About a year ago, I wrote a post about the American Veterinary Medical Association’s effort to revise their Model Veterinary Practice Act, a document states often use as a template for writing laws regulating the practice of veterinary medicine. I was specifically concerned about some weaknesses in the language concerning alternative medicine.
The setion defining Complementary and Alternative Medicine read:
“Complementary, alternative, and integrative therapies” means a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices, which at the time they are performed may differ from current scientific knowledge, or whose theoretical basis and techniques may diverge from veterinary medicine routinely taught in accredited veterinary medical colleges, or both. These therapies include, but are not limited to, veterinary acupuncture, acutherapy, and acupressure; veterinary homeopathy; veterinary manual or manipulative therapy (ie, therapies based on techniques practiced in osteopathy, chiropractic medicine, or physical medicine and therapy); veterinary nutraceutical therapy; and veterinary phytotherapy.”
My comment to the AVMA task force revising the document was:
The language “may differ from current scientific knowledge” and “may diverge from veterinary medicine routinely taught…” both imply separate but equal bases for knowledge and curriculum standards. However, as a science-based profession, all veterinary medical therapies should be held to the same standard of evidence, namely that of accepted science-based research. It would be more appropriate, and more effective in protecting the public, if the language read:
“…at the time they are performed are not consistent with established scientific knowledge or supported by broadly accepted scientific research…”
“…theoretical bases and techniques are not part of the science-based veterinary medicine routinely taught in accredited…”
The task force has published it’s recommendations, and with regard to alternative medicine, the act has been changed for the worse rather than the better. The task force describes the change this way:
“A new definition of “complementary, alternative, and integrative therapies” as meaning “a heterogeneous group of preventative, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians and veterinary technicians…”
This change removes any mention of science from the definition and suggests that alternative methods are alternative not because they are unproven or disproven but because they are unfamiliar, unpopular, or not rooted in “Western” culture.
The legitimacy of specific methods of preventing, diagnosing, and treating disease is not determined by a popularity contest. And scientific medicine is not a mere cultural point of view, though it certainly contains ideas and metaphors associated with the cultural context in which it was born and has developed. Scientific medicine has spread throughout the world and revolutionized human and animal health in only a couple of centuries, in a way traditional folk practices failed to do for millennia, because it works whether or not you believe in it, unlike say acupuncture.
Truly Western medicine, rooted in a narrow cultural tradition the way Traditional Chinese Medicine and Ayurvedic Medicine are, actually consists of the Humoral Medicine of Ancient Greece. And let us not forget that such mainstays of alternative medicine such as homeopathy and chiropractic were both developed in 19th century America and are as “Western” as it gets.
The AVMA has long taken the position that it exists not to protect veterinary patients or consumers but the interests of veterinarians, narrowly defined in primarily economic and political terms. Rather than work towards sound scientific standards of care, the organization prefers to defend veterinarians’ right to profit from anything they can sell as veterinary medicine without competition from non-veterinarians. If unscientific therapies are in demand, the AVMA has no objections to veterinarians selling them.
And as a membership organization, the AVMA must also bow to the wishes of its constituencies. These include several groups of veterinarians, including the Academy of Veterinary Homeopathy and the American Holistic Veterinary Medical Association, who promote alternative therapies regardless of the scientific evidence, and who are far better organized and funded than the Evidence-Based Veterinary Medicine Association and others promoting evidence-based medicine.
Given such policies, the AVMA position is not surprising. But it is disappointing and dangerous in that it gives the appearance of legitimacy to “philosophies and practices” which at best are insufficiently tested and at worst are based on pseudoscience and are clearly ineffective.