The Cone of Shame Veterinary Podcast

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 GUESTDr. 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.comhttps://vetmed.tamu.edu/gilab/service/assays/canine-microbiota-dysbiosis-index/Mentioned in this episode:Sign up for the Early Career Newsletter here!Register for the Dont Get Sued course!Care Is Your Calling!Office Hours w/ Dr. Andy RoarkInside 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.Mentioned in this episode:Register for the Dont Get Sued course!Office Hours w/ Dr. Andy RoarkInside 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!Care Is Your Calling!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.Mentioned in this episode:Care Is Your Calling!Register for the Dont Get Sued course!Sign up for the Early Career Newsletter here!Office Hours w/ Dr. Andy RoarkInside 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.Mentioned in this episode:Sign up for the Early Career Newsletter here!Care Is Your Calling!Office Hours w/ Dr. Andy RoarkInside 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!