brett-shorenstein: [00:00:00] I took entrepreneurship classes, I took finance classes, accounting classes, had a lot of this background knowledge, but nothing can prepare you for owning a small business other than owning a small business.
megan-sprinkle: Welcome to Vet Life Reimagined. Our guest is Dr. Brett Shorenstein, whose initial direction in education as a young man in New York City was not science but investment baking. So he discussed his interesting story of transitioning from finance to a successful veterinary practitioner and entrepreneur.
He's now the Chief Innovation Officer for Veterinary Innovation Partners, a veterinary owned and operated network of veterinary clinics. We discuss how to find your path in vet med that allows you to work in your area of interest and expertise. We also highlight the significance of mentorship, culture, standards of care and technology in veterinary medicine.
And since he has recently gone through a big project assessing multiple AI scribe systems and piloting a system [00:01:00] in multiple hospitals, I asked him to walk us through that process. So let's get to this cool conversation with Dr. Brett Shorenstein.
when did you know you are interested in veterinary medicine?
brett-shorenstein: I've known since I was three years old. my mom, and maybe she shouldn't save as many things as she does, but she even has some of those kindergarten drawings where it says I wanna be a veterinarian. And so, um, I took a little bit of a circuitous path to doing it, but um, it's something I've always wanted.
megan-sprinkle: Yeah, and I think you grew up in New York City and
so do you mind sharing a little bit about growing up in New York City and kind of what you were exposed to that might have deterior you just a little bit before you got to vet school?
brett-shorenstein: Yeah, for, for me growing up in New York City was, was normal because it was kind of the only thing I knew, certainly the, the hustle and bustle of New York City, I. certainly a lot of high achievers. So, I [00:02:00] think and high achiever is a relative term, but, a, a lot of, uh, certainly a lot of financial success.
I. In New York City and, and I think, the allure of that may, may have taken me a little bit off the path. in addition to, you know, being a veterinarian is hard and I, I saw, a lot of the, the hard work that was ahead and, and I said, Hey, if, if I'm gonna do it. That has to be the, the only thing I wanna do.
And that's, that's kind of the advice I give. any high school or or college student. to me it should be the only thing you wanna do. So, at the time, maybe it wasn't, uh, ready to make that commitment. Um, one of the things about growing up in New York City is, I grew up in a pretty large apartment building and so get a lot of exposure to dogs mostly.
I definitely did some cat sitting, but. A ton of dogs in the lobby and, uh, remember very fondly just hanging out in the lobby and, and getting to pet a wide, wide, wide variety of dogs. and, even walk some of them for their owners as kind [00:03:00] of a. A small job, as a high school student. So, but for me it was normal.
I think you get a lot of street smart in New York City, and if it tells you anything, I've moved to the suburbs with my kids, and think they're benefiting greatly from, uh, the suburb life as well. So.
megan-sprinkle: Yeah. So was there like a person that you ran into or saw them have specific success or, or what kind of eventually said, okay, you know, I'm going to college, I'm gonna major in finance and, and things like that.
brett-shorenstein: I think more so kind of my personal financial history. I went to private school in New York City and then my family had some financial difficulty and had to leave that school, which as a young kid was, was somewhat traumatizing. and so I think I always saw myself kind of never wanting to be in that position, for me or my family.
And so the easiest path to that, or, or financial independence was. [00:04:00] To go into finance. And so I think that that over kind of overrode passion. So it wasn't necessarily one person or one thing, but it was more, personal experience and saying, okay, I'm gonna sort of give up the dream for veterinary medicine.
I'll go make a lot of money. And maybe have an animal sanctuary or, or something of that nature. And, perhaps we'll get into, you know, that really not being enough.
megan-sprinkle: Yeah. Well, let's go there. So, finance is a big term, right? what was kind of the allure of investment banking specifically and yeah, what was the story of, of starting to understand more of what that is and meet the other people involved in investment banking?
brett-shorenstein: Sure. So, um, there's sort of a rigorous process in terms of, uh, even getting a summer job. so I went through that recruiting process, which, maybe there are some veterinarians listening that the recruiting process can be a little [00:05:00] vigorous, um, looking for jobs as a veterinarian. that being said, I think. Vets have a lot of, power in that process, which, which is a
megan-sprinkle: Right now.
brett-shorenstein: at the time as a student looking for a summer job, I had no power and, and, uh, worked hard to get a summer job. at Credit Suisse where I worked and the summer, I, it was kind of work hard, play hard, and they were doing a lot of client dinners and. it was early mornings, late nights, but it was temporary. And so when, I worked hard that summer and, and they were happy with my work. And so when they offered me the full-time job in junior year of college, it was kind of a natural, path to say yes and, and have a somewhat stress-free last year of, college.
And know that, as a young person, I'd be making as high of a salary as, as. Pretty much possible, coming right outta college. And, then when it became a full-time job, it was really on the third day of [00:06:00] full-time investment banking. I. we're the head of real estate investment banking, which I was kind of in that department.
I was always interested in real estate. I still am, the head of real estate investment banking said, don't get me wrong, I love making money, but I'm here because this is my passion and I love putting these deals together. And I felt this choking feeling like I made a big mistake. And I, I remember this distinctly.
I went on my company provided Blackberry, which. At the time, going on a Blackberry to look at an a website was very slow. Nothing like an iPhone. And I looked up what I needed to do to go to veterinary school. And so it was really that moment that I realized I had made a mistake and I, I think I felt scared, uh, excited. But mostly lucky that I figured it out at least early. I was in [00:07:00] vet school with, classmates who were 40, 50 years old. And, tremendous respect to them. I felt for me, uh, based on my goals with family and, and life. That would be a lot harder for me to do it then.
And so, um, while I definitely believe it, it's never too late to be what you might have been. I was happy. I, I discovered it somewhat early in my career. I.
megan-sprinkle: So what did you have to do? Because you, in, in college, you focused in more of a financial route. Did you have to go back and take science classes or what did you have to do?
brett-shorenstein: Yeah, so I worked the year and, um, amassed some money and, then, decided to leave. And, first I had to get all the pre-vet experience 'cause I had none of that. And,
and I. Most people listening know that that's a lot of hours of, of volunteering or, or jobs. And then I had to get, all of the prerequisites.
So I did a two year post back, uh, at Hunter College in New [00:08:00] York City. And then, my first job going from, Wall Street, like big views and, uh, amazing office. And, uh, I, I remember my, office chair, was a very fancy office chair to, my first job was at the Central Park Zoo, being an assistant zookeeper for the summer.
So. and as we discussed earlier, I, I'm very much a city boy. I had been to the zoo many, many times, but this type of work was like farm work. I had never used a, a rake before or anything of this sort. and so doing that, working with the Madagascar, hissing cockroaches, um, the snakes. I would be doing some of these things even though I'm more geared towards dogs and cats and they're truly my passion in terms of animals. When I was working with, with these other animals, I was saying to myself, I really want this. I really, I must really want this. If I am, you know, they said, oh, Brett, be careful that snake, bit [00:09:00] somebody the other day, but you'll be fine. And I was saying, all right, you know, I, I'll get through it. So I have some pictures with that snake and like to refer to 'em sometimes.
So, uh, yeah, a lot, a lot of hard work like all the veterinarians listening had to do. But yeah, I had to do it after college and that was challenging in terms of seeing my, my peers progress in their careers. And I sort of. Doing a 180, but, uh, I knew in my heart that it was, it was the right thing to do for me.
megan-sprinkle: Yeah. Now taking. All of the reasons why you actually went onto a financial track. You know, you were nervous about having financial concerns. Did you take that mindset into vet school? Were you kind of thinking about, okay, how do I put this passion into a career, but also support myself financially? Were you already thinking about that or were you just kind of like, okay, I'm gonna go into my, my vet experience and just learn and, and [00:10:00] figure it out later?
brett-shorenstein: I kind of threw the financial independence concept out the window a little bit and had trust that it would work out. But I, I, once I was kind of going for this full passion play, or as a good friend of mine, likes to call it a, a love story. I kept my options open. I, I had spent a lot of time at the animal medical center where, where I did end up doing, uh, rotating internship after school, which, thought was an incredible experience.
I had spent a lot of time there just because I was in New York City doing my coursework. So every free moment. I was there, I was shadowing Dr. Schwartz, who's, head of surgery. I was shadowing Dr. Palma head of internal medicine. And so I kind of went into vet school, I think with, uh, actually quite a bit of knowledge.
And also being inspired by some of these amazing doctors. So I kind of said to myself, I'm gonna do as well as possible in vet school so that every option is [00:11:00] open to me, knowing how competitive specializing is and, and was at the time. I kind of focused on just the, the academic part, so that my resume was as great as possible for any possible opportunity.
megan-sprinkle: Fundamentals. You gotta have the, the basics down before you can get too ahead of yourself. That makes complete sense. And, and so while you were watching these veterinarians. Whether it's, you know, during vet school and then you, you go on to do an internship as well, what did you admire about them that you wanted to kind of imitate going forward as your, as you are progressing in your career?
I.
brett-shorenstein: I think the thing I admired most is that they were subject matter experts in their field, basically nothing they couldn't do or, or didn't know about the disease processes. They were treated so true experts and, and that inspired me ultimately. [00:12:00] As I decided that I would sort of specialize, so to speak, in, in practice ownership, I wanted to become a subject matter expert in that, and, and part of that was because I had a lot of interests in medicine in surgery, and said to myself. This as a primary care doctor, you, you can't necessarily do as complicated cases per se, or most primary care doctors can't. However you can dabble, you get to do some ophthalmology, you get to do a little bit of everything. I. Which I still find very exciting as I continue to work as a veterinarian on a weekly basis. always learning and, able to exercise different skills. I, I saw the allure of that for general practice. And then, once again, I decided if I'm not gonna do a residency and specialize that I would, I would specialize, so to speak, in, in practice ownership. which also I, I didn't. I didn't really [00:13:00] truly know, what owning a small business would be like.
That's not something that I took entrepreneurship classes, I took finance classes, accounting classes. I had a lot of this background knowledge, but nothing can prepare you for owning a small business other than owning a small business. and so that, that was the biggest, kind of fire hose was just all that comes with, running a small business.
megan-sprinkle: Yeah. So did you start owning a practice pretty quickly after school or when did you decide to do that?
brett-shorenstein: Yeah, so I did the internship and then worked at a large practice on the upper East side of Manhattan, which had just transitioned to corporate basically a year before I got there. And I saw a lot of good things. I worked with a lot of great people And then I saw some of the reasons that there's some disengenderment with corporations in veterinary medicine, putting revenue targets on the wall in the break [00:14:00] room and giving everybody $30 if we hit them. And it was. Scary to me because it started to degrade the culture. And I came into a place that was known for a great culture, great clientele, and it was roughly eight doctors at the time. And, and now that hospital, I think it changed hands again, but it, it's like a one doctor hospital. And so it was a cautionary tale. In what can happen. I guess I contributed towards that 'cause I left. Uh, but worked, close to two years there because, there was good mentorship, there was great medicine, and we were able to, um, really work up the cases. The pet owners were on board with, whatever diagnostics were recommended. Um, so it was nice to practice in that environment. But, from a culture standpoint. I started to get scared because, I sacrificed a lot to do this, and that was when a lot [00:15:00] of the reports on, on mental health and burnout in the field and just started to sort of burgeon that that information wasn't even as available.
When, when I went into vet school, I don't think it would've deterred me one bit, but the information wasn't as available. And so I started to see that and, and started to feel unhappy in, in that position and really feel like there's gotta be a better way. And as opposed to relying on somebody else, I have to go and, and create my own culture.
And so, uh, about a year and a half in, I, I started looking for opportunities. I was incredibly in incredi. Luck is part of business success. There's, there's no doubt about it. We could call it luck, we could call it timing, but I was incredibly lucky to come upon Abingdon Square Veterinary Clinic, um, and Dr.
Diane De Lorenzo, who I. is a wonderful, wonderful person and veterinarian and, was [00:16:00] a mentor to me in those early stages where, um, you know, we came to an agreement for me to buy her practice and she, she taught me a lot about those small business things. Um, I certainly knew a lot about ways to grow the, business and grow the hospital. And grow the team and all of those, I'm, I'm proud to say happened. She just gave me a very calm mindset and, great expectations and, and showed me how the ropes of, of how she did things and how she handled things. And so. she didn't have to do it. and so I was very lucky for that and, and we're still close friends, so, that's really nice.
But that, that was where the kind of practice ownership journey started. And when I started it, my mindset was I'm gonna focus on three main things. The first being culture. And if we take great care of the people, they'll take great care of the pets. And [00:17:00] I had. Everyone I wanted to retain was retained at the hospital because I took that mindset to the hospital. The second was standards of care. the hospital at the time, the lepto vaccine wasn't a core vaccine for the hospital. I had just come from a MC seeing a lot of pets, pass away from lepto on their ER, which was very sad because it's preventable. So I would update standards, whether it was wellness lab work, or vaccines.
And so updated standards of care. And last was technology. So knowing that. Everyone loves to communicate via text and email, updating the reminder system from like a postcard system to, utilizing technology wherever possible. and since then we've updated a lot more technology, but my first was how are we gonna text with the owners, um, and make, make the practice more accessible to them?
megan-sprinkle: I think also [00:18:00] I heard you describe this particular practice as your first baby, and I think your, uh, was a son was born not long after that.
brett-shorenstein: Yeah, you're right.
Um, my son, so Abingdon Square, was about, two months before, My son was born. Um, and so Abingdon Square is very much my first baby. And I, I still treated as such and. everything that happens, I, I very much, uh, take personally.
megan-sprinkle: I, I think that's something special about ownership, you know, and you can plug in anything there if you think about it. Ownership, but you know. I'm sure Dr. Diane kind of felt like that too. This, this was her practice and, and she wanted to make sure, it was taken care of. And, and not to say that she isn't a wonderful person, but, but there is an attachment there that, you know, you still want it to be successful.
And I think this goes into, your future, what you're working on now, it is about practice ownership and veterinary led clinics. And there is [00:19:00] something a little bit different about being responsible and, and having that kind of investment into a practice. So , I'm sure you know it, you are. Took what you learned from all those other places and culture seems like the obvious first 'cause that's why you left. So let, let's let make sure , we solve that. , but I, I also I listened to a podcast with you and, one of your colleagues and he talked about how you were really leaning in and growing this.
Business quite well and successfully. So what was that like of, you know, you have your three pillars of focus here. What were you starting to see as you were growing your practice?
brett-shorenstein: Yeah, it, it was very exciting to see there's, there's different levers that you can turn, so to speak when growing a veterinary practice or potentially other small business. Obviously the vet practice is, is unique in its own way. it was very exciting to [00:20:00] see. The, the return visits, the, wellness blood work protocols, the, the data is pretty clear that one in seven wellness lab work, um, will have an abnormality requiring follow up, in, in young wellness panels.
So practice wasn't, uh, performing those young wellness. So seeing what we were catching and, having the doctors at first like, uh, is this really necessary? And, um, really exciting to see when you say, Hey, you know, just. No matter what you do, if I'm gonna change something, give it 110% effort and then if it's not working we'll fix it.
And to have that buy-in from the team is, is really exciting. And we've tried things, we've tried things and they haven't worked out. We've tried, hard push towards our online pharmacy when the. chewy scripts, et cetera, got too overwhelming and, that pushed some pet owners away. And so I think, mistakes are also important part of learning and, and [00:21:00] getting better and growing.
And, we didn't fail at too much, but if we failed, we, we failed fast and, and then move forward. But. Um, it was just exciting. It was exciting to, I was basically adding myself as a doctor to the, the calendar full-time. And so it was exciting to see that I wasn't fully booked. And, turning the search engine optimization on and, uh, looking at key keywords for what we were advertising for and. Uh, expanding hours and, adding team members and even adjusting how the workflow and how are we utilizing team members and, the little things. Um, sending a handwritten note to, new clients, welcoming them to the practice. And so it was exciting to just see all of those elements, um, really upgrading. Client service. I think that it's incredibly important part of the practice that, that some might [00:22:00] overlook. they are the gatekeepers and they're the first person that, that the client sees and the last one they leave. So, I spent a lot of time sort of expecting excellence there. Um, was lucky enough to have some colleagues, join me. At, at the practice that I had worked with before that I knew, really had what it takes as far as a, a client service, mentality. And also balancing that with, you know, the customer is almost always right, but if there was a bad acting customer really standing up for the team and saying, Hey, maybe this isn't the right practice for you. and saying, you know, we'll give you one more strike. and seeing some behavior change and, and some clients we had to, uh, move out the door. But, yeah, it was very exciting to, to see how much, you can grow a practice, by giving it, all of that love and, and nutrients.
megan-sprinkle: Yeah. Now I happen to know, 'cause I, I know how the story somewhat [00:23:00] goes. you knew some other veterinarians in. That had multiple practices. I think though, like six practices each. How did you get to know them and then, please fill in the story about how you are starting to think, uh, maybe on a bigger scale and want to work a little bit more with them.
brett-shorenstein: Yeah, so it was interesting, right when I was about to buy Abingdon Square our, our bank, very thankful to, them, they, they had put on a conference, in Florida for 20 forward thinkers in veterinary medicine.
megan-sprinkle: Cool.
brett-shorenstein: 19 of which were their clients that had like three plus practices. And it was me about to close on my first practice.
So I was very honored to be there and, I guess they, they saw something. and through the course of that, I, I, I got to know, um, Adam Insan and Don Costlow. just well over the, over the weekend, zero expectations, lot of respect for, for what [00:24:00] they had built. We stayed in touch, uh, loosely over time and, as I started to think about, Hey, this is going really well at Abingdon Square. how can I continue to challenge myself, continue to grow and also help more pets? Because I believe if, if I'm running a hospital really well, I'm helping more pets than I can physically see myself if I'm staffing it well, if I'm getting great vets. I'm helping more pets than than I could ever do, just being on my own.
So, started to think in, in those regards and start to look at a practice that, my partner, Don w was also sort of looking at and. That's when the light bulb sort of went off. And I, I said, Hey, you guys have, and, and then Don said, well, if we ever did something together, we're gonna do it with, with my partner Adam.
and so [00:25:00] that's when the light bulb went off and I, I said, Hey, what I've done is going really well. It's a small business at this point. You guys don't have such a small business, but there were about six hospitals each roughly. not so small, but they treated it like a small business. And I said, Hmm, let's think about the reason I left the reason it's going well.
I think we could be different. Vet owned, vet operated, vet led. I. And, um, actually you touched upon something earlier in this conversation where you were saying it's it's your baby. It and, the practice owners care what happens to it. And so my first inclination, and it was a very busy time for practice acquisition just in, in the field, there was a lot of consolidation going on and still dis engender with the corporations. And so I said we could be those safe hands for doctors looking to be proud of, of the transition. [00:26:00] Maybe we can't offer the top, top, top price, and if that's what they're looking for and they don't really care about what happens afterwards, then that's their choice and it's their baby. So it's their choice. For us,
we worked really well with people who were very passionate about seeing where their practice went. hopefully staying with the practice because we found ourselves, hopefully a very friendly employer, one who really cared, uh, about the hospital. And I took it personally. I wanted these doctors to be proud of what we did with the practice. I wanted these doctors to, really, trust us with their child be proud of where it went. Like, like Dr. De Lorenzo's, really proud of, of Abingdon Square. We've moved it and upgraded the facility and went from two exams to exam rooms, to five exam rooms. And to see her, you know, come and say, wow, it's amazing what your vision has been.
This [00:27:00] is beyond the vision I had for the practice and. And where you've taken it being so proud. So that, that's been the goal, in every circumstance. of course, some of the, owners or sellers, so to speak, priorities can change after you, um, you know, give, control your baby to somebody else or you start thinking about retirement. you know, a variety of different relationships and, and flavors, but we wanted to be those safe hands. And then from a veterinarian standpoint, we know, knew that recruiting, is very challenging right now and, and, and has been for several years, we thought we could have an edge there. giving medical autonomy, having each hospital have its own culture. And accentuate the culture that they had, have some core principles that kinda overlay, and take a lot of the headaches away, which all [00:28:00] corporations kind of do in terms of marketing, accounting, bookkeeping, recruiting, do all of that stuff, but. Kind of try our best to do it in a different way and, and preserve the hospital and not kind of make it a cookie cutter.
You're gonna be like everyone else. Um, whatever makes that hospital special and that the clients have that expectation. We wanna maintain that. And so that's, that's what we set out to do. and just be different.
megan-sprinkle: thinking about the recruiting part too. You, you probably have to understand each individual hospital if, if they do have such autonomy, you have to kind of understand each hospital and be able to best recruit for them. 'cause again, if culture is important, you wanna be able to recruit the right people.
And is that also when some of the mentorship programming came into the, um, into the system?
brett-shorenstein: Yeah. so one of the things we realized, which certainly no secret, if you wanna hire new grads, [00:29:00] you gotta have, an amazing mentorship program, and that spans from training your mentors to be mentors. And, going over with them best practices on, on being a mentor and then having a structured program as opposed to 60 different, um, mentor programs going on, having a structured program, where there could be realistic expectations. Okay, I'm gonna meet with my mentor once a week for half an hour. I'm gonna shadow for the first week in the hospital, and then transition to hour long appointments where my mentor would be available at the end so I can kind of run the plan by them for several weeks.
And so I. and also having a similar plan for surgeries and, dentistries. And so that's, something we, quickly realized was a necessity and something we're really proud of. And, not everyone's meant to mentor and not everyone wants to mentor. And so something else that I'm proud of [00:30:00] is that. We are not trying to fit a, a square peg into a round hole. If, if, if somebody wants to work in a region that we have and, and they need mentorship, if that's not the right hospital, I, I would love to be able to offer it everywhere and, and we're getting there. But if it's not the right hospital for them, we don't push 'em there.
And I meet with a lot of candidates fast forwarding a little bit to my role now, I meet with the candidates for every single one of our hospitals. Um, anyone who applies I, I meet with. And, I find that really exciting. And, and one of the common themes with people who weren't happy with their first year job right outta school, was they were basically kind of bait and switched.
And so. We're very careful to just do everything we can to, to do right by the veterinarians, in our quest, so to speak, to, to be in a destination employer. of course it helps the business, but I think there's something personal about it, [00:31:00] so to speak, and, and having this be our baby. we want vets to be happy.
there's more unhappy vets than I'd like. And while I can't solve that problem for our ecosystem, my goal is for, for people to, to fall back in love with veterinary medicine again. And that's, uh, an exciting goal. And we, we look to attack that with. high support staff to doctor ratios, which are really important.
Now we're, heavily investing in AI note taking for veterinarians. anything that's gonna make their day more efficient, be able to go home on time, and, enjoy what they do. because there are obvious elements of the job as a veterinarian that. Uh, even when I was career changing, didn't realize, and so as much as we can have vets, uh, work at the top of their license and, perform tasks that only a veterinarian can do, [00:32:00] we kind of get closer to achieving that goal of, of loving work again.
megan-sprinkle: Yeah, all of these things, that's a lot of responsibility. So I'm sure your role has changed over time and now even I, I think your title is Chief Innovation Officer and you have innovation in the title of the company. So do you mind going back a little bit and sharing why you chose the name you did for the organization and what your role today kind of looks like?
brett-shorenstein: Yeah. So interestingly, what I used to think was most innovative about the company was that we were the common sense company. We were doing things that, you know, um, let me give an example. I, I wanted to go to a wedding in, in my first job, but. Uh, there was another doctor that wa had already requested that, day off, and it, it, it was an important wedding to me and I was told no. And so that didn't seem like very good common [00:33:00] sense because there are per diem options and I respect practices that, that wanna minimize their use. But if a valued team member, needs to have off. My mindset is you gotta find a way to, get them off, off of work. and so if, you know, that could come in the form of even trading a shift, what, whatever it is. When a veterinarian comes to me with a request like that, I'm showing them that I'm doing absolutely everything possible to, to grant that request. So that's a small example of that shouldn't be innovative. But it sort of became innovative because there was a lot of this just kind of hardnosed business, not treating veterinarians like professionals, if you will.
and giving them some autonomy with in that regard. So that was where it was, in true innovation. that's in the form of cloud-based medical records. the ability to access them from iPads or iPhones or, and [00:34:00] wherever you are in the world. Um, while we very much believe in work-life balance and, would prefer our doctors don't have to work on records at home, if they need to pull something up, if they want to pull something up, the ability to do that.
Um, I mentioned earlier text messaging reminders, texting with owners. texting pictures postoperatively to, to show that, patient's doing well. so that's kind of the technology side. And then I'd say the largest innovation right now, um, which is a game changer, is AI, scribes and, uh, AI assistance.
And so. more currently my role is evaluating eight different, scribing tools and utilizing our, our medical advisory committee that we created so that these decisions aren't like, made in a vacuum for, for the company, but a bunch of doctors trying the different tools. And, you know, I kind of synthesize the feedback as well as use the tools myself and found the best [00:35:00] option for us that we're. now in the first cohort of, of rolling out about 10 hospitals, that'll start with AI note taking, by mid-March, which is, which is really exciting for us. And, once again, it'll be a, a great tool to, see that extra case if that's what's needed. But, um, most importantly, let veterinarians, you know, records are not that exciting. I don't really know anyone who loves doing a ton of records. and so for me, it, it's personally in a job that I already love, been even more satisfying, by utilizing the tool. So we're just looking yeah, once again, for any way to, improve the quality to the, the pet owner, to the patient. as well as to, our veterinarians and support staff make their day better.
megan-sprinkle: and I think AI scribes are kind of a hot topic right now. It's probably what, what I've heard from experts is that this is probably the most quickly [00:36:00] adopted tool in veterinary medicine when it comes to technology, and I was so. Interested with you having, again, all of these hospitals are given some autonomy, power, and you're trying to help make them all efficient.
How do you, and we'll stick with AI scribes, 'cause I'm sure we could get in nitty-gritty with all the different things you've looked at. But when it comes to an AI scribe. How are you evaluating these tools so that you know that it will work for all of the hospitals? Now you mentioned the medical advisory board and that may be part of the, the answer, but I'm really curious what have you, 'cause this has been your, like a big project right now, so maybe it's top of mind, but how did you like sit down and like analyze?
Alright, there's a lot of tools out there. Which one is gonna be right for all of these hospitals?
brett-shorenstein: Sure. the first was recommendations from trusted specialists. I mentioned in the beginning a, mentors at a MC, teaching [00:37:00] hospital, kind of seeing, you know, what, where are they at with, um, AI scribing. And so that, that was one, uh, peers outside of the company. Two was peers within our own ecosystem to make sure that there was buy-in. and that we kind of chose a, a clear favorite, I will say. they all at this point, there's exciting kind of roadmap stuff for the future, but at this point the function for all of them are pretty similar. Are pretty similar. So, then it comes down to the best user interface. easiest to use the app, not crashing. that sort of stuff. And then, and then kind of the format of, of the layout of the SOAP, integration with, EMRs, practice management systems. That's also important because, While copying, pasting in my mind is not that bad. That's just another step. And you add up all those copy and paste, that's maybe seven more minutes [00:38:00] in your day.
So, a way to just kind of click a button, bring the patients into the AI scribe, click another button and have them go back into the record system. So that was very important for us as well in kind of differentiating the tools. Um, what we're noticing with the layout, because we have a different, workflow in every hospital, technology might be different.
If there's a doctor who sees three patients at once. They can't just use their cell phone, they're gonna need a tablet or a computer that can record in the exam room so that they can kind of do that. If it's more of a kind of one-to-one, like we do at Abingdon Square, it kind of works for just the doctor to use their computer or phone and. There's not as much kind of back and forth and, coordination. so every hospital being different. That's why we kind of created this cohort where we have some emergency hospitals, and primary care also in different regions. So that, my goal is to get all the kinks out of the process. [00:39:00] Rolling anything out to 60 hospitals or so is a challenge, and so we're trying to kind of get the different flavors of how this might work, assess the technology at the practice, and make sure the practice is kind of set up for success. ultimately we are not forcing anyone to use the tool. I think that everyone will see the benefits and then wanna use it, but. I've talked to many doctors who have said, I don't love how the exam comes out, or I don't want to talk out my exam in the room. And so I've said, no problem.
Then, you know, but I'm sure you see the benefit of the subjective portion where it can just put the owner's complaint, and the medications they're on, and then the plan, comes out great. I'm sure there's little things to add. If, if you don't say it out loud, it can't read your mind, but I. so the common metric is can save like between one and three minutes per patient, by [00:40:00] utilizing the tool.
And so for those who are gonna only use part of the tool, maybe they'll save a one minute a day, but those add up. Those add up. And if somebody can go home 15 minutes early, that's great for me. you know, I think that that's great towards longevity and, I truly feel this tool can affect burnout in a positive way.
megan-sprinkle: Yeah. Well, and surrounding yourself with other people who are using these tools and seeing them go home and seeing how they are leveraging it. 'cause I, I understand that too. I am not very good at, at. Just talking into the void like this is why I have an interview show is 'cause I have a hard time just like talking to myself.
so I can see how that might be challenging to, to change, but do, I do think it's important to be around people that you admire and are, are pushing themselves to use new things. 'cause then it gets a lot easier I think. Um, 'cause you're just, you're all around it all the time and so it's easier to adapt than [00:41:00] trying to do it like on your own, if that makes sense.
brett-shorenstein: Yeah. And, and I absolutely also believe that while, from a diagnostic standpoint and, and recommendations and differentials, while I think. It is not going to replace veterinarians. I truly look at it like an assistant and if the pets can get better care by, putting a unique case and, there is now kind of functionality to get differentials or sort of recommendations on, on different treatment plans. that's exciting to me because once again. I would never just blindly follow that. But if, AI recommends something obscure like Bartonella testing for a patient, we're still having trouble figuring out, I mean, there are examples already where it's helped patients because of, of those zebra cases. And so, that's exciting to me as well where, where the patients can benefit from the doctors, [00:42:00] essentially having an assistant. Uh, for those rare conditions that you've only learned about in vet school.
megan-sprinkle: Yep. Not, not just efficient for the doctor, but if you're able to get to the diagnosis, you're able to get to the treatment better.
You make happy clients. Healthy pets. I mean, I think that's the, that was the goal at the beginning. So I think that those are all really exciting, ideas for our future that the vet med is just gonna get better and better.
brett-shorenstein: Absolutely.
megan-sprinkle: Well, speaking on that, what are you most excited for, for your personal future and, and for vet med in general?
brett-shorenstein: So. AI is, number one. I'm most excited about that right now and, and the continued learnings there, like we discussed beyond that, uh, I'm excited to, I. Continue growing and continue growing might mean focusing back to basics on, some of the hospitals that we've partnered with over [00:43:00] this last year.
We, partnered with, uh, amazing group of hospitals. they were under the name Valley Vet, uh, in Texas, California, Colorado. I haven't had personally, um, as much of an opportunity as I'd like to kind of dig in there. And look at some of the opportunities like I looked at with Abingdon Square and, where are the ways that, myself and, and my whole, we have an amazing team, can have an impact on those hospitals.
There's a lot of kind of. less exciting parts of, you know, merging with a, another organization, making sure you the, you know, you gotta get everyone paid on time, of course payroll. And luckily I don't have to personally deal with that anymore. But, um, there's, there's a lot of that goes along with, You know, acquiring a, a, portfolio of 24 practices and digesting and kind of bringing into the fold. And so now I think there's a opportunity to also look at those [00:44:00] centers and, and learn from each other. They're doing things that there, that could help Abingdon Square or our hospitals, in the East Coast.
And so there's no one right way of doing things. Um, I think we've established. a lot of great protocols, um, on the wellness side, things like that. but just excited to, to dig in there and, and learn more and see if there's an opportunity to, help more pets in Texas, which I could tell you when I graduated vet school, that would've been the furthest thing from my mind. and in visiting the hospitals, it's been amazing. I mean, they're big and. Nice and a lot of space, which I'm not used to in New York City, and really devoted, doctors and, and staff. And so, excited for, for this year to, to see where that might go as, as we kind of dig in a little bit, a little closer under the hood, so to speak.
megan-sprinkle: Yeah, well, you know, a whole nother location of, [00:45:00] of, new people as well. I'm sure they'll bring new perspectives and ideas and, I'm assuming chief innovation officer, that's, that's also part of your job is, is getting all of these perspectives and ideas and being able to implement them and move them to, you know, something that's really actionable,
brett-shorenstein: Absolutely. Absolutely.
megan-sprinkle: Now we don't have too much time to go into a big question, so I, but I do wanna go back to one because one is top of my mind of being a new mother. I wanna go back 'cause you, you, we talked about you got your first practice a couple months before you had your first child. And how have you implemented 'cause being a practice owner, being an entrepreneur, being any type of business owner is a lot of work and you, you're having to invest a lot.
How have you balanced being a father and. All of this other wonderful, fun career that you're enjoying.
brett-shorenstein: [00:46:00] It's a great question. to me, like my kids are the greatest joy of my life, and so, finding that balance has been incredibly, incredibly important. As a practice owner, there's no doubt about it, it is one of your children and it is a full, full, full-time job.
If the fire alarm is going off and it's a Sunday and the practice is closed, you know, you're the one who's getting that call from the, fire department, and you're going down there and you're figuring that out. And so. Um, it definitely takes on a life of its own and, and no one will care about your practice like you will.
you can have incredible managers. I've, I've worked with incredible managers and, if you know, snow removal is your responsibility for the property. And there's a big snowstorm on a Sunday. You're up late on Saturday night kind of figuring out what, what's the [00:47:00] snow removal plan. So, I think you have to expect that if you, if you're thinking about practice ownership, one trend has been, partnering with, businesses such as mine. Um, sort of a hybrid model and I would say, you know, try and really get to know who you're thinking about partnering with, but a lot of veterinarians don't come out with the background knowledge that, that I had from finance and management background.
And so. I think a nice kind of in-between is a partnership where a company like Mine's taking care of the things, a accounting, marketing, recruiting, a vendor contracts and you can kind of focus on being that medical leader and culture builder, but not necessarily have to wear the hat for all those departments.
I don't think I said HR in either. One, but HR is a big one.
megan-sprinkle: Everybody's favorite, right?
brett-shorenstein: And so, you know, wearing that hat was, was probably, that was probably the hardest hat, just [00:48:00] keeping up with, you know, medical leave and, all the different programs. I did that also through COVID, which was a, a huge stress in terms of making sure, especially when you wanna do things the right way, making sure you're complying with the state laws and federal laws.
And so. All of that can be stressful, amidst having a family. That being said, I think it's a worthy sacrifice whether you're doing it on your own or, or partnering, uh, if you have the inclination towards it, because you can also grow to a point where then you can have more work-life balance. So you'll still get those calls in the middle of the night about the alarm going off. And, as I grew Abingdon square, it was kind of this curve of, of a lot of involvement and then, creating, uh, almost a, a self-sustaining machine that if I wanted to work one less day a week and focus on my family, I had grown it to [00:49:00] that point. Um, but a lot of hard work goes into it to get to that point.
But you can. many practice owners can, achieve that work-life balance. There will be several years though where, you're burning the candle at both ends.
megan-sprinkle: Well, and on that note as my final question that I always ask people is, what are you really grateful for right now? What's the first thing that jumps to your mind?
brett-shorenstein: Uh, for me is, is that work-life balance? Um, I am grateful that, based on, building, our company that I'm really proud of, a lot of the innovation work and a lot of the. recruiting work. I do, um, I can do remotely. And that's, been something that, has been a real joy in terms of, being able to, spend time with my kids, especially in the morning, let's say, before school.
And, so I think I'm, I'm incredibly grateful for, for that.
megan-sprinkle: I hope you enjoyed this fascinating veterinary [00:50:00] story. We can make an impact in so many places. Check out the show notes for lots of resources. Please make sure you are subscribed on your podcast app. Subscribe on the YouTube channel and follow me on LinkedIn where I hang out the most. You can contact me on LinkedIn on the [email protected].
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