Podcast #47

Dr. Brooke’s Background:
Dr. Brooke graduated 3 years ago knowing that she wanted to work in emergency. She started off with a 6 month internship at the AES (Animal Emergency Services) in Brisbane, and continued on after to take a full time ECC job at the same clinic. She has enjoyed her work and time as a vet immensely, and is planning on sitting memberships next year. She also has a social media aspect of her life where she is“spreading awareness of our profession and the role of an emergency veterinarian.” The goals of her social media presence are to provide support and information for new grads and experienced veterinarians alike!

AES has an emergency course through Improve International which all of their emergency vets perform, it this was a big part of Dr. Brooke’s initial introduction as the ‘doctor’ in the room. Mentorship is so important as a new grad, and Dr. Brooke shares that she was NEVER alone for the first 6 months, always having a senior vet around. Her internship did involve primary case care, but there was always back-up, and she shares it was a great combination of having case responsibility but also having support! It was “an incredibly supportive program” and even after the internship and working as an emergency vet she has very good support. Finding a great work environment has “made life easy” for Dr. Brooke, and it’s a lesson to all new grads that it pays dividends to find a clinic that supports you and fosters the type of veterinarian that you want to become!
“Inside The Emergency Room” Book:
The current complete collection of Inside the Emergency Room books by Dr. Brooke
Inside The Emergency Room Series: Step-By-Step Diagnostic and Treatment Guidelines, GDVs and More, SIRS and Sepsis, Emergency Drug Handbook
Dr. Brooke’s passion for emergency medicine, along with her passion to provide support through social media, led her to see there was a need in the industry for a resource that is a little more beginner and practical than the typical emergency textbooks. She has created the E-Book Series Inside The Emergency Room for new graduates, and vets with less emergency experience, to have a guide of how to approach emergency cases. “I really wanted to condense the information into one easy resource.” It’s very straight-forward and to the point, and easy to read and follow, which is what we all need when we have a stressful and unstable case. There are a total of 4 books (as of date of writing) that include “Step-by-Step Diagnostic and Treatment Guidelines”, “GDVs and More”, “SIRS and Sepsis”, and an “Emergency Drug Handbook”.

When asked how it felt putting out a resource so early in her career, Dr. Brooke admits “It was nerve-wracking… who am I to put out a resource?” She shares however that being early in her career, and going through (or having just gone through) what her audience is going through, she can “offer a unique perspective as a new graduate.” She can relate, understand, and be in the same mind-frame as her readers, so she knows what they need, and what is just too much for right now. This is incredibly important, especially when so many veterinarians are sole-charge too early in their career, and don’t care or have time to think about the exact pathophysiology or pharmacokinetics of every disease or drug.. they just need to know what to do.. and they need to know NOW.

Dr. Brooke tell us that despite being a bit nervous and feeling slightly out of her comfort zone, a huge part of having the confidence and resilience to publish her book came from both a very strong support network, along with “realizing that every single vet at AES works up cases the same way I do, whether they have been graduated 10 years or 2 years.”

Dr. Brooke shares that she fortunately hasn’t experience much Tall-Poppy Syndrome or criticism in her career, and part of that is surrounding herself with other motivated and driven people. Dr. Brooke tells us that because there are so many people, and there are so many individual little sectors and niches in the veterinary field, and everyone supports each other, it has made the whole experience very positive and she hasn’t come across much resistance. Dr. Brooke confides that some of her support network include @dralexhynes who focuses on personal and professional development, @louisa_the_vet who focuses on clinical cases, and @foreignvets who focus on emergency cases and support for both English and polish vet students, amoungst others. Because there are so many different niches and each person is looking at the field in a slightly different way, “it doesn’t feel like we are competing which is nice… and we support each other equally as well.” One of the best ways to combat Tall-Poppy Syndrome is to surround yourself with other successful, self-motivated and ambitious people. Dr. Brooke has been able to do this through social media, and the veterinary community is so supportive in this regard that it has made it easy!
Do You Have A Positive Work Environment?:
In this veterinary world, so many vets face a negative, unsupportive and toxic work environment. Finding the right clinic is so important to enjoy and love your career, and Dr. Brooke was lucky (or strategic) in that she found a supportive clinic from the beginning of her career. Dr. Brooke shares that the directors of AES have “we want it to be a home for emergency veterinarians” mantra, and that has created a positive and progressive clinic.
Bubble that is clear and see-through
Transparency around salaries and around professional and personal goals takes a huge amount of stress away from employees!
Performance Reviews are performed every 6 months, and since salary is based on your commission, at these meetings the individual vets generated income is looked at objectively along with other aspects of their work. This open conversation removes the secrecy, and the ambiguity of salary, and allows for a clear understanding of income. This transparency of where income is generated and how that translates to salary is a breath of fresh air in the veterinary world, where salaries and value are so often hidden, “taboo” to talk about, or completely arbitrary! Dr. Brooke also describes how AES really pushes to have a positive work place where they really strive to celebrate their successes, and they really push the team effort aspect. Every win is a team win, and no win can happen alone. This creates a very supportive, helpful, and patient care focused clinic and environment.
What is working on commission like? Is there a push to over-service?:
Bee on a flower
“Honestly.. we don't have time to offer diagnostics that don’t need to be done.” Dr. Brooke shares that every shift, every night, she is a busy bee working on cases that desperately need her, so even if she or her colleagues had the inclination to ‘over-service’- which they don’t- they just don't have time!
“Honestly we are so busy at night, we don’t have time to offer diagnostics that don’t need to be done.” Dr. Brooke laughs at the thought that anyone thinks that emergency vets have time to do un-needed tests and treatments! She does admit that some diagnostics offered are offered to cover your a$$, and this is a nature of what we need to do in this litigious world, however she describes that how you deliver and offer the options greatly vary depending on the severity of the case.

“Only do what you do for your own dog” is a strong guiding policy for AES and Dr. Brooke follows this to guide her recommendations for clients. Diagnostics often will be recommended because “you need to rule out the life-threatening things, because if you miss it you know they will die.” Since animals hide their illnesses, and are often much more sick than they let on, diagnostics that are recommended and performed are always genuinely done out of the concern for the animal. One of the benefits that Dr. Brooke finds is that “working on commission motivates you to provide the best care… even at 5am when you are exhausted in the morning.” She shares a story of a dog that was a little bit unwell, had one vomit, and just wasn’t quite right. She was tired, and nearing the end of her overnight shift, however she offered the diagnostics, and she found a septic abdomen with a liver abscess. That animal is alive today because of an early diagnosis!

Both Dr. Ann and Dr. Brooke share that the diagnostics so very often surprise you, and Dr. Brooke shares “every single day I am surprised and reminded of why we offer the diagnostics… because we find stuff!!” Especially working emergency, where we do often work up cases more, because the owners are more stressed, more motivated and have already crossed the “I’m worried” threshold enough to go to the emergency clinic, so we find things more often. And it is that ‘finding things’ that pushes us to understand that we cannot know the result of the test prior to running the test, and therefore that test has immense value!
Have you ever struggled with Imposter Syndrome?:
Venn diagram outlining Imposter Syndrome
We will all suffer from Imposter Syndrome at some point in our careers… but it is realizing that we are educated, and knowledgable, and as Dr. Brooke puts it, focusing on our accomplishments, that will help!
“The biggest imposter syndrome period that I went through was in my first year. I just finished my internship, I just finished this insane surgery that was a thoracotomy [dog fight wounds] that was ripped to shreds, I called Gerardo in at 3am, and we got through this surgery together…it was insane and I got through that surgery and everyone was saying how amazing I did and all I could think of was ‘I couldn’t do it myself, I had to get someone in to help me.’ And I got stuck in this cycle of ‘I’m not good enough, look at all these other vets I’m working with that are so amazing, and if a patient ends up with me I’m not going to be able to offer the same level of care that another vet could offer.’ … It got to the point where I was talking to my manager about it and I talked to Alex, I took some time off and went to New Caledonia for 2 weeks… and it was then that I realized that the only difference between me and another vet is experience, and that’s nothing I can change.” Dr. Brooke realized that at that moment she had minimized her amazing accomplishments, and also recognized that she couldn’t change her experience level. She focused on studying, and focused on looking at her accomplishments and achievements, and hasn’t felt Imposter Syndrome since! Imposter Syndrome is so rampant in the veterinary world, and it’s something that all of us will likely feel at one point or another.

KICK ASS VETS shares that we feel that GP vets have such a hard job because the expectations of the clients is for their vet to be all the specialists in one. They want their animal’s complex and serious condition diagnosed and fixed, and for it to be done quickly, and on a tight tight budget. This sets up veterinarians, especially general practitioners, to feel Imposter Syndrome because it leads to situation after situation where they are expected to accomplish miracles. After so many people expecting miracles, you will eventually start to believe these expectations are realistic and criticize yourself, and feel like a failure when you can’t deliver. The expectations are so high, and are not realistic by any stretch of the imagination, especially with the time, energy and financial limitations clients set.

Think about it… cases that, in human medicine, would have 5 different specialists working on it, are being managed by general practice vets in between other appointments, on a limited budget, and without the benefit of collaboration, specialized training, or even the necessary equipment! The role and the job that veterinarians perform and do is so hard, and so amazing, however the unrealistic expectations of clients, and the unrealistic expectations set by how veterinarians are portrayed in movies (that they know everything about every single animal), means that we can so easily fall into this trap of “I don’t know enough” or “I don’t know what I should” or “I’m not good enough because I don’t know EVERYTHING”.

“I also don’t think that it helps that on Instagram we share the highlight reel, and for a lot of new grads that’s all they see”… Dr. Brooke discusses that vets are not good at sharing the bad cases, and the cases that go wrong. Dr. Brooke’s vet school year had a Facebook page where they put up a thread of all their mistakes… and it was not only sometimes very funny but also very therapeutic and helped each other work through mistakes. She shares that a classmate intubated the esophagus and the tube ended up in the stomach and the dog needed a gastrotomy to get the tube out. It happens to all of us, and to have a supportive group to share those stories, to laugh, and to cry together, is so important. We ALL make mistakes, we all miss things, and learning how to learn from mistakes, to talk about mistakes, to grow and to recover yourself after a mistake is made is very important. Morbidity and Mortality rounds can really help with that as well! I would encourage ALL vet school classes to follow in Dr. Brooke’s example in this and make a group with your class where you can share your failures, share your mistakes, and learn and grow together.

Dr. Brooke also talks about the importance of having a supportive environment so that when mistakes are made everyone can bring it to attention right away, so the animal can be attended to immediately instead of trying to cover up and hide mistakes. Having this supportive work environment is imperative for not only patient care, but for the mental health of all the staff!
Dr. Brooke’s General Advice:
1. Be Kind to yourself and forgive yourself. As Type-A people vets are not very good at letting go of mistakes or forgiving ourselves. When you make a mistake, take a few days to emotionally decompress, but then address the mistake objectively. Forgive yourself, and learn and grow!

2. Celebrate wins! As a new graduate especially, celebrate every little win! Focusing on your wins and celebrating those wins will help balance out the harder parts of the job. Don’t be worried about looking silly, or being judged, just be happy, do a little dance and celebrate every tiny achievement!

Thank you so much to Dr. Brooke for joining us. Dr. Brooke is such an inspiration, as someone that has worked hard and taken her career by the horns! Thank you for sharing your wins, but also sharing that you have failures as well, and that is OK. We are so exciting for you, and your new E-Books, and are exciting for what the future holds for your career!

For more from KICK ASS VETS follow us on Instagram @kickassvets or follow us on Facebook, or join the Facebook KICK ASS VETS Group to be part of the conversation!
Written by Dr. Ann Herbst BSc, DVM

Published August 9th, 2020

Advocate for yourself, you are the only one that will!

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