Venture Everywhere Podcast: Vivian Graves with Conor Harbeck
Vivian Graves, founder and CEO of Otia chats with Conor Harbeck, Associate of Everywhere Ventures on episode 76: Virtual Vet Care.
In episode 76 of Venture Everywhere, Conor Harbeck, Associate at Everywhere Ventures, talks with Vivian Graves, founder and CEO of Otis — a virtual veterinary clinic built to address rising pet care costs and capacity challenges through technology. Vivian shares how Otis grew from a personal pain point into a platform designed to help veterinarians treat more patients efficiently while reducing barriers to care for pet owners. Vivian also discusses Otis’s mission to expand access to affordable, high-quality veterinary services for households underserved by traditional brick-and-mortar clinics.
In this episode, you will hear:
How Otis’ virtual consultations cut rising vet costs
Expanding vet capacity by streamlining high-frequency cases
Collaborating with vets to design efficient care workflows
Monetizing treatments (not just consults) fuels sustainable growth
Strategies to make vet care accessible without compromising quality
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TRANSCRIPT
00:00:00 VO: Everywhere Podcast Network.
00:00:14 Jenny Fielding: Hi and welcome to the Everywhere podcast. We're a global community of founders and operators who've come together to support the next generation of builders. So the premise of the podcast is just that, founders interviewing other founders about the trials and tribulations of building a company. Hope you enjoy the episode.
00:00:33 Conor: Hi everyone, and welcome to the Venture Everywhere podcast. My name is Conor Harbeck, and I'm an Associate here at Everywhere Ventures. Today I'm joined by Vivian Graves, the founder and CEO of Otis, which is a virtual vet clinic on the mission to make high quality pet care more affordable and accessible. It's great to have you with us here today, Vivian.
00:00:52 Vivian: Hey, Conor, good to see you. Thanks for having me.
00:00:56 Conor: Of course. Tell us about the work you're doing now and the impact that you hope to make.
00:01:00 Vivian: As you mentioned, we are a virtual vet clinic. What that means though could be a lot of different things. Ultimately though, what we're doing is we're going after what I call the affordability crisis in the vet world.
00:01:11 Vivian: Three out of four households in the U.S. have a pet. That's a massive number of pets in the U.S. There's 330 million people in the U.S. and there's 200 million pets. But the biggest issue that pet owners cite that prevents them from getting care at the first sign of a symptom that their cat or their dog has, is always cost.
00:01:30 Vivian: So prohibitive costs essentially prevent people from getting the care that their pets need as early as they should be getting treated. And so for a lot of people, what that looks like is if their dog is itching like crazy, or if they're chewing their paws, they often wait a little too long to seek out care and their pets go untreated.
00:01:51 Vivian: Eventually what could be a minor issue might end up turning into a more severe and potentially emergency issue. And so what our goal is and what we're doing is we're trying to decrease that barrier so that people can seek out care earlier and get treatment for their pets.
00:02:06 Vivian: The way that we do that is by offering virtual consults with veterinarians. What we do specifically is we use technology to cut down the amount of time that it takes a vet to treat and diagnose each pet so that they can see more pets per hour.
00:02:22 Vivian: Specifically in-clinic, a vet can only see two to three pets per hour, which is a big part of the problem. There's a huge shortage of veterinarians. And so what that means is there's not enough vets for all the pets that we have in the U.S. Our goal is to increase the output that each vet has for common and recurring issues that can be easily treated virtually.
00:02:44 Conor: That's pretty incredible. It's similar to human medicine. Doctors only have such a short period of time to see each patient. I didn't really realize that was the same with pets. What inspired you to create this platform? How did you come across this problem? And specifically for the vets in the pet industry, how'd you land there?
00:03:00 Vivian: You bring up a good point, which is oftentimes people think of human health care and they think, "Oh, I use One Medical" or "I've gotten a telemedicine consult before for myself. Of course, this exists for pets." But the reality is that in the veterinary world oftentimes not just the technology, but the industry can often lag human healthcare for various reasons.
00:03:19 Vivian: In the pet world specifically, regulation for telemedicine has not moved as quickly in the pet world as it has in human health. So what that means is that in any given state in the U.S., you may or may not be able to get a diagnosis and a prescription from a vet online. This has been changing over the past few years, especially post-COVID.
00:03:39 Vivian: So one big landmark state that recently approved the use of telemedicine in the veterinary world was California last year, which is major since it has such a high pet population. But oftentimes people think that this is already something that's commonplace in the vet world when it's not.
00:03:56 Vivian: In terms of what led me to actually build this myself, it started with a personal problem. So I have a dog named Luna and she's a small Goldendoodle, of course, as the stereotype goes. But when I first got her, I was in business school. I was a student. I didn't have a salary.
00:04:14 Vivian: And so anytime she had a symptom or an issue, I fell into that same bucket of the person who waits a little too long to get care because maybe I'll Google it, maybe it'll get better. You feel incredibly guilty because your pet's health is so important to you.
00:04:29 Vivian: But eventually when her itching specifically got so bad that I couldn't ignore it, she was pulling out hair. When I tried to get an appointment with a vet, I just couldn't find one for two to three weeks because they were so overbooked.
00:04:42 Vivian: That was the first nugget in my mind that said, okay, something's going on here. How is it possible that even though these in-person consults can cost around $100 just to talk to the vet, but I can't really get seen anywhere.
00:04:56 Vivian: That was the initial question in my mind of what's going on here that led me to dig in further and really set me on the path of figuring out what was going in the pet industry.
00:05:06 Conor: That's great. For those listening, Vivian and I work in the same office and I'm a big fan of her Goldendoodle, Luna. She's a lot of fun, always brings joy to my day. I was going to ask next, who are the key people who helped put you on this path? But it sounds like maybe that key person was Luna.
00:05:18 Vivian: It really was Luna.
00:05:19 Conor: I love that. There's clearly this huge gap between the need and demand for vet services and the availability of vets needing to wait two to three weeks is crazy. How do you guys help close that gap specifically?
00:05:33 Vivian: To just put it into more specific numbers of that gap between the number of vets out there and the demand, specifically, there's estimated that in the next 5 to 10 years, there's going to be a shortfall of 33%, meaning if there's 133 appointments that are needed, there will only be 100 that can be staffed and filled by available veterinarians.
00:05:55 Vivian: So that's pretty significant and is expected to only get worse. What that means for the whole ecosystem is that wait times are going to continue to get even longer. Costs are going to keep rising as limited supply drives up pricing. Often people continue to delay care further and veterinarians who are already extremely burned out will face even higher burnout rates. So that's pretty critical.
00:06:21 Vivian: The way that we really address that is that initially it started selfishly just from a consumer perspective of how can I personally get lower cost care that's more accessible faster. But in talking to veterinarians, along the way, I eventually met Dr. Jamie, who's our vet director and who is integral in helping to found Otis.
00:06:41 Vivian: What I learned in talking to her and hundreds of vets along the way was that the veterinarians themselves are also getting crushed by this demand. And so what we set out to do was not just make consults more affordable and accessible for pet owners, but do so in a way that was net positive for the whole ecosystem.
00:06:59 Vivian: I previously went to MIT and one of the biggest things that I learned there was thinking about things from a systems dynamics perspective. So if you think about the concepts behind that, it's pretty simple. What you do in one part of the system can affect a lot of different other parts of the system.
00:07:15 Vivian: Our goal with Otis specifically is if we can find ways to make certain conditions treatable faster and more affordably, meaning we can cut down the amount of time that it takes a vet to treat that pet, that means that the vets in clinic will have more time and more bandwidth to treat issues that maybe require more time or are more critical for in-person care.
00:07:40 Vivian: So to put that specific example, I mentioned that veterinarians can only see two to three pets per hour in clinic. So that's not a lot similar to the human health rates, but there's certain things that they see on a daily basis very frequently.
00:07:54 Vivian: If you talk to a vet, the issues that come up over and over again for them on a daily basis are pretty much the same four to five things over and over again. One of them specifically is flea infestations. Your dog got fleas. You need to bring them in. They're itching and they need medication to stop the fleas from continuing to perpetrate the cycle.
00:08:14 Vivian: That really shouldn't require a 20 to 30 minute visit, but it takes up the same amount of resources in general for a vet clinic, staffing the front desk, having enough admin, having vet techs, having the vet available, same as if you had a pet that is coming in for an ulcer or is limping.
00:08:31 Vivian: For us, how can we take that flea infestation, collect all the information we need upfront before the vet's looped in so that when the vet actually is looped in and we're running up minutes on their clock, they can very quickly say, “This is a flea infestation. This is the medication I'm prescribing,” and the amount of time that they're spending on this consult is far less and they're able to increase their output?
00:08:55 Vivian: What that means for the in-person clinic on the flip side is they're able to have more time that is spent for things like a pet that's limping or an ulcer rather than having to see such a high volume of issues like flea infestations.
00:09:09 Conor: So you're basically creating a new model for delivery, taking a lot of the conditions that you see consistently that don't really need as much in-person time and saving that time and allowing vets to use their time more practically with the cases that actually matter.
00:09:24 Conor: How have you worked with vets? I heard you mentioned Dr. Jamie, who you've been working with, but how have you been working with vets and vet techs to refine this model and find a model that works for them? Because I'd imagine they were trained in a very traditional clinical setting. So how have you been doing that and what kind of feedback have you been getting from them?
00:09:40 Vivian: There's so much I could say about this. I'm not a veterinarian myself. And so when it comes to the veterinary side, the medical part of it, I always will defer to Dr. Jamie and to our vet team to say, okay, if we need to go from point A to Z, what are the different checkpoints or information that you need to make a diagnosis?
00:09:59 Vivian: What is the ideal amount of information or the ideal amount of photos, videos, whatever images of the pet's skin or whatever the condition is that you need to feel very comfortable to treat, diagnose, and prescribe for whatever is going on. My job and the rest of our team's job is to really say, okay, given what they need, how can we build around that?
00:10:22 Vivian: I think in the very beginning, we often thought, how can we take the in-person experience and make it virtual? I'd say probably a mistake we made early on and we've since flipped our thinking to say, it's not about taking the in-person experience and trying to fully replicate it online. It's more so the opposite of what are the things that veterinarians can't do in person that being virtual would enable us to do.
00:10:49 Vivian: One example of that is if you talk to a veterinarian, they'll often tell you that because they have such limited time during the consult, they don't feel they have enough time to necessarily answer all of the pet owners' questions. Sometimes they'll ask you, what should I be feeding my pet, even though they came in for a limp?
00:11:03 Vivian: They don't have enough time to answer the pet owners' questions, and they also don't always have enough time to fully educate pet owners on more complex things such as allergies. There's different types of allergies. There's food allergies. Everyone thinks their pet has a chicken allergy. There's environmental allergies.
00:11:18 Vivian: By using technology, now we think, okay, what are the things that this platform enables us to do that a vet in person can't necessarily do. And that often is providing them more robust education and being able to answer more of those questions.
00:11:32 Vivian: So if someone comes in to us, their dog is itching. Instead of the vet having to repeat the same 10-minute education that they do in every single consult, we automate that. We have videos, we have texts, we have more robust content that we can easily send to the pet owner in advance so that they come more prepared when they do interact with the vet.
00:11:52 Vivian: And the vet is then on the flip side, able to come more prepared with all the questions that they would routinely ask during those sessions. We cut down a lot of that back and forth that tends to be very repetitive. If you sit in on that consults like I have, I've done hundreds at this point, they end up looking pretty similar if they're the same symptoms or the same core issues.
00:12:11 Vivian: So really we're trying to not only replicate what's happening in clinic, but really amplify the ability of the vets to provide more robust and comprehensive care because we're not limited to that 20, 30 minute block.
00:12:26 Vivian: One thing that I'll add is when I think about how we work with our vet team and our vet techs, oftentimes I think of that quote. I forgot who said it, but the quote is, innovation is seeing what everyone else has seen and thinking what no one else has thought. For me, it's so important to have the vets as a core part of what we're building because I don't understand necessarily the medical side.
00:12:47 Vivian: But on the flip side, what I often hear from them is because they have been taught the gold standard of what veterinary care is, it's often hard for someone who's so deep in the industry to look from the outside and say, "Oh, instead of doing this the way it's always been done, how can we achieve the same ultimate goal but have it look or get there in a totally different way?"
00:13:10 Vivian: When it comes to Otis, that's really the core of how our team works together is how can the vet side amplify the business side and the tech side and how can the business and tech side amplify the vet side by seeing things in a way and looking at things with fresh eyes that you don't always have when you're very deep in your own industry?
00:13:30 Conor: I think that's a great perspective is listen to the people who've been in the industry, but also the fact that you found a team or vets that you work with who are open to seeing the future and working with you to make a better future for pets, pet owners and vets altogether. That's pretty incredible.
00:13:46 Conor: So my brother has two dogs and all of these issues that you're describing are things that I've heard him complain about as well. The allergy, the dog can't stop itching. They have to get a whole appointment just to have the same conversation and tweak one thing. In this day and age, that just doesn't seem the best use of everyone's time.
00:14:01 Conor: I know that a lot of people feel their pets and their dogs are their kids in many ways. So they want to make sure they're providing the best care possible. And it sounds like you're really helping vets do that.
00:14:12 Conor: I know also from his experience that vet care can be pretty expensive for pet owners. So how do you guys rethink the unit economics of pet healthcare outside of traditional pathways? We've seen some pet insurance companies and other things like that. So how have you guys been thinking about that?
00:14:29 Vivian: I think I've been fortunate in terms of my career to have worked in various different industries. But one specifically that I worked in prior to starting Otis was I worked at a large venture capital fund.
00:14:39 Vivian: Amongst other industries, I was focused on the pet industry and I was able to see a lot of different business models like the new pet insurance players and different dog walking services, different apps for pet owners.
00:14:51 Vivian: One thing that I really learned from that was just because someone says that they would love to have a certain service or maybe a venture capital investor thinks something is a good idea, it doesn't necessarily mean that a user or an end consumer will ultimately pay for it.
00:15:08 Vivian: We came out of this era of somewhat easier money where it was a bit easier to raise venture capital money and it felt like it was free flowing pretty easily.
00:15:18 Vivian: Now that we've moved away from that, there's this reckoning that's happened where you really can't succeed unless you're building something that people want and you're building something that people will really pay for. Revenue is a lot more in focus at the moment.
00:15:32 Vivian: When it came to looking at the economics of the business, one thing that I had seen a lot of founders try in the pet industry, and ultimately it felt like fool's gold, was trying subscription models when it came to online care for pets.
00:15:46 Vivian: Often the model was you pay, let's say, $30 a month, you get a subscription to ask unlimited questions to a vet online. That always sounded really great for the investors and the venture capitalists because it felt pretty similar to software subscriptions.
00:16:00 Vivian: The downside was that when it came to the actual consumer behavior, most pet owners, while similar to your brother, might have questions or they might need ongoing care, the majority of them don't necessarily need to pay every single month to get access to ask triaging questions for the lifetime of their pet.
00:16:17 Vivian: It was always very clear that while there had been players that had attempted that and potentially even raised a lot of money, it wasn't going to build a business with sustainable unit economics in the long term. Ultimately we're building a for-profit business with the goal of doing good for a whole industry, but we do need to ultimately make money.
00:16:35 Vivian: And so when it came to the actual business model itself, it was clear to me that we needed to make money from the areas where we were actually adding value to the consumer. For us, it meant not charging a membership, not charging a subscription for a service that people wouldn't actually use.
00:16:50 Vivian: Our goal wasn't to say, "Hey, let's make money on something people don't need." It was “let's make money where we can provide value.” With Otis, our goal isn't to necessarily make money on the vet consult. We actually are able to charge, in most cases, 80% less for the actual consultation with the vet compared to in clinic costs because we cut down the amount of time they spend.
00:17:13 Vivian: But we also aren't trying to necessarily make money off that consult. We pass on all the money we make from the consultation straight to the vet. So that goes straight to the vet's pockets because we know that this is gonna be a one-off thing. We're not really gonna get recurring revenue.
00:17:28 Vivian: Instead, we try to make money on where we can deliver ongoing services, which is often the products and medication that the pet owner needs on a recurring basis. For my dog specifically, she needs flea, tick, and heartworm prevention every month. She takes allergy medication.
00:17:44 Vivian: And so that's something that I'm going to buy on a recurring basis – similar to the way that a vet clinic will give you a diagnosis, will write the prescription, and will also sell you the meds in person.
00:17:54 Vivian: The difference is that because we can increase the utilization of each vet and we don't have the same operating costs of a brick and mortar like a front desk staff or a rent or physical location maintenance, we're able to charge less for the consult and we're able to stick to our revenue model being more focused on that ongoing treatment or ongoing medication that the pet needs.
00:18:18 Conor: That makes a lot of sense. I think that's actually the biggest headache for a lot of pet owners too is having to take that monthly flea, heartworm, tick or allergy medication and always having to go bring your dog to the vet or go to the vet yourself to get those prescriptions and get them filled. So that makes a lot of sense to me.
00:18:34 Conor: Sounds like you've got a bunch of different hot takes or different ideas. What would you say is your biggest hot take in the vet space?
00:18:42 Vivian: I don't know if I would call it a hot take, but maybe to your point, something that people might not always agree with me in this industry is around access to care. Everyone can get behind the idea that it's important for pet owners to be able to access care for their pets.
00:18:58 Vivian: However, when you talk to veterinarians and vet nurses, in veterinary school, what they're taught is to follow what's called the gold standard. So this means what is the recommended best form of care that a pet can receive when it comes to veterinary care?
00:19:16 Vivian: This is to me the ideal form of care. However, unfortunately, the gold standard isn't always accessible for everyone. Not everyone can afford to get all of the medication or all of the routine testing or all of the steps that are needed for that gold standard because they often can't afford it.
00:19:34 Vivian: There's some stats that I always think about all the time are around household savings. So 50% of U.S. households have less than $10,000 in their bank account and savings. One out of three has less than $5,000 in their bank account for savings. It's pretty astounding, but if you go to the grocery store and you see the prices lately, it makes sense.
00:19:53 Vivian: But on one hand, it's easy to say, if you can't afford this or if you don't have savings, you shouldn't have a pet. But the reality is pets bring us a lot of joy. They bring us a lot of benefits to our life. And 75% of households have a pet. So for me, it's about how can we really serve these people better and help them meet them where they're at?
00:20:13 Vivian: And so I would say to just answer your question, while I think that everyone should get the gold standard of care, I believe that because a lot of people can't afford it, it's our job to meet them where they're at and give them the care that they can afford.
00:20:27 Vivian: Oftentimes I've heard from some people in the industry that the downside of what we're doing is that by making care too accessible virtually, we're preventing people from going in person to seek care that they need to get in person. So routine annual exams or routine vaccines.
00:20:44 Vivian: There's this misconception that by making access too available will prevent people from going in-person. The reality is that gatekeeping will never push people to seek out in-person care. It's often the opposite.
00:20:58 Vivian: What we found with most of our customers is that for them, the options aren't, “do I go to Otis to get a consultation or do I go in person?” For a lot of them, it's, “do I either go to Otis or do I not get any care for my pet at all?”
00:21:11 Vivian: While it might feel like gatekeeping will push people to go in clinic, it honestly often has the opposite effect of if we gatekeep these services to only allow people to get care if they can afford the gold standard, it just means that more pets will go without care for longer.
00:21:27 Vivian: So that I would say is my... perhaps you can call it hot take and the ethos behind Otis, especially when it comes to the field of veterinary telemedicine.
00:21:36 Conor: I love that. So switching gears to wrap things up, just a few quick questions. What would you say is your superpower? What's the thing that you're most known for?
00:21:44 Vivian: I think if you were to ask other people, they would probably say tenacity. When I first started looking into Otis, this was many years ago, I think it was 2018, I would talk to so many experts and all of them would say, "Oh, you can't get a vet to write a prescription via virtual means. It's just not possible."
00:22:02 Vivian: Obviously the telemedicine landscape looked quite different 10 years ago than it does now. But if this is a need people have, how do we get to that end goal and how do we continue to push through even amidst people saying that it's not possible?
00:22:18 Vivian: If it wasn't for that, I don't think Otis would even exist because it's pretty easy to look at all of these expert opinions and say, "Okay, all these experts know so much more than I do, so it's just not possible to do it."
00:22:30 Conor: I'll agree if you think people think you're tenacious. I've seen you in person. I've seen you hustle. I've seen you here all day, every day and working away. So definitely agree on that one. What's your favorite productivity hack?
00:22:40 Vivian: Oh, that's a good one because I'm always trying to be more productive and I don't know if I figured it out. I recently started working with a coach and one thing that she often talks about is that founders in particular, but anyone who is in a very demanding profession or is highly productive, oftentimes will only rest when their bodies force them, when their bodies revolt and they just can't go on any longer. They've been burning the candle on both ends and they have to rest.
00:23:08 Vivian: One thing she always says that has really stuck with me is, instead of waiting for your body to force you into rest, what would it look like to choose rest before it chooses you, before you're forced into it? And so oftentimes when I think, oh, I need to be more productive or I need to do more, I think of that phrase, what would happen if I chose rest before it chose me?
00:23:29 Vivian: I try to do the opposite. This is a very new thing that's only started in the past month. But when I'm feeling this pressure of I need to do more, I need to be more productive, I've started saying, okay, if that's the case, let me do absolutely nothing. And then when I come back to working, I often find I'm 2X more productive or 2X more motivated because I've chosen that rest before it chose me.
00:23:52 Conor: Sounds a lot like how pet owners operate, waiting too long until their pet needs care. What's a book, podcast, newsletter, something that you enjoy?
00:24:00 Vivian: So unfortunately, I'm not a podcast girlie because I'm not really an audio person, but I recently read a very short book that I highly recommend. It's 50 chapters of short Buddhist teachings, which sounds very out there, but it's honestly, I think, applicable to pretty much everyone. It's called Comfortable with Uncertainty by Pema Chodron.
00:24:22 Vivian: But a lot of what it talks about is that as humans, we all have this inherent need to seek out certainty. The feeling of uncertainty or the unknown really scares us, makes us uncomfortable, and we don't like feeling uncomfortable. We don't like feeling scared. And so we try to find things that will give us that false sense of certainty.
00:24:43 Vivian: I know where I'm going to live for the next 10 years, or I need to find a partner so I can lock down that I have a spouse and a family. But the reality is that in life, anything can change in a second. Your husband can divorce you. You can lose your housing. Nothing is guaranteed and there is no certainty.
00:24:57 Vivian: The faster we can embrace that uncertainty, the faster we can move away from the root of all suffering, which is seeking out certainty when you can't attain it. So that was the very long cliff notes of the book, but I highly recommend.
00:25:11 Conor: Sounds good. I'll definitely give that a look.
00:25:13 Vivian: I'll lend it to you, Conor.
00:25:15 Conor: Perfect. So last two questions. How do you unwind? You said when you're stressed, you sometimes take a step back nowadays, do nothing. So what do you do in those moments to relax and unwind?
00:25:24 Vivian: This might be cliche because it's a pet focus company, but my biggest source of unwinding is being with my dog. I recently read a survey that, I think, it’s 70% to 80% of pet owners' favorite activity with their dog is just watching TV with their dog, which I find hilarious because we don't even know if the dog can process what's going on in the TV. But my biggest way of unwinding is just being with my dog.
00:25:47 Conor: That's incredible. I did not know that 80% of people's favorite activity is watching TV with their dog. I think they can. I've seen clips of dogs.
00:25:55 Vivian: My dog can. And then this is not what you asked, but also fun fact that I read in the study was that people were asked what they would give up for three more years of their dog's life. So if you could extend their dog's life for three more years, what would you give up? One out of seven said that they would break up with their partner or spouse in exchange for three more years with their dog.
00:26:14 Conor: That bond is pretty unbreakable.
00:26:16 Vivian: Yeah, literally.
00:26:18 Conor: Where can listeners find you?
00:26:19 Vivian: Aside from this podcast, this feels a little cringy, but I recently started a company TikTok. So it's @VivfromOtis. If you liked any of these pet facts or vet facts, that's basically the bulk of what I talk about on TikTok. So that's where you guys can find me.
00:26:35 Conor: Amazing. Thanks so much, Vivian. It was such a pleasure chatting with you and learning more. Thanks for joining us.
00:26:41 Vivian: Awesome. See you around the office, Conor.
00:26:43 Conor: Thanks.
00:26:45 Scott Hartley: Thanks for joining us and hope you enjoyed today's episode. For those of you listening, you might also be interested to learn more about Everywhere, where a first-check pre-seed fund that does exactly that invests everywhere. We're a community of 500 founders and operators, and we've invested in over 250 companies around the globe. Find us at our website, Everywhere.vc, on LinkedIn, and through our regular founder spotlights on Substack. Be sure to subscribe, and we'll catch you on the next episode.