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Will you have a virtual veterinarian?

Paul R. Biagiotti Published on 11 June 2014

veterinarian treating cow

As I squatted over the opened carcass and exposed organs of a necropsied calf recently, much like a vulture attracted to roadkill, it struck me that in another way I was also emulating my Roman ancestors.

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In ancient times, high priests would predict the future by sacrificing a sheep or calf and reading the entrails. Termed “haruspication,” the seer (or haruspex) would examine the liver, intestines and spleen and make a prophecy.

My attention was directed toward the particular calf, of course, attempting to answer why it had died and the future of disease in this herd, but my thoughts also wandered to those of a more personal nature.

I mentally assumed the role of haruspex, but rather than warning Julius Caesar to “beware the Ides of March,” I instead pondered my continuing role as a bovine practitioner and endeavored to read the future of the profession.

These are tumultuous and worrisome times for the dairy veterinarian. Our traditional role as a provider of reproductive and emergency services is being challenged by the inexorable progress of technology, economics and science.

As a bovine veterinarian in general practice, I confess to feeling a bit beleaguered. One indisputable fact is that our client base is shrinking. When I graduated from Tufts Veterinary School in 1988, there were about 150,000 dairy farms in the U.S. A recent estimate puts them at about 47,000.

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In my 25 years of practice, the average farm has increased in size, while the total number of dairy cows has remained the same. Paradoxically, perhaps, as herds’ sizes increase, the demand and need for cow vets per cow has decreased, effectively decreasing demand for dairy veterinarians overall.

There are multi-fold additional challenges. Technical roles that previously took up the lion’s share of the dairy vet’s workday may instead today be conducted in-house by non-professional employees or so-called lay practitioners.

Corporations increasingly provide technical veterinary advice and training as so-called “value-added” services. The dairyman may view them as ostensibly “free,” but he is in reality paying a subsidy for such services through the purchase of pharmaceuticals, biologicals or nutritional supplements.

Laboratory and “cow side” blood and milk testing for pregnancy and hormone status are increasingly available.

Robotic milking units are being married to complex testing mechanisms that give real-time, current physiological data on the cow, including conductivity measurements to diagnose mastitis status, progesterone levels to aid breeding management and beta hydroxy butyric acid (BHBA) quantification to reveal subclinical and clinical ketosis.

Individual cow monitoring technology via activity and rumination monitors is also developing quickly. Economical, in-dwelling rumen boluses that collect and report rumen pH, and other metabolic and physiological variables are on the horizon. As technology gets cheaper, smaller and faster, it is only a matter of time until reliable, accurate and timely physiological data from our cows is at our fingertips 24-7.

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A recent article in the Wall Street Journal predicted that in the next few years the field of human medicine will become radically transformed. Smartphones will pair with the Internet “cloud” to monitor individual health to the greater benefit of the patient.

So-called heuristic or learning algorithms will eliminate the SOP mentality that has pervaded not only the animal health world but that of the human as well. “One-size-fits-all” medical care will become a thing of the past, the authors claimed.

It is not difficult to envision the day when an animal caregiver will have individual cow vital statistics and health data available in real-time on his or her smartphone as well.

Tele-medicine is already being used in human medicine and in beef feedlot veterinary practice. Digital technology can transmit photographs, ultrasounds and other data real-time via Skype from the field to specialists for “virtual” evaluation, for example.

Taking these trends together, if one was to consult a visionary, it is likely that they would picture the bovine practitioner of the future as a “virtual veterinarian.” As a student of history, I feel that before we view this prospect as inescapable, we should first take stock of the past and present.

What has it meant to be a Doctor of Veterinary Medicine, or DVM? To the layman, it frequently means someone who, day to day, carries out technical tasks such as rectal palpation, vaccinations or surgery. This view, in actuality, just scratches the surface.

I recall the commencement speaker at my veterinary school graduation, Dr. Harold Hammerquist, presenting his definition. “The word ‘doctor’ has old roots meaning ‘teacher,’” he said. It is easy to see the association in modern veterinary practice, where the vet often teaches others.

“But more importantly,” he stressed, “the term doctor means teacher of yourself. Being bestowed with the title of doctor confers a life-long obligation to teach oneself through continuing education and developing new skills to improve one’s abilities and knowledge.”

There is much to teach ourselves. I’ve observed a recent tendency in our profession to try to be all things to all people, to be a jack-of-all-trades. Facilities engineer, mastitis and milking machine expert, computer data analyst, epidemiologist.

As in the old adage, I feel that in fulfilling this desire there is a danger of the production of an individual who is a “jack of all trades and master of none.”

The truth is that we all have different abilities and likes and dislikes. The traditional training of veterinarians in the role of a physician of animals, as a hands-on diagnostician and observer, are timeless and unlikely to be replaced by vicarious technology.

I’d therefore like to be an apologist for the traditional dairy veterinarian. It has been said that the average person only uses a small portion, about 10 percent, of their brain. This premise has recently come into question, but it is useful as an analogy. In a similar vein, I’ll propose that the average dairy producer only makes use of 10 percent of his vet’s capabilities.

For example, veterinarians are highly trained in pharmacology. This is why veterinarians are solely able to prescribe medications and why we possess the ultimate legal liability for drug use on a dairy. It is not difficult to predict the future on this point; due to increasing concerns over antibiotic resistance and drug resides of all kinds, drug use will be increasingly curtailed and restricted, if not prohibited altogether.

Over-the-counter (OTC) drug use will very likely become a thing of the past. Dairymen wishing to use pharmaceuticals will be required to obtain the services of a licensed veterinarian in a valid veterinarian-client-patient relationship.

Often, important drug-use decisions on the dairy, such as which products to use for dry treatment or clinical mastitis cases, are made without the input of the most qualified person on your advisory team but instead on hearsay or coffee shop conversation with well-meaning but unqualified nonprofessionals.

The next time a change in drug use on your farm is contemplated out of concerns about cost, availability or results, even if it is not a prescription product, ask your vet for his or her advice. They’ll be delighted to oblige.

As I completed my calf necropsy, I recalled the many ancient Roman virtues. They included tenacity, health, cleanliness, frugality, humanity, earnestness and responsibility. Had I been a haruspex, my prophecy would be: While the veterinarian of the future may be virtual, there will always be virtuous veterinarians. PD

Paul Biagiotti is a veterinarian with Basin Bovine Practice in Jerome, Idaho. Contact him by email .

PHOTO
The next time a change in drug use on your farm is contemplated out of concerns about cost, availability or results, even if it is not a prescription product, ask your vet for his or her advice. They’ll be delighted to oblige. Photo by PD staff.

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