The Cone of Shame Veterinary Podcast

A Cry for Help in Veterinary Pathology, Burnout, Economics, Digitization, and AI with Dr. Eric Fish Dr. Eric Fish, DVM, DACVP, joins Dr. Andy Roark to tackle a tough question: Why does being a veterinary clinical pathologist feel darker right now, and what happens if AI turns “nice to have” diagnostics into “don’t need to have”? They unpack burnout and pay compression (including pathologists earning less than new grad GPs), consolidation in the lab market, and how digitization has pushed cytology toward point-of-care and high-volume “turn and burn” workflows with per-case bonuses that can be as low as $8 to $12. Eric explains how consultative lab medicine has shifted toward internists, why cytology’s cost and turnaround time are eroding its value, and what a better future could look like with AI that augments, triages, and keeps a human in the loop. Gang, let’s get into this episode. Keywords: veterinary pathology, clinical pathologist burnout, digital cytology, AI in veterinary medicine. Links: Substack newsletter All Science Great and Small; LinkedIn. Dr. Eric Fish is a veterinary clinical pathologist and laboratory director at a large private referral center, with a career spanning academia, entrepreneurship, and industry. He co-founded Lacuna Diagnostics, the first point-of-care digital cytology company, spent years at IDEXX as a diagnostician and technology scouting manager, and even found time to work occasional relief ER shifts. Eric brings a unique perspective to the conversation around artificial intelligence: he has not only used voice recognition and large language model AI tools in his own practice, but also worked on teams building computer vision applications for medical imaging. He writes about AI and other hot topics in veterinary medicine in his Substack newsletter, All Science Great & Small.

Beyond Gabapentin and Trazodone, Smarter Pre-Visit Anxiety Meds with Dr. Chris Pachel Dr. Chris Pachel, DVM, DACVB, joins Dr. Andy Roark to tackle a problem every clinic knows too well, stressed pets, stressed owners, and appointments that start going sideways before the car even leaves the driveway. They dig into pre-visit pharmaceuticals beyond the usual gabapentin and trazodone, including when to increase doses, when sedation is masking anxiety (not fixing it), and how options like clonidine, benzodiazepines, and even dexmedetomidine can fit the patient in front of you. Chris also shares how his new Animal Behavior Clinic space in Portland is reducing stress fast, plus practical tips for at-home trial runs, safety planning, and cautions around acepromazine and “chill protocol” variations. Gang, let’s get into this episode. Dr. Chris Pachel is a board-certified veterinary behaviorist and is the owner and lead clinician at the Animal Behavior Clinic in Portland, Oregon. Dr. Pachel lectures extensively worldwide, teaches courses at multiple veterinary schools in the United States, and has authored numerous articles and book chapters for veterinarians and pet owners. He is a sought-after expert witness for legal cases and serves on the Editorial Advisory Board for dvm360. He is also a Vice-president of Veterinary Behavior for Instinct Dog Behavior and Training, as well as co-owner of Instinct Portland, which opened in the fall of 2020.

Dr. Andy Roark hosts Dr. Matt Salois, an economist, VMG president, and adjunct faculty at Cornell’s College of Veterinary Medicine, to discuss his Today’s Veterinary Business article on the “dangers of Dutch Pets veterinary telemedicine,” using a Trojan horse metaphor. They argue that when a “no strings attached” solution promises cheaper, easier access by reducing restrictions, vets should be skeptical because removing safeguards like the VCPR and physical exams is not the same as innovation. The conversation covers how pharmacy revenue subsidizes clinic services, concerns that Dutch’s model and rhetoric may erode trust in veterinarians, and how misdiagnoses without exams can increase costs, especially for seriously ill pets. They also discuss delayed presentation, accountability, and who bears risk when medical decisions go wrong.

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

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

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