July 6, 2025 • 51 mins
In this episode of the My DPC Story podcast, host Maryal Conception interviews Dr. Eve Harrison, a concierge, cash-based, house call Veterinarian based in Los Angeles. Dr. Harrison shares her journey from traditional veterinary training, including her struggles with the corporatized veterinary system (you'll be amazed at the similarities in the human world), to establishing her own integrative and concierge veterinary practice. Throughout the discussion, they draw parallels between human medicine and veterinary care, highlighting the challenges posed by corporate influences in both fields. Listeners gain insights into the importance of establishing long-term relationships with patients, managing holistic care, and the impact of corporate healthcare on both human and animal patients. Dr. Harrison's story sheds light on the shared struggles and the innovative paths taken by healthcare practitioners in providing compassionate and personalized care.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Maryal Concepcion (00:04):
Direct Primary care is an innovative
alternative path toinsurance-driven healthcare.
Typically, a patient pays theirdoctor a low monthly membership
and in return builds a lastingrelationship with their doctor
and has their doctor availableat their fingertips.
Welcome to the My DPC Storypodcast, where each week you
(00:26):
will hear the ever so relatablestories shared by physicians who
have chosen to practice medicinein their individual communities
through the direct primary caremodel.
I'm your host, MarielleConception.
Family, physician, DPC, owner,and former fee for service.
Doctor, I hope you enjoy today'sepisode and come away feeling
inspired about the future ofpatient care direct primary
(00:49):
care.
Eve Harrison, DVM (00:53):
The similarities between human
medicine and veterinary medicineare so uncanny.
It's kind of crazy that we don'tlearn more from each other on
the regular.
I'm Dr.
Eve Harrison with MarigoldVeterinary and the house called
Vet Academy, and this is mydirect veterinary story.
Maryal Concepcion (01:12):
Dr.
Eve Harrison graduated from theUniversity of Pennsylvania
School of Veterinary Medicineand then went on to do an
internship in medicine, surgery,cardiology, emergency medicine,
and the health of exotic animalsin San Diego before going to a
surgical residency in the BayArea before changing paths
completely to be a full-timeintegrative, concierge house
(01:32):
call veterinarian in the LosAngeles area.
She's also certified intraditional Chinese veterinary
medicine from the Chi Institute.
Her work outside.
Of clinical veterinary practicefocuses on grassroots efforts
and solidarity in protectingindependent veterinary practice
ownership.
In light of the corporatetakeover of veterinary medicine
and empowering individualveterinarians, he is a speaker
(01:54):
writer, content creator, and thefounder of the online Continuing
Education course, the Housecalled that Academy.
Through the academy, she offerscoaching and consulting to help
independent veterinariansnourish not only their patients
but themselves by helping themto cultivate profitable and
sustainable mobile.
Of their own.
She's also the founder of theAnnual House call and Mobile Vet
(02:15):
Virtual Conference.
Host of the house call Vet CafePodcast Concierge, vet
Mastermind, and Soul Shine Spicefor vet.
Dr.
Eve's passions are creativeentrepreneurship, veterinary
practice management,sustainability for
veterinarians, boundaries,authentic communication, and
releasing people in systems whoare not a good match for our
practices.
Or our lives outside of her workwith animals and their humans.
(02:36):
Dr.
Eve is a semi-professionalmusician, Flo Yogi MyFi, and a
certified compassion fatigueprofessional.
Welcome to the podcast, Dr.
Eve.
Eve Harrison, DVM (02:48):
Ah, thank you so much for having me.
I am just like really excitedand have been looking forward to
this call for a while.
'cause you've been on mypodcast.
It was one of my most belovedepisodes and so yay.
What an honor to be on your showtoo.
Thank you so much for having me.
Maryal Concepcion (03:04):
Absolutely.
And.
Yes, you did hear right.
In terms of Dr.
Eve's bio, she is aveterinarian, meaning we only
take care of the human speciesand she takes care of all the
other species.
And I, I just wanna put for theaudience a little, intro to this
whole conversation.
Dr.
Eve and I met at the TakeMedicine back conference back
in, maybe the spring of 2024.
(03:27):
Take medicine back as anorganization, really focused on
taking medicine back into thehands of physicians and their
patients and away from thecorporate practice of medicine.
And so what I was just flooredby was the similarities between
the human side of things as wellas the non-human side of things.
And so that is why I've askedDr.
(03:48):
Eve to come onto the podcast toshare her perspective, because I
think it's very eye-opening, notonly for us as physicians who
are listening out there, butalso for anybody who is
interested in, where healthcareis today for human and non-human
species.
And so I'm excited about thisconversation as well.
And, I hope that it iseye-opening and I hope you share
(04:08):
this episode with other people,because it does not matter what
type of corporate medicineyou're doing.
Corporate medicine is corporatemedicine.
Eve Harrison, DVM (04:15):
Yeah, absolutely.
Yeah.
And if you hadn't mentioned theTake Medicine Back conference, I
was gonna, because it wasrevolutionary.
Maryal Concepcion (04:22):
Absolutely.
So let's talk about when itcomes to when it comes to your
background in veterinarymedicine, we hear every week
from human physicians in termsof their, training after school,
basically.
So tell us in terms of aveterinarian's path after school
(04:44):
what is your guys' traininglike, what is the expectation
like, and how many ofveterinary, how many veterinary
grads go into employed medicineversus independent medicine?
I.
Eve Harrison, DVM (04:58):
Great questions.
So there, there are definitelysome, there, there's tremendous
amounts of similarities.
Like we have the match systemand everything.
We're not quite as what, what Ibelieve is sort of maybe more
regimented in the human medicalsystem.
Like my sister is a do.
So I watched her go through thatprocess.
My little sister's a pa so I, Iknow about that as well to some
(05:22):
extent.
But it seems that in veterinarymedicine, you could do an
internship, you could do aresidency, pretty rare in
general to be residency trained.
Whereas I understand in humanmedicine it's, required but for
us, it's very much like, if youwant to be a surgeon or you want
to be an internal medicinespecialist, or you want to be a
(05:42):
neurologist, you, you have to gointernship and then residency,
usually the internships are oneyear general rotating
internships followed bypotentially.
If it's a really difficultresidency program to get into,
sometimes there's specialtyresidencies.
That's another year or multipleyears until you get into the
residency program of yourchoice.
For me I, I sort of like tookthe express path, like
(06:06):
unbeknownst to me andundesirable to me in retrospect.
So I, I knew I wanted aninternship.
Personally, I, I, I'd heard frommany people, like it's really
good to have, formal mentorshipand go a little bit deeper into
each of these subjects, which,if you end up just going general
practice, which is kind of thedefault for small animal
(06:26):
veterinarians.
Mm-hmm.
So small animal being dog, cat,maybe what we call an exotic or
two, maybe a rabbit, maybe ahamster.
But usually like the default forveterinarians, general practice,
cat and dog.
Even if you wanted to kind of gointo general practice without
any sort of specialty, the wordon the streets is it's really
nice to have an internship sothat there can be a little bit
(06:48):
of handholding.
You can go a little bit deeperinto internal medicine, a little
bit deeper into surgery.
General practitioners inveterinary medicine are doing
all of it.
Surgery, neurology, literallyevery, it's insane when I
compare what vets do to what mysisters do on, on a, like a
general medicine basis, I'm justlike, We have to do surgery, we
have to do endoscopy, we have todo all this crazy mri, but
(07:09):
anyway, so, the, the path that Itook was I did my four year
veterinary training.
Well, we, okay, so pre, pre-medis the same as pre-vet,
essentially, so I'm going wayback.
Right.
So then you do your four yearveterinary training.
You can either go the path ofinternship plus minus residency
or just go straight into generalpractice.
I would say the majority ofpeople go generally into general
(07:31):
practice.
And then, I really don't know.
I'm pulling numbers out of.
Out of thin air, but in myobservation, it seems maybe 50%
of people do an internship,maybe 30%, and then maybe 10,
five to 10% go on to specializethat.
That's kind of my, my image ofit.
But don't, don't quote me onthat.
I, I haven't looked at anystudies on that specifically,
(07:52):
but that's my generalimpression.
And for me, I did my, my generalrotating internship.
I had an inkling I wanted to bea surgeon.
Maybe I like working with myhands.
I like fixing things.
Yeah, I don't know.
My, I have a, a medical familyand, and we are, or adjacent, I
grew up visiting the, or manytimes, so I thought maybe I
(08:14):
wanted to be a veterinarysurgeon.
And I'd also done some surgery.
Sort of like volunteer work onNative American reservations in
vet school.
And I really liked the surgicalaspect and it, it, it became
clear that you better know howto do surgery really well.
So I thought I wanted to be aboard certified surgeon to
really get all that training.
(08:34):
So I did my general internship.
I applied for residency.
Miraculously I got in, I thoughtit was gonna take me multiple
years as is the case with mostpeople going that path.
But for some reason I matchedright out of internship to my
shock horror imposter syndromeself.
I was just like, oh my God.
So there was a, a bit of a, ashock there.
(08:55):
And it didn't work out.
So, I did a few years of thatand then shifted to a totally
different direction.
So that's kind of a little bitof my story embedded in the
general veterinary path story,
Maryal Concepcion (09:06):
tell us when it comes to the similarities
between the, the practice ofmedicine, I'm just wondering if
you even saw along your journeychanges such that things were
becoming more corporatized, andif so, what did you see?
Eve Harrison, DVM (09:22):
Yeah, so I, I always kind of say that in, in
my observation, it seems likethe veterinary profession is
maybe like 10 to 20 years behindthe human medical field in terms
of the corporatization process.
This is just my, my intuitivesense, having seen a little bit
of both While I was in vetschool, I was feeling a lot of
corporate pressure to join acorporate internship.
(09:44):
We got talks from the corporateentities saying things like, if
you don't do an internship,you're gonna be a bad vet.
In fact, you, if you don't doour internship, you're gonna be
a bad vet.
I remember things like that.
I can't speak to how it wasbefore I joined the profession,
but all of my experiences as avet tech before I, or a vet
(10:04):
assistant to, to be more precisein the, the language in
independent practices.
I, I'd never seen anything likethis and I had been prepping to
be in vet school for maybe 10years prior or more.
So I, I was seeing onlyindependent.
And then when, when I got to vetschool, there was a very heavy
influence from the the corporatecompanies coming in, giving us
lunch talks, telling us abouttheir programs and why, why we
(10:26):
would be inferior if we didn'tjoin their programs, you know
what I mean?
So in vet school was the firsttime I saw it.
I, I graduated about 13 yearsago.
But I, I know that thecorporatization of human
medicine has been going on far,far beyond that, that period of
time, I, I, my family would talkabout it.
(10:47):
I would Just like out in theether, my friends who became
doctors, I heard about it aswell.
So this was the veterinaryexposure that I got once I got
into vet school,
Maryal Concepcion (10:57):
and
Eve Harrison, DVM (10:57):
I did a corporate internship.
I did a corporate residencymiserable.
I, I was absolutely miserable.
Like for the first time in mylife, I, I'm very open about it.
I had to go on antidepressantsand I've never come off, you
know, and, that's, that's asubject for another time.
But like the damage done in, inthose few years to try and
(11:18):
survive in what my professionportrayed to be, the path to
being a good doctor.
The, the path to being worthy inthe corporate paradigm I'm still
recovering to this day, to behonest, you know,
Maryal Concepcion (11:36):
and I appreciate that vulnerability
because, it's it's something sorelatable to our listeners out
there.
I'm wondering if even justbreaking down when it, it comes
to.
This place that was thecorporate experience that you
had?
I think about in the humanworld, we after we get our
golden handcuffs, we go to anemployed position, we get our
(11:58):
magical salary, and then all ofa sudden your, your feet are
wet, the water's warm, and nowthey're like, boom.
RVs.
Very commonly the human side ofthings is very much based on
productivity.
I love how productivity is, howto describe human medicine.
But in the vet world were you,in residency or just, in general
for somebody who is practicingin a corporate model can you
(12:20):
speak to us about is there aproductivity equivalent
Eve Harrison, DVM (12:23):
there absolutely is.
The good thing is I was neverput under productivity pressure
as an intern or resident.
I believe my mentors were in, inthat scenario.
I, I can't speak a hundredpercent to that.
But I I've not experiencedproductivity other than one time
(12:44):
in a corporate practice while Iwas doing relief work or
moonlighting work as I think youguys are more inclined to call
it.
More of the productivitypressure I've heard comes from
people who are associates atcorporate practices, associates
at corporate house callpractices you have to meet
certain amounts of seeingpatients or.
(13:06):
You will get spoken to, or you,you won't get the, the full pay
that you need to make in orderfor this job to be worth it.
Right?
Like, they'll say, oh, well,you'll get a bonus.
But it's like, if you don't makethat bonus, then you're living
on an income that is unrealisticfor, for someone trying to work
at this capacity.
(13:27):
You know what I mean?
I would say I've, I've been verylucky that I've, like, I learned
what corporate is.
I learned that I don't fit intothat type of hierarchical system
um, that has pressures.
I luckily, I was shielded fromthose pressures in my training.
But the environments that I wasin, the way I was learning, the
(13:48):
way patients were treated, theway my clinical intuition was.
Like devalued.
And, something other maybe moneyor bottom line, something else
other than what my clinicalimpression was, my care for the
patient was being put abovethat.
It was very, very clear.
But, as a result of that, I, Isort of like immediately was
(14:08):
like, I cannot work in theseenvironments.
And so by the time I was, not aresident or intern, I was like,
yeah, I'm not gonna subjectmyself to that.
So all of the horror stories aremy colleagues, my friends things
that I've seen and or beenoffered and been like, no, thank
you.
You know what I mean?
So thankfully I haven't beenlike under the productivity
(14:30):
hammer myself, thank God.
Maryal Concepcion (14:33):
Even though you weren't necessarily under
the productivity modelequivalent as a, you know, a
person who's been working in thesystem for.
Maybe two years, three years,sometimes the RVU go in,
depending on the contract soonerthan that.
Yeah.
When it comes to, thefrustration that humans have
with the human medicine system,I'm wondering, can you talk to
(14:54):
us about the, the patient sideof things?
Because, I think about,especially if you're dealing
with domestic animals, which is,the most common thing that we
see veterinary visits for.
There's a lot of corporate vetclinics and you're delivering a
completely different model.
And I'm just wondering, like,can you speak to experiences
(15:15):
that a person might typicallyexpect to have?
What's the visit time like?
What's an appropriate time likefor, a, a general checkup versus
something acute that couldhappen with a cat or a dog?
Eve Harrison, DVM (15:26):
I mean, Even outside of the productivity
model of, of incentivizing or deincentivizing people based on
their behavior aroundproductivity, the time slots in
most corporate and, and alsosome independent clinic
settings, which I think is aderivative of the corporate
mindset that we've beenindoctrinated with.
(15:46):
One way that that sort of canalso play out is with either 15
minute appointments or 20 minuteappointments or 30 minute
appointments.
I don't think any of those aregenerally enough time to handle
anything that really matters.
I've done relief work and as Imentioned in general practice
and in corporate, and to me, I,it's, it's like I.
(16:07):
Brutal on my nervous system.
'cause it's like, well first ofall, I'm trained in so much more
than, than just like the very,very basics.
The more you know, the harder itis to hold an appointment time
that is so restrictive whereyou're like, yeah, we can put a
bandaid on this.
Or I can really help you and in15 minutes I really can't help
you.
So this is painful foreverybody.
(16:29):
This is a, a very poor setup.
I have refused to work in aplace that has 15 minute or 20
minute appointments.
That's insufficient in, in myopinion.
If you're really doing goodmedicine, you really care.
You wanna hear.
You wanna give people the, thechance to speak about what's
going on about the animal.
We're in a situation whereanimals can't speak, right?
(16:50):
So the advocacy of the human onbehalf of the animal is even
more important.
I need to, I need to hear braindump for me.
Tell me what's going on and I'llpick out what I need to know.
I'll ask you all the questions.
The history alone could take 30minutes before I examine the
animal, before I come up with atreatment plan, let alone enact
any of those treatments.
Right?
Maryal Concepcion (17:09):
And I'm sure that there are other people out
there listening saying, but.
Why is she mentioning timeslonger than the humans get per
visit?
So also the fact that you'relike, I don't take jobs that
have shorter than the quoteunquote decent time to start
with, but it's, it's not evenenough.
I think very much about like apediatric patient and,
(17:29):
pediatricians especially arereally bombarded with like, well
child visits and sure you candeal with an ear infection same
time, five minutes.
Five minutes, it's like it'slike an auction and it's like
actually, especially whensomebody cannot advocate for
themselves, it is a lot of timesharder to get the history and it
takes more time because you.
Our thinking from, the shoes ofsomebody who might be
(17:53):
overwhelmed, especially again,going to pediatrics, like
multiple children working and aparent.
And then, it's like details arenot necessarily going to be at
the forefront depending on howlong it took to get in,
depending on how worried theparent is.
The listeners can absolutely seesimilarities there, even just
with the frustration of, oftime.
And I'm wondering in terms of,what does it look like for a
(18:14):
person who is going over time?
Like, what happens if they'relike, Dr.
Harrison, you're like 30 minutesbehind, you're an hour and a
half behind.
Eve Harrison, DVM (18:24):
Oh, I'm so glad you asked that question.
I was just like, oh, I justthought of two times that I need
to mention.
So, one time I was, I was doingmy relief work at a corporate
practice.
I was, 45 minutes behind.
This was not entirely my fault.
People showed up late and you,if you wanna in accommodate
them, you have to, everyone getsshifted, right?
You have an appointment thatthrows a monkey wrench in, in
(18:46):
your schedule.
You're not expecting somesomeone to be like literally in
an ICU crisis state that youneed to now handle that and then
move on with it.
So there was a, there was apoint where I was 45 minutes
late and I got a talking to bycorporate and I was like, get
real, get out of here.
Like you have no idea what'shappening on the floor right
now.
(19:06):
You have no idea.
Then during my residency, thiswas one of my favorites.
I was working with a cat thathad a urinary obstruction.
This is something that happensvery commonly in male cats.
And it's life threatening, ofcourse, right?
If you, you can't pee, youcan't, you know.
so anyway, this was a life anddeath situation.
(19:27):
The animal was very sick.
The client was trying to decidewhether to euthanize or to
proceed with care.
I took a long time with thisguardian of the cat.
And they were really, reallygoing back and forth.
You could see that this was likea deeply important.
Upsetting moment, and I mean,this is life and death.
Like in, in human medicine, it'sonly very recently that
(19:51):
euthanasia or like end of lifedecisions is even legal at all.
This is our every day, right?
This is so heavy, and to me, Idon't take that lightly and no
one takes it lightly, but to me,I, I wear my heart on my sleeve
every single euthanasia.
I feel that, and I don't wantthat to change.
So I spent a good amount of timewith this client.
(20:13):
Meanwhile, I had told my staff,please put in an IV catheter,
start IV fluids, do basic triagestuff, just stabilize, while I'm
having this conversation.
And I got them to proceed withcare like this is.
Not an old cat, like we can savethis cat.
Like, this is easy if you justlet us do it, but it required a
conversation, it required aheart to heart.
It required me hearing whattheir concerns were.
(20:35):
It required me to, to stepalmost a little bit outside my
role of a veterinarian and justbe a human using my
communication skills to get tothe heart of it.
And that's not something you'regonna do in 15 minutes, 30
minutes.
I probably was in there for 40minutes if I had to in and out,
just like you think on it, I'llcome back.
(20:56):
After that, I my mentors werelike, you took way too long in
there.
You endangered the life of thisanimal.
I'm like, do you understand whatI was doing?
I was saving, literally savingthe life of this cat.
Without that conversation,without taking the time, the cat
would be dead, period.
Right.
I employed basic triage.
(21:16):
Anything further that we neededrequired the permission, the
consent of the client, and I gotthat.
So you're welcome.
So that, that was one of myfavorite moments of like, this
is not.
This is not how I want tofunction in the world.
This is not how I doctor, I amsorry.
I am not gonna be a cog in thismachine.
(21:38):
You know what I mean?
Maryal Concepcion (21:40):
Absolutely.
And I just, I think about, howmany times, especially in family
medicine residency, anybodywho's right rotated in the ICU
or an emergency room, I mean,just the horrific things that
we've seen, drowning of littlekids people being coated and
coated when, that like it'sdoing more damage to their body.
I mean, so many violent and sadthings.
(22:02):
But, just recently having putour 16-year-old cat down, sorry.
Like in, in my experience, we'veput an animal down um, and and I
cannot imagine, you're, you'rean outpatient veterinary doctor
and yet you're doing end of lifecare.
(22:23):
I mean, yes, I do, I do care forpeople in hospice, but like, not
at the volume that you guyswould do.
And so I can't even imagine thethe, the, the vast difference in
the amount of times your heartis being not only worn on your
sleeve, but also just beingwronged to like the core because
of you being there for youranimals.
(22:46):
Just the same, like, we're therefor our patients.
Eve Harrison, DVM (22:49):
Yeah.
Yeah.
That's very well said.
I think that's one of the.
Primary reasons.
Just like you said, like thevolume of this high intensity
emotional content and, and likethe work itself.
That's why veterinarians have anuncanny rate of suicide.
I, I can't be on this showwithout mentioning it.
(23:11):
But it's, it's a real, realproblem.
There are a lot of studies outthere from the American
Veterinary Medical Associationpublished in the CDC
collaborations that show allthese statistics and things, and
there's a myriad, myriad numbersof reasons why that is.
And I know human doctors and,and caregivers and dentists as
well struggle with this.
(23:31):
Veterinarians are, are.
Kind of the top, the top ofthat.
Not to like, have any traumaOlympics, but it's simply a
fact, right?
And I think that the, thecorporate pressure, the
corporate structure, thecorporate mindset, even if it's
not an actual corporate practiceto, to see more and more and
more bottom line dehumanizepeople, dehumanize animals,
(23:53):
deani, animalize animals, right?
Like objectify get more doneproductivity, even if you're
being paid on a production modelor not.
That that's, that vibe is stilldeeply entrenched in the in, in
the sort of moia of the work andthat.
That wears on people.
That's, that's moral injury,that's depression, anxiety, loss
(24:15):
of meaning, loss of purpose, etcetera.
All of that.
It's so deep how harmful that iswhen we can't take the time that
is needed for these really heartwrenching difficult, emotionally
speaking and, andintellectually, physically
difficult cases, so, yeah.
And I'm so sorry about your cat.
(24:35):
I'm, I'm so sorry to hear that.
Maryal Concepcion (24:37):
Thank you.
I think about also, I.
When we are talking with people,whether they're speaking for
themselves or they're speakingfor their loved one who might
not be able to speak forthemselves for whatever reason.
Even just the medicalunderstanding, like taking the
time.
I, I, and I don't know if thisis a thing in veterinary
medicine as much as it is inhuman medicine, but like
(24:58):
suspicion about science andvaccines and like, are you
really trying to help me or areyou just trying to kill my
animal because you have somebodyin the waiting room, like, I
wonder if you can speak to usabout just, just the, the, the
things you have to do withpatients because you are, taking
care of, of somebody who is sickand who can't speak English or
whatever language the humanwould speak to each other in a
(25:21):
clinic.
Eve Harrison, DVM (25:22):
That's really a really, really interesting
point.
I, I was speaking to a colleagueabout the, recently about the
fact that this sort of doubtingand the skepticism about the
veterinary field and, and themedical field, it's, it's a
trauma response to what, whathas happened, right?
Like, we all get annoyed.
(25:43):
We're like, oh God, here we goagain.
Now I have to explain like howlife works, how fit science is a
thing.
Like, all right, here we go.
But the thing is like, peoplehave kind of have reason to, to
be skeptical.
I have reason to be skeptical ofmy own profession based on what
I've been through.
(26:03):
So.
In my own practice, I am reallyaware of this phenomenon.
I'm really accommodating of it.
I almost anticipate it being inintegrative medicine where I'm
incorporating all the regularWestern stuff along with
traditional Chinese veterinarymedicine holistic paradigms,
(26:25):
things like that.
Maybe some of it's cutting edge.
Some of it is notevidence-based, but anecdotally
based.
And I've seen it work many timesand yet, and I'm like, if it
works and doesn't cause anyharm, we're doing it.
Okay.
Like if, as long as the, theguardian is interested in that.
But in, in that sort ofcontainer, I am really dealing
with a lot of people who arevery skeptical, like I do in
(26:49):
particular attract those people.
'cause they're seeking outholistic care.
And usually those people areseeking holistic care'cause
they've either been burned bythe traditional, they have.
Know someone who's been burnedby the traditional, it didn't
work.
They were a, a cog in the systemthemselves.
They didn't like how that felt.
They felt invalidated,dehumanized uncared about
(27:10):
unseen.
And so they're, they're comingto me to, in hopes that I can
provide something different.
And that's my goal to reallytake my time.
I always say that I work on dogand cat time.
However long the animal needs,that's how long it's going to
take.
So it's very much an opencontainer.
It's very un, I'm veryboundaried, but my time is
(27:31):
unbounded.
Because you simply cannotquantify the amount of time that
a, a body, a living body isgoing to, what they're going to
bring to you, what they're goingto need, what the, what the
guardian is gonna be goingthrough as they observe this or
hold it, or, or we work throughwhat needs to be done.
So that's, that's kind of beenmy answer that I, I just sort of
(27:54):
step right out of the box rightoutta the matrix and I'm like,
you will not give me a 30 minuteappointment.
I'll take how, however long Iwant with this animal.
And I have an ETA window for allmy clients.
So they're like, they understandlike I would do the same for
them if I'm late to see them or,on the back end of my ETA
window.
It's'cause of dog and cat time.
(28:14):
And I would show them the samecompassion, empathy, and
flexibility in their moment ofneed, you know,
Maryal Concepcion (28:20):
I think here, especially because you are so
passionate about empoweringother veterinarians, especially
to understand your, what you'veexperienced, to take a zoom out
and really be able to crafttheir own.
Veterinary practice, just likewe've done in the human space
with direct primary care.
(28:42):
I'm just wondering if you cantell us even more about your
practice because I, I, I, I feelit's very similar in, we have
people who are, they haveanimals.
They need somebody to care forthese animals, and they're,
maybe not used to having a housecall a veterinarian, come to
their home.
How do you even get the word outabout, having a practice like
(29:06):
this?
Eve Harrison, DVM (29:07):
Thank you for asking about my practice.
So, my practice is calledMarigold Veterinary, named after
my heart, Catt Marigold, whodied but was one of my primary
inspirations for becoming a vetto begin with.
So my practice is named afterher.
It's a memorial for her.
I am a low volume house callpractice.
(29:28):
I don't typically see more thanthree to four patients a day.
That's even a heavy day for me.
When I say that I'm concierge, Iam a concierge house call vet.
When I say that, it's a littlebit different from human
concierge.
There's a lot more overlap, Ibelieve with DPC as we've talked
about.
There's, there's some similarityto human concierge, but it's a
(29:50):
cross, essentially.
It's a cross between DPC andhuman concierge.
So I am.
Essentially requiring amembership to be in my practice.
And it's a little bit higherthan what most DPCs charge, but
not as high as what humanconcierge doctors we're.
We're price wise, we'resomewhere in the middle as a
(30:10):
rule.
I mean, I can't speak to everysingle concierge vet out there.
There's only like 10 in theworld like that are doing what I
consider to be true conciergeveterinary medicine.
But of those I think we're, ourpricing is probably somewhere in
between.
because I require a membership,I don't have to take as many
clients.
So like I'm, that, that is whatallows me to be low volume.
(30:35):
And it also is what allows me tobe very, very selective about
exactly which clients I.
Feel I'm equipped to support Iemotionally and from, from a
veterinary perspective and who Ican sustainably keep in my life
(30:55):
for the long term.
Like when, when I take on aconcierge patient, they stay
forever, most of the time.
I, I can't guarantee everyonewould, but most of the time this
is a long-term relationship.
So this is what allows me toreally cr craft something
entirely outside the box.
Like I'm not strictly working ona time for money basis, right?
(31:15):
It's not that I have to have theanimal get sick so that I can go
out to get paid.
With concierge being onsubscription, I'm paid no matter
what.
And in fact, I'm actuallyincentivized that my patients
are healthy.
'cause then I have to go out andthey've, they've already, I've
already been paid.
So it's like, oh God, now I haveto go out again.
I mean, I don't actually feelthat way, but like my goal is
(31:36):
for the animal to be healthy andI'm incentivized for that.
To occur, from a financialperspective, an energetic
perspective it's just very muchmore aligned on all the levels
of caring about my patient,being a business owner, my own
energy.
All of that is so much morealigned because I don't have to
wait for an animal to get sick,for me to be able to earn an
(31:59):
income, you know what I mean?
Maryal Concepcion (32:02):
Makes sense to me.
I'm just like, wow.
Preventative care versus sickcare.
That's amazing.
Yeah.
And I'm wondering, as you aredescribing something very, very
similar to DPC in terms of themembership model and whatnot,
I'm wondering just dipping backinto the, the corporate side of
things are there insurancecodes, like when I talk about
(32:23):
sick care, we'll have likediabetes versus prevented
diabetes and we have a code forthe diabetes versus we do not
ever have a code for preventedsomething.
Eve Harrison, DVM (32:32):
This is a really interesting subject.
I think we're likewise maybe 10to 20 years behind you guys in
terms of the insurance companytakeover.
So right now in veterinarymedicine, people have the option
to get insurance.
They have a variety of differentcompanies they can choose from.
Each company has a differentpolicy, what they will and won't
(32:53):
cover, most of them do not coverpreventative care, but that's on
a, a policy by policy basis.
Some of them may, if you get arider, may include acupuncture
or some holistic care, maybesome rehab.
But in general primary care,like preventative care not
covered.
The way it works for us iscurrently this is, they're
(33:16):
trying to change it.
They're trying to, they'retrying to do to our profession
what they've done to yours.
Right now the client pays thevet directly and then the client
takes I think what you guyswould call a super bill and then
submits it to insurance.
And they may or may not getreimbursed, but the vet is
always reimbursed for theirservices.
'cause the client pays directlywhat is trying to happen.
(33:39):
And they have pitched it in somany glamorous ways and tried to
make it look like this is forour benefit and how wonderful
it's going to be.
But we know better.
I mean, I know better not allvets know better, right?
Which is why we're, we're indanger right now.
But what they're trying to do ishave direct pay from the
insurance to the veterinarian sothe client client is not
(34:02):
directly pay, so it's not thedirect, direct pay that's the
whole, that's the whole thing ofit.
So the vet may or may not getreimbursed for, for what they
recommend.
And therefore that is, as youguys all know intimately, that
is, like a hardcore control onthe medicine itself, which
nobody but the doctor, the vetand the client or the patient
(34:23):
should be involved in medicaldecision making.
What is or is not warranted.
Get out of our lives.
Do not insert yourself into themedicine.
Okay.
So that's what they're actuallytrying to do.
We've had a few a few inincidents of that occurring.
There was I have a colleague whowas working in the ER and the
(34:44):
client had that kind ofinsurance and they had to wait
to see if the insurance wouldapprove.
Meanwhile, we're in the er, thisis urgent, like we need an
answer.
The client wanted to go for it,but we had to wait to see if the
insurance would approve It like,so disgusting to me.
Like it was like she reportedthat it was like very
(35:05):
uncomfortable and really just,I.
Impeded timely, appropriate carefor this animal.
And, I mean, here's the thing.
Animals like, they're, they'renot people.
They're, they're very much likechildren.
Like kind of, you made thecomparison between pediatrics
and veterinary.
They eat things off the floor,they eat poison items, they,
they jump off things, they falloff.
(35:26):
Things like animals are accidentprone, they're illness prone
inherently, right?
So the, the likelihood of anemergency or something really
severe happening to any randomanimal, I believe is higher in
general as compared topotentially human patients.
Mm-hmm.
That's just my, that's myimpression.
I don't know a hundred percent,haven't done a study on it, but
(35:49):
kind of intuitively, again, sortof feels that way to me.
Maryal Concepcion (35:53):
as you are talking about this person and
this, this.
Prior auth of an actualemergency visit like that is
just so bad backwards because,we see the emergency room in the
human system being used as theprimary care because a person
can't get into primary care.
And, it, it behooves the systemto create a bad experience.
(36:14):
And primary care is such thatall the codes are coming through
the emergency room.
But when it comes to otherpeople, especially the people
who have leaned in and arelooking to you to teach them
about like, how do I do thisoutside of the system?
I'm wondering, what are someother maybe not even a canary in
the coal mine, maybe like thatcoal mine is bursting and
(36:36):
exploding actively, but like,when your colleagues are
reaching out to you to say like,I have seen this, or I cannot do
this any longer because of theemotional toll, especially that
you guys are putting into it.
What do you share with othersbased on what you've heard and
that you use as, look, there isa different way to practice
(36:58):
medicine.
Eve Harrison, DVM (36:59):
Yeah, that, that's the heart of everything I
do right now.
I would say that I speak toprobably 50 to a hundred people
per month.
Every single one of them hasthese concerns.
I can't do this anymore.
I can't provide the medicine Iwant to provide.
I'm not good enough.
(37:19):
And it's like, no, no, thesystem is not meant for how you.
Your integrity.
Actually, it, it shows up in somany ways.
This, like this pain impostersyndrome.
I'm not good enough.
I, I can't care for my animalsthe way I want.
I, I was forced to euthanizemore animals than I felt
comfortable euthanizing so thatI could earn my, bonus or
(37:43):
whatever.
There, there are companies that,that put that kind of pressure
on euthanasia that, that to meis a real dangerous precedent.
I don't wanna go too much intoit, but that is, when you're
dealing with euthanasia, that'sa very, very slippery slope when
you're putting corporate typepressure on it, when you're
putting production pressure onit.
(38:04):
So that's one of my, mean thatthat's something that really has
lit a fire under my butt to, tosort of like, look, there's
another way.
Just like you said, there'sanother way.
We don't have to, we don't haveto play by those rules.
We're the vet, we own thisprofession, not them.
(38:24):
Okay.
Not the shareholders, not thestructure that they're trying to
put us into and use us as cogsin the machine.
I, I say that phrase a lot'causethere's nothing, it's like a
assembly line.
We're, we're a cog in someoneelse's masterpiece of what, what
kind, what they're trying tocreate.
No, we own our profession.
(38:46):
We're smart.
We got through vet school,potentially internship, pr,
potentially residency.
We do surgery.
We, we do so many things.
You're gonna tell me thatrunning a business is too hard
for you now, come on.
So I sort of address that, that.
People sort of have resistanceto the business side, but to me,
(39:07):
I think business is, you don'thave to be like some MBA, like
obsessed with business or like,care about all these KPIs and,
and like get into that wholeweird world.
To me, business and businessownership and practice ownership
is simply a vehicle for takingback our power as the incredible
(39:28):
doctors that we are.
It's simply a tool in which tocontain our magic and offer it
to the world without amiddleman, without someone
taking a cut of our pay, withoutsomeone interfering with our
medicine, without tellingsomeone, telling us how many
euthanasias we have to do orshould be doing, or pressuring
(39:48):
us into things that cause moralinjury.
Maryal Concepcion (39:51):
I go back to my initial thought to say, oh my
gosh, I would love to have youshare your story on our podcast,
because even though again,we're, at my DPC story focused
on the human side of medicineevery week, I think it's just so
important to highlight how the,the need to protect the
profession of healthcare isuniversal when it comes to the
(40:16):
country that you're practicingin the city, the, the county,
the, the species that you areworking with.
When healthcare is on the table,it cannot be corporatized.
It cannot be rushed.
It cannot be determined bysomeone who's actually not the
physician and.
This is where the similaritiesare so apparent, and this is
(40:40):
where knowledge for me ishelping people have more
knowledge out there to helpprotect what we are
intentionally protecting byhaving our practices.
Eve Harrison, DVM (40:50):
I so agree that there, there is sort of
protection needed, like we'vetaken an oath to do no harm,
right?
To us, our work is sacred.
That connection between us andour patient and our client,
sacred shareholders, corporateCEOs, they are simply not on
(41:12):
that wavelength.
They simply have no concept ofwhat that means, right?
And so I think that it isincredibly important that we
build structures, our ownstructures to, to shield
ourselves, protect ourselves,protect this sacred.
That we've taken, it's almost aresponsibility that we have on
(41:34):
behalf of ourselves and or toadvocate on behalf of others who
are, are stuck under the thumbof the system and, and can't get
out.
Like either they've been soemotionally harmed or led to
believe they're not good enoughor financially trapped with the
golden handcuffs, as youmentioned.
Right.
So I think that protection is sovery important.
(41:55):
I think also like the nature ofour work is that we are not just
machines, like we all know thisis not just a science, it's art
and a science.
And when we're working withanimals, we're working with
their humans.
And the emotions are high.
I think, to ignore the fact thatwe are in a position to support
(42:21):
people beyond just the care ofthe patient is to vastly,
minimize what the, the job is,what, what the role of a
veterinarian is.
And I think many systems thattry to box us in try to really,
narrow the job description andit's like we're holding
(42:43):
something really precious.
We're, we're working with peoplein some of the most vulnerable,
painful moments of their lives.
And I think true medicine, Ithink this applies for what you
do as well.
Like you're holding people interrible diagnoses or, or the
treatment didn't work or they'rein literal chronic physical pain
(43:04):
all the time.
They're not okay.
That I think true medicine has,has got to address and see the
individual beyond the diagnosis,beyond what's written on paper
in the medical record.
I think it's almost likemalpractice to, behave as,
(43:25):
that's not my problem.
I mean, we don't have to beeveryone's therapist.
We there, there's boundaries ofcourse.
But to a certain point, if weare shutting out the wholeness
of what it means to be a doctor,which includes like care, care,
like really caring, actuallycaring and having time to care,
(43:45):
having emotional bandwidth tocare, having a structure set up
so that you can care and notinjure yourself emotionally and
so that you can care andcontinue to care.
I, I think that, that oursystems are currently not set up
to allow that.
So the fact that people areburning out, they're compassion
fatigue, they are morallyinjured, they are committing
(44:06):
suicide.
How, how is this surprising inthis kind of system?
You know what I mean?
Maryal Concepcion (44:13):
Absolutely.
And I'm just wondering in termsof.
Advocacy for humans who arelistening, who have non-human
humans like this is, this is thevery anthropomorph,
anthropomorphizing part of mewho went to, like, I got my BS
(44:34):
in anthropology.
But it's like, just for thelisteners out there who also
want to help their own pets andanimals be better cared for I
would just love if you had any,take on how we can also help our
own loved ones who might havefur or not fur.
(44:55):
And they actually have hair andthey don't shed amazing.
Or their snake, you get bettercare or their snake.
Yes.
Very, very true.
I worked at the zoo for eightyears, so yes, these are all
check, check, check things.
But you know, like, do you haveany, any words for the humans
out there who could help betteradvocate for their animals?
Eve Harrison, DVM (45:11):
Yeah.
Yeah, I, I absolutely do.
I would say integrative care issomething to consider.
Usually the culture ofintegrative veterinarians is
more inclined to be aligned withwhat I've been saying, like
seeing the whole system, theperson, the animal, taking a
little bit more time.
Integrative medicine as a ruletends to honor that principle.
(45:33):
More holistic medicine as well.
I would also say that if you arefrustrated with your current
vet, you don't like what they'redoing, they're making you feel
bad, don't go on Yelp and don'tgive them a pr a hard time.
Just find a different bet.
Who works for you, who makes youfeel heard, seen, honored makes
(45:53):
you feel like a, a valuableco-creator of the care you're a
doctor, right?
So you're of course gonna haveopinions.
You're of course gonna haveresearch things.
There may be things that theveterinarian knows that you do
not.
We find that sometimes with,with human doctors and nurses
come in and challenge us, andit's like, well, that's not true
of a cat.
(46:14):
So I would also say a little bitof humility.
We're doctors too.
And I would say it's yourresponsibility to find a
veterinarian that works for you,that you feel is caring for your
animal in the way that youconsider to be appropriate.
And instead of sticking with avet that you're frustrated with
and, and creating ongoingfriction or not seeing the care
(46:35):
you want, move shift.
Take the responsibility to seekout a vet that you resonate
with.
'cause they're, we're here,we're here, we're waiting for
you to come our way.
And we, we love to work withpeople who are in the know about
human stuff.
Whenever I have a, a humandoctor or nurse or anyone, we
(46:55):
talk shop all the time, it'slike so fun to be like, oh my
God.
Like how would you treat this inan, an in a human?
But yeah, I mean, animals arehumans too.
And, and when you can find a, avet that feels that way and you
can feel that they've done whatneeded to be done to create a
structure that can hold a reallyhealthy vet client patient
(47:17):
relationship, that's, that'syour vet.
Maryal Concepcion (47:21):
I love it.
Well, thank you so much Dr.
Harrison for joining us today.
I hope that the audience, justgot a healthy dose of reality
check there when it comes to thecorporate practice of medicine,
and I'm so grateful foreverything that you do, and I am
so excited that we're both outthere just spreading the word
about autonomous practice.
Eve Harrison, DVM (47:40):
I love it.
I'm so glad to be in touch withyou.
We're like the, the, theequivalent alternate universe
realities of each other doingwhat we do.
And it's just such a joy to, toknow that you exist and to be on
your podcast and that you'vebeen on my podcast, et cetera,
et cetera.
And so cheers to many morecollaborations, I hope.
Maryal Concepcion (48:01):
Thank you for listening to another episode of
my DBC story.
If you enjoyed it, please leavea five star review on your
favorite podcast platform.
It helps others find the show,have a question about direct
primary care.
Leave me a voicemail.
You might hear it answered in afuture episode.
Follow us on socials at thehandle at my D DPC story and
join DPC didactics our monthlydeep dive into your questions
(48:22):
and challenges.
Links are@mydpcstory.com forexclusive content you won't hear
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Join our Patreon.
Find the link in the show notesor search for my DPC story on
patreon.com for DPC news on thedaily.
Check out DPC news.com.
Until next week, this isMarielle conception.
Direct Primary care is an innovative
alternative path toinsurance-driven healthcare.
Typically, a patient pays theirdoctor a low monthly membership
and in return builds a lastingrelationship with their doctor
and has their doctor availableat their fingertips.
Welcome to the My DPC Storypodcast, where each week you
(00:26):
will hear the ever so relatablestories shared by physicians who
have chosen to practice medicinein their individual communities
through the direct primary caremodel.
I'm your host, MarielleConception.
Family, physician, DPC, owner,and former fee for service.
Doctor, I hope you enjoy today'sepisode and come away feeling
inspired about the future ofpatient care direct primary
(00:49):
care.
Eve Harrison, DVM (00:53):
The similarities between human
medicine and veterinary medicineare so uncanny.
It's kind of crazy that we don'tlearn more from each other on
the regular.
I'm Dr.
Eve Harrison with MarigoldVeterinary and the house called
Vet Academy, and this is mydirect veterinary story.
Maryal Concepcion (01:12):
Dr.
Eve Harrison graduated from theUniversity of Pennsylvania
School of Veterinary Medicineand then went on to do an
internship in medicine, surgery,cardiology, emergency medicine,
and the health of exotic animalsin San Diego before going to a
surgical residency in the BayArea before changing paths
completely to be a full-timeintegrative, concierge house
(01:32):
call veterinarian in the LosAngeles area.
She's also certified intraditional Chinese veterinary
medicine from the Chi Institute.
Her work outside.
Of clinical veterinary practicefocuses on grassroots efforts
and solidarity in protectingindependent veterinary practice
ownership.
In light of the corporatetakeover of veterinary medicine
and empowering individualveterinarians, he is a speaker
(01:54):
writer, content creator, and thefounder of the online Continuing
Education course, the Housecalled that Academy.
Through the academy, she offerscoaching and consulting to help
independent veterinariansnourish not only their patients
but themselves by helping themto cultivate profitable and
sustainable mobile.
Of their own.
She's also the founder of theAnnual House call and Mobile Vet
(02:15):
Virtual Conference.
Host of the house call Vet CafePodcast Concierge, vet
Mastermind, and Soul Shine Spicefor vet.
Dr.
Eve's passions are creativeentrepreneurship, veterinary
practice management,sustainability for
veterinarians, boundaries,authentic communication, and
releasing people in systems whoare not a good match for our
practices.
Or our lives outside of her workwith animals and their humans.
(02:36):
Dr.
Eve is a semi-professionalmusician, Flo Yogi MyFi, and a
certified compassion fatigueprofessional.
Welcome to the podcast, Dr.
Eve.
Eve Harrison, DVM (02:48):
Ah, thank you so much for having me.
I am just like really excitedand have been looking forward to
this call for a while.
'cause you've been on mypodcast.
It was one of my most belovedepisodes and so yay.
What an honor to be on your showtoo.
Thank you so much for having me.
Maryal Concepcion (03:04):
Absolutely.
And.
Yes, you did hear right.
In terms of Dr.
Eve's bio, she is aveterinarian, meaning we only
take care of the human speciesand she takes care of all the
other species.
And I, I just wanna put for theaudience a little, intro to this
whole conversation.
Dr.
Eve and I met at the TakeMedicine back conference back
in, maybe the spring of 2024.
(03:27):
Take medicine back as anorganization, really focused on
taking medicine back into thehands of physicians and their
patients and away from thecorporate practice of medicine.
And so what I was just flooredby was the similarities between
the human side of things as wellas the non-human side of things.
And so that is why I've askedDr.
(03:48):
Eve to come onto the podcast toshare her perspective, because I
think it's very eye-opening, notonly for us as physicians who
are listening out there, butalso for anybody who is
interested in, where healthcareis today for human and non-human
species.
And so I'm excited about thisconversation as well.
And, I hope that it iseye-opening and I hope you share
(04:08):
this episode with other people,because it does not matter what
type of corporate medicineyou're doing.
Corporate medicine is corporatemedicine.
Eve Harrison, DVM (04:15):
Yeah, absolutely.
Yeah.
And if you hadn't mentioned theTake Medicine Back conference, I
was gonna, because it wasrevolutionary.
Maryal Concepcion (04:22):
Absolutely.
So let's talk about when itcomes to when it comes to your
background in veterinarymedicine, we hear every week
from human physicians in termsof their, training after school,
basically.
So tell us in terms of aveterinarian's path after school
(04:44):
what is your guys' traininglike, what is the expectation
like, and how many ofveterinary, how many veterinary
grads go into employed medicineversus independent medicine?
I.
Eve Harrison, DVM (04:58):
Great questions.
So there, there are definitelysome, there, there's tremendous
amounts of similarities.
Like we have the match systemand everything.
We're not quite as what, what Ibelieve is sort of maybe more
regimented in the human medicalsystem.
Like my sister is a do.
So I watched her go through thatprocess.
My little sister's a pa so I, Iknow about that as well to some
(05:22):
extent.
But it seems that in veterinarymedicine, you could do an
internship, you could do aresidency, pretty rare in
general to be residency trained.
Whereas I understand in humanmedicine it's, required but for
us, it's very much like, if youwant to be a surgeon or you want
to be an internal medicinespecialist, or you want to be a
(05:42):
neurologist, you, you have to gointernship and then residency,
usually the internships are oneyear general rotating
internships followed bypotentially.
If it's a really difficultresidency program to get into,
sometimes there's specialtyresidencies.
That's another year or multipleyears until you get into the
residency program of yourchoice.
For me I, I sort of like tookthe express path, like
(06:06):
unbeknownst to me andundesirable to me in retrospect.
So I, I knew I wanted aninternship.
Personally, I, I, I'd heard frommany people, like it's really
good to have, formal mentorshipand go a little bit deeper into
each of these subjects, which,if you end up just going general
practice, which is kind of thedefault for small animal
(06:26):
veterinarians.
Mm-hmm.
So small animal being dog, cat,maybe what we call an exotic or
two, maybe a rabbit, maybe ahamster.
But usually like the default forveterinarians, general practice,
cat and dog.
Even if you wanted to kind of gointo general practice without
any sort of specialty, the wordon the streets is it's really
nice to have an internship sothat there can be a little bit
(06:48):
of handholding.
You can go a little bit deeperinto internal medicine, a little
bit deeper into surgery.
General practitioners inveterinary medicine are doing
all of it.
Surgery, neurology, literallyevery, it's insane when I
compare what vets do to what mysisters do on, on a, like a
general medicine basis, I'm justlike, We have to do surgery, we
have to do endoscopy, we have todo all this crazy mri, but
(07:09):
anyway, so, the, the path that Itook was I did my four year
veterinary training.
Well, we, okay, so pre, pre-medis the same as pre-vet,
essentially, so I'm going wayback.
Right.
So then you do your four yearveterinary training.
You can either go the path ofinternship plus minus residency
or just go straight into generalpractice.
I would say the majority ofpeople go generally into general
(07:31):
practice.
And then, I really don't know.
I'm pulling numbers out of.
Out of thin air, but in myobservation, it seems maybe 50%
of people do an internship,maybe 30%, and then maybe 10,
five to 10% go on to specializethat.
That's kind of my, my image ofit.
But don't, don't quote me onthat.
I, I haven't looked at anystudies on that specifically,
(07:52):
but that's my generalimpression.
And for me, I did my, my generalrotating internship.
I had an inkling I wanted to bea surgeon.
Maybe I like working with myhands.
I like fixing things.
Yeah, I don't know.
My, I have a, a medical familyand, and we are, or adjacent, I
grew up visiting the, or manytimes, so I thought maybe I
(08:14):
wanted to be a veterinarysurgeon.
And I'd also done some surgery.
Sort of like volunteer work onNative American reservations in
vet school.
And I really liked the surgicalaspect and it, it, it became
clear that you better know howto do surgery really well.
So I thought I wanted to be aboard certified surgeon to
really get all that training.
(08:34):
So I did my general internship.
I applied for residency.
Miraculously I got in, I thoughtit was gonna take me multiple
years as is the case with mostpeople going that path.
But for some reason I matchedright out of internship to my
shock horror imposter syndromeself.
I was just like, oh my God.
So there was a, a bit of a, ashock there.
(08:55):
And it didn't work out.
So, I did a few years of thatand then shifted to a totally
different direction.
So that's kind of a little bitof my story embedded in the
general veterinary path story,
Maryal Concepcion (09:06):
tell us when it comes to the similarities
between the, the practice ofmedicine, I'm just wondering if
you even saw along your journeychanges such that things were
becoming more corporatized, andif so, what did you see?
Eve Harrison, DVM (09:22):
Yeah, so I, I always kind of say that in, in
my observation, it seems likethe veterinary profession is
maybe like 10 to 20 years behindthe human medical field in terms
of the corporatization process.
This is just my, my intuitivesense, having seen a little bit
of both While I was in vetschool, I was feeling a lot of
corporate pressure to join acorporate internship.
(09:44):
We got talks from the corporateentities saying things like, if
you don't do an internship,you're gonna be a bad vet.
In fact, you, if you don't doour internship, you're gonna be
a bad vet.
I remember things like that.
I can't speak to how it wasbefore I joined the profession,
but all of my experiences as avet tech before I, or a vet
(10:04):
assistant to, to be more precisein the, the language in
independent practices.
I, I'd never seen anything likethis and I had been prepping to
be in vet school for maybe 10years prior or more.
So I, I was seeing onlyindependent.
And then when, when I got to vetschool, there was a very heavy
influence from the the corporatecompanies coming in, giving us
lunch talks, telling us abouttheir programs and why, why we
(10:26):
would be inferior if we didn'tjoin their programs, you know
what I mean?
So in vet school was the firsttime I saw it.
I, I graduated about 13 yearsago.
But I, I know that thecorporatization of human
medicine has been going on far,far beyond that, that period of
time, I, I, my family would talkabout it.
(10:47):
I would Just like out in theether, my friends who became
doctors, I heard about it aswell.
So this was the veterinaryexposure that I got once I got
into vet school,
Maryal Concepcion (10:57):
and
Eve Harrison, DVM (10:57):
I did a corporate internship.
I did a corporate residencymiserable.
I, I was absolutely miserable.
Like for the first time in mylife, I, I'm very open about it.
I had to go on antidepressantsand I've never come off, you
know, and, that's, that's asubject for another time.
But like the damage done in, inthose few years to try and
(11:18):
survive in what my professionportrayed to be, the path to
being a good doctor.
The, the path to being worthy inthe corporate paradigm I'm still
recovering to this day, to behonest, you know,
Maryal Concepcion (11:36):
and I appreciate that vulnerability
because, it's it's something sorelatable to our listeners out
there.
I'm wondering if even justbreaking down when it, it comes
to.
This place that was thecorporate experience that you
had?
I think about in the humanworld, we after we get our
golden handcuffs, we go to anemployed position, we get our
(11:58):
magical salary, and then all ofa sudden your, your feet are
wet, the water's warm, and nowthey're like, boom.
RVs.
Very commonly the human side ofthings is very much based on
productivity.
I love how productivity is, howto describe human medicine.
But in the vet world were you,in residency or just, in general
for somebody who is practicingin a corporate model can you
(12:20):
speak to us about is there aproductivity equivalent
Eve Harrison, DVM (12:23):
there absolutely is.
The good thing is I was neverput under productivity pressure
as an intern or resident.
I believe my mentors were in, inthat scenario.
I, I can't speak a hundredpercent to that.
But I I've not experiencedproductivity other than one time
(12:44):
in a corporate practice while Iwas doing relief work or
moonlighting work as I think youguys are more inclined to call
it.
More of the productivitypressure I've heard comes from
people who are associates atcorporate practices, associates
at corporate house callpractices you have to meet
certain amounts of seeingpatients or.
(13:06):
You will get spoken to, or you,you won't get the, the full pay
that you need to make in orderfor this job to be worth it.
Right?
Like, they'll say, oh, well,you'll get a bonus.
But it's like, if you don't makethat bonus, then you're living
on an income that is unrealisticfor, for someone trying to work
at this capacity.
(13:27):
You know what I mean?
I would say I've, I've been verylucky that I've, like, I learned
what corporate is.
I learned that I don't fit intothat type of hierarchical system
um, that has pressures.
I luckily, I was shielded fromthose pressures in my training.
But the environments that I wasin, the way I was learning, the
(13:48):
way patients were treated, theway my clinical intuition was.
Like devalued.
And, something other maybe moneyor bottom line, something else
other than what my clinicalimpression was, my care for the
patient was being put abovethat.
It was very, very clear.
But, as a result of that, I, Isort of like immediately was
(14:08):
like, I cannot work in theseenvironments.
And so by the time I was, not aresident or intern, I was like,
yeah, I'm not gonna subjectmyself to that.
So all of the horror stories aremy colleagues, my friends things
that I've seen and or beenoffered and been like, no, thank
you.
You know what I mean?
So thankfully I haven't beenlike under the productivity
(14:30):
hammer myself, thank God.
Maryal Concepcion (14:33):
Even though you weren't necessarily under
the productivity modelequivalent as a, you know, a
person who's been working in thesystem for.
Maybe two years, three years,sometimes the RVU go in,
depending on the contract soonerthan that.
Yeah.
When it comes to, thefrustration that humans have
with the human medicine system,I'm wondering, can you talk to
(14:54):
us about the, the patient sideof things?
Because, I think about,especially if you're dealing
with domestic animals, which is,the most common thing that we
see veterinary visits for.
There's a lot of corporate vetclinics and you're delivering a
completely different model.
And I'm just wondering, like,can you speak to experiences
(15:15):
that a person might typicallyexpect to have?
What's the visit time like?
What's an appropriate time likefor, a, a general checkup versus
something acute that couldhappen with a cat or a dog?
Eve Harrison, DVM (15:26):
I mean, Even outside of the productivity
model of, of incentivizing or deincentivizing people based on
their behavior aroundproductivity, the time slots in
most corporate and, and alsosome independent clinic
settings, which I think is aderivative of the corporate
mindset that we've beenindoctrinated with.
(15:46):
One way that that sort of canalso play out is with either 15
minute appointments or 20 minuteappointments or 30 minute
appointments.
I don't think any of those aregenerally enough time to handle
anything that really matters.
I've done relief work and as Imentioned in general practice
and in corporate, and to me, I,it's, it's like I.
(16:07):
Brutal on my nervous system.
'cause it's like, well first ofall, I'm trained in so much more
than, than just like the very,very basics.
The more you know, the harder itis to hold an appointment time
that is so restrictive whereyou're like, yeah, we can put a
bandaid on this.
Or I can really help you and in15 minutes I really can't help
you.
So this is painful foreverybody.
(16:29):
This is a, a very poor setup.
I have refused to work in aplace that has 15 minute or 20
minute appointments.
That's insufficient in, in myopinion.
If you're really doing goodmedicine, you really care.
You wanna hear.
You wanna give people the, thechance to speak about what's
going on about the animal.
We're in a situation whereanimals can't speak, right?
(16:50):
So the advocacy of the human onbehalf of the animal is even
more important.
I need to, I need to hear braindump for me.
Tell me what's going on and I'llpick out what I need to know.
I'll ask you all the questions.
The history alone could take 30minutes before I examine the
animal, before I come up with atreatment plan, let alone enact
any of those treatments.
Right?
Maryal Concepcion (17:09):
And I'm sure that there are other people out
there listening saying, but.
Why is she mentioning timeslonger than the humans get per
visit?
So also the fact that you'relike, I don't take jobs that
have shorter than the quoteunquote decent time to start
with, but it's, it's not evenenough.
I think very much about like apediatric patient and,
(17:29):
pediatricians especially arereally bombarded with like, well
child visits and sure you candeal with an ear infection same
time, five minutes.
Five minutes, it's like it'slike an auction and it's like
actually, especially whensomebody cannot advocate for
themselves, it is a lot of timesharder to get the history and it
takes more time because you.
Our thinking from, the shoes ofsomebody who might be
(17:53):
overwhelmed, especially again,going to pediatrics, like
multiple children working and aparent.
And then, it's like details arenot necessarily going to be at
the forefront depending on howlong it took to get in,
depending on how worried theparent is.
The listeners can absolutely seesimilarities there, even just
with the frustration of, oftime.
And I'm wondering in terms of,what does it look like for a
(18:14):
person who is going over time?
Like, what happens if they'relike, Dr.
Harrison, you're like 30 minutesbehind, you're an hour and a
half behind.
Eve Harrison, DVM (18:24):
Oh, I'm so glad you asked that question.
I was just like, oh, I justthought of two times that I need
to mention.
So, one time I was, I was doingmy relief work at a corporate
practice.
I was, 45 minutes behind.
This was not entirely my fault.
People showed up late and you,if you wanna in accommodate
them, you have to, everyone getsshifted, right?
You have an appointment thatthrows a monkey wrench in, in
(18:46):
your schedule.
You're not expecting somesomeone to be like literally in
an ICU crisis state that youneed to now handle that and then
move on with it.
So there was a, there was apoint where I was 45 minutes
late and I got a talking to bycorporate and I was like, get
real, get out of here.
Like you have no idea what'shappening on the floor right
now.
(19:06):
You have no idea.
Then during my residency, thiswas one of my favorites.
I was working with a cat thathad a urinary obstruction.
This is something that happensvery commonly in male cats.
And it's life threatening, ofcourse, right?
If you, you can't pee, youcan't, you know.
so anyway, this was a life anddeath situation.
(19:27):
The animal was very sick.
The client was trying to decidewhether to euthanize or to
proceed with care.
I took a long time with thisguardian of the cat.
And they were really, reallygoing back and forth.
You could see that this was likea deeply important.
Upsetting moment, and I mean,this is life and death.
Like in, in human medicine, it'sonly very recently that
(19:51):
euthanasia or like end of lifedecisions is even legal at all.
This is our every day, right?
This is so heavy, and to me, Idon't take that lightly and no
one takes it lightly, but to me,I, I wear my heart on my sleeve
every single euthanasia.
I feel that, and I don't wantthat to change.
So I spent a good amount of timewith this client.
(20:13):
Meanwhile, I had told my staff,please put in an IV catheter,
start IV fluids, do basic triagestuff, just stabilize, while I'm
having this conversation.
And I got them to proceed withcare like this is.
Not an old cat, like we can savethis cat.
Like, this is easy if you justlet us do it, but it required a
conversation, it required aheart to heart.
It required me hearing whattheir concerns were.
(20:35):
It required me to, to stepalmost a little bit outside my
role of a veterinarian and justbe a human using my
communication skills to get tothe heart of it.
And that's not something you'regonna do in 15 minutes, 30
minutes.
I probably was in there for 40minutes if I had to in and out,
just like you think on it, I'llcome back.
(20:56):
After that, I my mentors werelike, you took way too long in
there.
You endangered the life of thisanimal.
I'm like, do you understand whatI was doing?
I was saving, literally savingthe life of this cat.
Without that conversation,without taking the time, the cat
would be dead, period.
Right.
I employed basic triage.
(21:16):
Anything further that we neededrequired the permission, the
consent of the client, and I gotthat.
So you're welcome.
So that, that was one of myfavorite moments of like, this
is not.
This is not how I want tofunction in the world.
This is not how I doctor, I amsorry.
I am not gonna be a cog in thismachine.
(21:38):
You know what I mean?
Maryal Concepcion (21:40):
Absolutely.
And I just, I think about, howmany times, especially in family
medicine residency, anybodywho's right rotated in the ICU
or an emergency room, I mean,just the horrific things that
we've seen, drowning of littlekids people being coated and
coated when, that like it'sdoing more damage to their body.
I mean, so many violent and sadthings.
(22:02):
But, just recently having putour 16-year-old cat down, sorry.
Like in, in my experience, we'veput an animal down um, and and I
cannot imagine, you're, you'rean outpatient veterinary doctor
and yet you're doing end of lifecare.
(22:23):
I mean, yes, I do, I do care forpeople in hospice, but like, not
at the volume that you guyswould do.
And so I can't even imagine thethe, the, the vast difference in
the amount of times your heartis being not only worn on your
sleeve, but also just beingwronged to like the core because
of you being there for youranimals.
(22:46):
Just the same, like, we're therefor our patients.
Eve Harrison, DVM (22:49):
Yeah.
Yeah.
That's very well said.
I think that's one of the.
Primary reasons.
Just like you said, like thevolume of this high intensity
emotional content and, and likethe work itself.
That's why veterinarians have anuncanny rate of suicide.
I, I can't be on this showwithout mentioning it.
(23:11):
But it's, it's a real, realproblem.
There are a lot of studies outthere from the American
Veterinary Medical Associationpublished in the CDC
collaborations that show allthese statistics and things, and
there's a myriad, myriad numbersof reasons why that is.
And I know human doctors and,and caregivers and dentists as
well struggle with this.
(23:31):
Veterinarians are, are.
Kind of the top, the top ofthat.
Not to like, have any traumaOlympics, but it's simply a
fact, right?
And I think that the, thecorporate pressure, the
corporate structure, thecorporate mindset, even if it's
not an actual corporate practiceto, to see more and more and
more bottom line dehumanizepeople, dehumanize animals,
(23:53):
deani, animalize animals, right?
Like objectify get more doneproductivity, even if you're
being paid on a production modelor not.
That that's, that vibe is stilldeeply entrenched in the in, in
the sort of moia of the work andthat.
That wears on people.
That's, that's moral injury,that's depression, anxiety, loss
(24:15):
of meaning, loss of purpose, etcetera.
All of that.
It's so deep how harmful that iswhen we can't take the time that
is needed for these really heartwrenching difficult, emotionally
speaking and, andintellectually, physically
difficult cases, so, yeah.
And I'm so sorry about your cat.
(24:35):
I'm, I'm so sorry to hear that.
Maryal Concepcion (24:37):
Thank you.
I think about also, I.
When we are talking with people,whether they're speaking for
themselves or they're speakingfor their loved one who might
not be able to speak forthemselves for whatever reason.
Even just the medicalunderstanding, like taking the
time.
I, I, and I don't know if thisis a thing in veterinary
medicine as much as it is inhuman medicine, but like
(24:58):
suspicion about science andvaccines and like, are you
really trying to help me or areyou just trying to kill my
animal because you have somebodyin the waiting room, like, I
wonder if you can speak to usabout just, just the, the, the
things you have to do withpatients because you are, taking
care of, of somebody who is sickand who can't speak English or
whatever language the humanwould speak to each other in a
(25:21):
clinic.
Eve Harrison, DVM (25:22):
That's really a really, really interesting
point.
I, I was speaking to a colleagueabout the, recently about the
fact that this sort of doubtingand the skepticism about the
veterinary field and, and themedical field, it's, it's a
trauma response to what, whathas happened, right?
Like, we all get annoyed.
(25:43):
We're like, oh God, here we goagain.
Now I have to explain like howlife works, how fit science is a
thing.
Like, all right, here we go.
But the thing is like, peoplehave kind of have reason to, to
be skeptical.
I have reason to be skeptical ofmy own profession based on what
I've been through.
(26:03):
So.
In my own practice, I am reallyaware of this phenomenon.
I'm really accommodating of it.
I almost anticipate it being inintegrative medicine where I'm
incorporating all the regularWestern stuff along with
traditional Chinese veterinarymedicine holistic paradigms,
(26:25):
things like that.
Maybe some of it's cutting edge.
Some of it is notevidence-based, but anecdotally
based.
And I've seen it work many timesand yet, and I'm like, if it
works and doesn't cause anyharm, we're doing it.
Okay.
Like if, as long as the, theguardian is interested in that.
But in, in that sort ofcontainer, I am really dealing
with a lot of people who arevery skeptical, like I do in
(26:49):
particular attract those people.
'cause they're seeking outholistic care.
And usually those people areseeking holistic care'cause
they've either been burned bythe traditional, they have.
Know someone who's been burnedby the traditional, it didn't
work.
They were a, a cog in the systemthemselves.
They didn't like how that felt.
They felt invalidated,dehumanized uncared about
(27:10):
unseen.
And so they're, they're comingto me to, in hopes that I can
provide something different.
And that's my goal to reallytake my time.
I always say that I work on dogand cat time.
However long the animal needs,that's how long it's going to
take.
So it's very much an opencontainer.
It's very un, I'm veryboundaried, but my time is
(27:31):
unbounded.
Because you simply cannotquantify the amount of time that
a, a body, a living body isgoing to, what they're going to
bring to you, what they're goingto need, what the, what the
guardian is gonna be goingthrough as they observe this or
hold it, or, or we work throughwhat needs to be done.
So that's, that's kind of beenmy answer that I, I just sort of
(27:54):
step right out of the box rightoutta the matrix and I'm like,
you will not give me a 30 minuteappointment.
I'll take how, however long Iwant with this animal.
And I have an ETA window for allmy clients.
So they're like, they understandlike I would do the same for
them if I'm late to see them or,on the back end of my ETA
window.
It's'cause of dog and cat time.
(28:14):
And I would show them the samecompassion, empathy, and
flexibility in their moment ofneed, you know,
Maryal Concepcion (28:20):
I think here, especially because you are so
passionate about empoweringother veterinarians, especially
to understand your, what you'veexperienced, to take a zoom out
and really be able to crafttheir own.
Veterinary practice, just likewe've done in the human space
with direct primary care.
(28:42):
I'm just wondering if you cantell us even more about your
practice because I, I, I, I feelit's very similar in, we have
people who are, they haveanimals.
They need somebody to care forthese animals, and they're,
maybe not used to having a housecall a veterinarian, come to
their home.
How do you even get the word outabout, having a practice like
(29:06):
this?
Eve Harrison, DVM (29:07):
Thank you for asking about my practice.
So, my practice is calledMarigold Veterinary, named after
my heart, Catt Marigold, whodied but was one of my primary
inspirations for becoming a vetto begin with.
So my practice is named afterher.
It's a memorial for her.
I am a low volume house callpractice.
(29:28):
I don't typically see more thanthree to four patients a day.
That's even a heavy day for me.
When I say that I'm concierge, Iam a concierge house call vet.
When I say that, it's a littlebit different from human
concierge.
There's a lot more overlap, Ibelieve with DPC as we've talked
about.
There's, there's some similarityto human concierge, but it's a
(29:50):
cross, essentially.
It's a cross between DPC andhuman concierge.
So I am.
Essentially requiring amembership to be in my practice.
And it's a little bit higherthan what most DPCs charge, but
not as high as what humanconcierge doctors we're.
We're price wise, we'resomewhere in the middle as a
(30:10):
rule.
I mean, I can't speak to everysingle concierge vet out there.
There's only like 10 in theworld like that are doing what I
consider to be true conciergeveterinary medicine.
But of those I think we're, ourpricing is probably somewhere in
between.
because I require a membership,I don't have to take as many
clients.
So like I'm, that, that is whatallows me to be low volume.
(30:35):
And it also is what allows me tobe very, very selective about
exactly which clients I.
Feel I'm equipped to support Iemotionally and from, from a
veterinary perspective and who Ican sustainably keep in my life
(30:55):
for the long term.
Like when, when I take on aconcierge patient, they stay
forever, most of the time.
I, I can't guarantee everyonewould, but most of the time this
is a long-term relationship.
So this is what allows me toreally cr craft something
entirely outside the box.
Like I'm not strictly working ona time for money basis, right?
(31:15):
It's not that I have to have theanimal get sick so that I can go
out to get paid.
With concierge being onsubscription, I'm paid no matter
what.
And in fact, I'm actuallyincentivized that my patients
are healthy.
'cause then I have to go out andthey've, they've already, I've
already been paid.
So it's like, oh God, now I haveto go out again.
I mean, I don't actually feelthat way, but like my goal is
(31:36):
for the animal to be healthy andI'm incentivized for that.
To occur, from a financialperspective, an energetic
perspective it's just very muchmore aligned on all the levels
of caring about my patient,being a business owner, my own
energy.
All of that is so much morealigned because I don't have to
wait for an animal to get sick,for me to be able to earn an
(31:59):
income, you know what I mean?
Maryal Concepcion (32:02):
Makes sense to me.
I'm just like, wow.
Preventative care versus sickcare.
That's amazing.
Yeah.
And I'm wondering, as you aredescribing something very, very
similar to DPC in terms of themembership model and whatnot,
I'm wondering just dipping backinto the, the corporate side of
things are there insurancecodes, like when I talk about
(32:23):
sick care, we'll have likediabetes versus prevented
diabetes and we have a code forthe diabetes versus we do not
ever have a code for preventedsomething.
Eve Harrison, DVM (32:32):
This is a really interesting subject.
I think we're likewise maybe 10to 20 years behind you guys in
terms of the insurance companytakeover.
So right now in veterinarymedicine, people have the option
to get insurance.
They have a variety of differentcompanies they can choose from.
Each company has a differentpolicy, what they will and won't
(32:53):
cover, most of them do not coverpreventative care, but that's on
a, a policy by policy basis.
Some of them may, if you get arider, may include acupuncture
or some holistic care, maybesome rehab.
But in general primary care,like preventative care not
covered.
The way it works for us iscurrently this is, they're
(33:16):
trying to change it.
They're trying to, they'retrying to do to our profession
what they've done to yours.
Right now the client pays thevet directly and then the client
takes I think what you guyswould call a super bill and then
submits it to insurance.
And they may or may not getreimbursed, but the vet is
always reimbursed for theirservices.
'cause the client pays directlywhat is trying to happen.
(33:39):
And they have pitched it in somany glamorous ways and tried to
make it look like this is forour benefit and how wonderful
it's going to be.
But we know better.
I mean, I know better not allvets know better, right?
Which is why we're, we're indanger right now.
But what they're trying to do ishave direct pay from the
insurance to the veterinarian sothe client client is not
(34:02):
directly pay, so it's not thedirect, direct pay that's the
whole, that's the whole thing ofit.
So the vet may or may not getreimbursed for, for what they
recommend.
And therefore that is, as youguys all know intimately, that
is, like a hardcore control onthe medicine itself, which
nobody but the doctor, the vetand the client or the patient
(34:23):
should be involved in medicaldecision making.
What is or is not warranted.
Get out of our lives.
Do not insert yourself into themedicine.
Okay.
So that's what they're actuallytrying to do.
We've had a few a few inincidents of that occurring.
There was I have a colleague whowas working in the ER and the
(34:44):
client had that kind ofinsurance and they had to wait
to see if the insurance wouldapprove.
Meanwhile, we're in the er, thisis urgent, like we need an
answer.
The client wanted to go for it,but we had to wait to see if the
insurance would approve It like,so disgusting to me.
Like it was like she reportedthat it was like very
(35:05):
uncomfortable and really just,I.
Impeded timely, appropriate carefor this animal.
And, I mean, here's the thing.
Animals like, they're, they'renot people.
They're, they're very much likechildren.
Like kind of, you made thecomparison between pediatrics
and veterinary.
They eat things off the floor,they eat poison items, they,
they jump off things, they falloff.
(35:26):
Things like animals are accidentprone, they're illness prone
inherently, right?
So the, the likelihood of anemergency or something really
severe happening to any randomanimal, I believe is higher in
general as compared topotentially human patients.
Mm-hmm.
That's just my, that's myimpression.
I don't know a hundred percent,haven't done a study on it, but
(35:49):
kind of intuitively, again, sortof feels that way to me.
Maryal Concepcion (35:53):
as you are talking about this person and
this, this.
Prior auth of an actualemergency visit like that is
just so bad backwards because,we see the emergency room in the
human system being used as theprimary care because a person
can't get into primary care.
And, it, it behooves the systemto create a bad experience.
(36:14):
And primary care is such thatall the codes are coming through
the emergency room.
But when it comes to otherpeople, especially the people
who have leaned in and arelooking to you to teach them
about like, how do I do thisoutside of the system?
I'm wondering, what are someother maybe not even a canary in
the coal mine, maybe like thatcoal mine is bursting and
(36:36):
exploding actively, but like,when your colleagues are
reaching out to you to say like,I have seen this, or I cannot do
this any longer because of theemotional toll, especially that
you guys are putting into it.
What do you share with othersbased on what you've heard and
that you use as, look, there isa different way to practice
(36:58):
medicine.
Eve Harrison, DVM (36:59):
Yeah, that, that's the heart of everything I
do right now.
I would say that I speak toprobably 50 to a hundred people
per month.
Every single one of them hasthese concerns.
I can't do this anymore.
I can't provide the medicine Iwant to provide.
I'm not good enough.
(37:19):
And it's like, no, no, thesystem is not meant for how you.
Your integrity.
Actually, it, it shows up in somany ways.
This, like this pain impostersyndrome.
I'm not good enough.
I, I can't care for my animalsthe way I want.
I, I was forced to euthanizemore animals than I felt
comfortable euthanizing so thatI could earn my, bonus or
(37:43):
whatever.
There, there are companies that,that put that kind of pressure
on euthanasia that, that to meis a real dangerous precedent.
I don't wanna go too much intoit, but that is, when you're
dealing with euthanasia, that'sa very, very slippery slope when
you're putting corporate typepressure on it, when you're
putting production pressure onit.
(38:04):
So that's one of my, mean thatthat's something that really has
lit a fire under my butt to, tosort of like, look, there's
another way.
Just like you said, there'sanother way.
We don't have to, we don't haveto play by those rules.
We're the vet, we own thisprofession, not them.
(38:24):
Okay.
Not the shareholders, not thestructure that they're trying to
put us into and use us as cogsin the machine.
I, I say that phrase a lot'causethere's nothing, it's like a
assembly line.
We're, we're a cog in someoneelse's masterpiece of what, what
kind, what they're trying tocreate.
No, we own our profession.
(38:46):
We're smart.
We got through vet school,potentially internship, pr,
potentially residency.
We do surgery.
We, we do so many things.
You're gonna tell me thatrunning a business is too hard
for you now, come on.
So I sort of address that, that.
People sort of have resistanceto the business side, but to me,
(39:07):
I think business is, you don'thave to be like some MBA, like
obsessed with business or like,care about all these KPIs and,
and like get into that wholeweird world.
To me, business and businessownership and practice ownership
is simply a vehicle for takingback our power as the incredible
(39:28):
doctors that we are.
It's simply a tool in which tocontain our magic and offer it
to the world without amiddleman, without someone
taking a cut of our pay, withoutsomeone interfering with our
medicine, without tellingsomeone, telling us how many
euthanasias we have to do orshould be doing, or pressuring
(39:48):
us into things that cause moralinjury.
Maryal Concepcion (39:51):
I go back to my initial thought to say, oh my
gosh, I would love to have youshare your story on our podcast,
because even though again,we're, at my DPC story focused
on the human side of medicineevery week, I think it's just so
important to highlight how the,the need to protect the
profession of healthcare isuniversal when it comes to the
(40:16):
country that you're practicingin the city, the, the county,
the, the species that you areworking with.
When healthcare is on the table,it cannot be corporatized.
It cannot be rushed.
It cannot be determined bysomeone who's actually not the
physician and.
This is where the similaritiesare so apparent, and this is
(40:40):
where knowledge for me ishelping people have more
knowledge out there to helpprotect what we are
intentionally protecting byhaving our practices.
Eve Harrison, DVM (40:50):
I so agree that there, there is sort of
protection needed, like we'vetaken an oath to do no harm,
right?
To us, our work is sacred.
That connection between us andour patient and our client,
sacred shareholders, corporateCEOs, they are simply not on
(41:12):
that wavelength.
They simply have no concept ofwhat that means, right?
And so I think that it isincredibly important that we
build structures, our ownstructures to, to shield
ourselves, protect ourselves,protect this sacred.
That we've taken, it's almost aresponsibility that we have on
(41:34):
behalf of ourselves and or toadvocate on behalf of others who
are, are stuck under the thumbof the system and, and can't get
out.
Like either they've been soemotionally harmed or led to
believe they're not good enoughor financially trapped with the
golden handcuffs, as youmentioned.
Right.
So I think that protection is sovery important.
(41:55):
I think also like the nature ofour work is that we are not just
machines, like we all know thisis not just a science, it's art
and a science.
And when we're working withanimals, we're working with
their humans.
And the emotions are high.
I think, to ignore the fact thatwe are in a position to support
(42:21):
people beyond just the care ofthe patient is to vastly,
minimize what the, the job is,what, what the role of a
veterinarian is.
And I think many systems thattry to box us in try to really,
narrow the job description andit's like we're holding
(42:43):
something really precious.
We're, we're working with peoplein some of the most vulnerable,
painful moments of their lives.
And I think true medicine, Ithink this applies for what you
do as well.
Like you're holding people interrible diagnoses or, or the
treatment didn't work or they'rein literal chronic physical pain
(43:04):
all the time.
They're not okay.
That I think true medicine has,has got to address and see the
individual beyond the diagnosis,beyond what's written on paper
in the medical record.
I think it's almost likemalpractice to, behave as,
(43:25):
that's not my problem.
I mean, we don't have to beeveryone's therapist.
We there, there's boundaries ofcourse.
But to a certain point, if weare shutting out the wholeness
of what it means to be a doctor,which includes like care, care,
like really caring, actuallycaring and having time to care,
(43:45):
having emotional bandwidth tocare, having a structure set up
so that you can care and notinjure yourself emotionally and
so that you can care andcontinue to care.
I, I think that, that oursystems are currently not set up
to allow that.
So the fact that people areburning out, they're compassion
fatigue, they are morallyinjured, they are committing
(44:06):
suicide.
How, how is this surprising inthis kind of system?
You know what I mean?
Maryal Concepcion (44:13):
Absolutely.
And I'm just wondering in termsof.
Advocacy for humans who arelistening, who have non-human
humans like this is, this is thevery anthropomorph,
anthropomorphizing part of mewho went to, like, I got my BS
(44:34):
in anthropology.
But it's like, just for thelisteners out there who also
want to help their own pets andanimals be better cared for I
would just love if you had any,take on how we can also help our
own loved ones who might havefur or not fur.
(44:55):
And they actually have hair andthey don't shed amazing.
Or their snake, you get bettercare or their snake.
Yes.
Very, very true.
I worked at the zoo for eightyears, so yes, these are all
check, check, check things.
But you know, like, do you haveany, any words for the humans
out there who could help betteradvocate for their animals?
Eve Harrison, DVM (45:11):
Yeah.
Yeah, I, I absolutely do.
I would say integrative care issomething to consider.
Usually the culture ofintegrative veterinarians is
more inclined to be aligned withwhat I've been saying, like
seeing the whole system, theperson, the animal, taking a
little bit more time.
Integrative medicine as a ruletends to honor that principle.
(45:33):
More holistic medicine as well.
I would also say that if you arefrustrated with your current
vet, you don't like what they'redoing, they're making you feel
bad, don't go on Yelp and don'tgive them a pr a hard time.
Just find a different bet.
Who works for you, who makes youfeel heard, seen, honored makes
(45:53):
you feel like a, a valuableco-creator of the care you're a
doctor, right?
So you're of course gonna haveopinions.
You're of course gonna haveresearch things.
There may be things that theveterinarian knows that you do
not.
We find that sometimes with,with human doctors and nurses
come in and challenge us, andit's like, well, that's not true
of a cat.
(46:14):
So I would also say a little bitof humility.
We're doctors too.
And I would say it's yourresponsibility to find a
veterinarian that works for you,that you feel is caring for your
animal in the way that youconsider to be appropriate.
And instead of sticking with avet that you're frustrated with
and, and creating ongoingfriction or not seeing the care
(46:35):
you want, move shift.
Take the responsibility to seekout a vet that you resonate
with.
'cause they're, we're here,we're here, we're waiting for
you to come our way.
And we, we love to work withpeople who are in the know about
human stuff.
Whenever I have a, a humandoctor or nurse or anyone, we
(46:55):
talk shop all the time, it'slike so fun to be like, oh my
God.
Like how would you treat this inan, an in a human?
But yeah, I mean, animals arehumans too.
And, and when you can find a, avet that feels that way and you
can feel that they've done whatneeded to be done to create a
structure that can hold a reallyhealthy vet client patient
(47:17):
relationship, that's, that'syour vet.
Maryal Concepcion (47:21):
I love it.
Well, thank you so much Dr.
Harrison for joining us today.
I hope that the audience, justgot a healthy dose of reality
check there when it comes to thecorporate practice of medicine,
and I'm so grateful foreverything that you do, and I am
so excited that we're both outthere just spreading the word
about autonomous practice.
Eve Harrison, DVM (47:40):
I love it.
I'm so glad to be in touch withyou.
We're like the, the, theequivalent alternate universe
realities of each other doingwhat we do.
And it's just such a joy to, toknow that you exist and to be on
your podcast and that you'vebeen on my podcast, et cetera,
et cetera.
And so cheers to many morecollaborations, I hope.
Maryal Concepcion (48:01):
Thank you for listening to another episode of
my DBC story.
If you enjoyed it, please leavea five star review on your
favorite podcast platform.
It helps others find the show,have a question about direct
primary care.
Leave me a voicemail.
You might hear it answered in afuture episode.
Follow us on socials at thehandle at my D DPC story and
join DPC didactics our monthlydeep dive into your questions
(48:22):
and challenges.
Links are@mydpcstory.com forexclusive content you won't hear
anywhere else.
Join our Patreon.
Find the link in the show notesor search for my DPC story on
patreon.com for DPC news on thedaily.
Check out DPC news.com.
Until next week, this isMarielle conception.
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