How This Human Cardiologist is Bridging the M.D.-Vet Gap

A Q&A with Barbara Natterson-Horowitz, M.D., MA, who wants better cooperation between physicians and veterinarians.

Barbara Natterson-Horowitz co-authored the 2013 book “Zoobiquity” an examination of cross-species medicine.

Have you heard of TED talks? The 15-minute presentations enable a variety of fascinating people to share information on a variety of captivating topics—from science to technology to entertainment to business.

What would happen if you typed “veterinarian” in the search box at www.TED.com? You’d be sorely disappointed to see only a few entries. One leads to a presentation by Barbara Natterson-Horowitz, M.D., MA, a board- certified cardiologist in human medicine and a professor at the University of California, Los Angeles.

She advocates better cooperation and interaction between physicians and veterinarians. 

You can watch her talk below:

Her TED talk, which has been viewed well over a million times, was so interesting that I decided to interview her and dig deeper.

Q. How did you connect with veterinarians? 

I had been practicing  cardiology at UCLA for almost 20 years when I got a call from the veterinarians at the L.A. Zoo asking if I’d help image some of their animal patients. I said, “Of course.” 

It was there, listening to the veterinarian on rounds, that I had my first much-needed wakeup call. I became fascinated by the overlap between our patients’ pathologies and why there was such a gulf between our fields. That initial interaction with the zoo vets led to joining forces with science journalist Kathryn Bowers to write our book “Zoobiquity.” It was during the process of writing the book that we conceived of the Zoobiquity Conferences.

Tell me about the “Zoobiquity” book and the conferences. 

We began research and writing in 2008 for the book that ultimately became “Zoobiquity.” Our goal was to explore the intersection between human and animal health. We wanted to see if, through the comparative and veterinary approach, we could develop new hypotheses for some of the challenges that face human patients.

Zoobiquity book

Amazon

 Barbara Natterson-Horowitz, M.D., MA co-authred Zoobiquity with science journalist Kathryn Bowers

Initially, our plan had been to only cover somatic illnesses: cancer, cardiovascular disease, trauma, et cetera. But then we began learning about the wide range of psychopathologies that affects wild, farm and domestic animals. So we expanded the book to also look at overlaps in psychopathology across species. We launched the conferences to create living laboratories of collaboration.

What did you learn during this experience? 

The overlap in pathologies between human and nonhuman animals is tremendously large, although, of course, there are disorders that are unique to every species. One of the most important goals we have is to educate physicians and other human health care providers about the breadth of connections.

When I was in medical school, I learned that the connection between human and animal health was zoonoses. That was it. Unfortunately, that limited view still exists among some physicians. So exposing my colleagues to the reality that many of the same neurological, oncological, cardiovascular, rheumatologic, sports medicine and bio-behavioral syndromes they take care of in their human patients occur in animals as well has become a core mission for Zoobiquity.

You have Zoobiquity Conferences. What are the goals of the conference? 

We realized there were several specialties in medicine in which we couldn’t find any significant collaboration. So, along with partners at the UC Davis School of Veterinary Medicine and the UCLA School of Medicine, we created the Zoobiquity Conferences. The goal of these conferences is to stimulate conversations between vets and physicians caring for the same diseases in different species.

We match vets and physicians in similar fields and have them present cases on the same disorder. For example, a veterinary neurologist once presented a case of a glioblastoma in a Rhodesian ridgeback. Then a human neurologist presented a case of glioblastoma in a 41-year-old high school principal. A comparative and collaborative discussion followed. It was amazing.

We have covered many forms of cancer, cardiovascular diseases, behavioral syndromes and infectious diseases.

The conferences typically are hosted by a veterinary school and a medical school. There have been two international Zoobiquity Conferences to date: one in the Netherlands at Utrecht University and one in Australia at the University of Sydney.

What are the differences and similarities between what you advocate and the One Health concept? 

I think One Health often is believed to be about zoonoses only, which is an unfortunate misconception.

One of the goals of Zoobiquity is to increase awareness of the power of One Health among human health care professionals. One Health is one of the most important concepts of our time, yet the majority of physicians have not heard of it. We hope that Zoobiquity’s approach will ignite interest and bring physicians, dentists, psychotherapists and others to the One Health table.

Zoobiquity declares that while animals and humans share many diseases and other traits, veterinarians and physicians rarely consult with one another. Its founders propose an integrated, interdisciplinary approach to physical and behavioral health.

Barbara Natterson-Horowitz, M.D., MA

Zoobiquity declares that while animals and humans share many diseases and other traits, veterinarians and physicians rarely consult with one another. Its founders propose an integrated, interdisciplinary approach to physical and behavioral health.

What are the pros and cons of studying induced diseases vs. naturally occurring diseases? 

Studying the same naturally occurring diseases in animals and humans has many benefits. First, the natural history of these disorders is similar, with comparable responses to interventions such as chemotherapy and surgery. Furthermore, it can be highly informative to study illness in domestic animals and others with whom we share environments.

Finally, despite much promise, there are many challenges and limitations in studying induced diseases. Creating a disease to study in an animal does not offer the same naturalistic perspective learning about a spontaneously occurring syndrome.

How can we treat our respective patients better by listening to, talking to or reading our counterparts? 

For the most part, we’ve found that veterinarians read the human medical literature, attend human conferences and belong to human professional societies. Unfortunately, the opposite is not true. Most physicians spend their entire professional lives never collaborating with a vet or consulting the veterinary literature.

I truly believe human medicine could benefit from the comparative method, which lies at the heart of veterinary education. Physicians can learn a lot from watching vets practice. The mere fact that vets can’t use language to understand their patients means their physical diagnostic skills and observational perspectives are highly developed.

In your TED talk, you say your passion is to “close the gap” between vets and M.D.’s. What do you mean by that? 

The mission of the Zoobiquity conference is to bring physicians and other human health care providers to the One Health table. Every specialty of medicine can benefit from increased collaboration with veterinary colleagues. For example, there are striking similarities between osteosarcoma, malignant melanoma and mitral valve disease across species.

Physician scientists, for example, might conceive of novel hypotheses after being exposed to the comparative knowledge of veterinarians. Clinicians will become better at physical diagnosis.

What advice do you have for veterinarians and physicians who would like to cooperate but don’t live near a big university? 

My experience is that most physicians are fascinated by veterinary medicine, especially when the issues connect to their own medical practices. One way to close the gap between our fields would be to have veterinarians invited to some medical rounds and physicians invited to veterinary settings. Local exchanges like this could do a lot to close the gulf. Of course, all laws and rules must be followed, but even within these rules, there is a lot of room for conversation and intellectual cooperation.

Do you have any advice for researchers, professors and residents of both professions? 

There will be a lot of pressure on many young colleagues to specialize, to dive very deeply into one area. As you go deeper and deeper into one topic, keep one eye on the bigger picture. Thinking comparatively and environmentally is one way to make sure you avoid getting stuck in a narrow silo.

Cooperate, keep an open mind and, above all, have respect for the diversity of disciplines, which can help us better understand our patients.


Dr. Phil Zeltzman is a board-certified veterinary surgeon and author. His traveling practice takes him all over Eastern Pennsylvania and Western New Jersey. You can visit his website at www.DrPhilZeltzman.com, and follow him at www.facebook.com/DrZeltzman

Originally published in the April 2016 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today! 

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