Substance Abuse: A Culture Of Denial
|Veterinary Practice News Managing Editor Somyr McLean Perry contributed to this report.|
Veterinary medicine is the only U.S. medical profession that does not have a national monitoring program for substance abuse and mental health issues. Considering that medical professionals in general have a statistically higher incidence of suicide, drug and alcohol abuse, many who are passionate about veterinary wellness are asking why DVMs are excluded.
Authorities say they’re concerned not only for the health of those in the veterinary profession, but for the animals they treat as well. Even basic questions on the issue go unanswered, as no comprehensive, large-scale study of veterinarians and substance abuse has ever been conducted in the U.S.
“Veterinarians in need of assistance fear losing their license and the stigma attached to suffering from an addiction or mental issue,” said Jeff Hall, DVM, a self-described recovering addict who formerly chaired the American Veterinary Medical Assn. Wellness Committee.
“There isn’t an updated national support database of veterinarians, there isn’t a hotline. There isn’t a catalog of animals harmed by a compromised veterinarian or technician, there’s no statistic that shows veterinarians or staff who succumb to addictions or depression,” Dr. Hall said.
“No one is expressing an interest in gathering this information for the profession. Veterinarians have to fight for the same programs that have been automatically granted to other professions for years.”
Hall is a consultant at St. Jude Medical, a cardiovascular medical technology company in St. Paul, Minn., where he creates medical devices used in human medicine. He said that although addictions can make a person feel ostracized regardless of profession, veterinarians should have support from colleagues.
“AVMA dropped the ball in creating a program to address addiction issues,” he charged, citing “lack of acknowledgement of a significant problem within the profession.”
“In 2007, addictions cost the economy $185 billion,” said Herbert Munden, M.D., director and founder of Austin Addiction Medicine Services in Austin, Texas. “Chemical dependency is an equal-opportunity disease, affecting the dependent individual and all who surround him or her, and the veterinary profession hasn’t escaped this.”
The lack of acknowledgement that veterinarians suffer substance abuse is only part of the problem.
Veterinarians also seem to be more difficult to reach for preventive education, said Gregory E. Skipper, M.D., a fellow of the American Society of Addiction Medicine. Skipper is the medical director for the Alabama Physician Health Program and the Alabama Veterinary Professional Wellness Program. This state program seeks to aid in the early detection and treatment for veterinarians with drug or alcohol abuse, depression or other mental wellness problems without risk of disciplinary action.
Every two years, Skipper’s group visits hospitals and clinics in Alabama in an outreach effort to educate physicians on mental wellness and substance abuse awareness. They have not been able to reach veterinarians in the same way.
“We think the reason they are more difficult to reach is that unlike physicians, who frequent hospitals where they obtain much of their continuing education daily, and where we can give talks, veterinarians are more isolated in their private clinics, especially veterinarians with mental health problems,” Dr. Skipper said.
“Troubled vets especially seem to become reclusive, and their employees are reluctant to report them. Therefore they are more seriously ill by the time they come to our attention. We have empirically found that veterinarians are much more troubled and advanced in addictions or mental illness before they are finally reported,” Skipper said.
Hall received his DVM in 1977 from Cornell University and practiced veterinary medicine for nine years before entering a program for alcohol and drug abuse.
Twenty-two years later he still labels himself a recovering addict, saying that mentally and financially, he couldn’t continue practicing during or after he completed a six-month program. He said he decided to take control of his life and career by entering corporate America and forming Veterinarians in Recovery, a national support network for veterinarians in recovery from alcohol and drug addiction, providing support and referrals.
“In 1986, I went through a brutal divorce and had a relapse,” Hall said. “The experience gave me incentive to initiate Veterinarians in Recover in 1990.
“Society hasn’t yet grasped that addiction is not compromised morals, it’s a disease. As part of my recovery plan, I went to Minnesota to first flip burgers, sell ice cream and stay sober. After six weeks with direction from the treatment center, I began teaching at the Medical Institute of Minnesota in Minneapolis.”
Hall has stopped updating his network of veterinarians for now. He said the time and cost involved in keeping information current makes the job impossible for one person to handle. But he continues to thrive professionally, holding more than 20 patents dealing with cardiac defibrillation.
In February at the Western Veterinary Conference in Las Vegas, Denise Tumblin, CPA, president of Wutchiett Tumblin and Associates in Columbus, Ohio, a veterinary practice management company, lectured on why practice managers fail at their jobs.
She quoted from a survey conducted by her company and Veterinary Economics in which 100 veterinary practices across the country were surveyed. Among those practices, 14 percent of veterinary practice managers left practice because of substance abuse issues.
“The veterinary profession is way behind all other medical professionals’ comprehension of the need for a standardized veterinary wellness program,” said Jerome Williams, DVM, chairman of the Alabama Wellness Committee and owner of Red Mountain Animal Clinic in Birmingham.
The Wellness Committee supervises the Alabama Veterinary Professionals Wellness Program. Its members are nominated by the Alabama VMA and appointed by the Alabama Board of Veterinary Medical Examiners.
“Nothing will be done until there is an overt crisis over a compromised veterinarian committing an egregious crime,” Dr. Williams said. “There’s ignorance and a lack of commitment at the leadership level when it comes to veterinary wellness.”
Without a national program to guide them, individual state veterinary medical associations and state veterinary medical boards are left to cope with veterinarians needing help. But only a few states have coordinated wellness programs.
Skipper suspects that many associations want and value life balance for their members but the average veterinarian doesn’t believe drug and alcohol abuse is common in the profession. Because of this, he said, the associations aren’t sure they want to spend the money.
State VMAs’ Programs
Veterinary Practice News asked state veterinary medical associations about their programs through the American Society of Veterinary Medical Association Executives Among responses:
“The IVMA proposed changes to the Indiana Veterinary Practice Act during the 2008 Indiana General Assembly,” says Lisa Perius, executive director, Indian Veterinary Medical Assn. “In that, we have added provisions for the IVMA and the Indiana Board of Veterinary Medical Examiners to provide a monitoring program for substance abuse. The new law went into effect July 1. We plan to move forward with making this happen.”
“South Carolina’s Recovery Professionals Program is administered through one of the state drug and alcohol treatment centers,” says Marie Queen, executive director. “To my knowledge, SCVMA has never discussed having its own program.”
“Neither the VMA or Board has a veterinary substance abuse program,” says Tracy Thomas, administrative assistant for the North Dakota VMA. “Significantly limited financial resources means our state cannot support a substance abuse program.”
The Kentucky Veterinary Medical Assn.’s program has been in existence for about 20 years, but was a discrete volunteer program that assisted veterinarians, family and staff when they contacted the committee,” says Louise Cook, executive director, KVMA. “The Kentucky Board of Veterinary Examiners handles a program now.”
“We have a Wellness Program with three veterinarians who work confidentially with members of the association,” says Mollie Rasor, executive director, North Carolina Veterinary Medical Assn. “The North Carolina Veterinary Medical Board has a program called NC Physicians Health Plan that has been in place for four years. It’s [open to] all veterinarians and registered vet techs.”
“The Michigan Veterinary Medical Assn. does not have our own program,” says Karlene Belyea, executive director of the organization. “The State of Michigan has a program called the Health Professional Recovery Program that serves all health professions. We refer cases to them.”
“The Wisconsin Veterinary Examining Board has a great program,” says Leslie Grendahl, executive director, Wisconsin Veterinary Medical Assn. “Veterinarians in the program are monitored for several years, are allowed to practice and the program is not public record. The program is extremely expensive, considering the ongoing testing and monitoring.”
- “Nevada veterinarians piggy-backed with a medical professional program,” says Michelle Wagner, executive director, Nevada Veterinary Medical Assn. “I don’t know if the problem is getting worse, or people are just becoming more aware.”