Dr Belén Montoya suffered burnout from the very beginning of her professional career. We recently spoke to her on our VETVOICES IG Direct, where she told us how she learned to identify what was stressing her out in her profession and how she could take steps to avoid it. Today Belén has her own clinic specialising in felines and manages her time differently. She runs the educational account about the secrets of feline medicine @pensando_en_gato with 21K followers. Our VETVOICES LIVE dedicated to burnout was a fantastic opportunity to meet her live and interact with all the participants.

Belén Montoya graduated in 2003, a time when burnout didn’t even have a label yet, although the difficulties inherent to working in clinics were already being discussed at the university. As she was not drawn to emergencies or dealing with clients, Belén began working professionally with wildlife, but the field did not really win her over. Then the opportunity arose to join a clinic and she decided to try it out and see what it was really like.

“I lasted two days,” Belén told VetVoices Live. “I realised straight away that it wasn’t for me. You have to know yourself very well and know what you like in order to set limits. I like to call it ‘firewalls’, decisions you make to avoid what you don’t like doing or what doesn’t suit you. For example, my first firewall was ethics. I couldn’t work in a place where the bill came first and the animal last.

If you want to hear the conversation for yourself, click on the links you’ll come across in the interview. You’ll find them all subtitled in English:  instagram.com/reel/CixgXPToQ8E/

When was your first experience with burnout?

In the second small animal clinic where I worked. I worked in the emergency room non-stop, I spent entire weekends without leaving the clinic. I was in charge of the emergency telephone and I didn’t have time to go to the cinema or have a beer with my friends. I didn’t even have time for my partner. It was impossible to disconnect. And I really enjoyed my work. I enjoyed making diagnoses, working in a team, saving animals…but at the same time I thought, is this the price I have to pay to work doing what I love?

There were also other reasons that made it more difficult: the relationship with the management was complicated and the clients were from rural areas with less education about animals. Everything added up and was the perfect cocktail for me to jump ship. I stayed for a year and a half and then I looked for another job.

And the next job was better?

No, it was even worse. As I said, one of the causes that can lead to burnout in the veterinary profession is working against one’s own personal ethics. We can talk about bad salaries, bad working hours or toxic bosses and colleagues, but sometimes you have to work in clinics where ethics are conspicuous by their very absence: they force you to get the most money out of the clients or they know they should refer the patient but they don’t do it. If you’re an empathetic person and work out of vocation, this burns you out. Fortunately it doesn’t happen often, but sometimes it does.

In that clinic I ended up in a very bad way because I felt I was not able to carry out my work. I was terrible and I started to visit therapists and to take anti-anxiety medication and anti-depressants. I ended up thinking that I didn’t want to work as a vet any longer and I started to look for a life outside the sector.

As vets, we have to endure a little more each day until we end up in the emergency room with an anxiety attack.

But you stayed in the profession

Yes, I did. While I was thinking about what I could do with my life, the opportunity arose to join a clinic that offered me more stability and had a very good ethic towards patients and clients.
The problem was that the hours were unsustainable. I stayed there for a few years until what I call the metaphor of the frog and the pot happened to me. The fable tells how if you put a frog in a pot of cold water over the fire and heat it slowly, the frog gets used to the heat. By the time it realises it’s boiling, it’s too late to jump.

That’s what happens to us vets a lot of times. Each day we put up with a little more than the day before. Everyone has their own reasons: for money, for the prestige of the centre where you work, because you think you won’t find anything better or because you don’t want to disappoint those around you. Until you end up in A&E with an anxiety attack on the brink of no return.

It’s clear that the reasons for burnout are numerous and that you’re not even aware that you are burning out. 

The HappyVet Project’s burnout test is a very good tool because it looks at much more than a test. It gives you an exhaustive examination. We are often not aware of the level of burnout we’re at. I did a survey among my Instagram followers and they told me that they felt like crying before going to the clinic, had anxiety, irritability…

We are easily annoyed, we find it hard to concentrate or we internalise stress with muscular tension, skin problems, digestive or respiratory problems, even insomnia. I myself started sleeping badly when I was working in the emergency room and I haven’t slept well since. You also see veterinarians who are demotivated or worse, with total depersonalisation of the work. You are so burnt out that you don’t care about the patient. And this is very dangerous.

What solutions do you propose to reduce burnout in the profession?

The solutions to burnout are split 50/50 between oneself and the leadership of veterinary practices.

On a personal level, ask yourself what you want and what works for you. And above all, what you don’t want. In my case, emergencies were the worst thing about the profession. On the other hand, there are people who enjoy this kind of work.

We have to learn to ask for what we want with assertiveness, which in general is something we’re all still working on. We must talk about the things we don’t like and really talk well, before it is too late. Spending the whole day complaining only serves to make the working climate worse and increase our discomfort. And if after having asked assertively, nothing comes of it, you should consider whether it’s time to leave.

Fortunately, veterinary centres are realising the economic losses that burnout is generating. The sector has to change radically and implement measures, even if slowly, that show that the problem matters. I know many very good vets who have fallen by the wayside. And that is a pity. It would be good if tests such as burnout or Compassion Fatigue could be distributed on a regular basis to find out how staff are doing and whether measures need to be taken. This would prevent people from burning out and leaving the centre.

So do you think tests can help?

Of course they can. When I took the test I got a score of 17! That means I’m on the edge! I was shocked because now I’m working doing what I like, I have flexible hours, and so much more. In the end you realise that our work itself is risky, you are constantly on the edge emotionally speaking.
The issue of Compassion Fatigue is serious. I myself didn’t know it existed until 2008 and it helped me a lot to name it thanks to my therapist. It is very important to ask for help. Nobody will look down on you because it’s all very normal nowadays.

How did you overcome burnout?

First, by going to therapy. I recommend changing therapists if after a while you don’t see any progress. I’ve also benefited from personal development literature. I’ve discovered that I have full control over my life and that I shouldn’t normalise certain situations or attitudes. And that if I don’t take care of myself, no one else will do it for me.
This was the turning point in my decision to start my own clinic. It was the best fit for me because of my age and my personal view of the profession.

You did a survey among your followers, didn’t you, and what results did you get?

I’d like to thank everyone who participated and generously shared their answers with me.
I asked them what they do to disconnect from the clinic and they answered that they usually go outdoors, take a holiday – especially to the beach – or listen to music.

Another thing that really struck me was what they said about WhatsApp groups. Some people are very anxiety-ridden about being online and visible 24/7. There are many people who leave the group when they are on holiday and come back when they return. Others turn off their mobile phones. But there are also people who don’t mind being disturbed on any given day or prefer to keep up to date with what is going on in the clinic while they are free.

I also asked them which of the reasons for burnout affected them the most, whether it was the toxic atmosphere between colleagues/bosses, dealing with clients, personal problems, etc. I forgot to mention salary, which many people asked me for. The answers were:

– Toxic environment – 15%
– Dealing with customers – 26%.
– Personal problems – not a big issue
– Everything in general – 60%

This shows that this is a rough estimate. For those who find dealing with clients stressful, you can learn techniques on how to talk to clients about economic issues, grief management etc.

I know that when you start out, and I speak from my own experience, dealing with clients is the worst. With time you realise that everyone expresses themselves in their own way and it’s important not to judge. If you manage to convey to them that what is important to you is their pet, you manage to bring down their walls. If it doesn’t work, over time you learn not to take it personally: you’ve done the best you could with what you had. You also transmit confidence to the clients about your decisions and they end up trusting you.

HappyVet Project articles related to this interview that may also be of interest to you:

• Understanding pressure in veterinary practice: when it’s positive and when it’s not
• Something’s wrong… could it be burnout?
• 7 tips to boost resilience in vets and vet techs when facing stress
• Compassion fatigue in vets and vet nurses: identify the symptoms and learn how to protect yourself.
• 7 tips for talking about money with toby’s parents. Keep calm and don’t panic!
• Managing death and bereavement for families and the veterinary practice