were a superhero in your corner with the letters “LMSW” (licensed master social worker) printed on her chest? What if she was dually licensed in veterinary medicine and social work? What if she was able to counsel that grieving client so you could move forward with your area of expertise-being a rock star veterinarian? What if?

Let me introduce you to Katherine Goldberg, DVM, LMSW.

She wasn't wearing a cape when I met her, but within minutes of hearing her speak, she blossomed to hero status in my view. Dr. Goldberg is a veterinarian who came through the ranks of small animal internship training, private referral and academic emergency and critical care, racing towards an E/CC residency-but it was not to be. Additional time in the ICU after failing to match (thank you, “failure”) led to her seeing closely the ethical considerations of critically ill patients and the effects that providing that care had on the families who loved them.

Over several years, Dr. Goldberg shifted her veterinary focus to hospice and palliative care. Eventually, her passion for family-centered end-of-life care inspired her to become a licensed social worker and form an affiliation with the Veterinary Social Work Program at the University of Tennessee. Now, her practice, Whole Animal Veterinary Geriatrics and Palliative Care Services, focuses solely on consultation, education and mental health support. Hence, superhero.

Spending the day with Dr. Goldberg gave me a glimpse of possibilities for our profession. I learned that veterinary social workers have a mission to “attend to human needs at the intersection of veterinary and social work practice.” The first line of their oath reads, “I pledge my service to society by tending to the human needs that arise in the relationship between humans and animals.”

Wait? Human needs? Aren't we in this for animals?

Veterinarians clients need mental health support-and so do you

I asked Dr. Goldberg about the all-too-familiar sentiment that veterinarians like animals more than people and how this affects our wellbeing. Her answer was straightforward: “It represents a massive misalignment of expectations and reality.”

The patients seldom come alone, she emphasizes.

“Veterinary patients are not making their own appointments, driving themselves to veterinary hospitals, paying for their own care or making decisions about what that care looks like,” she says. “Veterinarians are caring for animals, yes, but they're doing it only through interactions with people. There is no area of the veterinary profession that doesn't involve human-human interactions.”

The veterinary profession needs to explore its identity as “human-helping” in addition to “animal-helping,” according to Dr. Goldberg. A major shift happened, she says, when she realized that "veterinarians can't positively impact animal welfare without influencing human behavior."

However, this doesn't mean veterinarians are generally qualified to fill the role of counselor in their practices. Dr. Goldberg thinks it starts with the schools and advocates for "interprofessional collaboration in veterinary teaching institutions with mental health professionals who have expertise in all domains of veterinary social work so that these aspects of veterinary medicine are supported." Others agree. The Association of American Veterinary Medical Colleges (AAVMC) now recognizes that veterinary mental health professionals (VMHPs) are “integral to the veterinary education system.” It's also why places like the University of Tennessee are offering specialized veterinary certificates for social workers.

Do these veterinary social workers only help clients?

Not at all. Their role in a practice or hospital is to help all the humans, including the ones wearing scrubs. Remember our opening scenario, where your patient died and your clinic came under attack? Or that time when you were called to euthanize the only companion of an aging widower? Or when you had to consult on an aggressive dog terrorizing children in a neighborhood (as well as your veterinary team), and the dog's owners refused to do anything about it? These are just a few of the stressors that contribute to moral distress, compassion fatigue and burnout.

Dr. Goldberg points out that while "veterinarians haven't cornered the market on distress," there are challenges that are unique to the veterinary world. "Without a doubt," she says, "the ethical terrain of our profession is the most unique influencer of veterinary professional wellbeing." Having a VMHP available to you and your team could be a game-changer.

So how does a veterinary practice get access to a VMHP? First, visit vetsocialwork.utk.edu to locate a veterinary social worker in your area. If there aren't any, the website provides tips for contacting local social workers and mental health professionals with an interest in the human-animal relationship. There are also training modules for purchase to learn more about the four key areas of veterinary social work: 1) animal-related grief and bereavement, 2) compassion fatigue and conflict management, 3) the link between human and animal violence and 4) animal-assisted interventions.

We all know the current statistics: The word “crisis” has become common vernacular among veterinarians when discussing mental health in our profession. Yet the data show that we don't have higher rates of mental illness than the general population, and we aren't entering this profession with higher rates of psychological distress. Somewhere along the way, we experience diminished wellbeing compared with non-veterinarians-some of us more than others-and too few of us seek help when distress arises.

Perhaps it's time to use the tools and people (ahem, superheroes) equipped to lead us into a new future. Maybe we should be striving to bring more humanity to the veterinary world.

Dr. Melissa Detweiler practices full-time in rural northeast Kansas. She also has a full-time husband (whom she practices with) and three full-time kids. In her “spare” time, she feeds the creative side of her brain by writing, blogging and podcasting. Dr. Detweiler can be found online at thisvetsvoice.com and dvmdivas.com or by email at melissa@dvmdivas.com.