Brainstorming an alternative to AOA

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Most osteopathic students or graduates share the same frustrations with the AOA regarding many important issues facing our profession today. These issues include but are not limited to: the opening of the first for-profit medical school, the development of a combined residency match, promoting public awareness of the equality of our training to that of our allopathic counterparts rather than our rapidly disappearing differences, and the issue of the degree title and its implications for public recognition and international practice rights. The wishes and viewpoints of osteopathic students and physicians that I've observed in public forums are resounding in their near unanimity regarding these issues, yet the AOA and COCA take little notice and indicate limited interest in addressing these issues.

It appears that the AOA represents a small minority of our classmates and colleagues. The vast majority of us are left with no professional organization to represent our views on many important topics. Our only other advocate is the AMA, yet our membership in that organization does nothing to help address many of the unique issues we face as osteopathic students and physicians.

Left with no representation, one option would be to create a new professional organization.

Here is a thread in which to brainstorm about such an endeavor, speculate, and otherwise sound-off. Ideas? Comments?

Originally Posted by Red Beard

Most osteopathic students or graduates share the same frustrations with the AOA regarding many important issues facing our profession today. These issues include but are not limited to: the opening of the first for-profit medical school, the development of a combined residency match, promoting public awareness of the equality of our training to that of our allopathic counterparts rather than our rapidly disappearing differences, and the issue of the degree title and its implications for public recognition and international practice rights. The wishes and viewpoints of osteopathic students and physicians that I've observed in public forums are resounding in their near unanimity regarding these issues, yet the AOA and COCA take little notice and indicate limited interest in addressing these issues.

It appears that the AOA represents a small minority of our classmates and colleagues. The vast majority of us are left with no professional organization to represent our views on many important topics. Our only other advocate is the AMA, yet our membership in that organization does nothing to help address many of the unique issues we face as osteopathic students and physicians.

Left with no representation, one option would be to create a new professional organization.

Here is a thread in which to brainstorm about such an endeavor, speculate, and otherwise sound-off. Ideas? Comments?

I certainly see how many DO graduates feel disenfranchised and barely feel like they have a voice in AOA's policies. The only way i see big changes taking place is if young DO graduates from this decade actively push for policy changes, this can happen if they take an important position in AOA. AOA is still driven by old mentalities that have no understanding of post graduate training issues that have clearly limited many DOs from reaching their full potential. I mentioned in a different thread about how we need the allopathic world to help us out of this ditch, they can advance our careers with more of a camaraderie.

The most annoying thing about their propaganda is how every GD thing explaining what is DO is, is accompanied by a photo of some doctor "laying hands" on someone.

Originally Posted by Lamborghini1315

The only way i see big changes taking place is if young DO graduates from this decade actively push for policy changes, this can happen if they take an important position in AOA.

I think this is key. That is why I encourage those of you who are frustrated with the system to become involved in it. The AOA has student and resident representatives on many if not all committees. You can have a voice. I did this for 2 years and it was enlightening...mostly in a positive way. I was on a graduate education-related committee and was very vocal about the combined match. I learned that students and residents *do* have good advocates in the AOA...but we need to be active to become the future decision-makers in the profession.

Goosedander - great comment.

As for those who would recommend involvement in the AOA, it's been discussed elsewhere why this won't work. The house of delegates is a hegemony of the old guard from the 5 states and you have no chance of effecting change from within...because the system is set up to suppress change.

We really need a Progress Osteopathic Association to rise up, seek a merger with our allopathic colleagues, advocate for degree change to Doctor of Medicine, Diplomate in Osteopathy, and wipe the five states rules from the books

Originally Posted by Old_Mil

As for those who would recommend involvement in the AOA, it's been discussed elsewhere why this won't work. The house of delegates is a hegemony of the old guard from the 5 states and you have no chance of effecting change from within...because the system is set up to suppress change.

If the young DOs never get involved in the AOA in any significant numbers, then nothing will change. If we do get involved, we become the future, not the "old guard." This obviously isn't a quick fix, but getting in new blood will change things over time.

Originally Posted by Red Beard

Most osteopathic students or graduates share the same frustrations with the AOA regarding many important issues facing our profession today. These issues include but are not limited to: the opening of the first for-profit medical school, the development of a combined residency match, promoting public awareness of the equality of our training to that of our allopathic counterparts rather than our rapidly disappearing differences, and the issue of the degree title and its implications for public recognition and international practice rights. The wishes and viewpoints of osteopathic students and physicians that I've observed in public forums are resounding in their near unanimity regarding these issues, yet the AOA and COCA take little notice and indicate limited interest in addressing these issues.

Left with no representation, one option would be to create a new professional organization.

Here is a thread in which to brainstorm about such an endeavor, speculate, and otherwise sound-off. Ideas? Comments?

I already know where this thread is headed, just like the past 2 or 3. The "hallowed" discussion of the D.O. name change. It seems as though every other thread created has something to do with it. I agree that the AOA probably mis-represents most of us in some ways and would like to see more recognition given to D.O. physicians for their accomplishments, but I am optimistic about what the future holds for us as future physicians in practice and the way that "we" can change this problem one physician at a time through example and hard work. I also agree that something needs to change with the whole "for-profit" idea before D.O. schools start becoming the same as Carribean schools. Please though, just for the sake of sanity, don't talk about "name change", there is already a thread right below this one about that and it is around 6-7 pages in length!

What do you mean about "for-profit" medical schools? Which one is that? I don't mean to sound ignorant, I'm simply misinformed.

Originally Posted by Slack3r

What do you mean about "for-profit" medical schools? Which one is that? I don't mean to sound ignorant, I'm simply misinformed.

Rocky Vista University considers it self a for profit school, as opposed to most other schools on the planet (Caribbean schools aside). It is located outside Denver.

Originally Posted by arlingtondoc

Rocky Vista University considers it self a for profit school, as opposed to most other schools on the planet (Caribbean schools aside). It is located outside Denver.

It's not that they just consider themselves a for-profit school, they ARE a for-profit school.

Originally Posted by Old_Mil

We really need a Progress Osteopathic Association to rise up, seek a merger with our allopathic colleagues, advocate for degree change to Doctor of Medicine, Diplomate in Osteopathy, and wipe the five states rules from the books

While I don't disagree, how about another idea.... instead of total merger.... Why not just one match, all GME in the country under one group. That way sub par programs either shape up or disappear and there should be more than enough slots for all students. The same theory could apply to medical school accreditation too, one group looks at all med schools. The school is approved or closes .... there could be no claims of one degree being better because everyone meets the same standard. (okay maybe wishful thinking but still should be helpful)

thoughts?

Recently, the ACGME said they didn't want one match, and the AOA said the same thing.

Originally Posted by cliquesh

Recently, the ACGME said they didn't want one match, and the AOA said the same thing.

The AOA has been saying that for years, contrary to the wishes of osteopathic students--that is the issue. I was not aware of any ACGME statement on the matter, where did you get that information?

Originally Posted by Red Beard

The AOA has been saying that for years, contrary to the wishes of osteopathic students--that is the issue.

Correction: " contrary to the wishes of some osteopathic students".

Correction: contrary to the wishes of most osteopathic students. 66% of us applied both MD/DO. 60% of us forgo osteopathic residencies for allopathic residencies.

The market is speaking, the AOA isn't listening.

Originally Posted by Old_Mil

Correction: contrary to the wishes of most osteopathic students. 66% of us applied both MD/DO. 60% of us forgo osteopathic residencies for allopathic residencies.

The market is speaking, the AOA isn't listening.

So you're saying the vast majority of osteopathic students participating in both matches, end up matching in the ACGME match. So what's the problem? How are DOs being shortchanged?

I don't really care if the matches are joined, but I don't see this as essential for osteopathic students. And I certainly don't think that any particular view is supported by "most" students.

I do enjoy the AOA boogeyman phenomenon that exists among osteo pre-meds and med students. Sort of like watching a monkey rattle the cages at the zoo. Sure, it passes time I guess, but it doesn't mean much in the real world.

For those against the AOA, I highly suggest that you try and get involved. As Dr. Mom points out, there are advocates for you out there. And there are tons of opportunities to be involved, and in many cases the ball can get rolling by sending off a simple email to the right persons. If you haven't tried to help work within the system, you don't have much room to criticize it. (And if you're a pre-med, I personally think that your silence is the better part of discretion, as your opinion means pretty much nothing. Just my opinion.)

Originally Posted by San_Juan_Sun

So you're saying the vast majority of osteopathic students participating in both matches, end up matching in the ACGME match. So what's the problem? How are DOs being shortchanged?

I don't really care if the matches are joined, but I don't see this as essential for osteopathic students. And I certainly don't think that any particular view is supported by "most" students.

I do enjoy the AOA boogeyman phenomenon that exists among osteo pre-meds and med students. Sort of like watching a monkey rattle the cages at the zoo. Sure, it passes time I guess, but it doesn't mean much in the real world.

For those against the AOA, I highly suggest that you try and get involved. As Dr. Mom points out, there are advocates for you out there. And there are tons of opportunities to be involved, and in many cases the ball can get rolling by sending off a simple email to the right persons. If you haven't tried to help work within the system, you don't have much room to criticize it. (And if you're a pre-med, I personally think that your silence is the better part of discretion, as your opinion means pretty much nothing. Just my opinion.)

you were once a pre-med and now a resident. Question: How much have the organization changed from then till now? Or you simply do not care about the future of aspiring physician but your own career? Yes, our goal and mission are to provide quality healthcare to our patients, but it is also to strive for a better niche for our successors in the field. As new MD institutions and existing ones increase their capacity for enrollment, where do you think some of the best/better residency spots will go? The point is, we are not going to concede that we shld be "marginalized" because what our degree says, but what are we capable as a physician shld determine where we go and do. However, being a DO in the first place make some residencies harder to get into (not impossible)! Having said those, AOA takes no interest to do anything but utters "there is nothing we (AOA) can do"....

Wouldn't it be sensible to come up with one official body that would be willing to listen, to try, to pursuit the better outcome desired by many? Or shall we all wait for all the "old guards" to finally decide to step down then we can initiate the change??? We all know and have had experience with whoever holds the authority speaks louder, and has the ability to act; not the ones with the dreams, the passion, or responsibilities, but the old-fashioned ones who will try everything to strike down changes that might challenge their status. Moreover, were they even democratically elected to represent DOs???

Out of curiousity, how does one get chosen for the House of Delegates for the AOA? It would seem to me the HOD would look for those individuals that want to perpetuate their dogma to take their places. The HOD have held their oligarchic principles over the rest of the DO community, and their is nothing we can do about it - because we aren't able to elect these "officials". So, back to my original question. People state that we need to infiltrate the HOD and change the culture. How does that happen?

You first apply to be a member of a speciality board. If you get accepted and you do "a good job," you can get bumped up to a delegate.

Originally Posted by Red Beard

The AOA has been saying that for years, contrary to the wishes of osteopathic students--that is the issue. I was not aware of any ACGME statement on the matter, where did you get that information?

I got it off Dr. DiMarco's blog. He just said it in passing, so I don't know how official it is, but I don't see why he would lie. This is his quote:

"Just wanted to get back to those of you still talking about the possibility of a Joint Match with the NRMP. The NRMP has recently informed us that they have no plans to pursue a Joint Match."

Originally Posted by cliquesh

"Just wanted to get back to those of you still talking about the possibility of a Joint Match with the NRMP. The NRMP has recently informed us that they have no plans to pursue a Joint Match."

You have to learn to parse the words of politicians as if they are spoken by politicians. It's the ACGME and its programs that either want or don't want a combined match, along with the AOA and its programs. If both these entitites decided to move the ball, the NRMP would come along for the ride.

His statement is like me saying I have no plans with Angelina Jolie this weekend.

AOA president's latest reply to what is proposed here and the associated name issue!

http://blogs.do-online.org/aoapresid...p?itemid=19731

Originally Posted by PipiChen

AOA president's latest reply to what is proposed here and the associated name issue!

http://blogs.do-online.org/aoapresid...p?itemid=19731

same political smooth talk, 'I can't personally do anything' x level has to do y, then get it approved from z etc.

To solve this problem we just need to get a division for Osteopathic Medicine under the AMA. Also, we should be Doctor of Medicine, Master of Osteopathy

This was one of the comments on the AOA president's blog:

"DOs today need to use the California merger as an example by which to bring about this change. The California merger was done outside of the AOA. DOs today need to proceed in the same way.

The AOA will never allow a change that would simply strip the need for its existence. This change is simple, and it does not involve the AOA."

So, what does dealing with this matter outside of the AOA exactly mean? How difficult is it to accomplish this?

Originally Posted by cliquesh

You first apply to be a member of a speciality board. If you get accepted and you do "a good job," you can get bumped up to a delegate.

This is the problem I have with the statement - "Get chosen for the HOD and change the AOA from inside."

The problem is since they are not elected officials they will continue to chose those with like-mindedness.

Originally Posted by msw

This was one of the comments on the AOA president's blog:

"DOs today need to use the California merger as an example by which to bring about this change. The California merger was done outside of the AOA. DOs today need to proceed in the same way.

The AOA will never allow a change that would simply strip the need for its existence. This change is simple, and it does not involve the AOA."

So, what does dealing with this matter outside of the AOA exactly mean? How difficult is it to accomplish this?

Men of power, position and pride will do whatever is in their means to validate their existance, especially if they're being paid handsomly.

'Michigan DO' is exactly right: the AOA is not going to nullify its own existence, which goes to the heart of why nothing practical ever has or ever will get done.

The simple premise that outside OMT there are no inherent defining qualities of osteopathic medicine scares the AOA & its delegates to death, especially considering the recent movement to make OMT available to MDs as CME.

When I was in school the Stros paid us a visit, and while debating the international problems DOs from the US face & the push for OMT CME for MDs, I asked him what else makes us unique...what else is inherent to our osteopathic education that separates us? His response:

There are aspects of you education you're not even aware of yet, things you'll learn in clinicals and residency...

Well, I'm here now, and haven't seen anything yet, but I'm at an allopathic institution...so is it my fault I'll never reach of pinnacle of osteopathic education?

Another interesting story...when the Stros came to my school, I had the opportunity to dine with him & his wife.

The most interesting part of the whole evening came when they both went on a tirade about how there really is a difference, how DOs do have more to offer.

Now, I can't speak for Dr. DiMarco, but I'm sure this holds true for MANY in the House of Delegates and the Old Guard: they truly, actually, honestly believe there is a difference, that 4 yrs of osteopathic education confers some ability absent in allopathic schools, and that our approach to patient care is better because of it.

I agree with figuring out a way to reignite what happened in Cali in the '60s. But on a much broader scale.

I have no idea how to do that though. Anyone?

Originally Posted by goosedander

I agree with figuring out a way to reignite what happened in Cali in the '60s. But on a much broader scale.

I have no idea how to do that though. Anyone?

The CA merger was agreed and carried out both by MDs and DOs. In that case, AMA must be willing to support this initiative to assimilate DOs into their camp...

First of all, we definitely need to have a tangible, strong, and influential group of leaders to organize. This grp must include MDs, DOs, JDs and statesmen etc. Concurrently we need to have DOs who support this change to stand out and make themselve available to make it happen. I mean the simple way to see this is: Could have President Obama won the last election based on his ideology to change alone without the historical turnout of newly registered voters?? Probably not~ Therefore, we cannot hide behind the curtain to wait for someone else to voice, to advocate, to change on our behalf; we have to come together and make it happen with our own hands <-- our OMT hands!

Originally Posted by Old_Mil

You have to learn to parse the words of politicians as if they are spoken by politicians. It's the ACGME and its programs that either want or don't want a combined match, along with the AOA and its programs. If both these entitites decided to move the ball, the NRMP would come along for the ride.

His statement is like me saying I have no plans with Angelina Jolie this weekend.

Originally Posted by goosedander

I agree with figuring out a way to reignite what happened in Cali in the '60s. But on a much broader scale.

I have no idea how to do that though. Anyone?

Round up all the old guys who did it back then and give em a come back. It will be like that Clint Eastwood movie 'Space Cowboys,' except with less Eastwood. We should see if Eastwood will work for the DOs ... he could change some minds.

I am one to believe that progress takes time. People that have come before us in this profession fought very hard for DO's to be able to practice 'equally' in every part of the US. You should wear those letters with pride. Should you want be an MD then there are over 100 schools that grant those degrees. Yes you may want the 'credibility' that has be bestowed upon the hallowed MD, but one could argue that DO's should be workind hard to build up their own infrastructure so that there will be more opportunities for DOs in GME. The fact that you want to assimilate is laughable. Why not just go to an MD school if you want to be an MD? If you want to have OMT training then become a DO. No system is perfect, and everyone is not going to be pleased. Focus on your training, serving your patients, and working within the system to provide more quality residency opportunities for those DOs that will come after you. Educate your patients and people in your community about the benefits of having a DO as one of their primary care physicians or specialist, and above all else STOP BI***ING. You have a great career, and we are here to serve.

***Not trying to get blasted for this message, just stating my opinion. I do respect the previous opinions, mine just happen to differ on some of the issues.

Peace

A few words of caution about a single match and other issues. If one match is desired, then that would be a strong impetus for MDs entering osteopathic residencies. While this is not without some merit and has been discussed by the AOA, untoward consequences may arise. Highly sought after specialties (EM, Ortho, Derm, etc) would now have a larger competition pool and it is conceivable than no DOs would match to these programs. DOs now enjoy many benefits that a single match would eliminate. Two shots at your desired specialty is likely better than one. While the AOA considers it unethical for a DO to sign outside of the match, many ACGME programs do this. Such programs cannot be AOA approved in any fashion. Should DOs be completely equal (for match purposes) with MDs, the signing outside of the match would not be permitted.