In this episode we explore one of the most persistent challenges in veterinary medicine: balancing consistency with flexibility. NVA GP Chief Medical Officer Dr. Sandra Faeh shares how medical excellence requires both clear standards and the ability to bend for real-world client needs. Then, Co-MDVM of Portland Veterinary Wellness Center, Dr. Torrey Schwartz, joins the conversation to discuss the tough choices leaders face, from extending hospital hours to supporting new grads through confidence-shaking decisions. Together, they unpack the tension between what’s best for the patient, doable for the client, and sustainable for the team, and how thoughtful frameworks help navigate the daily cost of choice.