A profession at the crossroads?

9/11 showed that many veterinarians are unprepared to adequately contribute to the nation's biosecurity. Is it too late to change?
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Despite public perception, veterinarians aren't just cat and dog doctors or the ones to call when a horse or cow is sick. Veterinarians apply their expertise in a range of fields, often with little recognition. They are biomedical researchers, government advisers, pathologists, and epidemiologists. For a time, a veterinarian even oversaw the Food and Drug Administration.

But these professionals are the exception. Many U.S. veterinarians are leaving college for careers as companion animal practitioners or in large animal medicine. Yet there are those convinced that many members of the profession have other areas of expertise to offer, specifically when it comes to protecting the public from foodborne pathogens and infectious diseases occurring naturally or introduced deliberately.

The attacks of 9/11 and the anthrax-laced letters have demonstrated that Americans are no longer safe within their borders. After declaring war on terrorism, the U.S. government began marshaling its resources to defend against the next attack. Never has the demand for individuals with the expertise and training to strengthen the country's biodefense capabilities been greater.

But many clinical practitioners find themselves lacking the training to meet the challenge. Indeed, the U.S. veterinary profession itself is at a crossroads. Will veterinarians continue to stress safeguarding animals and promoting the human-animal bond, or will they fully realize their role as guardians of public health?

Veterinarians have already shown they have much to contribute. For instance, their knowledge of zoonotic diseases made them instrumental in identifying West Nile virus and as key members of United Nations teams scouring Iraq for weapons of mass destruction after the Gulf War.

In the wake of 9/11, many veterinary colleges are asking whether they can do more to prepare students and veterinarians to help safeguard their country in this global environment where damaging and deadly pathogens are a mere plane ride away.

As it stands, few veterinarians are aware of the world beyond private practice. Moreover, few complement their veterinary degree with an MS, MPH, or PhD degree. This has led some to worry that the profession is in danger of failing to meet society's new needs.

"We're at kind of a crisis point," explained Dr. Lonnie King, dean of Michigan State University's College of Veterinary Medicine. "I'm concerned that we aren't preparing enough professionals to meet these really critical needs."

There is a shortage of veterinarians trained for biomedical research and not enough are working in laboratory animal medicine, food safety, and public health. New opportunities for veterinarians have opened up since Congress doubled funding for the National Institutes of Health to investigate infectious diseases, many of which are zoonoses, according to Dr. Lawrence E. Heider, executive director of the Association of American Veterinary Medical Colleges.

"You can see that there's a place for veterinarians in that research and there are going to be many more projects using animals in research," Dr. Heider said. "And there's going to be a quest for more animal models for research in those areas."

Every profession has its defining moments, a time that can shape generations to come. 9/11 was one such moment for the veterinary profession.

"Can anyone not say that we are living at such a point in time?" Dr. King asked a host of veterinary college deans and professors, researchers, government officials, military personnel, recent graduates, and students. They had gathered in Washington, D.C., this past November to discuss short- and long-term strategies for expanding veterinarians' participation in defending the nation from biologic attack and infectious zoonotic diseases.

The conference, "Agenda for Action: Veterinary Medicine's Role in Biodefense and Public Health," was hosted by the AAVMC. Much of the three-day meeting was devoted to the link between veterinary medicine and public health. Presenters discussed West Nile virus, bovine tuberculosis, and drug-resistant bacteria, as well as the damage a major animal disease outbreak, such as foot-and-mouth disease, can cause to a nation's economy.

Colorado Sen. Wayne Allard, a veterinarian, and Dr. Lester Crawford, deputy commissioner of the FDA, were featured speakers at the conference. Both men talked of how, since 9/11, the government has had to change to meet the challenges of the war on terrorism.

Allard spoke via recorded message about the threat of agroterrorism and called for increased funding to strengthen the network of veterinary diagnostic laboratories. This, he said, would aid in the rapid detection and identification of animal diseases and biologic agents.

Dr. Crawford, who, until recently headed the FDA on an interim basis, is convinced that a biologic attack will occur in one of the areas the agency regulates. The FDA, he said, must now think like a terrorist to thwart terrorism. The agency is accustomed to getting into the minds of criminals. But now the FDA must get into the minds of terrorists to be able to develop rules to protect the public from deliberately tainted food ingredients and drugs.

Dr. Leigh SawyerDr. Leigh Sawyer of the National Institute of Allergy and Infectious Diseases discusses strategies for training veterinarians to be bioterrorism experts.

With the government shifting its priorities, the veterinary profession must decide whether it will do likewise. The conference was a good start, according to Dr. Peter Eyre, dean of Virginia-Maryland Regional College of Veterinary Medicine. As he sees it, veterinary educators have emphasized companion animal medicine to the point of downplaying veterinary medicine's place in government, the corporate world, research, and public health.

"In our zeal to emphasize the human-animal bond—the warm, fuzzy part of veterinary medicine—we have neglected the fact that we are a public health profession," Dr. Eyre said.

Then as now, veterinarians have responded to pet owners' demand for better and more specialized veterinary care. But post 9/11, the profession must strike a greatly needed balance between careers in companion animal medicine and those in biomedical research, food safety, and public health.

At the conference, attendees brainstormed about how the profession can respond to society's needs. Some goals are elementary and can be achieved quickly, whereas others are more ambitious and would require a great determination and coordination throughout all sectors of the veterinary profession.

Short-term objectives include increasing veterinary students' exposure to and experience in diverse careers; developing continuing education opportunities for private practitioners in the areas of zoonoses and bioterrorism; and establishing co-curricular programs to support students' interest in research and biodefense.

Over the long term, changes could be made to veterinary curriculums to support nonpractice careers; to create dual-degree programs for DVM/MPH and DVM/MS for food safety, public health, and emerging diseases; and to link the nation's human and animal health diagnostic laboratories to enhance disease surveillance and response.

Following the November conference, the AAVMC impaneled an Emergency Needs in Veterinary Human Resources Task Force. It is the task force's job to examine ways that veterinary educators can prepare students and veterinarians to satisfy the demand for expertise in biomedical research, public health, and other types of public practice. The task force will then deliver a list of recommendations to be implemented by the veterinary colleges.

The obstacles to such changes are sizable. The veterinary profession, Dr. King said, is fragmented by an ever-increasing number of specialty areas. Diversity is good, but it makes it difficult to bring veterinarians together to talk about the needs of the profession. Dr. King is concerned that the veterinary colleges will be saddled with the sole responsibility for redirecting the profession. This effort involves all sectors of organized veterinary medicine, he said, adding that the AVMA and allied groups have a part to play, too.

For the AVMA's part, the Executive Board in November approved sending a letter of support with the AAVMC to the departments of Health and Human Services and Agriculture, encouraging the development and distribution of biodefense information to veterinary practitioners.

Dr. Eyre worries that if the profession doesn't turn around this trend soon, the jobs that would be properly filled by the DVM-PhD will be filled by MDs and PhDs. "If we don't have the people there to fill these slots, they're going to fill them with somebody," he said. "They're not going to be left vacant, because it's an urgent national priority now."