Dr. Fossum: It's very difficult, especially in the world of oncology. I think the latest number I read was 3.4% of oncology drugs that enter into phase one actually ever get registered with the FDA, 3.4%. And I really believe the reason for that is that we keep going from rodents to man instead of interspersing a more predictive model, which is dogs.
Dr. Venable: Welcome to the Veterinary Cancer Pioneers podcast, the show where we delve into groundbreaking work of veterinary professionals who are dedicated to advancing the field of veterinary oncology. I'm your host, Dr. Rachel Venable, and I'm thrilled to embark on this journey with you.
Hello and welcome to the podcast today. I'm so excited to have our guest, Dr. Theresa Fossum. She is a renowned veterinary surgeon with over 30 years of experience in veterinary medicine and research, teaching, and entrepreneurship. She authored a widely used small animal surgery textbook. I know because it's a vet student. I had the book and used it a lot. She has authored many publications. Research projects actually got over $30 million in funding, which is amazing. So definitely want to talk about that. But she's also the CEO of Phoenix Animal Wellness and started Dr. Fossum's Pet Care. And she also has her own podcast. So we'll talk a little bit about all these things. So definitely excited to dive in and learn more. Thank you so much Dr. Fossum for being here today. So you've done so much throughout your career I guess. How did it all get started? What got you inspired to do veterinary medicine to begin with?
Dr. Fossum: Oh boy. So I probably have a story that's not that different from a lot of people. I grew up actually on a ranch in, northern Idaho. We had cattle, I rodeo, and I knew I wanted to be a veterinarian. That was never the question. But I actually went into veterinary school pretty certain that I was going to do equine or at least equine/large animal. So I thought that's what I would do. And got into vet school, got into my fourth year still thinking that's what I was going to do. In fact, you know, those, rotations that you take. I took necropsy, advanced food, animal, and advanced equine, so you could tell where I thought I was heading. I had a professor. You know how that somebody, that one person can really change your life? And I had a professor, Jim Miller came up to me. I was in my fourth year, beginning in my fourth year, and he said, “You know, Terry, I know you want to do large animal, but I really think you should do a small animal internship because you'll get better medicine and then you can go do whatever.” And I was like, okay, that kind of makes sense. And not knowing, a whole lot about the application process, I actually applied to two, three private practices in California. That was it. I was very lucky that I got my first choice. This was a large, small animal practice in Santa Cruz, California. Great people. And the radiologists there was a really special guy. We had a case come in. Now, I don't even remember actually learning about it in Veterinary school, but it was a part of systemic shunts. So this was, you know, years ago and the people didn't have any money, and we didn't know what we were doing. The radiologist said, you know, if you want to try and ligate this, Terry, I'll, I'll help you. We'll do it together. Because at that point, the dog was ours. So we did it. And I didn't know. You can completely ligate some of them, so we completely ligated it. He adopted the dog, had it for another ten years, and I fell in love with surgery. And so that's my story. That's why I became a small animal surgeon rather than an equine or food animal veterinarian.
Dr. Venable: Yeah, that's a fascinating story. To me, it sounds like you like adventure and kind of taking risks because really, for an equine person to take a small animal internship in California, that's a pretty big risk. And just different things in your career. Would you say that's true?
Dr. Fossum: Rachel, I would tell you, I think I might be pathologically into that kind of stuff. I'm really serious and that I'm not saying this is a positive thing, but I am one of those people that when I get very comfortable with something, I'm ready to do something else. Like, I need that constant challenge, and I always want to be outside of my comfort zone. And that's actually what I tell a lot of younger kids when they ask me, like, what do you do? How do you move forward? I said, it's like, step out of your comfort zone. Take risks, because that's how you're going to learn. That's how you're going to get ahead. So yes, I'm always been that person. I enjoy it.
Dr. Venable: I love that. I think that's great. And sometimes I think surgeons, you guys kind of lean that way, maybe a little bit more. I mean, you have to be a bit more, especially oncology surgery. You've got to be a bit more willing to take risks. So I know, and I love that you did that surgery as an intern. I certainly would have been too scared.
Dr. Fossum: You know, honestly, when I say I didn't know what I didn't know, that's really what I meant. We didn't know at that time everything that we know about shunt, it would honestly, it took me probably another 5 or 6 years of doing them to really be comfortable. But I was lucky that that first case turned out, you know, beautifully. And I just had great mentors along the way that really have helped me. I know you have two that have really helped, sort of set the tone for where you go and what you do and there's such wonderful people in veterinary medicine.
Dr. Venable: I agree, I think we have some of the nicest people.
Dr. Fossum: I do too, you know what, and probably most the audience knows I'm lucky enough to travel a ton because that book over my left shoulder, I'm not that near is in every part of the world, and the one thing I can tell you about them is they're always nice people. They always care about their families and they care about their jobs, and they're just really welcoming. No matter where you go.
Dr. Venable: That's awesome. I love that and, you know, you've definitely done a lot of different stuff in your career. So academia and research and now entrepreneurship. What's maybe your favorite research interest that you've done?
Dr. Fossum: When I first started doing research, what I was doing was sort of the typical case study, small research projects that you would normally do, and then while I was on the faculty at A&M, it's a bit of a long story how it happened, but to just bring it into a nutshell. I got to meet and know, Dr. Michael DeBakey really well. And with his help, we were able to set up a good laboratory practice facility at that time. And this was 12, 14 years ago. It was a 60+ million dollar facility. It was one where we did research for industry. And what I saw with these companies coming through is something I become incredibly passionate about. And that is that I think we do drug discovery really poorly in this country, in the fact that we don't use really predictive animal models.
I know, you know this as well as I do. I mean, most veterinarians, I think, would agree that it's very difficult, especially in the world of oncology. I think the latest number I read was 3.4% of oncology drugs that enter into phase one actually ever get registered with the FDA, 3.4%. And I really believe the reason for that is that we keep going from rodents to man instead of interspersing a more predictive model, which is dogs. I mean, I know there are places doing that, but not in as big a way as we should be doing. We should be the vast majority, I think, of drugs going forward into the human market. We should have clinical trials if it's a pertinent disease and dog should have clinical trials done the dogs. That's really, I think, what all my years of research at a university, what I really learned was let's do a better job with drug discovery and let's not use inappropriate animal models, and dogs will benefit from that if we do it right.
Dr. Venable: I completely agree. You know, we've talked about this before, but yeah. So you know the dogs, they get cancer naturally. There's just so many things that we share that we know. While rodents are a good model and have a place, it's just like you said, it is such a huge leap to go from a mouse to a person. And so there's got to be somewhere. And I didn't realize the number was quite so low. Only 3% of drugs truly moving on. I mean, I think in some ways that so expensive.
Dr. Fossum: Oncology.
Dr. Venable: Sure. Yes. Yeah.
Dr. Fossum: Well, that's exactly why they're so expensive. Because you pay for the mistakes. Right. So if you have 96 plus percent never making it, but you already are in clinical trials, you've already spent millions, if not hundreds of millions of dollars. Those failures are going to get added in because the companies aren't paying for it. So yeah, you know, I'll give you an example. I know this sounds really weird, and I thought it was kind of weird when I started it. Two but now I'm a believer. I've started working on an Oleander product. So we have the extract and we can actually, even in livestock use, treated raw biomass of the plant. So, you know, everybody knows oleander is toxic, but if you microdose it, it has some really interesting properties. And one of them is that it is anti-neoplastic. But it works because some cancer cells upregulate the alpha three isomer and their sodium-potassium ATPase pump. And the normal isomer of this upregulated most cancers is the alpha one. That I mean most cells is the alpha one isomer. So if these cancer cells upregulate the alpha three, that's actually where oleander binds. So it only binds to the cells that have upregulated the alpha three isomer, which means not going to kill normal cells. But guess what. Rats don't have an alpha three isomer. They don't upregulate it. And that's what the studies were done on originally were rats, no relevance whatsoever. The other thing is they're totally resistant to the effects. You can't kill her. You can only kill a rat if you put enough oleander in that you drowned, and in it they are immune to it. So there's where you know the model, even though the FDA asked for rat studies, there's no relevance there. It's a waste of time and money.
Dr. Venable: Yeah. So how do you get around that? So. Or I guess how so if it didn't work in the rodent. How… what are you guys doing? How are you finding that this is working or not working?
Dr. Fossum: Yeah. So we did some dog studies. And so we do know we've taken different cancers from dogs and we've measured their alpha three isomer and the ratio of their alpha three to their alpha one. And so we know that dogs do upregulate the alpha three unlike rats. So we do know which cancers should respond to oleander. And interestingly enough there's actually some evidence out there that for some of the chemotherapeutics, it can actually reverse resistance to, and the two and these weren't our studies. These are studies out there by other people. But what was it, I think doxorubicin and the platinum-based drugs, it reverses resistance to them. The other really cool thing it does is that it is the most potent senolytic that has ever been identified to date. And so we all know we've got these senescent cells that are circulating. You know, they're bad because they've decided they're not going to die and they're not going to divide. They're just going to hang out and secrete these really inflammatory substances. And now most people think that's why we have chronic disease as we age. And oleander kills those cells, I wonder, and this has to get proven. But I would love to see this is you know, when we take a dog, like with an osteosarcoma and we amputate their leg and then three months later they have metastasis. Could those be the senescent cells are circulating? And if we gave standard of care plus senolytics, might we kill those cells and prevent the metastases? I think we might love to try it, but who knows? To my knowledge, nobody's really looked at it in an animal model just in in vitro.
Dr. Venable: And it does sound really fascinating because you're right there actually had a consult today in a case where it was like that, you know, as soon as the dog was diagnosed, there was some lung metastasis. And so it would be interesting. Yeah. Can we combine therapies? What can we do? I mean, it sounds like you guys are pretty early on with this drug. What is the pathway of trying to get to something like that. Like I know it takes a lot more work than most people think.
Dr. Fossum: You know what, if there's anything that I would really like to tell people, if you're thinking of, you know, becoming an entrepreneur and starting a company, it's going to take you way longer to get where you want to go than you ever would guess. It is not an easy process. There are many, many setbacks. It's hard. It's really hard work. And that whole overnight success. And maybe it happens for a few people and maybe like tech software, but it doesn't happen for anybody else. It's a lot of work and years and years and years.
Dr. Venable: Yeah. And you know, speaking of entrepreneur, you have two companies, right? Is that correct?
Dr. Fossum: Well, I do I started my own company because I wanted CBD for my own dog. I don't have them anymore. But I had a 14-year-old, Labrador Dan, whom I loved, and he had elbow dysplasia as lame. And I was looking for something. He had chronic kidney disease too, and he did not tolerate non-steroidal. So I was looking for something that would give him some relief. And I started reading about CBD. But then when I started really diving into the literature, I was like, oh man, I don't know. There's so many bad products out there because it's not regulated. So 70%, in fact, of the CBD products on the market today do not meet their label claims. They either have way more THC than they say that they have, which is bad for dogs, as we all know. There's some of them didn't even have any CBD in them. They have hemp seed oil. I guess some people think hemp seed oil is cannabinoids. It's not. It's oil. You're not getting any cannabinoids. So that was a lot of the products. So 70% didn't meet the label claim. So I was like, well how hard could this be? Let's just make our own. And that was how we started Dr. Fossum's Pet Care. And it was a huge mistake, I'll tell you, because we got kicked in the teeth at every step. Banks you can bank in a bank, credit card processors would kick us off for no reason. I mean, it's just hard. It's getting easier. It is truly hard. But we have a product there.
And then as you got more into natural products, I really wanted a natural again, my own dog had, had, cognitive dysfunction and I wanted a product for him. So I got with, Dr. Curtis Dewey, a friend of mine who's a neurologist and surgeon, and we came up with a formula for, CCD that has both western and eastern ingredients in it. And did a quick little study, 30 dogs, but and we saw, about a 38% improvement in cognitive function in 30 days, which meant that those dogs that were pacing at night and waking their owners up or vocalizing at night, a lot of them stopped doing that, which made people very, very happy. So that was the second product that we came out with.
And then this is a little weird for me too, but I spent a year as a special assistant to the Secretary of Energy a few years ago, and he called me former Secretary of Energy Rick Perry. I built that facility in Texas when he was governor, so I got to know him. He called me and he said, you know, Terry, I really need you to look at this Texas company that has oleander. And I was like, “Oleander? Governor Perry, that that is, toxic to dogs.” He's like, “Look at it. Just do me a favor and look at it.” And so I started going. This company actually been around for 30 years and had spent a lot of money and, but have really not commercialized anything other than a homeopathic and a cosmetic. And so I started looking through it and I was like, oh my gosh, this looks like an anti-itch product to me, as well as the anti-cancer and immune support. And so I said, okay, I like it, I like what I see. It's going to be tough, but I will take it on, let's do it. And so they asked me if I would be the CEO of that company. And we started combining them. So what we do is the R&D is the Phoenix company with the Oleander, but we sell through Dr. Fossum's pet care because we have all the distribution and, you know, marketing and international sales already set up. So that was sort of how we made the two to work.
Dr. Venable: I like it. So can you buy some of the Oleander or are you guys still in the R&D phase now?
Dr. Fossum: We're still in the R&D phase. In fact, I was just looking through. We started an anti-itch study. We only have about eight dogs completed so far. It's a 30-day study. So we do a CADESI evaluation and questionnaire a day zero, a day seven, and a day 30. And at a day seven, unless there's been a significant improvement, we unblind the placebos and switch them to active, because I don't think we realize how hard constant itching and licking is for owners. We had a number of owners who, even with seven days a placebo, dropped out because they just couldn't. They're like, nope, I'm going back. I'm going to give standard medication because my dog's itching. I can't wait seven days. But the ones that we were able to switch, really what we saw, the placebo dogs generally did this. Their scores got worse, the skin got worse. It’s itch more. And when we started, on the Oleander, they went like this as pretty dramatic. So we'll see. I mean, it's too few cases to say anything right now other than the trend is good. It looks like it's working. And here's why this is important to me. We have good products out there we know we've got. So we just do this all over the dermatology market. But I want a non-FDA approved anti-itch product that is cheap because there are so many people out there who cannot afford 90-100 bucks a month for their dog. You know, they got other things too. They're it's not just itching that they have to pay for. And so I want something that's, you know, $45 or less a month. And I think Oleander can do that if we don't go through the FDA, if we go through the FDA, you know, it's 6 to $9 million. You got an expensive product. You know, if your COGs are really low and ours are very low.
Dr. Venable: No. And I think that whole the 6 to 9 million, I think a lot of people don't realize that, you know, when products come to the animal market and, you know, we want good science and we need good science and research. But I think sometimes, you know, people get frustrated, like, why didn't they do these huge studies? And I think because you just said the animal market, can we really support are they going to have enough, you know, versus like in people especially oncology, you know, if you get that product that does make it, you know, they can charge. And there's still some debate on that, but they can charge a lot of money. You know, they can make so much more than what they can on the veterinary side.
Dr. Fossum: You know, on the vendor side, I think every time you talk about bringing a drug to market, you have to do the cost analysis, and you have to say, how much are we going to charge? How much will people pay, and is it worth it? As is tough. I mean, you know, it's not just 6 to 9, you know, million dollars, maybe more could go up to 11 for a companion animal product. But it's, you know, 5 to 7 years as well. So I mean, it's very expensive. That's why big companies do it and not small companies like mine. But I really am doing it for a different reason. I want to get a cheaper product out there that works. And we'll see. We'll see if we get there.
Dr. Venable: Did you ever imagine you'd be in the holistic natural path, market or trend? Have you always kind of been interested in that, or is that just been like a career twist you didn't see coming?
Dr. Fossum: It's definitely a career twist I did not see coming, and I still wouldn't consider myself an expert on natural products. But I've learned a lot, and I really like the idea, you know, CBD, where everybody knows CBD. So let's talk about it. We all know that the entourage effect is real, right? So CBD, you can have a full spectrum product, which means you're going to get all the cannabinoids, terpenes, and THC that's in the plant when you extract. And then you can have a broad spectrum, which means that you've removed the THC, which is what we did, because I didn't want any THC in our product because I was worried about dogs getting into it. And in fact, my own dog did get into a jar, and the entire jar had no issue. Vomited an hour later, but nothing else because there's no THC in it and I don't think you can overdose CBD. So I wasn't very concerned about him. But if you take that same plant down to isolates, do you take it down to CBD? You totally change the properties. So we believe that pharmacokinetics, full or broad spectrum product is more like sort of that pharmacologic profile where you get more, you get a better effect, but then it plateaus at some point. And if you get more, you're not going to get more of an effect. But you don't get a lesser effect either. That's full of broad-spectrum cannabinoids. If you take an isolate, it's a bell shaped curve, which means you have to know exactly how to dose it in that animal to get the maximum effect. And if you give too much, you're going to get a lesser effect. And I don't think we know that information in dogs. And so for that reason, I think the broad spectrum, or if you want to give full spectrum is the way to go. Isolates are tough. And to me, an isolate is like having a synthetic, you know, you've just got down to a single molecule, nothing else in it. There's not, you know, a number of compounds that are going to be synergistic. You've got that one. You just want to see how effective it is. Very different. And I think we get a little more leeway and maybe a little more efficacy sometimes with these natural products. I'm pretty excited about them, but I still have a lot to learn.
Dr. Venable: It is an interesting area. And and you know, my biggest concerns, one that you brought up. But a lot of times the products aren't pure or they're not necessarily what you think you're getting. You know, I've had clients like CBD, like they've told me, you know, I spent 20 bucks on Amazon and got this to I spent, you know, $300. And so how do you know if it's really got what it's supposed to have? Is there a way to know for some of these products?
Dr. Fossum: Well, the easy answer would be sure. Look at the certificate of analysis. If there's not one, don't buy the product. But a certificate of analysis is going to show you exactly what is in that product. And for CBD, it's really important because the cannabis plant is what we call a soil mediator, right? It pulls everything out of the soil. It was planted around Chernobyl to pull radiation out of the soil. Right? So if it's planted where they used to grow tobacco, you're going to get a lot of pesticides and herbicides in your... And we're concentrating it when we're abstracting. So you don't want you know, look at this certificate of analysis. And that will also tell you which cannabinoids are in it and what percent how much. So that's really important. The only reason I would say I used to say the easy answer is look at the certificate of analysis, is that there are a lot of fake certificates of analysis out there as well. So a good company will analyze the ingredients, they'll analyze the product, and then they'll have a third party analyze the product. That's what you want to see. If you have one that's, you know, not made up.
Dr. Venable: Right. Right. Yeah. Know that's kind of frightening that people would make it up. But I guess I'm not 100% surprised by that.
Dr. Fossum: It usually goes on their homepage, go down to the bottom where it tells you terms of use, all that. Usually they should have a CoA.
Dr. Venable: Okay, so I feel like we get a lot of questions from pet owners and some oncologists just keep it. But I feel like I get so many questions, you know, so many pet owners they want to use, you know, whatever they can. So I know we were talking about CBD, but really, any natural or supplements that would be the case? Is that right?
Dr. Fossum: If it's from plant origin, it should have a certificate associated with it, you should be able to tell what is in that product. And like I said, check for herbicides, pesticides, heavy metals. Those are the three contaminants. But we also look for fungal for microbial contamination of any kind. All that will be on a CoA. The issue that I see with people coming in with CBD that they buy is that a lot of the human companies thought that, oh, like we're selling CBD. Well, let's just slap a label and and say it's a pet CBD. And I don't think they gave any thought on how to dose it for dogs. You know, people, you take one tablet, you take one tablet, and yeah, you guy, you take one tablet too. Well, we don't do that a dog. So you don't go, you Chihuahua. You take one tablet, you Great Dane, you take it one tablet and you go, all good. They didn't give any thought to that. So I can't even tell on some of those how much they're getting and how to dose is just makes no sense. And when I try and figure it out, sometimes I'm like, I don't actually think you're giving like maybe 0.2mg/kg the doses 2mg/kg. I mean, people just don't. They don't know what they're getting and they don't know how they're dosing it. And there's just so many. It is a wild West when it comes to cannabinoid products.
Dr. Venable: Now, I can believe that. Like I said, I've kind of just seen different things from owners. So that's good to know kind of how to check up and follow up on all this and, and then just switch gears a little bit. You know, you talked about you guys are doing clinical trials and like with the itching the eight dogs. So how are you guys doing that. Because that seems like that can be a challenge for small companies too. Or how are you guys able to do clinical trials?
Dr. Fossum: You know, that's a great question. And this is really a question for you because I know you're into this as well. So here's how we struggle. It is tough. Well, first up, universities in their indirects are crazy. I, I think when I was at and our indirect for I don't know, 54% but a lot of universities over 100% you're going to double your cost. Your study right there, which most small companies cannot afford to do. So let's say that you said, okay, well, we won't do it a university. We'll do it in practice. I mean, I'm doing itch. There's not anything more dogs can do it for the itch. Right. Should be really easy, but it's very difficult. If the universities can't do research, the universities, they're either too expensive or we just can't get in, then we want to do them and especially practices. And that's really hard because specialty practices are corporate-owned. And by in large, a lot of them don't care that research gets done. I was just talking to a dermatologist this morning asking him if you would get involved with our study. And his comment was, we're corporate-owned. I don't think they'll let me. He said, I can consult, but I can't actually see cases. And that's so frustrating, you know? So we went to GP's and for itch we could do that. But for cancer, we couldn't do that. We'd have to, you know, go to the specialists. So it's tough I don't know, I worry that we're going to see a decrease potentially in the amount of research is being done, even though we're seeing more, more and more cases. But it's changing about that. Rachel, what do you see happening in the world of oncology studies?
Dr. Venable: I think you're you're right on. I mean, it's the corporations. It's either it's so hard to get through, and I get it to some degree. You know, they need checks and balances. And it's hard when you're potentially huge groups all over the country. But it does make it tough when they own most of the specialty market. You know, it's hard to find that independent group. And the other thing that I worry a bit about is the vet schools are certainly more equipped and have the staff and all those things, but I worry they're not really seeing the cases. And so we continue to get these 20-dog, 30-dog papers, and while it's better than nothing, I feel like even myself, I put so much faith, and you know, and how I practice odds and studies that if you really looked at, it's just like, you know, it's it's such a small number.
Dr. Fossum: I used to sit through the resident presentations at the surgery meeting, and I used to do that too. I'd be like, how can you say anything with six cases? That's six cases. I mean, how could you? We need to be a lot better. And I know what's happening and it's happening a lot more now. But doing multi-center trials and really getting those case numbers up because I'm with you. I'm sorry. Six cases of a particular cancer type. It's better than nothing, but not a lot better.
Dr. Venable: Yes, I agree, and I feel like sometimes this dogma comes around and the new products come out and people are like, well, it's not doing what we have published. But at times I even kind of question them like, yeah, but do we really believe some of the stuff we say that's public, you know, like even talking with other oncologists, like with lymphoma? I had this conversation actually with a company this morning, lymphoma with CHOP. A lot of times most oncologists will say, you know, average survival is around a year and 20% go out to two years. But when you talk to most oncologists, there's almost kind of this feeling in your gut. You're like, should I say 20% out to two years? Have I clinically really seen that? I mean, only if they do lots and lots of treatment, not with this one protocol. They're not going to do that, you know? And, I don't know, it would be interesting. Maybe we can get more people to comment on the podcast here because, you know, most of our listeners are veterinarians, veterinary oncologists. So I would be curious to hear different people's thoughts. But I know even for me, when I talk with pet owners, you know, it's an easy stat to quote. And there are some dogs that can do great, but I feel like, is it as high as 20%? I, you know, the study where that comes from had 50 dogs.
Dr. Fossum: So yeah. And then what you might be doing is actually people may decide to do the care, the treatment, or whatever based on those results, when in fact, maybe if it had been different, they wouldn't have chosen to do it. So it affects people's what I'm saying. And that's important. Right? So I don't know how we get around. I mean, here's what I don't want to make it sound like is that universities don't do great research because they do. I mean, they're doing amazing stuff. I just think the balance has shifted to where the case is seen in practice. And to your point, we need big numbers for these studies to really mean a lot.
Dr. Venable: Yeah, I know it'll be interesting. You know, the whole vet school and maybe you because, you know, you were in academia for quite a while. I worry a bit just, you know, again, because they're not seeing the cases. A lot of vet schools aren't really in major cities, you know, geography, history, things that change, things moved around. And so I do worry they're just not getting the caseload. Right now, it's so hard for schools to even have specialists. You know, it's just so hard to compete with private practice. Is that something you saw? Because I know at Texas, I'm not sure currently, but I know for a while they really didn't have a full oncology program. They'd, you know, lost their residents and things. I believe. Hopefully, all that is changed. But I know it was kind of dicey and there's been plenty of other schools I can think of where they have lost their residents because they didn't have any faculty.
Dr. Fossum: Yeah, that's so true in probably most specialties these days. I mean, yeah, academics are different. You know, you're not going to get paid as much. You're not going to be in clinics all the time. And so if you want to do research, the reason I went into academics is I did want to do research, and I did want to teach. But yeah, I mean, I worry about we have 11 new veterinary schools opening up. Rachel, how are they going to teach those students? Let's assume they're not going to be able to hire specialists. So are they all going to be the distributed model? How's that working? I mean, I don't know, I know you U of A had some issues with boards this year. Maybe they'll get past that next year. But I always worry that when you send students out into practices to get their education, the quality of that training is very dependent on the trainer. And, you know, some students are going to go into a practice where the people are just like, “I have been doing this for 30 years, and I so want just to teach you, you know if you follow me and I'm going to talk to you all day” and then you can have the others, you're like, “I'm really busy. Follow me. Be quiet, don't say a word.” And they never actually even talk to the student. And that's the disparity that you're going to get that you don't see the university, right? Because theoretically at least everybody's there because they want to teach. I worry about where that's heading to.
Dr. Venable: It is interesting. And yeah, I, I don't know if anyone's looked into it or if we have enough data on some of the distributed model, like you said, how the schools are doing with NAVLE scores and things. So it is interesting it and yeah, I've wondered that too, because it does seem like a lot of the new vet schools don't have teaching hospitals like I said, the ones that have teaching hospitals, it is tough. So I think that's something I hope the AVMA, I feel like they are trying to kind of talk about this more, get it out more, but it'll be interesting to see what the future holds, how this is all going to play out.
Dr. Fossum: And this is not to be disparaging against the distributed model, but I have a friend in California who's got a big practice, and he's got a consortium of other general practitioners that have good size practices around the country, and they have made a decision that they will not hire graduates from a school that has a distributed education. I don't know why I've never delved into it, but he has told me that they've all decided they won't want to hire students for that education process. So we'll see. I think it's too early to say how they're going to do the standing when you do it. When you become a surgeon, you have to do surgery with a surgeon. You don't walk into a room and do your first surgery by yourself. I hope you know, that sometimes you maybe have to, but that's not how you want to do stuff. So I think it's really important to have. I think teaching hospitals are so important. Maybe they're going to go the way of the dinosaur though.
Dr. Venable: Right? It'll be interesting. I hope just veterinarians, as a community, we can kind of get our heads together, get, you know, think outside the box, think of ways of like, okay, before this gets bad, how can we work with technology, work with, you know, society, how it is and what we can do? So that's what I'm hoping for. But I don't have a great answer. But I'm hoping we can come up with things.
Dr. Fossum: I mean, I do think technology is going to help us. I think, you know, we're already seeing AI written medical records, you know, hopefully won't be too long before people are not going home at seven and having dinner and then working on their records from 8 to 10. Hopefully that will stop. And because their records will be done when they leave the clinic. But I think we're going to see techs do more than that. I think we're going to see times when you put in the history signalman physical exam findings and AI gives you the top five diagnoses and gives you the percentages. We're going to see that it's already out there on the human side. I know we'll see it on the veterinary side before long. So it'll start making our differential lists. And then what it will do is you say, oh I think is this. And then it'll go well for your dog that weighs 34kg, these are the dogs you're going to put them on. It's going to become much more automated. I just don't see it happening.
Dr. Venable: Yeah. And some of that like you said, the medical records side I would be all for I. Yeah. Medical records are such a suck of your life. Like I get why they're important, but oh my goodness. So yeah I think like you said, it'll be interesting. It'll be I think some of it will be really exciting. Some of it we'll have to keep in check. But it will definitely be exciting times that we're coming up on for sure.
Dr. Fossum: For sure it's going to change the way that we do practice. I mean, I know that areas out there that currently they're tech for writing medical records is that they have somebody on the phone in the Philippines that is writing a record as they're, you know, talking to the client. I mean, there are different ways to get around it, but we're going to see more and more technology for sure.
Dr. Venable: Well, this has certainly been a fascinating conversation. I love how we've gone from a ranch in Idaho and, you know, academia, CBD and Oleander, and now vet schools and technology. So I think it's great. I love it. And, you know, before wrapping up, I always like to ask our guests, who would you recommend on a future podcast?
Dr. Fossum: You know, my husband has gotten really into the interventional stuff, and we wound up, I didn't attend the meeting, but we went up to Vancouver about a month ago, to a meeting there is some really cool stuff being done with, like tumor ablation, stuff like that, that it'd be fun to hear somebody talk about that. That's doing it in, veterinary medicine.
Dr. Venable: Yeah, yeah, that would be great, because I feel like that's one of those things I kind of hear of, but I'm not quite sure. Like, when do you, or what patients to recommend or who all's doing that? So yeah. No, that would be really interesting. Definitely. If you guys have good resources, certainly let me know. We'd love to reach out to somebody.
Dr. Fossum: I'll ask him if he remembers who gave that talk up there, because he said it was really good. That would be a good one. I think interventional stuff is definitely the way it's going, no doubt. Rachel, it's really been great.
Dr. Venable: Well, thank you, Dr. Fossum. It's been awesome chatting with you. I love all the different things that you're trying, and I love your advice to push through when you're comfortable and push through until you're not. I think that's fantastic.
Dr. Fossum: Thank you. It's been a pleasure. Thank you for having me.
Dr. Venable: Well, that's it for this episode of the Veterinary Cancer Pioneers podcast. If you enjoyed this episode and gained valuable insight, we would be so grateful if you could share our podcast with your friends and colleagues. And it would be even more wonderful if you want to give us a five-star rating, positive review, or any kind of feedback on Apple Podcasts or wherever you listen. The Veterinary Cancer Pioneers Podcast is presented to you by ImpriMed.
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