This week on Dr. Molly Says, we’re coming to you LIVE(ish) from a very not-fancy hotel room in Orlando… I’m joined by my friend and internal medicine specialist, Dr. Nicole Fein, and we’re diving into everything from what internists actually do to the reality of specialty vet care (plus a few unhinged tangents… obviously).
We break down how someone becomes a board-certified veterinary internist (spoiler: years of chaos + 16-hour exams), the types of cases they see all the time (yes… so much poop), and a hot take you might not expect: more diagnostics ≠ better medicine.
We also get into:
- When it’s actually time to see a specialist
- The relationship between pet owners, general practitioner veterinarians, and specialists (it’s a throuple, not a love triangle)
- Why some cases should be referred sooner (and what can go wrong when they’re not)
- The real cost conversations that need to happen in vet med
- Why internal medicine is basically the “everything that doesn’t make sense” specialty
PLUS: Dr. Nicole explains her viral “baby talking patients” videos (yes, including “mouth meat” 💀), we discuss cuteness aggression, and share what really happens behind the scenes at the vet.
And of course… we end with Global Pet Expo chaos: piglet parades (aka Frenchies in wagons), influencer pets, and why veterinarians are just trying their best out here.
LOVE YOU GUYS 💛
Timestamps:
00:00:00 Welcome + recording from a hotel bed
00:02:00 What is Global Pet Expo?
00:03:00 Meet Dr. Nicole Fine (internal medicine specialist)
00:07:00 How you become a veterinary internist (aka years of torture)
00:14:55 What cases internal medicine actually sees
00:18:30 Favorite cases (Addison’s, immune disease & emergencies)
00:21:00 What a typical day looks like (and why it’s so communication-heavy)
00:23:00 When should you ask for a specialist referral?
00:26:00 GP vs specialist dynamics (the “throuple” conversation)
00:33:50 Cases that should be referred sooner
00:37:00 Cost conversations & setting expectations
00:39:00 Making specialty care more accessible
00:42:30 Trends in cases + city vs rural vet med
00:46:00 IVDD, surgery vs medical management
00:49:00 Viral baby talk videos explained (yes… really)
00:55:00 Global Pet Expo chaos (piglet parade, influencer pets)
00:59:00 Outro
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Listen to the pod on YouTube/Spotify/Apple:
https://www.youtube.com/@drmollysayspod
https://open.spotify.com/show/7xmKqrXGPJXpsbDbtCMgfe?si=17148ddc74604cb1
https://podcasts.apple.com/us/podcast/the-dr-molly-says-podcast/id1800302028
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