Dr. Holland named Iowa Veterinarian of the Year for 2021

The State of Veterinary Medicine from Where I Stand
by Dr. Elizabeth Holland

Wow! The kindness in the wake of being named the Iowa Veterinarian of the Year blew me away. Thank you! It was a surprise and honor to be acknowledged in that way and a true joy to have my family surprise me in Ames.

Veterinary medicine is a profession I love. It is my great joy each day to observe the wonder of our relationship with animals. I love the challenge of combining education, healing and science to solve problems. But even more, I love the connection with my clients. I love finding common ground, laughing together, and having positive interactions. Almost as amazing is working with our team of individuals that care just as much as I do. They care about each patient, each client and each other and we keep each other going when things are tough at work or at home! How lucky am I!?

If you’ve been paying attention, you may have heard about the ongoing challenges veterinary medicine faces including high levels of burnout and most concerning, a large exodus from the profession altogether - from veterinarians and other staff members alike. These issues, obviously overlapping, are only worsening the challenge of having enough appointments for all the pets needing to be seen which escalated during the COVID-19 pandemic. We are certainly seeing this right here in Adel.

These areas cause me great concern, especially as someone that is so happy with my career choice. So I am committed to working on solutions! If you ask me, every single employee in my building is underpaid. I hope they don’t feel undervalued, but I can’t answer that with much certainty. I so often wish clients could be a fly on the wall as we struggle to balance the economics of running this clinic. We most certainly WOULD do it all for free if we could.

We will continue to try to balance our desire to provide amazing care to our clients without breaking them financially. I challenge you to look at a hospital bill from human health care and see what things cost and then compare it to what your veterinarian provides. It is mind blowing. As a profession, we have often shied away from the insurance model of human healthcare and I certainly see why, but on the other hand, if we can’t increase the wages, benefits and profitability of our profession, it will continue to shrink and that is something that should scare us all. I can honestly say that there could be a future where you do not have access to emergency or urgent veterinary care when you need it and that is troubling.

As I’ve said a number of times, the fact that we have a wellness clinic, surgical suite, dental practice, full laboratory, radiology unit, pharmacy (and more!) in one building is A LOT OF OVERHEAD! The cost of providing all of these services to clients makes our margins thin. It is simply a fact. When I participated in a business program that included all kinds of small businesses, it became abundantly clear that we work very, very HARD for our slim profit margins. It can seem inappropriate to talk about the economics of veterinary medicine, but if we don’t start talking about the problems and hunting for solutions, there simply won’t be enough veterinary clinics around.

Currently, it is difficult for me to encourage young students to pursue a veterinary degree. A large part of that is for the financial aspects mentioned above. The combination of school debt and earning potential honestly make the investment questionable. Of course, dreams are worth pursuing without the promise of a specific return on investment, but you also need to be able to feed and house yourself, not to mention have some wiggle room for unexpected life events. I feel if we don’t change course in some way, this profession will be missing out on absolutely outstanding individuals that see the writing on the wall; potentially the same individuals that could help solve these and other issues, not to mention be the great doctors our pets deserve!

For better or worse, many still choose to apply to veterinary school and that’s a good thing, but what we are seeing is more and more that are regretting that choice down the line. When the reality of the emotional strain is paired with the high demand, current climate of challenging clients (sorry- it’s not everyone but there are some!!), low wages AND being short staffed; a change can be appealing… that is, if you can still make your student loan payments.

I remain optimistic and determined to be a part of finding the solutions to these challenges. I know our pets need great healthcare and I truly believe pets improve the health and wellness of both individuals and society. So what will we do!?

One simple step is to consider insurance for your pet. The cost of veterinary medicine WILL increase. If we are going to start to solve the staffing crisis we must offer better wages and more benefits. Our teams deserve it and we must make it so. Unless there is a fundamental shift in the way we provide care (think only 1 clinic in the metro has x-rays, one does surgeries, etc) there is no way to even keep up with the cost of supplies without increasing fees. There are many insurance companies and I am NOT an expert, but our team can point you in the right direction. It is certainly our experience that if a client has insurance, they have more options for care.

We also really encourage people to budget, save and consider the true cost of a pet before getting one (or more often ANOTHER one!) The cost of a pet over his or her lifetime is somewhere around $17,000 and that, of course, is just an average. As our pets have worked their way “under the covers”, so to speak, veterinary medicine has continually advanced, offering more options for care than ever before with specialists in practically everything.

These issues are complex and I simply felt like raising awareness would be a good idea. I certainly feel an obligation to speak out for the amazing people that care for those without a voice. So stay tuned and please reach out if you have thoughts, ideas, questions or advice!

Having a pet is clearly a big responsibility and thankfully, I believe it is worth every penny!



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Below is a reflection Dr. Holland shared with colleagues regarding the award:

My husband is always reminding me to stop, breathe and graciously accept honors, awards or even the simplest of compliments I receive. To ignore or down play them is to take away from the individual that gave the accolade. He’s right, of course.

After doing a little soul-searching I have begun to understand that my (mis)behavior comes from an acknowledgment and perhaps a touch of embarrassment regarding my place of privilege. (sorry if this is a trigger word… please hear me out)

I know I have worked incredibly hard to get where I am. Academic achievements from the past as well as the ongoing sleepless nights of worry about patients, clients and employees are nothing to brush aside. But, in truth, I feel like I was set up to succeed.

Thanks to a combination of excellent and supportive parenting, a large group of caring extended family and family friends, good schools, healthy meals, high expectations and much more that I had very little influence on- I honestly feel I was funneled into this spot.
I know it’s not that simple, but I think it’s important to consider and I recognize that these factors, without a doubt, color my acceptance of praise.

To be sure, I’ve had bumps in the road, a season of deep depression leading to two hospitalizations as a high schooler, later dropping out of college twice due to continued mental health challenges, but what I always had was a strong and solid safety net. As long as I didn’t give up completely and was open to help (I will admit that took a lot some days) I was going to get that help. Having that framework within which to sink and then swim, I developed skills of resilience that have likely helped as much as many of the previously mentioned variables.

In veterinary medicine we make mistakes, we have treatment failures, we have difficult and sad goodbyes and of course, we disappoint many people, including ourselves. I believe that how we learn to carry (and release) these challenges determines how long we can continue to brave the stormy side of vet med. As high achievers, this is much easier said than done, especially the “disappointing others”, we are STRONG people pleasers and letting that sh*t go is hard!

As I entered the equally meaningful calling of motherhood, I was fortunate to have a supportive boss and team giving me time and space to adjust to a new level of demands for my time and attention … times three.

Then, as a practice owner, a role I had seen modeled within and outside of this profession, the ability to cut back my hours as a veterinarian to make time for all the other important pieces of me has made doing “all the things” more possible and mostly enjoyable.
My dad, a dentist and clinic owner, has always been my role model for business ownership and community involvement. As a leader, he was involved, engaged and has always served his community in a multitude of ways. Without his clear and constant example I’m not sure I would do the same. But with it, I have an obvious framework to follow.

What I now recognize is that making time for that piece of the puzzle, the non-vet, non-mom stuff may be the key to the work/life integration (my favorite way to phrase it!) we all seem to be pursuing.

Here is where I must briefly engage in the dynamics of gender which I can’t in good conscience ignore. As a woman and mother, the pulls on my time and heart are many. I feel very strongly that if I worked as a veterinarian full time and spent the rest of my time tending to my children (VERY tempting!) I would be missing something incredibly important.

This connection to community leads not only to a more meaningful impact on the world, but to much of my deep personal satisfaction in life. I highly encourage you, regardless of gender, to look for something outside of vet med and family that fuels you. Whether it is church, art, music, coaching, FFA, sports, scouting or other civic engagement - it is the diversity of purpose that balances out so much of the challenge we face as "working moms”. It’s counter-intuitive when time constraints are extreme, but through deep reflection, I see that this has been instrumental in my success and satisfaction.

So I am grateful. To be highlighted in this way is a true honor. But above all, I am blessed and also looking to do better. I look closely and see that my path to success is littered with roadblocks for so many. For all those without the foundational factors that set me on this path with a fully stocked supply pack. Blocking not only those equally as capable and deserving, but, without a doubt, those more innovative, creative, with vastly differing perspectives, ideas, grit and levels of resilience none of us can even imagine. When I think about the future of vet med, I think we need to break open our stale funnel and truly invite in this diversity. To guarantee its success, we will need to serve as models to those without them, to be the cheerleaders, the lighthouses, the life rafts and then lead with clear and kind focus as they enter uncharted territory. But we will also need to listen, to learn and to expand our vision of what is and what can be. Perhaps if we can open our arms and minds, we will learn to truly embrace the gifts of diversity, equity and inclusion not as a catchphrase but perhaps as a safety net for our profession.