For the past several months, Instinct has been building something exciting! Today, we’re thrilled to introduce Attending by Instinct, a new type of evidence-based AI assistant for clinical decision making that we think can supercharge veterinarians everywhere.
The insight underneath Attending is one that I think will resonate with every veterinarian. Strip our job down to its rawest form and it’s really three things: diagnosis, treatment, and communication. Now contrast that with where we actually spend our days, buried in everything else that comes out of the job: SOAPs, estimates, discharges, Rx labels, client updates, and on and on.
Attending marks the beginning of what we hope will be a fundamental improvement in our workflows. We’re starting with the part of the job that weighs most on veterinarians: the clinical decisions themselves.
The Problem We’re Solving
We started with a question: How do we bring the AI advancements happening all around us into our veterinary practices to solve ground-floor challenges, with the safety, trust, and responsibility Instinct is known for?
The issue we’re starting with is clinician confidence.
One of my favorite thinkers on technology and medicine, Atul Gawande, argues that modern practitioners need help across two axes: ignorance (the knowledge doesn’t exist yet) and ineptitude (the knowledge exists, but it’s increasingly difficult to apply it consistently). A century of science has helped close the ignorance gap. But it has made the ineptitude axis more difficult. Veterinary knowledge is growing faster than any of us can keep up with and it’s increasingly hard to apply it in the moment, with a full lobby and a phone that won’t stop ringing.
That gap costs our practices in ways I don’t think we fully quantify. At its best, it slows decision-making and eats away at the time of a practice’s most experienced knowledge worker. At its worst, it affects patient care. And it follows us home. Everyone has those cases that stay with you after a shift, the ones where you wonder if there was something else you could have done. I’m convinced that those cases are an overlooked contributor to the compassion fatigue and burnout our profession fights every day.
Expertise can’t (and shouldn’t) be measured by a veterinarian’s ability to instantly recall thousands of details, consensus recommendations, and the latest studies. It should be measured by applying all of that information with a layer of clinical judgment. So we set out to build a tool that supports the judgment and handles the recall.
What Is Attending?
First, the name is intentional. In a teaching setting, especially, the attending is the doctor in charge. And each attending has an army of smart assistants helping them: residents, interns, and students work the case, contribute research and ideas, and draft the endless paperwork checklist. Most veterinarians practice without that level of support.
Attending is a clinical decision support system designed to bring that same experience to every veterinarian by combining the superpowers of Instinct’s assets and decades of peer-reviewed content, including Standards of Care, Plumb’s, and Clinician’s Brief. Ask a clinical question in plain language and get a specialty-level answer in seconds, grounded in the latest peer-reviewed evidence, with inline citations you can verify in one tap.
Tools like this already exist in human health and have quickly become part of physicians’ daily practice. The single most important ingredient in any of them is the underlying data.
At Attending’s core are more than 30 years of evidence-based work authored by practicing veterinarians, pharmacists, and editors, and updated regularly by 200+ boarded specialists and pharmacy experts. Behind it all sit more than 20,000 primary sources (think academic journals, consensus statements, and guidelines) that are regularly evaluated and curated by experts and rigorously peer-reviewed.
Just as important is what Attending can’t touch. It has no access to the open web, no outdated texts that never went through peer review, and no anonymous forums. General-purpose AI tools will happily blend a current consensus statement with a decade-old Reddit thread and present both with the same confidence. With Attending, that can’t happen, so veterinarians are set up for success before they finish typing the question.
AI Safety, Trust, & Responsible Use
Transparently, Attending is AI. AI can make mistakes. Dr. Robert Wachter, in his excellent new book on AI in medicine, A Giant Leap, frames the trade-off well: “AI doesn’t have to be perfect to be better.” The real-world alternative to a tool like Attending was never an infallible specialist on call for every case. It’s a busy clinician doing their best with whatever references they can reach in the moment. Our job is to be meaningfully better than that while being honest about how AI can still get things wrong.
When I explain the risk of anesthesia to a pet owner, I make it clear that I can’t eliminate the risk, but in my hands, I can and will work hard to make it as close to zero as possible. That’s the same framing and approach we’re taking with Attending.
Attending is a decision-support tool, not a decision-maker. It doesn’t make diagnoses or treatment decisions for your patients. It surfaces trusted, cited information so the licensed veterinarian, the one who actually knows the patient and the unique case situation and has the years of training and judgment, can verify the info and ultimately make the call. You stay the Attending, applying clinical reasoning, making the decisions, and focusing on the work that drew you to this profession in the first place.
Even with strong controls and testing, AI won’t be perfect, but neither are humans. We take that insight seriously, along with our responsibility to reduce that risk as far as we possibly can and to make it easy for veterinarians to check anything that doesn’t look right.
Some of the important safeguards in Attending include:
- Content foundation: the only AI with Plumb’s, built only on peer-reviewed, up-to-date, carefully curated, and cited content.
- Multi-layered safety verification: Attending runs separate verification processes, both AI and human-reviewed. Dosing and other safety-critical information is retrieved directly from trusted sources rather than generated by AI.
- The veterinarian stays in charge: every answer shows its work. In-line citations link directly to the source material, so you can see the context an answer came from and apply your own judgment about how it fits your patient. When something doesn’t line up, you’ll see exactly why.
- An expert team committed to improvement: like everything we build at Instinct, you have our commitment that our team will work hard to improve Attending, including the safety and trust aspects, as technology evolves, and in partnership with our 25+ in-house veterinarian and pharmacist experts.
Decades of trusted clinical content give Attending a strong foundation. But we know that earning a veterinarian’s trust requires more: visible evidence, candor about uncertainty, and respect for the clinician making the decision.
Why This Matters to Me
Attending is the project I’ve been most excited about in years, because of the power it holds to help veterinarians and the patients and families they are entrusted to care for. I’ve wanted this kind of support on my own shifts: a trusted second look when colleagues are busy, evidence has changed, or a case feels unfamiliar at 2 AM. And after watching veterinarians use Attending in beta, I’ve never been more confident that we can deliver it.
The future of veterinary medicine will be shaped by clinicians who expect technology to augment their expertise and that’s exactly the future we’re building. And this is just the start. Attending will only get better and it improves the same way it was built: with veterinarians putting it to work and telling us what they need.
Get the first look. Attending is available today in Research Preview at instinct.vet/attending to verified veterinarians in the United States, Canada, Australia, and New Zealand. It works as a standalone tool for any veterinarian, no Instinct software required.
We hope you’ll join us.
