Last fall, I wrote about the American Holistic Veterinary Medical Foundation (AHVMF), an offshoot of the American Holistic Veterinary Medical Association (AHVMA), which is devoted to raising money for the promotion of alternative therapies. The AHVMA is a vigorous advocate of unproven and outright bogus therapies, and I have frequently discussed their activities. From the annual “scientific” meeting that includes promotion of ridiculous pseudoscience on the dime of herb and dietary supplement companies to its vigorous defense of homeopathy, the AHVMA has demonstrated a commitment to the standard of no standards when it comes to veterinary therapies. Despite lip service paid to science and free use of the language of evidence-based medicine, the organization is clearly an advocate for any and all therapies under the broad, essentially ideological label of complementary and alternative veterinary medicine (CAVM).
So while the AHVMF also talks about supporting legitimate scientific research, I have some skepticism about such claims. The parent organization, and many of the individuals involved in the AHVMF, have clearly demonstrate that they are unwilling to reject CAVM therapies even when they are inconsistent with established scientific knowledge or the results of scientific research. My suspicion (and I would certainly be pleased to be wrong here), is that the AHVMF is purely a marketing effort, aimed at promoting what its members already believe rather than finding the truth, and an attempt to create the impression of scientific and institutional legitimacy for therapies that have not been able to achieve these on the strength of the evidence for their effectiveness. A recent article on the AHVMF blog appears to support this interpretation.
The Veterinary School at the University of Tennessee recently received a $10,000 grant from the American Holistic Veterinary Medical Foundation to support “integrative medicine.” The faculty member who runs the Integrative Medicine Center at UT has written a blog post for the AHVMF which illustrates very clearly the goals of this effort.
These goals do not appear to be focused on supporting research to identify which CAVM therapies are actually effective. They appear to be more about pursuing a marketing strategy for bringing CAVM therapies into acceptance within the mainstream by making them more familiar, part of the veterinary curriculum, and something that everyone can see works “with their own eyes,” despite the absence of controlled research support or the existence of negative research data. This is pure proselytizing rather than research. For example:
I remember breaking ground for my own hospital, offering alternative veterinary medicine. It was exciting, but there was something missing. I was alone in my work so I dreamed I could turn my hospital into a center to bring in other alternative veterinarians to do lectures. I wanted to share this new knowledge…the clients heard me, but no one else
…My voice was not any louder, when I left my practice, to start an Integrative Medicine service at The University of Tennessee College of Veterinary Medicine. I worked the service knowing the clients would come, but I would smile quietly when I heard, “Why is Integrative Medicine seeing this case” while my neurologic patient was awaiting an MRI.
[When we achieved full faculty status,] I reached out to tell someone that would understand what this appointment meant and my voice was heard by the AHVM Foundation. Now it is time for all of us to reach out and be heard; the foundation is our voice. And for clients who have experienced alternative care, a vested veterinarian, we need to encourage them to support our Foundation
.…as full faculty at a veterinary teaching hospital, we have brought the Foundation here. We have students on our service being exposed to integrative veterinary care. We provide that comprehensive care to many of the faculty’s own furry pets; therefore, we are educating the educators. We are working to gather funds to launch an Integrative Medicine Fellowship, with the university’s mark and the Foundations support. We have Dean approval and are outlining the Fellowship program for maximum impact; we will need funding to make this happen
.…this is our opportunity to bring into the conventional veterinary medicine forum, another black bag: integrative veterinary medicine. I am overwhelmed with what the Foundation has done to date and the goals we have outlined going forward.
The article also illustrates how holistic medicine is so often promoted–not on the basis of evidence, of which there is usually little to none, but as a kinder and gentler and more hopeful approach than science-based medicine. Regardless of how one feels about acupuncture, chiropractic, Chinese Medicine, etc., I wonder how conventional veterinarians are expected to feel about this characterization of what holistic medicine is and what, presumably, conventional medicine is not:
I now realize is that what makes holistic and veterinarians different is not just our type of treatment, but how we approach our patient. In the integrative health movement we are constantly seeking therapies and approaches that are outside the box of conventional veterinary medicine. And for various reasons we need access to these therapies as many of our patients have failed to respond to standard approaches. They come to us with hope of finding help not available elsewhere.
…we approach with a lot of thoughtfulness, gentle treatment plans, and a lot of caring. We are vested in our patients. And once you become a vested, willing to travel a different path to investigate all the options, there is no turning back.
It’s nice to know that when we emotionally detached doctors who are stuck on the whole science thing have given up on our patients, at least they have someone caring to go to who is willing to try almost anything regardless of the absence of anything as pointless as evidence of safety or efficacy.
The infiltration of unproven, or disproven, alternative therapies into legitimate teaching and research hospitals, largely driven by the irresistible allure of funding for research and faculty contingent on a friendly approach to such therapies, has been dubbed “quackademic medicine,” and it represents a real threat to the well-being of patients.
The diversion of scarce resources to research on implausible or already disproven therapies when this research will never discourage advocates from using them regardless of the results impedes real progress in developing better treatments. The perception that such therapies must be legitimate and demonstrably safe and effective (otherwise, why would universities allow teaching and using them in academic hospitals?) creates a false impression of the evidence concerning these therapies and of their value. And despite claims to the contrary, inadequately tested CAVM therapies can directly harm patients. And the integration of unproven methods with science-based medicine can decrease quality of life and survival for patients with serious illnesses.
For all of these reasons, it is unfortunate that the strategy of promoting the integration of unproven or pseudoscientific therapies with legitimate science-based medicine at academic medical centers has reached the veterinary profession. The money this brings to the institutions involved will only harm the profession and our patients if, as seems likely, it is used to promote CAVM rather than conduct legitimate research that will separate the useful from the useless. Such funds would be better spent supporting independent research involving not only dedicated advocates of CAVM but neutral and skeptical researchers with a commitment to rigorous methodological quality and no pre-existing commitment to a particular outcome. Establishing centers to integrate CAVM therapies with conventional medicine when these therapies have not yet demonstrated they are safe and effective is premature and diminishes the integrity of veterinary medicine and is not in the best interests of our clients or our patients.