Tuesday, December 17, 2019

Nonsense About Veterinarian Suicide


Last year the CDC put out a nonsense "study" about suicide rates among veterinarians.

The press release screamed: "New Study Finds Higher than Expected Number of Suicide Deaths among U.S. Veterinarians"

Higher than expected?

Expected by WHOM?

Compared to WHAT?

The study is the first to show increased suicide mortality among female veterinarians. Female veterinarians were 3.5 times as likely, and male veterinarians were 2.1 times as likely, to die from suicide as the general population. Seventy-five percent of the veterinarians who died by suicide worked in a small animal practice.

Oh my!

But guess what?  This is not even bullshit; it’s a real lie. You see, a bullshitter does not CARE what they say or how it will be misinterpreted, while a liar KNOWS the truth, and is very careful to stay away from it.

And what truths did the CDC authors know and stay away from?

Well, for starters, they knew there is no evidence veterinarians have a higher than average rate of depression or mental illness.

Veterinarians are no more likely to be nuts than the average person.

The veterinary profession actually pays pretty well, has relatively high status, is not too numbingly boring, and has pretty good job security.

Sure a vet has to put down very sick and very old animals sometimes, but how is that a worse job than killing healthy livestock, which is a job hundreds of million of people across the world have done for thousands of years?

It's not.

How it is worse that shooting a deer or a duck which millions of Americans spend a huge amount of time in field and forest to do?

It's not.

In fact veterinarians are not even close to the top suicide rate.

You know who has a higher suicide rate?

  • Farmworkers, fishermen, and forestry workers (85 suicides per 100,000).

  • Construction and mining trades (53 per 100,000).

  • Installation, maintenance, and repair folks (48 per 100,000).



This information is breathtakingly easy to look up, and everyone who studies suicide data knows it, so not reporting it is a lie.

And did the press corps bother to do an even cursory data check?

They did not.  Why let reality get in the way of a terrific headline?

So what's actually going on with veterinary suicide?

Here we come to the second CDC lie by omission.  It seems the veterinary suicide rate is exactly the same as the suicide rate for human doctors who are paid huge sums of money and who work in a very high-status field.

Guess why?

It's not because doctors are particularly depressed or mentally ill; they're not.

Again, like veterinarians, there is no evidence that human doctors are more depressed or more likely to be mentally ill than any other group.

So what's going on?

Simple:  both veterinarians and human doctors have easy and ready access to life-ending drugs that they know will not cause them pain or discomfort, and which can be expected to work the first time they are tried.

And what about all those female suicides?  

That’s the third lie by omission. In the "normal" population, men die by suicide 3.5 times more often than women, largely because women tend to have far less access to guns. But female veterinarians and doctors have exactly the same access to phenobarbital as their male counterparts, so suicide rates tend to be a bit closer to parity.


Which brings me to the data set behind this study; it's a bit... thin.

The TOTAL number of suicides looked at was 398 over the span of 35 years, of which only 72 were female over that same 35-year period. I will let you do the math. Suffice it to say that from the headlines you would think female veterinarians were topping themselves left and right. In fact, they're not.

So why the lies and disinformation?

Simple: everyone is chasing grant money, everyone wants to see their "research" published, everyone wants a headline, and everyone wants to be asked to speak at a conference. "Veterinarians face a high suicide risk, especially women" (Today show) is the kind of headline that does all that, and more.

To be clear, I do not think this is an accidental lie.  I think this is a lie that was intentionally ginned up for the veterinary trades echo chamber.

The goal here, right from the start, was to write a headline to abet the crimes of price-gouging, upcoding, and delivering medically unnecessary services.

The CDC press release announcing the study noted that it was being published in the Journal of the American Veterinary Medical Association (JAVMA). 

The authors of the study can say, "Look, we got published" and ask for more funding, and maybe appear at a conference or two.

The AVMA can position their members as overly compassionate people who are victims of pet owners who may be inducing "stress" by asking questions about such core business practises as bill padding, upcoding, price-gouging, and selling medically unnecessary goods and services.

Look I get it. The CDC folks need funding, the AVMA wants to shield their trade from too much consumer scrutiny, and newspapers want quick headlines to wrap around the toothpaste ads.

That said, the good new is the bad news is wrong: your vet is probably no crazier or more depressed than anyone else, and is certainly less likely to commit suicide than all those farmers, construction workers, and repairmen you passed on your way to their well-appointed and air conditioned offices.

4 comments:

Viatecio said...

The number truly may be far lower than what is advertised.

But it still doesn't mean that the emotional toll of daily dealings with entitled people who think that services should be given away for free because "you love animals, don't you?" isn't there.

Even low-cost clinics have prices to pay, despite the significant discount from the large practices. And when a sick pet doesn't get the necessary diagnostics or treatment that could either change a working diagnosis or introduce a compounding factor into the equation because the owner declines the service for ANY reason (usually financial or "Oh he's fine"), it's just as frustrating as the people who shouldn't have pets and can't afford them demanding free services for a critically ill animal that actually does need that high level of care.

I've seen it both ways. Symptomatic treatment, smart preventative care and saying "No" to bill padding and add-on, unnecessary diagnostics for transient illnesses goes a long way. When people demand more (antibiotics for that kennel cough, anyone? DO SOMETHING TO MAKE THE COUGHING STOP NOW, DOCTOR), it's a judgment call of how far to go vs who declines what--and a vet that declines a client's request to do something or other usually needs a good explanation as to WHY even if the owner doesn't want to hear it. When an owner fudges on a recommendation that is actually needed based on presenting symptoms, though, the best the veterinary staff can do is wish for no prolonged suffering as the pet walks out the door.

It all adds up, is what I'm saying, and happens over a length of time.

Unknown said...

I understand your concerns about certain aspects of veterinary practice, and I agree that access to life-ending drugs are part of the story, but if you dig a bit deeper, you'll find that the increased susceptibility to suicide of veterinarians is a real issue, and a global trend. There are many scientific papers on this topic: here is an example https://pubmed.ncbi.nlm.nih.gov/20348468/
The authors of such academic studies do not do this just for the funding: I am afraid comments like that say more about you than they do about anything else. Are you really so motivated by a few bucks?
As it happens, the author of the paper I've shared above took his own life last month: this speaks to his ongoing battle with depression (which he finally lost). Any suggestion that his life's mission (to help tackle suicide in the vet profession) was in any way connected with hidden motives is insensitive and inappropriate.

PBurns said...

Dear Peter Wedderburn DVM:

Glad to illuminate further.


**1.** Your post was not about suicide writ large, but about some plague of veterinary suicide which, in fact, does not exist. You provide no data on veterinary suicide. You’ve linked to an abstract that provides no data and says nothing.

In fact, as I have noted, a great deal of research has been done on suicide by profession, and veterinary work does not score at all. See >> https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.htm

“Compared with rates in the total study population, suicide rates were significantly higher in five major industry groups: 1) Mining, Quarrying, and Oil and Gas Extraction (males); 2) Construction (males); 3) Other Services (e.g., automotive repair) (males); 4) Agriculture, Forestry, Fishing, and Hunting (males); and 5) Transportation and Warehousing (males and females). Rates were also significantly higher in six major occupational groups: 1) Construction and Extraction (males and females); 2) Installation, Maintenance, and Repair (males); 3) Arts, Design, Entertainment, Sports, and Media (males); 4) Transportation and Material Moving (males and females); 5) Protective Service (females); and 6) Healthcare Support (females). Rates for detailed occupational groups (e.g., Electricians or Carpenters within the Construction and Extraction major group) are presented and provide insight into the differences in suicide rates within major occupational groups. “

If you drill down on the link you see at >> https://stacks.cdc.gov/view/cdc/84275 that the CDC has suicide data by profession broken out in extreme detail.

The suicide rate for all occupations is 24.7 per 100,000 for ALL occupations.

It was LOWER in healthcare in general (of which veterinary care is specifically included) and was so low in veterinary care that it could not be independently calculated.

Suffice it to say that Engineering Technicuans had a suicide rate of 34.7, Bailiffs and Correction Officers 36, Chefs and Head Xooks 47.8, Supervisors of Housekeepers and Janitors 37.7, Sales Workers 34.7, Fishing and Hunting Workers 119.9, Construction and Extraction Workers 49.4, etc., etc.

To repeat: veterinary suicide rates were LOWER than for all occupations in general. This is real data with a real link >> https://stacks.cdc.gov/view/cdc/84275



**2.**. You seem to think I am callous because I don’t particularly elevate suicides in veterinary care above all other suicides or other deaths (from drug overdoses, alcoholism, smoking, etc).

Huh?

You don’t think it perhaps a bit callous on your part that you single out your profession for special attention even though it’s NOT a big bastion of suicide? I’ll let you ponder that.


MORE TO FOLLOW

PBurns said...

**3.** Why the focus on veterinary suicide? Well, it’s part of a generalized veterinary business plan (I’m NOT saying YOU are part of that plan) whose spin and frame is to paint veterinarians as victims — a way to push back on systemic fraud, price-gouging, and upcoding. Your response is NOT to say that these kind of rip-offs aren’t occurring — it’s to paint consumers as greedy whiners for pushing back and illuminating that the “poor veterinarians committing suicide” frame as a ruse, a shill, and a lie to make vets victims. I’ll let you ponder that one too.


**4.** I’m not too distraught about suicide — especially suicide by those working in their chosen work, with good educations, in socially-valued jobs, and at more than adequate income levels. I feel even less sympathy for medical professionals with the drugs and education to do the job right and without suffering. It’s a shame the UK does not have assisted suicide laws so more people can die free of pain and with dignity in old age. It seems the UK thinks it’s fine to help a dog out that is in pain, can’t stand, and is soiling itself without end, but not a human. Strange choice, but again I’ll let you ponder it. Lord knows a lot of veterinarians HAVE pondered it and availed themselves of another (very privileged) option -- good drugs to end it.

I am writing this on my cell phone, so apologies for typos — the screen is only 2 line high and the letters the size of a pin head!


Patrick

Sent from my iPhone