What's your alternative?

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NOTE: As of November 2007, the AVMA discontinued use of the term "informed consent" in matters relating to veterinary medicine replacing it with the term "owner consent".
(see JAVMA News, Dec. 15)

Acupuncture, homeopathy, botanicals, chiropractic. The very mention of these and other alternative and complementary therapies causes some in the veterinary profession to cringe. After all, they didn't spend years in veterinary school learning scientific principles only to have someone come along and presume to heal an animal with pins, plants, or pressure points.

Interest in these modalities is on the rise, however. In a talk at the AVMA Annual Convention in Salt Lake City, "Alternative Medicine: Past, Present, Future," Dr. Lynn S. Peck, research associate in the Department of Materials Science and Engineering at the University of Florida, demonstrated through statistical data that alternative and complementary therapies that are widely used today have been around for ages, and there is every indication that demand for them will continue to increase.

As clients continue to investigate alternative therapies such as massage and chiropractic, practitioners will want to be more knowledgeable about these modalities.
What's your alternative?

She compared a 1990 survey that indicated 34 percent of animal owners used alternative therapies with a 1997 survey in which the number had increased to 42 percent.

The same survey suggested that 60 percent of people who used alternative therapies did not disclose this information to their veterinarian. Dr. Peck said a dialogue must open up between clients and veterinarians about alternative therapies so that practitioners are not prescribing medication that could conflict with some other form of treatment. "They need to be able to talk to clients about it in a way that's open and nonjudgmental," Dr. Peck said.

She presented illuminating statistics from a variety of sources. An AAHA survey indicated six percent of its members were using alternative therapies in 1996. That number rose to 22 percent by 1998, and jumped to 31 percent in 1999. The most common modality represented was massage therapy. A recent survey of 7,000 AAEP members indicated that one in five were using some form of alternative therapy.

What is the appeal of these therapies, and why would people choose them over traditional medicine? Dr. Peck said many are drawn to them because they're natural rather than artificial, affordable, and sometimes, more effective.

She said the Internet has also been a contributing factor in the growth in use of these therapies. Communication on Web site message boards that laud the benefits of these therapies by pet owners abound.

Veterinary colleges are beginning to put more alternative medical therapy courses into the curriculum. Dr. Peck reported that 60 percent of veterinary medical colleges offer such classes. Most in the field agree that these courses should be taught in the latter years of education, after a solid foundation in traditional medicine has been established.

"We need to introduce and familiarize students so that they can make their own decision," Dr. Peck said. She also thinks such courses will help students to think critically and to intelligently answer their clients' questions after graduation.

The legal ramifications of the use of alternative and complementary therapies in veterinary medicine were the subject of a separate talk in Salt Lake City by veterinarian and lawyer Dr. Gregg Scoggins. He urged practitioners to be aware of the applicable laws governing veterinary practice and to be well versed on state practice acts, because definitions and applications of alternative and complementary therapies can vary widely from state to state. Like Dr. Peck, Dr. Scoggins underscored the value of communication between veterinarians and their clients, and stressed the importance of seeking and obtaining informed consent.

The AVMA Task Force on Alternative and Complementary Therapies continues to investigate these modalities. Research is likely to continue for generations to come. In the meantime, as Dr. Scoggins said, "We've got to deal with these issues while the experts are figuring these things out."

As both Dr. Peck and Dr. Scoggins were quick to point out, these therapies are currently being used, whether one is dubious about their efficacy or not, and sooner or later, some clients will want to investigate these modalities as options for treatment of their animals.