MISCA represents the realization of a dream that Dr. Reeder and Dr. Kuchenmeister have nurtured and developed over their combined 25 years in veterinary specialty medicine: a dream of a new model of practice based on innovation and collaboration. In their early years of practice in other specialty clinics, they established reputations for excellence in their respective specialties, yet they believed there was a better, more integrated way to serve their patients and clients. Soon after they met in 2013 at a large Portland-based veterinary specialty practice, they began performing innovative procedures together. They immediately recognized that their coordinated, minimally invasive approach transcended the boundaries and surpassed the benefits of traditional soft tissue surgery and internal medicine. Over time, Drs. Reeder and Kuchenmeister have come to understand that while the minimally invasive approach remains central to their treatment philosophy, MISCA’s most valuable offering to veterinary specialty medicine is its unique collaborative method. Since founding MISCA, the veterinarians’ collaboration has grown in multiple dimensions, including an ever-expanding range of innovative procedures, a coordinated approach to communication with owners and referring veterinarians, and the development of a truly specialized team of managers, referral coordinators and clinical staff providing team based care for the pet, owner and referring veterinarians.