Caleb Frankel: [00:00:00] This is an example of where software can have a really meaningful and powerful impact, and it, it gives me the goosebumps to say that we're actually doing something about it. And we're not even close to done, but those are the little things that I get so excited about.
Megan Sprinkle: Welcome to Vet Life Reimagined.
Dr. Caleb Frankel is a veterinarian and the founder and CEO of Instinct Science, an organization with a mission of improving the modern veterinary team experience. through better technology and systems. Instinct's practice software platforms power many veterinary practices by incorporating true workflow improvement, decision support, patient safety tools, and a charge capture automation.
Instinct and Caleb have been in the news a lot recently because of Instinct's recent acquisition of VetMedica. The creator of Plums and Clinicians Brief. Dr. Caleb has spent his clinical time in specialty and emergency hospitals, including a very large multi doctor practice in Florida. In this episode, we will learn the journey of creating instinct [00:01:00] science, how the acquisition of vet medics might not be as surprising as you think, how to avoid burnout even as an emergency doctor, what is exciting for the future of veterinary medicine, and much more.
Let's get to the conversation with Dr. Caleb Wrinkle.
Of course, I'm going to record myself making this confession. So when you first reached out to me to participate in the New Year's article on what I saw of the future of the veterinary profession, when I saw Instinct, I thought you were from the Instinct Pet Food Company.
I'm a nutritionist. I'm sorry. That is my world. And so I was like, Oh, well, good for Instinct for doing this article. So it took me a little while to figure that. Out which instinct you were from. So I do apologize for, for me taking a little while there.
Caleb Frankel: I have this funny saying that I tell people and some of my team repeats it, but professionally, I don't talk about politics, religion, or pet food.
I always say it in the emergency room. If like [00:02:00] a client comes in and says, Hey, well, I have you, what do you recommend for, or what do you think of raw food or whatever? And, and I always state those three things that I don't talk about professionally. That's hilarious. You just know who to call when they do want to have those questions.
So, yep, I had no idea what I was setting myself up for when I picked this specialty. So we're a different instinct. Yes. Yes. Yes. I apologize. And we'll talk much more about your, your instinct here in a second, but I love to start with kind of the origin of when did you know you wanted to get into veterinary medicine?
Yeah, looking back, I'm definitely one of those that falls into the category of I knew pretty early on and I think there were two early influences. So first of all, I loved, I always say science and animals, but I'll throw helping people in there. I am always drawn to that. I was like the weirdo kid who would always be finding ways to help people.
I don't know what It is about my nature, but, but it was those three things. And there was an incident in my [00:03:00] life where we had just moved into a neighborhood and there was an older man who moved in next door and he moved from a different state and his wife was coming, you know, like a couple of weeks later and he brought the cats and his job was to keep the cats alive.
And I met him because I was playing with neighborhood kids one day. I forget how old I was. I want to say 12 or 13 and he was frantically searching the woods behind my house for his cat and his cat was named gold bug. And he had one eye. I think he was hit by a car if I remember correctly. And he lost his eye and he lost the cat for a few days.
And he told me as a young kid. My wife's going to kill me. This was my one job. And I helped him look for the cat the next day. And I'm the one who found the cat. And that turned into a cottage industry for me in the neighborhood where I would take care of all of the animals. So I was entrepreneurial. So it was, there was definitely a part of me when I look back on that story.
It's super interesting to me because it [00:04:00] shaped sort of my early interest in, I think, animal healthcare, where it can sort of You can have such an awesome impact. So it shaped a few things. One is I started this cottage industry because he would always ask me to watch after his cats when they went away after this incident, cause I helped find the cat, but I remember, and I've, I've told this story before, but I like to say that I created the first electronic health record for animals because I was.
Always drawn to technology, Megan. And back, I had all these neighborhood pet sitting jobs in the summer. I remember when I was 13, I got one of the first computers. Like I was always drawn to computers. I'm old. So this was like 1995. I want to say I got my first computer and I created some kind of WordPad or early Excel, like tracking of all of the pets in the neighborhood.
And so when I lecture sometimes I like to drop that as my street cred. So, so that, that I think shapes, you know, very early on, but then, you know, fast forward to high school, there was a program in my high school. [00:05:00] I think around the time I was 16. So early in high school, where you would, if you were doing well, I think you were in honors classes or something, you would be placed into careers that you were interested in in the afternoon.
And so I got selected for this program and it was the first time I got faced with, what, what do you want to explore? And I listed all these careers and the first one I got placed in was on my list was a veterinarian and truthfully I had No idea, you know, I don't remember taking the pets to the vet. I just love science and I loved animals, right?
So I got placed with a veterinarian and i'm from central pennsylvania and the veterinarian I got placed with Did amish farms in the morning and small animal medicine in the afternoon and evening And it was a true James Harriot like story. And so I got placed and I went and did my first day with him.
And I remember staying till like eight, nine o'clock at night. I think he had an emergency come in and with a small animal part of the day. And he was there [00:06:00] late, you know, there were no emergency hospitals. He was one of the few in the town. And from that day forward, I was just obsessed. I canceled all my other.
Career opportunities and told the guidance counselor, just put me in vet hospitals is where I'm going to be. And I never looked back after that. I'm 1 of those just driven people who never changed my major. And it's kind of weird that I'm running a software company because I'm a planner and I knew what I was going to do.
And this was it. Not at all in my glimpse in my eye of where I was going to head. So. Well, speaking of that, if you are a planner and you are focused, which sounds a lot like me when I was in high school, it's like, Nope, no matter what you tell me, this is what I'm going to do. I'm going to go into vet school.
Did you picture yourself as a similar way of practicing the James Harriet mixed animal practice going into vet school or what were you thinking about for you? Yeah, that's a great question. So I never had any large animal experience growing up. I was from a small town, but you know, it was really just the pets I had.
[00:07:00] So I, there were lots of farms around me, but no farming experience, no equine experience. I really fell in love with the bovine medicine when I was shadowing veterinarians in high school. And so when I went to vet school, I thought I wanted to do mixed animal medicine. Listed myself in the mixed animal track before that I decided to go to undergraduate to study animal science And the reason I picked animal science versus biology for those that don't know those are probably the two most common majors Animal science gives you a lot of background in animal husbandry and large animal medicine biology.
I think Really moves you to the science and you don't get any of that experience. And I picked animal science very intentionally because I wanted to get some mixed animal, large animal, farm animal experience. And so when I got to vet school, you had to pick, um, like, you know what you're doing, right? When you're a first year student, but you picked your track and I picked mixed animal medicine.
And then, you know, as I got more into school, I realized what I think a lot of veterinarians think about as they start to get [00:08:00] out into practice, which is, you know, your work is so Much. It's such a big part of your life that I always teach, you know, the vet students and the interns that I work with confidence is like a really important thing.
We don't think about it much. Right. And what I found was I just wasn't healthy as a. Person if I was practicing mixed animal because I never felt fully confident that I was doing the best job. And so very early on I wanted to chase confidence. And so I picked small animal and switched it up as I went forward.
And I think that was a really good thing for me personally. That's a very good insight to discover at that age, because I didn't have confidence at all, even if I was focused in small animals. So I think that is, it's a really good thing to recognize. It's still a lot, right? It's still a lot, even if you're dealing with, you know, basically two species.
So no, that's, that's fantastic. And I also saw that [00:09:00] you, you decided to do an internship after vet school as well, which, When I was also coming out of vet school, that was like. Normal. That was the thing. You know, a lot of people did internships because the jobs are not quite as hot as they are now. And so you wanted to learn and differentiate yourself.
Is that also your thought process when you were doing that? Or? Yeah. Yeah. I had a specific goal. I will say when I did an internship. So I. Again, I knew what I would. So from the time I was 16, I was going to be a veterinarian and I was, I was entrepreneurial. So I have very little medicine background in my family or anybody in my life.
So really I had a lot of business people to look up to, and that's what I knew. So I was entrepreneurial and it's one of the reasons I love veterinary medicine, but I wanted to own and start chains of really high quality specialty emergency centers. That was my goal. And I figured that out early on because I sort of found that coming from a [00:10:00] small town, we didn't have any 24 hour centers.
And I saw that, you know, when I was growing up, I lived in the middle of Pennsylvania. And so you either had to drive to Penn or Cornell, which were two to three hours away. And we did take our pets to one of those. And so I think that shaped like this. doesn't have to be like this. There can be 24 hour centers for pet care.
And, you know, back then that was a novel concept. I think now it's not, obviously. Blue Pearl wasn't a thing then, all any of these specialty emergency chains that exist. So my idea was to become an internal medicine specialist because I was, I was definitely a medicine head and I wanted. To do an internship at a residency and then open chains of high quality specialty hospitals.
Clearly that is not how it turned out. I'm not a specialist. I do work exclusively in specialty emergency centers, and I love that corner of the industry. But I quickly realized in, I think it was probably my internship that. Internal medicine and what I loved about it at [00:11:00] Penn where I went to vet school was it was really challenging, complicated cases that the ER wanted to get off their plate.
And you sort of did like the Dr. House exploratory on them. And then you get out into the real world and you realize, and there's nothing wrong with this, but internal medicine is pretty heavily chronic care. And that was not what I loved. I loved challenging cases and figuring them out. And I found the emergency room to be the best place to do that.
I also loved helping people and like a weirdo. Whenever there's a really difficult client, I'm the one, most people in the hospital say, can you deal with this person? Cause I love it. I love like challenging people. And so I think the other challenge I loved was earning somebody's trust or a family's trust when they need.
To trust you, but they can't trust you. They have no trust with you. Right. And that's exactly what the emergency room is. So, yeah. So I did my internship because I thought that's what I was going to end up doing is, is being an internist, but I changed that pretty quickly and I'm a big believer in internships and looking back, I wish it was mandated [00:12:00] actually.
And I wish it was mandated today. Now I understand the economics of that and why it may not be, but. I think the veterinary world and veterinary practitioners would be better off if they were mandated to do internships. And if we changed the way our profession worked to do that. Yeah, I agree. Going back to your comment about confidence.
I also wanted to specialize. So that was another part of doing an internship is that would accelerate my chances of getting into a residency. But. I, I found a great place for mentorship and it really helped my confidence and I, I still remember some of those weekends working as an intern. And so, yeah, I, I agree that they, they do have advantage.
I do wish you. You could get paid a little bit more than you do as an intern. So I think there's some opportunities for kind of changing up a little bit of it, but yeah, absolutely. If you aren't doing an internship, at least be very, very picky about where you go so that you can find those [00:13:00] opportunities for mentorship and kind of make it your own internship.
But yeah, I think I agree with you for sure. Yeah, and I can't help. I'm very curious about this because that is very different with the love of difficult clients. So do you mind elaborating a little bit more on what are some of the things that you do to help build trust, especially with difficult clients?
What else is it about it that you kind of enjoy? I had some amazing mentors in my clinical year and my internship, and they shaped it. Yeah. Some of the things that I think turned me into the clinician I am. And, and, uh, you know, I'm, I'm obviously only practicing roughly one day a month these days, so I still am in practice, but instinct and running that is my full time job.
But I'm weird, Megan, in that I didn't burn out. I'm not burnout. I didn't leave clinical practice because I didn't like it or didn't want to be doing it full time. I left it because I'm super frustrated about a [00:14:00] problem and I'm a train wreck, maybe in a bad way or a good way, when I see something that should be better and, and could be better.
And so I'm sort of running towards that fire, not away from practice by any means. And when I go into practice, I love it. And I think a lot of people Enter the profession with the wrong mindset around this. I had a great intern director who sort of taught me to look at these challenges as an opportunity.
Otherwise you will bounce so fast. And so one thing is sort of this get to mentality, not have to mentality. So I've always operated from this like. Hey, you know, there's an emergency here and the clients are awful, like, you know, the nurses who come back and tell you that they're going to be the worst clients of your day.
Like, okay, that's a great thing to hear. And so you could say, well, I'm next for a case. I guess I have to take this case. Or you could say, I get to potentially defuse a bomb in room seven, right? Sounds like a cool challenge with little downside. Like, well, I get yelled [00:15:00] at, or will they be annoying or will I take it home?
Sure. Like maybe, but I don't know why, but I've been drawn towards those situations. Maybe because I've had some success with few of them early on, maybe because I'm always pretty good at empathizing with. The other side of the exam room table when I had kids and I would take them to the pediatrician, I would get reminded of what it's like to be on the other side of that table.
I remember when I first got a pet as an adult and I took them to the vet and I was in vet school, by the way, when this happened, it like clicked for me what it's like to be on the other side of the table. And I told myself, don't ever forget that. Because it's easy to forget when you're just trying to see room after room and help pet after pet.
Right? So I don't know what it is about me, but I, I love going to New York City and sitting on a park bench and watching the weirdos. Right? Like, I'm just a people watcher. I'm an introvert. Like, I'm, I'm actually, you know, it's tiring for me, but, but I. I do love it. [00:16:00] I love difficult people. And I think that way, like, you'll be less burnout because you sort of understand it's part of the job.
And, and if you look at it that way, maybe it could be a good part as weird as that sounds. Yeah, no, I think mindset's huge. And once you see it work, once you kind of get that reward, and you're like, I did that. It's like, oh, wow, we went from, you know, the bomb to all right, we're talking and we're. We're getting somewhere.
So that can be really rewarding. The term burnout is probably getting overused now. We're probably getting sick of hearing it, but it, you know, there are some opportunities I think to help make, especially emergency medicine, more of a sustainable career. People are also going to get tired of me telling the story, but when the Merck animal health did their.
Study on, I think they use the term well being study more positive focus, well being a study several years ago [00:17:00] that the part that stood out to me was actually when they told a story about going to a veterinary school and talking with some of the students and one of the students when they said, So what are you interested in doing?
He said, I'm really passionate about emergency medicine, but I know I'm going to burn out. So I'm still working on my black at plume. Wow, that's, that's a terrible mindset that we, you know, the, the way that this is being discussed is it's being accepted as it's just going to happen. And so I'll just need to come up with a backup plan instead of working on what can I do to make this sustainable so I can continue to do this type of medicine that I love.
And so I think mindset's a good. A good one for that. I think that's like in life in general. If we can work on that growth mindset, it's very helpful. But are there other things that you found that you could do to help make it more like you are ready to come back the next day that you aren't getting tired of this?
Yeah, this is a really hard one, but I get out on time most days [00:18:00] and, you know, that sounds basic, but I bet there are very few emergency doctors who actually say that, but I've prioritized it since I, my first year after my internship. And I think I bugged some more senior emergency doctors because I wasn't what I called a clock watcher.
And there are people who are clock watchers that are like, Hey, like, you're the junior ER doctor. You can't leave on time. If I'm not leaving on time. And I always said, BS, like, that's your problem, not mine. And I did it because I think you're right. Like this, most emergency doctors burn out after five years becomes a self fulfilling prophecy if we, if we aren't careful with it.
And so it's really not fair for me to say this because I'm, you know, doing emergency medicine part time, but, and I could have gotten there, who knows. Right. But I will say early in my career, when I was doing this full time, I was very careful about getting out on time. Repeatedly. Now, there are days where you don't get out on time, right?
Because you're your patients come first and your clients come first. But what I mean [00:19:00] is I made myself really efficient. I would do the work ahead of time to have systems in place so that I would get my records done. I never write records after I go home. I Was not on social media in between cases. I was doing things to get me ready to go home and see my family on time.
And I viewed it as a mission that would make me more sustainable over time. Because if you're doing 12 hour shifts. And they're actually 16. I think you can add up all those extra hours and just take them off the backside of your career because you can't do it. And I've seen it over and over. And we're also passionate about what we do.
Like, you know, veterinarians aren't here for the money. We know that they're driven by very different things. And so. I think it's hardwired into people to just keep doing it because there's dopamine hits and continuing to see cases towards the end of your shift and not writing your records because there's no dopamine hit in writing your records or being, you know, creating a system of handouts so that when you write one, you've [00:20:00] got it now later for, you know, all the cases that you see after.
So. I think that is one of the biggest things that I did over my career. And then the other thing is systems around making yourself confident. I think it is, you lose so much time in not knowing what to do with a case. So when I watch interns and new graduates, you become so much more efficient when you know what to do and you know how to think, and you know the tools to go to that help you make decisions in decisiveness because you want to do a good job.
Makes you not only not go home on time, but it also makes your work, which is most of your life, just not a happy experience. And so if you work on those two things, I think it works really well in your favor for the long term. And ironically, I see how instinct can come in and help us. Do a lot of what you just talked about.
So let's, let's go back. Cause I don't know if it was all in your mind at the time, but you started talking about, you, you fell in love with a problem that you saw in veterinary medicine. Do you [00:21:00] mind talking about what was that problem that you saw and what were kind of the steps that you started to take to figure out how to solve it?
Yeah, falling in love is a really positive way to say that. I like the problem. I mean, the reality Megan is I hated, you know, the problem. I mean, this is born of, like, extreme disgust in me, but you're right. It's an obsession with the problem in a not healthy way. So it started when I graduated from vet school.
So when I came out of that school, I went into an internship in a very progressive, large specialty emergency center in South Florida called Coral Springs Animal Hospital. And back then they had won, you know, multiple practice of the year awards. They were, I say that because they were trying to do everything they could to be the best, right?
Every tool they would invest in anything, systems, new building, top clinicians from around the country, like they were very forward thinking. And that was why I was drawn there as an intern. And they had great leadership. You know, the backdrop to this is I'm one of those weirdo [00:22:00] veterinarians who never was a nurse.
I was never a technician. I think some of the best vets were I wasn't and it is what it is. But I really just hadn't spent much time in the real world. So I go to vet school. Right? And. When you're in vet school, you're just trying to survive and learn. So I'm not really paying attention to systems. Like this is back in 2008 when I graduated from Penn.
Okay. Just to shape the world. So there were no iPhones. Okay. I was carrying around a Dell Axum, which is like a Palm pilot competitor because I was like in nerd mode. I was always using systems to make myself better. So in school I was the only one, I mean, everybody else was like, what are, what is wrong with that guy?
I had some. Plums version, which is actually very telling going forward. I had created all my rounds notes in a digital way on this thing. So basically I was like, I could, I had tools, right. And I was always trying tools to make my life better. So fast forward, I get out into the real world. [00:23:00] And I start, you know, practice my first day as an intern and my first year was on paper records, which is rare these days.
But back then I did spend a year on paper records, but I went through the next year, the transition and around then a lot of these. Especially the progressive large hospitals were for the first time making the transition off paper records into digital. And the way they were doing it is in these antiquated legacy systems, because they're all that existed.
And these systems were built to be the cash register and the Rolodex at a hospital. That's what the systems were used for, for the better part of a decade or two. And now they were releasing rudimentary features to retrofit these things with your medical records. So all of a sudden my care was filtered through the system, right?
And I became obsessed with how bad it was, and I could see how it was starting to affect my peers. And I became obsessed with this problem. And I looked around, I said, there's got to be better systems. No, I thought we were using the best [00:24:00] that existed. The hospital owner at that center got me on IDEX's software advisory board.
It was called the cornerstone referral advisory board crab. I don't think they liked that acronym back then, but they, they named it, I guess. And I was the only clinician on this. So what it was was a group of practitioners from. Some of the top centers out there that were using their system and in the referral community.
So it had like AMC in New York and University of Florida and a bunch of the other schools that were using it and they were trying to help them make it better. But it's a really hard problem when you have legacy systems. I think IDEX was doing their best to try and I commend them for that, but it was, it was a losing battle and I, I was the only clinician on it.
There were a bunch of IT people on it and I probably annoyed everybody. But I started to become obsessed with this problem back then. And the other thing that shaped it is I had spent some time in industry. So summers between undergrad and vet school, and I think even [00:25:00] early vet school, I worked at a global consulting firm called Google.
Google. Booz Allen Hamilton as an intern in the summer. Okay, so very few people know what you know that is or what consulting is. And it's always like a nebulous thing. But the easy way to explain it is companies or government agencies would pay them huge amounts of money to solve a challenging problem, right?
They would say, we've got this problem. Here's a lot of cash. Can you just fix it? That's the best way I described what I was working on. And they needed an animal health expert to work on a system that I think the USDA was developing. But what that experience really gave me was the view of what other industries were doing with technology that veterinary medicine was not.
And I sort of saw the workforce getting really inefficient. And so I started tinkering with all kinds of systems because I said, you know, This is the best PIMS I think exists. That seemed like, you know, a given. I knew nothing about coding or technology or software back then, but I just I was a hobby technologist.
So I started putting systems in place for the [00:26:00] whole 50 doctor specialty hospital. So here's a great one because it shapes what I did. Looking back, I over engineered an Excel, and then later Google Sheet when it came out, treatment sheet for the specialty hospital. So I created this like Excel sheet. It must have taken me hours on weekends.
But I coded formulas and calculators, and I created templates for all the things the emergency team started seeing over and over again. So I had like, you know, the gastroenteritis one, I had the foreign body post op. I had a GDV. I had hit by car. I had all these templates. So you could just open the Excel sheet.
You'd print it out instead of writing it every day. And the whole specialty hospital adopted it, which was kind of funny. And that was shaped because we all know that these treatment sheets end up becoming a huge problem in hospitals. They have to be gathered up every morning by the billing team. And you don't know where you're Care is when you're trying to round and I once dumpster dove with a nurse for one because it was like a huge ICU sheet and we don't know what happened to it.
[00:27:00] And usually if you can't find it, it ends up swept off the table into a dumpster. We found it. But all these things sort of shaped how I, how I sort of got here. So hopefully that gives you the color of all the things that led to it. Yeah. And, and then also around this time, I think you, you started a blog too.
Was that also to kind of. Get out some of the thoughts and things you are seeing, I guess, not on digital paper, because I think that's a really cool aspect of your story to as you started to really publicly talk about this and in your blog, which, by the way, whoever does your logos and everything, like pick the brain is I love that logo.
I love instincts logo. So kudos. But so is that also kind of around this time as well? Yeah, we have some really talented people on our team, and we have one designer who does all that, and she is incredible, and I've worked with her for years. So, yeah, the blog came about because a few years after I started tinkering with all these systems, so I [00:28:00] created like TV screens of like a status board and all this stuff.
And by the way, I created lots of stuff that failed. Um, but, but the stuff that worked and stuck, people were drawn to. And so we would host CE events for the 600 referring veterinarians who would send us cases. Right. And like every once in a while, they'd all come in for a CE event and they'd go, how, you know, they'd ask the hospital owner, how'd you make that?
Or how'd you do that? And, and the real story about the blog is. I would get deployed to these hospitals because they would go, Oh, we have this like emergency doctor who does this stuff. He'll come out and show you. And I would get deployed as part of my job. And I'm an efficiency obsessed person. And that was really inefficient.
And so the story of the blog is I wanted to be able to give out links to some of the things. So the early blog was just like, here's how I did this. Here's how to do this. You should try this. It's huge. And that, yeah. Led to speaking engagements and writing articles for, you know, publications like clinicians brief that I really didn't intend.
And [00:29:00] but what I started to see by putting my thoughts out there is. I'm not the only one with this problem and that actually, I know that sounds weird, but like when I was at my hospital and I really look back on like 2010 Caleb, I just thought it was our problem. I don't know why I wasn't thinking about solving like building a PIMS for the future.
Right? I was just like, this is ridiculous. And so here we go. But then when I started speaking and writing and I just saw that everybody had this problem and I was like, huh? Yeah. Maybe I can be part of the solution. And that's when it first clicked for me. I did have no tools to build a software company.
It wasn't, you know, even remotely in my mind, but it just clicked that everybody had this problem I had become obsessed with. And it sounds like other people really were noticing. And I, this is just super important, especially now of part of your story is that you started working for brief media, which I did not recognize that word just as standalone.
But [00:30:00] when you look at it, you're like, Oh, I do. I see this where it's coming up. Yes. Because that's the, like the original. Like digital plums and everything that you helped with as well with Elizabeth green. And she started that over 20 years ago, I think was brief media. And she was working on her MBA at the time.
And now she's like the Elizabeth green. So, so what was that experience? Well, that came about because of the blog. So I tell this story. I mean, it's, it's something I tell when I lecture to the, I do a lecture on how to thrive to students all over the country as a new grad is, is sort of the lecture and, and I tell this story about just chasing, you know, what you're passionate about because you can, you can put a lot of energy into it, but you never know where it's going to take you.
And that is definitely my story. So. You're right. A lot of people don't know the, the name brief media, then they change it to vet medics, but that's like the parent brand to clinicians brief and plums. And I didn't know the word brief media either, but in 2013, I started writing this blog and I wrote [00:31:00] this article about different digital tools for pharmacology references.
So I'm a pharmacology nerd. I always have been, but there was nothing good digital. And if anything should be digitized, I was like, come on, like plums at least. Right. Okay. And I wrote an article about this and some human health resources, and I didn't know this, but brief media, then just, they were clinicians brief, which I knew and read every month was partnering with Don Plum, the author of Plums, who I didn't know was a real person.
I just never thought about it. Right. Um, but they had partnered with him to finally build a high quality digital reference out of the. you know, 20, 30 year old textbook. And, and it was a great idea, but they didn't have anybody who understood how veterinarians use it to sort of run it. They had veterinarians, but they weren't tech savvy or they, you know, had their hands full.
And so. I was sitting in my kitchen one day and I, I had a gmail notification about an email and I opened it and I [00:32:00] remember getting it and it was from Elizabeth Green who introduced herself cold over email, said I'm the CEO of brief media, which runs clinicians brief and I love your blog and I read your post about pharmacology.
I would love to talk to you. I remember showing my wife. I was like, The CEO of clinicians brief emailed me like it blew my mind and my I think my wife's reaction was are you sure it's not spam? Yeah, which is like, okay great. It wasn't it was really her and she wanted to meet at BMX in a couple months And I was going for CE and so we met And we had breakfast and that led to me being told about their project and they were looking for a veterinarian.
And I did a little bit of consulting over the next few weeks for them. And then they offered me a job. I was director of new product development, which I was not qualified for that title, by the way, but they had a lot of faith in me. And I'm a learning animal. And I just started reading everything I could about software development.
By then I had already thought about starting a company. You know, my idea was to build software for veterinary [00:33:00] practices of the future. Which is what instinct will become, but I had no tools or understanding of how to do it. I had been on about a year of a journey of reading, listening, doing everything I could to start to educate myself on what it would take to run a software company.
But I had no people around me who knew how to code. I taught myself to code 1 summer realized I was really bad at it and I didn't like it, but. I took that role because I said, who knows where this will lead. And so originally, actually I told her no to the job offer. And I remember my wife being like, are you crazy?
Like, this is a great opportunity to enter industry, try something different. But the reason I said no is I felt actually really guilty about leaving practice is the honest answer. I loved practice. I felt like I was good at it and I was only about five. Maybe 5, 6, 7 years out, and I felt like it was too early.
It felt like the thing I would do, here's the self fulfilling prophecy. I said to myself, that's something I'll do when I'm burned out, right? Is what I was telling myself. But I wasn't burned out. And I said, maybe in [00:34:00] 20 years, right? And I actually emailed her no to the job. And then, like, I think a few days later, I said, Could we have a phone call about this?
Is there any way I could stay in practice part time? And she's like, yeah, why didn't you just ask? And so we worked out an agreement where I stayed in practice halftime and I worked halftime working on plums and I built a team. There were a couple of people there that helped me lead this. And back in 2014, we started working on the plums application and what it would mean to build a plums application.
And I taught myself everything from, you know, high quality software development to design, to managing software life cycles. To QA to commercialization. I knew nothing about sales, high quality support. So, and I found out I had a blast doing it. Like, I loved it and I like creating. So that was probably part of it.
But in 2015, we launched problems. It's obviously super successful. It's definitely a full circle sort of story because I left to start instinct as, you know, and a couple of weeks ago, instinct acquired the company that opens clinicians, brief and [00:35:00] plums, which is, you know, I realize a pretty ridiculous statement, but.
When you understand our journey, it makes complete sense. It's the next logical step for both of our companies. And it's a really cool story because we know each other very well. Me and the team there and Beth Green have become friends over the years and have a lot of mutual respect for everybody, which is a really cool fit for something like this.
So that's the story at a high level. Yeah. Well, and that also speaks volumes to the importance. Of building relationships as you go, right? Because you, I mean, not that you're thinking this in the moment, right? It's like, well, I never know, you know what, when I'll need something, like, that's not the right mindset, but just being that good person and caring about people and building those relationships still rewarding.
And as this is a great example of that is it was is probably a Pretty, I mean, I'm sure it's still a lot of work. Acquisitions are no joke, but you know, you knew these individuals, you knew how it [00:36:00] fit in beautifully together. And so if you had to compare all acquisitions, this is probably a fairly smooth acquisition for you.
Yeah, so far it's been, I think it's really been magically sort of comfortable and I hope both teams feel that way. I know it's different for my team, which is acquiring and their team, which is being acquired. But I think we've been able to show in the first few weeks and build the trust that we need to.
That, you know, we're a great partner for the next adventure of these important products for the industry. And, and I think instincts become the kind of company that, you know, we're proud to bring them in and we're able to, it's sort of the scale we are now. So, yeah, and this is a total don't burn bridges story.
I mean, we left to start our own company, which could be a contentious thing at some organizations, right? Me and a few who worked on plums decided to leave because we thought that's what it would take to start instinct. Not, you know, do it on our own. We felt like it was big enough and I could see a lot of ways where both sides would burn bridges over that.
Right? [00:37:00] But we didn't. We stayed really good. Colleagues and partners, we, you know, in the early days, we integrated plums, plums had never been software and we integrated it into instinct, which was really unique. And we worked hand in hand with their team. Sometimes their team would call on me for advice, or I would call on them for advice on certain projects.
And we would always. Be there for each other. So, yeah, I mean, it is a relationship story and I think it makes this a lot easier and better acquisitions are still a lot of work. I don't think many people understand that we're still catching up on sleep, but it's a really exciting thing and I think it's going to be amazing for the future of the industry.
And then this is where I was thinking about all that you are talking about when it comes to efficiency and building your confidence. If you could take away a lot of these little things that really start to add up and not only reduce your efficiency, but it also definitely impacts your, your mental well being too.
Because again, back to me, not being a very Confident early veterinarian in practice [00:38:00] being able to look up medical doses like I'm sorry. Pharmacology was not my favorite topic. That one was really hard for me, which is really sad because my dad's a child psychiatrist and he's like all about medication.
So I didn't get that one. But they were really challenging for me to remember. And I mean, yes, I walked around my little one. Cheat sheet notebook, but being able to do that in a system. And I think there was one that I saw where it will also like, if you put in two medications and they may have some, you know, drug interactions.
Yeah. That'll pop up and say, are you sure? And then you will be able to, I mean, Oh my God. If I knew that I had that behind me, you know, digital double check, I think that would allow me to have that additional confidence that you need to kind of build, we have to make so many decisions. There's so much going on.
All those systems can really, really make a difference. This is the, yeah, this is the, you know, the problem that I'm [00:39:00] obsessed with. And I don't think it's the way most people think about it. So I think a lot of people think of like, oh, we need to build a PIMS because this one's ugly and it looks like Microsoft DOS.
And it's like, yeah, I mean, that's that needs to be improved. But the real opportunity is exactly what you said, right? It's the things that these systems could do, but nobody's even attempting. So, yeah, I mean, early on, we, I challenged our team to build these patient safety warnings, which had never been done that I know of in, in, in a veterinary software and in all of the huge hospitals that we were in, we turned it on one day.
And if you went to put an overdose of ketamine on the treatment sheet. Which is super important. Instinct steps in and goes, are you sure? And by the way, we do this in specialty hospitals. We know because of how many times the warnings are triggered, they weren't there. We do these hundreds of times a day.
Probably right. They don't often don't result in major issues because our nurses are amazing and they may catch it. [00:40:00] But the Swiss cheese model, if you've heard of for patient safety, yeah. Every once in a while, all the holes are going to line up and one's going to get through and that patient's going to either die or be harmed.
And that has a huge spiral effect on the team that endures that, right? Obviously, the patient is harmed by it, but we also forget about what that does to the team because nobody's doing that intentionally. Right? So. This is an example of where software can have a really meaningful and powerful impact.
And it, it gives me the goose bumps to say that we're actually doing something about it. And we're not even close to done. But those are the little things that I get so excited about. And plums pro this new tool that they have is just something I. Dreamed of when I was a veterinary student or wished for, I guess, and they're early in the journey on it, but I think it is going to be so exciting because human health has this.
This is a fixed problem. We don't have anything like this. And we're wandering around in the clinic floor, not [00:41:00] even realizing we should, which is always crazy to me. You brought up drug doses. I remember in school how helpless I felt because Plums was published every four or five years and my clinical year, someone will probably fact check me on this, but I'm pretty sure it was like in the third year since it had been published.
So I felt like Plums was useless actually. And that sounds so silly, but for forever, every four years, a textbook would be published and updated. Right? And it shouldn't be like that. It doesn't have to be like that. Plums is now updated almost daily. I don't think people realize that some of them are really small things, but that's incredibly powerful.
So that when you go into the app and you look up a drug, you know, That it's so up to date because there's a team behind you making sure that whatever you're looking up has all the up to date information and that clearly you're going to have to tase me because I could talk about this all day gets me so excited.
No, I love it too. And again, I'm kind of thinking back on starting [00:42:00] practice and like how all of those things I think would have just been a game changer. And when I was an intern, I, I was at a hospital that transitioned from paper on to. The digital medical records, so I can also say I've also lived through having to change and it is challenging, but man, it's worth it when you have all those.
Yes, it takes a little time to learn something new, but you will, you'll be so grateful. Afterwards, when you do start to see all of the efficiencies start to add up. Well, unfortunately we are running out of time. So I, I want to switch over to just some final questions, but the first one is, is, is there something that's just top of mind right now that you would like to offer the veterinary profession as maybe something like words of encouragement or something you're excited about it with the future of veterinary medicine?
I think the thing I'm most excited about and I, um, [00:43:00] I got to meet you at VMX and I sort of told you this too, but there's a whole new generation because you're like, I don't want to age anybody here, but I think you're like 10 years after me. So I see you and, and there's a lot of people like you doing some really interesting things in the profession.
And I get really excited to see another group. I have a group of friends who. I, I view as my generation and we like did some things beyond clinical practice. And, and now I see a whole wave that I keep meeting and it's really encouraging just to see that people are doing different things, whether it's sharing stories like you are, or writing about the future of AI or opening up clinics with a different model of ownership.
There's so many people doing some really cool things and you probably meet more of them than I, than I do. But I would say this profession is so special. It's. You know, it, I think we, like you said, we, we talk about it in a really negative way sometimes with the best of intentions. Right? But I think it leads [00:44:00] to the self fulfilling prophecy I mentioned earlier.
And I wish it was flipped a little bit. You can do anything you want in this profession. And it has this like mix that I always think of that. I can't think of another profession that has it where you, you have, you know, helping. Yeah. You have a prestigious job that people respect you. You have unlimited challenges.
There's entrepreneurship opportunities behind every rock you lift up. It's a community that's pretty small. So you get to, you know, I'll see you at conferences every time we'll, we'll know each other. You have the ability to literally literally do everything. And I think that's so exciting. I completely agree.
As you know, I, it just gets me so excited, which again, is. One thing that is so exciting about doing Vet Life Reimagined is I get to hear everybody talk about this and it's just, just inspires me every time. So I love it. But to learn more about you, do you have any interest or [00:45:00] skills that maybe not a lot of people know about?
So Yeah, I mean, I have a family that takes up a lot of my time, and those of us who have kids know that means you just sort of get exponential pets, so it's like with every kid comes a bunch of new pets, so that takes up a lot of my time, but I guess things people don't know, or maybe are surprised by.
The nurses who work with me in the clinic know this, but I listened to a lot of hip hop. Most days I'm doing my work with headphones on. I do my best work with headphones on hip hop in my headphones. So that's one thing during the pandemic. I took up a hobby that I had always been really interested in, but my kids got me more interested and that's astronomy.
So I started dabbling in astrophotography, which is, you know, actually a really challenging. Type of photography, taking pictures of the night sky. So maybe that's one thing people don't know. I'm no expert at it and I wish I had more time for it, but I, over the past three years, I've started teaching myself and taking some classes on it.
That is [00:46:00] fascinating. One of the things that was kind of fun moving from St. Louis to Savannah, Georgia is. The sky is so much clearer here in Savannah and I love it. Like you can just look up and you see all the constellations. So if you make it to Savannah, it might be a fun place to try to take some pictures.
So yeah, that's awesome. Now, is there anything on your bucket list that you would like to do? And this can be unrelated to veterinary medicine. It can be related, whatever comes to mind. Bucket list. I it's travel for me. I love travel. So I didn't travel much as a kid. My parents weren't big. But in my adult life, starting in college, I started traveling internationally for the first time and my wife loves it too.
So it's starting to take my kids on more international excursions. So there are so many places I haven't been to. I checked a couple bucket lists. Items off. I saw the Aurora Borealis in Sweden, which I highly recommend to people. I would love, I'll list one. I would love to [00:47:00] see the Southern Lights in Antarctica, which I know is a crazy thing to say, but I almost did it.
I had a trip planned during the pandemic, which got canceled and I never did it again with friends. So we were going to go down to South America and potentially end up on a, you can take a boat, but maybe I'll, I'll list that one day I'll do it. So. And well, now you can take a picture of it because you, you've learned how to do that.
So there you go. Maybe, yeah. Yeah. Very cool. And finally, what is something you are very, very grateful for? What's something I'm very grateful for. So I think I could say my family, cause that's an easy one, but I'll stick with veterinary medicine. And I, I tell my team this all the time, but I am extremely grateful to have the opportunity to be working on these problems for this industry.
In some ways, I feel like I shouldn't be the one that's the imposter syndrome in me. Why aren't other people fixing these? But that's also how I got into it. And I always say, I feel extremely grateful every morning to wake up and be able to work on these problems with this team that I've [00:48:00] surrounded myself with.
For this industry that I care a lot about and that's that life reimagined. And I am so glad you were here. Thank you to Dr. Caleb for taking the time during a busy conference time and acquisition to share his story. I also want to thank our buzzsprout monthly sponsors fire consulting, and we'll Hughes.
We have some new sponsors that are contributing to us. special campaign coming up, so stay tuned. Make sure you check out the YouTube channel for video additions and shorts. I also received a beautiful piece of feedback this week on LinkedIn, letting me know that VetLife Reimagined is impacting you is really encouraging for me.
So thank you. And until next time.
