Who Owns the Microphone (Part 1)? Why Vet Med needs its courage back (#445)

Once upon a time, if you wanted to challenge an idea in veterinary medicine, you wrote a letter.

You read an article in a journal, you disagreed with the conclusions, or the statistics, or the ethics, and you put pen to paper.

A few weeks or months later, your letter appeared in print alongside a reply from the author.

The whole profession could see the debate, in black and white, preserved for the record.

It wasn’t perfect, but it was authentic and ours. It was slow, thoughtful, accountable.

Now ask yourself a simple question:

Where, in 2025, does our profession openly and respectfully

challenge one another’s ideas?

Not gossip. Not anonymous sniping in private chat groups. Not passive-aggressive subtweets.

I mean:

Visible, professional, case- and evidence-based challenge.

I’m not sure we have a good answer.

From Letters to Log-Ins

The old letter to the editor space has been quietly hollowed out. Many journals still have some form of correspondence section or online commenting, but it’s sidelined, hidden behind logins, or so delayed that it has little impact on real-time practice.

In its place we’ve built a messy patchwork:

• Closed professional forums.

• VIN, specialist listservs, invitation-only WhatsApp groups.

• Institutional spaces.

• M&M rounds, journal club, internal email lists.

• Open platforms.

• LinkedIn, Facebook groups, X, Reddit.

Each of these serves a purpose. None of them feels like the shared public square of the profession.

Closed forums are safe and can be superbly collegial. But they’re invisible to the wider community and to the next generation of vets looking for role models of how to disagree well.

Social media has reach and immediacy, but it also has algorithms, pile-ons, and the constant risk that a good-faith challenge to an idea will be misread as a personal attack, or worse, a reputational landmine.

And so, more often than not, we say nothing.

The Real Risk Isn’t Being Too Critical.

It’s Being Too Quiet.

We like to tell ourselves that silence is kindness.

I don’t want to embarrass them. I don’t want to start a fight in the comments. My employer wouldn’t like me being controversial online.

All understandable. All human. But here’s the uncomfortable truth:

If we can’t challenge each other’s ideas,

we will quietly lower the standard of our own medicine.

If no one pushes back on weak data, weak reasoning, or premature conclusions:

• Questionable treatments become normalized.

• Flimsy extrapolations become accepted wisdom.

• Marketing slides quietly masquerade as medicine.

  
  

The point of challenge is not to humiliate colleagues. It’s to protect patients, protect the public, and to protect the profession from sleepwalking into group think.

We pride ourselves on evidence-based practice.

Evidence without argument is just decoration.

Challenge Is Not Abuse. Disagreement Is Not Disloyalty.

Somewhere along the line we’ve blurred the line between challenging an idea and attacking a person.

So, let’s draw that line again, very clearly.

We don’t have to sugar-coat everything. In fact, over-sweetening breeds distrust. But we do have to keep the target where it belongs: on the idea, not the individual.

Challenge is a sign of respect.

It says:

I take your work seriously enough to engage with it, publicly and honestly.

Silence, especially from those who know better, can be a quiet form of abandonment.

Where Should We Be Having These Conversations?

Right now, our debates are scattered across:

• Specialty listserves no one outside the club can see.

• Hospital rounds that live and die in a conference room.

• Social media threads that flare brightly and then disappear into the algorithmic void.

  
  

Maybe it’s time to admit that the profession needs both:

1.      Safe, closed rooms.

• For the raw, detailed case discussions, the tell me how you really managed this exchanges, and the vulnerable learning moments.

  
  

• VIN, specialist forums, private groups - these are essential.

2.      A visible, accountable public square.

• For reasoned disagreement about published work, new guidelines, industry messaging, and high-impact clinical claims.

A space where vets can model public intellectual honesty for students, younger colleagues, and the wider profession.

Right now, we lean heavily on the first and almost entirely neglect the second.

LinkedIn Is Not a Journal, But It Is a Stage

Like it or not, LinkedIn and other platforms have become a kind of live, global hallway conversation for veterinary medicine.

That can be dangerous. But it’s also an opportunity.

A thoughtful post that says:

Here is a recent paper / protocol / case series.

Here’s why I’m uneasy about the conclusions.

Here’s the older work that raised different concerns.

I’d love to hear how others are thinking about this.

…can do more for critical thinking in one day than a buried online comment on a journal website will do in a year.

The key is how we show up there:

• Lead with curiosity, not accusation.

• State your conflict of interest, or lack of it.

• Anchor your challenge in data, not ego.

• Invite response, don’t deliver a verdict.

If we want the culture of LinkedIn to be better, it won’t be because the algorithm got nicer. It will be because people who care about respectful challenge showed up and modeled it.

What Would Letters to the Editor 2.0 Look Like?

If we’re serious about rebuilding a culture of open, respectful debate, we might need to reinvent the genre entirely.

Imagine if:

• Journals treated rapid responses and letters as first-class content, prominently displayed, citable, and encouraged.

• Specialty colleges hosted structured case debates online, with faculty and practitioners presenting contrasting views on real cases, and the recordings were open to all members.

• Professional associations curated moderated discussion threads on contentious topics (new drugs, guidelines, surgical trends), where strong disagreement was welcomed and abuse was not.

• Senior clinicians and academics made a habit of posting public, evidence-based critiques, by name, of ideas they disagreed with, in a tone that was firm, fair, and teachable.

  
  

In other words, we’d stop pretending that no one wants conflict and start acknowledging that what we actually want is honest conflict handled well.

A Profession That Can’t Argue Can’t Grow

Veterinary medicine is at an inflection point, economically, technologically, and ethically.

We are grappling with AI, corporatization, pricing, access to care, the explosion of diagnostics, and the expectations of a public that is more informed and more anxious than ever.

This is not the moment for us to become timid.

So, here’s the challenge:

• If you see something in print or online that doesn’t sit right and you say nothing, you’re voting for the status quo.

• If you quietly dissect a paper in the tearoom but never send a letter or post a considered critique, the public conversation remains poorer than your private one.

• If we keep all our best arguments locked away in closed forums, we shouldn’t be surprised when the visible narrative of the profession becomes shallow, commercial, or worse, unquestioned.

  
  

We need our courage back.

Not the courage to be cruel.

The courage to be clear.

To say, in public and in print:

I respect you. I respect our patients. I respect the evidence.

And because of that, I disagree, and here’s why.

That’s not disloyalty. That’s professionalism.

Maybe the letters moved from the back pages of journals to the timelines of social media and the threads of online forums. Fine.

Then the question isn’t:

Where did the letters go?

The real question is:

Are we still writing them?

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