There is currently a trend in veterinary medicine toward what is called Evidence-Based Medicine (EBM). The idea is that we veterinarians should only treat pets with scientifically proven therapies. This process is intended to eliminate the doctor’s personal bias and therapies that are ineffective or possibly harmful.
With EBM there is a hierarchy of evidence that should be considered when a vet chooses a therapy for a particular animal. At the lowest level of evidence is personal experience with an individual case. This is often called rather disparagingly, anecdotal evidence. Let’s face it, anything can happen once. Just because a pet’s cancer disappeared after taking a particular supplement does not mean that that supplement will help the next pet with cancer.
Highly regarded in EBM are the almighty double-blind, placebo controlled studies and research based on them. These studies appear to be essential as they separate out the body’s ability to heal itself (placebo response) from the actual action of the drug or therapy. The fact that the studies are double-blind is supposed to eliminate researcher bias (more on this coming up). The emphasis on EBM has gone to the extreme such that for the most part, only treatments that have been proven with double-blind, placebo controlled studies are considered to be legitimate.
This is a great concept. Who doesn’t want to be treated by scientifically validated therapies? Unfortunately, there are several problems with the practical application of EBM.
- Medical research is expensive – A single clinical trial can cost as much as 100 million dollars. Small supplement and natural pet food companies or holistic associations cannot afford such research.
- It only makes sense to spend research dollars on patentable treatments – This rules out truly natural substances such as herbs. You can patent Milk Thistle. If you can’t make money off the research via a patented medication, why would you spend the needed money for the research?
- Pharmaceutical companies and major pet food manufacturers are the major source of veterinary medical research – The problem with that is that multiple studies show that industry-sponsored research is often biased. Dr. John Ioannidis has published papers with 1,328 different co-authors at 538 different institutions in 43 countries. According to Dr. Ioannidis, up to 90% of published medical information is flawed.
If your veterinarian (or medical doctor for that matter) is relying strictly on published medical information for his prescribed treatment options, then his therapy will be 90% flawed. In other words, he will get it right 10% of the time.
Lack of “adequate” research is why alternative medicine is considered alternative and is excluded from EBM. This lack of “evidence” is also an excuse for the rejection and criticism of many helpful alternative therapies by well-meaning, conventional practitioners. This attitude may lead your veterinarian astray.
Have you experienced bias against natural therapies?