Shownotes
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 and surgery centers, mobile specialists, and imaging centers. They discuss expectation-setting, community-of-care coordination, telemedicine uncertainty, and the competitive tensions between independent and corporate models.
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Office Hours w/ Dr. Andy Roark
Inside the Uncharted Veterinary Community, Dr. Andy Roark hosts Office Hours where veterinary leaders can bring real-world challenges and get practical guidance from someone who understands the realities of practice life. These sessions give veterinarians, practice managers, and team leaders a chance to ask questions, workshop difficult situations, and gain perspective on issues like team dynamics, communication, burnout, and clinic operations. Instead of navigating leadership challenges alone, members get direct access to Andy’s insight along with the support of a community of veterinary professionals working through many of the same challenges.
Transcripts
Welcome everybody to the Kone
of Shame Federated podcast.
2
:I am your host, Dr.
3
:Randy work.
4
:Guys, I'm back with my good friend, Dr.
5
:Jules Benson.
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:we are talking about practical
ways to improve access to care.
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:And so I, kind of crotchety
at the beginning of this.
8
:episode, it's kind of a old man
shakes fist at clouds moment for Andy.
9
:Just so you know, there's a lot of
talk about access to care and there's a
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:lot of advocacy, which is great at the
beginning, and then it's time to shift.
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:To what are we actually doing here?
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:Like, what is feasible?
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:What can we do right now in the moment
to start helping pets get care when
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:pet owners are struggling to afford it?
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:And, Jules wades into this
with me, which I really love.
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:He's got just such great ideas
about what is actually possible
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:and, where there's Less upside
and, and we really get into that.
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:I, a big believer that there are
models to care that we are not using
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:or that we could tweak and improve
to really make a big difference.
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:I don't believe that vet practices
trying to be all things to all
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:people is the, approach that makes
care accessible and affordable.
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:I don't buy it.
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:The Four Seasons, veterinary
hospital with their white gloves.
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:They're just not gonna be
doing low cost spay and neuter.
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:That's just, that's not who they are.
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:And it doesn't make sense and
it's confusing and, just so many
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:better ways to get care done.
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:And so anyway, that, that's
what I'm excited about.
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:And Jules just wades
right into it with me.
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:And one of the things I love about Jules
Benson is he is very comfortable telling
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:me no and telling me that he disagrees
and telling me that he thinks I'm wrong.
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:And that's why I get so
much out of talking to him.
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:I, my.
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:Opinion almost always changes
while I'm talking with him.
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:Like I'm not saying I go to Jules's side,
but I definitely rethink some of my own
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:assumptions and some of my positions
just because he's very smart and very
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:persuasive and I just really enjoy him.
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:So guys, we're gonna, mix it
up a little bit and talk about
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:actually talking about right now?
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:If we want to improve access
to care, let's get into it.
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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-_4_02-09-2026_154150:
welcome to the podcast, Dr.
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:Jules Penson.
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:How are you, my friend?
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
I am very good.
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:Dr.
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:Andy
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:dr--andy-roark-_4_02-09-2026_154150:
Man, it's always good to have you here.
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:you've been a, a run on the show
recently because I find that you and
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:I have much to discuss these days.
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:for those who don't know you, you,
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
text messages.
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:dr--andy-roark-_4_02-09-2026_154150:
there's, yes.
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:Yeah.
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:Yeah.
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:The philosophic text messages that I send,
there's mostly like, this is ridiculous.
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:Did you see this?
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:face palm emoji, things like that.
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:Yes.
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:you're getting a lot of
those from me these days.
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:I am, bit of a philosophic bender.
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:for those who don't know you, I
have to say before we get started,
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:you are the founder and principal
at Titum Lucidum Consulting.
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:You are an industry strategist
and a thought leader, and you are
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:someone who I just really enjoy.
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:Talking with, and so my recent
philosophic bender that I needed
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:to talk to you about is this.
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:So I, you know, we're talking, you and
I talk a lot about access to care and,
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
Yep.
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:dr--andy-roark-_4_02-09-2026_154150:
and getting pets taken care
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:of, and your pet is actually
getting taken care of right now.
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:Like you have a pet in
surgery at the moment.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
we just fielded a call and he's
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:having a resection anastomosis
at 11-year-old kitten who ate
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:something that he shouldn't have.
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:So as you said, I'm
sure this will teach him
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:dr--andy-roark-_4_02-09-2026_154150: yes.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
lesson
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:dr--andy-roark-_4_02-09-2026_154150:
Oh, I understand.
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:Like, no, he's, I'm confident
he's gonna remember this and
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:change his bad cat behavior.
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:Yeah.
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:So, I'm talking about access to
care and thinking a lot about
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:access to care and that's great
and I love it and it's important.
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:And there's a lot of people
who are talking about access
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:to care, and that's good too.
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:However, we've definitely reached
the point of the conversation where
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:there's a lot of advocacy and not
so many actual things that I think
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:that we should be doing in practice.
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:And again, I You're, I'm,
open to challenges on this.
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:I'm very interested in shifting from.
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:I feel like there's a lot of hand
waving around access to care of, we
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:should do blank and we should do blank.
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:And I look at that and I think,
there's, there's truth to what's
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:being said, but I don't know how
to apply it in my role as a doctor.
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:And I think a lot of things.
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:a lot of things are hypothetical.
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:They're like, you know, we should
have a safety net for pet owners.
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:And I'm like, great.
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:Tell me more.
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:Like, like
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
Socialized
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:dr--andy-roark-_4_02-09-2026_154150:
social.
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:Yeah, exactly.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
Absolutely.
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:Yeah.
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:dr--andy-roark-_4_02-09-2026_154150:
I, here's the thing too.
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:My super optimistic, idealistic
heart would make a case for that.
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:And I would say, look, we know that people
live longer and are happier, and mental
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:health is better when people have pets.
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:And like, I would love for
our government to subsidize in
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:some way people having pets.
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:I,
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
and we're, starting to see some
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:legislation around pushing pets as a
social determinant of health, which is one
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:of the first, so our friends align care
are doing that legislation at the moment.
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:So like the things in the works.
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:dr--andy-roark-_4_02-09-2026_154150: yes.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
far from it.
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:As a, as an entity.
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:dr--andy-roark-_4_02-09-2026_154150:
It's not happening this year.
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:I, I would say it's gonna,
it's gonna be a, a long way.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
It's,
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:dr--andy-roark-_4_02-09-2026_154150:
long way.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
the, it's on its way,
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:but yes, it's a journey.
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:dr--andy-roark-_4_02-09-2026_154150:
It's on its way when pigs, pigs
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:flying on their way as well, but.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
we, it's a, it's a different conversation,
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:but I think when you start to, when
you legislate that pets are a social
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:determinant of health for all the
reasons you said, and that having pets
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:makes humans healthier, therefore.
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:money, quote unquote, for
the human healthcare system.
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:You start to end the point
where you can fund pet programs
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:through human healthcare.
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:Like that's, I think that's
the short to medium term goal.
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:So yes, you're right.
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:It's not fully, it's not, it's not
a, a healthcare system forecasting
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:doctors subsidized by the government.
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:It's saying, can we help the care of
humans by advocating or subsidizing Kappa
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:dr--andy-roark-_4_02-09-2026_154150: Yes.
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:So what I heard was you can stop your
emergency fund saving because Jules
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:thinks the American government is going
to back us up in the very near future.
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:No.
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:Okay.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
yes.
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:dr--andy-roark-_4_02-09-2026_154150: Okay.
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:So anyway,
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
that is not, that is not true, but yes.
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:dr--andy-roark-_4_02-09-2026_154150: okay.
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:but in all seriousness, so I would love
to see a social safety net for, pets
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:there's just not one in the near future.
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:And so one of the things I
always admire about you and I
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:really enjoy is our conversation.
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:We, some thoughts and I, I
want to hear, hear yours.
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:When I say to you, Jules, like, what do
you think is really possible right now?
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:In terms of actually increasing access to
care, what are your favorite possibilities
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:or paths that are, that are realistic?
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
So I think, think it's worth
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:pointing out first of all that
access to care is a huge umbrella,
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:dr--andy-roark-_4_02-09-2026_154150: Okay.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
So I think when, when we look at the
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:last 10 or 20 years, we have dramatically
increased some forms of access to care.
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:When you look at at specialty healthcare.
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:and boarded surgeons and, and internists.
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:we think back 30 years ago, those all
resided in, pretty much in vet schools.
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:Like you had to go to a, to a place
that was teaching veterinary medicine to
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:see a boarded specialist in something.
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:So in the last 30 years, we have
dramatically increased access to care
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:for specialty veterinary medicine.
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:So again, just to say like, businesses
have seen the value of that.
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:And they've seen that people
are willing to spend money and
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:therefore we've seen growth in that.
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:So I just wanna point out that
this is a massive spectrum.
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:dr--andy-roark-_4_02-09-2026_154150:
right.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
So access to care is everything from
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:access to specialty care, all the
way down to people who are receiving
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:no care or pets who are receiving
no care whatsoever at the moment.
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:dr--andy-roark-_4_02-09-2026_154150:
when you hear people sort talking
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:about access to care, does your mind
immediately go to people who are
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:receiving no care at the moment, like
the lower end of the, financial spectrum?
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:Or do you actually think about access
to care in terms of specialty medicine?
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:I think you're right in, in
the, the definition of this.
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:what does your knee jerk when
people say that, say that to.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
so it's my way of saying that I think
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:care accessibility is a huge spectrum
and it's been a, it's been a journey
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:for me and for many, I think in
this space saying, okay, I think we
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:instinctively, and the knee jerk reaction
is to say, access to care is, is pets
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:who are not getting care currently.
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:dr--andy-roark-_4_02-09-2026_154150: Okay.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
absolutely right.
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:I think you say that to say access care
to most people and they will think that.
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:I think the reality is that we have huge
issues with care accessibility in what
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:we think is our historic core audiences.
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:So people who are earning upwards of, you
know, households are earning upwards of
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:50 or $90,000 a year, we're starting to
see data that suggests that they are not
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:seeing care as accessible as they used
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:dr--andy-roark-_4_02-09-2026_154150: Okay.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
And so, so I think when we say what
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:are the access to care opportunities.
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:and I wanna be very careful about
how I think about this because, you
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:know, we're both veterinarians, but
we're both business people as well.
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:when you look at this and say, what
is the opportunity in access to
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:care, I think a lot of people think
about, well, here's the compassionate
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:need for care accessibility.
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:Literally, there are pet families
who are going without care at the
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:moment because they cannot afford it.
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:And I think when I look at it, I
say, and, and this goes back to this
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:was, the innovation summit in 2018.
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:This was kind of the first.
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:Kind of area of my brain that
was activated around this.
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:David Howeth, who at the time was,
the President PetSmart Charities, he
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:presented these data and said like,
okay, here's the Bureau of Labor Labor
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:Statistics data on household incomes.
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:If we suggest that people under $25,000
are getting less care, less frequently
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:than others, what could we do about that?
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:Is there a business case that suggests
that they wanna spend money and there's,
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:they put together some of the stats that
people's had around like, okay, they're
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:willing to spend up to $200 a year.
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:Identified almost a $13 billion
opportunity from a commercial
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:strategy point of view.
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:And so when I, we start talking
about things like spectrum of care,
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:I don't look at spectrum of care
as a purely compassionate entity.
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:dr--andy-roark-_4_02-09-2026_154150:
Right.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
I look at it as what is, the sustainable
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:future of veterinary medicine?
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:And so I try and be pretty hard-nosed
about what access to care means to
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:me and frankly, how it's sustainable.
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:dr--andy-roark-_4_02-09-2026_154150:
I think that that's required to
234
:have a productive conversation.
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:I think the thing that I found myself
saying recently, and I try to say
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:it in a very compassionate way, Vet
medicine is a four cash business.
237
:and so to the point that I made earlier,
there's not a social safety net.
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:there's nothing behind
your average vet clinic.
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:And I think that gets downplayed a lot.
240
:And I think a lot of people talking
with good intention, I, but I don't
241
:think that they grasp that real reality.
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:And you and I have talked about
this before, when you say.
243
:I think the vet industry has a
responsibility to support pet owners.
244
:When you say that to a single
mother, practice owner.
245
:What you're really saying is I
think you have a responsibility.
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:You know what I mean?
247
:Because there's no one coming to help her.
248
:And so like the staff
is still gonna get paid.
249
:They're not gonna clock out
and help and they shouldn't,
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:and that's, that's not legal.
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:We don't want that.
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:But, but the staff's not gonna clock out
to help her, And like the A VMA is not
253
:gonna send an emergency veterinarian in
by helicopter to at 6:00 PM to do this
254
:procedure to help the pet owner who
can't go to the emergency clinic like.
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:There's nobody but her and, and so
I, I just think that I'm not trying
256
:to make a, a big point that vets are,
are mistreated or not appreciated.
257
:But that is the reality I think
at the practice level for, for
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:most of these things is this
is a straight cash business.
259
:There's not any other, there's no floating
money behind it to fill in the space.
260
:It's not like the emergency
room where if I go and get care
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
Sure.
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:dr--andy-roark-_4_02-09-2026_154150:
and you know, and walk away that,
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:that the government's gonna help
make the emergency room whole.
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:You know, that, that we don't
have anything like that.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
when I think if we look at our,
266
:amazing and, and admirable efforts
we have in philanthropic care and
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:dr--andy-roark-_4_02-09-2026_154150: Yes.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
care for pets.
269
:Like there's, amazing and
fantastic work going on there.
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:But I, I think this is another
pet Smart charities data point,
271
:but I think they, they identified
in the last couple of years.
272
:There's basically a $30 billion hole
in pet care in the us, which, you know,
273
:it's, and, and to, to some degree, it
sounds hopeless to say, but it's almost
274
:like pouring water on dry sand, right?
275
:You can pour as much money
as you want into this, but
276
:there'll always be a great need.
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:It goes back to one of our
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:dr--andy-roark-_4_02-09-2026_154150: Yes.
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
about an infinite need
280
:bound by finite resources.
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:dr--andy-roark-_4_02-09-2026_154150: Yeah.
282
:dr--jules-benson--he-him-_1_02-09-2026_134149:
so, so as you, as you're looking at this,
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:I love that example you gave of the, of
the single practitioner and I, and I,
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:you know, some of the ways that we've
talked about this previously, it's not.
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:I think the way I look at it's that
it's not, you should be doing better.
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:I think it's, hey, there are ways that
you could approach some of these things
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:that might stretch your resources further.
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:dr--andy-roark-_4_02-09-2026_154150: Yes.
289
:dr--jules-benson--he-him-_1_02-09-2026_134149:
we look at that, whether, you know,
290
:whether it's that triangle of, cost
access, you know, and, and, you
291
:know, quality, how are we helping,
you know, veterinary practice.
292
:And there's some really interesting
thoughts at the moment around, okay, AI
293
:tools, can they help you increase your
resources by not adding more bodies?
294
:So, you know, you know, so
that, and that's, that's one of
295
:the things that's Tim Posited.
296
:But a really good example, and this
is fairly new to me, was the Open Door
297
:Veterinary Collective, did some great
data on people proactively aware of our
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:finance options and meeting people much
more upfront with, instead of just giving
299
:them the, the estimate saying if you
can't afford it, to some other staff.
300
:Having that information upfront and
having them have been proactive about.
301
:There may be a need for financing,
like veterinary care is expensive.
302
:How, you know, let's, let's make this
aware to you upfront that actually
303
:can double people's, resources
when it comes to receiving care.
304
:So that's a, that's a care accessibility
option that just potentially by altering
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:one of our behaviors, veterinarian
can, you know, improve their
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:ability for their clients to access
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:dr--andy-roark-_4_02-09-2026_154150:
I think that's,
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:dr--jules-benson--he-him-_1_02-09-2026_134149:
Yeah.
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:dr--andy-roark-_4_02-09-2026_154150: how's
your credit card balance looking today?
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:You know,
311
:like, that's not viable.
312
:And of course, that's not what they meant.
313
:What they, what was meant was
exactly what we're talking about is
314
:let's start to talk about financing
options, how people pay for care.
315
:You know, all, all of these sorts
of things to lay that groundwork
316
:around these financial conversations.
317
:Not in a, not in a sleazy
way, but in a systematic way.
318
:I think there's a lot of opportunity
there, and I think that that
319
:conversation around normalizing
financing and how people pay,
320
:dr--jules-benson--he-him-_1_02-09-2026_134149:
What.
321
:dr--andy-roark-_4_02-09-2026_154150:
I, I think that that's worthwhile.
322
:dr--jules-benson--he-him-_1_02-09-2026_134149:
I mean, if you think about
323
:it, like when you think about
orthodontics and kids, right?
324
:dr--andy-roark-_4_02-09-2026_154150: Yes.
325
:dr--jules-benson--he-him-_1_02-09-2026_134149:
you
326
:dr--andy-roark-_4_02-09-2026_154150: Good.
327
:Good example.
328
:dr--jules-benson--he-him-_1_02-09-2026_134149:
how many people are
329
:paying for that upfront
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:dr--andy-roark-_4_02-09-2026_154150: Yeah.
331
:dr--jules-benson--he-him-_1_02-09-2026_134149:
they'll finance that and that there
332
:are finance options available.
333
:I mean, one of the, one of the amazing
things has been, with, you know, a
334
:colleague and I starting a practice, this
year and we spent a lot of time looking
335
:at websites and there's just some amazing,
like when you look at veterinary websites,
336
:there's no, not that we hide it, but
it's not something we proactively talk
337
:about in terms of, of providing payment.
338
:there was some, just some really
good websites we saw, which were
339
:around either, you know, dentistry
or even, fertility planning, right?
340
:Just saying like, Hey, you
know, acknowledging, hey,
341
:this could be expensive,
342
:dr--andy-roark-_4_02-09-2026_154150: Yes.
343
:dr--jules-benson--he-him-_1_02-09-2026_134149:
be a cost.
344
:We, there are finance options and here's
a whole page of our finances that you
345
:can go to before you even consider
whether you want the care or not.
346
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
347
:I, I like that.
348
:And, I, one of the things that I get kind
of bent outta shape a little bit about is
349
:like, I don't think the problems around
accessibility or affordability for vet
350
:medicine are unique to vet medicine.
351
:I think that, I think the
world is getting so expensive.
352
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Yeah.
353
:dr--andy-roark-_4_02-09-2026_154150: I
feel like a lot of times vets get kind of
354
:called out and, and the reason is because.
355
:The increase in prices in, in vet care
have far outpaced in general inflation,
356
:but they, they haven't really far outpaced
a lot of other healthcare sectors like,
357
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Right.
358
:dr--andy-roark-_4_02-09-2026_154150: you
know, emergency care for, for humans,
359
:general healthcare, things like that.
360
:And so I go, well, you know.
361
:Our problems are not unique to us.
362
:There's a lot of other
people like the orthodontics.
363
:What an, what an excellent, I say
with, a kid with braces, over here.
364
:Yeah.
365
:What a, what an excellent call out.
366
:And so I, I think that there's a
lot of things that we're seeing
367
:in other industries that can help.
368
:Do you see greater.
369
:Lesser or the same opportunity in
refining what we currently have
370
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Mm-hmm.
371
:dr--andy-roark-_4_02-09-2026_154150:
laid out in our business models,
372
:like how ve practices currently offer
versus developing new business models.
373
:Are you more bullish
on new business models?
374
:Are you more bullish on, a refining
increased efficiency in what
375
:we have or, or about the same.
376
:dr--jules-benson--he-him-_1_02-09-2026_134149:
I think it's a yes.
377
:dr--andy-roark-_4_02-09-2026_154150: Okay.
378
:dr--jules-benson--he-him-_1_02-09-2026_134149:
so I I, have been for many years now, a
379
:believer in, let me phrase it this way.
380
:I think when we look at the needs of
our communities and we look at, you
381
:know, John Q general practice, right?
382
:If we think about general practices.
383
:it reasonable to think that general
practice, especially in urban and
384
:suburban environments, can meet the needs
of everybody within their community?
385
:is that a realistic expectation that
they can reach a, a level of price,
386
:a level of, of quality, a level of
accessibility that works for everybody?
387
:dr--andy-roark-_4_02-09-2026_154150:
Can they be all things to all
388
:people in this diverse community?
389
:Yeah.
390
:Yeah, exactly.
391
:I I think that's a, I think that's
a good philosophical question to ask
392
:and the, the answer is, un undoubtedly
you cannot serve, you know, from the
393
:socioeconomic bottom to top of your
entire community in an optimal way.
394
:You just can.
395
:dr--jules-benson--he-him-_1_02-09-2026_134149:
and I think it was more true
396
:20 years ago than it is now,
397
:dr--andy-roark-_4_02-09-2026_154150:
That you could get closer to
398
:success 20 years ago than today.
399
:Okay.
400
:I buy that.
401
:dr--jules-benson--he-him-_1_02-09-2026_134149:
I think you could be more things and,
402
:and for all the reasons, whether it's,
you know, our advancing quality of
403
:care, whether it's just the cost of
404
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
405
:Well, the spectrum, 20 years ago
was smaller, you know what I mean?
406
:As as
407
:dr--jules-benson--he-him-_1_02-09-2026_134149:
a hundred percent,
408
:dr--andy-roark-_4_02-09-2026_154150:
as opposed to what we have now.
409
:Yes.
410
:I think that, I think you
make a good case for that.
411
:dr--jules-benson--he-him-_1_02-09-2026_134149:
so I think when we look at it, and
412
:this, this goes exactly to your point,
you know, and around, you know, other
413
:people have been doing versions of this.
414
:when we go to, you know, we are, we are
met of a certain age and, and we need
415
:certain examinations at certain times.
416
:Now, you know, when, when we
go and have, an examination for
417
:our gastrointestinal health.
418
:We don't go to the, I think we
talked about this last time.
419
:We don't go to the, to the gp.
420
:We don't go to
421
:dr--andy-roark-_4_02-09-2026_154150:
Right.
422
:dr--jules-benson--he-him-_1_02-09-2026_134149:
specialist.
423
:We go to somebody who is, that's all
they do is, you know, those procedures.
424
:And I think when we start talking about
focus care, if we think about what it
425
:takes to do one thing and do it really
well and do it really efficiently.
426
:And I think an awesome example, and
if anybody, listening doesn't have
427
:good grounding in this, which I didn't
when I first heard about it, is high
428
:quality, high volume spay neuter.
429
:dr--andy-roark-_4_02-09-2026_154150: Yes.
430
:dr--jules-benson--he-him-_1_02-09-2026_134149:
I think it's an incredible model and
431
:the fact that you can say both high
quality and high volume, like the, the
432
:things are so systematized that you
can run through these procedures at
433
:such a rate and still maintain really
high quality and really high outcomes.
434
:That to me an example of like, where
else in our industry, A, is there
435
:volume and B, can we systematize things
in such a way that you're, you are
436
:really getting the advantage of that.
437
:We're starting to see it already, right?
438
:I mean we're, we're starting
to see it in dental practices.
439
:We've seen those cropping up
over the past five years or so.
440
:We're starting to see it in, in
focus care centers for surgery.
441
:Like I think more and more we'll start
to see filling the middle ground of
442
:things that can be done by others,
pop up as as focused business models.
443
:dr--andy-roark-_4_02-09-2026_154150: I
think your, mobile specialists also kind
444
:of fall into that, like it used to be that
we had to ship cases over to the specialty
445
:hospital to get an abdominal ultrasound
and now we've got a mobile specialist
446
:and they roll in and it's a significant
price savings to the pet owner.
447
:The specialists still get paid, quite,
you know, quite well, and we get to
448
:continue to be very involved in the case.
449
:And so I think that's a great example
of how you can tweak a business model.
450
:And really actually increase,
access to care in that regard.
451
:I, I really love the idea of
the, of the high volume, high
452
:quality, spay neuter facilities.
453
:And again, to me there's oftentimes
they're set up as nonprofit organizations.
454
:There's just a lot of things about it.
455
:Some like these were set out
to do a specific function and
456
:they were built strategically.
457
:And I just think that that is such an
important way to look at, you know, how
458
:we approach paying for care as opposed to,
459
:You know, Hey, your vet clinic
really needs to lower your
460
:price on space and neuter.
461
:, Or to have deep discounts
for certain people.
462
:I go, how do, that's just fundamentally,
that doesn't make sense to me.
463
:I, I, I don't know how to, I don't
know how to feel, applying these
464
:sort of need-based standards, you
know, that's not, that's not how
465
:I wanna practice and it's not in
the, the world I wanna live in.
466
:dr--jules-benson--he-him-_1_02-09-2026_134149:
and I think the much harder part is when
467
:you start to get down into, okay, how do
you provide a level of general practice
468
:that is more accessible for more people?
469
:IE how are you providing ear infections?
470
:Gastroenteritis, like the, the
things that we see 70, 89% of
471
:the time in general practice.
472
:Are there, are there models
that you can use to do that?
473
:And we've seen several pop up
over the past 10 years or so.
474
:But I, think I consistently see
the problem of, whether it's all
475
:the way from urgent care down to
community, care centers or minute
476
:clinics, I think we haven't quite
cracked how to make that profitable
477
:and how to make that accessible.
478
:And, I, I don't know that we have.
479
:Created an expectation in our pet families
that there is a version of veterinary
480
:medicine that might look different to
what they've been used to, or if they've
481
:never had veterinary medicine before,
what their expectations should be.
482
:So I, you know, as a, as a marketer and
a strategist, I, I'm a huge believer
483
:in that you lead with expectations.
484
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
485
:dr--jules-benson--he-him-_1_02-09-2026_134149:
I don't know that, that we've
486
:had the capability to do that or
done that successfully in some
487
:of the models that we've seen.
488
:dr--andy-roark-_4_02-09-2026_154150:
Well, I think you're right.
489
:I think there's a lot there about
leading with expectations and I think
490
:that we're looking at new ways of
doing things and it's, it's hard to
491
:set expectations when you haven't
492
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Yep,
493
:dr--andy-roark-_4_02-09-2026_154150:
haven't actually done it before.
494
:I think it's, interesting.
495
:I've been rolling around in my
head since you said it earlier.
496
:You know, when I look at human
medicine and you talk about
497
:increased specialization, I.
498
:See increasing prices, like, you know,
so when, when we go to the, you know,
499
:to the GI doctor, that's gonna, that's
gonna be a more significant investment,
500
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Okay.
501
:dr--andy-roark-_4_02-09-2026_154150:
than it is to go to the gp.
502
:And just the way human medicine
are been set up is whenever you
503
:leave your gp, you know, the, the,
cost of care is going to go up.
504
:It's interesting to think about
what you are talking about
505
:specialization increasing, you
know, in increasing efficiency.
506
:dr--jules-benson--he-him-_1_02-09-2026_134149:
might be the wrong word,
507
:dr--andy-roark-_4_02-09-2026_154150: No.
508
:dr--jules-benson--he-him-_1_02-09-2026_134149:
maybe focus
509
:dr--andy-roark-_4_02-09-2026_154150: But
510
:dr--jules-benson--he-him-_1_02-09-2026_134149:
your specialization just connotes that
511
:like, you know, someone's boarded,
512
:dr--andy-roark-_4_02-09-2026_154150:
yeah, exactly.
513
:And, and I don't mean around being
boarded, but I mean, I, I think you're
514
:probably right in, in, terminology
is probably important around, around
515
:focused care or It is, but it is
specialization of the service, right?
516
:You say, Hey, we only do
abdominal ultrasounds.
517
:That's what we do.
518
:Yeah.
519
:It's, it's narrowing in the focus.
520
:But, but to have that, not to be as a.
521
:Higher step up the, towards the
gold standard, but to be like, Nope.
522
:It's, it's a different way of doing
it and it's much more cost effective.
523
:dr--jules-benson--he-him-_1_02-09-2026_134149:
or
524
:Even breaking down some of those
steps that we had, like, you
525
:know, we're, we're starting to
see some imaging centers, right?
526
:So previously you had to go to a
specialist in order to get, you know, an
527
:MRI or you know, something more advanced.
528
:Now you're seeing MRI, you know, specialty
imaging centers where that's all they do.
529
:And they interact both with specialists
and with, with general practitioners.
530
:And I think.
531
:I think this is the big step, right?
532
:Is, you know, you and I have
talked before about what, what
533
:we're calling a community of
534
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
535
:dr--jules-benson--he-him-_1_02-09-2026_134149:
If you, if you start to have these focus
536
:care centers within your community,
how are we interacting with each other?
537
:And frankly, I mean, again, I think
some of the issues that we've had
538
:previously have been that people see
some of these things as a threat.
539
:dr--andy-roark-_4_02-09-2026_154150:
Yes, without a doubt.
540
:dr--jules-benson--he-him-_1_02-09-2026_134149:
and without a doubt, right?
541
:And, and I, I think some of
what we have to do is to.
542
:Understand that business models are
there to serve different people and or
543
:that they're serving different needs.
544
:If you're a general practice who,
your focus is brush, steel and chrome
545
:and white coats, you know, we can be
fairly sure that you're not, you're
546
:not seeking to, to go further down the
socioeconomic, you know, kind of, slope.
547
:And that you probably don't want people
who, who can't spend more than $200.
548
:So how do we activate a
community of care within that?
549
:geographic location or even again,
and we've had long conversations
550
:about this as well, like what role
can and should telemedicine play
551
:within some of these things as well.
552
:I is, could that be a part of the glue
that sticks some of this together?
553
:I think there's, and the jury
is still very far out on that.
554
:We've seen some pretty consternation
over the role of telemedicine
555
:within our communities.
556
:dr--andy-roark-_4_02-09-2026_154150:
I think that you're right
557
:around the possibilities.
558
:You know, we talk about telemedicine, we
talk about, I don't wanna say the scarcity
559
:mindset, but it is a, a scarcity mindset,
560
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Sure.
561
:dr--andy-roark-_4_02-09-2026_154150:
of, small business owners.
562
:And again, when I say scarcity, that seems
really negative, but we, again, there's
563
:nothing behind the veterinary practice
except often the veterinarian, but even
564
:the companies, behind them, There's not
an endless pool of money, and vet medicine
565
:is not a highly pr profitable business.
566
:And so when you say, Hey, just relax,
we're gonna open up this new service,
567
:and, but like, trust me, like it won't
be your clients and this won't go away.
568
:I don't know that there's any amount
of expectations that you can do
569
:that takes the fear out of that.
570
:I think what's going to happen or what
ultimately will, Things are gonna shift
571
:and they're going to change, you know?
572
:And so if part of your business moves
to something else, I don't think
573
:veterinarians everywhere is gonna just
fall apart and go out of business, but
574
:their practice is going to look different.
575
:And what it's gonna
look like is not known.
576
:And it's not proven.
577
:And so I think you'll always have
that problem with e expectation
578
:setting and with fear of change.
579
:Don't you agree?
580
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Well, I think the rules of economics
581
:suggests that this, this might be a
net positive for the consumer, right?
582
:If you, if we think about other areas
of stratification, you know, the hotel
583
:industry is one that, that, you know,
my co-author and I drin you use all
584
:the time, which is like, Hey, you
know, if you're going to a Motel six.
585
:You're pretty sure what you're getting
and what the, approximate cost will be.
586
:Versus if you go into the four seasons,
the economic realities of the world
587
:might mean that at some points in time,
the Motel six is much more popular than
588
:the Four Seasons for various reasons.
589
:And so, like, again, I think trying
to, trying to find your audience and
590
:cater that audience and create that
competition, I think instead of having
591
:a bunch of ve presses that look the
same within the geographic area.
592
:Creating models that compete with each
other across different strata, I think
593
:could create in interesting, and again,
when I say interesting, you know,
594
:upsetting, you know, competitive elements
between, you know, different models.
595
:dr--andy-roark-_4_02-09-2026_154150:
I heard commentary around sort of the
596
:modern business, especially around
the tech business recently, and it
597
:was saying that we have a problem in
how sort of commerce works in America
598
:because the business strategy of the,
of larger companies, I'm thinking
599
:specifically about like Meta and Google.
600
:It's really not about.
601
:Making something that competes,
a against competitors based on,
602
:on attracting and drawing people
in 'cause they want to use it.
603
:It's all really about trying
to lock people in where they
604
:don't have much of an option.
605
:You know, it's about, so for, for
Facebook it's about, if you get it,
606
:this person's friends all on there
and the friends don't want to do a
607
:new thing, that's where they are.
608
:Then I can kind of keep this person here.
609
:'cause they're sort of, they're
sort of locked in and, I'm trying
610
:to think of another example.
611
:If, it's so, like
Ticketmaster is like, you
612
:dr--jules-benson--he-him-_1_02-09-2026_134149:
go back.
613
:Go back to hotels like, you know, if
you're in the Marriott group or the
614
:Hilton Group, then you're gonna G,
you're gonna try and make sure that you
615
:spend your money in one or the other.
616
:'cause you're incentivized.
617
:Or
618
:dr--andy-roark-_4_02-09-2026_154150:
right.
619
:dr--jules-benson--he-him-_1_02-09-2026_134149:
right.
620
:Is another
621
:dr--andy-roark-_4_02-09-2026_154150:
Oh, exactly.
622
:Like if you wanna, if you want to get
points we're, you know, you're gonna
623
:have to, you're gonna have to do this,
and then you get these benefits and.
624
:dr--jules-benson--he-him-_1_02-09-2026_134149:
even worse,
625
:dr--andy-roark-_4_02-09-2026_154150: yeah.
626
:Oh, is that if you wanna
keep your status, yeah.
627
:You have, you have to do this.
628
:Well, again, and, and like, so you just,
I buy entertainment tickets for like
629
:concerts or basketball games or whatever.
630
:I wish that I didn't have
to use Ticketmaster, but
631
:they, they made the websites
and they're all locked in.
632
:And trust me, I'm not choosing
Ticketmaster or their subsidiaries based
633
:on I'm, my excitement about the value
that they add, I'm, I'm locked into that.
634
:So I, it was interesting to hear this
and sort of have this mindset of.
635
:Our businesses in general really
starting to focus on how do we,
636
:lock people into these services?
637
:And I, I don't like that.
638
:And, and I, I really, I like what
you're sort of saying around, can,
639
:can we get back to the idea of
providing value that make people
640
:say, I, this is what I want to do.
641
:I
642
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Yeah.
643
:dr--andy-roark-_4_02-09-2026_154150:
there's something wonderful
644
:about the hotels where that is
an industry where I feel like.
645
:Based on my budget, based on what
I'm looking for, I can, you know,
646
:I can sort of pick my option.
647
:And, I've stayed at the four season
and I've stayed at Motel six.
648
:And, you know, often, you know, I,
I choose something, in the middle
649
:because it's kind of a nice mixture
for me of, of value and quality.
650
:And I go, this is kind of where I am.
651
:And so I, I, I really do like that.
652
:But I can imagine early on when there were
three types of hotels, There was probably
653
:not a lot of excitement about these, about
other, you know, other models coming in.
654
:dr--jules-benson--he-him-_1_02-09-2026_134149:
And you think about all the resources
655
:we have to judge that by now.
656
:Like we don't just have the brand name
and kind of the associations with that.
657
:We have all these review
sites and all the rest.
658
:We're starting to see some of that
more in better medicine, but just like.
659
:I mean, you know, when you buy online, I
assume you're quite like me in that like
660
:before you buy something, especially if
it's a considerable, you know, purchase
661
:by which at our age now that's over $50.
662
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
663
:dr--jules-benson--he-him-_1_02-09-2026_134149:
if it's over $50, we
664
:have to do some research.
665
:but you're gonna spend some time looking
at the reviews and, and, and I think now
666
:we have this qualitative ability, like
you've seen the, the, ai summarization of
667
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
668
:dr--jules-benson--he-him-_1_02-09-2026_134149:
people like this, people like this.
669
:They didn't like this.
670
:We're starting to get to see
more and more of that right.
671
:With, with our own businesses.
672
:And I think it's gonna, it's gonna
help people contextualize what we're
673
:offering and how we're offering it.
674
:dr--andy-roark-_4_02-09-2026_154150: Yeah.
675
:dr--jules-benson--he-him-_1_02-09-2026_134149:
I think that's, I think that speaks
676
:even more to the need for us to say,
what are we offering specifically to
677
:our community that other people aren't?
678
:frankly, where and where
should we be handing off?
679
:And I, I do think we're gonna
start to see, you already see it.
680
:Like you, you'll, you'll rarely find
an independent value practice who will
681
:want to refer to a corporate 24 hour.
682
:There's, already, we're already starting
to see some of those schisms, and I think
683
:you'll start to see potentially more and
more of a community of care, especially
684
:around independent practices and maybe to
your point, more and more consolidation
685
:of services and more loyalty driven
through some of that corporate colleagues.
686
:So again, and there's, and there's
reasons that happened to you.
687
:You did a podcast recently on, on
the role of capitalism and, and
688
:VetMed, and I think that's, that's
exactly the way to think about it.
689
:Like everybody here is, is
trying to keep the lights on.
690
:You know, and the, and that, that
means something quite different
691
:to the corporates perhaps, than
it does to the independence,
692
:but you know, each to their own.
693
:And it's some of the reasons
that we've seen some of these
694
:models fail recently, right?
695
:A corporate, urgent care located next to
a corporate gp, many independent gps are
696
:gonna send their practice, their, clients
to, you know, the corporate urgent care.
697
:dr--andy-roark-_4_02-09-2026_154150:
Right.
698
:dr--jules-benson--he-him-_1_02-09-2026_134149:
doesn't make sense for them to want to do
699
:dr--andy-roark-_4_02-09-2026_154150:
the, yeah, there's, there's the worry
700
:about sending 'em to over to the
Marriott and the Marriott's like,
701
:Hey, we got a point system over
here, and you've already got points.
702
:And so Yeah, I, I
703
:dr--jules-benson--he-him-_1_02-09-2026_134149:
Yeah.
704
:dr--andy-roark-_4_02-09-2026_154150:
get it.
705
:Dr.
706
:Jules Benson, thanks so much for being
here and talking through this with me.
707
:I could, I could talk with you all day.
708
:Where, can people find you online?
709
:Where can they keep up with you?
710
:dr--jules-benson--he-him-_1_02-09-2026_134149:
they can find me on LinkedIn mostly.
711
:I I do most of my thinking
out loud on there.
712
:And, and some of the conversations
that we all have on, on LinkedIn
713
:are endlessly frustrating and
entertaining and equal measure.
714
:dr--andy-roark-_4_02-09-2026_154150:
Outstanding.
715
:I'll put a link in this show note.
716
:Jules, thanks for being here guys.
717
:Thanks for tuning in everybody.
718
:Take care of yourselves, gang.
719
:And that's what I got guys.
720
:Thanks for being here.
721
:Thanks to Jules for being here.
722
:If you like the episode, like, and
subscribe, share it with your friends.
723
:Help me get the word out and spread,
spread the joy of the Kona Shame show.
724
:It just, it means the world
to me when people do that.
725
:if you were less impressed with the
episode, then maybe you journaling.
726
:Journaling maybe is, is a good, it's
a good way to process those feelings.
727
:And I'll, I'll just know
that I'm, I'm trying my best.
728
:I'll try, I'll try to do better next time.
729
:Anyway.
730
:Take care everybody.
731
:I'll talk to you later on.
732
:Bye.