THE VET'S OATH
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A New York Times article on September 22, 2012 took another shot at the racing industry. However, this time the attack is less a bomb and more a debate. At the center of the story is the question of the role of the veterinarian in the care of horses on racetracks. Since they are legally the only ones who can prescribe medication to horses, much of the root cause analysis of the medication debate can circle back to them.
Like our family doctors who pledge to the Hippocratic Oath, 'to do no harm", so do veterinarians pledge a similar oath when treating horses. Yet, some are questioning which comes first --- their oath or their practice. Unlike, human medical practice where there is a doctor-patient relationship with all the rights for treatment empowered to the patient, veterinarian medicine has a "vet-trainer" relationship where the trainer, not the owner, decides the appropriate medical treatment for the horse.
This business relationship causes numerous conflicts. The trainer makes money as long as his owners engage him/her. Integral to the engagement is winning and return on investment. Often times, that algorithm comes ahead of what is best for the horse. Without a national policy on medication use and severe enforcement, trainers are primarily concerned that their owners will leave them for a winning trainer, regardless how he wins. As Eric Reed, a Kentucky-based trainer with more than $13 million in career earnings, [puts it] "If you can't beat them, join them." Unfortunately, he is right.
In the case of the vet, the conflict is also, financial. A majority of their business is in medication prescription and administration. They are both the doctor and pharmacy on the racetrack. The more they prescribe, the more they sell and the more they make. So if a trainer wants a drug administered, it is hard to argue. Dr. James Hunt, a prominent New York veterinarian says in the Times article, "...[we]... must also understand that trainers make nearly 100 percent of all veterinarian decisions regarding the medication of their horses."
Can this ever be changed? The New York Times article is thorough in its analysis and leads to a few alternatives.
Owners must accept their responsibility in the vet-owner relationship. As Ms. Hartis said in the article, "If a horse is sound, why does it need all these drugs? ..."I never gave consent." Owner's consent is relevant.
In human health care we have "health care proxies and health care durable powers of attorney". Why not in equine care?
Regulators must look at the role veterinarians play in the mess. If they are the only ones licensed to prescribe and to administer medications, why are they not held accountable for illegal use of medications? "Losing a racing license is not a big enough deterrent," said Edward J. Martin, president of the Association of Racing Commissioners International, a trade group, in the Times article. "We believe losing a veterinarian's license is. This is a hole in the regulatory scheme and needs to be plugged."
The role of the racing associations operating tracks cannot be forgotten. They are the workshop of the practitioners. They could be more involved. Like hospitals that give doctors privileges to practice, why can't racetracks award and review privileges for trainers, veterinarians and others who work on their grounds?
If one or more of these avenues are addressed by the industry as suggested by the New York Times, we might see improvement. It can't hurt to try.
