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AVH and AHVMA Reps Play Crucial Role in Recent AVMA Meeting By Shelley Epstein, USA
Five representatives of the American Holistic Veterinary Medical Association attended the AVMA meeting, January 3-6, 2013, where Resolution 3 from the Connecticut VMA entitled, “Homeopathy has been identified as an ineffective practice and its use is discouraged,” was discussed. Two of these veterinar- ians were also representing the AVH: Dr. Ann Swartz, the AVH’s incoming president, and Dr. Shelley Epstein, AVH past presi- dent. They were all very pleased with the reception they received and how open minded and polite the delegates and officers of the AVMA were.
They reported that a large number of delegates either practiced a CAVM modality, had an associate in their clinic who used one, or referred to a veterinarian who practiced one. The majority of the attendees were eager to learn more about homeopathy and ask questions that had arisen dur- ing the past few weeks.
By the time the important meetings started (there were four major ones and many minor ones), the sentiment was heavily against this resolution. The minor meetings included the state district meetings. Dr. Epstein attended her District 2 meeting, which included PA, DE, VA, MD, DC and NJ. Dr. Ann Swartz attended her District 11 meeting which included OR, WA, AK, ID, WY and MT. The chair of District 11, Dr. Thomas Meyer from WA, also serving as the Vice President of the Executive Board (EB), imme- diately invited Dr. Swartz to “belly up” to the table with the rest of the del- egates! (The usual procedure is for observers to sit at the back of the room.) Both doctors noted how important it was that individual AVH mem- bers had contacted their state delegates to voice their disapproval with the resolution and to resolve many of the misunderstandings that had been generated by the resolution. Dr. Swartz also noted that every dele- gate and alternate was supportive of the practice of homeopathy at the District 11 meeting.
The “Allied Associations” also held a meeting to discuss all the resolu- tions. (Drs. Swartz and Epstein did not attend this.) This group includes such varied organizations as the American Animal Hospital Association, American Association of Equine Practitioners, and the Student AVMA. The opinion of the Allied Associations was that this resolution should not be approved.
Our AVH representatives also attended the four major meetings. The first was the House Advisory Committee (HAC). This group had leaders from many aspects of veterinary medicine, including private practices, univer- sities and government. The various speakers emphasized that it is impor- tant that the AVMA represent “all segments” of the profession, and that the AVMA’s job was bringing the profession together. They discussed many therapies that veterinarians perform, like stem cell therapy for example, have thin evidence bases. In fact, it was noted that many if not most of the therapies performed in day to day veterinary practice have a thin evidence base. They noted that clients have choices in the therapies they choose, and that it is most important that they can go to competent veterinarians.
The HAC voted unanimously, as per AVMA protocol, to recommend send- ing the resolution to the Council on Veterinary Services (COVS). This com- mittee is also charged with the review of the AVMA’s Guidelines on Complementary and Alternative Therapies, which is due for its five-year review in March.
Just after the HAC vote on Resolution 3, Drs. Swartz and Epstein crossed the hall to attend the Executive Board (EB) meeting, which also renders weighty decisions on all the resolutions. At this meeting, Dr. Doug Aspros, AVMA president, stood up and declared emphatically that this resolution did nothing to further the AVMA. He went on to say that such resolutions
should be discouraged in the future. The EB then voted to recommend “disapproval” of the resolution.
The third preliminary meeting and the one
considered to carry the most weight was the
Reference Committee 6 (RC6) meeting. This
committee was charged with specifically reviewing this resolution in order to make a recommendation to the House of Delegates (HOD). Members of this committee represent various states and associations as well as the above committees and were responsible for sorting through mounds of documentation regarding all Resolutions.
All comments were in opposition to the resolution except for those of Dr. Arnold Goldman, the delegate from CT and sponsor of the resolution. Notable comments included the delegate from Alabama saying that he does relief work at a practice that uses homeopathy and it is a very well- run practice with attention to detail. The representative of the United States Uniformed Services, representing the Allied Organizations, noted that CAVM modalities should not be held to stricter rules of proof than any other modalities. Further, she noted that perhaps smaller groups repre- senting modalities do not have enough proof because they do not have the funding for the research. Three members of the RC6, when called upon to give their opinions, stated that their minds had changed within the past 24 hours due to information or personal contacts they had received. The representative from the Student AVMA stated they had much discussion on Resolution 3 and decided they were against it (but would be fine if this were sent to the COVS).
In both the HAC and RC6, the question arose as to how or why this res- olution was developed. Dr. Goldman was present to address this in the RC6, explaining how they formed the Evidence Based Veterinary Medical Association (EBVMA) which believes no CAVM modalities are evidence- based. The EBVMA decided to start by isolating homeopathy which they considered the “weakest link” and “most indefensible” so that homeop- athy would be separated from the other CAVM modalities. He felt that since this was not an issue that was isolated to CT, it should be brought in front of the entire AVMA.
Once all the representatives had spoken, Dr. Epstein was permitted to speak. She discussed how she has been an AVMA member for 31 years, minding her own business, practicing veterinary medicine and becoming involved with the research in homeopathy. She noted that she had a case report published in the prestigious JAAHA. Then two months ago, she received an email informing her that the AVMA had to consider a resolu- tion discouraging its members from using homeopathy because it had been “identified” as “conclusively” ineffective. She felt that this was her personal Kristalnacht, that the walls came down around her and that she was being marginalized from within her own AVMA.
Dr. Epstein then felt it was important to revisit the question of how this resolution came about. She pressed Dr. Goldman to name the author of the White Paper. He acknowledged that it was written in part, although he was reluctant to specify what percent, by a non-CT individual. Dr. Epstein noted that this individual is an outspoken skeptic. She also noted that this information was germane to the discussion, as the White Paper was commissioned by the CT VMA and was presented to the delegates as if it were an impartial systematic review. She noted that in fact it was a cherry-picked paper, and was not in accordance with the impartiality expected of a systematic review or any paper claiming to be impartial. In that regard, it was important to question the authorship.
Dr. Epstein concluded by acknowledging that although it was not the intent of the CT VMA, the AVH and AHVMA welcomed a review by the COVS.
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