The term “integrative” is tossed around quite a bit in medicine. What exactly does it mean? To answer, some background is in order. The historical “conventional” practice of veterinary medicine was broadly divided into the disciplines of medicine and surgery.
Licensed general practitioners are qualified to diagnose disease, perform surgery and prescribe medications. In addition to general practice, conventional health care now widely branches into specialties with each focused on individual body systems or specific practice types. Just as in human medicine, veterinarians can choose to specialize in a specific area of veterinary medicine.
The American Veterinary Medical Association (AVMA) has oversight to accredit institutions to provide veterinary education, test graduate veterinarians for licensing and recognize organizations granting specialty certifications. As for the veterinary specialist, the AVMA now recognizes 46 of these highly focused disciplines that require a graduate veterinarian to complete rigorous training as well as examinations for recognition as a board-certified specialist. Examples of these board certifications include Cardiology, Internal Medicine, Surgery, Ophthalmology, Neurology, Dermatology, Oncology, Behavior and more. But in order for a veterinarian to practice in any capacity, each individual state government specifies how a veterinarian gains licensing and exactly what procedures constitute the practice of veterinary medicine in that particular state.
Where does “Integrative” veterinary medicine come in to play? Historically, many health care procedures and remedies were not considered as mainstream medical or surgical modalities and not taught in medical school. Examples include manual therapies [medical manipulation (chiropractic), therapeutic massage, physical rehabilitation (physical therapy)], herbal therapy (phytotherapy), acupuncture, food therapy and homeopathy. Fortunately, these modalities are now recognized by the AVMA and regulated by most states as the practice of veterinary medicine. The following is the AVMA definition of these modalities:
“Complementary, alternative, and integrative therapies“ means a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians and veterinary technicians/technologists. These therapies include, but are not limited to, veterinary acupuncture, acutherapy, and acupressure; veterinary homeopathy; veterinary manual or manipulative therapy (i.e., therapies based on techniques practiced in osteopathy and chiropractic medicine); veterinary nutraceutical therapy; and veterinary phytotherapy. (AVMA Model Veterinary Practice Act -August 2019; Section 15 Updated January 2021)
At this point in time, integrative medicine is not a board-certified veterinary specialty. A 2020 survey of 43 of 49 accredited veterinary schools responding, reported 13 that offered a formal course in Integrative Veterinary Medicine and 33 that offered some level of instruction in the curriculum. The most common Integrative Medicine topic covered in veterinary school curricula were rehabilitation and acupuncture. In conclusion, fortunate veterinarians will graduate veterinary school with a good introduction to Integrative Medicine. Veterinarians proficient in the practice of these modalities spend considerable post-graduate time and resources to gain education and experience in the practice of these valuable modalities.
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