ONE HEALTH COMES OF AGE

By Donald F. Smith, Cornell University
Posted August 10, 2012

        The AVMA meeting in San Diego this week featured lectures and meetings on One Health, which is the branch of science that unifies human health, animal health and environmental health.
        The One Health concept was the signature initiative of Dr. Roger Mahr when he was president of the AVMA in 2006-07. He challenged the veterinary profession to assert greater involvement in what scientists and regulatory officials were warning was the growing threat of diseases like avian flu and West Nile virus. These infectious diseases, called zoonotic, were erupting with greater frequency and virulence in the U.S. and around the world.

Dr. Roger K. Mahr, CEO, One Health Commission
President of the AVMA (2006-07)
Photo courtesy of the AVMA    

        One Health or One Medicine was advocated in the 19th century by physicians like William Osler (Johns Hopkins) and veterinarians like James Law (Cornell). However, physicians became less engaged in the potential spread of diseases between animals and people in the last few decades as the development of clinical specialties has changed the focus from the health of populations of people to that of the individual. 
        A One Health Commission was established to promote the understanding, prevention and treatment of zoonotic diseases. This becomes more important as the number and virulence of pathogenic organisms is growing and as the global travel of people, food components, and the movement of animals is increasing. 
        A second component of One Health is the realization that animals get many of the diseases and conditions that affect people. This was considered so important in the early days of veterinary education that at least two veterinary colleges (those at McGill in Montreal and Columbia University in New York) were actually referred to as colleges of comparative medicine. A book called Zoobiquity that provides several interesting examples of comparative medicine has recently received attention in the mainstream media (1).
        The third element of One Health relates to the ways in which pets and other animals actually promote human health. (2) A growing body of research is documenting the improvement of the physical, social, emotional and mental health of people who share their homes and environments with pets. Whether its walking your dog in the morning, riding your horse in the afternoon, or experiencing wild animals in their natural environment, animals improve the human condition. If these benefits to human health can be measured, we have the potential to not just improve the quality of life for both people and animals, but also to reduce the cost of human health care.
        One Health is an example of Back-to-the-Future Medicine, the re-discovery of concepts of medicine from past decades, but critically important in today's world. The leadership of veterinarian Roger Mahr was pivotal to energize a movement whose time had come.

(1) Zoobiquity: What Animals Can Teach Us About Health and the Science of Healing, by Barbara Natterson-Horowitz and Kathryn Bowers (Random House, Inc, 2012).
(2) The role of animals in promoting human health has been termed "zooeyia" by veterinarian Kate Hodgson who works with both physicians and veterinarians. 

Dr. Smith welcomes comments at dfs6@cornell.edu.

Veterinarians working with Physicians

By Donald F. Smith, Cornell University
Posted July 15, 2012


         A 200-page report on the Workforce Needs in Veterinary Medicine was recently released. Five years in the making, the authors (mostly veterinarians and several of whom I know well) assessed the current and anticipated needs of veterinarians. They paid special attention to agricultural animals, global food security, industry, public service and biomedical research.  However, the role of practicing veterinarians in promoting the role of pets to enhance human health and well-being within the family was not given a high priority compared to other critical-need areas.
         I recently authored the following op-ed on the question, "What can physicians learn from veterinarians?" It presents a more expansive view of how veterinary medicine can enhance human health by considering our pets an integral part of a healthy family structure.  


Reprinted from Zocalo Public Square, June 17, 2012
How to work together
         "When my daughter was a first-year Yale medical student in 2006, I told her that family medicine practices would someday offer services for both people and puppies. They would enter the same door and be seen by the appropriate member(s) of a team of healthcare professionals that included physicians, veterinarians, clinical psychologists, and veterinary behaviorists for annual checkups; nutrition, exercise, and disorder counseling; noninvasive imaging; and family planning.
         "There was a time when physicians and veterinarians worked together, and when Harvard and New York University’s medical and veterinary students learned side-by-side. But the replacement of the horse by the automobile led to the closure of almost all of the large urban veterinary colleges by the mid 1920s, and the medical disciplines drifted apart. However, the modern resurgence of comparative medicine has given the once-accepted concept of one medicine, one health new hope as more physicians recognize what they have in common with veterinarians.
         "As a veterinarian, I dream of a day when cancer wards of hospitals, assisted living homes for the aged, and hospice centers for the dying welcome pets to provide comfort, reduce pain and suffering, relieve anxiety, and smooth the transition from machine-living to compassionate-passing. I dream of a day when we consider substituting pets for prescriptions, and when we can modulate high blood pressure and cholesterol levels by more dog-walking and less pill-popping.
         "I long for the day when the NIH funds research that examines the positive role that pets can have on children with mental disorders, on returning veterans with PTSD, and on prisoners as they return to society.
         "I am ever hopeful for the day when physicians partner with veterinarians—with their education in comparative medicine and their sensitivity to the human-animal bond—to advance human health and reduce the cost of healthcare."


Dr. Smith invites comments at dfs6@cornell.edu