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

ABOUT OUR GUEST

Dr. Lily Chen, DVM, CVA, IVCCP is the founder of Integrative Pet Wellness Center in Los Angeles and The Unicorn Vet, an education platform helping veterinarians turn microbiome theory into clinical reality.

Through her course, The Magic of Microbiome, Dr. Chen teaches vets how to make FMT and microbiome therapy practical, profitable, and implementable—because the science is solid, but most practitioners don't know where to start. She also hosts My Dog Is Better Than Your Dog podcast and believes the future of veterinary medicine is root-cause healing, not just symptom management.

LINKS

The Unicorn Vet: https://theunicorn.academy/

Dr. Lily Chen on Instagram: https://www.instagram.com/dr.lilychen/

Integrative Pet Wellness Center: integrativepet.com

https://vetmed.tamu.edu/gilab/service/assays/canine-microbiota-dysbiosis-index/

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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.

Register for Office Hours here!

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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Register for the Dont Get Sued course!

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.

Register for Office Hours here!

Learn more about Simparica Trio here!

Sign up for the Early Career Newsletter here!

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

Dr. Josh Rosen is a relief veterinarian and veterinary content creator based in the New York metro area, practicing across NYC, Long Island, and Northern New Jersey. A graduate of the Virginia-Maryland College of Veterinary Medicine, his clinical interests span preventative care, urgent care, soft tissue surgery, dentistry, dermatology, and internal medicine. Working across many practices has given Dr. Rosen a rare, unfiltered view of what's actually happening on the ground in veterinary medicine today, including the growing gap between how organized medicine operates and what the people doing the work know it needs. He channels that perspective into his platform, @dogtorjosh on Instagram, where he covers clinical empathy, effective communication, team culture, and all the relatable laughs we share in this amazing profession. Today, he's advocating for a profession led by those with real, lived veterinary experience, rather than metrics alone.

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Register for the Dont Get Sued course!

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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.

Register for Office Hours here!

Dr. Charli Dong, DACVD, joins the podcast to tackle one of the most frustrating and common cases in practice: the itchy dog that just will not get better. If you have ever had a client convinced it is “just a food allergy” while their dog continues to suffer, this episode is your playbook. Dr. Dong breaks down canine atopic dermatitis in a way that actually makes sense, from puppies presenting earlier than expected to the messy overlap between food allergies and environmental triggers. You will walk away with a clearer approach to multimodal management, including when to use diet trials, how to set realistic expectations, and why the skin barrier and nutrition matter more than ever. This is practical, real-world dermatology that helps you feel more confident the next time an allergic dog walks through your door.

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

Hill's Therapeutic Derm: https://www.hillsvet.comxpet-nutrition/derm

Hill's Veterinary Academy: https://na.hillsvna.com/en_US/dashboard

Dr. Charli Dong is a board-certified veterinary dermatologist with extensive experiencing diagnosing and managing canine allergic skin disease, including canine atopic dermatitis. Her clinical and research interests focus on improving the lives of itchy dogs through better long-term management strategies, skin barrier support and evidence-based therapeutics – a holistic approach. Education is central to Dr. Dong’s passion. She has served as Exam Chair for the American College of Veterinary Dermatology, is actively involved in training dermatology residents and teach veterinary students, and is a frequent national and international speaker. She has authored numerous scientific publications, with an emphasis on translating emerging research into practical, real-world guidance for both veterinarians and pet owners.

Dr. Andy Roark welcomes Caitlin Palmer (aka “the desk winch”), a veterinary receptionist at Southern Vet Clinic and a member of the President’s Advisory Board for the North American Association of Veterinary Receptionists (NAVR), to talk about the state of the front desk. They discuss how changing communication preferences and tools like AI may increase the importance of front-desk staff as key client communicators, and why reception should be viewed as a long-term career path with better pay, recognition, and continuing education. Caitlin shares common pain points like disrespectful clients, vaccination hesitancy conversations, lack of appreciation, and the rift between front and back teams, plus the hidden challenge of having to be “on” all the time. They cover solutions like cross-training, consistent messaging, and NAVR’s goals for CE and future certification, and share where to find NAVR and Caitlin online.

Caitlin Palmer has spent 16 years in veterinary medicine with a passion for helping animals and the people who love them. She is widely recognized for her TikTok character the “DeskWench,” where she humorously portrays both a veterinary receptionist and “Karen Stevens,” everyone’s favorite disgruntled client, highlighting the real-life challenges of working at the veterinary front desk. Caitlin originally began her adult life as a theatre major studying acting and music, but ultimately chose a career in veterinary medicine because she couldn’t imagine being away from her dog. After overcoming her own battles with mental health, she became a strong advocate for supporting veterinary teams and fostering healthy clinic culture. Caitlin believes that while not everyone performs the hands-on medical aspects of veterinary care (something she jokes she certainly couldn’t do), pets don’t bring themselves to the veterinarian—making CSRs an essential part of patient care and the veterinary team. She proudly serves on the President's Advisory Board for NAAVR and is HONORED to share her passion with you all! Through education, storytelling, and humor, she encourages veterinary receptionists to take pride in their role and recognize the powerful impact they have every day.

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Sign up for the Early Career Newsletter here!

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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.

Register for Office Hours here!

Register for the Dont Get Sued course!

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

Links: https://veterinarysustainabilityalliance.org

Dr. Richardson holds a BA in Ecology and Evolutionary Biology, a PhD in Zoology and a DVM degree. He is a small animal practitioner licensed in British Columbia and Ontario, owns The Animal Cinic in Toronto and has a special interest in environmentally sustainable practice. The Animal Clinic was the first clinic in North America to receive the Green Paw Certification for sustainability. He is the Past-President of the OVMA and The Farley Foundation, the co-founder and chair of the OVMA’s Sustainability Committee, Director of the Veterinary Sustainability Alliance and member of the CVMA Sustainability Advisory Group. A keen year-round cyclist and advocate for active transportation, Dr. Richardson can often be found on his bike or with a camera in his hand (or sometimes both).

Mentioned in this episode:

Uncharted Practice Owner Summit at NAVC SkillShop

Owning a veterinary practice comes with challenges no one teaches you in school. The Uncharted Practice Owner Summit, hosted at NAVC SkillShop in Orlando, is a hands-on leadership workshop designed to help owners strengthen their teams, improve operations, and make confident business decisions. This small-group, working session focuses on real-world tools and honest conversations, not passive lectures. Spots are limited. Register now!

Register for Uncharted Practice Owner Summit at NAVC SkillShop here!

Sign up for the Early Career Newsletter here!

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.

Register for Office Hours here!

Learn more about Simparica Trio here!

Dr. Kat Sutherland (PhD), assistant professor at the Ontario Veterinary College, joins Dr. Andy Roark to tackle a question every new grad wrestles with, how do you speak up and create change without feeling like you’re overstepping? In this episode, they dive into change management for early career veterinarians, unpacking the real barriers like confidence dips, imposter syndrome, and unclear communication skills. You’ll hear practical strategies for getting buy-in from your team, navigating resistance, and advocating for yourself without burning bridges. They also explore the reality that not every idea lands, not every change happens quickly, and sometimes success is simply doing your best within your control. If you’ve ever felt unheard, hesitant, or unsure how to lead as a new doctor, this conversation will leave you feeling more grounded, capable, and ready to take thoughtful action. This episode is brought to you by Hill's Pet Nutrition!

AVMA Landing Page with info for registration: https://www.avma.org/events/avma-convention?gad_source=1&gad_campaignid=23627178955&gbraid=0AAAAAoVzcHYPsfiSRGJpEBl-1N6zrUTh1&gclid=CjwKCAjw1N7NBhAoEiwAcPchp0NyVcJaJlNGK1w599SAxBZS9kWb2hroimNavrQQRgLOaZ7fxPhENBoCW1EQAvD_BwE

https://www.avma.org/events/avma-convention/what-is-the-cost

Kat is an educator and researcher in the area of veterinary professional-client-patient interactions, and an assistant professor at the Ontario Veterinary College (OVC). Kat's research with the Relationship-Centred Veterinary Medicine at the OVC team explores how communication and relationships in veterinary medicine can be enhanced to improve the lives of animals and the people who care for them. She is passionate about teaching, and enjoys supporting student veterinarians and practicing veterinary professionals in developing their clinical communication and relationship-building skills.

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

Dr Peter Weinstein is a husband, father, pet parent, veterinarian and leader. He has been involved with virtually all aspects of veterinary practice from a 15-year-old kennel kid to a hospital owner. Organized veterinary medicine has been a passion as well with various roles and leadership and presidencies of Southern California VMA, California VMA, and Vet Partners. He is a published author, most notably of the E-Myth Veterinarian-Why Most Veterinary Practices Don’t Work and What to Do About It.

Currently, he is teaching business and finance at the Veterinary College of Western University of Health Sciences. He likes to think of himself as a free-thinking change agent and disruptor who, because he has a daughter who is a recent graduate from veterinary school, is working for an even better veterinary profession in the future.

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Register for the Dont Get Sued course!

Sign up for the Early Career Newsletter here!

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On Demand Team Training Bundle

Great medicine can still lead to tough conversations with clients. The Team Training Bundle gives your veterinary team practical tools to handle angry clients and communicate clearly in the exam room, so every interaction builds trust instead of tension. Flexible, on-demand training makes it easy to strengthen communication across your entire clinic.

Learn more about the Team Training Bundle here!

Dr. Jules Benson, DVM, founder of Tapetum Lucidum Consulting and a data strategist, joins Dr. Andy Roark to tackle a frustrating truth in the access to care conversation, lots of well-meaning advice for vets is not practical in real clinics with limited time, fixed protocols, and real-world overhead. They dig into the “iron triangle” of cost, quality, and access (the good, fast, cheap problem), and why defining “quality” often gets tangled up with “most advanced care.” Along the way, they talk about client trust as a process issue, how most practice websites fail to differentiate who they are for, and why strategy means saying no, including being clear about what a clinic will not do. They explore stratified care models like nonprofit care, mobile practice, focused care centers, and urgent care, and the idea of a community of care that hands clients off appropriately. Gang, let’s get into this episode. Keywords: veterinary access to care, veterinary client communication, veterinary practice strategy, cost quality access Dr. Jules Benson is the Principal at Tapetum Lucidum Consulting and the 2025 Chair at the Veterinary Innovation Council (VIC). With over two decades as a practitioner, industry executive, strategist, and data and technology leader, his focus lies in identifying and applying innovation that can improve the lives of pets, pet families, and veterinary healthcare teams.

Mentioned in this episode:

Register for the Dont Get Sued course!

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.

Register for Office Hours here!

Sign up for the Early Career Newsletter here!

Learn more about Simparica Trio here!

Dr. Nathan Peterson, DVM, DACVECC, takes us straight into one of the most uncomfortable questions in veterinary medicine: are we sometimes prolonging suffering, and what does that do to our teams? In this episode, Dr. Andy Roark and Dr. Peterson unpack medical futility, moral distress, and veterinary burnout in a way that feels both honest and actionable. They explore what happens when technicians feel stuck providing care that conflicts with their values, and why that tension matters more than we think. You’ll hear practical ideas like creating psychological safety, building a “pause button” for team concerns, and even introducing ethical rounds to navigate tough cases together. If you’ve ever wrestled with end-of-life decisions, team conflict, or the emotional weight of patient care, this conversation will leave you thinking differently and leading better. Gang, let’s get into this episode!

Mentioned in this episode:

Sign up for the Early Career Newsletter here!

Learn more about Simparica Trio here!

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.

Register for Office Hours here!

Register for the Dont Get Sued course!

Tasha McNerney, CVT, VTS (Anesthesia & Analgesia), tackles one of the most common clinical dilemmas, how do you safely sedate dogs and cats for quick procedures without committing them to a full day of anesthesia or risking complications. If you have ever hesitated before radiographs, wound repair, or diagnostics because you wanted fear-free handling but also needed efficiency, this episode delivers practical answers. Tasha walks through reversible sedation protocols, multimodal analgesia, and how to combine opioids, dexmedetomidine, and local blocks to maximize comfort while protecting the airway. She also shares feline sedation strategies, when to add ketamine, and how local anesthesia can do the heavy lifting for painful procedures. You will walk away with confidence, safer sedation choices, and tools to deliver high-quality care even in spectrum-of-care situations. Gang, let’s get into this episode!

Veterinary Anesthesia Nerds: https://www.veterinaryanesthesianerds.com/

Tasha McNerney obtained her CVT in 2005 and has worked clinically in the areas of anesthesia and surgery ever since. Tasha obtained her CVPP (certified veterinary pain practitioner) designation in 2013 and became a veterinary technician specialist in anesthesia in 2015. Tasha has been a featured speaker on various anesthesia and pain management topics at several international veterinary conferences. Tasha is the author of many articles and blogs on anesthesia and pain management related topics. In 2013 Tasha created the Facebook group Veterinary Anesthesia Nerds, which has over 65,000 members taking part in education and exchange of ideas from all over the world!

Mentioned in this episode:

Register for the Dont Get Sued course!

Sign up for the Early Career Newsletter here!

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.

Register for Office Hours here!

Learn more about Simparica Trio here!