For us in veterinary medicine, the external customer is, of course, the client. They are the reason that we are in business, the initiator of a value stream’s work and they are the ultimate determiner of value. But, there are also internal customers. Within a value stream, the customer is the receiver of the product, service, or information from the previous step. For instance, the doctor would be the internal customer of the results in the step that performs a general health profile on a patient.