Academy of Veterinary Homeopathy Lawsuit Update

Back in May, I wrote about a lawsuit involving the Academy of Veterinary Homeopathy (AVH) and the American Association of Veterinary State Boards (AAVSB) committee that certifies continuing education courses veterinarians must take to maintain their state licensure (the RACE committee). In brief, the RACE committee changed their standards for approving continuing education programs to require some minimal standards of scientific legitimacy for veterinary continuing education. The standards requires approved courses,

build upon or refresh the participant in the standards for practice and the foundational, evidence-based material presented in accredited colleges or schools of veterinary medicine or accredited veterinary technician programs…CE programs that advocate unscientific modalities of diagnosis or therapy are not eligible for RACE approval…All scientific information referred to, reported or used in RACE Program Applications in support or justification of an animal-care recommendation must conform to the medically accepted and scientifically supported standards of experimental design, data collection and analysis.

As I’ve discussed in detail before, homeopathy cannot by any but the most absurd contortions of reason be viewed as a scientifically legitimate or validated approach to health care, so it is not surprising that once RACE ceased rubber stamping applications for approval and applied these reasonable standards, homeopathy courses were judged ineligible for continuing education credit. It is also not surprising, of course, that homeopaths and others practicing scientifically questionable veterinary medical methods would object.

What is surprising and disturbing, however, is that the limited media coverage of the AVH lawsuit has been generally biased in favor of the AVH position, and there has been virtually no criticism of the deeply anti-science stance of the AVH, which if successful will essentially end all meaningful regulation of veterinary continuing education. Like much media coverage of creationism, journalists seem to believe that fair coverage requires ignoring the overwhelming consensus among scientists and veterinarians that homeopathy is nonsense and presenting veterinary homeopaths as a legitimate minority community being unjustly discriminated against. The media reports I have seen so far seem to entirely ignore the underlying issue of the scientific evidence against homeopathy or the threat the lawsuit, if successful, poses to the very idea of regulating the standard of veterinary care through the process of state licensure.

The Media Gets It Wrong
The Veterinary Practice News reported on this lawsuit in early August.  In a roughly 2000 word article, the author extensively quoted five supporters of homeopathy and of the lawsuit. She also quoted an official at the AAVSB who was not free to comment on pending litigation. And finally, she interviewed me for the article as the sole critic of the AVH position.

I was quoted as saying that homeopathy was not a science-based intervention, which is accurate. I was also quoted as saying that, “Alternative medicine providers are often better at treating psychological aspects of a medical incident an owner is dealing with, and there’s no doubt they are caring and compassionate…”This is partially correct in that I did acknowledge that alternative practitioners are undoubtedly as caring and compassionate as other veterinarians, but it misrepresents the point I was making that the reason methods like homeopathy are popular with a small percentage of the pet-owning public is not because they actually work but because of the psychological effects, essentially a placebo-by-proxy, that the interaction with the practitioner has on the owner.

Lastly, I was quoted as saying that, “these therapies are not taught in veterinary schools.” This is followed by a “gotcha” list of veterinary schools that offer elective courses in “integrative medicine” or have “holistic medicine” student organizations. This is clearly intended to undermine the credibility of my comments. However, this is again a manipulative misrepresentation of my position.

Homeopathy is clearly not part of the core veterinary curriculum, nor is it generally accepted as a valid approach to medicine at U.S. veterinary colleges. The AVH does not dispute this in their complaint. And of the four veterinary schools (out of 28 in the U.S.) mentioned in the article as having “elective courses in CAVM or integrative veterinary medicine,” I could not find any that actually do have a course in homeopathy, though CSU does offer an elective called “Critical Overview of Complementary and Alternative Medicine” taught by Narda Robinson, who is a vocal critic of homeopathy. It is possible, of course, that a couple of schools do have credulous individuals on faculty who teach that homeopathy is scientifically legitimate, but if so these represent a rare minority opinion which is discounted by the overwhelming majority of veterinary scientists. The article was a barely disguised propaganda piece for the AVH position with only a superficial nod towards the idea of journalistic neutrality.

Another article on the subject was released today by the Veterinary Information Network (VIN) News Service. This article is more neutral than the VPN piece, but it still creates a false impression of the nature of the debate. It misrepresents the conflict as a balanced difference of opinion within the profession, when in fact it is about a small group of believers in a long-discredited belief system agitating for a special exemption from the scientific standards normally applied to mainstream veterinary medical practices.

The article extensively quotes the AVH veterinarian and attorney who filed the lawsuit, and also less extensively the president of the AAVSB. In general, much attention is given to the idea that homeopathy and other alternative approaches are “discriminated against,” and almost no attention is given the underlying scientific issue and the question of whether education of licensed veterinarians should be rooted in accepted science.  

What’s the Point of Continuing Education for Vets?
I have discussed the legal and historical issues of licensing healthcare providers, including veterinarians, in detail elsewhere. In brief, the state is required to establish standards for the practice of medicine and issue licenses to healthcare providers in order to protect the public health and prevent unsafe and ineffective treatments from being sold as legitimate healthcare. Prior to the development of this practice, quacks and charlatans routinely sold useless or harmful, even deadly “remedies” freely, to the great harm of patients in need of real care. Continuing education requirements are part of this system, and they are intended to ensure that veterinarians stay current on progress in veterinary medicine.

It makes no sense to have such standards if there is no reasonable, scientific criteria for what counts as legitimate continuing education. Should veterinarians be able to maintain their licensure by studying anything they want? Psychic surgery, astrology, voodoo, faith healing, etc? The AVH argues that the standard of scientific evidence is fundamentally unfair. According to the VIN article, the new RACE standards’ emphasis on science, “worked to preclude homeopathic courses that were not based on what RACE committee members considered to be clear, evidence-based science. It narrowed the road to acceptance, critics say, giving more weight to published science and less to the experts in homeopathy. ”

This as much as admits that homeopathy is not accepted as scientifically legitimate by anyone but homeopaths. The logical consequence of this, apparently, is that only experts in homeopathy should be allowed to judge if  homeopathy is scientifically legitimate. And presumably only psychics, astrologers, and voodoo priests should be allowed to judge whether these are legitimate veterinary medical approaches?

This is a form of special pleading which says that there is no real scientific standard of evidence that can prove anything is or is not effective medicine, so followers of every individual approach should simply be free to judge their own practices by their own standards and then the state should simply endorse their judgments. Such an approach effectively eliminates any meaningful standard of quality for veterinary care and takes us back to the medical anarchism of the 19th century.

Taking this sort of approach even further, the American Holistic Veterinary Medicine Association has formed its own standards group, the Registry of Alternative and Integrative Veterinary Medical Education (RAIVE) to circumvent the RACE standards board with one stacked with believers in alternative therapies and more inclined to rubber stamp continuing education in these approaches. This will be meaningless, of course, unless state veterinary boards agree to accept RAIVE in lieu of RACE approval. Of course, since such boards are fundamentally political, rather than scientific, agencies, and they have a solid history of ignoring blatantly even the most egregiously ridiculous and harmful sorts of medical nonsense so long as it is promulgated by a licensed veterinarian, it seems not unlikely that this separate-and-equal approach to deciding what is legitimate medicine will succeed.

Why Does It Matter?
The simple answer to this is that our patients are better off if they receive effective care. And this is more likely to happen if veterinarians are trained in legitimate scientific medicine. We have a special privilege by virtue of the license we are granted by the state to practice veterinary medicine. We can make our living providing healthcare for animals. And this privilege is granted us with the understanding that we will employ safe, effective, scientifically valid treatments. Our clients come to us trusting that our status as licensed veterinarians means we are meaningfully different from unlicensed individuals who might offer veterinary services. The state has essentially certified that we can be trusted to take proper care of our clients’ companion animals using valid methods.

If any and all methods are considered equally acceptable as support for our licensure, and if only believers in a given method are allowed to judge the legitimacy of that method, regardless of how few they are or how lacking the scientific evidence in support of their beliefs, than licensure is meaningless. A pet owner has no way of knowing if the licensed veterinarian they go to is practicing accepted, scientific medicine or a completely bogus method they have invented and judged legitimate all by themselves.

The harm that unscientific approaches to medicine, including homeopathy, can do is real and easy to illustrate (here and here, for example). The issue behind the AVH lawsuit is not fairness or open-mindedness, it is about whether scientific evidence and regulatory standards are to have any meaning or any influence on the quality of veterinary care the public is offered. The AVH is fundamentally seeking an exemption from any such standards and the right of any group to judge their own beliefs and promote them as legitimate under the imprimatur of state government without interference from the judgment of the rest of the profession or state regulators.  

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11 Responses to Academy of Veterinary Homeopathy Lawsuit Update

  1. Narda Robinson says:

    Skeptvet,

    I appreciate your giving words to what I was feeling; i.e., that there was an underlying tone in both write-ups of the poor homeopaths being discriminated against.

    I’m glad that at least Veterinary Practice News provided some commentary from you; it assures the reader that there’s at least one critical thinker in the conversation.

    I will clarify the CSU position on CAVM. Thanks for the feedback on the impression that the article gave. I agree.

  2. skeptvet says:

    Yes, the media often does a poor job of accurately characterizing scientific issues and frequently fails to see through transparently illogical arguments. I am ambivalent about being the “token skeptic” in articles like that in VPN. On the one hand, if I don’t comment there will be nothing to counter the propaganda of the AVH. On the other hand, the truncation and misrepresentation of my position can easily make the skeptic position, which with regard to homeopathy is the mainstream and evidence-based posiiton, seem less rational and less widely accepted than the position of the AVH, even though exactly the opposite is true.

  3. Narda Robinson says:

    I’m delighted that you were consulted for the VPN piece, and this continued conversation through your blog as well as on VIN gives voice, however truncated, to the often silent majority who have, for decades, harbored concerns about the promulgation of the unscientific and dubious subset of complementary and alternative veterinary medical (CAVM) approaches.

    Dr. Ramey did much to get this conversation started, especially for the equine realm. Now that you have joined in and given small animal practitioners a forum for discussion as well as illumination of the murky details that infiltrate so much of unscientific CAVM, those who previously had no means to contribute can do so.

    Veterinarians in administrative and legislative roles can find fact-based discussions through your blog, readily and at their fingertips, thoroughly referenced to support your arguments.

    No “my guru said this is true so I have to believe it” here! What a welcome change.

    Although we cannot control how writers who interview us eventually present our input (except in those welcome times when authors send us for pre-approval the excerpts they will use and their context well in advance of publication), I think it is vital to hear from rational and critical thinkers such as yourself.

    Even with stunted sound bites but even more so in your blog, your words strike a much different chord in the reader’s mind. I think it’s the ring of truth and its harmonious resonance with science that compares so sharply with the shrill, sustained cacophony of dissatisfied belief-system advocates who, in the absence of science and substance, demand acceptance through political pressure, organized letter-writing campaigns, and other means.

  4. Ryan Gates says:

    Good post. I’ve said for many years that the lack of education in the field of science at the earliest levels, and in fact throughout American education will be our undoing. There is simply an inability on the part of the general public to think critically when it comes to issues of not only science, but also economics, politics, philosophy and law. Certainly we may come to different conclusions after thinking critically within many of these areas, but at least an honest look will be taken, rather than taking the “feel good” approach or blindly following an agenda-driven media, institution, association or individual.

  5. skeptvet says:

    Critical thinking certainly does seem to be a scarce commodity. I fear the problem may be less in the nature of our educational system than in a fundamental lack of interest in critical thought and reason, especially when it conflicts with what we wish to believe.

  6. art malernee dvm says:

    required by law CE needs to be measured scientifically. A good first step would be to require an hour of required by law veterinary CE to be measured in real time or just call it one credit of CE like the physicians do now. If a priest sold holy water as medicine he would be put in jail if he did not stop. A veterinary licence should not used as a get out of jail free card so vets can continue to sell tap water as medicine.

    >>> I did acknowledge that alternative practitioners are undoubtedly as caring and compassionate as other veterinarians>>>>>

    why do you” believe” that? It seems to me being a delusional or crooked veterinarian which ever the case may be when selling homeopathy would negatively effect your ability to care and be compassionate toward your patient.
    art malernee dvm
    fla lic 1820

  7. skeptvet says:

    Being wrong does not imply being unkind. Homeopaths are deeply mistaken about the facts, believing that an inert substance is actually exerting a medicinal effect. But they are no more or less likely than anyone else to be stupid, crazy, or unkind. We are all mistaken about many of our beliefs. That’s the whole point of skepticism, after all; that normal, intelligent, educated people are subject to the same cognitive biases and failings as anyone else, and not immune to false beliefs. I think it is a huge mistake to start charicaturing those who believe in medical nonsense or blaming false beliefs on uniquely personal failings. There may be relevant temperment variables, in that a predilection for relying on faith or personal experience even when contradicted by more reliable evidence may be a stronger tendency in some individuals than in others. But on the whole, I see no evidence that believers in unscientific medical approaches are any less intelligent or committed to the welfare of their patients, on averagge, as those opposed to such approaches.

  8. Art says:

    But on the whole, I see no evidence that believers in unscientific medical approaches are any less intelligent or committed to the welfare of their patients, on averagge, as those opposed to such approaches……….
    I agree with you about the lack of evidence. There are no randomized controlled trials to measure how sucessfully compassionate doctors or nurses are that I know of. The best know veterinary management geru that i know likes to say show them that you care even if you must fake it. So even if we could measure compassion we would then want a way to measure who was faking it.

    Art Malernee dvm

  9. art malernee dvm says:

    Nada, is there a Robyn at AAVSB/RACE? Paul Pion wrote there was but then removed his VIN.com post. I would like someone to call and talk to from RACE about hours of CE awarded for attending state veterinary board meetings. The florida veterinary board is awarding afternoon hours of CE in the liquor bars at the hotels where the state board meeting is held. The fla state board also fines vets at the board meeting in the morning if a licensed fla veterinarian does not have the proper hours of CE. I cannot report the fla state board to itself for CE violation since they are the one who fines vets for not getting enough CE. The fla veterinary board publishes opening and ending times of the meeting so the public can see afternoon hours of CE awarded when the board members are on their way home or eating and drinking at the hotel.
    art malernee dvm
    fla lic 1820

  10. Narda Robinson says:

    Yes, Robyn Kendrick is the Executive Director. I responded to Paul’s post where he complained that Robyn didn’t return his calls. Robyn’s contact information is available at the aavsb.com website. While the AAVSB in an association of its member boards, I don’t think they are in charge of oversight. You might contact the Department of Regulatory Agencies in your state if you have questions or concerns. Just a guess.

  11. Art says:

    I did contact the department that regulates the fla vet board and got a deer in the headlights non response even when shown the section of fla law that defines a hour of CE must be measured as no less than 50minutes long. I was able to get the fla pharmacy board to email me that when the pharmacy board certify a hour of CE credit for attending the fla state pharmacy board meeting the pharmacist are in the board meeting not the liquor bars in the afternoon awarded CE hour. But the pharmacy board does not publish the opening and closing time of their board meeting like the fla vet board does so I was not able to verify if the fla pharmacy board was telling the truth.
    Art Malernee dvm
    Fla lic 1820

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