AVMA President-elect Address to the House of Delegates

July 14, 2006

President Childers, members of the House of Delegates, members of the Executive Board, fellow colleagues and guests, I am honored by this opportunity to address you as I prepare to assume the responsibilities of the office of AVMA President. I gratefully acknowledge your genuine trust and support during this past year, and I respectfully seek your continued support in the year ahead. I also want to recognize and express appreciation for the conscientious and dedicated efforts of the entire AVMA staff.

As I revealed to you two years ago in my candidate introductory speech, I gain daily strength from a strong faith in God and family. I am pleased to have the presence of my family here today, and I would like to introduce them to you...my wife Marilyn, my daughter and son-in-law Deanna and Keenan Baker, and my son David.

"I solemnly swear to use my scientific knowledge and skills for the benefit of society."

Colleagues, when you and I repeated those words and were admitted to the veterinary medical profession, we had just earned the value of a lifetime, the value of our diploma.

No other profession, I believe, has a comparable value to society. No other profession has as much impact on the health of both animals and people.

As I share my message with you, I ask that you to think about these questions: What is your value as a veterinarian? What is the value of the AVMA?

As colleagues we can be justly proud of our rich heritage. I am grateful for my roots on a dairy farm in Iowa, and for those life experiences that I had prior to becoming a Doctor of Veterinary Medicine. Like most of you, I became a veterinarian because of an early human-animal connection.

My first animal bonding was with a Guernsey calf. I can still recall the thrill of participating in my first pet parade. With the aid of a bottle of milk replacer, I proudly led my calf around the hometown square with a sign on my back. It read: "June is dairy month, we drink milk."

During my formative years in 4-H and FFA I came to recognize and appreciate the value of animals. I acquired a tremendous respect for animals. Perhaps it is knowing the value of an animal's lot in life – whether for companionship, food, entertainment, research, or education – that creates the greatest respect that I have for animals today and for their value to society.

As the AVMA celebrates its 143rd anniversary, it's fitting for all of us to reflect on our value and honor our great legacy, our tremendous accomplishments, and where we are today. Yet it is far more important to keep looking to the future – and making certain that it is a promising future – a future with even greater value.

AVMA's top five critical issues touch our lives every day, whether student or established veterinarian. Effectively addressing these issues ensures our future and helps us to better serve society.

Those critical issues?

One: animal welfare.

The AVMA is committed to establishing a strong and viable Animal Welfare Division. Animal welfare, as a science, must become a part of veterinary education. All veterinarians need a clear understanding and appreciation for animal welfare science and its ethics.

Two: economic viability.

The National Commission on Veterinary Economic Issues – the NCVEI – has worked to significantly increase practice incomes and veterinarian salaries by creating pricing tools and benchmarking models for small animal, equine and food animal practice. More than 12,000 practices and over 33,000 veterinarians have utilized the NCVEI tools.

Three: veterinary services.

The AVMA has focused on being an advocate for veterinarians at the state level on legislative and regulatory issues...issues affecting your individual states, and potentially, other states as well.

Critical issues four and five: veterinary workforce and veterinary education. These cannot be separated.

AVMA accredited colleges and schools of veterinary medicine are an essential and valuable first line resource in preparing the next generation to fulfill critically important roles. We need an increase in the applicant pool, both in numbers and in the diversity of applicants: a diversity in professional interests, from public health, comparative or biomedical research, food animal or rural practice, to academia and government service; and a diversity of race, gender and ethnicity; if we are to meet our goal of serving the diverse needs of society.

In addition, critical paradigm shifts are needed in our approach to education if we are to meet the growing demands of our profession. We need creative approaches...such as collaborative training across universities. We also need to bridge relationships among disciplinary areas...such as veterinary medicine with human medicine, biomedical engineering and animal science.

The AVMA is – and will continue to be – a committed partner with colleges in recruiting and preparing additional veterinary graduates. This close working relationship is particularly important as the Association of American Veterinary Medical Colleges – the AAVMC – and the AVMA work collaboratively to pass the Veterinary Workforce Expansion Act. This legislation will provide competitive grants to increase the educational capacity at colleges, particularly focused on public health and biomedical research. It was introduced in the Senate by our dedicated colleague from Colorado, Senator Wayne Allard.

To prove the need for this Act, the AVMA is partnering with the AAVMC to help fund a National Academy of Sciences study to assess current and future veterinary workforce needs. The results of this study will provide Congress with additional data to ultimately approve funding for this Act.

During the past year, three studies have been released which underscore the urgent need for more veterinarians in the United States. Two were produced by the National Academy of Sciences. A third, addressing the shortage of food supply veterinarians, was commissioned by the Food Supply Veterinary Medicine Coalition. The overriding recommendations from all of these studies focus on improving communication, coordination and collaboration among professional associations, colleges, government agencies and industry.

The studies conducted by the National Academy of Science clearly indicated that the continuing convergence of animal health, human health, and ecosystem health is the new reality, and that the concept of "one medicine" should be embraced.

The "one medicine" concept is not new. The famed physician, Sir William Osler, who founded the medical teaching hospital concept at Johns Hopkins University in the 1800's wrote, "veterinary medicine and human medicine complement each other and should be considered as one medicine."

One health. One medicine.

Just recently, Dr. David Schwartz, Director of the National Institute of Environmental Health Sciences, unveiled a strategic plan for the scientific community. It emphasizes the use of environmental health sciences to better understand the causes of disease and improve human health. He stated that "almost every human disease can be caused, modified, or altered by environmental agents."

Tuberculosis, HIV, West Nile virus, Lyme disease, monkeypox, avian influenza and many more certainly prove this statement. They also underscore the concept of one health, one medicine.

Let's look further:

  • 75% of the diseases that have emerged in the past 25 years are zoonotic.
  • 38,000 animals cross U.S. borders every day.
  • 21 billion animals were produced for food and fiber around the world last year alone.
  • The factors creating emerging diseases remain intact.

Colleagues, it is imperative, now more than ever, that the AVMA play a significant leadership role in the veterinary profession around the world. It is important to share our accreditation standards with foreign veterinary colleges and to encourage them to achieve those standards if world health and safety are to be attained.

Nurturing existing international relationships and establishing new ones through participation in the World Veterinary Association (WVA) and other international associations will help encourage the advancement of the veterinary profession worldwide. The veterinary profession is fortunate to have AVMA Past President Dr. Leon Russell providing visionary leadership as WVA President. I pledge to you, Dr. Russell, my commitment in urging the AVMA to work closely with the WVA to achieve our mutual goals and objectives.

Strengthening relationships with international organizations, including the World Health Organization, the United Nations Food and Agriculture Organization, and the World Organization for Animal Health will further enhance global health and development – and solidify AVMA's role as a visionary organization in global health issues. As I participated in the first International Symposium on Emerging Zoonotic Diseases this past March, the potential impact of this global relationship was strikingly revealing. It became clear that our future is "One World, One Health, One Medicine."

It is also timely for us to provide the valuable expertise in ecosystem health that we as a profession possess. Our voice needs to be strong and united – and to that end, I urge the Association of Wildlife Veterinarians and the Association of Zoo Veterinarians to continue your efforts to secure representation in this AVMA House of Delegates. Your representation, your voice, and your input are vital as integration of the health sciences occurs.

Animal health is truly at a crossroads. Its convergence with human and ecosystem health dictates that the "one world, one health, one medicine" concept must be embraced. We need our colleagues in human medicine, public health, and the environmental health sciences. Together, we can accomplish more in improving global health than we can alone – and we have the responsibility to do so.

I propose we embark on meeting this responsibility by looking forward with vision as we reflect on a vivid and sustained success from our recent AVMA history. In his 1995 President-elect address to the House of Delegates, Dr. Sherbyn Ostrich stated, "The most serious challenges that face our profession today involve education and economics." What followed was the 1996 AVMA Economic Symposium, which was followed by Past President Dr. Jim Nave's appeal for "call to action", and the ultimate formation of the NCVEI. The NCVEI has become the driving force behind the dramatic rise in the economic vitality of our profession.

I propose that we use this precedent to guide us in a four-step process that will ultimately define a national action plan and establish a driving force to meet today's critical challenge: expand the veterinary workforce to meet our societal responsibilities with a focus on one world, one health, one medicine.

The first step I envision is establishment of a Steering Committee for the One Health Initiative. I propose that pertinent AVMA councils and committees work with the AVMA/AAVMC Joint Committee to develop a list of key partners with a one health focus, including the American Medical Association, industries, and various government agencies – including the US Departments of Agriculture, Homeland Security, Health and Human Services and Interior, the CDC, FDA, and state animal and public health representatives. The goal would be to present a recommendation for action at the November 2006 Executive Board meeting to establish a Steering Committee for the One Health Initiative.

The second step I propose is to conduct a National One Health Summit. One of the main charges of the Steering Committee will be to plan and coordinate a National One Health Summit in the spring of 2007 to bring together the leaders who are needed to effectively launch the One Health Initiative.... veterinarians, physicians, public health professionals, biomedical researchers, ecologists, and others. Follow-up working groups would summarize information presented at the summit and develop recommendations for future action.

Out of this information would come our third step, to establish a One Health Initiative National Action Plan. The Steering Committee will also coordinate the efforts of the summit working groups and receive their reports and recommendations. This input would then be used in the development of a One Health Initiative National Action Plan.

I envision the final step to be the establishment of a National Commission for the One Health Initiative. I propose that a National Commission for the One Health Initiative be established and charged with executing and implementing the One Health Initiative National Action Plan. The National Commission would replace the Steering Committee with a refined and enhanced partnership structure to maximize the impact of the one health focus.

Potential outcomes of the One Health Initiative would include:

  • enhanced collaboration among the colleges of veterinary medicine in developing centers of excellence for education and training in specific underserved areas;
  • enhanced collaboration among veterinary clinicians and researchers to embrace the concept of translational medicine – medicine from the research bench to the patient, whether that patient be in an urban clinic, on the farm, or in the wild;
  • collaboration between the veterinary and human medical professions to address critical needs to improve animal and human health globally; and
  • collaboration among multiple professions – veterinary, human medicine, ecology, wildlife, and public health – to meet new global challenges head-on.

Communication will be essential to our success.

I began this address by talking about value – our value – the value of the veterinary diploma. Part of our challenge will be to communicate to all audiences the immeasurable value that the veterinary profession has to society. Our image ultimately will determine our profession's status, authority, influence and relevance, not only nationally, but internationally.

The veterinary profession, and in particular the AVMA, provides value to each of us by enabling us to grow and become leaders in our profession. As I travel throughout the country meeting with colleagues, I'm struck by the amount of leadership force, and potential leadership, that is present.

A profound leader whom I greatly admire is former New York Mayor Rudy Giuliani. In his book, Leadership, Mayor Giuliani states that being a leader is both a responsibility and a privilege. That sense of responsibility and privilege must be nurtured and developed within our profession, particularly in our students and recent graduates. Effective leadership can move great value even higher.

The critical importance of leadership has now become paramount to the AVMA with Executive Vice President Dr. Bruce Little's recently announced impending retirement.

Dr. Little's leadership over the past 10 years has been key to establishing the stature of the AVMA to one of greatness ... as recognized throughout the world: a highly credible and competent staff that increased during his tenure from 95 to 135; AVMA membership that grew from 57,000 to nearly 74,000 under his leadership; and a solid fiscal position exemplified by an increase in association assets from $19 million to over $41 million, including the acquisition of our own building in Washington, D.C.

As colleagues we can be justly proud of the great accomplishments of the AVMA under Dr. Little's leadership. Dr. Little, you, too, can look with pride on your outstanding achievements on behalf of the AVMA and the veterinary profession.

Dr. Little's decision to retire creates the most critically important task to be addressed by the Executive Board during the coming year. The next Executive Vice President will assume significant responsibilities, and the right individual will lead the AVMA to even further greatness.

In closing, let me return to where I started: value. What is your value as a veterinarian? What is the value of the AVMA?

I would like to leave you with this final thought. By working together we can unveil the radiant value of our profession. We can convert our 21st century challenges into opportunities. We can improve the lives of our patients, our clients, our colleagues, and our society in general, truly fulfilling our professional oath to use our knowledge and skills for the benefit of our global society.

One world. One health. One medicine.

That, my colleagues, translates to value.