Dr. Brianna Armstrong, DVM, independent veterinary practice owner and social media voice, is here to tackle a question that's guaranteed to get people talking: Is veterinary medicine actually overpriced, or is it just expensive? We're digging into the rising cost of veterinary care, why pet owners and veterinary professionals don't always see eye to eye on pricing, and how different practice models could help make care more accessible without sacrificing sustainable businesses and healthy teams. From price transparency to navigating financial limitations without guilt or shame, we're challenging some big assumptions about what veterinary care should cost. Gang, let’s get into this episode!

TikTok, Instagram, and Facebook: @dramstrongdvm

LinkedIn: Briana Armstrong, DVM

Dr. Brianna Armstrong is a veterinarian, practice owner, technology founder, and leadership consultant whose work bridges clinical medicine, innovation, and people-centered leadership in veterinary care. While earning her DVM at Texas A&M, she founded SKYPaws LLC and developed a patented wireless patient monitoring device, reflecting her early focus on improving clinical workflows through technology. As a hospital owner, she has built systems around structured onboarding, behavior-based core values, and communication frameworks to enhance team clarity, accountability, and psychological safety. She also consults and speaks on leadership and cultural transformation, helping veterinary organizations create sustainable, people-first workplaces. Dr. Armstrong is the co-host & founder of Choose People Love Pets, a podcast that explores leadership and highlights non-traditional veterinary career paths through candid conversations with industry innovators. Across her clinical, entrepreneurial, and media work, she is dedicated to expanding what’s possible with a DVM degree and supporting the growth of veterinary teams and leaders.

Dr. Emily Tincher, DVM, Chief Veterinary Officer at Nationwide and co-founder of Clarity Vet Surgical Center, is back for her sixth visit, and we're tackling a question every vet team runs into: why does the same treatment plan land perfectly with one client and fall completely flat with the next? We dig into the three Cs of pet owner decision-making (cost, choice, and convenience) and Nationwide's new free pet parent personality quiz, which helps clients figure out their priorities before they ever walk into the exam room. You'll come away with simple ways to flex your communication, build client trust, and meet every pet owner where they are, no judgment required. Gang, let's get into this episode!

Thank you to Nationwide Pet Insurance for making this episode possible!

LINKS

Nationwide Pet Insurance Veterinary Healthcare Team Resources

Pet and Pet Parent Quizzes

Follow Dr. Tincher on LinkedIn

The Nationwide Pet Health Zone - Breed Related Insights

ABOUT OUR GUEST

Dr. Emily Tincher is a veterinary executive and emergency clinician whose career spans clinical practice and the design of systems that better support pets, families, and veterinary teams. A second-generation Auburn veterinarian, she grew up in her family’s rural Kentucky practice, where broad-based medical and surgical care and deep relationships with pet families shaped her commitment to accessible, relationship-centered care. She is also Co-Founder of Clarity Veterinary Surgical Center, which expands access to surgical and dental care through focused care practice design.

Dr. Tincher serves as Nationwide’s Chief Veterinary Officer and AVP, Pet Health & Strategic Partnerships, where she focuses on care delivery that is clinically sound, financially sustainable, and responsive to the needs of today’s pet families.

A nationally recognized advocate for spectrum of care, Dr. Tincher has served in veterinary leadership roles for more than a decade and is the Immediate Past President of the Veterinary Leadership Institute Board of Directors. She is a frequent speaker at major veterinary conferences across North America and has authored publications on cost of care, access to care, payment options, and pet family-centered approaches to veterinary medicine.

Dr. Sarah Boston, veterinary surgical oncologist, comedian, and the very first guest EVER on the Cone of Shame Veterinary Podcast, is back, and things go off the rails almost immediately! We're talking about the hills we wish we'd stood on earlier in our veterinary careers, emotional blackmail, professional boundaries, and some of the uncomfortable realities of veterinary medicine, including pet relinquishment, animal welfare, and how we compensate veterinarians. Sarah and I don't agree on everything, and that's half the fun as we challenge each other's perspectives on where our profession is headed and what really deserves our energy. Gang, let’s get into this episode.

Dr. Sarah Boston is a veterinary surgical oncologist. She is an ACVS board certified small animal surgeon and an ACVS Founding Fellow of both Surgical Oncology and Oral & Maxillofacial Surgery. She spent the first part of her career in academia as a tenured faculty member at both the University of Guelph and the University of Florida. She currently is in Ottawa, Ontario, Canada in private practice. She is an international speaker on surgical oncology as well as a keynote speaker on other hilarious topics. Dr Boston is also a best-selling author and stand up comedian. Her book, Lucky Dog: How Being a Veterinarian Saved my Life was a bestseller and she has just finished her first novel and she is frantically trying to get it published. Sarah is a graduate of the Humber College Comedy Performance and Writing Program 2023 and a comedian with YukYuks in Canada. She is the host of the podcast Comedicine, where she interviews healthcare professionals who are also comedians. She is a nerd and believes that we all need to laugh more.

Stephen Niño Cital, RVT, SRA, RLAT, CVPP, VTS-LAM (Research Anesthesia), joins me to ask a question that might sting a little: are we giving maropitant to our spay patients and calling it pain control? Stephen explains why MAC sparing is not the same as true analgesia, why nausea makes pain worse (and quietly throws off our pain scores), and why maropitant still belongs in every anesthetic protocol, just not for the reason many of us think. You'll walk away better at reading veterinary research and with a stronger plan for surgical pain management. Gang, let's get into this episode.

Register for the 2027 Uncharted Veterinary Conference!

Dr. Bob Lester, DVM, co-founder of WellHaven Pet Hospital, is back, and we're talking about a silver tsunami that could completely change veterinary medicine! As pets live longer, what does that mean for our appointment schedules, chronic disease management, preventive care, and the way we run our practices? We're digging into the opportunities of geriatric veterinary medicine, how wellness plans could help pets live longer, and why communicating the value of veterinary care matters more than ever. Gang, let’s get into this episode!

Today's Veterinary Business: Dr. Bob Lester's article, "How Veterinary Practices Can Prepare for an Aging Pet Population"

Contact Dr. Bob Lester: drrlester@comcast.net

Dr. Alex Sigmund, DVM, DACVO, a board-certified veterinary ophthalmologist and the face behind The Vet Eye Guy, is here to call us out on something I may or may not be guilty of: reaching for NeoPolyBac every time a dog shows up with a red eye! We're digging into why that approach can lead to missed diagnoses, how to recognize serious conditions like glaucoma and dry eye, and the essential ophthalmic diagnostics every general practice should have in its toolbox. From tonometry tips to empowering veterinary technicians, Alex shares practical ways to improve eye care, practice better antibiotic stewardship, and catch problems before they become emergencies. Gang, let’s get into this episode!

The Vet Eye Guy: Follow Dr. Alex Sigmund on Instagram, TikTok, and Facebook (@TheVetEyeGuy).

The Vet Eye Team: Dr. Alex Sigmund's veterinary ophthalmology practice in Atlanta, Georgia.

Dr. Ryane Englar is joining me on the podcast today to tell her unique story: What happens when you go blind as a veterinarian? Dr. Englar takes us through the journey, from her first symptoms, to diagnosis, to treatment and transplant, to learning to move through the world differently with a disability. Dr. Englar is extremely open, honest, and insightful in this episode, and she shares some really powerful messages that apply to us all. Definitely do not miss this one!

Dr. Ryane Englar's new book, " Postcards from Life's Passenger Seat: Reflections on Sight, Identity, and Belonging"

All books by Dr. Englar

Email Dr. Englar: renglar@arizona.edu

Ryane E. Englar, DVM, DABVP (Canine and Feline Practice) graduated from Cornell University College of Veterinary Medicine in 2008. She practiced as an associate veterinarian in companion animal practice before transitioning into the educational circuit as an advocate for pre-clinical training in primary care. She debuted in academia as a Clinical Instructor of the Community Practice Service at Cornell University’s Hospital for Animals. She then transitioned into the role of Assistant Professor as founding faculty at Midwestern University College of Veterinary Medicine. While at Midwestern University, she had the opportunity to teach the inaugural Class of 2018, the Class of 2019, and the Class of 2020. While training these remarkable young professionals, Dr. Englar became a Diplomat of the American Board of Veterinary Practitioners (ABVP). She then joined the faculty at Kansas State University between May 2017 and January 2020 to launch the Clinical Skills curriculum.

In the 420th episode of the Cone of Shame Veterinary Podcast, Dr. Andy Roark talks with Steven Satal about the state of cannabinoid medicine in veterinary care after the early surge of interest 8–10 years ago. Satal clarifies terminology and legal distinctions between hemp (≤0.3% THC) and cannabis/marijuana (>0.3% THC), noting the 2018 Farm Bill definitions may change. They discuss how the field has plateaued but become more normalized, with over 40 PK/PD dosing studies across species and increasing specialist referrals for cannabis consults focused on harm reduction, dosing, and product selection. Satal emphasizes cannabinoids are not a silver bullet; his main uses are chronic pain, epileptic disorders, and canine cognitive dysfunction, with some evidence for itch reduction in dermatology. He typically starts dogs/cats at 2 mg/kg CBD twice daily and adjusts, stresses variable product quality, cites brands with supporting studies, and outlines cautions with sedating drugs and liver monitoring; he does not recommend cannabinoids for pre-visit anxiety.

Stephen Niño Cital holds a Masters in veterinary anesthesiology and is a veterinary technician specialist (VTS) in research anesthesia among other credentials. He has a passion for anesthesia, pain management, and integrative medicine. Stephen has authored numerous peer reviewed articles and contributed to several textbooks- including acting as the lead editor for the first veterinary cannabinoid medicine textbook and more recently a second edition of a pain management textbook. He has many exciting professional highlights but some of his favorites include being part the scientific team that discovered acidic cannabinoid forms are absorbed more efficiently than decarboxylated forms, discovered a common drug used in anesthesia causes a serious complication known as methemoglobinemia in monkeys, invented a smaller and more practical blood filter for animals during blood transfusions, and helped gain title protection for veterinary technician specialists. Stephen is a lab manager for HHMI at Stanford University in the department of neurobiology, and the Chief Veterinary Nursing Officer and director of the pain and cannabinoid medicine services at Remedy Veterinary Specialists. Additionally, he is the COO of the Veterinary Anesthesia Nerds, LLC., and Executive Director of the Academy of Laboratory Animal Veterinary Technicians and Nurses, and president of the California RVT Association. His current pursuits include completing another acupuncture certification and a VTS in neurology.