How Dr. Kate Elden is Expanding Access to Care: Future of Veterinary Telemedicine

What if the future of veterinary medicine isn't choosing between in-person care and telemedicine — but learning how they work together?

In this episode of Vet Life Reimagined, Dr. Megan Sprinkle sits down with Dr. Kate Elden, Chief Medical Officer at Dutch, to explore how veterinary telemedicine is expanding access to care for pets and creating new possibilities for veterinarians.

Kate shares her remarkable career journey from equine medicine in Malibu to canine rehabilitation, practice ownership during COVID, and ultimately helping build one of the largest veterinary telemedicine platforms in the country.

Whether you're curious about telemedicine, passionate about improving access to care, or simply wondering what the future of veterinary medicine might look like, this conversation offers an optimistic and thoughtful perspective on where our profession is headed.

Resources:

• Video version on YouTube
• Podcast episode guide on Substack
• Dutch Veterinary Telemedicine
• PetSmart Charities Access to Care research
• Human Animal Bond Research Institute (HABRI)

Subscribe, share with a colleague, and keep reimagining what's possible in veterinary life.

Transcript

Kate Elden: [00:00:00] I want to kind of like have an influence, leave something for the people that come after on how care is delivered and the people who can get veterinary care, and so I saw this opportunity as a way to really do that

Megan Sprinkle: A childhood human-animal bond moment planted a seed that eventually took her from equine medicine in Malibu to building the future of veterinary telemedicine for over a million pets across 50 states. Welcome to Vet Life Reimagined. Dr. Kate Elden always knew the human-animal bond was something special, but she couldn't have dreamed how it would shape her life and career.

Kate will share a special part of her childhood that etched the human-animal bond into her eventual pursuit of veterinary medicine at UC Davis with horses firmly in her mind. But as you probably figured out by now on the podcast, things happen and life can change. What [00:01:00] followed an accident was a fascinating winding path from canine rehabilitation, small animal relief work, a brand new clinic that opened just before COVID, and then telemedicine, a pivot she was skeptical about first and then couldn't stop believing in it.

Today, Dr. Kate Elden serves as chief medical officer at Dutch, a subscription-based veterinary telemedicine platform that has now facilitated over a million veterinary interactions across all 50 states. She mentors the nearly 200 veterinarians on the platform, helps shape the future of how pet care is delivered, and is one of the most passionate voices in the profession for reaching the 52% of pets that are currently getting no veterinary care at all.

In this conversation, we talk about Kate's remarkable journey, what telemedicine actually makes possible that in-clinic care can't, the changing relationship between pet [00:02:00] parents and the profession, and a striking survey finding about veterinarians and access to care that she can't stop thinking about.

It's a rich conversation to the very end. Let's get to the conversation with Dr. Kate Elden.

You had some early experience when it came to kind of the power of animals.

And so, while you may not have jumped right into vet med at, at birth like some people , uh, what was your early experience with your family and how animals impacted you?

Kate Elden: Yeah. Thanks so much for asking. So, it's true, I wasn't one of those, one of those vets who, like, came out knowing I wanted to be a vet forever. But the, bond between people and pets was something so near and dear. I grew up with, an older brother who has a neurodevelopmental disability and some autism. And, it's a lot of things growing up with someone like that [00:03:00] in the family. but he would do some things that just, like, terrified my parents. He would step out into the middle of the street without paying attention, and then he would, he would also sometimes just, like, raid our fridge in the middle of the night.

And I have these, like, memories as a kid of seeing a lock on our refrigerator because he would, like, eat all the cheese in the fridge. and one day when I was with my mom at home, we were watching TV, she saw this commercial ... I'm dating myself here because these are old. But I saw a commercial with her of a canine companion for independence, so one of these, support dogs stopping a blind person from walking out in the middle of the street. And my mom was like, "That's it. We need one of those dogs. They're gonna save my brother." And so within a year, we had this most beautiful dog in our house, and, her name was Jamie, and she is just, like, such a blessing. [00:04:00] And One thing that happened right away after we got this dog was my brother no longer woke up in the middle of the night and no longer, was up waking us up, um, raiding the fridge.

He just, like, slept through the night. And, uh, went in to go chat with him about it, and I was like, "Buddy, what's going on? Um, you know, you haven't been waking up anymore." And he said, "Jamie protects me from my nightmares." And, you know, I was little at that time, and I already loved this dog, but then I just had this realization that, Okay, maybe she wasn't, like, saving him from oncoming traffic all the time, but man, she saved all of us so many good nights of sleep. Like, the lock came off of the fridge, and this connection that she had with my brother with a disability, like, we never knew he was having nightmares. We didn't know it was possible he could sleep through the [00:05:00] night, but he did.

And I saw, like, oh, gosh, there's so much to this connection, the non-verbal communication that we have with our pets. There's so much love there, and, um, I think the connectedness of animal health and human health, I think that there is a real connection. And actually, the HABRI, the Human Animal Bond Research Institute, publishes a lot of good data on that.

So yeah, that's, that's my story of how I got into pets, and then, you?

know, I thought I was gonna be a horse vet forever uh, when I was in vet school. But, you know, life throws you turns. I think you've experienced some of that too, right? 

Megan Sprinkle: Oh, yeah, absolutely. And again, here on the podcast, I, I hear it all the time. and I think you had a turn even before that. So I think you s- actually started out pursuing human medicine, and so what eventually converted you [00:06:00] to go to vet school?

Kate Elden: Yeah. I, I was one of those girls that was always, like, horse obsessed. And now It's kind of funny, I'm a parent now, and I thought about it. I was like, "Oh, gosh, I hope I don't have kids that are as horse as

Megan Sprinkle: It's expensive.

Kate Elden: I I know it's such an expensive.

hobby, but I was definitely one of those girls. I'm so grateful for, all the times I got driven to the barn and just, like, spent time working with horses. It really shaped me, and I learned about hard work. Um, definitely secured that, like, non-verbal communication with animals and how important the bond is. I also had a parent growing up, My mom had breast cancer when, I was in middle school, and so I saw her go through that, our family went through That and I was like, "Mm, I'm gonna become a doctor. I wanna do an MD-PhD program and cure cancer." And even did my, like, middle school science fair project on socioeconomic levels and different awarenesses of breast [00:07:00] cancer, in young kids.

I'm just now reflecting on what a Type A

Megan Sprinkle: That was in middle school? 

Kate Elden: I know. 

Megan Sprinkle: Impressive

Kate Elden: like a lot of veterinarians have this kind of like type A, you know? And it's almost our like it's our Achilles heel sometimes too. But yeah, I was thinking human medicine and then I actually did the work and I started volunteering in hospitals, worked in hospitals and just kind of I found myself like driving to the parking lot hating it.

I didn't like working inside the hospital. I still love people and helping people and always will, but I think I wanted to just be outside and with animals and so I pivoted, and turns out your human prerequisites transfer to veterinary school. So I was able to make that switch, yeah 

Megan Sprinkle: Yeah, uh, what was your vet school experience like? And, you know, what kind of... [00:08:00] A- any fun memories that kind of contributed to who you became as a person, but also maybe who you became as a doctor?

Kate Elden: Oh, yeah. I loved my vet school experience. I got to go to UC Davis, and I think some of my best memories come down to this, like, companionship that I had with my classmates. there's still a bunch of us that are still really connected, and even just this morning, um, one of my friends who is an internist in Annapolis a video of her colleagues, at surgery opening up a kidney and finding a kidney worm.

And, you know, we're all chatting daily about these things, and we're living different worlds. Like, I'm doing telemedicine. She's an internist. We have another horse vet. We've got, you know, one that's doing urgent care and, and GP. So that companionship, like even in vet school and our different interests, I [00:09:00] feel like now I still just...

I love all veterinarians. I think that there's this, like, common thread of we all do it because we, you know, care about animals, and I can just, like feel that in vet school. I finally felt like I'd found my people. And my memories come from just the fun that we had. I, I can remember, some jokes that we played on our own, instructors, our own professors when they were up there, and we just, you-- know, we had, we had fun with it.

So 

Megan Sprinkle: it's, it's good to embrace the type A-ness, but also to be able to have fun with things, right? Like, sometimes we have to remind ourselves that it's, you know, we need to enjoy life too. So no, I'm really glad that you built such strong relationships, that you had some fun and, could, you know, play some jokes on the professors.

but I, I was kind of looking back at some of your experiences and, all [00:10:00] throughout vet school, I noticed a lot of equine, experience and getting into the, I think you were president or co-president of AAEP and you were on the foal team and... So were you pretty much focused on the horse side as you went through vet school?

Kate Elden: Oh, yeah. I was all horses all the way. And even if you'd asked some of my friends that knew me in vet school if

they thought I would ever be working with dogs and cats, they would say, "No way. This girl..." Yeah, I was president of the Equine Medicine Club with a friend, and, yeah, I was so focused on that, and I have no regrets.

I had, you know, I had a lot of fun and I, I got to, work in the mountains at a horse and mule pack station, and both deliver rural care that way, and, you know, within the structure of a veterinary hospital, and just thought I was gonna work with horses forever. Um, and then I did, an internship in Colorado.

So I worked in Colorado for a [00:11:00] year and then came back to Southern California, and was driving around Malibu. I had this great job after my internship. I had my own technician and my own X-ray and ultrasound unit, and I was taking care of the horses of the rich and famous, really high-level performance horses and backyard ponies. And then one day I got kicked, I got kicked pretty bad. it was on a pre-purchase exam, and this horse was just being naughty. and his hoof came really close to my head. He cow kicked me, I wasn't behind him. He, he kicked me, like, when I was kind of at his flank. and my collarbone was broken, and I had some time to just kind of reflect on, uh, this choice that I, you know, that I thought I made for life. And I was like, "You know, maybe, maybe I'm gonna try something different." And actually, I got into, canine rehab and worked with a canine rehab facility. I was like, [00:12:00] "Aha, I can do this," like treating a dog like a small horse. That felt really natural. I was doing that for a bit, and then just started doing relief in practices and, and, I got lo- I lost track of your initial question, Megan. What was that? Did I answer it? 

Megan Sprinkle: It's okay. You went down your journey. That's how we do this, so it's this is fine. Well, I, I thought it was interesting when I was listening to some podcasts that you've been on. I, I mean, what are the odds? I think you said that around the same time you got hurt, so did your husband, and so it was probably like mutual reflection.

But I, I thought it was interesting because I think you, you mentioned that you both ... You know, when we're faced with hard things, we can often learn a lot about ourselves, and you said that, you know, you both kind of l- uh, looked at your challenge but maintained some type of positive outlook. And, so do you mind describing a little [00:13:00] bit about that?

Because, I mean, s- certainly that had to have impacted, you know, how you look at the world.

Kate Elden: 100%. So yeah, I had been working in, um, in the LA area as a horse vet and then got kicked, and I couldn't do my regular job in every way. And so, yeah, so I was rehabbing, and I reconnected with, my now husband who I'd known since high school. And he, around the same time, was hit by a car, by a drunk driver, and he is lucky to be alive. He, broke a lot of bones. He was unconscious for an hour, and, came back from this injury, and himself, he was, just hoping that he was gonna get all of his, like, cognitive abilities back, too. So both of us went from, being in a place in our career where we had, like, made it. You know, we were doing the things that we set out to do, and then, like, life literally gave us a butt-kicking. And we [00:14:00] had to, you know, we had to come back from that, and I think what we both saw in each other was the same thing, was that- like anybody can be nice when life's going well, when things are going well, right? And, it's easy to be your best self and especially when you're dating people to do that, um, when things are going well.

But it's when you're presented with like a challenge or when something really hard happens is when you see what people are really made of, you know? And do you make this choice to say, "Hey, I'm gonna make the most of this," or, "I'm gonna turn lemons into lemonade," and, "Am I gonna wake up every day to choose to be happy?" and I saw that in my husband, and that's what I wanted, and it's a bit of fortitude. And actually, I think it's a leadership trait too that I've learned over the years because ... And as a mom, all moms are leaders. you can wallow in the negative things. Like, we all have a negativity bias, right?

That's like a survival instinct in a lot of ways, but it doesn't [00:15:00] serve us well in these moments of leadership, in life. So, uh, the choice to have a positive outlook to wake up and be happy and, and be grateful for the things that we do have. so I did that and I saw that in my husband, and I was like, "You know, maybe I kinda wanna have a family someday." And I think the lifestyle of being an equine vet is gonna make that harder. And so I, dipped my toe in the water of small animal medicine, and I loved it. I loved being able to help my friends and family out that had dogs and cats, this whole world.

that, you know, I, I used to tell them when they had a dog question for me, I would say, "Oh no, you have to go talk to a veterinarian about that." I joke, but though a lot of horse vets feel that way because you don't work on dogs and cats, and then, know, you learn. It's a, it is definitely, it's a scary thing for a lot of vets shift from equine to small animal [00:16:00] because you train so hard in that specialty. but then yeah, you, you shift.

It's a career change. And gosh, I just, I loved... I could help so many more pets every day, and that was really rewarding, so I had a good time with that. And then I, I was working in, um, some private practices doing relief, and I got to work in Banfields and in, VCAs. I did a lot of different things within, uh, small animal practice and had reconnected with a mentor of mine and opened up this brand-new shiny hospital in a part of San Diego.

And we'd just kind of like gotten the team all trained up, gotten the place running, and then COVID hit So, so, you know, I, I worked hard at Small Animal and then built this thing, and then I was like, "Oh gosh, okay." And so many practices closed their doors during COVID, um, and ours did too. And another moment of [00:17:00] reflection was like, "Okay, now what am I gonna do?"

and I started doing telemedicine, and that's what led me to where I am today. And, So I was skeptical at first. It was because I was, like, sitting at home with nothing to do and I was like, "I wanna use my skills to still help patients however I can." And I did chat-based telemedicine, and I did video telemedicine, and I continued to do some of that when our hospital opened up again. But it was that, like, moment during COVID where I think I just got addicted to it, for lack of better word. Like, I just, I loved it. And I realized that for one, there were people that just weren't getting any care for their pets because getting into the clinic was really hard, and they just, like, seemed to like this kind of judgment-free zone. know? Like, "Oh, if I can get care from my house, like, then I'm gonna get more." And I was like, "Oh, great. Let me help you. I get to help you more. Perfect." and then I [00:18:00] saw for myself as a working parent, I'm like, "Oh, I can do this anytime," which is also pretty great trying to balance all the things, you know?

fitting in how am I gonna make it to this important thing at my kid's school, and also have a, meaningful career as a veterinarian and... And then I, I actually worked, as a medical director at a hospital here in San Diego, with a medium-sized corporate group, and, it was a great practice.

It was a practice I grew up... Uh, La Jolla Veterinary Hospital, I grew up bringing my pets there as a kid, so it was a little bit of like a homecoming for me. And then I, I continued to see this like, Oh, gosh, I know... And the PetSmart Charities report that came out validated this for me, is that there's 52% of pets that are just not getting any care. And I thought about those pets that I saw during COVID, and I'm like, [00:19:00] "I know that there's, more that I need to reach or that I want to reach." And I always kinda like saw myself as doing something bigger in vet med. Like, I love the individual patient care. I still do it. uh, every Wednesday I see appointments. but this idea of being able to help pets at scale is, like, really interesting to me. And so, we layered on a telemedicine, um... Or I built a telemedicine department for our, our hospitals, I liked that. I saw the value of instead of vets, like, in between appointments stopping. you know, you're, like, doing a surgery or you're, um, seeing, you know, ear infection, eye case, then break and do telemedicine.

Th-that gets kinda tricky with the technology Uh, uh, so having like a separate block where you just see telemedicine cases back to back and have the tech all set up. Like, I think we, we joked before this before this recording that, like, celebrating just [00:20:00] getting everything logged on is a win, and pet parents feel that too.

I still do that with every telemedicine case and be like, "Yes, we have our microphone working. Our video is working." it's just like another stress to vets that are

seeing appointments in the hospital, and I think that's why, like... Actually, my heart breaks a little bit when I hear some veterinarians talk about telemedicine and they've got, criticisms about it or they've tried it and it didn't work, and I can definitely relate to the, you know, it's hard to do it in between appointments, like, for all those reasons. but there are other things about telemedicine that people criticize. Like, I had one comment from a vet that was like, " How do you diagnose intestinal parasites through a video?" I'm like, "Well, I ship them a fecal test." Or, you know, like I- they have a urine test kit that they send off to the lab, and we can do a lot through [00:21:00] that.

But I wanna, like, I've realized over the years to just say outright, I don't think that telemedicine is perfect, but it's progress and helps, like, reach these pet parents that I think, you know, either it's too expensive or it's hard. I saw a patient or a client yesterday who was in a wheelchair. The week before, I saw a woman who was recovering from a surgery, that people have reasons, and I don't wanna lose them in the vet ecosystem. And I also really think that someone's zip code or the number on their bank account shouldn't affect whether they get to have a pet and whether that pet gets to be healthy. So that's my... I feel like that's my life mission right now. 

Megan Sprinkle: Yeah. You're so good at painting the picture of some of [00:22:00] the cases that this really, really helps. And so, , maybe even if you think back on when you really started to fall in love with this type of practicing, do you remember particular cases that you're like, "Oh my goodness," like, "This is the only way I would've been able to help them"?

Kate Elden: Uh, 100%, and I think there were some turning point cases for me. one was within one month I had four, feline cystitis, lower urinary tract cases in cats that I resolved through telemedicine. And for me, that was a... Like, oh, these cats are no longer peeing outside of their litter box. Four of them, one month. W- it felt like that was so much harder when I had them in the clinic. that kind of rate of resolution for their presenting complaint, FIC cases are hard to [00:23:00] treat. Sometimes those cats can be really a challenge. but what I was able to do with telemedicine was to see that, like I say, their natural habitat. I could see inside the home. I had pet parents walk me through... You know, they had four cats in the house, and they said they had five litter boxes. "Yes, doc, I've got five litter boxes." I'm like, "Okay. Show those to me."

You know, and they walk me through, and all four litter boxes... five litter boxes were right there in the hallway next to each other. so I was like, "Okay, let's work on that one." Another one was, she had gotten a robot litter box that, you know, " Yes, doc, I've got a nice big litter box. I've got two of them." I'm like, "Okay. Show them to me. Oh, tell me about that litter box, you know. When did you get it? Did it start around..." You know, so these things that people don't think to say. And I hear the argument that, you know, some vets would [00:24:00] say like, "Oh, but if you do an adequate history taking," I'm like, yeah, okay.

But a picture's worth a thousand words sometimes. And seeing at home, what the cats are doing. Also with like behavior, watching two cats, you know, one might just be sitting in a hallway, but that's actually like a sign of aggression or resource guarding. So seeing them at home is just so helpful.

So that was for me like helping those cats that were peeing around the house, like, "Wow, this is the best rate of resolution that I've ever had. Something special is happening here." And then a lot of the cases were around allergies and itch, like early in the pandemic. And just the basic talking people through like, "Oh, they're licking their paws.

Well, let me tell you what to do about that," felt so easy for me as a vet and the pet parents were so grateful. They were just [00:25:00] so grateful and that just hooked me. being able to educate, 'cause I do like to educate people and like, "Well, actually what's going on there is environmental allergies." I would just give away all the information to these pet parents if I could, which is not a good business model. I don't recommend that, but that's what I, I want to do, and I feel like I could do that, and pet parents were so grateful for it. So I think just being able to also send people some Apoquel when their dogs were really itchy and not making them

come into the clinic for it. And then I saw that, I'm like, "This would turn into a hotspot." And I saw that for some of my own cases that I also saw in the hospital. Rather than h- having to wait for an appointment so they could get their anti-itch medication early before it became something worse, I had some aha moments there, and I started to question, is it right what we were doing? Is it right to force them to come [00:26:00] in if I kinda knew they didn't have to? Oh, senior dogs. This was the other one, because I love old dogs so much. A little... I'm like a sucker for the silver fox, a little gray muzzle. Walking through people's homes to see like a step that they don't even realize is actually quite difficult for an aging dog.

You know, telling them to put a ramp there or to put a yoga mat down or a rug so they have more traction. Thinking thinking through with them about the daily life of the pet and what's important to them. Like, you know, it-- "You're always sitting on that couch on our telemedicine calls, and your dog's right next to you.

Is that what you guys do that you, you used to be able to do, but you can't do now that they're older? Let's get a ramp. like focus on making that bond accessible for them so that their dog can get back up on the couch and sit with them. So those are some examples of I think just things that like hooked me [00:27:00] on telemedicine.

Kate Elden: Oh

one more. I was working with a couple of fear free hospitals. I think I had this revelation. I'd never worked with fear free hospitals, but I started doing that when I was doing telemedicine. I learned so much, so much from... especially from these technicians that had been working in fear free hospitals, and telemedicine is inherently fear free. and being able to get pets', anti-anxiety medications before veterinary visits and then follow up with their care, because a lot of pets that go to fear free hospitals have a... They get anxious, and they have a hard time in the vet clinic, so you really do wanna manage things at home when you can. 

Megan Sprinkle: Th- those are great examples. So I wanna go back to where you said you built telehealth into a practice. And yes, I remember back when we were transitioning away from the COVID practice and [00:28:00] try to go back to somewhat of the, pre-COVID ways of practicing, getting back into clinic.

And there was still a lot of people that were trying to do both, and there was a lot of criticism about that because literally they were, they were basically trying to do two jobs, right? Like double the work 

Kate Elden: hard. I, I feel that. 

Megan Sprinkle: and so obviously that is not the right way to do it. how did you build telemedicine into a, a typical in-clinic practice?

Kate Elden: Yeah. So, and I, I had to advocate for it because a lot of vets had had that experience about telemedicine. They hear it and they're like, "Wait a second, I don't know if I want that." but what I did was I did the telemedicine appointments remotely from this very office that I'm in right now, and, We made it super easy.

It's way easier than people realize. We used Zoom links, and I had a Calendly, and I connected it up so that different hospitals could book with me and so [00:29:00] that they wouldn't overlap booking appointments, and we'd send the client a Zoom link, and they would hop on. And each practice was a little bit different with, really their just their pets that they served. Um, one of our hospitals it was more of like a concierge style service, where I would see like follow-up appointments to talk about puppy socialization um, and do like post-op surgery checks. Um, I had a couple fear-free practices where actually every appointment, if it was a new pet, before they were seen in person, we established VCPR virtually, and they got some trazodone and some gabapentin, and I started going through their medical history making sure that we are prepared for our in-person appointment. I had a super busy kind of more medicine-focused practice where I did a lot of like diabetes management and follow-up with Freestyle Libres. Like, you can do a lot of diabetic management from home. and these [00:30:00] guys were like moving and grooving, and they would have me do, normal lab consults and talk with pet parents about lab work and next steps. But the technology component of it is a lot simpler. you know, would ask me, " How do I set up telemedicine at my hospital? which system do I use?" And I'm like, "Well, could just use Zoom or Google Meet." You know, we're overthinking it. a lot of clinics are already using scribe tools.

You just like copy and paste that into their record, and there's no need to overcomplicate it. But I think what worked was separating the, like you said, separating the telemedicine from the, inside the clinic work.

Megan Sprinkle: You went from clinical work and it sounds like basically you're like, "Here, let me show you how it can work," and you kind of started by taking it on. And then did you bring on more veterinarians? What did-- or were you just the [00:31:00] only one in the clinic? Oh, wow. That's a lot of cases.

Kate Elden: was, well, I was the only one doing telemedicine. Was that your question? 

Megan Sprinkle: yes, yes. Okay

Kate Elden: Yeah, I was the only one doing telemedicine. And, we can make that work because you can adjust your schedule as you need, you know? in a hospital, you've gotta account for the technicians and the other people that are working around you and supporting you. and with telemedicine, I had my availability, people would schedule when they would schedule, and if we needed more appointments, I opened up more availability and saw more cases. So yeah

Megan Sprinkle: So what was it like to have someone who believed in telemedicine as much as you did start to invite you into doing it like a little bit bigger? What was that next step for you?

Kate Elden: Um, [00:32:00] think I was just excited. at first the, uh, organization that I work with, called Dutch, they reached out to me and my response was like, "You know, I'm really proud of the thing that I built here. I'm not sure if I'm interested in it." My first response was like, " No, I'm good." And then I thought about it more, and I just started getting more and more excited, and I always had that kind of bug that was like, "Yeah, I wanna have a bigger impact," and you know, I want to kind of like have an influence, leave, leave something for the people that come after on how care is delivered and the people who, who can get veterinary care. and so I saw this opportunity as a way to really do that and just, like, so mission-aligned. you know, I've worked with several different types of groups and, private practices and corporate groups, and when I talked to our founder about a medical [00:33:00] question early on, his name's Joe, and I said, "Joe, well, I think we should do it like this." Um, and it'll be a bit of a change." And he said, "What's best for the pets, Kate? Let's do that." And I was just like, "Yes. Yes, this is what I need to be doing." and so yeah. So it's exciting. It's different. What I'm doing now is like a startup tech company, and the pace is faster, you know, we pivot, we test, we adjust, we learn, and then we adjust, and we're growing. I'm doing a little bit of everything. Like I'm still seeing appointments on the platform, but also, there's a marketing component, there's a medical quality component, there's a mentorship component, which I love. I don't think that we realize that bedside manner is a thing, but also web side manner, you know, how you show up on camera is also a thing.

And we've [00:34:00] got almost 200 vets that work with us that I like will coach and mentor on how to show up on camera for people. that's super fun. There's a recruiting element. We're just... It's, it's exciting. And then we get to talk about, okay, what do we wanna build? What are priorities for next year?

I get to do a lot of vision planning for the future. And my vision is always that every pet gets an in-person vet and an online vet that they could use both. And I say that all the time is like our goal here is not to compete, but to complement. And I think... I mean, I just want all, vets to kind of feel this feeling of like we're in this together, and let's talk about our profession and make it as good as we can together by talking about these things.

And, yeah, not being afraid to kind of like put it all in a blender and re-envision what we think, veterinary medicine could be. I'm not a fan of like just [00:35:00] maintaining the status quo just because we've been doing something for so long, right? Pet parents want something different now. They're, they're really educated, these pet parents. Like they've got ChatGPT, the internet's working great. and so they come to us with a lot of information different than before. It's also like an opportunity for them to make errors in ways that they haven't before. So, I like being, like, on the cutting edge and being part of building the care that the pet parent right now wants. 'Cause I've even felt like I've seen a shift. Like, I don't know if you can relate to this, but even from when I've started, practicing, like, I think the relationship that pet parents have with their veterinarian is shifting, and I d- f- like, it's a little sad to me to say that people are losing trust in their veterinarians. They're educated. There's a different level of skepticism. I don't want people to lose trust in, in us, but with cost of care getting [00:36:00] so high, I think that that's also really real. you know? So, being able to, like, connect with these pet parents in a way where it's like a shame-free zone. That's also something I think I realized when during COVID when I was first starting out on telemedicine is, like, this space, when people are in the comfort of their home, and you're not ... Like, there's no services that we're selling. Yeah. And veterinarians, through our telemedicine platform, like we don't get paid for any, products that are sold.

our veterinarians are paid per pet that they help, and so, you know, like through telemedicine, the goal is just to help the pet. Doesn't matter if they buy anything or not, and I think that level of connection with the pet parent was really special. And I s- I'll say to people even now, like, "This is a shame-free zone.

Tell me if you think you're gonna be able to go into a clinic. That's what I really want you to do, but if you're not, let's talk about what else we can do [00:37:00] at home because I wanna meet you?

where you're at." and so Yeah. that like shifting relationship. I wanna just evolve with the pet parent today.

Megan Sprinkle: what you're feeling has data behind it. So at the ACVIM forum, they brought in a, a veterinarian and an economist, and he says, "We have data that cost of care is going up." That's no surprise.

 the number of clinic visits is going down. For most people, that's not a surprise. but the interesting thing was that when they looked at the income of the individuals who are pet owners who are not going into the veterinary clinic, yes, there is a segment of those individuals who financially are struggling to afford veterinary care, but that's not all of the population.

There's a lot more. And you shared with me that [00:38:00] Dutch just recently did a a survey among the people who are members or subscribers, I don't know what you call them. and I do like just to kind of e-explain, So Dutch has a... It's, it's like a subscription model, so they're, they're paying, so they have unlimited access to phone a vet, basically.

Or if you wanna clear that up a little bit, that, that's fine. But I'd love to, one, understand like how you interact with, clients, and then when you did that survey, on why they wanted to use telehealth, what was your finding?

Kate Elden: Yeah. So, you're right. We are a subscription-based, organization, so pet parents will sign up for Dutch. They sign up for a year at a time. It's about $11 a month. There are promo codes that are going all the time, so you can get a little bit off of that. But then pet parents have unlimited access to [00:39:00] veterinarians for up to five pets in their household.

And people are always like, "That's too good to be true." And it's true. That's, that's how it happens. we've had, like, over a million veterinary interactions through the platform, all across all 50 states, meaning, like, video calls, messages, things like that where our vets are connecting with pet parents.

So we've got a lot of data, a lot of interactions between pets and their veterinarians, or between pet parents and their veterinarians. And we wanna learn from our member base and, uh, learn how we can serve them. And the other when we did the survey, we broke down to there's primarily four different types of members. One was, like, the doting, pet parent who, you know, will do anything for their pet. They've got an in-person vet that's just supplementary, so they're getting this, like, perfect, my idea of perfect care. they've got the vision. then there is a financially-focused [00:40:00] pet parent where, they're on the platform because it's what they can afford, cause veterinary care is, is expensive otherwise.

then we've got, like, a, constituents of doubtful pet parents that I think, you know, whether they're doubtful of telemedicine or doubtful of veterinary care in general, they're just, like, the skeptics of veterinary medicine and what is being offered to them. And then the fourth one is, like, the busy bee person who's very active and, moving all around.

They might be traveling. Um, these tend to be entrepreneurs. And so there's, like, these different groups of pet parents that we have and we wanna be able to serve all of them, right? Um, and how do we maybe shift some of these pet parents that are doubtful, into believers that, you know, veterinary care you should before making a medical decision, talk to a veterinarian, whether that's in person or through a telemedicine platform.

these are the pet parents, and I think you referred to [00:41:00] this on one of your previous podcasts about, like, the, the lost pet parent, right? Like, and some of these pet parents are still not even finding us through telemedicine, surely. Like, We want to, all the pets, and the, the doubtful ones are the ones that we need to, to help out the most or, or to connect with the most, I think.

So this, the, like, this kind of research and customer insights helps us learn about How do we reach more and help more people? And it's really fun working with, working with a company like Dutch and a startup. I'm like, "Gosh, we have so much data." because everything is online and transcribed, it's, it's a lot easier to do that than with like a PIMS system.

You know, I've worked with all of the major ones. but just being able to analyze data, like I'm a scientist, I like seeing the data and the numbers, and I also love senior pets. I can't say that enough, but so I'm like, "Aha, I wanna start [00:42:00] talking to these pet parents at age five and six before they're saying like their pets are slowing down."

So those are the things that are, are on my mind. I'm like, "How am I gonna use this data to make sure we're connecting with everybody when it's a prime age?" 

Megan Sprinkle: I have spoken to many wise individuals and the ones also that have commented about the changing relationship, you know, the relationship between, owners and their pets have evolved. And so this world has changed, and like you said, there's, information everywhere. And, and so it's just natural for things to evolve and change.

And I, I was speaking to someone just this week about it doesn't mean that you have to be all things to all people. The great thing about this, and for your career, because you can find places where you are passionate and you can thrive, like you've described, [00:43:00] where we can work together to, in our own ways and in our own strengths, be able to connect with as many pet parents as possible, animal owners as possible, 'cause, uh, you know, maybe there'll be a, farm animal Dutch, a segment one day, and y- you can do a little equine work again.

but you know, like, there's lots of people and lots of places that having multiple business models and multiple ways to engage and support pet parents allows us to reimagine the community that veterinary medicine can be a part of, that we can create, so we continue to be part of the pet's ecosystem instead of staying with the status quo, everything like we've done, and we start to lose people.

Uh, I feel like if we don't start embracing this, those numbers will just get bigger. And so I, you know, I'm glad that you're being part of that [00:44:00] impact. And, one last question, slightly adjacent to this, but I, I wanna go back more to you as an individual in your career.

you have now embraced this ability to have a larger impact on pets, on clients, but also colleagues. You've done a lot of leadership roles and, and like you said, you're, you wear a lot of hats now, and I'm sure that this job you never would've dreamed of, coming out of vet school, this is very different.

What have you learned most about yourself, and what are you most excited about in, in your career today? what gets you excited to wake up every day and excited for the future?

Kate Elden: Oh, this is such a good question. I find all veterinarians so endearing. I just have a love for our profession, and I, I've loved mentoring. And one thing that I've realized that's been super rewarding for me working at [00:45:00] Dutch is when I talk to our veterinarians on the platform, all their stories are different, and a lot of them have said that if it weren't for working at Dutch, they would've left the profession or, they wouldn't have as happy of a lifestyle. and so being able to h- help these veterinarians stay in the profession to help, you know, them continue to use their skills for patient care. Two-thirds of our vets still work in, brick-and-mortar regular practices, and they supplement and they do Dutch, certain days of the week or in their free time. so think it's providing like a work-life balance for them and the opportunity to just do something different, and for me, that's, pretty cool. That's rewarding. and I love the conversations that I have with vets around, you know, they ask a lot of like, would you do, doc?" [00:46:00] And I think at this point in my career, I've gotten really comfortable, with talking people through doing the right thing, and it's tricky sometimes with telemedicine because we're working within regulations. We have, you know, a lot of scrutiny around judicious use of antibiotics and I would I feel really comfortable saying our veterinarians are even more judicious about their use of antibiotics 'cause they know, um, they know that there's that scrutiny out there. And then just having these like heartwarming conversations with vets around, "Well, what's the right thing for that pet?" And then they answer their own question and then they're, they're like, "Oh, thank you so much," and I'm like, " I didn't do anything. You figured that out." but just that being able to have a lighthouse and this kind of like relationship based care, talking people through how do you connect with the owner and figure out what's right for them in [00:47:00] their specific scenario, and encouraging vets to follow like somewhere on the spectrum of care whether it's, like, convenience and lifestyle fit or meeting people in a financial situation.

so that's been super rewarding, and that's, like, kind of... Those are the unexpected things for me. I love, visioning the future and thinking about maybe one day we're gonna have, more at-home testing for pet parents. Maybe one day we'll be able to do, like, an at-home heartworm test for pet parents. Um, I want all pets in the South on heartworm prevention. Like, how do I make that dream come true? Um, well, we've gotta be able to test them more affordably. I see scenarios where pet parents are choosing between, like, testing or prevention. I see that all the time. So being able to kind of affect what the future?

of veterinary care looks like, that I think is the [00:48:00] most exciting thing for me.

Like, I... That's what I get up and get excited about every day and just trying to think about, okay, what is vet med gonna look like in 10 years, and how can we build that in a responsible way, with, you know, a pets first mindset? 

Megan Sprinkle: I absolutely love that. Well, Before I ask my final, final question, is there anything else you feel like we've missed that, you would also wanna share with other veterinary professionals that you've learned?

Kate Elden: Um, I think... You know, have been grappling, um, this is a thought. Hopefully it's, uh, doesn't lead us off on a tangent at the end of the podcast. But talking about that, PetSmart Charities report with the 52% of pets that are getting no care, something that's been like circling around in my brain a lot is this idea that pet ownership and pet care like shouldn't just be [00:49:00] for the wealthy, and the veterinary care also should be accessible because we know pets are 

important 

and good for human health. And there was a, stat in that, report where veterinarians were asked what came closer to their personal views, is it that the responsibility of the veterinary industry to make veterinary care affordable for pet owners was one option, or the other option was People should not own pets if they can't afford veterinary care at the current market rates. So this has been like rattling back, like vets had to answer, is it the responsibility of the vet industry to make veterinary care affordable for pet owners, or should people not own pets if they can't afford veterinary care at current market rates? what do you think the response on that survey was?

Megan Sprinkle: So this was asking veterinarians

Kate Elden: [00:50:00] This was asking veterinarians in a survey, this like mass survey that PetSmart Charities sent out, and it's the same data that showed that 52% of pets in the US are getting no care, is that same survey went out to vets and they were asked this question of, "Is it the responsibility of the veterinary industry to make veterinary care affordable for pet owners or people should not own pets if they cannot afford veterinary care at current market rates?"

And veterinarians

were asked which view came closer to their own, this like survey response is rattling around in my head because I'm, I, I'm a hard time making sense of it 

Megan Sprinkle: Okay. Well, well where's the answer?

Kate Elden: 66% of 

vets

answered that people should not own pets if they cannot afford veterinary care at current market rates 

Megan Sprinkle: [00:51:00] Interesting, 'cause I would... Yeah

Kate Elden: like blown away by that 

Megan Sprinkle: You know, when I graduated 2014, uh, when I graduated vet school, I remember that somewhere I picked that up. Like, s- I remember someone saying that. And so when you were about to a- make me guess, I w- I was gonna say, like, if you had polled people in, in 2014, I'm pretty confident that the majority would've said that.

I am saddened that in 2026, that that is the majority answer from veterinary professionals, and I wonder if it... I mean, they were only given two options. So I wonder if it is the fear of having to re- either quality of care or reduce, basically s- practice the same quality of care [00:52:00] but at lower rates, right?

And that would be seen as attacking the veterinarian, the veterinarian's value. I see that rattling around people's heads the way that is phrased. nonetheless, that is still sad that they're like, "Well, no, you- people just shouldn't have pets."

Kate Elden: I'm with you. Like I, and so I, I think you're-- I mean, my initial response is to have compassion for vets. Like, why did they make that choice? and I think a lot of it comes from this, like, veterinarians today are working in the infrastructure that they're, they're working in, right? They're working in the infrastructure of these hospitals, a lot of them corporate-owned, and, the pressures that are placed on them.

And when someone asks them that question that's like, "Hey, is it the responsibility of the veterinary industry?" They're thinking, you know, "Is it my responsibility to make care affordable?" It feels that way, [00:53:00] and if I was a veterinarian reading that, I'd be like, "Well," you know, the vets are the ones that are-- they're the only ones that are client-facing in that infrastructure.

And if you feel like someone's saying that's like the weight of the world put on your shoulders, saying it's your job to make it affordable. And, and so in my mind I'm like, of course they, they're pushing back and saying no, then, you know. B- but so I read that and I was just like, I was both shocked cause I myself, you know, I like I struggle with the cost of care. For vets to just say, "Well, then you shouldn't own a pet," it loses the fact that, like, also in that research, 92% of pets, when there was a pet in front of them, they offered a spectrum of care, rather than, you know, saying, "No, I'm not gonna be able to help you." they met the client where they were at. So, veterinarians' behavior is that they are helping people. You know, when it comes down to it, they, [00:54:00] are, working with them to create more affordable options. so it's just this idea that's like, okay, I think that that question, unearths a real emotional thing that veterinarians are facing today, and that question of Who is it that fixes that? How do we fix that? I think that's real. I think it's good for us to talk about. I wanna put it out there that, like, the veterinarians are the ones having the face-to-face interactions in this infrastructure, and change comes from the inside out, right? And I don't think veterinarians actually feel that they don't think people should own pets if they can't afford it. I think that they actually just feel like it's too much weight on their shoulders when they're the ones, the only ones carrying that burden, you know? And, and maybe like, yes, the technicians and the, front staff also do too. But I don't know. [00:55:00] That... I just, I, I wanted to bring that up because I love veterinarians, and that stat like shocked me, and I want to say to vets, don't be afraid to speak up if the infrastructure that you're working in is, feels rough, that the pressures are real, and you can make a difference.

Your voice matters. and you know, like a call to action, let me know if you agree with me that pet ownership and the ability to get care, like I don't think that you know, how much you have in your bank account should determine whether or not you get to have a pet and get to take good 

Megan Sprinkle: Yeah. 

Kate Elden: of them. 

Megan Sprinkle: I think you're, you're empowering people, right? I love that you said you do have a voice. If you see something that's missing, speak up. And maybe not everybody is open to hearing that or, or they're not gonna do anything about it, and that means that you need to go somewhere else where you can have a voice.

And it doesn't mean completely just quit right there on the spot. I [00:56:00] mean, go talk to Kate and network and, and start having these conversations because I, I think when we start connecting with other people, okay, now it's not just on my shoulders, right? Now I have somebody else who sees what I see, and we can work together.

We can find other ways to address the challenge that, that we all see together, and I think that's the e- empowering part. That's what you can do. You do have some next steps. You can, connect with other people. You can go to conferences and hear things and, and again, find the people that are, are probably hearing and seeing the same things you do.

And there are people who want to do something and are trying to do something. And when we can come together, I think you might have mentioned this at one point, right? If we can work together, that's when we can start really making a difference. It's not all on one person's shoulders. Um, it-- but, but it does mean you still have the ability to voice, to act, all of those things.

Um, but don't feel like you're by [00:57:00] yourself.

Kate Elden: Yeah, absolutely. And if, yes, veterinarians, there are so many different ways of practicing within our profession that can be rewarding it's not so narrow as a lot of us, like, think. I, I had this vision of what vet medicine was gonna look like when I was in vet school, and man, I have reformed that so many different times. and I feel like my career's just getting started. So 

s- want to, you know, also remind other vets out there listening that, if you feel stuck in a spot, don't be afraid to talk to other vets. Conferences are a good time to do that. Send me an email, drkate@dutch.com. You know, I'm, I'm always happy to chat 

Megan Sprinkle: Yeah. And me too. Th- this is why I do this podcast . So thank you for helping me share that. Um, well, my final question I always love to end on is, and this can be personal or work or whatever first comes to your mind, but what is something you are really grateful for?

Kate Elden: Oh, [00:58:00] I s- go through this question with my kids every night when I put them to bed. I would say I'm so grateful for my family, you know, my, my family and my kids, and our health. I, I think about that all the time, and, like, those little things that we take for granted. I feel like that's, like, a kind of a mushy, uh, answer, but it's, it's real.

I love them so much, and I love that I'm doing what I'm doing and I get to spend time with them and, uh, especially in these early years

Megan Sprinkle: That was Dr. Kate Elden, and I want to leave you with something she shared with me the morning after we recorded. She had been sitting with that PetSmart Charities stat, the one about sixty-six percent of veterinarians, and she said vets and pet parents are actually struggling with the same thing. The affordability of care is hard for pet owners, but it takes a toll on the veterinary team too, and that gets forgotten.

Behind every one of those [00:59:00] difficult financial conversations with a pet parent is a veterinarian and a veterinary team who got into this profession because they wanted to help every animal in front of them and who struggles alongside the owner because they are on the same team. Kate wants to hold space for that, and so do I.

Kate and I discuss a lot in this episode, and we want you to know that you are not alone. And if you want to connect with Dr. Kate directly, she shared her email, drkate@dutch.com. For the key takeaways from today's conversation and reflection questions to apply them to your own life and career, head over to the Sprinkle of Wisdom Substack for the Podcast Club guide.

Please subscribe, share the episode with someone in vet med that you might think, would appreciate it, and resources are always in the show notes. And until next time, keep reimagining what's possible in veterinary life.