Reconciling the business-care paradox: a Q study of veterinarians' professional identity formation

Veterinary medicine is shaped by the business-care paradox, a persistent tension between commercial sustainability and ethical care commitments. Emotional labor is central to how practitioners navigate this paradox, yet the subjective processes through which they construct and sustain professional identity amid these competing demands have received little empirical attention from a subjectivity standpoint. Existing studies illuminate how emotions mediate this paradox yet stop short of examining the distinct identity pathways that practitioners adopt.

Employing Q-methodology, 30 small-animal veterinarians in employee roles across private practices in southeastern China sorted 42 statements. The statements were developed around four core mechanisms of emotion-mediated paradox navigation: emotional salience, flexible emotional labor, emotional traces, and ongoing learning. Principal component analysis with varimax rotation identified shared subjectivity patterns, while semi-structured post-sorting interviews elicited rationales for extreme placements, strengthening interpretive validity.

A three-factor solution explained 58% of variance, revealing three distinct identity trajectories. The pragmatic service provider reframes business decisions as necessary for sustainability, prioritizing clinic viability, and employs emotional detachment as a protective strategy. The conflicted caregiver experiences moral distress and identity dissonance when financial constraints limit care, feeling torn between ideal and feasible treatment. The resilient integrator treats constraints as parameters for creative problem-solving, drawing on adaptive learning while sustaining core ethical commitments. These viewpoints represent qualitatively distinct modes of emotional labor engagement.

The findings reveal three distinct modes of emotional labor engagement, each reflecting a different pathway of professional identity construction. For veterinary educators, these findings highlight the need for differentiated support strategies, each tailored to a distinct identity trajectory. Spanning moral distress mitigation to resilience cultivation, such strategies are essential for sustaining both practitioner wellbeing and care quality.