Veterinarians are Bombarded with Conflicts of Interest

In the USA, in 2016, a new USFDA policy will ensure that veterinarians play a key role with respect to the use of antibiotics by farmers. Whereas people doctors prescribe antibiotics, in the farming industry and in food companies they can buy very similar antibiotic drugs over the counter and add them to feed. This, arguably, has led to an overuse of antibiotics which has resulted in a surge in antibiotic-resistant superbugs.

On the face of it, the new policy should be welcome because it places the veterinarian in the role of gatekeeper to the purchasing and use of antibiotics.

However, there are neither laws no regulations which require veterinarians in the USA to disclose any financial connection that they might have with drug companies. It doesn’t matter how much they receive from drug companies or how influential the connection between drug company and veterinarian is, they are not required to disclose that information to either the FDA or the public.

Therefore, we have to conclude that veterinary medicine when compared to human medicine is under-regulated which has led to conflicts of interest which in turn undermines ethical integrity and excellence in veterinary practice.

What is a conflict of interest? It can occur when a person has more than one goal; primary (this is usually the standards required in their work) and secondary goals. A conflict of interest occurs when in trying to achieve the secondary goal the person makes it harder or impossible to achieve the primary goal.

The influence of the drug companies can extend to the training that veterinarians receive and it even reaches into high schools where, for example, a company called, Zoetis, donated $50,000 as a contribution to funding a week-long Perdue University veterinary camp for 10th, 11th and 12th graders.

The big pharmaceutical companies also influence the training that current and future veterinarians receive in the USA. They regularly suggest topics and recommend speakers under the continuing education program that veterinarians must participate in.

This conflict of interest extends to beyond the individual veterinarian to their representative, non-profit organisation, American Veterinary Medical Association (AVMA). The AVMA benefits from contributions from the pharmaceutical industry. Although the AVMA code of ethics make it obligatory for veterinarians to divulge all potential conflicts of interest (to who?), it was only after Reuters requested information that they disclosed that they had received $3.3 million from drug companies over the preceding four years.

In the above introduction, I am simply making the point that it must be very difficult for a veterinarian to make decisions about a companion animal’s welfare in an entirely neutral way. In addition to the conflict of interest referred to above, the veterinarian servicing the general public is providing his or her service to the owner of the animal who is being treated.

Therefore, the veterinarian ultimately has to follow the instructions of the cat owner or if the owner fails to provide instructions they must be influenced by what they think the animal’s owner wants and demands or indeed can afford to pay.

What I propose, therefore, is that the veterinarian has at least two conflicts of interest when diagnosing and treating the illness of a companion animal: the influence of drug companies and the influence of the animal’s owner.

There is, in fact, a third conflict of interest namely the products that veterinarians sell in their clinics (other than drugs). In all the clinics I go to there are a healthy number of products on sale, the most prominent of which is dry cat and dog food. This is often Hills. We know that Hills has somewhat of a stranglehold over the cat food that veterinarians sell.

We, the public, don’t know what sort of commission the veterinarian receives on selling cat food at their clinic. But we know it exists and we also know that dry cat food provided as an exclusive food for a cat is not healthy and therefore on this occasion the vet’s conflict of interest works against his stated oath.

I wonder whether the declawing of cats is in part driven by the drug companies. We know that declawing causes massive pain and therefore requires a lot of post operational painkilling drugs. I wonder if the drug companies have an influence over whether a veterinarian declaws cats because of any commission that they might receive as a result of using their painkilling drugs.

At the end of the day what veterinarians end up prescribing depends on who they’re getting paid by. These are the words of a cattle rancher in Colorado. And he’s correct.

American veterinarians say that they use and distribute drugs (a dual role) because there are no pharmacies and in any case it is more convenient. They also say that the profit margins in selling drugs are usually small.

And that is another point, veterinarians who treat companion animals, as we know, sell drugs over the counter to the owners. We don’t know what sort of commission they receive on a sale or even if there is a commission but you can see the potential for a compromise in ethical standards.

My impression is that antibiotics are overprescribed to companion animals by veterinarians. This is partly because they are prescribed as a precaution due to the fact that the veterinarian isn’t quite sure whether the dog or cat has a secondary infection or not and possibly partly because they are influenced by the pharmaceutical companies.

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