The Hardest Decisions We Make as Vets Aren’t Medical
Sep 05, 2025
The Weekly Evolution
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The Hardest Decisions We Make as Veterinarians Aren’t Medical
A few months ago we made a post about this idea and it seemed to resonate. We’ve seen too many doctors step away from practice recently. We became curious why friends and colleagues reached burn out around 5-7 years post-graduation—and either left the field or continue to suffer through every shift.
Our observations led us to this conclusion: the hardest part of our job is not making medical decisions. It’s making financial and ethical decisions.
Finances are Intertwined with Every Treatment Plan
Our ability to diagnose and treat pets depends on what the customer can afford. In a daytime vet practice, the average bill is probably $200-400. At the ER, the average bill is $1000.
This is the cost of care and we can assure you that vets are not hiking prices simply because they can. The increased cost of veterinary care over the last 10 years is primarily due to the elevated standard of care expected for pets now that they're often treated as family members. The prices are also what they are to be able to sustain fair wages for vets and vet nurses/vet techs. This point alone can be an entire post. Of course things like rent, cost of goods, equipment, etc. have inflated too, consistent with other industries.
All of this to say, veterinary care is a service that costs money. Sure, it’s similar to human medicine in ways, but insurance isn’t widespread, there’s no medicare or medicaid, and there’s no vet clinics required to treat pets with no money (like a hospital would for a person who can’t afford care). This little “finance” difference profoundly changes the way we practice vet med.
Here’s Why It Gets Tough
Of the 10-20 cases we often see in a shift, at least a quarter of them are complex. They’re complex because
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It requires making a hard call (hello, decision fatigue, regret, and second-guessing)
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It’s sad (euthanasia is ALWAYS sad)
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It’s hurtful when people blame us (fortunately these are more rare because we've worked on our comms skills, but when it happens, we feel a sense of anger, defeat, and unfairness that we're being blamed when we care about what’s best for the pet).
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We don’t have time to process our emotions in the moment (they stay mitigated throughout the shift so we can move from case to case)
THIS IS WHY VETS BURN OUT. This is why vets leave the profession. This is why vets have pre-shift anxiety. This is why vets have trauma. This is why vets search for ways to numb out. Arguably, this is why some vets seek out leadership roles off the floor (yes we know, bad reason to get into leadership, but we’ve seen it many times). It’s not the medicine. It’s the other stuff.
Alright, it's not all doom and gloom. Continue reading about these hard decisions on my blog for specific examples and a few solutions that have helped us manage this part of vet med.

What’s New on the Pod?
One of my recent podcast episode released yesterday. It's a punchy 26 minutes of listening that will leave you with a burst of confidence to get out there and be yourself! We share our personal transformation stories and walk you through an exercise to make more authentic decisions for you now.
We also introduce the Four Os to help you make decisions with clarity:
- Obligations: Are you saying yes because you feel like you should?
- Optics: Are you doing it to look good in someone else’s eyes?
- Objectivity: Are you choosing it just because it makes sense on paper?
- Outcomes: Are you clinging to a specific result instead of following what feels aligned?
Full video linked below.
🎙️ Ep. 17 Why is it so hard to be ourselves? With Anna & Bethany
🎧You can also listen on Spotify or Apple Podcasts

Work With Me
Life Coaching for Veterinarians:
You’ve worked incredibly hard to get where you are. But despite the long hours and the sacrifices, it still feels like something’s missing. Maybe you're dreaming about becoming a medical director just a few years out of school, learning how to read a P&L, or finally feeling confident enough to negotiate your worth. Maybe you’re curious about running a relief business, earning income virtually, or stepping into a leadership role at HQ.
Whatever your vision, one thing’s clear: you didn’t sign up for a life of survival mode. And you don’t have to stay there.
I'm so excited to be opening coaching for the first time. This is our deepest level of support that pours into your unique goals and vision.
The Evolved Vets 6 month 1:1 Code Blue Coaching Program starts in October with one spot left. Book an Alignment Call to see if it’s a good fit for you.
Membership:
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Your Coach,
🩵Dr. Beth the Vet