I've only met Dr. Cowley once, for a pre-purchase exam. He was very personable & arrived on time. His office staff was very efficient, & I got appointment very quickly and at a very convenient time. Where Dr. Cowley really shines is the thoroughness of the exam. We did all of the usual stuff, & took the time to explain what he was doing, what he was looking for, and the ramifications of what he found.For example, he caught a very subtle change in the horse's movement after a flexion test. X-rays showed that it was a minor issue, but at least now I have all of the information to make a good decision - exactly what you want from a PPE. Overall, extremely satisfied and highly recommended.