Veterinarians are required by the state laws that control their licensure and scope of practice to keep up with changes in the body of knowledge and techniques that makes up veterinary medicine. Such continuing education is a requirement for all vets, and most actively seek out more than the minimum requirement because they genuinely wish to continually improve the care they provide. However, because there is a political dimension to continuing education, and government bodies are involved in establishing what constitutes legitimate training for the purposes of meeting the legal requirements, the process invariably is influenced by the same sorts of unscientific ideologies that allow for insurance reimbursement for unproven therapies and that prevent sensible regulation of dietary supplements. This is sadly, and yet humorously evident in the offerings at the upcoming American Holistic Veterinary Medical Association (AHVMA) annual conference, to be held in Fitchburg, MA September 12-15 of this year.
The national standard for accreditation of veterinary continuing education is the Registry of Approved Continuing Education (RACE) established by the American Association of Veterinary State Boards (AAVSB). Most state veterinary medical boards require continuing education courses submitted for maintenance of state licensure be RACE certified. The 2009 AHVMA conference has applied for RACE certification, but this has not yet been officially granted. However, the organization’s 2008 conference was approved, and there do not appear to be any substantive difference in the content of the two conferences.
According to its website, “The American Holistic Veterinary Medical Association explores and supports alternative and complementary approaches to veterinary healthcare, and is dedicated to integrating all aspects of animal wellness in a socially and environmentally responsible manner.” Like most industry organizations, the group engages in lobbying for its agenda, supports social and business networking among members, publishes a journal, and promotes its vision of veterinary medicine. It also provides continuing education opportunities consistent with its CAVM-centered philosophy.
All of this is impressive considering that no clear, consistent definition for “holistic” exists. It is a warm a fuzzy marketing term that seeks to promote unproven therapies alongside, or even in place of, scientific medicine by peddling the nonsense that somehow science-based medicine somehow ignores the person and just treats the body or treats just symptoms not diseases or their causes. I’ve never actually met a veterinarian who considers the patient irrelevant to the health of the knee or the gallbladder or the white blood cell, but CAVM practitioners like to suggest that such myopia is the only alternative to embracing vitalism and faith-based medicine.
As to the substance of the continuing education offered by the AHVMA, it is an eclectic hodgepodge of methods and philosophies that seem to have little in common beyond their lack of sound supporting evidence. There are, of course, classes on the Big Three of CAM, acupuncture, chiropractic, and homeopathy. Bach Flower Therapy gets some play, and there are some anti-vaccine offerings. The summary for a lecture titled Equine Disease Manifestations from Rabies Vaccination sounds fair and balanced:
“In western N.Y., there has been a true spread of Rabies in the raccoon population. In response to this threat, the state instituted an oral Rabies vaccine drop throughout western N.Y. and requires any horse that steps foot on state land to have an annual Rabies immunization. The result seen from this aggressive immunization procedure is an increase in physical, mental, and spiritual disease in our equine companions. Many of these diseases seem to be not only a combination of an acute reaction to the attenuated rabies virus with a worsening of the animals underlying chronic disease but also new intense emotional diseases that have not been seen. Many of the disease seen are hind leg weakness and lameness, severe mental aggressions and fears, including a almost intentional harm to the rider, and choke. Cases with the homeopathic treatment will be discussed.” [emphasis mine]
Some of the details of the offerings on homeopathy were new to me. The science of homotoxicology apparently warrants its own seminar. According to one site, in homotoxicology “diseases are considered to be ultimately caused by toxins, whether toxic chemicals, bacterial exotoxins, biological endotoxins, post-traumatic cellular debris and also byproducts of the bodies metabolic processes. Furthermore, disease symptoms are said to be the result of the body’s attempt to heal itself and should not necessarily be suppressed.” As usual, the answer to the ill effects of these toxins on the body is to give people water that once contained a few molecules of something that Hahnemann or somebody else once said might cause symptoms like those thought to be caused by the toxins. I am particularly impressed by this testimonial from one of the doctors presenting at the seminar:
“A series of seemingly random events led to my initial foray into homotoxicology, and unexpectedly good results from the therapy intrigued me. I had to know the reasoning, theory, and therapeutics of this medical art. It has consumed my interest for many years, with more magic still to be learned.”[emphasis mine]
And speaking of toxins, did you know this?
“The recent increase of animal shoulder and hip mobility restrictions can be attributable to nutrition. “Leaky Gut” syndrome, caused by intestinal GLUTEN, creates protection mechanisms altering gait mechanics. Glycoproteins in gluten have a “glueing”[sic] effect, reducing healthy tissue motility. Osteopathic techniques and modified diets can substantially impact symptoms.”
The conference also promises to discuss the homeopathic concept of the tubercular miasm, defined elsewhere thusly, ” A miasm is not an infection or an intoxication, but a vibratory alteration of man’s vital energy, determining the biological behaviour and general constitution of the individual.” The AHVMA lecture specifically addresses treating this miasm with “remedies sourced from insects.” Yummy!
But consistent with the “holistic” commitment to never critically judging the plausibility or soundness of any idea, the offerings go well being what might be called “mainstream woo.” There is a lecture titled “Plant Spirit Medicine – Deepening Your Relationship with Plants.” Another set of lectures for veterinary technicians involves “Using the Bioenergetic Field to Empower Your Life Personally and Professionally” and considering “How Your Bioenergetic Field Affects Your Patients.” There’s also “The Science of Energy Medicine,” which “will discuss the underlying mechanism of biofield theory with special attention to quantum physics and wave theory.”
My two favorites, though, might generate some controversy even among proponents of CAM. The first is a lecture entitled “Spiritual Nemenhah Indian Adoption as it relates to legal adoption.” The Nemenah cult is the group that achieved some notoriety when 13 year old David Hauser chose to stop receiving chemotherapy for his lymphoma and was temporarily taken into hiding by his mother. His parents are members of this faux Native American religious group that emphasizes alternative medicine. Even some proponents of CAM have balked at supporting the groups extreme approach. The AHVMA lecture sounds like a “health care choice” gambit to avoid federal laws regulating medical therapies and drugs:
“As an adopted member of the Nemenhah (“village of healers”) Band, I will explain how adopted members can obtain a significant level of protection from CODEX and other laws which are threatening our health liberties.The Nemenhah Indian Band was established as an Indigenous Group based on traditional writings which integrate “medicine and religion as one” under Indian belief. By Congressional and International law Indians are offered unique protection under recent preeminent treaty. Those who manufacture or dispense herbs, homeopathy, nutrients and any other emerging natural healing modality, will be interested to know their products and practice can be protected under Nemenhah Band legal protection.” [emphasis mine]
The ethical and legal questions this lecture raises strike me as significant, and the implicit endorsement of the AHVMA of what amounts to a call to defy federal health and consumer protection laws casts a rather sinister light on the organization’s agenda.
Finally, “holistic” veterinary medicine apparently goes beyond the mere healing of animals with unproven therapies. The greater goal is apparently to heal our hospitals and even the Earth itself (herself?), according to a lecture entitled “Geopathic Stress and Earth Acupuncture–Sick buildings and Sad Houses.”
“During this outdoor demonstration identifying and correcting geopathic stress with earth acupuncture techniques, participants will have an opportunity to find earth meridians using dowsing rods, and directly perceive both healthy and unhealthy landscape chi before and after treatment.”
As humorous as much of this is, verging as CAVM so often does on self-parody, it is sobering to realize that this sort of nonsense has been officially approved as continuing education credit. How can a regulatory structure possibly protect the public and their pets and still allow veterinarians to maintain their licenses by studying Earth Acupuncture and Bioenergetics, or by attending lectures that blame animal illness on vaccination or obscure “toxins” or that actively encourage veterinarians to evade federal law by joining a faux Native American cult that encourages parents to deny life-saving therapy to their children with cancer? One of the reasons why a neutral, live-and-let live attitude towards faith-based medicine doesn’t seem to me an acceptable stance is the kind of real danger that this sort of thinking represents to our patients. Danger that is magnified dramatically by the official imprimatur of regulatory agencies that are supposed to protect our health but who set standards based on popularity rather than science.