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401 - Three Super-Judgy Things Vets Should Stop Saying (Maybe)
11th June 2026 • The Cone of Shame Veterinary Podcast • Dr. Andy Roark
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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 long after it's over. Gang, let's get into this episode!

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Transcripts

Speaker:

Welcome everybody to the Cone of Shame Veterinary podcast.

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I am your host, Dr.

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Andy Rourke.

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Guys, I got a great one for you today.

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If you can't afford the

vet, don't get the pet.

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You can't care more than the client does.

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That's below the standard of care.

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These are the three statements

that we are talking about today.

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I am here with Dr.

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Kate Boatwright.

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She, made a social media post

that says, these are judgy things

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that vets should stop saying.

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I had a strong reaction and

I was like, I think we should

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talk about all of these things.

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And I think that shutting

people down is maybe a bad idea.

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the whole episode, we unpack these things.

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Such a good conversation with Kate.

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we agree on some things and

we don't agree on some things.

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But it's overall, I, I, I leave the

conversation feeling really good.

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I'm glad that we got to talk.

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I think that Kate's

got really good points.

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She's so thoughtful.

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And, guys, I, I think that you're

gonna really enjoy this episode.

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It's a little bit long.

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I just didn't wanna cut it off.

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I, I was like, we've got these

three things that I want to get

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through, and I, we were just

having such a good conversation.

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I just, I had to let it

go a little bit longer.

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I think this is totally gonna be worth

your time and you're gonna enjoy it.

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I don't know.

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Let's, let's check it out and see.

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Kelsey Beth Carpenter: This is your show.

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We're glad you're here.

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We want to help you in

your veterinary career.

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Welcome to the Cone of Shame with Dr.

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Andy Roark.

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dr--andy-roark-_1_04-29-2026_130434:

Welcome back to the

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podcast, my friend, Dr.

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Kate Boatwright.

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How are you?

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kate-boatright--she-her-_1_04-29-2026_130440:

I'm good.

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It's great to be back.

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dr--andy-roark-_1_04-29-2026_130434:

It's always nice to have you.

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You are, for people who don't know

you, you're a professional writer.

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You are a mentorship consultant.

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You write a lot about mentorship.

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You are a spectrum of care advocate.

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I read a lot of your stuff on,

access to care, contextualized

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care, spectrum of care.

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you're a practicing veterinarian,

so your stuff is really grounded

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and, and actually practical,

which I always really like a lot.

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That's a big deal for me is like,

what do we actually do with this?

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And Kate, I think you s- I think

you speak really well to that.

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And so I always really enjoy your stuff.

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And you had sort of a social

media post that I came across on

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LinkedIn, because that's where

all the young people hang out.

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Uh, all the young, cool people social

media-wise, they're on LinkedIn with me.

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kate-boatright--she-her-_1_04-29-2026_130440:

Absolutely.

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dr--andy-roark-_1_04-29-2026_130434:

and yeah.

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And so, that's when I was scrolling on

the LinkedIn, and saw, I saw this post

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you had, and it was like three super

judgy things that vets should stop saying.

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And I flipped through, and the three

things that you put in this post were,

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"If you can't afford the vet, you

don't get the pet," was the first one.

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"You can't care more than the

client does," and, "That's

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below the standard of care."

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And so, like, those were the three things.

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You were like, "These are super judgy

things that vets should stop saying."

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And I kind of had an emotional reaction

at that moment because I was like, really?

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Like, like all, like there's, there's a

lot of nuance around each of these things.

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And I was like, what does she mean when

she says just we should stop saying them?

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Like, I agree that maybe they, they sound

judgy when you say them out loud, but

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also each of these, I was like, "I've said

that, I've said that, and I've said that."

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and I have meant them.

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And there's context around, like,

where I said it and why I said it.

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So part of it might just be me

going, am I the bad guy here?"

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But, but another part of me goes, "I

think that there's a lot of nuance here."

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And so, you and I have been

friends a long, long time, and

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you are a really deep thinker.

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And I thought, "Let's just,

let's, let's just hash, I'm gonna

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hash through these real quick."

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And so if you're up for it, Kate, what

I'd like to do, I'd like to start at

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the third one because I feel like,

I feel like they're less of a, a, a

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barrel of monkeys, you know, starting

at the end and then coming forward.

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And so, that's below the standard of care.

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As a super judgy thing vets should stop

saying, unpack that for me, please.

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kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

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So it's not that we need to stop

saying that's below standard of care

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because there are absolutely things

that happen out there that are below

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

need to stop doing but where,

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you know, for me, what I see a

lot is the interchange of gold

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standard care and standard of care.

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

hear a vet say, "Well, that's

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below standard of care," when what

they actually meant was that's

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not the gold standard for this.

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And there's a lot of room in between

standard of care and gold standard

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that we often are operating in.

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And so I think for me, where it becomes

judgmental is, especially if we're talking

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to a young colleague, you know, as soon

as you hear, "Oh, you did something

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below standard of care," everybody

is like, "Oh, what did I do wrong?"

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

And

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dr--andy-roark-_1_04-29-2026_130434:

that's, 'cause that's

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like malpractice, right?

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it's, it's below what your peers

would consider a reasonable standard

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of care is essentially malpractice.

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Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

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But when we start saying something's

below standard of care, when

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really it's just not the gold

standard, that's where it becomes

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

I think we, you know, we

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interchange those two terms and

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dr--andy-roark-_1_04-29-2026_130434:

So I love the idea of

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interchanging those terms.

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So gold standard and standard

of care are not the same thing,

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kate-boatright--she-her-_1_04-29-2026_130440:

we

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dr--andy-roark-_1_04-29-2026_130434:

and I do-- I really like the

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call out of not switching them.

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I have a proposal for you, and I

have a conspiracy theory for you.

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And so I'm gonna give you the proposal,

and you can tell me if you're on

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board or if you're not on board or if

you're kind of straddling the line.

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Okay.

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I think that there's three

terms that we should be using.

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And so there's gold standard of

care, which for me is the highest,

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you know, technical level at which

we could This means MRI machines.

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This means, you know, ventilators.

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This is, you know, the going to

the, to the vet schools to have, the

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specialists from Germany do the thing.

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Like, that is, the gold standard of care.

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It's like, "Yeah, I could send you down

to University of Georgia, you know,

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and, and you can get worked on there."

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Like, that is, gold standard.

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And then standard of care is,

like, what we consider to be...

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If you say, "This is not standard

of care," that means this is

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not an acceptable level of care.

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I think that there's another

phrase, and maybe this isn't right,

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but here's my proposal to you.

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I think there should be a

third phrase, which is standard

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of care for this practice.

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And the reason I'm saying that is, Kate, I

think in order to have access to care and

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to, like, actually make care affordable, I

think one of the things that has to happen

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is I think vet medicine needs to get more

transparent about who we're trying to be.

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And, like, the biggest headaches

that I have had around money

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are often when I'm working in a

really nice, h- just a high-end,

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high-touch, customer service practice.

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We have nice things, and we have a

nice building and, all of the bells

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and whistles and the equipment.

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And as a result, our prices support that

infrastructure that we've built and that

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extended time that we give to people.

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It's not right or wrong.

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And again, I think an important

part of this is me saying,

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this is not necessarily...

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It's not better than anything else.

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It's just what we did at this practice.

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It's what this practice was built for

and what those owners wanted to be

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and what that thing was made to be.

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And what is the standard of care at that

practice was pretty well defined, and

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there was definitely a space beneath that

practice's standard of care and what you

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would say is actual standard of care.

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And so here's the thing too.

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A-as, as medicine gets more sort of

corporatized or even as SOPs get more

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rigid, meaning, you know, you're, you

wanna work here, Kate, you're a vet,

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you're an associate, this is how we

work up a, a urinary tract infection.

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Like, this is what we do here.

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I don't think that's wrong

for them to say, "This is what

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we expect our doctors to do.

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This is how we expect our, our

doctors to handle these cases."

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I don't think that's wrong, and

There's, there's a place where as

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a vet I go, "I understand that this

could have been done a different way."

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That's not really allowed here,

and I don't make the rules,

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and I don't set the prices.

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And so I don't know.

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So I'm gonna stop sort of talking here.

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I think you sort of get the idea

of what I'm saying around...

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I think that, I think that there are

floors of what is acceptable at, you

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know, swanky downtown animal hospital,

and that would be totally acceptable.

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That's just not what we do here, and if I

do it here, the medical director and the

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regional director are gonna look at my

records, and they're gonna have a problem

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and say, "That's not how we do this."

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and so anyway, do you buy-- Are

you in or out on my proposal for

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this practice's standard of care?

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kate-boatright--she-her-_1_04-29-2026_130440:

I'm mostly in.

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here's my counter

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dr--andy-roark-_1_04-29-2026_130434:

I like it.

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All right.

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kate-boatright--she-her-_1_04-29-2026_130440:

one, I hate the term gold standard care.

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dr--andy-roark-_1_04-29-2026_130434: Okay.

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kate-boatright--she-her-_1_04-29-2026_130440:

have started trying to

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use textbook approach

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dr--andy-roark-_1_04-29-2026_130434: Okay.

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kate-boatright--she-her-_1_04-29-2026_130440:

pla- I think it a little less judgy,

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but still that top level, top tier

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

I absolutely agree.

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We've got that, we've got that top

tier, and we've got our standard of

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care, and I, like the idea of kind

of trying to define that in between.

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dr--andy-roark-_1_04-29-2026_130434:

I say the most medically aggressive.

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That's what...

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And I don't like it.

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I don't think that...

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I don't think

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kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

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dr--andy-roark-_1_04-29-2026_130434:

I don't.

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kate-boatright--she-her-_1_04-29-2026_130440:

like I

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never

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dr--andy-roark-_1_04-29-2026_130434:

I'll say.

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kate-boatright--she-her-_1_04-29-2026_130440:

gold standard with a

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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I will say if we want to be...

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approach this from the most

medically aggressive standpoint.

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And again, I don't like aggressive.

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it's not right, but I'm still searching.

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kate-boatright--she-her-_1_04-29-2026_130440:

Yeah, I agree.

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I have not yet discovered the perfect

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

tier, but I agree.

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Definitely top tier, and then you've

got your, your standard and I agree,

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we need more definition, or ways to

talk about those options in between.

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and I, I...

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It's part of why I really...

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I love the UK's terminology

of contextualized care

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

because it takes that like option

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one, option two, op- it takes that

rank order out of it, and it's what

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is the best option for this pet?

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but that's gonna go down

a whole other rabbit hole.

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So coming back to your idea

of like a practice standard, I

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think you're absolutely right.

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Different practices have

different standards.

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am the veterinarian where I wouldn't work

at a practice that says, "If you don't do

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it this way, we're not okay with that."

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There are some practices where the culture

is where, you know, yes, this is, this

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is our starting point, but we give our

doctors the autonomy to be flexible.

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dr--andy-roark-_1_04-29-2026_130434: Sure.

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I think that...

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kate-boatright--she-her-_1_04-29-2026_130440:

it all comes down to the

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culture of the practice.

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dr--andy-roark-_1_04-29-2026_130434:

I, I think that you're right.

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And so here's, here's kind of my...

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here's my, my, my sort of picture of this.

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I think historically it's always been like

the vets, like we meet clients where they

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are no matter what- practice you go to.

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And it still, it always bothered me when

I was at this-- Like, so there's this one

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practice I'm thinking about specifically.

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I loved it there.

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It was a great practice.

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I was really proud of the

work that we did there.

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And it bothered me when pe- people

would come in, and they would be,

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they would not have the resources

to really do what their pet needed.

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And, like, you know, the,

at some point, for a lot of

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conditions, there's a bottom line.

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You know what I mean?

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With the, if this leg is

fractured, y- you gotta fix it.

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There's n- there's not a like, "Oh,

let's kinda, you know, let's, let's skirt

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around it," or, "Let's do the cheap..."

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At some point, there's a floor to what

you can charge at this practice to do

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the procedure that needs to be done.

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Like, just there is a floor.

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And I knew that if they went down

the road a couple of miles, there was

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another practice down there that was

a low-cost, high-volume practice, and

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that their money would go a lot farther.

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And so when I say, I'm okay with

saying that's below the standard of

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care here, that is 100% dependent.

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And this is why I'm saying I think this

is the f- I'm hoping this is the future.

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I think you have to, if you're going

to do that, I think you also have to

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be transparent when people walk in

the door about what your prices are.

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Which is why when I look at the

UK, and they're like, "We need more

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tri- price transparency," at first,

I was like, "I think that's bad."

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And now I'm going, "I'm

not sure that that's bad."

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I think that being transparent about

what things cost at your practice

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is part of communicating clearly

who you are, and then you don't

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have to be apologetic about it.

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You can say, "This is what we do, and

if, you know, if you wanted a lower

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cost approach, there are other places

that you can go," and I'm gonna sleep

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soundly knowing that you know that.

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So, like, if I own Outback Steakhouse,

and you roll in, and you're like, "Oh man,

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the food here is so expensive," I'm not

gonna lose sleep at night because I know

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that you know that McDonald's is a thing.

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but in vet medicine, I don't know

that they can tell the difference

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between Outback and McDonald's.

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They're all in very similar buildings,

and they all say they have high quality

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medicine, and I think that that's sort of

the lack of transparency I'm playing with.

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So anyway, I, I could buy this.

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So that's kind of my proposal

to you is, is there a standard

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of care for this practice?

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And I, I, whether we like it or not,

and I could be wrong, I'm wondering

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if in the next five years you're

not gonna see that crystallize

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more, especially as, especially as

management uses, like, the AI scribes.

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They're like, "Tell me about what Dr.

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Roark's doing in the exam room.

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Tell me about, you know, what

recommendations he makes and things."

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I'm not, I'm wondering if we're not

coming towards an era where what the

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vets do is gonna get more scrutiny

in the rooms than it has before, and

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we're gonna find ourselves in a place

where there is an acceptable standard

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below what we are supposed to offer.

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And I, I, I, I think, I, I wonder how

we're gonna get our heads around that.

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kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

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dr--andy-roark-_1_04-29-2026_130434:

So there's that.

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So that's, that's my proposal.

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kate-boatright--she-her-_1_04-29-2026_130440:

yeah, I like the idea of like...

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I mean, and I do see it where we're

seeing, especially our independent

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practices are niching down

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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kate-boatright--she-her-_1_04-29-2026_130440:

gonna, you know, we're gonna serve

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this this population of clients.

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And I think the big thing for that to

work we have to be collaborative in our

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dr--andy-roark-_1_04-29-2026_130434: Yes.

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kate-boatright--she-her-_1_04-29-2026_130440:

You had to know that

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that practice was up the

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dr--andy-roark-_1_04-29-2026_130434: Yep

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kate-boatright--she-her-_1_04-29-2026_130440:

would be able to provide

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what that client needed.

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And

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dr--andy-roark-_1_04-29-2026_130434: Yes.

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kate-boatright--she-her-_1_04-29-2026_130440:

needing that.

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And I had the same reaction to the

price transparency, and I think as long

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as price transparency is paired with

client education about what it means,

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dr--andy-roark-_1_04-29-2026_130434: Yeah.

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:

kate-boatright--she-her-_1_04-29-2026_130440:

then I'm on board with

322

:

dr--andy-roark-_1_04-29-2026_130434: I,

and I think that that's, I think that

323

:

that is the challenge for vets, and I

think that that's a, a worthy challenge.

324

:

I think that, I think it's probably a

good thing for, you know, ABC Animal

325

:

Hospital down the road, it ... when

you look and you're like, "Man, those

326

:

guys charge 30% more than every other

vet, clinic, general practice in town,"

327

:

I think it's a good thing for them to

have to say, "This is why we do that."

328

:

And if they can't justify that,

I'm not convinced that that's bad.

329

:

I th- I really think that, you know,

the data that gets thrown out all

330

:

the time about, prices at vet clinics

are rising and visits are dropping,

331

:

that is disproportionately driven by

a certain percentage of the practices

332

:

that radically raised their prices,

333

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

334

:

dr--andy-roark-_1_04-29-2026_130434:

and they had a significant fall off,

335

:

and also they had doctors leave, and

so they lost production capacity.

336

:

And everyone's like, "Oh, man, visits

are falling across the industry."

337

:

And it's like, well, they're not really.

338

:

they're disproportionately

falling in certain practices

339

:

that have been really aggressive.

340

:

But that doesn't get communicated and,

and I think it would be interesting

341

:

if those practices that were

aggressively raising their prices, I, I

342

:

Can they, you know, can they justify

what service they, they bring above

343

:

the other practices to the pet owners?

344

:

I think that that's kind of what the

market, if you wanna say, "I want the

345

:

market to be involved in regulating

cost of, of care," I think that's

346

:

kind of what the market requires.

347

:

It's that lack of transparency, I

think, that is kind of m- muddling,

348

:

muddling a lot of things up.

349

:

I told you I had a conspiracy theory

for you, and h- here, here it is.

350

:

I think this is why I had an

initial negative reaction when I

351

:

read this thing about, you know,

that's below the standard of care.

352

:

And I'm just curious if

you, if you can buy in.

353

:

You can give me a one to five, where five

is I'm totally on this conspiracy theory

354

:

with you, Andy, and one is I think you're,

I think you're tinfoil hat-wearing.

355

:

there is an attack on standard of care in

vet medicine right now from groups that

356

:

would very much ... They, they very much

would like to implement business practices

357

:

that are currently not allowed to them

because we have a standard of care.

358

:

And so I see groups out there who are

s- who are things like, "You know, boy,

359

:

we could save pet owners a lot of money

if, they didn't have to see the vet.

360

:

They could just come into our store

and, and straight up get our stuff.

361

:

Boy, we could save pets, pet

owners a lot of money if their

362

:

pets never had a physical exam.

363

:

They could just tell us what they

think is wrong, and we could sell them

364

:

the drugs that we think are right.

365

:

Boy, we could save pet owners a lot

of money if we had people who are

366

:

not veterinarians doing surgery."

367

:

Just think of ... And then you go, "But

that's below the standard of care."

368

:

And I think that there are a, a,

there's a select group- With a lot

369

:

of influence that wants to tear down

standard of care as an idea and be

370

:

like, "That's a bunch of garbage.

371

:

That's-- Standard of care is not

something that, that, that even

372

:

we should even be talking about.

373

:

That's, that's just from

misinformed veterinarians."

374

:

And so again, that's

conspiracy theory Andy.

375

:

Scale of one to five,

are you in, are you out?

376

:

kate-boatright--she-her-_1_04-29-2026_130440:

I'm getting on the ship with you, yeah.

377

:

dr--andy-roark-_1_04-29-2026_130434: Okay.

378

:

All right.

379

:

I like this.

380

:

All right, I got it.

381

:

All right, I'm gonna move on.

382

:

We're gonna run out of time here,

but I, I, I wanna talk about this.

383

:

Number two, working backwards , you

can't care more than the client does.

384

:

I-- This-- Of the three things

that you put on there, this was

385

:

the most-- This is one I was most

surprised to kind of see from you.

386

:

Tell me why, why did you pick this one?

387

:

What, like, tell, t- give me,

give me your head space here.

388

:

kate-boatright--she-her-_1_04-29-2026_130440:

and like you said, I mean, there's,

389

:

there's a ton of nuance here.

390

:

dr--andy-roark-_1_04-29-2026_130434:

Right.

391

:

kate-boatright--she-her-_1_04-29-2026_130440:

said to me, I, I've, I'm sure

392

:

I've said it to other people.

393

:

dr--andy-roark-_1_04-29-2026_130434:

Yeah, tell me.

394

:

kate-boatright--she-her-_1_04-29-2026_130440:

that it, it kinda ca-

395

:

floated through my mind.

396

:

and you know, for me, we absolutely

get into situations where we face moral

397

:

distress and ethical dilemmas because

we know that this pet needs a certain

398

:

level of care and the client isn't

able to provide it or isn't interested

399

:

in pursuing it, but at the same time

they don't wanna euthanize, and we get

400

:

into these really sticky situations.

401

:

I think this phrasing comes around

as a way, you know, to kind of help

402

:

us separate ourselves and, and give

us a l- uh, s- give us some comfort

403

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

404

:

kate-boatright--she-her-_1_04-29-2026_130440:

you know, "Yes, I see that you care.

405

:

I know this is hard."

406

:

I am 100% on board with that.

407

:

Where I think concern and where

I think the judgment comes in is

408

:

Assuming that the client doesn't care,

409

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

410

:

kate-boatright--she-her-_1_04-29-2026_130440:

and I think that's where

411

:

I struggle with it.

412

:

and, and that was the best

phrasing I could kinda come

413

:

up with to capture that Idea

414

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

415

:

kate-boatright--she-her-_1_04-29-2026_130440:

the client isn't doing what we recommend,

416

:

they don't care about their pet,

417

:

dr--andy-roark-_1_04-29-2026_130434:

when when I s-

418

:

kate-boatright--she-her-_1_04-29-2026_130440:

what I don't agree with.

419

:

dr--andy-roark-_1_04-29-2026_130434:

I-- When I sat with this for a while,

420

:

I was like, "What is she-- Like,

why is that a super judgy thing?

421

:

What does she mean?"

422

:

I do think you're...

423

:

Okay, so I think you have a really

strong point here, and I think that,

424

:

I think that you're right in that

when I say to the young doctor who's

425

:

crying because this person just is

like, "Nah, I'm not, you know, I'm not

426

:

treating this skin infection again.

427

:

We can put him to sleep."

428

:

when, and she, and she's crying,

and I go, "Look, you can't care

429

:

more than the pet owner does."

430

:

first of all, that's a

terrible hollow thing to say.

431

:

I think what I am trying to say, and,

and don't get me wrong, I don't say

432

:

this a lot, but I have said it, and I

have said it to younger doctors in a

433

:

moment when I didn't know what else to

say, in that I think in order to be, I

434

:

think to be successful in vet medicine

and to be, and to, and to, to be safe,

435

:

I guess, over the long term, I think

you have to be able to keep a certain

436

:

amount of emotional distance in order to

do what we do day after day after day.

437

:

And maybe I'm wrong, and like, again,

I, I, I think I should probably

438

:

just caveat this all and say I'm

speaking very much for myself.

439

:

Maybe there's other people who can,

who can put their heart into this and,

440

:

and be fully, you know, empathizing,

empathetic every day in every appointment.

441

:

I just can't.

442

:

In order for me to be happy and to be

able to keep putting the white coat on day

443

:

after day, I have to keep a certain amount

of, of clinical and emotional distance.

444

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

445

:

dr--andy-roark-_1_04-29-2026_130434:

doesn't mean I don't care, right?

446

:

There's cognitive empathy,

and there's emotional empathy.

447

:

And cognitive is I go, "I can

totally understand how they feel."

448

:

And like that, I recognize that it's

absolutely heartbreaking, and I don't

449

:

know what I would do in their position.

450

:

But the emotional empathy is like,

is as if I'm the pet owner's, like

451

:

this is part of my family, and I go,

"That's just not sustainable for me."

452

:

I think I do see that, and the

nuance for me is I do think

453

:

the difference in cognitive and

emotional empathy is important.

454

:

I think vets should be, should work

on cognitive empathy, which is really

455

:

understanding in a non-judgmental way what

people are going through, what they're

456

:

experiencing, what they're w-worried

about, what they're really asking, what

457

:

the question behind the question is, and

being as supportive as they can be while

458

:

also not letting-- You can't put your

heart into the euthanasia room four times

459

:

to five times a day and, and be okay.

460

:

At least, at least I can't.

461

:

And so anyway, I, that's,

that's how I feel.

462

:

I think your point about the judgment,

I think is a really good one.

463

:

kate-boatright--she-her-_1_04-29-2026_130440:

before you brought up the cognitive

464

:

versus emotional empathy, that was

exactly what was going in my head is

465

:

like, I think I first read that in, Oren

Jay Sofer's book, "Say What You Mean."

466

:

and if you haven't read it, it's

a fantastic communication book.

467

:

I highly recommend.

468

:

But it, But yeah, that difference of

levels of empathy, and I 100% agree.

469

:

Like, we h- we have to have

empathy in vet med, but I think

470

:

we have to dig into that deeper.

471

:

It's not just I'm gonna emotionalize

and internalize every case.

472

:

And it's-- That's something

that came very difficult to me.

473

:

and some

474

:

dr--andy-roark-_1_04-29-2026_130434:

it's hard.

475

:

kate-boatright--she-her-_1_04-29-2026_130440:

closer to home.

476

:

and there, you know, there are

absolutely some where, like, I am,

477

:

you know, I am an emotional wreck

478

:

dr--andy-roark-_1_04-29-2026_130434:

Oh, yeah.

479

:

kate-boatright--she-her-_1_04-29-2026_130440:

them.

480

:

I also have strategies that I've

developed over time to support my--

481

:

You know, say, to say, "Okay, I know

tonight I need to give myself a break."

482

:

Like, you know, I can't go

home and watch a medical drama.

483

:

That's

484

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

485

:

kate-boatright--she-her-_1_04-29-2026_130440:

to home.

486

:

dr--andy-roark-_1_04-29-2026_130434:

Right.

487

:

Yes.

488

:

kate-boatright--she-her-_1_04-29-2026_130440:

no, no binging "The Pit" tonight.

489

:

I need

490

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

491

:

kate-boatright--she-her-_1_04-29-2026_130440:

you know, different.

492

:

dr--andy-roark-_1_04-29-2026_130434:

Oh, yeah.

493

:

I think everybody's got buttons,

and as you go on in your life, you

494

:

will develop new buttons, you know?

495

:

And it's funny.

496

:

I, I'll give you a weird sort of

analogy of this is when I was young,

497

:

when I was a young man, I watched

movies all the time about where

498

:

children were taken, and the hero had

to chase after them and retrieve them.

499

:

And I was like, "Yeah."

500

:

And then when I became a parent of young

children, like, kidnap movies, like, they

501

:

really stressed me out in a deeper way

that, you know, I never felt that before.

502

:

But, you know, you

503

:

kate-boatright--she-her-_1_04-29-2026_130440:

thousand

504

:

dr--andy-roark-_1_04-29-2026_130434:

these periods.

505

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yes.

506

:

Yeah.

507

:

dr--andy-roark-_1_04-29-2026_130434:

then you, you...

508

:

I think I, I think you develop that.

509

:

At least for me, I think you

develop that with breeds.

510

:

You know what I mean?

511

:

You say, you know, I had this...

512

:

I had a, I had an old Vizsla that I put to

sleep who was my, you know, my, my heart

513

:

dog, and I think when I put old Vizslas

to sleep, I, I can't help but, like, my...

514

:

There's a, a more emotional empathy

there than I want there to be.

515

:

Like, I, that brings back

a real part of me that I...

516

:

And again, I don't, I'm not

trying to put it into a box,

517

:

but also I have to be aware.

518

:

Like, that, that's, that's a bigger

toll on me than, than sort of some,

519

:

some other, It's either euthanasia

appointments, stuff like that.

520

:

moving on.

521

:

I, I, I wanna take this idea of, I

think the judgment in the last thing

522

:

that we talked about, you can't

care more than the client does.

523

:

We're, we're making a judgment about

how much this person cares, right?

524

:

I think that there's a lot

of judgment ideology tied up

525

:

in this, in this last one.

526

:

If you can't afford the

vet, don't get the pet.

527

:

Okay?

528

:

I-- This, this one lights me off right

now, and like, I'm trying not to let it...

529

:

Like, I, but I have an emotional

reaction to this and, and

530

:

I'll tell you why in a minute.

531

:

But, but lay this down for me, Kate.

532

:

if you can't afford the

vet, don't get the pet.

533

:

There's some version of that I think

everyone has heard and heard said or

534

:

more likely recently heard reported that

veterinarians said, things like that.

535

:

But so s- lay that out for me.

536

:

Kind of what's your thinking

about that as far as a, a judgy,

537

:

a judgy thing vets shouldn't say?

538

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

539

:

So, and, and I think this is

another one that the context that

540

:

you're saying it in changes the

541

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

542

:

kate-boatright--she-her-_1_04-29-2026_130440:

Because yes, there are clients that

543

:

we have that, you know, have multiple

pets and we know they, you know, they

544

:

struggle to afford the preventative

care, and then they get another pet,

545

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

546

:

kate-boatright--she-her-_1_04-29-2026_130440:

like: "Why?"

547

:

You know,

548

:

"Why did we

549

:

dr--andy-roark-_1_04-29-2026_130434:

Or they, go and buy another pet, right?

550

:

I mean, like, I, I'm not trying to

be a, a jerk here, but, like, we...

551

:

If you've been in vet medicine very

long, you have seen the person who

552

:

really struggles to pay to, for

preventative care for their pets,

553

:

and then they come in with a Frenchie

they spent, you know, $3,000 on.

554

:

And again, so now I'm getting

judgy here, but, like, I'm not...

555

:

This is-- Everything I just said has been

reported to me as, you know, as true.

556

:

I'm not, I'm not guessing at

what they paid, but th- they have

557

:

come in and said, "Yeah, I spent

three grand on this Frenchie."

558

:

And I'm thinking you have You know,

you have raged at me personally

559

:

for what minimal care costs in, you

know, in the past, and it was nowhere

560

:

close to that, to that figure, and

I felt like I bent over backwards to

561

:

help you get the pa- care you need.

562

:

And then you have, you've added a,

a- another pet that's gonna need care

563

:

on top of that, and at some point...

564

:

Anyway, so I have a, a bit of

emotional reaction to that.

565

:

And again, still assuming the best

intent and seeing people as good

566

:

and wanting people to have love in

their hearts and in their families,

567

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

568

:

dr--andy-roark-_1_04-29-2026_130434: those

things can be really hard to balance if

569

:

you're a human being looking at them.

570

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah, and so that's where, you

571

:

know, like, I, like, I, I totally

understand where the phrase comes from.

572

:

I've

573

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

574

:

kate-boatright--she-her-_1_04-29-2026_130440:

had, you know, situations

575

:

where I'm like: "Why?"

576

:

You know, "Why are we

getting this new pet?"

577

:

but I think, you know, I think

the situation where I struggle

578

:

with it when I've heard it is in

situations where maybe this is an

579

:

older pet, you know, new client.

580

:

We don't know the history.

581

:

Maybe when they got that puppy, they

had a six-figure income and did all the

582

:

things, and now they've lost their job.

583

:

You know, they're doing, you know,

they're doing what they can to scrape

584

:

by, and it's like, well, that doesn't

mean they don't deserve to, you know,

585

:

to keep this pet in their family.

586

:

dr--andy-roark-_1_04-29-2026_130434:

Absolutely.

587

:

kate-boatright--she-her-_1_04-29-2026_130440:

so that's where I struggle with that, is

588

:

where we just pass that blanket judgment,

589

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

590

:

kate-boatright--she-her-_1_04-29-2026_130440:

and say like: "Well, you know, if you

591

:

can't afford, you know, if you can't

afford care, you shouldn't get a pet."

592

:

And I also struggle because we

know that there are so many health

593

:

benefits to pet ownership for our

594

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

595

:

kate-boatright--she-her-_1_04-29-2026_130440:

And so from a, from out from

596

:

that One Health perspective,

there are things that...

597

:

You know, I think there are a lot of

opportunities for support, and there

598

:

are a lot of options for basic care

599

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

600

:

kate-boatright--she-her-_1_04-29-2026_130440:

can be met.

601

:

and so I think just making a blanket,

well, if you can't afford the pet...

602

:

Well, if you go into it and you have,

you know, you know that, you know,

603

:

you can do the basic care, you have

the support system to be able to

604

:

get that level, you know, that basic

care, yeah, you m- you may not be

605

:

able to afford the $1,000 emergency.

606

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

607

:

kate-boatright--she-her-_1_04-29-2026_130440:

go into-- going into it with a plan,

608

:

and as long as people are educated

609

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

610

:

kate-boatright--she-her-_1_04-29-2026_130440:

it, that's where I, I don't want us

611

:

to just put a barrier up of like,

"Oh, if you don't have X amount

612

:

of money, you can't own a pet."

613

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

614

:

I, I think, I think you're

s- I think you're spot on.

615

:

I, I have always believed that I, that

veterinarians should not judge clients.

616

:

Like, I, I think that looking in the

parking lot and saying, "This person

617

:

who's complaining about the price

is driving a BMW," I think that...

618

:

I, I think that's bad.

619

:

I think that's unfair to that

person, 'cause you really don't

620

:

know anything about that person,

621

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

622

:

dr--andy-roark-_1_04-29-2026_130434:

also it's only gonna make you unhappy,

623

:

and it's not gonna change the situation,

and it just makes you resentful.

624

:

It's kind of this poison that you're

drinking just for yourself, expecting

625

:

it to somehow, like, cure a situation.

626

:

It j- it just doesn't, it doesn't work.

627

:

And, you know, it's funny, there's,

there's multiple ways to look at this.

628

:

So, so there's the, the, you know, you

have the person with the BMW and the pet,

629

:

and, you know, they lost their job, and

we ha- we have no idea, and it's not our

630

:

business to know, and things like that.

631

:

And I'll go even further.

632

:

At the same time, I know that...

633

:

So, Meals on Wheels is a charity that

I think is absolutely wonderful, right?

634

:

it's, it's an organization that takes food

to people who can't leave their homes.

635

:

Most of these people are,

are, are elderly people.

636

:

Most of them live alone.

637

:

It's not even just the

food that they bring.

638

:

It's the...

639

:

It, it, the nutrition is, is really

important for these people, but

640

:

also just the companionship, having

someone come to their home, and,

641

:

like, that, I love that organization.

642

:

That organization means a lot to me.

643

:

And there are statistics about what

percentage of the people who receive,

644

:

like, Meals on Wheels also have pets,

and one of the big problems that Meals

645

:

on Wheels have is that these people will

give part of their food, which is one meal

646

:

a day, they will give it to their pet.

647

:

And I would never wanna

take that person's pet away.

648

:

I, I, like, w- I, I can get emotional

sort of thinking about, like, imagine

649

:

just being by yourself, and you're

puttering around this little apartment

650

:

or this little house all day and, and

you have very limited mobility, and

651

:

you've got this little companion, and

someone's like, "Well, you can't afford

652

:

that pet, so you shouldn't have it."

653

:

I'm like, like, that's horrible to...

654

:

Like, and you know what I mean?

655

:

Like, that is absolute

villainy in, in my mind.

656

:

I saw this guy.

657

:

I was just driving down the road.

658

:

This is, like, yesterday morning,

driving down the road, and there was

659

:

this guy just walking down the railroad

track, 'cause the, the road goes over

660

:

the bridge, which is over the railroad

tracks, and he, he's walking down.

661

:

He's got his backpack on.

662

:

I'm presuming it's probably everything

he owns in this backpack, and it was just

663

:

that picture because he had the yellow

Lab that was just, you know, just kind

664

:

of trailing behind him, and, like, you

could tell, just at 45 miles an hour, you

665

:

could tell that dog was with that guy.

666

:

And there was...

667

:

It wasn't, there was no leash, which

again, you could say, "That's awful.

668

:

He should have a leash."

669

:

Like, he didn't have a leash.

670

:

He was just walking along behind

this guy, and I'm like, "I would

671

:

never wanna separate those people."

672

:

someone who's got seven dogs is screaming,

has screamed at this vet, "How dare you?

673

:

How could you, charge

this, you know, for this?"

674

:

Or whatever.

675

:

And the person, I'm like, "You know,

look, this person's got a pile of animals,

676

:

and it's not your responsibility to

pay for their, for their healthcare."

677

:

Like, that's not the

responsibility of the veterinarian.

678

:

And so when I have that thought, or if I

say that, that's really what I'm, what I'm

679

:

sort of getting at is I, I believe that.

680

:

And so it's funny, I saw, there

was a survey that came out, and

681

:

it was, it gave vets two options.

682

:

It was for veterinarians, gave

them two options, and it said,

683

:

"Which of these two statements are

you most likely to agree with?"

684

:

You only have two options.

685

:

The first one was, "If people can't

afford pets, they shouldn't have them."

686

:

And the second one was, "The vet

industry has a responsibility

687

:

to help people get care."

688

:

And that was the two, the two options.

689

:

And I felt like that was really a

manipulative question because I think,

690

:

I think that that whole if people who

can't afford pets shouldn't have them, I

691

:

think that that's language that's meant

to be emotional, and it makes you feel

692

:

like a villain if you check that box.

693

:

I think it's meant to make

vets feel like a villain.

694

:

And the only other option is, in my

mind, veterinarians have a responsibility

695

:

to make this happen for people.

696

:

And I go, I, I don't think that

that's a reasonable expectation.

697

:

Like, I, and I don't like the moral

weight being put on me of, "Hey, Andy

698

:

Roark," in- say you're an independent

practice owner, "Hey, you need to,

699

:

like- Either, either people who can't

afford pets shouldn't have them, or

700

:

you need to make this care happen.

701

:

I'm like, "Well, wait a second now.

702

:

I, I didn't, I didn't sign up to pick

up the tab for everyone who comes in and

703

:

says they're having emotional hardships."

704

:

Like, a- again, and, and maybe that

makes me seem like a monster, but I'm

705

:

really looking at this as a practitioner

of almost 20 years who loves this

706

:

job and who wants to keep going.

707

:

And as I-- boy, I've seen so many

of our colleagues, I've seen them

708

:

financially, you know, just crash and

burn because they gave everything away.

709

:

They couldn't charge for their services.

710

:

And I understand their heart was in

the right place, but they ended up

711

:

working until they died because they,

like, they, they weren't able to

712

:

take care of themselves financially

because they didn't feel that that

713

:

was something that they could do.

714

:

And then also just the burnout, you

know, of the people who are like,

715

:

"I want to go home and be with

my family and my young children."

716

:

But these people, you know, "But

you have a responsibility to

717

:

stay here and do surgery tonight

because, you know, that's, that's

718

:

the only way this is gonna get done.

719

:

And also, by the way, these people

can't really pay for it, so you're

720

:

also gonna lose money doing it."

721

:

And I go, "I, I'm sorry, I don't

think that that is a reasonable

722

:

burden to put on veterinarians."

723

:

And so anyway, it's, it's hard for me

to juggle both of those things of, of,

724

:

of really wanting to support pet owners

and being non-judgmental, and also to

725

:

be adamant, and I am adamant, it is not

the responsibility of the veterinarian

726

:

to pay for people's healthcare.

727

:

Like is our res- it is our responsibility

to do the best job that we can.

728

:

It is our responsibility to

prioritize the, the care of the

729

:

pet and to be the pet's advocate.

730

:

Like there's-- we have a lot of

responsibilities, but actually

731

:

picking up the tab, I, I don't know

that that is our responsibility.

732

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

733

:

And, and I agree with that.

734

:

I think what-- I, I think, you know, like

you said, it's, it's our responsibility

735

:

to, to work with clients and try to find,

you know, it's being comfortable offering

736

:

that range of options or knowing that the

clinic up the street can, you know, can do

737

:

that surgery and, and it's go-- you know,

here's the pros and cons of, you know,

738

:

going to the specialist versus the n- you

know, the non-specialist for this surgery.

739

:

But that doesn't mean it's, you know,

it doesn't mean it's below standard

740

:

of care to go to and, and I think, you

know, and, and I think this is where,

741

:

you know, and, and I hope to continue to

see more conversations around, know, how

742

:

we, how we give people options to pay

743

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

744

:

kate-boatright--she-her-_1_04-29-2026_130440:

I

745

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

746

:

kate-boatright--she-her-_1_04-29-2026_130440:

pay at time of service all or

747

:

nothing is it-- we gotta change it.

748

:

dr--andy-roark-_1_04-29-2026_130434:

Oh, I, I'm so, I am so with you.

749

:

Like, this is...

750

:

So this has been a project I'm

actually working on right now.

751

:

And so I've had this...

752

:

I've, I've, I've been

wrestling with this a lot.

753

:

And so there, you know,

there are I said tinfoil hat.

754

:

There are definitely people out there

who have ideas about how to give

755

:

prescription medications to people more

cheaply, you know, or make wellness

756

:

care happen more cheaply by, you know,

by, by not, by just saying people

757

:

don't need to see veterinarians, that

physical examinations aren't important.

758

:

And, and I think that that's...

759

:

H- here's the thing.

760

:

I think the vast majority of people

would save money under that model and

761

:

not have problems, the vast majority.

762

:

But the ones who do have problems

are gonna have huge problems, and

763

:

pets are gonna suffer and die.

764

:

And then those people are gonna show up

with a pet that has a foreign body for

765

:

three days, you know, and is terribly

dehydrated or, a, a cat that's in, that's

766

:

a, that's in DKA, diabetic ketoacidosis,

because we treated its, diabetes with

767

:

some antibiotics because nobody does a

physical exam, nobody did any diagnostics.

768

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah,

769

:

dr--andy-roark-_1_04-29-2026_130434: And,

770

:

kate-boatright--she-her-_1_04-29-2026_130440:

checked the urine.

771

:

They just assumed it was a UTI.

772

:

dr--andy-roark-_1_04-29-2026_130434:

exactly right.

773

:

And, like, there's going to be a real and

significant cost for those unfortunate

774

:

people, and I think that there's,

there's a big enough percentage of

775

:

them that, that that's going to, that

that's gonna, that's gonna be a problem.

776

:

And here's the thing.

777

:

one, I, I think you're gonna see a

real problem with, with affordability

778

:

of care when people have been told,

"Oh, you don't need to see the vet.

779

:

You can do these other things."

780

:

And now we're gonna get pets

three days later, and you're

781

:

gonna see a real problem in care.

782

:

The other thing is this, and this

isn't, this is about sort of any of

783

:

the online pharmacies or pharmacies,

moving out of the vet clinic.

784

:

Vet medicine was built on a model where

product sales subsidized veterinarian time

785

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

786

:

dr--andy-roark-_1_04-29-2026_130434:

It like, from the ol-- from James

787

:

Herriot days, like he didn't

charge for his hourly rate.

788

:

He went out there and he sold

dewormer and vaccines, and that

789

:

paid for his time and energy.

790

:

And veterinarians to

this day still do that.

791

:

I s- I would say, honestly, the time when

you go into a vet clinic and you see the

792

:

technician who's credentialed, and you

see the veterinarian, and you talk to them

793

:

and you're there for 45 minutes, or heaven

forbid, your pet's there for surgery

794

:

and they're doing an hour-long surgery,

and you've got multiple technicians and,

795

:

you know, things like that, all of that

cost has been subsidized by products.

796

:

And if those products go away and

people buy that stuff somewhere else,

797

:

there's not gonna be any alternative

except for veterinarians to charge

798

:

purely for the time of their, their,

of themselves and their people.

799

:

And you're going to see the cost of, of

things like surgeries, you're gonna see

800

:

diagnostic costs, they are going to go up

to make up for the fact that these profit

801

:

centers have been lost from vet practices.

802

:

And again, I don't-- I'm not blaming

pet owners, and I don't expect pet

803

:

owners to have this long view of,

"If I get a script and go somewhere

804

:

else, the long-term impacts are this."

805

:

I don't expect that.

806

:

And they, they're not

bad for trying to find

807

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

808

:

dr--andy-roark-_1_04-29-2026_130434:

the, the best way to, to take

809

:

care of their pets and save money.

810

:

I can't blame anybody for that at all.

811

:

But I still do look at that

and say, I think that there's

812

:

two types of access to care.

813

:

There's access to care, around

wellness care, you know, like vaccines,

814

:

deworming, just flea control, and

then there's, access to care for

815

:

surgical procedures, things like that.

816

:

And when you say, "If people can't

afford pets, they shouldn't have them,"

817

:

I thought you brought this up earlier

really nicely, what are we talking about?

818

:

Are we talking about if you can't

afford rabies vac- a rabies vaccine,

819

:

then you shouldn't have a pet?

820

:

Like, well, I mean, at some point, maybe

that's ma- like we're at, that's pretty,

821

:

that's a pretty bad spot to be in.

822

:

or are you saying if you can't afford

to go and pay $2,500 for a foreign

823

:

body surgery, you shouldn't have a pet?

824

:

And I go, I don't think anybody thinks

that that's, that that's the case.

825

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

826

:

dr--andy-roark-_1_04-29-2026_130434:

anyway, I just, I think that, I think

827

:

that's starting to kind of get into the

nuance of like, what are, what are we,

828

:

what are we even talking about here?

829

:

Anyway, I, I think, I think overall,

I think trying to judge people and

830

:

say, "This person should have a pet.

831

:

This person shouldn't have a pet," I

don't think any of that stuff makes sense.

832

:

I think that you're absolutely

right about we need to talk to

833

:

people about how to get, care

834

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

835

:

Mm-hmm.

836

:

dr--andy-roark-_1_04-29-2026_130434:

pay for it.

837

:

And so I was, you know, thinking

about surgeries and, and the higher

838

:

cost, you know, of, of procedures.

839

:

I bought, I bought tickets to see the

Atlanta Hawks to play with my daughter.

840

:

So she's re- she's gotten really

into sports, and she's like, "I

841

:

wanna go see these basketball games."

842

:

And I went and I looked at what do NBA

tickets cost, and they're not, they're not

843

:

wildly expensive, but they're not cheap.

844

:

But the thing that struck me, Kate,

was from the moment you start looking

845

:

at tickets, they are showing you

what they cost on a monthly basis.

846

:

Like, just straight, straight

off the bat, they were like...

847

:

You know, I looked at the Atlanta

Hawks and they were like, "This

848

:

is, this is the full price.

849

:

This is your Hawks pay price."

850

:

And it was broken down

into a monthly payment.

851

:

And it was like they

didn't wait for you to ask.

852

:

They didn't let you say, "Oh, this is

too expensive," or things like that.

853

:

They were just very upfront with, "This

is how we can break these prices down.

854

:

This is what we can do."

855

:

And that kind of spoke to me as

like, maybe, you know, I don't see

856

:

a downside to us as a profession

starting to think more about that

857

:

and trying to help people that way.

858

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah, and there's da-- there are, you

859

:

know, there are companies that run

managed payment plans, and there are

860

:

published papers with high repayment rates

861

:

dr--andy-roark-_1_04-29-2026_130434: Yes.

862

:

kate-boatright--she-her-_1_04-29-2026_130440:

so I do, I, I, you know, it, it is in

863

:

a model I'm very interested in and,

and do a lot of, you know, you know,

864

:

kind of try to keep up with, you know,

what's available and all of that.

865

:

And, you know, going back to

your responsibility, comment

866

:

earlier, you know, I, I agree.

867

:

That should not be responsible

for subsidizing the care But I do

868

:

think we need to be responsible

for educating clients about the

869

:

importance of that routine care.

870

:

The importance of, hey, if you are coming

in for that routine exam and, you know,

871

:

hey, you've mentioned now that your cat's

PU/PD and we noticed it lost a pound this

872

:

year, maybe, you know, we're gonna have

873

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

874

:

kate-boatright--she-her-_1_04-29-2026_130440:

And I've had some clients where I've said,

875

:

"Hey, you know, this is an obese cat.

876

:

They've lost a little bit of weight.

877

:

You're telling me you feel

like they're drinking more.

878

:

Yeah, ideally, let's run

a full senior blood panel.

879

:

If we can't do that, how about

we just check a blood sugar?"

880

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

881

:

Yeah, yeah.

882

:

kate-boatright--she-her-_1_04-29-2026_130440:

caught diabetes that way of

883

:

dr--andy-roark-_1_04-29-2026_130434:

Yeah, or I was gonna say, or

884

:

check, check, check your analysis.

885

:

Yeah, something like that.

886

:

Yeah.

887

:

kate-boatright--she-her-_1_04-29-2026_130440:

usually, I...

888

:

The blood sugar's cheap,

so I'm like, "Let's check

889

:

dr--andy-roark-_1_04-29-2026_130434:

Oh, nice.

890

:

Yeah.

891

:

kate-boatright--she-her-_1_04-29-2026_130440:

high, now we're gonna run...

892

:

You know, now I have more to say,

"Hey, this-- I'm really concerned

893

:

that this could be diabetes.

894

:

the other...

895

:

You know, here's what we

need to do to confirm this."

896

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

897

:

I think you're right.

898

:

I, I remember early on I had a mentor

that, that I worked with and, you know,

899

:

we had, I can't remember what case it

was or what was going on, but, but it was

900

:

something and, and the owner really could

not afford-- They couldn't afford care.

901

:

They could afford some of the care.

902

:

And I kind of went to the, this guy,

'cause he was the boss and he owned

903

:

the place, and I was like, "You know,

I'm looking at this and I wanna help

904

:

these people out, and this is kind

of what they have, and I'm just kind

905

:

of where I really truly think we

need to get to in order to do care

906

:

that's gonna actually help this pet."

907

:

And he was like, "You know what?

908

:

Just do it."

909

:

And I said, "Okay."

910

:

and it sort of my business mind was

kicking in, but I was like, "How do

911

:

you, how do you kind of justify that?"

912

:

I asked him later, like, "How do you..."

913

:

He like, "You just, just, just do it."

914

:

And he said, "You know, some things

in vet medicine are the cost of

915

:

doing business, and like sometimes

you just take care of people.

916

:

That's just what you do."

917

:

kate-boatright--she-her-_1_04-29-2026_130440:

Mm-hmm.

918

:

dr--andy-roark-_1_04-29-2026_130434:

always remembered that, and

919

:

I think he's totally right.

920

:

But I think that I, I think I rage

against the expectation that veterinarians

921

:

will pick up the tab even while

I don't personally have that much

922

:

of a problem, you know, sometimes,

923

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

924

:

dr--andy-roark-_1_04-29-2026_130434:

like trying to help people out.

925

:

But it's funny, but it's really

about like, for me, it's very much...

926

:

It's one thing when you do something

nice for someone and they're, and

927

:

they're grateful, and you feel good

that you did this and you helped.

928

:

It's another thing when you do something

nice for someone and they fully just

929

:

expected you to do that for them, and

they don't seem to be appreciative of it.

930

:

And, and I, I...

931

:

A- And there's just, there's so

much nuance and context around,

932

:

around money and judgment.

933

:

And I think that this is an area

that, it's where we obviously continue

934

:

to-- we need to continue to kind

of work and sort of find our path.

935

:

And I don't think there's gonna

be a, you know, a magic solution

936

:

that's gonna fix everything.

937

:

I think it's gonna be multimodal.

938

:

I think it's a lot about

communication and planning.

939

:

I do think we can do a lot more

work in payment strategies.

940

:

I think that we can do more work

in talking about pet insurance,

941

:

especially as the cost of like emergency

surgery and things go up, which is

942

:

what pet insurance is perfect for.

943

:

There-- I just think that there's

a lot of things like that.

944

:

kate-boatright--she-her-_1_04-29-2026_130440:

there's

945

:

dr--andy-roark-_1_04-29-2026_130434: Cool.

946

:

kate-boatright--she-her-_1_04-29-2026_130440:

lot of opportunity, and I think we're

947

:

at the I feel like we're kind of at

a crossroads in the profession where

948

:

there's, there's a lot of external

threats, there's a lot of opinions,

949

:

and it's, you know, it's time for us to

decide what we want the profession to

950

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

951

:

Oh, I agree.

952

:

kate-boatright--she-her-_1_04-29-2026_130440:

want that future to be.

953

:

dr--andy-roark-_1_04-29-2026_130434: My,

my worry is that there will be a push,

954

:

powered by public sentiment about vet

medicine being too expensive that will

955

:

make wellness care much cheaper for,

pet owners and drive the cost of things

956

:

like s- like life-saving emergencies,

like surgeries, things like that.

957

:

That's gonna really drive those

costs up because, vets are gonna

958

:

lose a- all those sort of the profit

centers, and they're not gonna be

959

:

able to subsidize those things.

960

:

And, and I, I really worry that we're

gonna move much more towards a culture

961

:

where, euthanasia is a very common,

response to things that in the past we

962

:

could have fixed surgically, but just

the costs have just gone up so much.

963

:

And it was, it was interesting.

964

:

I was, I was listening to

somebody, and they were talking

965

:

they were talking about, you know, having

a foreign body procedure, for, for $7,000.

966

:

And again, I live in South

Carolina, and they were like,

967

:

"Oh, yeah, you know, we, we...

968

:

You go in and you do the

$7,000 foreign body procedure."

969

:

And Kate, I remember when foreign

bodies were, you know, we could

970

:

get it done $1,500, $2,000, and

I haven't been around that long.

971

:

but that was just wild to me, $7,000.

972

:

And it's like I just don't know many

people who got $7,000 laying around.

973

:

And so anyway, that's,

that's sort of my concern.

974

:

Well, thank you for being here, my

friend, and talking through this with me.

975

:

I love your writing.

976

:

I love your articles.

977

:

I love digging into these,

into these ideas and getting

978

:

into the nuance with you.

979

:

Kate, where can people find you online?

980

:

Where can they follow along with

what you do and learn more about it?

981

:

kate-boatright--she-her-_1_04-29-2026_130440:

Yeah.

982

:

So the best way to follow along, is to

follow me on either Instagram or LinkedIn.

983

:

I do post the same

984

:

dr--andy-roark-_1_04-29-2026_130434: Yeah.

985

:

kate-boatright--she-her-_1_04-29-2026_130440:

is, you know, kind of that perpetual like

986

:

to-do list that doesn't have a deadline.

987

:

but someday it'll get updated, to, to

better encompass what I'm doing now.

988

:

But I, and then I'm in-- I write

for a lot of the magazines.

989

:

I often hear people saying like,

you know, when I meet them like,

990

:

"Oh yeah, I've seen your name

around," or, "I've met you before."

991

:

And I'm like, "I, I don't

know where you saw it.

992

:

I'm sorry.

993

:

It's everywhere."

994

:

but yeah, I mean, I love talking access to

care and spectrum of care and mentorship,

995

:

so absolutely please reach out.

996

:

dr--andy-roark-_1_04-29-2026_130434:

Outstanding.

997

:

Thanks, Kate.

998

:

Thanks, everybody.

999

:

I'll talk to you guys later on

:

00:44:11,097 --> 00:44:12,567

Speaker: And that's what we got guys.

:

00:44:12,567 --> 00:44:13,467

Thanks for being here.

:

00:44:13,467 --> 00:44:15,687

Thanks to Kate for

Boatright for, joining us.

:

00:44:15,747 --> 00:44:18,257

gang, I hope that, I hope you,

had something to think about

:

00:44:18,257 --> 00:44:20,057

here and, that you enjoyed it.

:

00:44:20,057 --> 00:44:23,087

If you did, enjoy the episode, like

subscribe, you know, write a, write

:

00:44:23,087 --> 00:44:26,297

us an honest review, whatever,

whatever your little platform where

:

00:44:26,297 --> 00:44:29,537

you get podcasts or watch on YouTube

allows you to do, that's fantastic.

:

00:44:29,747 --> 00:44:31,397

Anyway, gang, take care.

:

00:44:31,397 --> 00:44:32,207

I'll talk to you later on.

:

00:44:32,447 --> 00:44:32,717

Bye.

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