Animal health and human health are inextricably linked. So much so, that initiatives to unite human and veterinary medicine which have existed for centuries (as reported by the American Veterinary Medical Association Hippocrates (“On Airs, Waters, and Places” (estimated 400 BC)).

More recent initiatives to unite the professions have been advanced by the One Health Initiative:

The One Health Initiative is a movement to forge co-equal, all inclusive collaborations between physicians, osteopaths, veterinarians, dentists, nurses and other scientific-health and environmentally related disciplines, including the American Medical Association, American Veterinary Medical Association, American Academy of Pediatrics, American Nurses Association, American Association of Public Health Physicians, the American Society of Tropical Medicine and Hygiene, the Centers for Disease Control and Prevention (CDC), the United States Department of Agriculture (USDA), and the U.S. National Environmental Health Association (NEHA). Additionally, more than 800 prominent scientists, physicians and veterinarians worldwide have endorsed the initiative.

While many aspects of human and veterinary medicine may be similar, and these initiatives could benefit all patients and the professions, there remain undeniable differences between the two that cannot be reconciled. For example compare the recent article published in the New York Times, titled Modern Doctors’ House Calls: Skype Chat and Fast Diagnosis with the recent decision in the 5th Circuit, Hines v. Alldredge, 783 F.3d 197 (2015).

The Times article describes the increasingly accepted practice of human medicine via skype and other virtual online resources. In stark comparison, in Hines v. Alldredge the 5th Circuit upheld the Texas statute that requires a veterinarian to conduct a physical examination of an animal or its premises before the veterinarian can practice veterinary medicine with respect to that animal.

In this Texas case, Dr. Ronald Hines, a retired veterinarian licensed to practice in the State of Texas, founded a website after retirement where “he began ‘to provide veterinary advice to specific pet owners about their pets.’” Hines, 783 F.3d at 199.

In 2012, the Texas Board of Veterinary Medical Examiners (‘the Board’) informed Hines that by providing veterinary advice without a physical examination, he had violated Texas Law.

The 5th Circuit upheld this finding in the lawsuit Hines filed seeking declaratory and injunctive relief, claiming that “the physical examination requirement violates his First Amendment right to free speech as well as his rights under the Due Process and Equal Protection Clauses of the Fourteenth Amendment.” Id.

The Hines decision has been the first of its kind in veterinary medicine and seems to be inconsistent with the current advancements in human medicine. The difference between the two is demonstrative of the difference between the two medical practices. In human medicine, for the most part, the patient can describe their symptoms, what they are, when they started, and how they are affecting the individual. In veterinary medicine,  practitioners must attempt to identify what is wrong with their patient using at least four of their five senses (not taste), listening to the observations of the patient’s owner, and performing diagnostic testing which begins with a hands-on physical examination.  A physical examination is the crux of Texas’ definition of the practice of veterinary medicine.

This is not to say that online veterinary diagnostics are irrelevant. That would not be accurate. But an accurate diagnosis must start with a physical hands on examination. At least for now. At least in Texas.