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Breaking barriers, bridging care

  • Community medicine illustration

    Breaking barriers, bridging care

    Outreach at the College of Veterinary Medicine is driven by students and focused on community.

    Illustration by Hairun Li

DVM students at the University of Minnesota College of Veterinary Medicine (CVM) spend four rigorous years preparing for their careers. The first three focus on classroom-based curriculum. But while textbooks, lectures, and laboratories are a crucial foundation, they can only take students so far.

Kristi Flynn and her small, black dog named Tula
Kristi Flynn with her dog Tula

“You can sort of mockup these conversations,” says Kristi Flynn, DVM, “but until you’re having them in person, it’s hard to imagine what the dialogue is going to look like.”

Flynn is a faculty co-advisor for the CVM’s Veterinary Treatment Outreach for Urban Community Health (VeTOUCH). She works alongside co-advisor Emily Walz, DVM, MPH, who is also the faculty advisor for the College’s Student Initiative for Reservation Veterinary Services (SIRVS).

 

 

Students in these clubs work with real patients and clients early in their education, in a setting where what they say and do matters.

Emily Walz, DVM, MPH

Emily Walz in a gray blazer with glasses
Emily Walz

“Students in these clubs work with real patients and clients early in their education, in a setting where what they say and do matters,” says Walz. VeTOUCH and SIRVS clinics are also one of the few spaces for collaboration between students across class years. 

Camaraderie is critical—especially in outreach as student-driven as VeTOUCH and SIRVS. “Veterinary student officers volunteer their time to write grants, train fellow volunteers, coordinate with local partners, and solicit donations, all while juggling a full course load, not to mention employment and family,” Walz says.

Quality care — for all

According to the Access to Veterinary Care Coalition, nearly 28 percent of US households experienced barriers to veterinary care from 2017–18. Nationwide, an estimated 40 million pets lack regular medical care. Most affected are lower-income households and younger pet owners. Most owners consider pets family but, for all groups and all types of care, the most significant barrier is financial.

But generous donors, sponsors, and partners—including Purina, the Minnesota Veterinary Medical Foundation, IDEXX Laboratories, Banfield, and PetSmart Charities—are helping the CVM do its part in improving access to high-quality care while providing DVM students the chance to refine clinical and client-facing skills. The ultimate goal? To empower members of underserved communities to make the best pet care-related decisions possible.

Since 2008, VeTOUCH has partnered with Hennepin Avenue United Methodist Clinic in Minneapolis to host clinics. Volunteer students and veterinarians offer pets of low-income residents of the Twin Cities medical care, nutritional support, and referral resources for spay and neuter surgery. 

Meanwhile, SIRVS has provided wellness exams, medical care, spay and neuter surgery, and husbandry education in tribal communities since 2009. The group’s dedicated outreach efforts have cultivated long-standing collaborations with partners including the Mille Lacs Band of Ojibwe, Leech Lake Band of Ojibwe, White Earth Nation, and Lower Sioux Indian Community. 

VeTOUCH and SIRVS unite to partner with the Little Earth Residents Association and the Minnesota Spay Neuter Assistance Program (MNSPAP) to provide surgical and wellness services twice annually for residents of the Little Earth of United Tribes housing complex.

Kayla Sample, '18 DVM, and Jonathan Elbaz, class of 2021, on a SIRVS trip
Kayla Sample, '18 DVM (left), Summer Lara, UMN pre-veterinary student and frequent SIRVS volunteer (center), and Jonathan Elbaz, class of 2021 (right), on a SIRVS trip

Roots run deep

Each CVM partnership is founded on mutual agency and respect. Transparency with both partners and clients is essential, as is acknowledging clients’ efforts to provide their animals with the best possible care. “This is especially important when we work in Native American communities,” says Walz, “or with other populations who have experienced historical trauma around medical care delivery.”

 

People’s lived experiences and their knowledge should be our foundation

Lauren Bernstein, MVB, MPH

Lauren Bernstein
Lauren Bernstein

“People’s lived experiences and their knowledge should be our foundation,” says Lauren Bernstein, MVB, MPH, a Veterinary Public Health and Preventive Medicine resident at the CVM’s Center for Animal Health and Food Safety. She volunteers for VeTOUCH and SIRVS. “Clients know their animals better than we could ever know them in the 30 to 90 minutes that we work with them.”

Marilou Chanrasmi, formerly vice president of the Native America Humane Society, has been a friend and advocate for tribal communities since 2009 and helped the CVM establish and maintain these long-standing relationships. The College recently awarded Chanrasmi with one of the CVM's most prestigious honors: The Outstanding Service Award, which recognizes individuals from the community for their accomplishments, service, and contributions to veterinary medicine. Awardees are acknowledged annually at the spring scholarship reception. However, the COVID-19 pandemic prevented the CVM from hosting one such event.

Chanrasmi says it takes years to build trust with tribal communities. “You can’t go in and expect to do things a certain way. You have to have a way about you.” She says the late Larissa Minicucci, DVM, MPH, associate professor in the CVM’s Department of Veterinary Population Medicine, had that. 

Larissa had a real interest in working close to home and serving locally underserved communities. She poured everything into that program. It was a labor of love

Lou Cornicelli, PhD

Larissa Minicucci works with a client on examining a pet dog
Larissa Minicucci

Minicucci built SIRVS from the ground up. She established tribal contacts through dedicated cold calling. “Larissa had a real interest in working close to home and serving locally underserved communities,” says Minicucci’s husband, Lou Cornicelli, PhD. “She poured everything into that program. It was a labor of love.”

Despite a metastatic colon cancer diagnosis in May 2018, Minicucci continued her efforts. She attended SIRVS clinics, even as her health declined. Toward the end of her fight with cancer in 2019, she and Cornicelli gave clear instructions: no flowers, no cards. Instead, colleagues and loved ones surprised them by raising money for SIRVS. Anna Ruelle, '11 DVM, a previous president of the CVM's Alumni and Friends Society board, launched a donor page through the Minnesota Veterinary Medical Foundation and raised nearly $19,000. The CVM launched a crowdfunding page to honor Larissa's commitment and dedication to the program she built. The community raised nearly $45,000 to help fund future community medicine clinics. 

Minicucci passed away last November, leaving Cornicelli with a $100,000 American Veterinary Medical Association life insurance policy. “She wanted to create a service-learning fund with part of that,” he says. They hadn’t discussed the details, but Cornicelli was encouraged by the SIRVS donations. He donated all $100,000 toward creating a named endowment fund: the Dr. Larissa Minicucci Community Veterinary Medicine Endowment Fund. “The goal is to establish a professorship in her name to continue and grow the work she was doing on the Reservations,” he says.

Cornicelli’s generous contribution launches the effort with meaningful momentum. However, donations are being accepted as the fund aims to raise at least $1 million. “The University has been tremendous,” Cornicelli says. “They’re fully supportive.”

Student-driven, community-focused

Bernstein and student Kim Nguyen perform a neuter on a dog
Bernstein and Kim Nguyen, class of 2023, perform a neuter surgery on a dog. "This was her first-ever dog neuter and she absolutely aced it," Bernstain says. "We always talk about how the student plans to approach a surgery beforehand. We also discuss what potential post-operative complications translate to in plain language for clients who are monitoring the patient's healing following surgery. It helps remind students that SIRVS isn't just about doing surgeries while in school — it's about making safe decisions for the patient, communicating with the anesthesia team, and communicating effectively with clients."

“We’re lucky to have committed people that come and help our students learn,” says Flynn. Clinics are first come, first served. Client patience affords students thorough practice, but excellent customer care remains a priority.

Bernstein and Walz conducted the first-ever process-flow analysis for both VeTOUCH and SIRVS to identify problematic bottlenecks or inefficiencies in the clinics’ execution in order to serve more patients and families. They have also spearheaded a data management protocol for the clubs. “Collecting some of this hard, epidemiological data will inform even better care,” Bernstein says. “The goal for these next few months is to start diving into that data and analyzing it.” 

According to Bernstein, the clinics get a lot of returning patients, and growing demand for geriatric care is one of many factors shaping the future of SIRVS and VeTOUCH. To track evolving client needs, both programs maintain open dialogues with community members.

Made to last

Minicucci designed SIRVS with tremendous foresight. “It’s incumbent upon the student leadership of SIRVS to train the next leaders,” explains Cornicelli. “So it’s a phenomenally self-sufficient student-run organization.”

These values permeate VeTOUCH, too. As in SIRVS, an annual transition of leadership fosters fresh ideas for program improvement. “Each year is very individual in what direction they think we should go,” Flynn says. 

These student leaders are dedicated. They are truly in charge and deserve the credit for the success and positive reputations of these organizations.

Emily Walz, DVM, MPH

“These student leaders are dedicated,” says Walz. Despite faculty oversight, “they are truly in charge and deserve the credit for the success and positive reputations of these organizations.”

Recently, VeTOUCH leadership implemented an electronic medical records system to improve information access between clinics. “I’m so proud of them,” Flynn says. “They did all the research, looked into all the options, and made the decisions.”

Dignified care: demystified

Walz feels one of the most extraordinary things about VeTOUCH and SIRVS is their commitment to serving families “in a dignified and accessible way.” Clinics take place at familiar places within each community. Valuing transparency, students, faculty, and volunteers recognize pet owners as vital members of the care team who play a foundational role in the decision-making process. 

Cultural humility is a commitment to lifelong learning and critical self-reflection.

Lauren Bernstein, MVB, MPH

Bernstein says it’s unhelpful to make assumptions about clients’ financial health, access to education, or sociocultural beliefs because the most effective patient solutions come through joining veterinary expertise with local expertise. That’s where cultural humility—which Bernstein describes as “a commitment to lifelong learning and critical self-reflection”—is key. And it’s a fundamental component of the CVM’s outreach programs. This philosophy helps veterinary health professionals understand the complex interplay between their own cultural identity and that of clients and get ahead of resulting biases.

SIRVS members attend an annual lecture by Monte Fronk, Mille Lacs Band member and emergency management coordinator, where Fronk discusses cultural humility and communication in the tribal communities they visit. Simultaneously, VeTOUCH students work with a veterinary social work intern to learn effective care and communication with clients navigating challenges, such as homelessness, addiction, or disability. VeTOUCH has also collaborated with volunteer student interpreters. Future plans include exploring best practices in navigating language barriers between providers and clients. 

Local champions

The past few years have seen budding relationships with the Fond du Lac Band of Lake Superior Chippewa, Red Lake Nation, and Bois Forte Band of Chippewa. Walz also notes potential partnerships with other groups, such as MNSNAP, “to complement the wellness services provided at the Little Earth of United Tribes housing complex in Minneapolis.”

With each new relationship it is imperative to identify local or neighborhood animal champions who are willing to work alongside our team. Building grassroots support can then be combined with the resources of respected organizations.

Emily Walz, DVM, MPH

“With each new relationship,” Walz says, “it is imperative to identify local or neighborhood animal champions who are willing to work alongside our team. Building grassroots support can then be combined with the resources of respected organizations.” One such organization is the Animal Humane Society (AHS). Its veterinary centers have provided the Twin Cities with low-cost veterinary care since 2011.

Last September, AHS opened its new University Avenue center in St. Paul, which is collaborating with the CVM to open a veterinary clinic. There, DVM students will help provide services to pet owners in the Frogtown and Rondo neighborhoods in St. Paul. “The AHS shares our vision to expand community medicine programming,” says Walz.

Our futures, connected

Bernstein says veterinary medicine is critically linked with public health: whether seeking resources for human or animal care, the barriers remain the same. “I think having compassion and recognizing those barriers makes a big difference for overall patient health.”

With that in mind, the CVM is supporting “wrap-around services,” which connect owners to resources that decrease barriers for both people and pets. For instance, the College is growing its partnerships with the School of Social Work and School of Nursing to provide better community referrals and holistic support for clients and their families.

One new partnership between the CVM and the Community-University Health Care Center (CUHCC) is evaluating the benefits of offering pet services for the center’s patients and clients. The pilot program would also allow trainees in human and veterinary medicine to learn and work together. This collaborative care model champions the One Health philosophy — the efforts to attain optimal health for people, animals, and the environment.

The CVM is also in the early planning stages of a partnership with the University’s Urban Research and Outreach-Engagement Center. Walz reports that initial conversations have elucidated an interest in serving the pet-owning community in North Minneapolis. “As this is a new relationship, we want to proceed mindfully. Developing new partnerships is a process.” To serve with intention, all parties must take time to listen to the unique voice of each community.

Still, at the heart of all partnerships—past, present, and future—there remains one constant: “Helping pets helps people,” says Flynn. “Pet ownership isn’t a privilege—we all benefit from having animal companions in our lives.”

 

Community partnerships, community impact

Robin Ahrenhoerster

Robyn Ahrenhoerster

Class of 2023, incoming VeTOUCH vice-president 

 

“I’m beyond thankful to be a part of both VeTouch and SIRVS and I can’t wait to see what the future brings for these remarkable organizations. One of the reasons I chose to apply and come to the veterinary school here at the University of Minnesota was because of all the organizations that we as veterinary students can get involved in outside of school. But once I got involved with both VeTOUCH and SIRVS, I realized that these organizations are much more than just getting more veterinary experience. 

 

“Getting more clinical experience is definitely very beneficial, but being able to work with communities and serve their members is the highlight of it all. Being able to troubleshoot problems and walk through clients on maintaining healthy pets, not only helps me improve my clinical knowledge and my client communication skills, but it provides a much-needed service to communities that will benefit from it. 

 

“Furthermore, one thing that stood out to me about VeTouch and SIRVS is that they are sustainable organizations. A lot of the time, you go and volunteer in a community that you won’t ever go back to again. Both VeTOUCH and SIRVS build relationships with these communities and continue to go back to provide a continuous and reliable service.”

Graham Brayshaw

Graham Brayshaw, DVM

Director of animal services, Animal Humane Society

 

“At Animal Humane Society, we have a close connection with the University of Minnesota, partnering on many programs that we think are mutually beneficial. Be it providing space and animals for ESAS so fourth-year students can hone their spay/neuter skills, giving preceptors a chance to practice shelter medicine for two weeks, or even just giving students an experience at an outreach vaccine clinic, we hope that we provide the veterinarians of tomorrow experience and exposure to what it is like to be a vet in animal welfare. The U provides expertise, equipment, and access to care that we don’t have as an animal welfare non-profit. There are several animals every year that we could not get into homes without the CVM, whether it is access to an MRI or the ability to perform life-saving heart surgery on a puppy or kitten. 

 

“We hope this partnership can grow and are looking forward to having students at our new veterinary center that is coming to Frogtown. We are excited for students to get a chance to help provide veterinary care to a portion of the population that does not normally have access to a regular vet clinic. We will be able to provide care to more people and animals in need, and students will get a chance to practice ‘real-world’ medicine in a non-tertiary referral facility. It is a great situation when the animals, their owners, and both our organizations win.”

 

Monte Fronk

Monte Fronk

Mille Lacs Band member and emergency management coordinator

 

“This program has now provided ten years of clinics to the Mille Lacs Band of Ojibwe. Our reservation has seen a substantial improvement in reducing the amount of unplanned litters as a result of the spay and neuter clinics. The fact that we have done a record number of surgeries proves how important this is to our community members and is something we look forward to every year. Not only do the spay and neuter clinics provide a much-needed preventative capacity, but the wellness checks and vaccinations contribute to the overall improvement in the health of the four-legged members of our households. Healthy animals contribute to a healthier household. This program has been valuable in serving our community.”

 

Jessica Byrne, Kristina Spencer, and Hilary Hooberman

Hilary Hooberman 

Class of 2022, SIRVS president

 

“Being a board member for SIRVS has greatly enhanced my professional development, as it has taught me about leadership, team building, effective communication, problem solving, and cultural humility. SIRVS also provides a way for me to take what I have learned in the classroom and apply it to real-life cases; I am able to see and examine a patient and work with a doctor to evaluate findings, make a diagnosis, and form a treatment plan. I think many students also find that this hands-on experience reminds us why we are in veterinary school and what we are working towards. We are also able to engage in many great conversations with clients about their pets and the pets’ health, and those types of conversations are difficult to fully simulate in a classroom.  

 

“We are very lucky to have amazing veterinarians and veterinary technicians who come from all over the country to volunteer at the SIRVS clinics. They provide incredible mentorship and tremendously enhance student learning.”

 

Jonathan Isla

Jonathan Isla

Class of 2022, VeTOUCH co-president

 

“Every interaction at these clinics helps us grow as clinicians, as well as develop into more well-rounded community members. We create a unique learning space that is not easily replicated in a classroom setting. Being an extraordinary veterinarian is about more than just the knowledge; for this reason, our student-run clinics help our communities while simultaneously offering veterinary students invaluable experience. For me, VeTOUCH and SIRVS have enabled me to better diagnose and treat common illnesses while working with limited resources. These experiences are better preparing me for work-life beyond the classroom and I am grateful to have been given the opportunity to help run these free clinics.”
 

Katie Mignola

Katie Mignola

Class of 2022, VeTOUCH co-president

 

“I love that VeTOUCH gives me a chance to give back to the community and help hundreds of pets every year, all while being a valuable learning experience. It helps remind me why I want to be a veterinarian when most of my days are just about lectures and studying.”

 

Susan Miller

Susan Miller, DVM

Executive director, Mission Animal Hospital

 

“As a 501c3 nonprofit organization, Mission Animal Hospital is dedicated to reducing barriers to high-quality and compassionate veterinary care. We are excited to offer a community-based external elective rotation for University of Minnesota 4th year veterinary students! During this rotation, students are able to directly manage client-facing ‘spectrum of care’ conversations and engage in patient-centered and experience-based medicine that focuses on problem-solving to achieve best outcomes in the context of limited resources. Having student support allows our organization to maximize our daily impact and helps prepare students for real-life situations they will face as veterinarians.

 

“Mission Animal Hospital is a high-volume nonprofit 501(c)(3) organization seeing greater than 20,000 patient visits a year. Our guiding mission is to remove barriers to care, helping to preserve the human-pet bond for all.”


Learn more about Mission Animal Hospital

 

Maddy Moore

Maddy Moore

Class of 2023, SIRVS president-elect

 

“When I joined SIRVS, I really didn’t know what to expect. After my first trip, I truly discovered the impact it had on everyone involved with this organization. The difference we were able to make in the lives of the animals and their owners that we offered services to was incredible. No service experience I have ever done compares to what SIRVS offers to communities and the students that serve. It gives students a chance to hone their skills, gain confidence in their knowledge, and grow as more compassionate, adaptable doctors. It gives communities an opportunity to receive veterinary care with kindness and devotion to owners and pets alike.”

Angela Nordman

Angela Nordman

Citizen of the Leech Lake Band of Ojibwe

 

“I’ve had the honor and privilege to work with SIRVS both personally and professionally since 2014. Not only has it allowed community members to care for their animals close to home, which is critically important, but it’s also provided opportunities for our young people to learn about careers in veterinary medicine. SIRVS has brought peace of mind to our citizens and empowered them with the knowledge and resources to care for their animals. SIRVS clinics have also provided a valuable opportunity to build relationships and strengthen the Tribe’s partnership with the organization over time. 

 

“SIRVS is very important to me personally, having had the opportunity to work with and collaborate with my friend, the late Dr. Larissa Minicucci. I have seen the heart and passion that SIRVS staff have not only for the animals, but also for the people who love them. That’s why I bring my own animals to the SIRVS clinics for wellness checks. My husband and I care for a 3-year-old black rescue cat named Boogid and an elderly rescue pitbull named Bo. We choose to have their wellness checks done at the SIRVS clinics because of the opportunity that it brings to the CVM students for hands-on experience. I hope that the SIRVS program, and it’s collaboration and partnership with the Leech Lake Band, only continues to grow and flourish into the future.” 

 

Caitlyn Rize

Caitlyn Rize

Class of 2021, former VeTOUCH co-president 

 

“VeTOUCH has provided infinite opportunities for me on a personal level. From budgeting to managing team conflict, I have significantly built both tangible and intangible leadership skills. VeTOUCH also introduced me to coalition-building concepts as I used networking skills to solicit volunteers, partners, and donors. Additionally, VeTOUCH allowed me to form deep relationships with faculty members who have aided me in my professional development and future career planning. I have also been afforded a handful of awards, scholarships, and conference opportunities that I am sure I can attribute to my leadership position with VeTOUCH. Finally, I am certain that my experience with VeTOUCH will open up post-grad opportunities that I can't even imagine at this point in my career. I am eternally grateful for my experience with VeTOUCH and I hope that future students are able to continue on the legacy.”