#140: Science vs Profit: Navigating Medicine, Money, and Morals. With Dr Brennen McKenzie

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Have you ever felt pressured, as a vet, to do more 'stuff' - diagnostics, procedures, and sell more, even when you can’t quite see the clinical justification for it?
In this episode we welcome Dr. Brennen McKenzie-veterinarian, researcher, creator of the SkeptVet blog, author of Placebos for Pets? The Truth About Alternative Medicine in Animals, and all-round lover of science-based thinking. And who better to help us draw the line between solid science and revenue-driven decision making than someone who is known for their scepticism? Dr. McKenzie brings real-world wisdom and refreshing honesty to the debate. Together we explore the often-unspoken pressures of profit-driven care, commission-based pay, and what happens when business incentives conflict with good science. Brennen shares lessons from two decades in practice on how to use Spectrum of care reasoning to make clinical decisions that respect science, client resources, and the needs of your employer.
A must-listen for any vet who’s ever questioned the system—and their place in it.
Find out more about Brennen's current work in longevity at loyal.com.
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Episode Topics and Timestamps
08:11 The Shift to Profit Driven Veterinary Practice
09:46 A Guide to Evidence-Based Decision Making
12:00 Client Communication and Financial Constraints
17:31 Spectrum of Care: A New Approach
32:15 Overdiagnosis and Screening: A Critical Look
39:09 Cognitive Psychology in Veterinary Decision Making
42:45 The Power of Checklists in Medical Practice
43:18 Balancing Autonomy and Systematic Decision Making
45:52 Clinical Audits: Improving Practice Through Data
48:36 Intuitive vs. Algorithmic Thinking in Veterinary Medicine
51:37 The Pitfalls of Anecdotal Evidence in Veterinary Practice
01:07:40 Communicating with Clients About Unproven Therapies
01:18:17 Pass Along Question and The One Bit of Advice