Episode 32

full
Published on:

9th Nov 2023

OneHealth with guest Dr. Michael Blackwell

On this episode, our guest Dr. Michael Blackwell explains the concept of OneHealth and the importance of caring for both animals and their caretakers to promote wellness throughout the community, with a particular emphasis on services for communities lacking in resources. Family health does not stop at the humans or the animals, but involves both. And this must incorporate mental and physical health care.

A collaborative effort between veterinarians and social workers is important in providing a comprehensive program for long term results and not just a “spot fix”. And this approach has broad benefits to the environment, diseases, and even the current shelter overpopulation problem.

Dr. Blackwell is the Director of the Program for Pet Health Equity in the Center for Behavioral Health Research at University of Tennessee, Knoxville, and is also the Director of AlignCare Health Inc.

Mentioned in this episode:

Keep it Humane Podcast Network

The Animal Welfare Junction is part of the Keep It Humane Podcast Network. Visit keepithumane.com/podcastnetwork to find us and our amazing animal welfare podcast partners.

Transcript
DrG:

Hi, and welcome to the Animal Welfare Junction.

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This is your host, Dr.

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G, and our music is written

and produced by Mike Sullivan.

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Today, I am so stoked about my guest.

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Um, I met Dr.

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Michael Blackwell this year at the HSUS

Animal Care Expo during a roundtable

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discussion on the topic that we're going

to be discussing today, One Health.

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And it was such a huge motivating factor.

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I'm actually getting chills.

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Um, because it is something

that over time I have seen that

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is needed, that is necessary.

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And that we are just not offering

and we just need to increase this.

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So I am really looking forward to this

conversation and to teaching people

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about the importance of One Health.

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So thank you so much, Dr.

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Blackwell, for being here today.

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Dr. Blackwell: Well, thank you, Dr.

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G.

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I appreciate the opportunity to

visit with you and your listeners.

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Very, very important topic

here that you're covering.

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DrG: So for those of you, for those

people that may be listening who

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don't know who you are, can you let

them know kind of where you started

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and what brought you to where you

are today and your current position?

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Dr. Blackwell: Well, my

name is Michael Blackwell.

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I'm a veterinarian with

training also in public health.

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Um, my career started as a kid

because my dad, uh, was a general

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practitioner, mixed animal practitioner

during, during my upbringing.

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So I've been in the veterinary medicine

world my entire life, um, and, uh,

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of course grew up privileged as a

result of that and being privileged

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in this sense has afforded me the

opportunity to learn a lot of things,

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to experience a lot of things.

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And I've enjoyed a few

careers along the way.

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You know, I thought I would be a mixed

animal practitioner just like my dad.

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Uh, he closed his practice during my

senior year of high school and joined

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the faculty at Tuskegee University

College of Veterinary Medicine.

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So, um, I went back to Oklahoma,

um, after training at Tuskegee

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and, uh, practiced for a few years.

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But during that time, Felt a real

calling to do more than I was able

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to do in my small town in Oklahoma.

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That led to 23 years with the

United States Public Health Service.

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Most of that time with the

Food and Drug Administration.

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My last duty, um, Was a chief of

staff of the Office of the Surgeon

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General of the United States.

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So speaking of those opportunities

and exposures that I got along

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the way, that 23 year career

really did expand my understanding

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of the world as a veterinarian.

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And better understand and how

important our profession is, uh,

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to the well being of our planet.

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Frankly, um, a left active duty with

the United States Public Health Service

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to become dean of the veterinary

college at the University of Tennessee.

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And frankly, uh.

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I took that position because of the

need to focus on public health more than

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colleges were at the time and, , , after

a few years as Dean, , I left that work

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to focus really solely on animal welfare.

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issues.

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, I think like many veterinarians, , I knew

there were these issues out there around

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animal welfare, but, , I was indirectly

connected with them until I got involved

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with sheltering and, , that opened my eyes

even more to many of the issues, , that

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our communities face, our families face.

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So, um, to fast forward, therefore, , it

was the day that A Vietnam veteran's

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dog got euthanized over, , because of a

treatable medical problem, uh, injury.

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And that euthanasia occurred because

he could not pay for the needed care.

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And for the first time in my career,

again, I grew up in the profession.

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I saw euthanasias performed as a kid,

but for the first time, it just seemed

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all wrong that being the nation that we

are, it seemed all wrong that we have

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people who have contributed to our well

being, like our men and women in uniform,

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um, like our public servants, school

teachers and other public servants,

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but often, , not earning a lot of,

, income, but deserving of a relationship

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with a pet, , as a family member.

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And so it was then that I knew I had

to dedicate my, my life to the work

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of improving access to veterinary

care so that all, um, Get the care

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that they deserve to, to, to have.

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And that's irrespective of

their socio economic reality.

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And therein is where it

starts to get interesting.

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DrG: That is a great, that is a

great story because I mean it does.

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It does bring about different aspects.

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Um, you know, I didn't grow up poor.

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I didn't grow up rich, but I grew up

very comfortable, but I grew up seeing

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some of the struggles that some of my

friends and family were going through.

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So I Never look down on them as them

being lesser because they could not

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afford some of the same things as me.

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They were in a different economic status,

but they, they were the same people.

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And I've always maintained that,

uh, somewhat similar to you.

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I, when I went to vet school,

I had a different plan.

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I.

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I thought I was going to be a surgeon,

which I do a lot of surgery, but

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you know, I was going to go and do

a residency or something and, you

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know, kind of playing it by ear

as to where I was going to end up.

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But I started working at a vet clinic

that did a lot of rescue work, and we were

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seeing all of these animals here in, in

central Ohio that were being brought in.

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From rural areas because those rural

areas did not have access to care.

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So then they were dumping into central

Ohio and we were seeing animals that

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were being euthanized or that were

sick or whatever, whatever it was.

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And even the rescue saying, well,

we're, we're getting them out of

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there because if not, they're just

going to get killed down there.

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So it changed my whole perspective

little, and it wasn't overnight.

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It was a little bit, a smooth

transition, but into the need.

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That that these underserved

communities had and kind of led to

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me wanting to do something about it.

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Right.

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So, um, and that's where

that's where I am right now.

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And still.

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You know, working to, to make it better

because to your point, I mean, it is

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important for us as veterinarians to

help both the animals and the community,

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uh, that we're going to be talking

about the concept of one health and

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just in, in very broad terms, but just

from personal experience, I've known of.

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human doctors that will say, Oh

yeah, that's an animal condition.

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You need to talk to your

veterinarian about it, like

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scabies or worms or whatever.

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Like they will not give a, they

will not give a real answer.

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Dr. Blackwell: Right.

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Yeah.

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Yeah.

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And that reflects a

fragmented healthcare system.

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And so when, when I think in terms

of One Health, our work is about.

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Strategically connecting the health

care system so that it's less fragmented

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so that families are being served

holistically and yeah, there are

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those moments when a veterinarian

really needs to be in the room or

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physician, depending on the situation.

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But too often, um, families are sent

down the road, uh, here and there,

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uh, to get care that could be here.

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Packaged and delivered in

a, in a more holistic way.

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DrG: So what is for people that do not

understand what one health means, what

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is the concept of one health and how

does that involve not just veterinarians,

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but other professionals as well?

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Dr. Blackwell: It's a simple concept.

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It's based on the reality

that on this planet.

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Humans, animals share the same environment

as a shared environment or ecosystem.

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And when we are trying to improve the

health of any one of those three, whether

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it's humans, animals, or the environment,

We need to factor in consider all three.

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So if I'm, if I'm wanting to improve the

health outcomes for human population,

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my plans are, are not adequate.

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If I've not even considered the

impact of animals on humans.

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And vice versa.

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But also what their shared

environment looks like.

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So it's not always air and

water quality in this case.

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We often think of, uh, socioeconomics.

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That's an environmental reality, uh,

the shared environment of a family

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based on their socioeconomic reality.

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So, um, that's what One Health is.

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Now to bring that home, when I think

of access to veterinary care, I So as a

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veterinarian, my heart is breaking for

this pet that needs care, and I want to

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figure out a way to get care to that pet.

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But it turns out the barriers to

me being able to get that care

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to that pet are associated with

the humans in the pet's life.

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And so programs that don't address the

human reality are going to come up short.

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In trying to reach the pets

that are currently underserved.

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Um, and so when looking at the

people in their realities, we

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see, while the barriers associated

with them, and that quickly starts

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to clarify their environmental

reality, that's low socioeconomics,

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which is more than limited money.

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It may represent housing insecurity,

food insecurity, language

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barriers, and so on and so forth.

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So looking holistically at the family,

the humans, the animals, and their shared

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environment is what One, One Health is.

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DrG: One of the things that I have

a huge issue with is the whole

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concept of if you cannot afford

an animal, you should not have it.

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Right.

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And, and that is something that

is, that I see more and more,

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uh, recently on social media.

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I was, saw a post where somebody was

talking about subsidizing and affordable

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care and somebody else went as far as

basically saying that somebody that is

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low income is an irresponsible pet owner.

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And in my personal experience, I've

seen people that will go hungry

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just so that their animal will eat.

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I mean, that is a bond.

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That is, that is something that

We don't know because we don't

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have to make that decision.

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If we were in that

decision, what would we do?

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Right?

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So, and that comes down to the importance

of the human animal bond, kind of

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regardless, regardless of the ability of

the person to financially help, , and be

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economically stable, and also not taking

into consideration that that person

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may have been economically, financially

stable when they got that animal,

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and then something happened, illness.

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Work, whatever the reason and now

they're not able to afford that pet.

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So how do we help with that?

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Right?

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So

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Dr. Blackwell: I appreciate the

way you summarize the reality.

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Um, you know, my response to, uh,

that statement is first and foremost,

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acknowledging there's logic there.

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Okay.

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So, okay.

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It's a logical statement by some

measures, but At the heart of it,

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what's going on there is the person

who makes the statement is at risk.

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Of attacking the relationship as

opposed to attacking the problem

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of lack of systems to ensure

everybody has access to health care.

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It's the relationship is not the problem.

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Now, some can be because there are

instances where that relationship should

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not exist, but most often what we're

talking about, especially if it's a

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case of someone with limited means,

yes, the bond often is tighter there.

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Um, even among the unsheltered, they

may be the poster, a poster image of

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the human animal bond relationship.

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Um, and so, is the relationship

the problem, or is it our lack of

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diligence in having systems to ensure

they have access to, to health care?

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DrG: Yeah, I think we, we're always kind

of like looking at something to blame.

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And I think that by shifting the blame to

the person can't afford it, we eliminate.

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our blame of we are not

providing a care that's needed.

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Uh, and, and, and I'm not saying that

to trash on veterinarians because

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we have to charge for our services

and we have to make a living.

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We have bills to pay loans to repay

and everything, but the majority

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of us go into this profession.

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wanting to help animals.

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And I think that a huge component of

like compassion fatigue is going into

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that room and seeing that treatable

condition and giving an estimate and then

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the person saying, I can't afford it.

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I'm either taking my sick animal home

to continue to suffer a poor quality of

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life or die at home, or you're going to

have to euthanize this treatable animal.

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Animal and I mean, it is an knee jerk

reaction to say that person shouldn't

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have that dog as opposed to I didn't

do something to help that situation.

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Dr. Blackwell: Yeah.

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And, and, you know, , Dr.

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G, , veterinary medicine cannot

buy ourselves solely, , fix

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this societal problem.

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, it's bigger than veterinary medicine.

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Uh, so in a sense, we are

victims of the realities that

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that we're talking about here.

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There are a lot, a lot of victims,

the individual needing the care, that

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individual's family, the veterinary

care team, and the community,

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because we're not preventing and

controlling zoonotic diseases when

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they don't have access to care.

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Everybody loses.

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So, What we need to do is work matter

of factly to Advocate for and facilitate

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a system of delivering veterinary care.

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You know, we, we grew up as a profession,

um, largely out of agriculture, but,

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uh, grew a thriving profession based

on a thriving middle class post.

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World War two, uh, middle, the middle

class was growing leaps and bounds and

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more and more discretionary money was in

the pockets of the families along the way.

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The role of the pet in our society

also transitioned or evolved to

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becoming a full fledged family member.

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Now, that's based on the Harris poll,

the latest Harris poll and survey

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and families with pets, 95 percent

considering the pet, a family member.

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So lack of a system and a system that

is built around family health care.

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So, when we, when we change our

perspective and we see ourselves as

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family health care providers, just as

the pediatricians, the geriatricians,

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okay, we're one of the teams taking

care of a family by focusing, in this

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case, on the non human family member.

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By not having that system, then

we're trying to figure this out on

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our own, along with animal welfare.

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Folks, uh, but the money is

not even in the two industries

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to take care of the problem.

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You know, if we look at human health

care and you ask 100 people that you

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meet randomly, do you pay 100 percent

for Your health care and you're

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getting you know, good quality care.

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You may be lucky to find one person, but

most likely out of 100, you won't find

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that person because we as humans rely

on assistance to get our health care.

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It's in the form of insurance.

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Primarily, um, we don't have

enough insurance options for

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families based on the fact that

less than 3 percent of the families

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actually use pet health insurance.

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Hopefully those policies

are going to improve.

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Uh, the finance industry is needed in

this moment because if the policies are

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going to put that family further in a

hole, um, because of a high interest

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rate and so forth, um, and I understand

they've got a crunch the numbers

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and manage their risk and so forth.

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But I'd like to believe that there,

there are better options to be found

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from financing to pet health insurance.

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Now those two things I just mentioned

are not putting that burden on veterinary

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medicine to figure out because we know

how to treat the patients generally

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on a dime instead of a dollar.

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We've historically had to do that.

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Um, It's not even given that opportunity.

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And so yes, when we turn people away,

not having helped them, or we take

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the life of someone they love, and

mind you, we're standing there knowing

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exactly how to help the patient.

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You know, our well being is going

to be undermined every time we

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go through that, that incident.

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And at some point, it's going

to start to, uh, interfere with

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our ability to stay healthy and,

uh, and serve everyone, frankly.

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Uh, so it's a situation of victims all

around and that's occurring because

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we don't have a systems approach.

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And, um, including other industries

outside of veterinary medicine

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DrG: and that, and that is so important.

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I think about, you know, the,

the service that we offer

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with my mobile clinic, right?

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So we'll go to, we'll go to locations.

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We'll do spay, neuter, wellness,

care, and then an occasion.

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There are people that will come in with

an animal that's Horribly injured or

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long term illness and they literally have

no option and we are not the best place

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for it, but we're the only place for it.

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And kind of understanding as veterinarians

that this may not be the best situation,

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but this is the only situation.

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What can I do?

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And I think that we're making a big

difference to those communities.

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Both in in the service that we're

giving and in the education for the

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owner so that they can be better

caretakers for their animals.

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But as you say, it's kind of like taking

care of 1 problem at 1 point in time.

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We are not really fixing

the problem of this person.

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Being able to maintain the

spay, neuter the vaccine.

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Yeah, it got taken care of.

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But how do we make sure that this animal

is fed, that they're on preventive

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care, that they, that they have the

other things that they need to keep

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themselves, other animals in the community

and the people in the community safe.

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Dr. Blackwell: Yeah, you know,

um, with two out of three of

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our households having pets.

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And less than 4 out of 10 have children.

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Family has been redefined by our society

to include human and non human members.

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, So you're more likely to encounter

a family that's a biodiverse family,

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as opposed to a family with children,

, or just, , adults, adult humans.

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And so I start from that perspective,

you know, when I think about,

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well, who is it that we're serving?

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You know, we said we're going to

benefit society and that oath, you know,

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that first line of the oath we took.

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Well, society is.

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Uh, extremely diverse, uh, combination

of privileged and non privileged,

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um, and expectations have evolved

through time because of the, um,

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the place of the pet in our society.

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So even though the laws are still saying,

uh, the pet is personal living property.

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Just like the plants in my office

here, you know, society says, if you

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abuse that pet, you can go to jail.

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They don't care what I do with my

other living property called a plant.

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And so, um, too often.

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I hear 1 of our colleagues say, well, you

know, they're just property under the law.

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Yeah, but we got to be careful

with that one because that's not

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the way the families view it.

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And, uh, and our words and our actions

ought to reflect a sensitivity to

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the fact that we're serving a family.

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And not just an animal, um, when we are

taking care of that patient, um, because

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it's family health and then you bring

in all these other pieces like housing,

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food and transportation and all the rest

and we look at our, our selves today

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and we say, well, where's the system

that was built for these families?

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It doesn't exist.

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You know, there are micro versions

of what needs to happen, but

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we need a national approach.

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Where, um, there's predictability

and consistency to help ensure

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essential services from medical

care to housing, food and so forth

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are available to our families.

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DrG: I think that that that

hits it right on and that, I

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mean, there's still property.

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So why would, you know, why, why

should we care to spend money

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and funds on somebody's property

because we're not seeing it as.

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For the importance that they have, or

for the sentient beings that they are.

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Yes.

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Um, so we have a, there is a disconnect

into the importance of, yeah, as

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you said, what constitutes a family.

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I know that, you know, I have my, my

cats, I have my child, and it's not

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about who I like better than who.

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Sometimes I like the cats better, right?

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But, but my cats are important to me.

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So I don't see them as disposable.

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I don't see them as, you know, okay, you

know, whatever happens is no big deal.

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If somebody injures them, just pay me

what they're worth and I'll be okay.

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It's not like breaking

my TV or hitting my car.

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There is a deep emotional attachment

to our animals as we should have.

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So, so yeah, we have to approach this.

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Much larger.

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Dr. Blackwell: You're not over

interpreting by your own lifestyle

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the word property in law.

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And I think law is going to change

because now there's already a movement

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to have court appointed representatives

for the pets in the justice system,

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uh, often custody, uh, You know,

battles, if you would, or, , people

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leaving estates or something to a pet,

you don't leave property to property.

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So it really, really is important that we

catch up to where society is the law will

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catch up to, but let's not be the ones

that's dragging the process along because,

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and we are at risk of doing that because.

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If you improve, increase the value of

that pet, my liability concerns go up.

358

:

That's real.

359

:

There's a lot of logic and it's

property, uh, liability issues.

360

:

All of that's there.

361

:

But at the end of the day, do

we really want to diminish the

362

:

significance of the human animal bond?

363

:

You know, and we can't have it both ways.

364

:

We really cannot, in my mind, you know, we

either celebrate, honor the human animal

365

:

bond, or we dismantle it, diminish it.

366

:

By uh, treating the patient as

mere property of no consequence

367

:

anymore than a chair back home,

well, a chair, a plant back home.

368

:

'cause a chair is not living

property, but a a, a plant back home.

369

:

And we know that's, that's

not the way society works.

370

:

We just cannot run certain realities

that we're confronted with.

371

:

DrG: Yeah, I was gonna say I'm taking

a companion animal law class and

372

:

one of the things that they discuss

in some of these court cases is the

373

:

concept of opening up the floodgates

374

:

to litigation, if we make animals not

be property, because right now, again,

375

:

if somebody harms an animal or an animal

is harmed, yeah, if it's cruelty to

376

:

animals, then that's that's different.

377

:

But then other than that,

they're just property.

378

:

Well, if we don't consider them

property, then what is going to

379

:

be added and what kind of, uh,

lawsuits or other filings can happen?

380

:

Because now we are harming a

living being instead of just

381

:

damaging somebody's property.

382

:

Dr. Blackwell: Mm hmm.

383

:

You know what I think is going to happen?

384

:

I think, , by the end of the decade,

70 percent of voters or eligible

385

:

voters will be millennials and Gen Z's.

386

:

Two generations that have adopted

the bonded family, we call them

387

:

lifestyle, human animal bond

related or associated family unit.

388

:

Um, I fully expect that laws will start

to be changed, public policies will

389

:

be adjusted because let's just take

government, for example, a government

390

:

program that is intended to support the

health and well being of families at risk.

391

:

will not have the luxury of ignoring

the presence of the non human

392

:

family members in the household.

393

:

You can't possibly do a good job and

the families are going to demand that

394

:

programs get adjusted accordingly.

395

:

, we might think that, well, you

know, the middle class probably

396

:

wouldn't go along with that.

397

:

But when we look at the socioeconomic

trends in the country, our

398

:

middle class is still decreasing.

399

:

While we're seeing, uh, an

enlarging of the working poor

400

:

class of families in our country.

401

:

So I look down the road and I'll look

at what the potential is for change

402

:

and oh, let's not place this strictly

on compassion because why would

403

:

the government have to be concerned

public health, the lack of prevention

404

:

and control of zoonotic diseases.

405

:

In the face of climate change.

406

:

Where we can predict, , larger

populations of vectors, , growing

407

:

populations of microbes and new

microbes entering the picture and new

408

:

communities and to not have a more

robust system to ensure availability

409

:

of health care for those pets means.

410

:

A national security threat.

411

:

So I look at it from that standpoint.

412

:

And for that reason, I, I see it as

existential as an existential crisis,

413

:

much like climate change is just

cannot be ignored and treated the

414

:

same as we have been and currently

still are, for the most part.

415

:

It will be to our detriment as a nation.

416

:

DrG: I think, you know, we also

kind of have to start with schools.

417

:

And like you said, you know, you

want it to be part of the school

418

:

to change the way that things were.

419

:

And I think that we have to

change the mindset of the

420

:

veterinarians that are graduating.

421

:

And even not just the mindset, but

even the pool that we're drawing from.

422

:

Because, you know, like here

in Ohio, for instance, uh,

423

:

we made a map of the deserts.

424

:

The places in Ohio that

lack veterinary care.

425

:

And the majority of those are

also lower income communities.

426

:

There's no resources as far as

food resources or pharmacies,

427

:

doctors, like there's just a void.

428

:

And then I saw the class that

for this year for the vet school,

429

:

and it has students from many

counties throughout the state.

430

:

And you know, which counties

are not represented.

431

:

Those deserts.

432

:

Dr. Blackwell: Yeah, I was

going to say, let me guess.

433

:

DrG: Yeah, right?

434

:

And, and I think that that in itself is a

huge problem because I feel that if you're

435

:

not from, from a certain area, if you

don't grow up in a certain culture, you're

436

:

going to have no interest in going there.

437

:

Right?

438

:

Like somebody that grows up in

central Ohio is not going to

439

:

want to go to southeast Ohio

to live or to work or anything.

440

:

Right.

441

:

There are places.

442

:

again, devoid of resources, not

just veterinarians, but there's,

443

:

there's not much happening there.

444

:

So who is going to go work in these

places that have no resources?

445

:

Well, we need to perhaps start taking

kids into a school that are from those

446

:

areas because they are more likely

to go back and help their community.

447

:

But then we also face the challenge that

Who are the role models to these kids?

448

:

There's no veterinarian to work.

449

:

When I was in high school, I

went to work for a veterinarian.

450

:

I knew what I wanted to do,

but I needed the experience.

451

:

And I went to the veterinarian, I had

two amazing role models, and then that

452

:

took me through to where I'm at today.

453

:

Who is the role model for veterinarians,

technicians, for anything in

454

:

these underserved communities?

455

:

Dr. Blackwell: Yeah, this is, uh, this

is why, , there still needs to be ongoing

456

:

discussions about people who've been

left behind, marginalized communities.

457

:

Middle America is filled with

these kinds of communities, uh, the

458

:

flyover communities of the country.

459

:

As far as academic veterinary

medicine, we have a passive system.

460

:

I often say without doing a thing,

we just simply open our door and

461

:

there's a long, long, long line

of people wanting to come in.

462

:

You didn't do a thing to

get that line to form.

463

:

So by being able to sit back and

just let this passive system work.

464

:

Well, what happens is you get

the privilege showing up and

465

:

that's not a slight on them.

466

:

It's just simply saying what comes

with privilege is the ability

467

:

to go to a professional school.

468

:

You know, I think of these young

people who grew up in some of our

469

:

rural communities and not necessarily

the strongest school system.

470

:

And this is across race.

471

:

It's not necessarily a minority

thing here in this case.

472

:

, they're disadvantaged.

473

:

They're not privileged, , in the

same sense of someone who grew

474

:

up in a thriving, uh, suburban

community with strong school systems.

475

:

So academia, yeah.

476

:

If I were King for a day would become

way more strategic and proactive in how

477

:

we fill those seats because it's only

through that process that we're going to

478

:

get the representation that you spoke of.

479

:

Otherwise, we will continue to lack

cultural competence because we'll

480

:

just a bunch of privileged people

who are doing the best they can

481

:

and trying to know and understand.

482

:

Unless you walk that walk,

you know, live that reality.

483

:

Maybe you don't know really what

it's like to, to serve a community

484

:

that that's, , marginalized.

485

:

Let's just put it that way.

486

:

.

DrG: I love that you just brought up the term of cultural competence,

487

:

because I feel like I've been yelling

that for the last year and it's mostly.

488

:

There are, there are quite a few

people that see what we do and they,

489

:

they talk about wanting to reproduce

that kind of system as far as the

490

:

mobile affordable and accessible care.

491

:

And they always ask about, you

know, what, what we're doing.

492

:

And I say, what we do, we have a certain

number of surgeries or procedures or

493

:

spots that we can do, but we leave it to

the community to tell us what they need.

494

:

Right.

495

:

Uh, my, my niece is a psychologist,

uh, down in Florida and she works in,

496

:

in Miami with, with different groups.

497

:

And I interviewed her actually

about the human animal bond

498

:

from a human perspective.

499

:

And she brought up the fact that we

have to bring care and assistance that

500

:

is necessary and that it is accepted.

501

:

If those things are not met,

then we're just self serving and

502

:

we're doing it for ourselves.

503

:

Then it's that savior, hey, I went

in and I helped all these people.

504

:

But are we helping?

505

:

Because...

506

:

You know, they say you can take the

horse to water, you can't make it drink.

507

:

Well, I can take my truck down to,

to a certain community and say, Hey,

508

:

I'm, I'm sterilizing dogs today.

509

:

But the community doesn't need

nor want their dogs sterilized.

510

:

Am I helping anything?

511

:

I am not.

512

:

So we have to, we have to listen.

513

:

We have to understand.

514

:

And that's where that, that diversity

of students is going to help.

515

:

Because again, you don't know

what someone needs unless you,

516

:

you grow up in that situation.

517

:

You understand the needs

and you can provide it.

518

:

In a, in a proper way.

519

:

Dr. Blackwell: That's the strongest

argument for diversity in this profession,

520

:

or in any, in any sense, because, um,

you know, I, I sometimes say, um, I

521

:

asked the question, can a 100 percent

white profession serve a diverse nation?

522

:

Theoretically, yes.

523

:

But practically, based on, um, a historic

perspective, that's probably not going

524

:

to happen, and for practical reasons,

for logical reasons, again, this logic

525

:

thing keeps getting in our way, that's

why we call them a paradox, you know.

526

:

Um, so, uh, not being culturally

competent is one of our limitations.

527

:

Um, and being more of a privileged

crowd, we are even further removed

528

:

from being culturally competent.

529

:

You know, um, Dr.

530

:

G, you can take a dart and throw it

at the United States map, and you

531

:

can throw it 100 times, 1000 times,

and no matter where it lands, We

532

:

don't even know the distribution

of diseases in that community.

533

:

Why?

534

:

We've never wanted the measures.

535

:

We did not advocate for

these measures to be taken.

536

:

We don't, we can't, a community cannot

plan for needed services because

537

:

they don't even have an understanding

of their own needs in some cases.

538

:

But we start by trying to understand

what they understand about their

539

:

needs, as you were saying a moment ago.

540

:

And then help them to move to a

different level of understanding

541

:

if that seems to be, uh, needed.

542

:

But we shouldn't be in the 20th

century and can't hit a community

543

:

in this country and not know the

distribution of the diseases.

544

:

You know, what are the top 10?

545

:

We can take national data from big,

big data databases, um, And we can do

546

:

a guesstimate about that, but there

ought to be more precision than that.

547

:

We have the capability as a nation.

548

:

And again, veterinary medicine

doesn't even have to do it.

549

:

We just need to advocate

for it being done.

550

:

There are public universities across

the country with students who would

551

:

welcome these kinds of projects.

552

:

And it wouldn't cost the profession

anything, but we want, we have to want

553

:

to know, we have to be curious enough.

554

:

For whatever reason, to advocate for

these measures to be taken, um, and,

555

:

and on the human side, especially from

a social service perspective, there

556

:

are all kinds of survey instruments

that are being utilized to understand

557

:

communities in order to make plans.

558

:

There's a healthy people's strategic

plan of the nation with social

559

:

determinants of health being discussed.

560

:

What are those key

leading health indicators?

561

:

If we are the full fledged medical

profession that we are, you,

562

:

you would think that we would

be mirroring or looking somewhat

563

:

like, uh, healthcare in general.

564

:

So when I talk about fragmented

healthcare, we are really disconnected

565

:

from how health care works, including

the fact there needs to be a systems

566

:

approach and that it's family health care

made up of an interprofessional group of

567

:

disciplines or people and organizations

and not the sole proprietorship

568

:

that operate under their own roof.

569

:

And they don't share any information.

570

:

They don't receive much as

far as being in a system.

571

:

So I keep going back to that

systems thing, because I think

572

:

until we have that in place, we

won't achieve cultural competence.

573

:

DrG: So one of the important things about

this is the inclusion of the social worker

574

:

into the veterinary care, and that's

one of the things that I'm looking into

575

:

and wanting to add to our services as

a way to provide more long term care.

576

:

So can you discuss the role of the

social worker in, in In conjunction

577

:

with veterinary medicine for the short

term problems, but then in helping

578

:

that that family continue to care

for themselves and for their animals.

579

:

Dr. Blackwell: Yeah.

580

:

Okay.

581

:

Um, thank you for the question.

582

:

So let's establish the context.

583

:

Again, the context is.

584

:

I, as a veterinarian, can't do

what I've dedicated my life to

585

:

do because of human realities.

586

:

Now, I can either go back to school

and learn things about communicating

587

:

in difficult situations and diffusing

things and, and I can leave the practice

588

:

and I can go out and help my client get

these other essential resources, or I

589

:

can choose to partner With a profession

that actually exists for those reasons,

590

:

you know, social work is a very, very

important profession at the heart of it is

591

:

meeting people where they are and helping

them to get to where they need to be

592

:

resource wise and so forth,

connecting them with needed resources.

593

:

Um, while I was with the office of

the surgeon general, we were often

594

:

talking about disparities and help.

595

:

And I was shocked when I learned that the

number one reason that families were not

596

:

accessing services in their community was

that they didn't even know Either that the

597

:

services were available to them, or they

didn't know how to navigate the system.

598

:

Well, veterinary medicine is,

we've got our plates full.

599

:

We need to be focused on

what we're trained to do.

600

:

But we ought to care enough about

the client that we're serving in that

601

:

veterinary client patient relationship.

602

:

That we would want to be in a One

Health system where somebody is

603

:

attending to our client's needs while

we take care of the client's family

604

:

member, the non human family member.

605

:

So social work is that, that profession,

foremost profession, and finding,

606

:

linking people with needed resources.

607

:

Veterinary social work was started

here at the University of Tennessee

608

:

in 2002, while I was dean, because we

wanted Social workers to get additional

609

:

training in how to support the

humans where pets are in the picture.

610

:

So a simple example, if a social worker is

trying to address a housing situation, so

611

:

either the person is already on sheltered

or they are insecure in their housing.

612

:

And they're doing that work without

considering the non human family member,

613

:

they're not doing the job that the family

actually needs their help with because

614

:

they've left out a family member, uh,

so rather than spending time trying

615

:

to line up housing, where the policy

won't even allow the pet to be there.

616

:

Or maybe they have a pet policy, but

there are some other policy related

617

:

matters that represent a barrier.

618

:

Um, what a veterinary social worker

would do is not make that mistake.

619

:

Because they're going to be

factoring in the presence of the pet.

620

:

They also, by the way, though, attend to

the human needs, even around livestock.

621

:

So, when a family loses, um, Their flock

or herd or whatever due to the population

622

:

because of a terrible disease or whatever.

623

:

There are huge mental health impacts

on that family and , there hasn't

624

:

been historically that system

to attend to the family's need.

625

:

So veterinary social workers would

be that special discipline within

626

:

social work where additional

training has been acquired.

627

:

And how to work with families where

animals are part of the picture.

628

:

DrG: I really like the inclusion.

629

:

Uh, I interviewed, , Alicia Kennedy from

Australia and she is an amazing woman.

630

:

And she, she was talking about the

importance of the social worker as

631

:

she helps primarily seniors, but

in how it helps along the whole

632

:

way, like you brought up the, the

mental health aspect, we just.

633

:

Think about the, the economic aspect or,

you know, even the housing aspect, but

634

:

we don't think about the emotional toll

that it takes on that person to not be

635

:

able to provide the help or if the animal

needs to be euthanized because it's at

636

:

that point in life, how difficult it is

for that person, like you're going to

637

:

euthanize their, their dog or their cat.

638

:

And then this person, especially

in her case, the elderly,

639

:

They're just going to go home.

640

:

It's like, okay, well, I hope you're okay.

641

:

Um, you know, like there's,

there's nothing else.

642

:

And as veterinarians, there's

not much for us to do.

643

:

I mean, what do we do?

644

:

We just send a sympathy card

and, and hope that that's okay.

645

:

But what, what can we do?

646

:

We're not trained for that.

647

:

So I think that that is an amazing place

for social workers to just take, take

648

:

one where the veterinary work ends.

649

:

Take on the human aspect from there

and just kind of complete the circle.

650

:

Dr. Blackwell: Yes.

651

:

Yes, because, um, you know, I,

I also often comment on the fact

652

:

that when someone is in crisis

when humans are in crisis, we are

653

:

emotional one way or the other.

654

:

And when we're emotional,

we're not always logical.

655

:

We certainly don't always.

656

:

communicate in the most, um, , I

guess, straightforward way.

657

:

Um, it's human.

658

:

It's human reality.

659

:

And I tell you, the veterinary social

work thing, uh, my vision for what became

660

:

veterinary social work actually started

while I was in practice in Maryland.

661

:

Before I became Dean at Tennessee, and

I had a good clientele, um, very middle

662

:

class clientele, every now and then,

um, lower income people, but it was

663

:

during that practice that I recognized,

oh boy, this is not my dad's veterinary

664

:

practice world, you know, people had

changed, you know, the bond was so on

665

:

display all the time, and I was As chief

of staff, we were working on the first

666

:

surgeon general's report on mental health.

667

:

And so suddenly, or gradually, really, I

came to appreciate how often I had been

668

:

looking across that table into the eyes

of depression and anxiety or anxiety.

669

:

I felt so inadequate in that

moment because I always prided

670

:

myself as being a people person,

as really serving my clients.

671

:

Having those conversations that

around end of life, uh, addressing

672

:

the guilt, but coming out of not

a formerly trained perspective.

673

:

So, uh, social work, veterinary

social work grew out of a realization

674

:

that we were way in over our

heads there and we needed the.

675

:

The allied profession to be there with us.

676

:

Uh, that would safeguard the mental health

of the of the veterinary care team as

677

:

it safeguards the health of the family.

678

:

DrG: I recently spoke in my last

podcast about the concept of no kill

679

:

and how people are really upset about

the number of animals or the, the

680

:

percentages as far as no kill and, and

one of the things is that I think that.

681

:

The perspective is in the wrong place.

682

:

We're seeing the euthanasia is the problem

and it's not the problem is the result

683

:

of a problem and everybody is like, well,

to to fix the euthanasia number, then we

684

:

just need to release animals that are not

altered and we need to adopt to everybody.

685

:

And we just need to have

better policies and not intake.

686

:

And that's not fixing the problem.

687

:

That's not closing that that

spigot so that it doesn't

688

:

keep putting water through.

689

:

Right?

690

:

And it's not

691

:

Dr. Blackwell: Oh, that's mopping

the floor and not turning off.

692

:

DrG: Right.

693

:

Exactly.

694

:

Because, I mean, I, I struggled a

little bit with the, with the subject

695

:

of that podcast because I don't want

to come off as being pro euthanasia

696

:

because that's not the point.

697

:

My point is we have to understand that

euthanasia is just an end result, and

698

:

we need to take accountability for

how these animals are ending up in

699

:

shelters, how these animals are ending

up in these situations, how people are

700

:

ending up having to relinquish their

animals, or Not even relinquishing the

701

:

animals, they just have unsterilized

animals because there's no access to

702

:

spay and neuter services, so then their

large dogs are having all these puppies,

703

:

and where are they going to end up?

704

:

I think that, you know, in looking at

the whole, how do we fix the shelter

705

:

problem, this is a huge way, like, one

of the many things that we need to help

706

:

that shelter problem, is to keep them from

ending up at the shelter to begin with.

707

:

Dr. Blackwell: Yeah,

and in order to do that.

708

:

Just as I believe companion animal

veterinarians are actually in the

709

:

business of family health care,

shelters are social service agencies.

710

:

Their work is as important

outside of those walls.

711

:

As it is inside of the walls

and and yet historically.

712

:

It's been inside the walls that

the problem is being addressed and

713

:

we're really just mopping the floor,

, without turning off the spigot.

714

:

So, culturally shifting

to a social service

715

:

.

Foundation, uh, brings with it what all social services, social service

716

:

agencies do, and that is being connected

with the system in one way or another,

717

:

usually in multiple ways, because, yes,

if you, if you don't stop them from

718

:

coming in, and let's just say what,

what are some of the common reasons?

719

:

Well, uh, the family, uh, the, the, the

pet has a medical, , need family can't

720

:

find an option in the community

and they come to the shelter for a

721

:

solution, which too often involves

relinquishment, um, but the family is

722

:

hoping that their loved one get some help.

723

:

They're not necessarily just

discarding someone they love.

724

:

Um, I mean, all you got to do is spend

a little time in an intake area of

725

:

a shelter and just see the, the, the

emotional trauma that's going on there.

726

:

So, , Going back to cultural

competence, if the profession is

727

:

going to become culturally competent,

it's not just understanding the

728

:

community, but understanding what

our role is toward the community.

729

:

As family health care providers,

cultural competence for shelter is

730

:

not just understanding the community

but understanding again how to work

731

:

with that community outside of those

walls in order to address the problem.

732

:

DrG: Yeah, I think that You know,

it's, it's kind of, I think of,

733

:

it's a simple problem with a

very difficult solution, right?

734

:

It's kind of like the best way to say it.

735

:

It's like, we know, we know what

needs to happen, but there's so

736

:

many things that need to come.

737

:

Together to be able to do it and

and to your point at the beginning

738

:

of this of this conversation is is

not just a veterinarian problem.

739

:

We just have part of the problem.

740

:

It's not just a society problem.

741

:

It's not just a physician's problem.

742

:

We all have to just.

743

:

Come together into the concept

of one health and take care

744

:

of everything together.

745

:

Dr. Blackwell: Yes.

746

:

Yes, and I hope I hope Those who are

listening to to this podcast And in our

747

:

individual conversations that we become

advocates for the development of a

748

:

systems approach and that needs to be a

one health System that's when veterinary

749

:

medicine will be able to do a better job

of reaching those underserved individuals.

750

:

We just have no other choice but

to work with others to address it.

751

:

It will be to our detriment

to not have such a system

752

:

formed very quickly, actually.

753

:

Um, do I have optimism?

754

:

Yes.

755

:

Because again, I think the public health

issues and which include mental health,

756

:

by the way, is not just physical health.

757

:

Um, these are going to be big

drivers for change out of necessity.

758

:

And, uh, I fear that we

may might be dragged along.

759

:

I'm hoping we're not being dragged along,

but rather we're like, you know, on the

760

:

front line helping to make this happen.

761

:

DrG: Anybody that's listening that

wants to learn more about One Health

762

:

and about veterinary social work

and about the things that we need

763

:

to do as a community to do better

for our pets, what kind of resources

764

:

would you recommend that they visit?

765

:

Dr. Blackwell: Well, they can

certainly go to our website at, uh, P.

766

:

P.

767

:

H.

768

:

E.

769

:

Paul Paul Henry Edward dot U.

770

:

T.

771

:

K.

772

:

dot E.

773

:

D.

774

:

U.

775

:

U.

776

:

T.

777

:

K.

778

:

University of Tennessee, Knoxville.

779

:

Yes.

780

:

Um, besides that, uh, there is a lot of,

uh, besides our website there, there,

781

:

there are a lot of other resources.

782

:

Uh, simple Googling will get you to a lot

of those resources, uh, of information.

783

:

Unfortunately, there won't

be a whole lot around.

784

:

Systems that we've been working on

a system called the Align Care and

785

:

you'll find information there on Align

Care, but we need more thinking about

786

:

a systems approach my interfacing

with the human health care community.

787

:

They are ready, they, they see the same

problem from their, their perspective,

788

:

even though they don't understand it

from the veterinarian's perspective.

789

:

So I think.

790

:

Time is ripe, if you would, for a system

to start to be formed in a larger sense.

791

:

DrG: Excellent.

792

:

Well, this has been an

amazing conversation.

793

:

I'm so happy that I got to spend this

hour talking to you, and I hope that

794

:

everybody that's listening understands,

has a better understanding, and a little

795

:

bit less judgment of those individuals

who perhaps cannot take as good care

796

:

as we think they should be, because

it's also a matter of perspective.

797

:

Um, but, but yeah, you know,

thank you so very much.

798

:

And I hope to talk to you again at

some point and, and if anything, be

799

:

able to share some of the, some of

the things that we can do and get your

800

:

information on how we can do better.

801

:

Dr. Blackwell: Well, thank you

for allowing me to join you

802

:

today and have this conversation.

803

:

Very, very important one, so I appreciate

the work you're doing because we, we

804

:

do need people like yourself who are

carrying the messages forward and out

805

:

there and stimulating the thinking.

806

:

Thank you for all of that and I wish

you the best as you continue your work.

807

:

DrG: Thank you so very much.

808

:

Well, for everybody that's out there,

take care of yourself, take care of

809

:

your animals and thanks for caring.

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About the Podcast

The Animal Welfare Junction
Veterinary Forensics
The Animal Welfare Junction is a podcast developed to bring awareness to different topics in animal welfare. The host, Michelle Gonzalez (Dr. G) is a veterinarian who provides affordable veterinary care in the State of Ohio, and also a Forensic Veterinarian helping with the investigation and prosecution of cases of animal cruelty and neglect.
The topics presented are based on the experiences of Dr. G and our guests and include discussions about real cases, humane projects, and legal issues that affect animals and the community. Due to the nature of the discussion, listener discretion is advised as some topics may be too strong for some listeners.

About your host

Profile picture for Alba Gonzalez

Alba Gonzalez

Michelle González (DrG) was born and raised in Puerto Rico. Her passion growing up was to become a veterinarian. She obtained a B.S. in Zoology at Michigan State University and the Doctor of Veterinary Medicine degree at The Ohio State University, followed by a 1-yr Internship in Medicine, Surgery, Emergency and Critical Care at the University of Missouri-Columbia. In 2006 she founded the Rascal Unit, a mobile clinic offering accesible and affordable sterilization, and wellness services throughout the State of Ohio.
Dr. G is involved in many aspects of companion veterinary medicine including education, shelter assistance and help to animals that are victims of cruelty and neglect.
DrG completed a Master’s degree in Veterinary Forensics from the University of Florida and a Master’s in Forensic Psychology from Southern New Hampshire University. She is currently enrolled at the University of Florida Forensic Science program. She assists Humane organizations and animal control officers in the investigation, evaluation, and prosecution of cases of animal cruelty and neglect.