The Cone of Shame Veterinary Podcast

Dr. Chad R. Brown, DVM (Purdue), executive director of the Lloyd Veterinary Medical Center at Iowa State University, joins Dr. Andy Roark to tackle a gut-punch truth in veterinary medicine: good decisions do not always equal good outcomes, and outcome-based judgment can be brutal on clinicians. They unpack how hindsight bias and outcome bias trick us into “judging our past self with our future self’s information,” rewarding lucky medicine and fueling shame after tough cases. Chad argues for de-emphasizing outcomes and emphasizing decision-making processes we can control, like communication, diagnostics, anesthesia monitoring, and checklists, especially when training students, intern...

Dr. Steve Deels, a New Zealand emergency veterinarian and career coach, joins Dr. Andy Roark to tackle a familiar gut punch: "you can save a life at 2:00 a.m. and still get a one-star review because the wait was too long." They dig into dark humor as a healthy coping tool, the unrealistic expectations placed on vets as jack-of-all-trades clinicians, and how Steve’s early mixed-animal work and later corporate clinic burnout pushed him toward life coaching and practical strategies like daily journaling (three successes and one gratitude). You will walk away feeling validated, more resilient, and better equipped to...

Dr. Ivan Zak, DVM, entrepreneur and former CEO of SmartFlow and Galaxy Vets, joins Dr. Andy Roark to dig into one of the spiciest topics in vet med, whether production pay is actually “bad,” and what happens when salary-only pay gets weaponized as burnout prevention. They unpack Ivan’s experience switching Galaxy Vets to straight salary, watching productivity and hours drop, and realizing the business risk of blocked schedules and reduced case acceptance. Ivan shares how that led to Galaxy Vets’ shared production approach in Canada, where vets earn 25% based on total organization revenue divided by shifts, paired with employee...

Tabitha Kucera, VTS (Behavior) and founder of Chirrups and Chatter, joins Dr. Andy Roark to unpack what "keep them quiet" actually means after surgery. Using real cases like a beagle mix post-abdominal surgery and a cat post-PU, Tabitha shares low-mobility enrichment options such as snuffle mats, frozen Kongs, and scent work that support recovery without heavy sedation or strict confinement. The result: better client guidance, stronger outcomes, and stronger relationships.

Episode Links:

chirpsandchatter.com

small-paws.ca

@chirpsandchatter

Tabitha Kucera is an Elite Fear Free Registered...

Dr. Roberta Westbrook, DVM, takes us inside the world of shelter medicine and challenges what many of us think we know about high quality, high volume surgery, access to care, and animal welfare. From the evolution of modern shelters to the realities of pet homelessness, community responsibility, and the future of keeping pets with the families who love them, this conversation will leave you with a whole new perspective on the incredible work happening behind the scenes.

This episode is brought to you ad free by Hill's Pet Nutrition!

Dr. Lisa Radosta, DVM, DACVB, joins Dr. Andy Roark on the Cone of Shame Veterinary Podcast to discuss canine cognitive dysfunction syndrome (CDS) and how to tell normal aging from something treatable. Radosta emphasizes screening all dogs starting at age seven, tracking mentation and behavior changes against each dog’s baseline, and watching for signs such as disorientation, interaction changes, sleep-wake disruptions, house-training lapses tied to learning and memory loss, anxiety, and aggression. She recommends annual screening until about age 10 to 11, notes CDS exists on a spectrum that can affect quality of life, and advises working up systemic disease wh...

Building Confident New Grad Vets: Mentorship, Psychological Safety, and Onboarding That Works

Dr. Jason Szumski, DVM, joins Dr. Andy Roark to tackle a problem every hospital feels, new grads want to do great medicine, but they are often scared of mistakes, lawsuits, and being “on their own” before they are ready. They dig into why mentorship is the top priority for vet students, what strong onboarding actually looks like (psychological safety, structured but flexible timelines, and honest expectations that new grads are an investment), and how to build real autonomy without ripping away the security blan...

A Cry for Help in Veterinary Pathology, Burnout, Economics, Digitization, and AI with Dr. Eric Fish Dr. Eric Fish, DVM, DACVP, joins Dr. Andy Roark to tackle a tough question: Why does being a veterinary clinical pathologist feel darker right now, and what happens if AI turns “nice to have” diagnostics into “don’t need to have”? They unpack burnout and pay compression (including pathologists earning less than new grad GPs), consolidation in the lab market, and how digitization has pushed cytology toward point-of-care and high-volume “turn and burn” workflows with per-case bonuses that can be as low as $8 to $12. Eric e...

Beyond Gabapentin and Trazodone, Smarter Pre-Visit Anxiety Meds with Dr. Chris Pachel Dr. Chris Pachel, DVM, DACVB, joins Dr. Andy Roark to tackle a problem every clinic knows too well, stressed pets, stressed owners, and appointments that start going sideways before the car even leaves the driveway. They dig into pre-visit pharmaceuticals beyond the usual gabapentin and trazodone, including when to increase doses, when sedation is masking anxiety (not fixing it), and how options like clonidine, benzodiazepines, and even dexmedetomidine can fit the patient in front of you. Chris also shares how his new Animal Behavior Clinic space in...

Dr. Andy Roark hosts Dr. Matt Salois, an economist, VMG president, and adjunct faculty at Cornell’s College of Veterinary Medicine, to discuss his Today’s Veterinary Business article on the “dangers of Dutch Pets veterinary telemedicine,” using a Trojan horse metaphor. They argue that when a “no strings attached” solution promises cheaper, easier access by reducing restrictions, vets should be skeptical because removing safeguards like the VCPR and physical exams is not the same as innovation. The conversation covers how pharmacy revenue subsidizes clinic services, concerns that Dutch’s model and rhetoric may erode trust in veterinarians, and how misdiagnos...

Dr. Lisa Radosta, DVM, DACVB, joins Dr. Andy Roark for a timely Hall of Fame episode that every veterinary professional should revisit before fireworks season kicks into high gear. If you've ever had a client call in a panic hours before the fireworks start, this episode breaks down what you can do, what realistically helps, and how to set pets up for success when noise phobias strike. Gang, let's get into this episode!

Dr. Matt Silvius, DVM, shares a career journey that challenges the idea that veterinarians only have one path to leadership. Matt shares his journey from kennel technician to practice owner and multi-site leader, exploring entrepreneurship, mentorship, and the many ways veterinarians can build fulfilling careers. If you've ever wondered what career growth, ownership, or leadership opportunities can look like in modern veterinary medicine, this episode will leave you inspired to think bigger about what's possible.

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Tasha McNerney, CVT, CVPP, VTS (Anesthesia & Analgesia), tackles one of the most stressful situations in veterinary medicine: the critical feline patient crashing through the door after severe trauma. If you've ever felt the urge to rush a painful cat straight into anesthesia, this episode will help you slow down, stabilize first, and make smarter decisions about oxygen delivery, shock management, analgesia, and anesthesia protocols. You'll walk away with practical tips to improve patient outcomes and a clearer understanding of why stabilization is the first treatment. Gang, let's get into this episode!

Dr. Tess House, DVM, MPH, dives into a topic that can spark strong opinions: commercial dog breeding kennels. If you've ever wondered what veterinarians can do to improve animal welfare in these facilities, or what standards, oversight, and welfare programs actually look like behind the scenes, this episode breaks it all down in a thoughtful and practical way. You'll learn about USDA licensing, programs of veterinary care, canine welfare assessments, and how veterinarians can help breeders and pet owners make better decisions for dogs. Gang, let's get into this episode!

Resources Mentioned

Vicky Ograin, RVT, VTS (Nutrition), MBA tackles a challenge every new veterinarian faces: how do you earn trust, build confidence, and collaborate effectively when the technicians around you have far more real-world experience than you do? Dr. Andy Roark and Vicky share practical advice for creating strong doctor-technician partnerships, giving and receiving feedback, and building a team culture that benefits patients, clients, and the entire veterinary team.

This episode is brought to you by Hill's Pet Nutrition!

Dr. Kate Boatwright, DVM, joins Dr. Andy Roark for a thoughtful (and surprisingly spicy) conversation about three phrases veterinarians say all the time: "If you can't afford the vet, don't get the pet," "You can't care more than the client does," and "That's below the standard of care." Together, they unpack the nuance behind these statements, explore judgment in veterinary medicine, discuss spectrum of care, client financial limitations, veterinary burnout, and what compassionate, contextualized care really looks like. If you've ever wrestled with balancing patient advocacy, client realities, and your own emotional wellbeing, this episode will leave you thinking...

Dr. Sarah Boston, DVM, DVSc, DACVS-SA, joins Dr. Andy Roark for a hilarious and surprisingly thoughtful conversation about the worst advice they've heard in veterinary medicine. From "if you love what you do, you'll never work a day in your life" to "just let them simmer" when clients are upset, they unpack the well-intentioned wisdom that can sometimes lead us astray, while exploring career development, work-life balance, veterinary culture, and what actually makes good professional advice. You'll laugh, nod in agreement, and probably rethink a few pieces of guidance you've accepted as truth. Gang, let's get into this episode!<...

Jon Ayers, former Chair and CEO of IDEXX, joins Dr. Andy Roark for a conversation that might completely change the way you think about veterinary PIMS, AI scribes, and the future of practice workflows. If you’ve ever felt frustrated by clunky software, disconnected systems, or the endless admin burden slowing your team down, this episode digs into why AI could dramatically reshape how veterinary teams interact with medical records, client communication, and even daily decision-making. From open APIs to AI-powered workflows, Jon breaks down what practice owners should be asking about their software now, and why the clinics th...

Dr. Gianluca Bini, DVM, DACVAA, is here to talk about one of the scariest parts of veterinary medicine: anesthesia, and why so many of us may be overcomplicating the wrong things while underestimating the stuff that actually keeps patients safe. Dr. Andy Roark and Luca dive into veterinary anesthesia safety, monitoring, equipment, technician training, and the myth of the “perfect protocol,” all while making anesthesia feel way more approachable and practical for GP teams. If you’ve ever felt intimidated by anesthesia, worried about complications, or wondered what actually matters most in keeping patients safe, this episode will leave you fe...

Dr. Flavia Vedova, DVM, MBA, DACVIM (Nutrition), jumps into one of the most confusing parts of pet nutrition, figuring out when to switch diets, what “all life stages” actually means, and whether your large breed dog really needs a large breed formula. If you’ve ever stared at a pet food bag wondering if you’re helping your patient thrive or just falling for clever marketing, this episode breaks down senior pet nutrition, large breed puppy growth, calcium and phosphorus balance, and the future of pet food labeling in a way that actually makes sense.

This episode is broug...

Dr. Lily Chen, DVM, joins Dr. Andy Roark to tackle one of the most frustrating cases in veterinary medicine: the chronic diarrhea dog that just keeps coming back for more metronidazole. From microbiome testing and dysbiosis to fecal transplants and the surprising behavioral changes pets can show after treatment, this episode dives into the growing world of microbiome therapy and what it might mean for chronic enteropathy cases in practice. If you’ve ever felt stuck managing recurring GI disease, this conversation might just give you a new tool for your veterinary toolbox. Gang, let’s get into this epis...

Dr. Andy Roark hosts Dr. Jules Benson, founder and principal of Titum Lucidum Consulting, to push the access-to-care conversation from advocacy into practical, feasible actions veterinary teams can take now. They frame access to care as a broad spectrum, noting growth in specialty access while affordability challenges are expanding even for middle-income households, and they stress veterinary medicine’s cash-based reality and the lack of a true safety net. Benson argues access solutions must be sustainable business models, citing data-driven opportunities and examples such as proactively normalizing financing options, focused care models like high-quality high-volume spay and neuter, dental an...

Dr. Josh Rosen (known online as D-O-G-T-O-R Josh) joins host Dr. Andy Roark to debate a provocative question: should veterinary operations leaders who come from outside medicine be required to complete a clinic-based onboarding before leading teams? They explore the tension between “medicine people” focused on individual patients and “operations people” focused on scale, and how lack of day-to-day context can lead to decisions (like shorter appointments, pricing changes, wellness plans, or staffing shifts) that fuel burnout, harm client relationships, and hurt retention. Rosen argues leaders do not need technical skills like drawing blood, but they do need repeated, ongoing...

Dr. Charli Dong, DACVD, joins the podcast to tackle one of the most frustrating and common cases in practice: the itchy dog that just will not get better. If you have ever had a client convinced it is “just a food allergy” while their dog continues to suffer, this episode is your playbook. Dr. Dong breaks down canine atopic dermatitis in a way that actually makes sense, from puppies presenting earlier than expected to the messy overlap between food allergies and environmental triggers. You will walk away with a clearer approach to multimodal management, including when to use diet tria...

Dr. Andy Roark welcomes Caitlin Palmer (aka “the desk winch”), a veterinary receptionist at Southern Vet Clinic and a member of the President’s Advisory Board for the North American Association of Veterinary Receptionists (NAVR), to talk about the state of the front desk. They discuss how changing communication preferences and tools like AI may increase the importance of front-desk staff as key client communicators, and why reception should be viewed as a long-term career path with better pay, recognition, and continuing education. Caitlin shares common pain points like disrespectful clients, vaccination hesitancy conversations, lack of appreciation, and the rift b...

Dr. Matthew Richardson, veterinary practice owner and director of the Veterinary Sustainability Alliance, joins Dr. Andy Roark to address a growing challenge in veterinary medicine: how clinics can reduce their environmental impact without sacrificing patient care or profitability. He breaks down healthcare’s carbon footprint and shares practical, real-world changes clinics can implement, from energy-efficient upgrades to reducing anesthetic gases. They also introduce the Green PAW Certification, a step-by-step program designed to help practices take measurable, sustainable action.

Links: https://veterinarysustainabilityalliance.org

Dr. Richardson holds a BA in Ecology and Evolutionary Bi...

Dr. Kat Sutherland (PhD), assistant professor at the Ontario Veterinary College, joins Dr. Andy Roark to tackle a question every new grad wrestles with, how do you speak up and create change without feeling like you’re overstepping? In this episode, they dive into change management for early career veterinarians, unpacking the real barriers like confidence dips, imposter syndrome, and unclear communication skills. You’ll hear practical strategies for getting buy-in from your team, navigating resistance, and advocating for yourself without burning bridges. They also explore the reality that not every idea lands, not every change happens quickly, and some...

Dr. Peter Weinstein, veterinarian and independent ownership advocate, joins Dr. Andy Roark to explore why more veterinarians are choosing to own their practices and step away from corporate structures. They break down the resurgence of independent veterinary practice ownership, including the financial realities, student debt concerns, and the desire for autonomy and purpose driving this shift. If you’ve ever wondered whether owning a veterinary practice is still possible or worth it, this episode will challenge your assumptions. Gang, let’s get into this episode.

Dr Peter Weinstein is a husband, father, pet parent, veterinarian and leader. He h...

Dr. Jules Benson, DVM, founder of Tapetum Lucidum Consulting and a data strategist, joins Dr. Andy Roark to tackle a frustrating truth in the access to care conversation, lots of well-meaning advice for vets is not practical in real clinics with limited time, fixed protocols, and real-world overhead. They dig into the “iron triangle” of cost, quality, and access (the good, fast, cheap problem), and why defining “quality” often gets tangled up with “most advanced care.” Along the way, they talk about client trust as a process issue, how most practice websites fail to differentiate who they are for, and why stra...

Dr. Nathan Peterson, DVM, DACVECC, takes us straight into one of the most uncomfortable questions in veterinary medicine: are we sometimes prolonging suffering, and what does that do to our teams? In this episode, Dr. Andy Roark and Dr. Peterson unpack medical futility, moral distress, and veterinary burnout in a way that feels both honest and actionable. They explore what happens when technicians feel stuck providing care that conflicts with their values, and why that tension matters more than we think. You’ll hear practical ideas like creating psychological safety, building a “pause button” for team concerns, and even introd...

Tasha McNerney, CVT, VTS (Anesthesia & Analgesia), tackles one of the most common clinical dilemmas, how do you safely sedate dogs and cats for quick procedures without committing them to a full day of anesthesia or risking complications. If you have ever hesitated before radiographs, wound repair, or diagnostics because you wanted fear-free handling but also needed efficiency, this episode delivers practical answers. Tasha walks through reversible sedation protocols, multimodal analgesia, and how to combine opioids, dexmedetomidine, and local blocks to maximize comfort while protecting the airway. She also shares feline sedation strategies, when to add ketamine, and how local...

Maria Pirita, CVPM, joins Dr. Andy Roark to tackle a frustrating reality many veterinary leaders are facing right now, your clinic feels slammed every day, yet the appointment book is quietly shrinking. In this Uncharted crossover episode, Maria and Andy unpack why declining veterinary visits can hide behind busy schedules filled with same day appointments, and why that pattern can create serious problems for clinic planning, revenue stability, and patient care. They explore practical leadership strategies for veterinary practice managers, including how to identify leading and lagging metrics, avoid “rollercoaster marketing,” reactivate existing clients, and build real team buy in w...

Dr. Peter Weinstein, DVM, is asking a question many veterinary professionals feel but rarely say out loud, is veterinary medicine slowly losing its soul? In this thought-provoking conversation, he breaks down the concept of the “enshittification cycle,” and how corporate pressures, rising costs, and unrealistic client expectations can pull focus away from patients, teams, and community. More importantly, he offers hope. From strengthening veterinary team utilization to improving veterinary client communication and exploring new practice models, Dr. Weinstein shares practical ways clinics can restore trust, affordability, and purpose. This episode will leave you thinking differently about leadership, affordability, and what...

Dr. Jules Benson, BVSc, MRCVS, founder of Tapetum Lucidum Consulting, tackles one of the biggest questions facing veterinary medicine right now, why trust in veterinarians feels more fragile than ever. Fresh off a conference, he and Dr. Andy Roark explore how corporate growth, changing client perceptions, and rising costs are reshaping veterinary client trust and the perceived value of care. They dig into relationship-centered care, the importance of authentic practice values, and how evidence-based veterinary medicine, including spectrum of care and real-world outcome data, can help teams communicate options clearly and confidently. You will walk away with a deeper...

Dr. Emily King, DVM, founder of All Star Veterinary Clinic and veterinary social media educator, joins Dr. Andy Roark to tackle a growing tension in veterinary medicine, the public narrative that vets, corporate groups, and private equity are driving up costs while telemedicine companies promise cheaper alternatives. After a high-profile interview featuring Dutch telehealth’s CEO stirred controversy, Dr. King shares what really happens inside veterinary clinics, how social media can build trust with pet owners before they ever walk through the door, and why transparency matters more than ever. They dig into veterinary telemedicine, private equity in veterinary me...

Dr. Emily Singler, VMD, jumps right in with a question every practice owner should be asking, are we truly supporting our people through pregnancy and parental leave, or just hoping it works out? In this episode, she and Dr. Andy Roark unpack how smart veterinary parental leave planning, thoughtful postpartum support, and clear communication help protect team morale, reduce resentment, and keep great people in veterinary medicine long term. You will walk away with practical ideas for accommodations, keeping in touch during leave, and making the return to work feel supportive for both new parents and the rest of...

Dr. Emily Singler, VMD, jumps right in with a question every practice owner should be asking, are we truly supporting our people through pregnancy and parental leave, or just hoping it works out? In this episode, she and Dr. Andy Roark unpack how smart veterinary parental leave planning, thoughtful postpartum support, and clear communication help protect team morale, reduce resentment, and keep great people in veterinary medicine long term. You will walk away with practical ideas for accommodations, keeping in touch during leave, and making the return to work feel supportive for both new parents and the rest of...

Bill Schroeder, owner of InTouch Practice Communications, jumps in to tackle a big question every clinic owner is starting to feel: if pet owners are asking AI instead of visiting websites, are veterinary clinic websites becoming obsolete? Dr. Andy Roark and Bill unpack how AI search and conversational search are changing veterinary website marketing, why strong veterinary SEO and original content still matter, and how clinics can position themselves so AI tools actually send clients their way. If you’ve been wondering whether your website is still pulling its weight, this episode gives practical reassurance and direction for the ro...

Simon F. Haeder, PhD is an associate professor of public health at The Ohio State University, and jumps in with a question every clinic feels right now, how easy is it really for pet owners to get veterinary care? Using a massive secret shopper study, Simon shares what thousands of calls to clinics reveal about preventive care appointments, rural versus urban access, and what wait times actually look like across the country. Dr. Andy Roark and Dr. Simon Haeder unpack what this means for practices, pet families, and the bigger picture of veterinary access to care, plus they explore...

Dr. Sarah Boston, DVM, DVSc, DACVS, boarded surgical oncologist, author, podcaster, and stand up comedian, joins Dr. Andy Roark for a candid, funny, and slightly unhinged conversation that started with a text message and turned into a full blown existential check on veterinary medicine. Ever feel like the system is just a little… off? From commission based pay and buried service fees to corporate pressures and the emotional tax of modern practice, Andy and Sarah dig into why so many vets feel icky about how medicine is monetized right now. You will hear honest reflections on compensation models, professional va...