Is our divided profession a profession in decline?

Richard Halliwell is concerned by criticisms of the veterinary profession in the recent select committee report on a new Veterinary Surgeons Act. He fears that a lack of leadership and division within the veterinary profession may have contributed to loss of influence, and makes some suggestions for putting that right.     

Mental health in the veterinary profession: an individual or organisational focus?

The veterinary profession is experiencing a shortage of veterinarians, with attrition recognised as a substantial contributor. Research has also indicated increased levels of mental ill health and alarming suicide rates in practitioners. The primary aim of this study was to investigate the impact of eleven modifiable workplace factors on mental health outcomes, job appreciation and intention to leave the veterinary profession. The second aim was to ascertain whether workplace factors influence mental health outcomes after controlling for individual resilience. An online survey was completed by 73 practising Australian veterinarians. Unfavourable workplace factors correlated with adverse outcomes including depression, stress, reduced job appreciation and increased likelihood of leaving both the role and the profession. Workplace factors remained linked with the outcomes of job appreciation, depression and stress whilst controlling for practitioner resilience. Job appreciation was a significant predictor of intention to leave both the current role and the profession. Via multiple linear regression, two categories were identified as associated with improved psychological outcomes and job appreciation. These were workplace factors that represent breaks from workload and control or decision latitude in the workplace. Whilst resilience represents a key area for intervention, workplace factors potentially represent an easier-to-modify area for intervention.     

Gazing into the crystal ball: where should the veterinary profession go next?

The Foresight Report, published in 2007, provided a vision for the future of the veterinary profession. Many of the directions set in the report have already been remarkably accurate, but fiscal constraints stemming from the global recession that began in 2008 will have a significant impact on academia and on the future of the veterinary profession. Three primary forces will shape veterinary education in the coming decade: (1) the urgent need to lead an integrated approach to animal, human, and environmental health; (2) the continued information explosion; and (3) the challenge of delivering high-quality veterinary clinical training at a time of fiscal restraint. Despite economic woes and financial pressure, this is the time to rethink veterinary medical education. This article outlines these challenges and suggests ways to continue to evolve veterinary education.     

Anaesthesia in the fourth dimension. Is biological scaling relevant to veterinary anaesthesia?

Fundamental laws, such as gravity and thermodynamics, are in common use in the physical sciences but are less applicable to biology. However, although there are fewer biological laws relative to other disciplines, the ones that exist are of great importance, e.g. natural selection. Another example may be a new law of biological network design which explains observations on how metabolic rate changes as organisms change size. It has been known for some time that as animal size increases its metabolic rate falls ( Rubner 1883 ; Kleiber 1932 ; Adolph 1949 ; Schmidt‐Nielsen 1984 ; Calabrese 1991 ). This has developed from a physiological curiosity to a tool that is used extensively to predict drug effects across species ( Lave et al. 1999 ). The function of this article is to review the development of this concept, and to examine its application in veterinary anaesthesia.     

Is evidence-based medicine so evident in veterinary research and practice? History,obstacles and perspectives

Evidence-based medicine (EBM) refers to the conscientious, explicit and judicious use of current best evidence from research for the care of an individual patient. The concept of EBM was first described in human medicine in the early 1990s and was introduced to veterinary medicine 10 years later. However, it is not clear that the EBM approach promulgated in human medicine can be applied to the same extent to veterinary medicine. EBM has the potential to help veterinarians to make more informed decisions, but obstacles to the implementation of EBM include a lack of high quality patient-centred research, the need for basic understanding of clinical epidemiology by veterinarians, the absence of adequate searching techniques and accessibility to scientific data bases and the inadequacy of EBM tools that can be applied to the busy daily practise of veterinarians. This review describes the development of EBM in the veterinary profession, identifies its advantages and disadvantages and discusses whether and how veterinary surgeons should further adopt the EBM approach of human medicine.     

Occupational disability and job satisfaction in the equine veterinary profession: How sustainable is this ‘tough job’ in a changing world?

This study used a questionnaire to evaluate the working situation, associated injuries and diseases of equine practitioners in the Netherlands. Equine veterinary work is physically demanding, strenuous and predisposes to diseases and injuries. Despite this, male and female equine practitioners alike appreciate their jobs and hardly ever take sick leave. There was no cynical attitude towards their own profession, but there was awareness of the risks and physical consequences, which are more or less taken for granted by the contemporary equine veterinarians. The profession still appeals to new generations of young practitioners, at least in most European countries, but there is no guarantee that this will remain so. It is the task of the profession itself to anticipate the impending changes, by improving conditions for pregnancy and childcare, for example, and to put more effort in educating (future) equine veterinary professionals about their personal health situation and work‐associated risks. The objectives will be to attract well‐prepared professionals and veterinary entrepreneurs.     

Evidence-based complementary and alternative veterinary medicine--a contradiction in terms?

Complementary and Alternative Medicine (CAM) like acupuncture, herbal medicine and homeopathy is increasingly used in the treatment of human and animal disease. On the other hand, CAM is discussed controversially, especially in the context of Evidence-Based Veterinary Medicine (EBVM). This paper provides a balanced analysis of the currently available data on CAM in human and veterinary medicine. In conclusion, little rigorous research data concerning the efficacy and safety of CAM has been published. However, acupuncture is gaining increasing acceptance in academic medicine, based on several metaanalyses that show efficacy for specific conditions. In practice, decisions concerning CAM therapies should also be based on the best available evidence provided by scientifically valid data. This implies that CAM interventions must be validated by stringent high quality research to obtain an objective and replicable overview of efficacy and safety. Nevertheless, trials should be designed according to important aspects of CAM therapies (e.g. individual treatment). In conclusion, Evidence-Based Alternative Veterinary Medicine is not a contradiction in terms.     

Is it time to define veterinary professionalism?

The medical profession has spent much time and many resources engaging in a discourse of medical professionalism and debating the appropriate attitudes and behavior of physicians, but little has been published concerning the concept of veterinary professionalism. Physicians are commonly examined by social scientists and educationalists to establish definitions of medical professionalism in order to teach and assess these values within curricula. This challenging process has not been without criticism, however, with some calling the numerous definitions unhelpful, especially when these behaviors are not demonstrated in practice or the wider sociological implications of medical professionalism are ignored. Veterinary curricula often include professional skills, and there has been some discussion about their inclusion as well as the scope of veterinary surgeons and their role in society. Despite this, no true definition of veterinary professionalism exists, and the teaching of the values and behaviors expected of veterinary professionals may not be explicit. Regardless of the difficulties of engaging in such a discourse, perhaps it is time that this occurred and a realistic and usable definition of veterinary professionalism is established. This is a period of change for the veterinary profession, and a teachable and assessable definition can provide some clarity and assist educators within ever evolving veterinary curricula.