Reinventing Osteopathic Medicine: Or, so you say want a Revolution?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

drusso

Full Member
Moderator Emeritus
Lifetime Donor
Joined
Nov 21, 1998
Messages
12,528
Reaction score
6,917
There has been a lot of good discussion here lately about the future of osteopathic medical education, the expansion of osteopathic medical schools, the role of osteopathic medicine as a social movement. These articles review the evolution of osteopathic medical education and expansion. I've also posted some abstracts and links to other resources to keep the discussion going.

"How Private Colleges of Osteopathic Medicine Reinvented Themselves"

Profession Identity: The key to the future of the osteopathic medical profession in the United States

Comparison of osteopathic and allopathic medical Schools' support for primary care.

Does the Osteopathic Internship Have a Future?

Researched and Demonstrated: Inquiry and Infrastructure at Osteopathic Institutions

The DO's: Osteopathic Medicine in America

**THE PARADOX OF OSTEOPATHY**

An Overview of Osteopathic Medicine

Members don't see this ad.
 
Hmm... I'd like to read those articles, I really would. Sadly, you gotta pay to play.

I don't suppose we could lobby Lee to spend some of revenue generated by allowing Rick's School Of Aroma Therapy and Medicine advertise here in an attempt to purchase some of these articles for us?

I'm actually serious. Maybe The Journal of Academic Medicine would look kindly at helping out a bunch of knowledge starved premed and med students?
 
Ok... I've read the articles I could. I want a revolution! We have to be able to unite somehow to stop the proliferation of schools and increase the number of residencies. Those of us that currently attend osteopathic institutions are the future. If the AOA cannot sustain us, then we have no choice but to move over to the AMA. The AOA and the accrediting council are nothing without our membership. They have come several times to OUCOM saying that they would be willing to apply our allopathic residency years towards AOA internship. Isn't that a change of tune from a few years ago??? They were practically begging us to join osteopathic boards. Why??? Because they need the dues and fees. They are squirming.... but they have done very little for us. I understand that they are the voice of osteopathic medicine. But they have said and done little lately. I AM NOT saying we should become MD and merge with the allopathic institutions. I am proud of what I am. I am saying we should seek better representation. I feel the AOA has limited our ability to expand by imposing ridiculous rules. They are not aiding in the accredidation of allopathic residencies or in the creation of new osteopathic ones. What about the issue of qulity control? By making medicine a competition about US vs. THEM it has done nothing but hinder us. Yes, we have a different philosophy.... But we have the same ultimate goal. To care for the sick people of this society. Our leadership has decided to focus on DO pamphlets and commercials. The DO difference??? How about supplying us with training so we can be living testaments to what a DO is.
I am not sure what we need to do.... or how to do it. I hope people on this board can come together to make a change. We all complain about it... so let's do something.
Can we lobby the AOA? Put pressure on them? Organize a front? Effect the election of a new president. The AOA is not the only institution... the accrediting coucil needs to get the message to? I am ignited. Let us gather the facts, join together, and effect our future...NOW!
 
Members don't see this ad :)
drdrtoledo said:
We have to be able to unite somehow to stop the proliferation of schools

Unless you go to KCOM or CCOM or one of the other first schools, you are a DO student because of the very "proliferation" you want to stop. It's kind of strange to want to save a profession and yet limit the number of people joining it. It's like trying to form an army, but being upset about the large number of recruiting offices.
 
(nicedream) said:
Unless you go to KCOM or CCOM or one of the other first schools, you are a DO student because of the very "proliferation" you want to stop. It's kind of strange to want to save a profession and yet limit the number of people joining it. It's like trying to form an army, but being upset about the large number of recruiting offices.

As has been said... the profession should not proliferate until it is capable of accomodating what members it currently has. Some of us would like DO residencies because we don't want to lose the OMM and other aspects of our "culture". There is a place in many specialties for the application of such methods. Unfortunately, our leadership does not see this. We need to emphasize this concern. Allopathic institutions want us, but what is going to happen as we add more and more people into the applicant pool? Some people are going to be left scrambling. There are only so many spots. As a profession we should be self-sufficient without having to depend on others.

Of course, it would be nice to see more DO's. It would also be nice if those DO's had good quality residency's waiting for them. If we want to claim that we are unique, our training should be as well. It's like building an army but not having enough uniforms or weapons to supply the troops. You need to build the infrastructure of our GME before we increase our numbers. Just having more bodies doesn't help anyone.
 
drdrtoledo,
Great post. Well said.
Having graduated from an osteopathic school and completing an allopathic residency and fellowship, I share your opinion.
 
The important thing is that if you want to encourage change you have to get involved. Even if you do an allopathic residency, join the AOA. The money you give them will also give you a voice. I myself am discouraged with the representation that the AOA is giving to the osteopathic profession. However, the only way to change that is to be involved in the movement!
 
Hey Guys and Gals,
Let me just say how happy/proud I am to see so many fellow DO students who actuaklly give a damn about our future as osteopaths! I know that the vast majority of us are pursuing an osteopathic medical education because we all really want to. I am really happy to see so many steadfast people who care about their fellow D.O.s. Let's keep up our morale!
:thumbup: :love: :)
 
brianjc said:
The important thing is that if you want to encourage change you have to get involved. Even if you do an allopathic residency, join the AOA. The money you give them will also give you a voice. I myself am discouraged with the representation that the AOA is giving to the osteopathic profession. However, the only way to change that is to be involved in the movement!

You know, we should all get together via e-mail or this forum and start this process ourselves. Yes, we all feel that change is needed...what can we do about it. A good place to start might be forming a list of objectives...a practical list of what we can actually do to improve the situation. If we are unhappy with the way the AOA provides representation...then let's provide our own in the manner that we feel appropriate. Reform is very much a part of osteopathy as the four tenents. My question for the rest of you...would be does anyone have any suggestions as to where we can get started? It's been hard to run across people who actually want to take an active role and I would love to hear everyone's suggestions. What should we try to fix first?
 
Perhaps someone could develop a website for this situation. I agree with a lot that has been said in this forum. As far as limiting the number of applicants, I agree. It should be more about quality, not quantity. I know this has been brought up in other forums, but I feel that with all these new schools opening up, it makes the osteopathic world look more like the chiropractic profession (accept as many people as you can and make more money for the school). Remember, quality is what matters. We need to address setting up better residency programs and encouraging more research. Should we get a mass email from students and send it to the AOA. WE NEED a Voice!
 
As osteopathic physicians we need to decide where we want to go. I get the feeling that most DO's want to be seen as physicians first and foremost. Unfortunately, the AOA has it's own agenda which has nothing to do with it's members wishes. The AOA is composed of people intent on maintaining a system where they can be big fishes in a small pond while at the same time ensuring the continuation of a system to validate their own professional existance which is based on bitterness against mainsteam medicine that rejected them. I don't believe that the younger generation of DO's carry such a grudge, due in large part to the older generation of DO's fighting for, and gaining, recognition.

We have several choices. We can totally ignore the AOA and all things DO, including AOA residencies and internships. The problem is that there will always be enough people who want to be surgeons, ER docs, etc, who can't get into ACGME programs and will fall back to less competitive AOA programs. Another option is to stay within the system, run for office, get involved, and change the system from within.

Personally, I think we should quit all things AOA and start a new organization. A good starting point would be an AMA Member Group. There are already member groups for IMG's, women, and minorities, so why not for osteopathic physicians?
 
Lexmark said:
The other choice is to stay within the system, run for office, get involved, and change the system from within.

I'll do it, send me. We can do better. Help is on the way!
 
Lexmark said:
We have several choices. We can totally ignore the AOA and all things DO, including AOA residencies and internships. The problem is that there will always be enough people who want to be surgeons, ER docs, etc, who can't get into ACGME programs and will fall back to less competitive AOA programs. Another option is to stay within the system, run for office, get involved, and change the system from within.

Personally, I think we should quit all things AOA and start a new organization. A good starting point would be an AMA Member Group. There are already member groups for IMG's, women, and minorities, so why not for osteopathic physicians?

I think that the majority of young DO's embrace the philosophy and identity of being a DO so scarpping the whole thing and starting over is not practical. Nor is it practical to turn to the AMA and MD's for help. This is fundamentally not their problem. It is ours. And, the problem is all in the execution of what the profession is attempting to do. It is not so much a problem with osteopathic GME--there are some very good DO residency programs out there as well as some real stinkers--the problem is a matter of priorities.

The profession does not support nor hold accountable COM's and OPTI's for quality the way the allopathic world does. Things are simply "looser." Too many people tacitly accept a lower bar for accountability, quality and rigor. This in turn breeds apathy. There also needs to be a fundamental change in the academic culture at COM's. COM's need to continue to evolve from trade schools to full fledged academic health science centers.
 
Members don't see this ad :)
I'm not suggesting starting over. By using an AMA members group we will simply have a focal point for those people who want to see change. And by using the facilities offered by the AMA I don't think we'll be getting MD's involved in our issues. After all, we are physicians, recognized by the AMA. We would be better off looking at the osteopathic profession through the eyes of the AMA than the AOA.

I don't agree that the majority of young DO's embrace the philosophy and identity of being a DO. I have tried in a previous post to establish what exactly is the DO philosophy, something that still remains elusive. I think most younger DO's see themselves as physicians first and osteopaths 2nd, or even 3rd, behind their speciality. About 50% of DO grads go into ACGME programs, and it's not just because there are not enough quality AOA programs. Many of us just want to escape the bogus world of the AOA and COMs.

By removing ourselves from the AOA and forming a group within the AMA we would then be able to offer DO's the opportunity to allow the voice of the majority to be heard over the lunatic fringe of the osteopathic administration that blights the whole profession.
 
drusso said:
Too many people tacitly accept a lower bar for accountability, quality and rigor. This in turn breeds apathy.

This is unacceptable. PERIOD.

drusso said:
COM's need to continue to evolve from trade schools to full fledged academic health science centers.

Agreed - but will it ever happen in our lifetime?
 
Lexmark said:
I don't agree that the majority of young DO's embrace the philosophy and identity of being a DO. I have tried in a previous post to establish what exactly is the DO philosophy, something that still remains elusive. I think most younger DO's see themselves as physicians first and osteopaths 2nd, or even 3rd, behind their speciality. About 50% of DO grads go into ACGME programs, and it's not just because there are not enough quality AOA programs. Many of us just want to escape the bogus world of the AOA and COMs.

I've developed and published a psychometrically valid instrument to measure osteopathic attitudes. A difference in self-perception does exists. This is beginning to be used in studies and will help delineate what is "osteopathic" and how it affects the development of practice patterns


Development of the Attitudes Toward Osteopathic Principles and Practice Scale (ATOPPS): preliminary results.

Am Osteopath Assoc. 2003 Sep;103(9):429-34.

Russo DP, Stoll ST, Shores JH.

Department of Osteopathic Manipulative Medicine, University of North Texas Health Science Center at Fort Worth-Texas College of Osteopathic Medicine, USA. [email protected]

Little empirical work has been done to examine how osteopathic medical students' attitudes toward osteopathic principles and practice (OPP) develop and evolve over the course of their medical education. A major obstacle to conducting this research is the absence of reliable and sensitive instruments to measure students' attitudes toward OPP. The purpose of this project is to develop a sensitive and reliable instrument to measure students' attitudes toward OPP. Face-to-face and telephone interviews were conducted with osteopathic medical students, osteopathic manipulative medicine (OMM) residents, OMM undergraduate fellows, and three board-certified OMM specialists. These interviews were summarized in a 39-item instrument administered to 127 students at the completion of their core OMM rotation at the University of North Texas Health Science Center at Fort Worth-Texas College of Osteopathic Medicine. Factor analysis of student responses to the 39 candidate items yielded two interpretable factors. Factor 1 contained 24 items and accounted for 33% of the item response variance, and factor 2 contained four items and accounted for 5.6% of the item response variance. Based on these results, 14 of the original 39 statements were eliminated and the smaller second factor was dropped. Factor 1 contained items reflecting both positive and negative attitudes toward the application of OPP in patient care, the importance of OPP in medical education, and professional distinctiveness. One of the original 39 candidate items was returned to factor 1 because it was judged by the investigators to be consistent with the underlying construct of the scale and helped balance the number of forward-scored and reversed-scored items in the final instrument. Two internal consistency estimates of reliability were computed for the revised 25-item Attitudes Toward Osteopathic Principles and Practice Scale (ATOPPS): the Spearman-Brown unequal-length corrected coefficient alpha and the split-half reliability coefficients. Estimates for the split-half coefficients were .89 for part 1 and .87 for part 2. The Spearman-Brown coefficient alpha was .93, indicating substantial internal consistency. The 25-item ATOPPS seems to reflect a continuum of positive and negative attitudes toward OPP. This preliminary report documents reliability for the 25-item ATOPPS. With continued support for its construct validity, ATOPPS provides investigators with a reliable tool to assess the development of attitudes toward OPP.
 
The truth of the matter is that the revolution has already started. A previous generation of DO's fought long and hard to be accepted into mainsteam medicine. Now that same generation wants to turn the clock back slightly, while still retaining the new found privilages. It simply doesn't work like that once you have opened Pandora's box.

Consider Dr. Thomas's inaugural address as 2004 - 2005 AOA President. " I will make it my number one priority to tell the world that we have the right health care system." As DO's we now work within conventional medicine; it's what we strived for. If we want to challenge conventional medicine, then everyone else will probably suggest we leave the club.

Once in the real world we realize that MD's and DO's work in exactly the same way. There is no difference, no unique philosophy, and certainly no "treating the patient and not the disease", unless you choose FP over IM.

The time has come to redefine ourselves within the world of conventional medicine that we now live in. The AOA doesn't represent the views of the majority of DO's. But, the AOA, rather than listen to DO's has another plan.

Dr. Beehler, in his inaugural speech wanted COMs to only admit students that would undertake "To maintain AOA membership throughout their entire professional lives" and that would "seek out and obtain AOA board certification.".

Desperate measures from an organization struggling for breath. Time for the morphine.
 
Lao Tzu, in "The Art of War" tells us to: know your enemy more than you know yourself.

Honestly, the only way to know the enemy is to engage the enemy in his/her duties, study his/her ways, actions and belief/thought systems, even to go as far as knowing their physical-chemical makeup.

You're asking: "Uhh.. Drfting, you got a point here?"

Yes, I have many points. Some of these, people aren't going to like.

1) If we future osteopaths *truly* want something done, we have 2 options, and both will get us there:
a) organize in a collected, focused, structured, determined, group-wise kind of mission
OR
b) we all come up with vague "standards" we want to reach, and we brainstorm as many actions we can take. we list those so people can, at least, find one thing that inspires them, and a few people begin pioneering, making paths for others to follow.

The concepts conveyed above can be intertwined in a nice mesh that would make us a pretty wacked-out "enemy" to behold.

2) I'm a firm believer that a few people agreeing something needs to be done is *NOT* enough. The few agreeing need to *DO* something.

You probably ask: "What the heck are you talking about? *ME*? What can *I* do? How can little 'ol *me* make a difference?"

The age-old situation: Someone not yet sucked into the system looks at it and says, "I need to fix something here. But what first?" only to get lost in the bowels of inaction so long as to become as potent as a frozen rose.

Going forward, I think we need to brainstorm about how to TAKE ACTION and WHERE WE WANT TO GO.

---TAKING ACTION:

1) Write letters to the AOA.

*We need stats not only on PLANNED residencies, but on FUNDED and ACCREDITED residencies. If they will not give us these stats, then at least one of us at each COM will need to do the research. I know my school, NYCOM, has the NYCOMEC book, listing all PLANNED, FUNDED and AOA-ACCREDITED residency spots at each of the networked hospitals.
Why are these stats important? To factually decide whether, truly, the AOA has/hasn't begun growing, expanding, and funding residency spots in proportion to the number of D.O.s graduating each year. We probably need historical data, if the AOA will give it to us. How far back? Maybe someone can help with this?

*Based on the stats, we need to ask questions...thought-provoking, guided, to-the-point questions in a setting that can be "refereed" so that no one can hide behind stoic or vague answers. Who'd be our "referee"? We need to brainstorm.
- Do we want closed-doored discussion? open to the public? open only to DOs and student DOs and the AOA?
- IF this is some "objective" of ours, we need to ask: What is being done/can be done by the AOA to insure that *all who want to* will be able to get AOA-accredited and FUNDED residency spots out of their COM?
- I think we definitely need to ask, "Does the AOA ideologically preceive itself superior, inferior or equal to the AMA?" Given the concept of "psychological complexes," if the leadership is going one way, and the students another, then something urgently needs to be done.
- Another nexus of questions to ask are: What does it mean for a residency to be FUNDED? Where do the FUNDS come from? How long before a PLANNED residency becomes FUNDED? How can we get more FUNDS to PLANNED residencies? What is the extent the AOA is involved in the FUNDING of a residency?
- On a scale of 1 to 10, How important is it to the AOA that future DOs have:
1) research experience? What is being done to increase the opportunities?
2) a desire to go to an AOA residency over an AMA residency? What is being done to further scrutinize and qualify a hospital as "worthy" of having an AOA-accredited residency?
3) a desire to go through the traditional 1-year rotating internship?

2) Talk with your classmates. Get them fired up. Get them to this page. Get them to talk with others. Get them to brainstorm with you. Get a general assessment of the overall class attitude, and report back with your school as the heading, and some categories you make up on your own. We know high-ranking people of COM's lurk here and read more than we know.

3) Run for SGA offices...high-ranking positions. Become a member of SOMA and/or other Osteopathic-related associations to begin understanding what their aims, goals and motives are. Report back here and let us all know what your assessment is. Eventually, enough people will bring a good "synthesis" of what these organizations are all about.

4) Each person should at least go to AOA's website and look up the position papers and see whether you agree. Do you want to be part of a group that feels X, Y, Z, A, D, and G, but you simply don't "jive" with their positions? It'd be sort of like joining the NRA when you support Kerry and his wishing to enact laws enforcing liability onto gun manufacturers, meaning: the gun company could be held liable for killing, injuring, maiming, hurting, grazing, dismembering, etc someone. Ask yourself, would gun companies want policemen packing their brand of weapons to shoot criminals, whose surviving family members could sue and win because of the liability laws?

Yes, this is extreme. No, the position papers from the AOA are, truly, not insane, too liberal, freakish, or haughty..in my honest opinion. To be fair, I suggest everyone go to this link and download the .pdf: AOA Position Papers
reasons for doing this: a) you're gonna be a DO, b) it's good to know the belief systems present in the system that will garner, groom, mold and shape you, c) if you happen to NOT be a pre-DO, student DO, or even a DO who hasn't read this, the educational value is outstanding, rewarding, and beneficial.


5) Make signs, placards, printouts, etc and post them in public places around school, saying things like, "What has your AOA done for you lately?" or "Truly, how many AOA residencies are there?" or " What's the AOA's stand on sodas in schools?" or "How often do you dream about your 1-year, rotating AOA internship?" Don't give people answers on the media. Let these questions fester in their minds. Report back with some assessment of the effects of this type of signage. :)


---WHERE WE WANT TO GO (with this)

1) What do we want to see happen? What demands are we gonna throw on the table? What requests do we want to make? Name a position... where do we all stand/ what's the general consensus?

2) As a group, who are WE? Are we limiting ourselves to people in DO school? residents also? board-certified DOs also? even AOA members? faculty at our schools?

3) We need to answer one question, and then, depending on the answer, we can either move forward or cause a ruckus discussing things: Do we feel we are inferior to, equal to, or superior to the AMA and MDs? [do realize here that I am asking for ideology, and the intent is to stir, churn and watch what settles. I'm not asking for chaos or bashing or condemning, etc. I am intending straightforward discussion.] With a final resolution / consensus from this "input session" we will find the clear-cut direction of our next steps. Think of this as a guage of how far the students/grads, etc feel Osteopaths have come since the older generations were given equal practice rights.


Once we decide what we're trying to accomplish, and where we feel we stand in relation to our counterparts / co-workers in the allopathic field, then we know where we're coming from and where we're trying to go...we get past those hurdles and the rest is just tweaking and number influence (see TAKING ACTION, above).

Thanks, ahead of time, for the input, if any. Let's use this as a "starting point" and let our input drive the directions from here. :D
 
Drfting Sun said:
---TAKING ACTION:

1) Write letters to the AOA.

*We need stats not only on PLANNED residencies, but on FUNDED and ACCREDITED residencies. If they will not give us these stats, then at least one of us at each COM will need to do the research. I know my school, NYCOM, has the NYCOMEC book, listing all PLANNED, FUNDED and AOA-ACCREDITED residency spots at each of the networked hospitals.
Why are these stats important? To factually decide whether, truly, the AOA has/hasn't begun growing, expanding, and funding residency spots in proportion to the number of D.O.s graduating each year. We probably need historical data, if the AOA will give it to us. How far back? Maybe someone can help with this?

I did some looking:

I got these stats from AOA Annual Statistics.
I'm uncertain what these stats actually mean: do the total number of AOA-approved residency training positions open up every year? that is, do they "refresh"? or, do only a certain percentage of those positions open every year (ie.. only a few people exit residency and become board certified)? I would think the latter is true, leaving these stats to be deceptive to the casual observer.

Before I list the stats, I am using acronyms to condense things: A-ARTPr and A-RTPos stand for AOA-approved residency training programs, and positions, respectively. A-AITP and A-AIP stand for AOA-approved internship training programs and AOA-approved internship positions, respectively. I understand "programs" to be different hospitals, and the "positions" mean warm bodies can fill them and get paid. I apologize for the inconvenience of having NO tables, but, I'm trying my best here!

*From the Factsheet 2000:

Entering #: Not available (if you're looking through the factsheet, lemme know if you find this stat.)
A-ARTPr and A-RTPos: 496/4,304
A-AITP and A-AIP: 165/2,334

*From the Factsheet 2001:

Entering #: Not available (if you're looking through the factsheet, lemme know if you find this stat.)
A-ARTPr and A-RTPos: 501/4,426
A-AITP and A-AIP: 176/2,489

*From the Factsheet 2002:

Entering #: 2,927
A-ARTPr and A-RTPos: 508/4,563
A-AITP and A-AIP: 193/2,647

*From the Factsheet 2004:

Entering #: 3,043
A-ARTPr and A-RTPos: 509/4,615
A-AITP and A-AIP: 210/2,665


YEAR # Entering A-ARTPr and A-RTPos A-AITP and A-AIP

2000 n/a 496/4,304 165/2,334

2001 n/a 501/4,426 176/2,489

2002 2,927 508/4,563 193/2,647

2004 3,043 509/4,615 210/2,665

(I apologize here for the formatting. I have put it in a .txt file and attached it to this post. I hope that helps.)

We know the stats in the right column refresh each year because the 1-year rotating internships are just that... 1 year. Still, the number of A-AIP does not equal the # Entering. In fact, historically, we don't know if it ever HAS. We don't even know how many students graduate each year, therefore we don't know if the # graduating = the number of A-AIP. I'm beginning to see why only 5 states require the rotating year. :eek:

Then, there's a huge discrepency between the # of A-ARTPos and the # Entering each year. What is that discrepency? I cannot tell because I have yet to understand the number of graduating residents/year, ie. the # of spots opening up each year for the people coming out of the rotating year. :eek:

If you look at this as a progression over time, you only see from 2000 to 2004, a net addition of 311 A-ARTPos. Shouldn't the number of A-RTPos opening each year/becoming available at least equal the number of students that graduated two years prior? :eek:

We need more stats on the # A-RTPos opening up each year.

Anyone else have more "analysis" coming from these stats? :idea:
 

Attachments

  • AOA stats.txt
    342 bytes · Views: 263
I can ask around for the information you want from each school (mine being DMU-COM), but who do I ask? We have a clinical affairs office, but i think they only deal with 3rd and 4th year rotations. Maybe we have a "DMU-COM Book". And do I want to be secretive about my inquiries or what?
 
I like this discussion. Why aren't the young DO physicians and residents not doing much for change? It's because they are busy obtaining training or seeing patients. My best friend recently lost his spot in residency b/c the osteopathic hospital in TX has closed and the "rug has been pullen from under his feet." I do not see the AOA rushing to help him find anything yet :mad:
Then I get letters in the mail demanding my new "resident" membership fees to become a member of the AOA! What is this so-called "voice I get

I would like to see this new generation of physicians who graduate from DO schools integrate into the AMA world. It is full of bright inquiring minds and definitely a number of hostile ones as well, but overall we are accepted by them, trained by them, and supported/encouraged in our quests beyond primary care. Not to mention, they for the most part, provide more stable university or community hospitals to train in as well.

Osteopathy is not my profession!! My profession is to become an anesthesiologist!! It is tempting to suggest that "new" generation of DOs band together with the common goal of patient care excellence and training those that follow us, but the actual numbers would be relatively small, so joining the AMA, and working towards union/integration of MD and DO alike seem like the most logical direction to me.
 
I think I will join the AMA as well. I don't think I will contribute any money to the AOA, especially since it doesn't act in our best interests.
 
jss2003 said:
I think I will join the AMA as well. I don't think I will contribute any money to the AOA, especially since it doesn't act in our best interests.

i would say that it is very important for DOs and DO students to join both the AMA and the AOA - for the reasons i have described in previous posts. there are still a lot of osteopathic or DO-specific issues out there - especially in the area of medical education, and really the only way to create change so that the AOA does speak in out best interests - is to get involved in the AOA, or at the very least - strongly voice your concerns to the student and resident leadership (see my previous posts on how to write a resolution and how to contact leadership).

also - while i have some disagreements about some of the positions the AOA has taken and the internal politics of the AOA - they actually have a great staff in washington that does a great job with the resources they have.

take it from someone who has completed health policy internships in both the AMA and AOA Washington offices - we need to be a part of both of these organizations.

bl
 
it's so funny to read all this revolution business... i'm a DO, i like the profession and to echo some of what's been said here and in other threads (ad nauseum), i can't see that great of a distinction between MDs and DOs at this point. at least not in terms of clinical practice. DOs long, long ago RIGHTLY incorporated the fruits of scientific labor into their treatment practices. Still argued against many of the medical practices of his time expressly because they weren't based on any sort of science but rather on tradition. patients weren't helped and were often hurt because of this. his system was based on long, hard study of anatomy followed by long, hard years of clinical practice. were his studies rigorous by today's standards? probably not. but then, neither were anyone elses. and as western life sciences progressed, DOs accepted the medical treatments that came out of this progress.

but guess what, as osteopathic theories and techniques have progressed, MDs, PTs, chiros, PMR docs, and a whole host of others have incorporated them too. they've incorporated the "holistic" thing as well. i would bet (and i would win) that the number of people in "MD world" who apply osteopathic principles in their day to day practices exceeds the number of DOs that do - even if they don't call them osteopathic principles. and as someone else mentioned on another thread, being a DO doesn't necessarily mean you're an osteopath.

if you accept all of the above, then it won't be so hard for you to accept this: the revolution is over and we won. or at least we kinda won...DO schools are still behind when it comes to teaching or even introducing OTHER systems of medicine. this was substantiated in a published report a while back which examined med school curricula for teaching alternative and complementary systems. (not that i personally agree with all of those practices...i do think we as physicians should at least be aware of the major ones.)

so then this leaves the question, what's the real difference between "DO world" and "MD world"? i can think of two:

1. In a hundred years of existence, DOs have contributed next to nothing to the scientific basis of medicine. Today all of the DO schools together rank...what was it...200th or so in terms of NIH funding. THAT'S ALL 20 SCHOOLS TOGETHER! how many of our schools have PhD programs? That's really sad when you consider the origin of our field.
2. The DOs are continually fretting about being accepted by MDs. That's also sad.
 
It is true that many M.D.s are practicing medicine in a more holistic manner than has been seen in the past. I think most health practitioners see the benefits of prevention and the value of whole-mind, body, spirit care, whether they have the time to address these things is another issue. BUT, if you put aside all philosophical differences between MDs and DOs, there is still manipulative therapy. M.D.s, with very few exceptions, cannot or will not do manual medicine. Allopathic physicians seldom touch their patients, except with some sort of instrument, and they can do relatively zilch to alleviate some of the most common and essential aches and pains experienced by humans. OMT sets us apart, in my opinion; it puts us ahead of our allopathic counterparts.

OMT has virtually disappeared where it was once quite common in the last several years, as DOs have fought to attain status equal to MDs. Many DOs in primary care do very little to no OMT. I don't see how it would necessarily follow that if we start re-emphasizing OMT, there would be wide-spread objections. I think there is a pro-active alternative/complementary healthcare climate in this country now that would possibly embrace OMT like never before. I think that NOW, this is what clearly sets us apart, and there should be a rebirth of OMT, with an emphasis on those techniques best supported by good science.

Also, full-fledged health science centers at COMs are not the only answer to curing the academic plight--although I do think that is important. The emphasis in most DO programs is on patient care, and rightly so. But, if we want to have an ever-evolving, ever-growing profession, it must be scientifically founded and empirically based. DOs in practice, DO students and M.S. and Ph.D. students alike should be empowered to do research in areas specific to osteopathy. When I read issues of the JAOA that have several molecular studies, but not one study on efficacy/safety of an OMT technique...we have a problem. Funding is a serious problem, and it needs to be addressed and dealt with meaningfully and completely. It seems that for years COMs concentrated their efforts on teaching students medicine. Well, unfortunately that's not good enough. To assemble the best faculty for students and to secure the future of the profession, there must be an incredible increase in the amount of research at osteopathic institutions, particularly areas related to manipulation.

-CW, TCOM 2008
 
drusso said:
I think that the majority of young DO's embrace the philosophy and identity of being a DO so scarpping the whole thing and starting over is not practical. Nor is it practical to turn to the AMA and MD's for help. This is fundamentally not their problem. It is ours. And, the problem is all in the execution of what the profession is attempting to do. It is not so much a problem with osteopathic GME--there are some very good DO residency programs out there as well as some real stinkers--the problem is a matter of priorities.

The profession does not support nor hold accountable COM's and OPTI's for quality the way the allopathic world does. Things are simply "looser." Too many people tacitly accept a lower bar for accountability, quality and rigor. This in turn breeds apathy. There also needs to be a fundamental change in the academic culture at COM's. COM's need to continue to evolve from trade schools to full fledged academic health science centers.

thanks russo for this great thread. very interesting. it still astonishes me how many DO's don't know the first thing about osteopathy, nor do they care. Sadly, most new DO's are not osteopaths at all... just MD's wearing the wrong initials (+ a little chiropractor training). Sick.

Its even more amazing how much of a difference you can make if you help first and second years see the clinical relevance of what they learn. Give them some functional anatomy and they run with it and become fantastic. Don't and they slack off in OMM class, become competent in their chosen specialties while blowing off OMM and osteopathic thought in rotations... and after not using it for those 2 years, they are allopaths forever. Our education system needs total overhaul if we are to save the profession.

Long live the revolution!


P.S.
I wont rehash my arguments about what osteopathy really is and why we do it, but feel free to read: http://forums.studentdoctor.net/showthread.php?t=158339&page=2&pp=20
 
bones said:
thanks russo for this great thread. very interesting. it still astonishes me how many DO's don't know the first thing about osteopathy, nor do they care. Sadly, most new DO's are not osteopaths at all... just MD's wearing the wrong initials (+ a little chiropractor training). Sick.

Its even more amazing how much of a difference you can make if you help first and second years see the clinical relevance of what they learn. Give them some functional anatomy and they run with it and become fantastic. Don't and they slack off in OMM class, become competent in their chosen specialties while blowing off OMM and osteopathic thought in rotations... and after not using it for those 2 years, they are allopaths forever. Our education system needs total overhaul if we are to save the profession.

Long live the revolution!

I will take that as a compliment! :) Save the profession? You truly believe that "functional anatomy" -bones, tendons, and 'rhythmic impulses' will save medicine? I encourage you and anyone else to study and love anything you want, but if I told you anesthesiology was the cornerstone of medicine (because it treats pain, the number one chief complaint) you might laugh.

Most OMM guru's turn me off not because they love OMM, but because so many of them act like it is the center of the medical universe.

I am happy that you have found something you love!
Good luck!
 
timtye78 said:
I will take that as a compliment! :) Save the profession? You truly believe that "functional anatomy" -bones, tendons, and 'rhythmic impulses' will save medicine? I encourage you and anyone else to study and love anything you want, but if I told you anesthesiology was the cornerstone of medicine (because it treats pain, the number one chief complaint) you might laugh.

Most OMM guru's turn me off not because they love OMM, but because so many of them act like it is the center of the medical universe.

I am happy that you have found something you love!
Good luck!

THE REVOLUTION has the opportunity to save the profession- of osteopathic medicine ... ya goof :rolleyes:

I dont think anywhere in that post did I say that some "rhythmic impulse" was to save medicine...:laugh: and my goal was certainly NOT to turn you on :eek: :eek: :eek:

OMM is a specialty- as is neurology or anesthesiology. Osteopathy is a system of medicine... more than a specialty (i.e. the entire reason we have our own schools and degree). capiche? :smuggrin:
 
Drusso and colleagues,

This thread/sticky has been a true gem. Not only is there some great insight, but a call for activism as well. Its clear that with new generations come new ideas. Even the current osteopathic literature shows signs of internal strife. The osteopathic profession should embrace the current dialogue and not shy away from necessary change. The roots of osteopathic medicine were fertilized in the soil of social change; today's DO's find themselves in a similar situation. We should stop referencing the influenza epidemic of 1918 as testament to our profession's timelessness. Thanks everyone for the emotionally charged posts... Its comforting that such inspired dialogue can take place without deconstruction into defensiveness, 'flame wars,' and indignation.

-Push
 
Quote from "Sun Tzu: Know thy enemy as you know thyself." That is the correct way to quote the author of the Art of War. And it bothers me tremendously that you view the AMA as an enemy I am considering becoming a DO because I agree with their approach to medicine. But as I observe and read in here I am noticing that the field is fraught with a lot of diverging views that are leading me to question my decision and perhaps I would be more inclined to pursue the MD where at least I know the AMA has their act together.

It is my firm belief to treat the patients with the utmost respect care and quality you expect to receive yourself. And if the AOA and the AMA are fighting or you DO's and DO's in school can not present yourselves as unified force then the AMA will always win. At this point I will be reconsidering my options for MD school and DO school as I am getting a very sour taste in my mouth about the profession of DO.

Regards,

Falco3030

Drfting Sun said:
Lao Tzu, in "The Art of War" tells us to: know your enemy more than you know yourself.

Honestly, the only way to know the enemy is to engage the enemy in his/her duties, study his/her ways, actions and belief/thought systems, even to go as far as knowing their physical-chemical makeup.

You're asking: "Uhh.. Drfting, you got a point here?"

Yes, I have many points. Some of these, people aren't going to like.

1) If we future osteopaths *truly* want something done, we have 2 options, and both will get us there:
a) organize in a collected, focused, structured, determined, group-wise kind of mission
OR
b) we all come up with vague "standards" we want to reach, and we brainstorm as many actions we can take. we list those so people can, at least, find one thing that inspires them, and a few people begin pioneering, making paths for others to follow.

The concepts conveyed above can be intertwined in a nice mesh that would make us a pretty wacked-out "enemy" to behold.

2) I'm a firm believer that a few people agreeing something needs to be done is *NOT* enough. The few agreeing need to *DO* something.

You probably ask: "What the heck are you talking about? *ME*? What can *I* do? How can little 'ol *me* make a difference?"

The age-old situation: Someone not yet sucked into the system looks at it and says, "I need to fix something here. But what first?" only to get lost in the bowels of inaction so long as to become as potent as a frozen rose.

Going forward, I think we need to brainstorm about how to TAKE ACTION and WHERE WE WANT TO GO.

---TAKING ACTION:

1) Write letters to the AOA.

*We need stats not only on PLANNED residencies, but on FUNDED and ACCREDITED residencies. If they will not give us these stats, then at least one of us at each COM will need to do the research. I know my school, NYCOM, has the NYCOMEC book, listing all PLANNED, FUNDED and AOA-ACCREDITED residency spots at each of the networked hospitals.
Why are these stats important? To factually decide whether, truly, the AOA has/hasn't begun growing, expanding, and funding residency spots in proportion to the number of D.O.s graduating each year. We probably need historical data, if the AOA will give it to us. How far back? Maybe someone can help with this?

*Based on the stats, we need to ask questions...thought-provoking, guided, to-the-point questions in a setting that can be "refereed" so that no one can hide behind stoic or vague answers. Who'd be our "referee"? We need to brainstorm.
- Do we want closed-doored discussion? open to the public? open only to DOs and student DOs and the AOA?
- IF this is some "objective" of ours, we need to ask: What is being done/can be done by the AOA to insure that *all who want to* will be able to get AOA-accredited and FUNDED residency spots out of their COM?
- I think we definitely need to ask, "Does the AOA ideologically preceive itself superior, inferior or equal to the AMA?" Given the concept of "psychological complexes," if the leadership is going one way, and the students another, then something urgently needs to be done.
- Another nexus of questions to ask are: What does it mean for a residency to be FUNDED? Where do the FUNDS come from? How long before a PLANNED residency becomes FUNDED? How can we get more FUNDS to PLANNED residencies? What is the extent the AOA is involved in the FUNDING of a residency?
- On a scale of 1 to 10, How important is it to the AOA that future DOs have:
1) research experience? What is being done to increase the opportunities?
2) a desire to go to an AOA residency over an AMA residency? What is being done to further scrutinize and qualify a hospital as "worthy" of having an AOA-accredited residency?
3) a desire to go through the traditional 1-year rotating internship?

2) Talk with your classmates. Get them fired up. Get them to this page. Get them to talk with others. Get them to brainstorm with you. Get a general assessment of the overall class attitude, and report back with your school as the heading, and some categories you make up on your own. We know high-ranking people of COM's lurk here and read more than we know.

3) Run for SGA offices...high-ranking positions. Become a member of SOMA and/or other Osteopathic-related associations to begin understanding what their aims, goals and motives are. Report back here and let us all know what your assessment is. Eventually, enough people will bring a good "synthesis" of what these organizations are all about.

4) Each person should at least go to AOA's website and look up the position papers and see whether you agree. Do you want to be part of a group that feels X, Y, Z, A, D, and G, but you simply don't "jive" with their positions? It'd be sort of like joining the NRA when you support Kerry and his wishing to enact laws enforcing liability onto gun manufacturers, meaning: the gun company could be held liable for killing, injuring, maiming, hurting, grazing, dismembering, etc someone. Ask yourself, would gun companies want policemen packing their brand of weapons to shoot criminals, whose surviving family members could sue and win because of the liability laws?

Yes, this is extreme. No, the position papers from the AOA are, truly, not insane, too liberal, freakish, or haughty..in my honest opinion. To be fair, I suggest everyone go to this link and download the .pdf: AOA Position Papers
reasons for doing this: a) you're gonna be a DO, b) it's good to know the belief systems present in the system that will garner, groom, mold and shape you, c) if you happen to NOT be a pre-DO, student DO, or even a DO who hasn't read this, the educational value is outstanding, rewarding, and beneficial.


5) Make signs, placards, printouts, etc and post them in public places around school, saying things like, "What has your AOA done for you lately?" or "Truly, how many AOA residencies are there?" or " What's the AOA's stand on sodas in schools?" or "How often do you dream about your 1-year, rotating AOA internship?" Don't give people answers on the media. Let these questions fester in their minds. Report back with some assessment of the effects of this type of signage. :)


---WHERE WE WANT TO GO (with this)

1) What do we want to see happen? What demands are we gonna throw on the table? What requests do we want to make? Name a position... where do we all stand/ what's the general consensus?

2) As a group, who are WE? Are we limiting ourselves to people in DO school? residents also? board-certified DOs also? even AOA members? faculty at our schools?

3) We need to answer one question, and then, depending on the answer, we can either move forward or cause a ruckus discussing things: Do we feel we are inferior to, equal to, or superior to the AMA and MDs? [do realize here that I am asking for ideology, and the intent is to stir, churn and watch what settles. I'm not asking for chaos or bashing or condemning, etc. I am intending straightforward discussion.] With a final resolution / consensus from this "input session" we will find the clear-cut direction of our next steps. Think of this as a guage of how far the students/grads, etc feel Osteopaths have come since the older generations were given equal practice rights.


Once we decide what we're trying to accomplish, and where we feel we stand in relation to our counterparts / co-workers in the allopathic field, then we know where we're coming from and where we're trying to go...we get past those hurdles and the rest is just tweaking and number influence (see TAKING ACTION, above).

Thanks, ahead of time, for the input, if any. Let's use this as a "starting point" and let our input drive the directions from here. :D
 
undefined:D Tim I agree with you and I have come to discover that the School for DO's in Oklahoma looks like a good choice for me if I go in the profession.
If you don't mind me asking where did you graduate from? And how do you like bein a DO? My ultimate goal is to become an Anesthesiologist as well.

Thank you,

Falco3030
undefined

timtye78 said:
I like this discussion. Why aren't the young DO physicians and residents not doing much for change? It's because they are busy obtaining training or seeing patients. My best friend recently lost his spot in residency b/c the osteopathic hospital in TX has closed and the "rug has been pullen from under his feet." I do not see the AOA rushing to help him find anything yet :mad:
Then I get letters in the mail demanding my new "resident" membership fees to become a member of the AOA! What is this so-called "voice I get

I would like to see this new generation of physicians who graduate from DO schools integrate into the AMA world. It is full of bright inquiring minds and definitely a number of hostile ones as well, but overall we are accepted by them, trained by them, and supported/encouraged in our quests beyond primary care. Not to mention, they for the most part, provide more stable university or community hospitals to train in as well.

Osteopathy is not my profession!! My profession is to become an anesthesiologist!! It is tempting to suggest that "new" generation of DOs band together with the common goal of patient care excellence and training those that follow us, but the actual numbers would be relatively small, so joining the AMA, and working towards union/integration of MD and DO alike seem like the most logical direction to me.
 
:D Tim I agree with you and I have come to discover that the School for DO's in Oklahoma looks like a good choice for me if I go in the profession.
If you don't mind me asking where did you graduate from? And how do you like being a DO? My ultimate goal is to become an Anesthesiologist as well.

Thank you,

Falco3030


timtye78 said:
I like this discussion. Why aren't the young DO physicians and residents not doing much for change? It's because they are busy obtaining training or seeing patients. My best friend recently lost his spot in residency b/c the osteopathic hospital in TX has closed and the "rug has been pullen from under his feet." I do not see the AOA rushing to help him find anything yet :mad:
Then I get letters in the mail demanding my new "resident" membership fees to become a member of the AOA! What is this so-called "voice I get

I would like to see this new generation of physicians who graduate from DO schools integrate into the AMA world. It is full of bright inquiring minds and definitely a number of hostile ones as well, but overall we are accepted by them, trained by them, and supported/encouraged in our quests beyond primary care. Not to mention, they for the most part, provide more stable university or community hospitals to train in as well.

Osteopathy is not my profession!! My profession is to become an anesthesiologist!! It is tempting to suggest that "new" generation of DOs band together with the common goal of patient care excellence and training those that follow us, but the actual numbers would be relatively small, so joining the AMA, and working towards union/integration of MD and DO alike seem like the most logical direction to me.
 
Falco3030 said:
Quote from "Sun Tzu: Know thy enemy as you know thyself." That is the correct way to quote the author of the Art of War. And it bothers me tremendously that you view the AMA as an enemy I am considering becoming a DO because I agree with their approach to medicine. But as I observe and read in here I am noticing that the field is fraught with a lot of diverging views that are leading me to question my decision and perhaps I would be more inclined to pursue the MD where at least I know the AMA has their act together.

It is my firm belief to treat the patients with the utmost respect care and quality you expect to receive yourself. And if the AOA and the AMA are fighting or you DO's and DO's in school can not present yourselves as unified force then the AMA will always win. At this point I will be reconsidering my options for MD school and DO school as I am getting a very sour taste in my mouth about the profession of DO.

Regards,

Falco3030

You obviously care about patients, which is the most important thing to consider in either camp. I don't believe that the AMA is the enemy at all- the enemy lies within (and thus the Sun Tzu quote is quite relevant). The only way to "lose" this fight is to forfeit our identity and training as DO's and merge with MD's as some of the students on here suggest.


My recommendation if you are interested in anesthesiology-

I think the real issue comes down to what kind of anesthesiologist you want to be. If you plan on working outpatient in a pain clinic, OMM will be invaluable in making real strides toward permanent pain control in your patients. Usually MD's can offer little more than narcotics, muscle relaxants, steroids and antidepressants (this can be very frustrating), whereas DO's that have placed an emphasis on their osteopathic education can diagnose the structural origins of pain and treat them directly, often offering permanent improvement in patients pain with minimal medication use. For surgical anesthesia, however, the DO approach offers few if any tangible advantages. You will have to decide which approach fits you better. There are far more allopathic residencies, but you can enter the best allopathic residencies as either MD or DO if you are a strong student.


michael
 
I posted two very long posts, months ago, before entering Osteopathic medical school. Time has changed me, and I want to detail a few points I have observed.

1) I misquoted and incorrectly referenced the "know thy enemy" quote, and for that, I should be flogged with a wet noodle. :confused:

2) Enemy was the term I used to help us (whoever we are) discover, truly, what /who that entity is.

It seems that not many of the people reading have responded; I truly expected about 5 or 6 pages to read through with good discussion, and that has not happened.

There are a few main points brought up in reference to the "enemy" that I feel need to be addressed:

a) THE AMA: This group is not against "us," and, from what I can read, are truly about their *own* agendas. They have even adopted DO as a reference to "physician" instead of it solely being MD. (There was a thread on this topic months ago, and I could not find it today.)

b) WITHIN: Groups have their own "psyche" due to the values, beliefs and systems the members of that group establish and uphold. Therefore, I referenced the AOA's stance paper for insight.

Therefore, I also contend that, unless we get some sort of "measure" of the psyche of the AOA, the current COMs, residents and certified DOs, "we" students are going to sit by and watch the potential for "accentuating that DOs, *because* they practice OMM, are unique"-- a reference to a general point made in Gevitz's speech to us 1st years at NYCOM, during Orientation Week, as being the next step in our evolving as a profession.

Dr. Gevitz set it in stone for me about my "position" as a future practicing DO:

I am not different than an MD student; that has already been legally established. I am unique because I am learning to approach a patient with a set of mental/philosophical "tools" as well as the "tool" of being able to treat somatic dysfunctions with my hands.

Here is what my position is, formally voiced:

Instead of DOs incorporating with MDs and losing our uniqueness, at every point of junction where it's medically judged proper to treat using OMT, we need to.

I finally found, what I think to be, the "voice" that "we" need to develop, erasing the question of an "enemy within," unless you choose not to develop that voice.

3) No one has clearly defined the "we" I proposed that should be found.

Ideally, it'd be every future and present DO; experience tells me that's not going to happen. Modulating down to the clearest view of what "really" is possible, I'd say that "we" should be defined as:

"Those who are studying DO philosophy and treatment modalities, who support that uniqueness, and who, at any possible juncture within proper medical judgement, consistently choose to implement OMT."

This takes care of students, residents and certified DOs, as well as patients who ask for OMT, and and and those inquisitive-minded MDs who are under way at Harvard, learning OMT techniques. I'm learning that it's not enough for the DO to know his/her stuff, it's also a patient education issue, and as more patients learn about efficacy, the more they should ask for it.


4) As far as education issues go, money is the short answer, and imposing stricter standards is the most-influential suggestion made. It's pretty clear to me that the positions at hospitals this year for 3rd and 4th year rotations will be different for me in my 3rd year because of money exchanges and connections.

Residencies, I know jack diddly squat about, and can only read from different sites about the integration of OMT into that residency. Hopefully, the more OMT is stressed, the more that DO is likely to practice OMM when s/he is out practicing. I honestly think OMT should be stressed wherever it can be medically and feasibly integrated. This comes down to the AOA enforcing guidelines on AOA-approved residencies, and those residency directors employing DOs who integrate OMM into their practices.

Does anyone know of a study saying whether DOs who are residency-trained with integrated OMT actually use OMT in practice? Maybe such a study would be able to give direction to policy change, or give insight into what could be done better.

5) In reading another thread, I found this quote by healthydawg:

"before i fall off my soapbox, let me offer at least one possible cure for this malaise. that is to get the AOA, ACOFP, ABCDE, XYZPDEQ and whoever else is running this show to STOP FRETTING ABOUT WHERE WE ARE IN RELATION TO THE MDs. WE WON THAT BATTLE...ENOUGH ALREADY! WE'RE DOCTORS! rather, we should be working day and night to develop REAL research programs in our schools, hospitals (all 6 of 'em), non-profits, etc. REAL PROGRAMS that do BASIC SCIENCE research AS WELL AS clinical (OMT) research. real programs as in the kind that produce scientists (PhDs) who can seriously study OMT and every thing else. give me some real reasons to have as much faith in OMT as i do in abx."
http://forums.studentdoctor.net/showpost.php?p=1989575&postcount=36

I think healthydawg has very correctly given definition to the direction we need to go in: validate OMT by studies.

My questions at this juncture are:

Does anyone know how to get funding for research?

Does anyone know someone who knows how to get funding?

Does anyone have any experience with research design?

Is researching these techniques as easy as saying, "Ahh.. headache without aura. We will suppose no difference in pain reduction (over time?) between treating with aspirin, treating with aspirin and cervical HVLA to the OA joint with myofascial release to the OA joint, and only cervical HVLA and myofascial release"?

Does anyone know what the standards are that need to be met in an OMT study to be determined "reliable" and to be "accepted" by the scientific community?

I will leave off with this post for now, and I hope, when you incorporate it with the first two posts I wrote, you get some more direction.

I encourage more people to place themselves at the edge of the envelope and keep going. Stop the cycle of complex inner turmoil of being someone in relation to someone else; develop your unique "tools" and try showing others around you that it's cool if they develop and use theirs. ;)
 
We are a unique group of individuals who thoroughly look at the true causes of a disease, and not merely its symptoms. I know of more DO's saving lives, than their MD counterparts.

I have worked on a post-surgical floor, where both MDs, and DOs practice, and most of the patients, I have taken care of, have told me that it was a DO, not an MD, that relieved their pain; finding the true anatomical anomaly that was causing such anguish. Most MD's don't have the concept to tell their patients to change their behavior or enviroment, as well as looking at socioeconomic/psychosocial patterns.

Most DOs provide thorough tests and evaluations to find the truth, instead of trying to treat the symptoms. DOs treat the very cause of illness.
One patient of mine told me that he had seen three MDs before he saw a DO, where he had symptoms of Shortness of breath, malaise, and back pain. It was the DO that found a 4 cm AAA in the patient's abdomen.

I am very proud to be going to Osteopathic Medical School because I full heartily believe in the philiosophy and logic behind Osteopathy. A physician who disagrees with the benefits of touch;massage; the removal of blockage and strain on the nerves, blood vessels, joints, bones and muscles; proper exercise; proper sleep; eating in moderation; proper hygiene; and having an healthy attitude, is not a physician at all.

We still see the Mega Drug Corporations making millions, while flying doctors to Hawaii, or taking them out for Brunch, trying to persuade doctors to sell these toxins. Some drugs are okay, and have a high efficacy and low toxicity, but many patients I see take drugs to counteract the symptoms of other drugs. I honestly hate medicine doctors because they only focus on the symptoms, and don't look deep into a patients history, nor do they question the way the patient is living. Some drug breakthroughs are a miracle (antibiotics, aneasthetics, etc.), but most drugs perhaps do more harm than good. As physicians we should be skeptical of these drugs, and demand proper research, and thorough investigation from independent laboratorys that have nothing to gain financially.

DOs learn from nature, observation, and touch. We look beyond the symptoms, and look at the true cause. We believe the body has a natural tendency to want to be healthy, and when disease prevails, there are anatomical and physiology abnomalities that exacerbate and ****** that tendency.

I disagree with Dr. Joseph Mercola's biased article, "The Paradox of Osteopathy," where he states, "A decreasing interest in osteopathic manipulation may also indicate that more physicians enter osteopathic medical school not as a result of a deeply held belief in the osteopathic philosophy but after failing to be admitted to allopathic medical schools. The osteopathic physicians who are more committed to osteopathic manipulation tend to be more likely than their colleagues to have a fundamentalist religious orientation. "
I am not a fundamentalist religious person, and I know many students who have only applied to DO schools. I was in an allopathic medical school, but I changed my mind after interviewing many of my patients, and talking with many DOs. I realized that at allopathic schools, you focus not on the person, and try to prevent certain behaviors, but to simply treat the symptoms, and partly the disease. Half assed medicine in my opinion.

Dr. Joseph Mercola even questions why we even have DO's in America today, or even the benefit of OMT. There have been many articles written, including The New England Journal of Medicine that show overall health benefits, and reduction in pain from the use of OMT. The efficacy of OMT has been shown, and also published in many articles. I have seen the efficacy with my own eyes, and you can ask any number of patients who have seen a DO that they not only were relieved of their pain, but the overall costs, and time in the hospital were decreased.
 
I am a PM&R resident at the University of Michigan, one of the largest and most "respected" allopathic hospitals in the country (not boasting, I'm saying this to make a point).

I use OMM every week on my patients. MD and DO Attendings in my program regularly refer patients to me for OMM.

We have an MD attending on faculty who does OMM full time, and has excellent skills.

If OMM does not work, we have PT/OT, medications, orthotics, or spinal injections such as epidurals and facet blocks to use.

My point is, if Dr. Still's vision was to improve medicine, he has helped to do so here, at least. Goal accomplished in my book. Vice Versa, the allopathic world has improved the care I can give to my patients.

Most of the PM&R docs I have worked with are very osteopathic in approach.

Best, Ligament
 
Firstly, let me just say that I am humbled to observe the type of enthusiasm exhibited by all the people who invest in this forum. One of our degree's major challenges has always been to become like our counterparts even subsequent to the legalization of the D.O degree as an equal to the MD. A challenge, that has been overcome with great velocity over the past few decades. However, as we all now, there is much more work to be done.

From reading the numerous threads posted, I am ambivalent about the notion adopted by nearly everyone here. As I do understand that there is a need for change in medical education among osteopathic med schools, I also think more diplomatic attempts are indicated first. We constantly complain of the lackadaisical attitudes of the AOA in regards to augmenting the quality of medical education, medical professional representation, and OMM research. We talk about the dearth in clinical research at D.O schools, namely in regards to OMM and we even talk about ranking low in terms of NIH funding for basic science and clinical research. These are all valid and crucial points and require attention to sustain the merit of our medical education; however, I feel that more diplomatic approaches are indicated first.

Research
We discussed the need for an increase in NIH funding among DO medical school. However, the fact is that most DO schools don't have the experience or resources in order to compete with high quality grant proposals compiled by competing schools. As a result, NIH funding to most DO schools is low.

Secondly, most DO schools don't provide enough of an incentive to their faculty to apply for these research grants (most likely due to the fact that these schools don't put enough of a significance on research); thereby, decreasing the necessary publication output.

In terms of OMM, we talk about design flaws. A common problem in performing OMM research is the high level of subjectivity of physician perception. As a result, the study loses its objectivity and impedes the significance. Therefore, an institution needs to create a quantitative method for ascertaining the significance of change before and after OMM treatment.

We also need to team up with major institutions to aid us in OMM research. I believe it was mentioned in this forum that Harvard is teaching its trainees OMT. Also mentioned in some literature I was reading some time back, Harvard researchers found basic science findings that imply a valid efficacy of OMT. This is the precise collaboration that is necessary in order to validate OMT. Of course, the question remains - if the treatment helps a patient; what's the purpose of the study? Well I think most of us know the consequences of our medical system shifting towards the Evidence Based approach. Ergo, no evidence = no compensation (figured that would be important to most of you)

In conclusion to the research aspect, it's essential that institutions motivate their faculty to perform research and provide incentives to do so. It would also be beneficial if our esteemed AOA could provide grant writing courses as CME for physicians and scientists who are interested in augmenting research at their institutions. Research is definitely a wave of the future and if our schools don't keep up, the consequences are obvious.

Proliferation of Schools
The major fear that I have of an increased number of schools is a direct decrease in the quality of the applicant pool. Although the AOA and AMA are working together to eradicate the physician shortage that faces our nation today; an increase in the number of medical school is only going to drive down the quality of the applicant pool. Secondly, as others mentioned, is the AOA willing to increase the quality and quantity of post-graduate programs? If the answer is no, then why open up new medical schools when you can't sustain the needs of the ones that already exist? One of AOA's major problems is that it acts most prematurely during times that warrant rationalistic thinking. Not to get me wrong, I don't think that we should do away with AOA as after all, it does play a large role in political inner workings of our system and fights for students; but I do feel that more attention should be tendered to the medical education and less towards making OMT brochures.

In conclusion, I feel that we need to come up with a plan on how our medical schools can retain the quality of education without becoming obsolete. One of the ways we can do this is might be by creating medical schools at prominent universities that don't yet have them. This affiliation creates greater resources for our medical schools and adds distinction to our degree. This is the exact thing that our "profession" needs if it wants to succeed socially, academically, and politically.

Publications
This is something that hasn't been discussed a whole lot. Although we speak of Norm Gevitz's book and various articles that have been published about osteopathic medicine; my take on achieving a positive image in the media is BECOME PROMINANT IN MEDICINE. That doesn't mean that all our students and faculty need to win Nobel Prizes (although it sure does help!); but it doesn't hurt students and attending to publish a few case reports here and there. The initials D.O after a paper further propagates our recognition and visibility in the academic world. I often peruse MDConsult and JAMA among the other medical journals I subscribe and it's alarming to see how little our attendings and students contribute to medical literature. I understand that medical school and practice life are busy but if you're not going to contribute to Medicine while you are in your academic stage, then when?

My Final Conclusions
Becoming an osteopathic physician is no different than becoming an allopathic physician. Both are highly qualified professionals that serve humanity in their quest to combat suffering. Just as there are good osteopathic physicians, there are good allopathic physicians; and there are numerous allopathic physicians that are more "osteopathic-minded" than some of us will ever be. Everyone has their own reasons for becoming a D.O but in the end, it's up to us to gain the recognition we strive for.

As a result, it's healthy and essential to talk about all the things that are wrong with the system so we can fix them later. As a younger generation of D.Os, it is up to us to change how our organization represents us by taking action and offering solutions to the problems. I, for one, would be thrilled to collaborate with others to enhance the quality of medical education for us and the next generation.

(Sorry about the amazingly long post!)
 
drusso said:
Uacharya,

I think that you've summarized the problems well. How about potential solutions?

I believe I've provided potential solutions; however, only after others acknowledge the necessity for change can one commit a plan of action.
 
I fully agree with Uacharya: Instead of having mushroom-like private osteopathic schools that look like the Caribbean private medical schools; the best remedy would be to have more Michigan-state U-like, Athens-Ohio-like and UMDNJ-like osteopathic schools that are part of the reputable universities.
 
Top