Hi, and welcome to the Animal Welfare Junction. This is your host, Dr. G, and our music is written and produced by Mike Sullivan. Today, I am so stoked about my guest. Um, I met Dr. Michael Blackwell this year at the HSUS Animal Care Expo during a roundtable discussion on the topic that we're going to be discussing today, One Health. And it was such a huge motivating factor. I'm actually getting chills. Um, because it is something that over time I have seen that is needed, that is necessary. And that we are just not offering and we just need to increase this. So I am really looking forward to this conversation and to teaching people about the importance of One Health. So thank you so much, Dr. Blackwell, for being here today.

Well, thank you, Dr. G. I appreciate the opportunity to visit with you and your listeners. Very, very important topic here that you're covering.

So for those of you, for those people that may be listening who don't know who you are, can you let them know kind of where you started and what brought you to where you are today and your current position?

Well, my name is Michael Blackwell. I'm a veterinarian with training also in public health. Um, my career started as a kid because my dad, uh, was a general practitioner, mixed animal practitioner during, during my upbringing. So I've been in the veterinary medicine world my entire life, um, and, uh, of course grew up privileged as a result of that and being privileged in this sense has afforded me the opportunity to learn a lot of things, to experience a lot of things. And I've enjoyed a few careers along the way. You know, I thought I would be a mixed animal practitioner just like my dad. Uh, he closed his practice during my senior year of high school and joined the faculty at Tuskegee University College of Veterinary Medicine. So, um, I went back to Oklahoma, um, after training at Tuskegee and, uh, practiced for a few years. But during that time, Felt a real calling to do more than I was able to do in my small town in Oklahoma. That led to 23 years with the United States Public Health Service. Most of that time with the Food and Drug Administration. My last duty, um, Was a chief of staff of the Office of the Surgeon General of the United States. So speaking of those opportunities and exposures that I got along the way, that 23 year career really did expand my understanding of the world as a veterinarian. And better understand and how important our profession is, uh, to the well being of our planet. Frankly, um, a left active duty with the United States Public Health Service to become dean of the veterinary college at the University of Tennessee. And frankly, uh. I took that position because of the need to focus on public health more than colleges were at the time and, after a few years as Dean, I left that work to focus really solely on animal welfare. issues. I think like many veterinarians, I knew there were these issues out there around animal welfare, but, I was indirectly connected with them until I got involved with sheltering and, that opened my eyes even more to many of the issues, that our communities face, our families face. So, um, to fast forward, therefore, it was the day that A Vietnam veteran's dog got euthanized over, because of a treatable medical problem, uh, injury. And that euthanasia occurred because he could not pay for the needed care. And for the first time in my career, again, I grew up in the profession. I saw euthanasias performed as a kid, but for the first time, it just seemed all wrong that being the nation that we are, it seemed all wrong that we have people who have contributed to our well being, like our men and women in uniform, um, like our public servants, school teachers and other public servants, but often, not earning a lot of, income, but deserving of a relationship with a pet, as a family member. And so it was then that I knew I had to dedicate my, my life to the work of improving access to veterinary care so that all, um, Get the care that they deserve to, to, to have. And that's irrespective of their socio economic reality. And therein is where it starts to get interesting.

That is a great, that is a great story because I mean it does. It does bring about different aspects. Um, you know, I didn't grow up poor. I didn't grow up rich, but I grew up very comfortable, but I grew up seeing some of the struggles that some of my friends and family were going through. So I Never look down on them as them being lesser because they could not afford some of the same things as me. They were in a different economic status, but they, they were the same people. And I've always maintained that, uh, somewhat similar to you. I, when I went to vet school, I had a different plan. I. I thought I was going to be a surgeon, which I do a lot of surgery, but you know, I was going to go and do a residency or something and, you know, kind of playing it by ear as to where I was going to end up. But I started working at a vet clinic that did a lot of rescue work, and we were seeing all of these animals here in, in central Ohio that were being brought in. From rural areas because those rural areas did not have access to care. So then they were dumping into central Ohio and we were seeing animals that were being euthanized or that were sick or whatever, whatever it was. And even the rescue saying, well, we're, we're getting them out of there because if not, they're just going to get killed down there. So it changed my whole perspective little, and it wasn't overnight. It was a little bit, a smooth transition, but into the need. That that these underserved communities had and kind of led to me wanting to do something about it. Right. So, um, and that's where that's where I am right now. And still. You know, working to, to make it better because to your point, I mean, it is important for us as veterinarians to help both the animals and the community, uh, that we're going to be talking about the concept of one health and just in, in very broad terms, but just from personal experience, I've known of. human doctors that will say, Oh yeah, that's an animal condition. You need to talk to your veterinarian about it, like scabies or worms or whatever. Like they will not give a, they will not give a real answer.

Right. Yeah. Yeah. And that reflects a fragmented healthcare system. And so when, when I think in terms of One Health, our work is about. Strategically connecting the health care system so that it's less fragmented so that families are being served holistically and yeah, there are those moments when a veterinarian really needs to be in the room or physician, depending on the situation. But too often, um, families are sent down the road, uh, here and there, uh, to get care that could be here. Packaged and delivered in a, in a more holistic way.

So what is for people that do not understand what one health means, what is the concept of one health and how does that involve not just veterinarians, but other professionals as well?

It's a simple concept. It's based on the reality that on this planet. Humans, animals share the same environment as a shared environment or ecosystem. And when we are trying to improve the health of any one of those three, whether it's humans, animals, or the environment, We need to factor in consider all three. So if I'm, if I'm wanting to improve the health outcomes for human population, my plans are, are not adequate. If I've not even considered the impact of animals on humans. And vice versa. But also what their shared environment looks like. So it's not always air and water quality in this case. We often think of, uh, socioeconomics. That's an environmental reality, uh, the shared environment of a family based on their socioeconomic reality. So, um, that's what One Health is. Now to bring that home, when I think of access to veterinary care, I So as a veterinarian, my heart is breaking for this pet that needs care, and I want to figure out a way to get care to that pet. But it turns out the barriers to me being able to get that care to that pet are associated with the humans in the pet's life. And so programs that don't address the human reality are going to come up short. In trying to reach the pets that are currently underserved. Um, and so when looking at the people in their realities, we see, while the barriers associated with them, and that quickly starts to clarify their environmental reality, that's low socioeconomics, which is more than limited money. It may represent housing insecurity, food insecurity, language barriers, and so on and so forth. So looking holistically at the family, the humans, the animals, and their shared environment is what One, One Health is.

One of the things that I have a huge issue with is the whole concept of if you cannot afford an animal, you should not have it. Right. And, and that is something that is, that I see more and more, uh, recently on social media. I was, saw a post where somebody was talking about subsidizing and affordable care and somebody else went as far as basically saying that somebody that is low income is an irresponsible pet owner. And in my personal experience, I've seen people that will go hungry just so that their animal will eat. I mean, that is a bond. That is, that is something that We don't know because we don't have to make that decision. If we were in that decision, what would we do? Right? So, and that comes down to the importance of the human animal bond, kind of regardless, regardless of the ability of the person to financially help, and be economically stable, and also not taking into consideration that that person may have been economically, financially stable when they got that animal, and then something happened, illness. Work, whatever the reason and now they're not able to afford that pet. So how do we help with that? Right? So

I appreciate the way you summarize the reality. Um, you know, my response to, uh, that statement is first and foremost, acknowledging there's logic there. Okay. So, okay. It's a logical statement by some measures, but At the heart of it, what's going on there is the person who makes the statement is at risk. Of attacking the relationship as opposed to attacking the problem of lack of systems to ensure everybody has access to health care. It's the relationship is not the problem. Now, some can be because there are instances where that relationship should not exist, but most often what we're talking about, especially if it's a case of someone with limited means, yes, the bond often is tighter there. Um, even among the unsheltered, they may be the poster, a poster image of the human animal bond relationship. Um, and so, is the relationship the problem, or is it our lack of diligence in having systems to ensure they have access to, to health care?

Yeah, I think we, we're always kind of like looking at something to blame. And I think that by shifting the blame to the person can't afford it, we eliminate. our blame of we are not providing a care that's needed. Uh, and, and, and I'm not saying that to trash on veterinarians because we have to charge for our services and we have to make a living. We have bills to pay loans to repay and everything, but the majority of us go into this profession. wanting to help animals. And I think that a huge component of like compassion fatigue is going into that room and seeing that treatable condition and giving an estimate and then the person saying, I can't afford it. I'm either taking my sick animal home to continue to suffer a poor quality of life or die at home, or you're going to have to euthanize this treatable animal. Animal and I mean, it is an knee jerk reaction to say that person shouldn't have that dog as opposed to I didn't do something to help that situation.

Yeah. And, and, you know, Dr. G, veterinary medicine cannot buy ourselves solely, fix this societal problem. it's bigger than veterinary medicine. Uh, so in a sense, we are victims of the realities that that we're talking about here. There are a lot, a lot of victims, the individual needing the care, that individual's family, the veterinary care team, and the community, because we're not preventing and controlling zoonotic diseases when they don't have access to care. Everybody loses. So, What we need to do is work matter of factly to Advocate for and facilitate a system of delivering veterinary care. You know, we, we grew up as a profession, um, largely out of agriculture, but, uh, grew a thriving profession based on a thriving middle class post. World War two, uh, middle, the middle class was growing leaps and bounds and more and more discretionary money was in the pockets of the families along the way. The role of the pet in our society also transitioned or evolved to becoming a full fledged family member. Now, that's based on the Harris poll, the latest Harris poll and survey and families with pets, 95 percent considering the pet, a family member. So lack of a system and a system that is built around family health care. So, when we, when we change our perspective and we see ourselves as family health care providers, just as the pediatricians, the geriatricians, okay, we're one of the teams taking care of a family by focusing, in this case, on the non human family member. By not having that system, then we're trying to figure this out on our own, along with animal welfare. Folks, uh, but the money is not even in the two industries to take care of the problem. You know, if we look at human health care and you ask 100 people that you meet randomly, do you pay 100 percent for Your health care and you're getting you know, good quality care. You may be lucky to find one person, but most likely out of 100, you won't find that person because we as humans rely on assistance to get our health care. It's in the form of insurance. Primarily, um, we don't have enough insurance options for families based on the fact that less than 3 percent of the families actually use pet health insurance. Hopefully those policies are going to improve. Uh, the finance industry is needed in this moment because if the policies are going to put that family further in a hole, um, because of a high interest rate and so forth, um, and I understand they've got a crunch the numbers and manage their risk and so forth. But I'd like to believe that there, there are better options to be found from financing to pet health insurance. Now those two things I just mentioned are not putting that burden on veterinary medicine to figure out because we know how to treat the patients generally on a dime instead of a dollar. We've historically had to do that. Um, It's not even given that opportunity. And so yes, when we turn people away, not having helped them, or we take the life of someone they love, and mind you, we're standing there knowing exactly how to help the patient. You know, our well being is going to be undermined every time we go through that, that incident. And at some point, it's going to start to, uh, interfere with our ability to stay healthy and, uh, and serve everyone, frankly. Uh, so it's a situation of victims all around and that's occurring because we don't have a systems approach. And, um, including other industries outside of veterinary medicine

and that, and that is so important. I think about, you know, the, the service that we offer with my mobile clinic, right? So we'll go to, we'll go to locations. We'll do spay, neuter, wellness, care, and then an occasion. There are people that will come in with an animal that's Horribly injured or long term illness and they literally have no option and we are not the best place for it, but we're the only place for it. And kind of understanding as veterinarians that this may not be the best situation, but this is the only situation. What can I do? And I think that we're making a big difference to those communities. Both in in the service that we're giving and in the education for the owner so that they can be better caretakers for their animals. But as you say, it's kind of like taking care of 1 problem at 1 point in time. We are not really fixing the problem of this person. Being able to maintain the spay, neuter the vaccine. Yeah, it got taken care of. But how do we make sure that this animal is fed, that they're on preventive care, that they, that they have the other things that they need to keep themselves, other animals in the community and the people in the community safe.

Yeah, you know, um, with two out of three of our households having pets. And less than 4 out of 10 have children. Family has been redefined by our society to include human and non human members. So you're more likely to encounter a family that's a biodiverse family, as opposed to a family with children, or just, adults, adult humans. And so I start from that perspective, you know, when I think about, well, who is it that we're serving? You know, we said we're going to benefit society and that oath, you know, that first line of the oath we took. Well, society is. Uh, extremely diverse, uh, combination of privileged and non privileged, um, and expectations have evolved through time because of the, um, the place of the pet in our society. So even though the laws are still saying, uh, the pet is personal living property. Just like the plants in my office here, you know, society says, if you abuse that pet, you can go to jail. They don't care what I do with my other living property called a plant. And so, um, too often. I hear 1 of our colleagues say, well, you know, they're just property under the law. Yeah, but we got to be careful with that one because that's not the way the families view it. And, uh, and our words and our actions ought to reflect a sensitivity to the fact that we're serving a family. And not just an animal, um, when we are taking care of that patient, um, because it's family health and then you bring in all these other pieces like housing, food and transportation and all the rest and we look at our, our selves today and we say, well, where's the system that was built for these families? It doesn't exist. You know, there are micro versions of what needs to happen, but we need a national approach. Where, um, there's predictability and consistency to help ensure essential services from medical care to housing, food and so forth are available to our families.

I think that that that hits it right on and that, I mean, there's still property. So why would, you know, why, why should we care to spend money and funds on somebody's property because we're not seeing it as. For the importance that they have, or for the sentient beings that they are. Yes. Um, so we have a, there is a disconnect into the importance of, yeah, as you said, what constitutes a family. I know that, you know, I have my, my cats, I have my child, and it's not about who I like better than who. Sometimes I like the cats better, right? But, but my cats are important to me. So I don't see them as disposable. I don't see them as, you know, okay, you know, whatever happens is no big deal. If somebody injures them, just pay me what they're worth and I'll be okay. It's not like breaking my TV or hitting my car. There is a deep emotional attachment to our animals as we should have. So, so yeah, we have to approach this. Much larger.

You're not over interpreting by your own lifestyle the word property in law. And I think law is going to change because now there's already a movement to have court appointed representatives for the pets in the justice system, uh, often custody, uh, You know, battles, if you would, or, people leaving estates or something to a pet, you don't leave property to property. So it really, really is important that we catch up to where society is the law will catch up to, but let's not be the ones that's dragging the process along because, and we are at risk of doing that because. If you improve, increase the value of that pet, my liability concerns go up. That's real. There's a lot of logic and it's property, uh, liability issues. All of that's there. But at the end of the day, do we really want to diminish the significance of the human animal bond? You know, and we can't have it both ways. We really cannot, in my mind, you know, we either celebrate, honor the human animal bond, or we dismantle it, diminish it. By uh, treating the patient as mere property of no consequence anymore than a chair back home, well, a chair, a plant back home. 'cause a chair is not living property, but a a, a plant back home. And we know that's, that's not the way society works. We just cannot run certain realities that we're confronted with.

Yeah, I was gonna say I'm taking a companion animal law class and one of the things that they discuss in some of these court cases is the concept of opening up the floodgates to litigation, if we make animals not be property, because right now, again, if somebody harms an animal or an animal is harmed, yeah, if it's cruelty to animals, then that's that's different. But then other than that, they're just property. Well, if we don't consider them property, then what is going to be added and what kind of, uh, lawsuits or other filings can happen? Because now we are harming a living being instead of just damaging somebody's property.

Mm hmm. You know what I think is going to happen? I think, by the end of the decade, 70 percent of voters or eligible voters will be millennials and Gen Z's. Two generations that have adopted the bonded family, we call them lifestyle, human animal bond related or associated family unit. Um, I fully expect that laws will start to be changed, public policies will be adjusted because let's just take government, for example, a government program that is intended to support the health and well being of families at risk. will not have the luxury of ignoring the presence of the non human family members in the household. You can't possibly do a good job and the families are going to demand that programs get adjusted accordingly. we might think that, well, you know, the middle class probably wouldn't go along with that. But when we look at the socioeconomic trends in the country, our middle class is still decreasing. While we're seeing, uh, an enlarging of the working poor class of families in our country. So I look down the road and I'll look at what the potential is for change and oh, let's not place this strictly on compassion because why would the government have to be concerned public health, the lack of prevention and control of zoonotic diseases. In the face of climate change. Where we can predict, larger populations of vectors, growing populations of microbes and new microbes entering the picture and new communities and to not have a more robust system to ensure availability of health care for those pets means. A national security threat. So I look at it from that standpoint. And for that reason, I, I see it as existential as an existential crisis, much like climate change is just cannot be ignored and treated the same as we have been and currently still are, for the most part. It will be to our detriment as a nation.

I think, you know, we also kind of have to start with schools. And like you said, you know, you want it to be part of the school to change the way that things were. And I think that we have to change the mindset of the veterinarians that are graduating. And even not just the mindset, but even the pool that we're drawing from. Because, you know, like here in Ohio, for instance, uh, we made a map of the deserts. The places in Ohio that lack veterinary care. And the majority of those are also lower income communities. There's no resources as far as food resources or pharmacies, doctors, like there's just a void. And then I saw the class that for this year for the vet school, and it has students from many counties throughout the state. And you know, which counties are not represented. Those deserts.

Yeah, I was going to say, let me guess.

Yeah, right? And, and I think that that in itself is a huge problem because I feel that if you're not from, from a certain area, if you don't grow up in a certain culture, you're going to have no interest in going there. Right? Like somebody that grows up in central Ohio is not going to want to go to southeast Ohio to live or to work or anything. Right. There are places. again, devoid of resources, not just veterinarians, but there's, there's not much happening there. So who is going to go work in these places that have no resources? Well, we need to perhaps start taking kids into a school that are from those areas because they are more likely to go back and help their community. But then we also face the challenge that Who are the role models to these kids? There's no veterinarian to work. When I was in high school, I went to work for a veterinarian. I knew what I wanted to do, but I needed the experience. And I went to the veterinarian, I had two amazing role models, and then that took me through to where I'm at today. Who is the role model for veterinarians, technicians, for anything in these underserved communities?

Yeah, this is, uh, this is why, there still needs to be ongoing discussions about people who've been left behind, marginalized communities. Middle America is filled with these kinds of communities, uh, the flyover communities of the country. As far as academic veterinary medicine, we have a passive system. I often say without doing a thing, we just simply open our door and there's a long, long, long line of people wanting to come in. You didn't do a thing to get that line to form. So by being able to sit back and just let this passive system work. Well, what happens is you get the privilege showing up and that's not a slight on them. It's just simply saying what comes with privilege is the ability to go to a professional school. You know, I think of these young people who grew up in some of our rural communities and not necessarily the strongest school system. And this is across race. It's not necessarily a minority thing here in this case. they're disadvantaged. They're not privileged, in the same sense of someone who grew up in a thriving, uh, suburban community with strong school systems. So academia, yeah. If I were King for a day would become way more strategic and proactive in how we fill those seats because it's only through that process that we're going to get the representation that you spoke of. Otherwise, we will continue to lack cultural competence because we'll just a bunch of privileged people who are doing the best they can and trying to know and understand. Unless you walk that walk, you know, live that reality. Maybe you don't know really what it's like to, to serve a community that that's, marginalized. Let's just put it that way.

I love that you just brought up the term of cultural competence, because I feel like I've been yelling that for the last year and it's mostly. There are, there are quite a few people that see what we do and they, they talk about wanting to reproduce that kind of system as far as the mobile affordable and accessible care. And they always ask about, you know, what, what we're doing. And I say, what we do, we have a certain number of surgeries or procedures or spots that we can do, but we leave it to the community to tell us what they need. Right. Uh, my, my niece is a psychologist, uh, down in Florida and she works in, in Miami with, with different groups. And I interviewed her actually about the human animal bond from a human perspective. And she brought up the fact that we have to bring care and assistance that is necessary and that it is accepted. If those things are not met, then we're just self serving and we're doing it for ourselves. Then it's that savior, hey, I went in and I helped all these people. But are we helping? Because... You know, they say you can take the horse to water, you can't make it drink. Well, I can take my truck down to, to a certain community and say, Hey, I'm, I'm sterilizing dogs today. But the community doesn't need nor want their dogs sterilized. Am I helping anything? I am not. So we have to, we have to listen. We have to understand. And that's where that, that diversity of students is going to help. Because again, you don't know what someone needs unless you, you grow up in that situation. You understand the needs and you can provide it. In a, in a proper way.

That's the strongest argument for diversity in this profession, or in any, in any sense, because, um, you know, I, I sometimes say, um, I asked the question, can a 100 percent white profession serve a diverse nation? Theoretically, yes. But practically, based on, um, a historic perspective, that's probably not going to happen, and for practical reasons, for logical reasons, again, this logic thing keeps getting in our way, that's why we call them a paradox, you know. Um, so, uh, not being culturally competent is one of our limitations. Um, and being more of a privileged crowd, we are even further removed from being culturally competent. You know, um, Dr. G, you can take a dart and throw it at the United States map, and you can throw it 100 times, 1000 times, and no matter where it lands, We don't even know the distribution of diseases in that community. Why? We've never wanted the measures. We did not advocate for these measures to be taken. We don't, we can't, a community cannot plan for needed services because they don't even have an understanding of their own needs in some cases. But we start by trying to understand what they understand about their needs, as you were saying a moment ago. And then help them to move to a different level of understanding if that seems to be, uh, needed. But we shouldn't be in the 20th century and can't hit a community in this country and not know the distribution of the diseases. You know, what are the top 10? We can take national data from big, big data databases, um, And we can do a guesstimate about that, but there ought to be more precision than that. We have the capability as a nation. And again, veterinary medicine doesn't even have to do it. We just need to advocate for it being done. There are public universities across the country with students who would welcome these kinds of projects. And it wouldn't cost the profession anything, but we want, we have to want to know, we have to be curious enough. For whatever reason, to advocate for these measures to be taken, um, and, and on the human side, especially from a social service perspective, there are all kinds of survey instruments that are being utilized to understand communities in order to make plans. There's a healthy people's strategic plan of the nation with social determinants of health being discussed. What are those key leading health indicators? If we are the full fledged medical profession that we are, you, you would think that we would be mirroring or looking somewhat like, uh, healthcare in general. So when I talk about fragmented healthcare, we are really disconnected from how health care works, including the fact there needs to be a systems approach and that it's family health care made up of an interprofessional group of disciplines or people and organizations and not the sole proprietorship that operate under their own roof. And they don't share any information. They don't receive much as far as being in a system. So I keep going back to that systems thing, because I think until we have that in place, we won't achieve cultural competence.

So one of the important things about this is the inclusion of the social worker into the veterinary care, and that's one of the things that I'm looking into and wanting to add to our services as a way to provide more long term care. So can you discuss the role of the social worker in, in In conjunction with veterinary medicine for the short term problems, but then in helping that that family continue to care for themselves and for their animals.

Yeah. Okay. Um, thank you for the question. So let's establish the context. Again, the context is. I, as a veterinarian, can't do what I've dedicated my life to do because of human realities. Now, I can either go back to school and learn things about communicating in difficult situations and diffusing things and, and I can leave the practice and I can go out and help my client get these other essential resources, or I can choose to partner With a profession that actually exists for those reasons, you know, social work is a very, very important profession at the heart of it is meeting people where they are and helping them to get to where they need to be resource wise and so forth, connecting them with needed resources. Um, while I was with the office of the surgeon general, we were often talking about disparities and help. And I was shocked when I learned that the number one reason that families were not accessing services in their community was that they didn't even know Either that the services were available to them, or they didn't know how to navigate the system. Well, veterinary medicine is, we've got our plates full. We need to be focused on what we're trained to do. But we ought to care enough about the client that we're serving in that veterinary client patient relationship. That we would want to be in a One Health system where somebody is attending to our client's needs while we take care of the client's family member, the non human family member. So social work is that, that profession, foremost profession, and finding, linking people with needed resources. Veterinary social work was started here at the University of Tennessee in 2002, while I was dean, because we wanted Social workers to get additional training in how to support the humans where pets are in the picture. So a simple example, if a social worker is trying to address a housing situation, so either the person is already on sheltered or they are insecure in their housing. And they're doing that work without considering the non human family member, they're not doing the job that the family actually needs their help with because they've left out a family member, uh, so rather than spending time trying to line up housing, where the policy won't even allow the pet to be there. Or maybe they have a pet policy, but there are some other policy related matters that represent a barrier. Um, what a veterinary social worker would do is not make that mistake. Because they're going to be factoring in the presence of the pet. They also, by the way, though, attend to the human needs, even around livestock. So, when a family loses, um, Their flock or herd or whatever due to the population because of a terrible disease or whatever. There are huge mental health impacts on that family and there hasn't been historically that system to attend to the family's need. So veterinary social workers would be that special discipline within social work where additional training has been acquired. And how to work with families where animals are part of the picture.

I really like the inclusion. Uh, I interviewed, Alicia Kennedy from Australia and she is an amazing woman. And she, she was talking about the importance of the social worker as she helps primarily seniors, but in how it helps along the whole way, like you brought up the, the mental health aspect, we just. Think about the, the economic aspect or, you know, even the housing aspect, but we don't think about the emotional toll that it takes on that person to not be able to provide the help or if the animal needs to be euthanized because it's at that point in life, how difficult it is for that person, like you're going to euthanize their, their dog or their cat. And then this person, especially in her case, the elderly, They're just going to go home. It's like, okay, well, I hope you're okay. Um, you know, like there's, there's nothing else. And as veterinarians, there's not much for us to do. I mean, what do we do? We just send a sympathy card and, and hope that that's okay. But what, what can we do? We're not trained for that. So I think that that is an amazing place for social workers to just take, take one where the veterinary work ends. Take on the human aspect from there and just kind of complete the circle.

Yes. Yes, because, um, you know, I, I also often comment on the fact that when someone is in crisis when humans are in crisis, we are emotional one way or the other. And when we're emotional, we're not always logical. We certainly don't always. communicate in the most, um, I guess, straightforward way. Um, it's human. It's human reality. And I tell you, the veterinary social work thing, uh, my vision for what became veterinary social work actually started while I was in practice in Maryland. Before I became Dean at Tennessee, and I had a good clientele, um, very middle class clientele, every now and then, um, lower income people, but it was during that practice that I recognized, oh boy, this is not my dad's veterinary practice world, you know, people had changed, you know, the bond was so on display all the time, and I was As chief of staff, we were working on the first surgeon general's report on mental health. And so suddenly, or gradually, really, I came to appreciate how often I had been looking across that table into the eyes of depression and anxiety or anxiety. I felt so inadequate in that moment because I always prided myself as being a people person, as really serving my clients. Having those conversations that around end of life, uh, addressing the guilt, but coming out of not a formerly trained perspective. So, uh, social work, veterinary social work grew out of a realization that we were way in over our heads there and we needed the. The allied profession to be there with us. Uh, that would safeguard the mental health of the of the veterinary care team as it safeguards the health of the family.

I recently spoke in my last podcast about the concept of no kill and how people are really upset about the number of animals or the, the percentages as far as no kill and, and one of the things is that I think that. The perspective is in the wrong place. We're seeing the euthanasia is the problem and it's not the problem is the result of a problem and everybody is like, well, to to fix the euthanasia number, then we just need to release animals that are not altered and we need to adopt to everybody. And we just need to have better policies and not intake. And that's not fixing the problem. That's not closing that that spigot so that it doesn't keep putting water through. Right? And it's not

Oh, that's mopping the floor and not turning off.

Right. Exactly. Because, I mean, I, I struggled a little bit with the, with the subject of that podcast because I don't want to come off as being pro euthanasia because that's not the point. My point is we have to understand that euthanasia is just an end result, and we need to take accountability for how these animals are ending up in shelters, how these animals are ending up in these situations, how people are ending up having to relinquish their animals, or Not even relinquishing the animals, they just have unsterilized animals because there's no access to spay and neuter services, so then their large dogs are having all these puppies, and where are they going to end up? I think that, you know, in looking at the whole, how do we fix the shelter problem, this is a huge way, like, one of the many things that we need to help that shelter problem, is to keep them from ending up at the shelter to begin with.

Yeah, and in order to do that. Just as I believe companion animal veterinarians are actually in the business of family health care, shelters are social service agencies. Their work is as important outside of those walls. As it is inside of the walls and and yet historically. It's been inside the walls that the problem is being addressed and we're really just mopping the floor, without turning off the spigot. So, culturally shifting to a social service Foundation, uh, brings with it what all social services, social service agencies do, and that is being connected with the system in one way or another, usually in multiple ways, because, yes, if you, if you don't stop them from coming in, and let's just say what, what are some of the common reasons? Well, uh, the family, uh, the, the, the pet has a medical, need family can't find an option in the community and they come to the shelter for a solution, which too often involves relinquishment, um, but the family is hoping that their loved one get some help. They're not necessarily just discarding someone they love. Um, I mean, all you got to do is spend a little time in an intake area of a shelter and just see the, the, the emotional trauma that's going on there. So, Going back to cultural competence, if the profession is going to become culturally competent, it's not just understanding the community, but understanding what our role is toward the community. As family health care providers, cultural competence for shelter is not just understanding the community but understanding again how to work with that community outside of those walls in order to address the problem.

Yeah, I think that You know, it's, it's kind of, I think of, it's a simple problem with a very difficult solution, right? It's kind of like the best way to say it. It's like, we know, we know what needs to happen, but there's so many things that need to come. Together to be able to do it and and to your point at the beginning of this of this conversation is is not just a veterinarian problem. We just have part of the problem. It's not just a society problem. It's not just a physician's problem. We all have to just. Come together into the concept of one health and take care of everything together.

Yes. Yes, and I hope I hope Those who are listening to to this podcast And in our individual conversations that we become advocates for the development of a systems approach and that needs to be a one health System that's when veterinary medicine will be able to do a better job of reaching those underserved individuals. We just have no other choice but to work with others to address it. It will be to our detriment to not have such a system formed very quickly, actually. Um, do I have optimism? Yes. Because again, I think the public health issues and which include mental health, by the way, is not just physical health. Um, these are going to be big drivers for change out of necessity. And, uh, I fear that we may might be dragged along. I'm hoping we're not being dragged along, but rather we're like, you know, on the front line helping to make this happen.

Anybody that's listening that wants to learn more about One Health and about veterinary social work and about the things that we need to do as a community to do better for our pets, what kind of resources would you recommend that they visit?

Well, they can certainly go to our website at, uh, P. P. H. E. Paul Paul Henry Edward dot U. T. K. dot E. D. U. U. T. K. University of Tennessee, Knoxville. Yes. Um, besides that, uh, there is a lot of, uh, besides our website there, there, there are a lot of other resources. Uh, simple Googling will get you to a lot of those resources, uh, of information. Unfortunately, there won't be a whole lot around. Systems that we've been working on a system called the Align Care and you'll find information there on Align Care, but we need more thinking about a systems approach my interfacing with the human health care community. They are ready, they, they see the same problem from their, their perspective, even though they don't understand it from the veterinarian's perspective. So I think. Time is ripe, if you would, for a system to start to be formed in a larger sense.

Excellent. Well, this has been an amazing conversation. I'm so happy that I got to spend this hour talking to you, and I hope that everybody that's listening understands, has a better understanding, and a little bit less judgment of those individuals who perhaps cannot take as good care as we think they should be, because it's also a matter of perspective. Um, but, but yeah, you know, thank you so very much. And I hope to talk to you again at some point and, and if anything, be able to share some of the, some of the things that we can do and get your information on how we can do better.

Well, thank you for allowing me to join you today and have this conversation. Very, very important one, so I appreciate the work you're doing because we, we do need people like yourself who are carrying the messages forward and out there and stimulating the thinking. Thank you for all of that and I wish you the best as you continue your work.

Thank you so very much. Well, for everybody that's out there, take care of yourself, take care of your animals and thanks for caring.