Do you have a dog? A cat? Considering that roughly 150 million households in the U.S. claim ownership of a dog or cat, there’s a good chance you own or have owned a pet. Given that, there’s also a good chance you’ve been to the veterinarian a time or two.

The schooling required to be a vet (and the cost of that schooling) is closely equivalent to that of medical doctors, but, despite providing care to what many people consider family members, vets often start off making three times less than physicians.

In my experience, as a licensed veterinary technician in both private practice and academia, veterinarians are caring, compassionate, and empathetic people. They enter the field of veterinary medicine because they love animals and want to provide care, despite the potential debt and often low relative salaries. But often times, they’re treated differently than their physician counterparts. It’s not uncommon to read Yelp reviews saying vets suggested unnecessary treatment, or that a particular clinic has opted to inflate costs for an unjustified reason. In my time in the profession, I’ve even heard it suggested that if vets really loved animals, they would provide treatment for free.

In America, many people are faced with outrageous medical costs and impersonal care, but medical doctors work with insurance plans to offset some of the out-of-pocket costs incurred by patients, whereas pet care doesn’t have that buffer. Pet insurance plans are still relatively new and not the standard. When confronted with a treatment for their pet like chemotherapy, that can cost thousands of dollars out of pocket, owners are faced with a difficult question: how much is my pet worth? If the answer is “not that much” or the owner cannot afford the care, the blame can sometimes shift toward the vet.

The stress of practicing medicine, the guilt and anger over having to charge fees, and the abuse and vitriol they face takes a toll. One study showed that 1 in 6 veterinarians have considered suicide and that veterinarians are 1.5 times more likely to experience major depressive episodes than other adults. In addition, according to the 2012 CVMA National Survey Results on the Wellness of Veterinarians, nine percent of respondents had previously attempted suicide and 49 percent considered themselves at risk for suicidal ideation. It is of note, however, that data concerning suicide attempts may be skewed; due to access to lethal drugs, suicide attempts by veterinarians may more often be successful than for people without similar access.

According to the American Veterinary Medical Association, veterinarians are also at increased risk for developing compassion fatigue which is “the result of a medical caregiver’s unique relationship with a patient, through which empathy allows the caregiver to ‘take on the burden’ of the ill or dying patient.” Compassion fatigue is characterized by stifled emotions, sadness, a decrease in perceived enjoyment, a tendency toward isolation, short attention span, mental and physical exhaustion, poor hygiene, nightmares, and/or substance abuse.

It’s also not uncommon for veterinarians to be placed in the uncomfortable position of having their diagnoses and recommendations dismissed. “I’ll just ask my groomer” or “I’m just going to Google it” or “But my breeder said…” are commonly heard phrases in veterinary offices, minimizing the 8-12 years of secondary education, internships, residencies, and hours of continuing education.

Veterinary medicine is a very taxing job,” says Stefanie Sullivan, DVM, a residency-trained emergency/critical care veterinarian at Veterinary Care and Specialty Group in Chattanooga, Tenn. “We tend to spend long hours working through difficult cases, treating patients, writing records and counseling clients. We beat ourselves up when we can’t figure out a case or it doesn’t go the way we thought. We take these emotions home. Our personal lives suffer. And unfortunately, we are berated more than praised for the work we’ve done. It can all be a very difficult burden for one person to bear.”

In the end, it is the thing vets are so frequently accused of not having that pushes them to work every day: a love for animals and a passion for providing care.