SkeptVet revives debate over alternative medicine and evidence

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A new SkeptVet essay is putting a familiar fault line in veterinary medicine back into focus: whether alternative medicine can coexist with science, or whether the label itself reflects a rejection of science-based standards. In “Is Alternative Medicine Compatible with Science?”, Brennen McKenzie argues that therapies grouped under complementary and alternative veterinary medicine, or CAVM, should not get a separate evidentiary lane simply because they’re framed as holistic, integrative, natural, or traditional. His central claim is straightforward: if a therapy works, it should be evaluated and adopted as medicine; if it doesn’t, branding shouldn’t shield it from scrutiny. (skeptvet.com)

That argument lands in a profession that has been wrestling with these questions for years. McKenzie has repeatedly challenged efforts to legitimize modalities such as veterinary acupuncture through formal specialty pathways, including a 2025 post opposing another attempt to secure board specialty recognition through the AVMA’s American Board of Veterinary Specialties. More broadly, veterinary organizations in several countries have tried to draw a line between adjunctive use and substitution for proven care, emphasizing that animal welfare, informed consent, and evidence standards still apply when complementary therapies are offered. (skeptvet.com)

In the new piece, McKenzie argues that the umbrella term CAVM covers a very mixed set of practices, but says they’re united largely by being positioned as an alternative to science-based medicine rather than by a shared scientific framework. He points to examples such as homeopathy, Reiki, chiropractic “subluxation” theory, and acupuncture rationales that invoke undetectable energies or mechanisms not convincingly demonstrated. He also argues that use of alternative therapies can correlate with lower confidence in conventional medicine and, in some settings, worse outcomes when proven diagnostics or treatments are delayed or refused. (skeptvet.com)

The broader policy environment is more measured in tone, but not entirely at odds with that concern. The British Veterinary Association says it supports evidence-based treatment decisions and cannot endorse therapeutic claims without proven efficacy; if complementary treatments are used, they should complement rather than replace conventional medicine, and veterinarians should disclose the evidence base, safety issues, and possible interactions so clients can make informed choices. The New Zealand Veterinary Association similarly says complementary and alternative treatments should face the same science-based assessment as conventional therapies, and that unproven claims shouldn’t be made in the absence of credible evidence. (bva.co.uk)

There’s also an active debate over where specific modalities belong on the evidence spectrum. A 2022 review in Veterinary Clinics of North America: Small Animal Practice discussed “evidence-based complementary and alternative canine orthopedic medicine,” reflecting that at least some adjunctive practices are being examined within a conventional evidence-review framework rather than dismissed wholesale. At the same time, even AVMA policy language around regenerative medicine warns that rapid adoption without adequate validation can expose patients to unnecessary risk and veterinarians to liability, underscoring a larger profession-wide concern: novel or nontraditional therapies still need solid data. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For practicing veterinarians, technicians, and hospital leaders, this isn’t just a philosophical argument. It affects how clinics market services, how teams talk with pet parents about uncertain benefits, and how they document informed consent when evidence is thin, mixed, or absent. It also shapes referral decisions, continuing education priorities, and risk management. If a modality is offered as an add-on, clinicians still have to answer basic questions clearly: What is the diagnosis? What evidence supports this intervention for this indication? What are the risks, interactions, costs, and opportunity costs if effective treatment is delayed? (bva.co.uk)

The communication challenge may be especially important as “integrative” language becomes more common in companion animal medicine. Pet parents often hear “natural” as safer, gentler, or more personalized, but that can blur the distinction between low-risk supportive care and therapies making efficacy claims without adequate proof. McKenzie’s post is likely to resonate with clinicians who worry that the profession sometimes soft-pedals that distinction in the name of openness or client demand. It may also draw pushback from practitioners who see selected modalities as useful adjuncts, particularly in pain management and rehabilitation, even when mechanisms remain debated or evidence is indication-specific rather than broad. That latter point is an inference based on the continuing publication of modality-specific reviews and the profession’s ongoing public debate. (skeptvet.com)

What to watch: The next flashpoints are likely to be specialty recognition efforts, conference programming, and state or college guidance on how non-conventional therapies can be offered within a valid VCPR and with appropriate disclosure. As those debates continue, the core issue probably won’t be whether a therapy is labeled alternative, but whether it can meet the same evidentiary and ethical standards as everything else veterinarians do. (skeptvet.com)