AACOM Response to "The Unintended Consequences of the ACGME Merger"

[ToKingdomCome]

Yea I don't see biases going away very quickly, and I doubt they'll ever really go away at "elite" med schools. It's pretty lame if they discriminate against "low" tier MD school applicants anyway. I don't know who'd wanna train with people that arrogant.

Edit - People who are more concerned with what their mom or mom's friends think of them probably go for that ***t

Hahahaha this made me crack up "dit - People who are more concerned with what their mom or mom's friends think of them probably go for that "

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Members don't see this ad.

 

[Bender B Rodriguez DO]

The response does nothing at all to address most of Dr. Gevitz's core arguments, including the impending redundancy of the AOA specialty colleges. Nor does it address the concern of many in the DO world that respected PD's will no longer be able to retain leadership over their programs if they were trained by the AOA, or any of the other issues which have been brought up, such as the fact that the ACGME had made no assurances whatsoever that programs will stop discriminating against DO applicants.

And awesomewhatever: there are reasons why good programs might not meet ACGME standards which have nothing to do with the program's outcomes. Likewise, there are reasons why solid DO schools (again in terms of actual outcomes) may not meet LCME standards. Please do some research on this before making long posts on the topic.

So what if some PDs are lost? Ultimately the merger is in our best interest. Yes, the AOA should push to keep them, but if their positions are lost, why should I care?

 

[Trannie]

So what if some PDs are lost? Ultimately the merger is in our best interest. Yes, the AOA should push to keep them, but if their positions are lost, why should I care?

You want the honest cold truth that everyone here neglects to say? Basically no one cares if those PD's get demoted. Why? Because you will still get:

1. MD's directors who will still match DO if the institutions are considered "osteopathically-focused" and/or have a lot of DOs on the residency committee which these AOA programs already have.
ORRRRR

2. As people fail to mention: there are still DO physicians that are ACGME board certified who can take their positions and continue the business as usual.

Verdict: no one really cares for those poor PD's. The ONLY reason some people may be whiny about it, is because they fear their own residency application may be hindered, but no reason beyond that.

 

[SnowDoggy44]

You want the honest cold truth that everyone here neglects to say? Basically no one cares if those PD's get demoted. Why? Because you will still get:

1. MD's directors who will still match DO if the institutions are considered "osteopathically-focused" and/or have a lot of DOs on the residency committee which these AOA programs already have.
ORRRRR
2. As people fail to mention: there are still DO physicians that are ACGME board certified who can take their positions and continue the business as usual.

Verdict: no one really cares for those poor PD's. The ONLY reason some people may be whiny about it, is because they fear their own residency application may be hindered, but no reason beyond that.

I think some people, including myself, fear that losing AOA-boarded DO PDs may lead to a loss of osteopathically-focused residencies or perhaps a reduction in the quality of osteopathic-related training in said programs. I hope this is a fair concern.

 

[dyspareunia]

I think some people, including myself, fear that losing AOA-boarded DO PDs may lead to a loss of osteopathically-focused residencies or perhaps a reduction in the quality of osteopathic-related training in said programs. I hope this is a fair concern.

From my understanding there are very few DOs who actually practice OMM and I think we can all agree that DO schools are being filled with an ever increasing number of failed MD applicants so it follows that very few DO students actually care about Osteopathic medicine.

 

[OCDEMS]

I have been surprised by the number of people willing to sell the DO program directors down the river. The comment about them "having other things to do" was particularly concerning, as if a bunch of (predominately) medical students on SDN are the authority on dictating what they can and cannot do with their lives. I'm sure there are plenty of AOA-boarded program directors who enjoy their job for a variety of reasons, not least being the ability to shape the careers of future osteopathic physicians.

Listen, I'm pro progress. That doesn't mean it's acceptable for any member of a profession to just give up on those that came before them. Grandfathering has been used in medicine before and there is no reason why we, as students, can't rally behind the idea of AOA-boarded PDs being fully grandfathered as part of the merger. The details of that process are up to the adults to decide, but we should stand behind it. It was the one major issue with the merger that I think most people can agree is sort of messed up.

 

[Bender B Rodriguez DO]

I have been surprised by the number of people willing to sell the DO program directors down the river. The comment about them "having other things to do" was particularly concerning, as if a bunch of (predominately) medical students on SDN are the authority on dictating what they can and cannot do with their lives. I'm sure there are plenty of AOA-boarded program directors who enjoy their job for a variety of reasons, not least being the ability to shape the careers of future osteopathic physicians.

Listen, I'm pro progress. That doesn't mean it's acceptable for any member of a profession to just give up on those that came before them. Grandfathering has been used in medicine before and there is no reason why we, as students, can't rally behind the idea of AOA-boarded PDs being fully grandfathered as part of the merger. The details of that process are up to the adults to decide, but we should stand behind it. It was the one major issue with the merger that I think most people can agree is sort of messed up.

We are the future. They are the past. For a bunch of people that train residents "out of the goodness of their heart" because they believe in the continuation of the profession, they should be willing to sacrifice themselves for the greater good. Gevitz says 500 MDs didn't match. Would he prefer 500 MDs do match and thousands of DOs be out on the street? I made an investment by going to a DO school. They better honor it or they can expect many lawsuits from thousands of graduates. Grandfather the PDs if you can. If not, too bad.

 

[NeuroLAX]

I appreciate and acknowledge the utility of OMM, and I do not under any circumstance endorse getting rid of OMM. However, I see it being more of an asset to the medical profession as its own niche than as an entirely separate profession. All medical students should have the opportunity to learn OMM if they are interested. I'm not sure how the AOA and ACGME plan on handling prerequisites in OMM at the undergraduate level, but hopefully we will see an expansion of interest within the MD community, especially amongst the students that had a genuine interest in learning OMM but for one reason or another chose to attend an MD school. Likewise, special programs should be established at residency programs so these students can continue OMM education/training, have opportunities to pursue a fellowship, or perhaps eventually be recognized with board certification in osteopathic medicine. Something similar already exists with education in integrative medicine. The University of Arizona even has a special curriculum devoted to teaching medical students about integrative medicine throughout all four years. Certain FM, IM, PM&R, and Preventive Medicine residencies have an Integrative Medicine in Residency (IMR) program that respond to ACGME competency-based education objectives. There are fellowships as well as the opportunity to be board certified. Overall I think OMM can be implemented and grow under a similar model. Obviously OMM cannot be learned through online distance modules like IMR, but the infrastructure is already present at current AOA programs, so any new school/program could seek the guidance of these programs and the AOA as they establish their new program. AOA-trained physicians may even be recruited to start these types of programs across the country.

I'm very optimistic about the merger. I do understand why some people are upset about DO PDs potentially being canned/babysat/etc. However, I am confident that this issue will be sorted out as the discussions continue.

 

[Drrrrrr. Celty]

As I've said before... Osteopathic medicine should be examined as what it is. A paradigm of medicine that encorperate a particular philosophy and upholds the existence of OMM both by practice and by research.

I think in the end both school be fused and OMM critically examined for uses as a educational modality and as a methodology in clinical settings.

I think the ACGME and LCME will be cool about it and everyone will be happy. But obviously many people act as if any and all change is radical and destructive to the profession.

 

[OCDEMS]

We are the future. They are the past. For a bunch of people that train residents "out of the goodness of their heart" because they believe in the continuation of the profession, they should be willing to sacrifice themselves for the greater good...

Ok, selfish, but ok. Just make sure you're the first in line to fall on the sword in 20-30 years when, and if, someone comes for your job to satisfy the younger generation.

I'm not sure how the AOA and ACGME plan on handling prerequisites in OMM at the undergraduate level, but hopefully we will see an expansion of interest within the MD community, especially amongst the students that had a genuine interest in learning OMM but for one reason or another chose to attend an MD school....

I haven't written this here, mainly to avoid hysteria, but regardless of what the AOA thinks about the OMM prerequisite I have heard that some MD schools are already planning to prepare their students for the merger, which tells me that they (LCME accredited schools) already have an idea regarding what the prerequisite will and will not be. I overheard two students in my class talking about how two of their friends, at separate MD schools, were told by their faculty that their individual school would be making preparations to address the topic of an osteopathic prerequisite for residency entry. When I asked these two students for clarification, I was specifically told that one school may actually be adding a week to their second year for a basic introduction to OMT.

What does this tell me? Possibly nothing. It could be complete BS. These two students didn't have any more details but I found the specificity of "one week" to be oddly compelling, given that 1-2 weeks/a weekend was the amount of time floating around on SDN as a hypothesized bridge-program. If true, it means that there are parties out there on both sides of the fence that are much more knowledgeable than any of us. It also implicitly means that some MD programs are preparing their students for exactly what was considered a possible scenario on these forums: rapid MD entry into previously DO-only specialities. It also tells me that the deans at these schools are working on the understanding that the osteopathic competency requirement will be somewhat farcical, since even the most strident critics of OMT will acknowledge that it takes more than a week to be competent with the portfolio of techniques in manipulative medicine, regardless of your opinion on their effectiveness.

I'm still not anti-merger, but I do think that these are the types of details that all parties need to be aware of. You're going to want those DO program directors hanging around when the competitiveness of previously protected DO residencies suddenly increases. The merger needs to happen, but it needs to occur with adequate protections for all parties involved, MD and DO students. MD students need to at least be facile with osteopathic techniques to enter osteopathically-focused residencies (not experts), especially in the primary care arena where they are performed more frequently. Likewise, DO students need some assurance that, while competition may increase, that they will be looked at on relatively equal footing.

 

[NurWollen]

I think keeping current AOA-trained PD's after to merger is complete is in our (current generation of students) best interest. It's the best guarantee that current AOA programs stay DO-friendly.

 

[Bender B Rodriguez DO]

Ok, selfish, but ok. Just make sure you're the first in line to fall on the sword in 20-30 years when, and if, someone comes for your job to satisfy the younger generation.

I wouldn't be doing it out of the goodness of my heart. I would fight for my position because it would be in my best interest. I'm doing the same right now. But either way, you massively discount that this scenario affects the entire profession for generations. I have no problem being selfish. I think they are also selfish, so I'm acting in my best interest the same way they are.

 

[GUH]

So what if some PDs are lost? Ultimately the merger is in our best interest. Yes, the AOA should push to keep them, but if their positions are lost, why should I care?

Shame on you.

From my understanding there are very few DOs who actually practice OMM and I think we can all agree that DO schools are being filled with an ever increasing number of failed MD applicants so it follows that very few DO students actually care about Osteopathic medicine.

Prove it. Just because you and a few others here failed to become MDs doesn't mean that all or most DO students want their profession to disappear.

 

[GUH]

I appreciate and acknowledge the utility of OMM, and I do not under any circumstance endorse getting rid of OMM. However, I see it being more of an asset to the medical profession as its own niche than as an entirely separate profession. All medical students should have the opportunity to learn OMM if they are interested. I'm not sure how the AOA and ACGME plan on handling prerequisites in OMM at the undergraduate level, but hopefully we will see an expansion of interest within the MD community, especially amongst the students that had a genuine interest in learning OMM but for one reason or another chose to attend an MD school. Likewise, special programs should be established at residency programs so these students can continue OMM education/training, have opportunities to pursue a fellowship, or perhaps eventually be recognized with board certification in osteopathic medicine. Something similar already exists with education in integrative medicine. The University of Arizona even has a special curriculum devoted to teaching medical students about integrative medicine throughout all four years. Certain FM, IM, PM&R, and Preventive Medicine residencies have an Integrative Medicine in Residency (IMR) program that respond to ACGME competency-based education objectives. There are fellowships as well as the opportunity to be board certified. Overall I think OMM can be implemented and grow under a similar model. Obviously OMM cannot be learned through online distance modules like IMR, but the infrastructure is already present at current AOA programs, so any new school/program could seek the guidance of these programs and the AOA as they establish their new program. AOA-trained physicians may even be recruited to start these types of programs across the country.

I'm very optimistic about the merger. I do understand why some people are upset about DO PDs potentially being canned/babysat/etc. However, I am confident that this issue will be sorted out as the discussions continue.

I agree that it's great to give others exposure to OMM (even if it's merely superficial), but lumping it in with "integrative medicine" places OMM in the same category as things like homeopathy, which is not what we should aim for. As someone said in a previous post, it would make more sense for it to be treated as a medical specialty (assuming that it does not remain a distinct profession).

 

[Dr. Zombie]

I agree that it's great to give others exposure to OMM (even if it's merely superficial), but lumping it in with "integrative medicine" places OMM in the same category as things like homeopathy, which is not what we should aim for. As someone said in a previous post, it would make more sense for it to be treated as a medical specialty (assuming that it does not remain a distinct profession).

It makes sense to just make everyone MD and have FM/NMM and OMM residencies.

Unfortunately, the executive positions on these osteopathic academic and GME boards would be rendered obsolete and they would rather keep their jobs than to make the best decisions for their osteopathic physicians.

 

[dyspareunia]

Shame on you.

Prove it. Just because you and a few others here failed to become MDs doesn't mean that all or most DO students want their profession to disappear.

I'm an MD student. From perusing the pre-DO forum I've gathered that DO school interviews are very much like MD school interviews with the addition of "Why DO?". That in itself is evidence that DO schools are aware there are many MD wannabes (for lack of a better term) applying and want to weed them out. There's also the fact that DO schools have become better known in recent years, which resulted in an increased number of applicants. Since MD schools get more applicants than DO schools it follows that much of the increase in DO admissions was due to applicants who in previous years would've only applied to MD schools; likely because they didn't know DO schools existed.

Also, what exactly is the "DO profession"? A DO is just an MD that learned how to do OMM and given the fact that most DOs don't even use OMM, I'd say there isn't anything separating the average DO attending from the MD attending.

 

[Apprands31]

I am a DO student. We should not have to rely nor be afraid of competition. To say we have to keep DO PDs in order to "protect our residencies for our students" cheapens our degree.

 

[Trannie]

Shame on you.

Prove it. Just because you and a few others here failed to become MDs doesn't mean that all or most DO students want their profession to disappear.

LOL!!??? Please explain to us what do you mean by the "DO profession"??? Because the last time I checked, the DO profession is the same as the MD profession with a few hundred hours of OMM.

How is converting all schools under LCME, and (like another poster mentioned above) still preserving OMM as an elective and keeping OMM residencies---how is it a failure to preserve the "DO profession"???

The "DO" degree shouldn't have gotten to the level that it did solely under the basis of OMM which has been poorly researched to begin with. It should have either stayed under "osteopathy" or implemented under electives in MD schools and/or made into ACGME residencies.

No country should've allowed an entire new medical school system and an entire branch of residencies simply because of a few hundred hours of OMM.

In today's times, maybe if DO schools actually matriculated more research-prone applicants, then we can get this long-waited substantial OMM research underway. But guess what? we are stuck with mid to low-tier applicants (and the rare few high-tiers who are more likely to wanna specialize) with small to no desire to be research pioneers --> into DO schools that make little effort to pave the way for good research but wanna increase class $ize, so of course OMM will stay obscure and undermined by MD physicians.

Glorious be the day LCME takes over all the schools! In the meantime glorious be the day the merger goes into full effect!

 

[Drrrrrr. Celty]

The reality is we shouldn't be fighting it. We should be embracing it and preparing for how to maximize DO's place in the new ACGME/LCME systems.


We need to aim to be the best we can and be the strongest in the new system. That way we will pave a better future for us all.

 

[petyr_baelish]

What does everyone think about Gevintz' statement that the LCME has strict standards and expectations for accreditation that some DO schools can't meet? He claims that DO schools have less, not to mention tuition-based, revenue and larger faculty-to-student ratios.

Are we banking on DO schools to increase revenue (*cough* tuition) to reach those LCME standards? Gevintz assumes that the LCME will not change their standards which I think is fair.

Despite evidence that our private schools
produce a competent annual cohort of individuals well prepared for
graduate medical education, the LCME finds this model utterly
incompatible with its long-held standards and expectations.

I am worried about schools closing down and a few thousand medical students getting left up a creek without a paddle in the middle of their degree.

 

[Bender B Rodriguez DO]

Shame on you.

Oh I'll now go cry and feel terrible because I think thousands of students now and to come should be prioritized over some PDs I have never met and don't care at all.

What does everyone think about Gevintz' statement that the LCME has strict standards and expectations for accreditation that some DO schools can't meet? He claims that DO schools have less, not to mention tuition-based, revenue and larger faculty-to-student ratios.

Are we banking on DO schools to increase revenue (*cough* tuition) to reach those LCME standards? Gevintz assumes that the LCME will not change their standards which I think is fair.


I am worried about schools closing down and a few thousand medical students getting left up a creek without a paddle in the middle of their degree.

The premise rests on the ridiculous assumption that DO schools would be forced to meet LCME standards. He argues that if DOs don't accept, the MDs will take to the media. That's ridiculous considering they didn't and couldn't do it in the past -- much less now with the size of DOs today. Slippery slope is one of the fallacies you learn in Intro to Philosophy, but apparently the grand Sociologist Gevitz didn't get the memo. MDs have no interest in destroying DO schools. If anything, DO schools help them get qualified American graduates. The alternative scenario of closing DO schools would mean Caribbean schools proliferate and keep buying rotation sites the MDs want.

 

[D4C]

What does everyone think about Gevintz' statement that the LCME has strict standards and expectations for accreditation that some DO schools can't meet? He claims that DO schools have less, not to mention tuition-based, revenue and larger faculty-to-student ratios.

Are we banking on DO schools to increase revenue (*cough* tuition) to reach those LCME standards? Gevintz assumes that the LCME will not change their standards which I think is fair.


I am worried about schools closing down and a few thousand medical students getting left up a creek without a paddle in the middle of their degree.

Most DO schools are private, where do you expect their funding to come from? Generous donations from alumni? Not quite sir, but wouldn't that be nice (maybe I'd get a break on tuition then)
When, and I really do believe it to be a matter of time, the LCME takes over accreditation, DO schools that do not meet the standards should and will be shut down. What will happen to the current students? Perhaps the school will be allowed to graduate them, but not take in anymore students.

 

[Dochopeful13]

Osteopathic schools are not going anywhere in the near future. Twenty years from now might be a different story though.

 

[meliora27]

When is the final vote on this? At the house of delegates meeting in Chicago over the summer?

 

[OCDEMS]

I don't think you'll see osteopathic schools go anywhere, which is why the LCME accreditation issue is a nonstarter, as others have mentioned above. If anything, they'll continue to increase in number and entrance will become more competitive. Why?

1) Despite what anyone on the opposing side will say, come 2020 there will be zero difference between the two professions from a practical standpoint. There really isn't now, but the merger will virtually eliminate any perceived downside to going the DO route for most applicants. The last vestiges of an argument against the osteopathic profession will have been eliminated since all GME will be under one roof.

2) No one is going to challenge DO expansion. At least not anyone important. State governments hear "more doctors" and zero financial outlay. The federal government hears "primary care."

3) DOs have the better public argument. The American public loves a cowboy, a disrupter, or whatever you want to call it. People inherently distrust organized medicine and osteopathic medicine bills itself as the reformation. Plus, for a variety of reasons, DO schools produce more primary care physicians. From a taxpayer's standpoint, DO education is cheaper. Do you really think anyone in the public is going to perceive the MD world as anything other than a bully if they tried to eliminate the DO profession now? I think the AOA/ACGME knows this more than we give them credit for and that the 8 member representation you see on the ACMGE board is more than rainbows and butterflies.

Finally, 28% of any organization is a tremendous amount of power. A lot of people on the ACMGE board are about to gain 8 new friends who will be a very cohesive and formidable voting bloc. Let's get past voting on strictly osteopathic issues. What happens if you piss off the DOs or you let DO discrimination run rampant among program directors? What happens when you go to vote on something more contentious and more pressing for the larger medical community? Do you really want 8 people unified against your position? Very soon, if you want to get anything done, you're likely going to need the DOs on board with the plan. I don't know about anyone else, but that's a level of influence that the osteopathic profession has never wielded before and it could be a powerful influence for change.

 

[Drrrrrr. Celty]

I don't think you'll see osteopathic schools go anywhere, which is why the LCME accreditation issue is a nonstarter, as others have mentioned above. If anything, they'll continue to increase in number and entrance will become more competitive. Why?

Your point 1 explains it clearly.

1) Despite what anyone on the opposing side will say, come 2020 there will be zero difference between the two professions from a practical standpoint. There really isn't now, but the merger will virtually eliminate any perceived downside to going the DO route for most applicants. The last vestiges of an argument against the osteopathic profession will have been eliminated since all GME will be under one roof.

Why then be distinct? Why have a different degree? Why have a different licensing exam? Why not use the same accrediting body for medical schools? Why not use the same application service... etc etc.

2) No one is going to challenge DO expansion. At least not anyone important. State governments hear "more doctors" and zero financial outlay. The federal government hears "primary care."

Banks and the Federal government will challenge it when it becomes evident that students aren't matching and thus not paying their loans back.

3) DOs have the better public argument. The American public loves a cowboy, a disrupter, or whatever you want to call it. People inherently distrust organized medicine and osteopathic medicine bills itself as the reformation. Plus, for a variety of reasons, DO schools produce more primary care physicians. From a taxpayer's standpoint, DO education is cheaper. Do you really think anyone in the public is going to perceive the MD world as anything other than a bully if they tried to eliminate the DO profession now? I think the AOA/ACGME knows this more than we give them credit for and that the 8 member representation you see on the ACMGE board is more than rainbows and butterflies.

Most people don't know that DO's exist, nor do they understand the distinction. People are interested in doctors that treat them well. If tomorrow the MD world eliminated the DO profession, more than 80% of the population would be affected or care.

Finally, 28% of any organization is a tremendous amount of power. A lot of people on the ACMGE board are about to gain 8 new friends who will be a very cohesive and formidable voting bloc. Let's get past voting on strictly osteopathic issues. What happens if you piss off the DOs or you let DO discrimination run rampant among program directors? What happens when you go to vote on something more contentious and more pressing for the larger medical community? Do you really want 8 people unified against your position? Very soon, if you want to get anything done, you're likely going to need the DOs on board with the plan. I don't know about anyone else, but that's a level of influence that the osteopathic profession has never wielded before and it could be a powerful influence for change.

You do realize that's an argument for a bipartisan catalyzation right? If the DOs on the council vote as one head or hard line then eventually the MDs will as well. And in the end 72 > 28. The DOs will be influential and be able to strongly defend themselves if necessary.

 

[Dochopeful13]

Is the lcme accreditation issue currently being discussed/voted on?

 

[Dochopeful13]

A final vote on what?

 

[chizledfrmstone]

Is the lcme accreditation issue currently being discussed/voted on?

No.

 

[MUSCULOSKELETAL23]

Can you elaborate?

MD attending to DO resident: how many times have you put on patient? what year are you again?
DO resident: once I will be a pgy 3 next july

why did that happen above?? because central lines need to be done by surgical residents first not IM residents.

This is one of example. some AOA(not all) are in programs that give no opportunities to do procedures. MD attendings consider DO residencies as "cushy" life style. some hospitals have 30 surgical residents in 220 bed hospital or less run by AOA. Residents have to be on waiting lists to scrub in for Hartman surgeries. AOA surgical residents that I rotated with claimed that they fulfill requirements. Only fulfilling Requirement is not good for future surgeons. Ask ACGME surgical residents. They do way more than "requirements".

 

[MUSCULOSKELETAL23]

The Post above is regarding to my previous post that mentions that MDs mocking DO residencies

OCDEM says
3) DOs have the better public argument. The American public loves a cowboy, a disrupter, or whatever you want to call it. People inherently distrust organized medicine and osteopathic medicine bills itself as the reformation. Plus, for a variety of reasons, DO schools produce more primary care physicians. From a taxpayer's standpoint, DO education is cheaper. Do you really think anyone in the public is going to perceive the MD world as anything other than a bully if they tried to eliminate the DO profession now? I think the AOA/ACGME knows this more than we give them credit for and that the 8 member representation you see on the ACMGE board is more than rainbows and butterflies.

my response
"people inherently distrust organized medicine" this sounds like most patients are hipster wannabe or something. according to ACGME when AOA/ACGME merger failed, ACGME claims that 60percent AOA residency attendings are MD. so ACGME can say that AOA itself was taught by MDs. "reformation" could not be done under MD teachings. Dear "reformation" groups AOA/AACOM/DOs what book are you reading in first two years?? textbook written by MDs. Just like Gevitz, ACGME can say they are seeking for unified organization to serve publics and patients better.

 

[OCDEMS]

You do realize that's an argument for a bipartisan catalyzation right? If the DOs on the council vote as one head or hard line then eventually the MDs will as well. And in the end 72 > 28. The DOs will be influential and be able to strongly defend themselves if necessary.

Except that's not how voting on a board works. Sure, you're right about the difference when it comes to voting on something purely not in the interests of the DOs, but what happens when someone on the board needs their pet project approved? Grudges can last a long time and there are multiple organizations at ACGME with varying long-term political goals that are not always going to line up. Example: The American Hospital Association, who is a constituent member, is not always going to have the same view on things as the other organizations. The same goes for other members. This is how you utilize leverage. It only requires that you wait until there is dissent among the original members and that you carefully insert your votes on the side that's willing to work with you best in the future. Finally, depending on the organization's bylaws, many actions can often require supermajorities. Again, if the issue is even remotely controversial among the other member organizations, the DOs come into play. This is the entire basis of power for a legislative caucus, coalition, etc.

I also completely disagree with the public not knowing about DOs. That is very state dependent. In some states, including those with lots of congressman, there is a heavy DO presence. Regardless, let's assume that 0% of the population knows what a DO is. It doesn't matter. The argument is still better and it plays out better in the media. Americans love an underdog. Also, you're right about people wanting doctors who treat them well. Since that's a subjective measure (as we all know), it's subject to bias. People want the doctor who is nice, personable, and approachable. They want good medical care but they also want to feel important. Whether it's true or not, DOs have the market on "holistic medicine." That's a powerful brand in this country.

 

[Apprands31]

Frankly, as soon as I graduate, I hope the LCME absorbs the DO schools. I hope the standards are improved, the weaker schools are shut down and it becomes very, very competitive to enter a DO school. I hope they keep the degree though because if the DO schools are forced to be competitive then my degree will be that much more valuable.

 

[Drrrrrr. Celty]

Americans don't like underdogs. Americans cheer for those who are most likely to prevail because they don't like being wrong.

And if no one knew who DOs were then no amount of advertising or argument would have a good effect. It's essentially the same as using a foreign word in the middle of a conversation. Most people will nod and pretend to know what you said to avoid being awkward and forget it ever happened.

But yes, the DO cause is hampered by a general ambivalence to their existence by both themselves and their patients who want to be treated for their lifestyle disorders and medication management necessity and to get out of the office as soon as possible before they find out they have cancer or a nightmare.

 

[GUH]

LOL!!??? Please explain to us what do you mean by the "DO profession"??? Because the last time I checked, the DO profession is the same as the MD profession with a few hundred hours of OMM.

How is converting all schools under LCME, and (like another poster mentioned above) still preserving OMM as an elective and keeping OMM residencies---how is it a failure to preserve the "DO profession"???

The "DO" degree shouldn't have gotten to the level that it did solely under the basis of OMM which has been poorly researched to begin with. It should have either stayed under "osteopathy" or implemented under electives in MD schools and/or made into ACGME residencies.

No country should've allowed an entire new medical school system and an entire branch of residencies simply because of a few hundred hours of OMM.

In today's times, maybe if DO schools actually matriculated more research-prone applicants, then we can get this long-waited substantial OMM research underway. But guess what? we are stuck with mid to low-tier applicants (and the rare few high-tiers who are more likely to wanna specialize) with small to no desire to be research pioneers --> into DO schools that make little effort to pave the way for good research but wanna increase class $ize, so of course OMM will stay obscure and undermined by MD physicians.

Glorious be the day LCME takes over all the schools! In the meantime glorious be the day the merger goes into full effect!

+1 troll for the ignore list.

 

[GUH]

Oh I'll now go cry and feel terrible because I think thousands of students now and to come should be prioritized over some PDs I have never met and don't care at all.

The premise rests on the ridiculous assumption that DO schools would be forced to meet LCME standards. He argues that if DOs don't accept, the MDs will take to the media. That's ridiculous considering they didn't and couldn't do it in the past -- much less now with the size of DOs today. Slippery slope is one of the fallacies you learn in Intro to Philosophy, but apparently the grand Sociologist Gevitz didn't get the memo. MDs have no interest in destroying DO schools. If anything, DO schools help them get qualified American graduates. The alternative scenario of closing DO schools would mean Caribbean schools proliferate and keep buying rotation sites the MDs want.

I'm glad that a future colleague has gone on this forum and openly said that he is selfish. What a good fit you are for a career in medicine.

 

[OCDEMS]

Americans don't like underdogs. Americans cheer for those who are most likely to prevail because they don't like being wrong.

The DO argument is a winning one for a variety of reasons beyond platitudes about "underdogs." It's a far more substantive debate that wins on merit too, as far the public's interest is concerned. Listen, you and I probably don't disagree on the foundation of this argument. I'm actually all for more unity in the medical profession. I'm playing the other side in this debate only because I think that AOA has a winning argument in any debate about it's future, good or bad for the profession as a whole.

 

[Drrrrrr. Celty]

+1 troll for the ignore list.

Lol GUH when are you going to join the anti-establishment club and the Medicinae Anarchae?

 

[Drrrrrr. Celty]

The DO argument is a winning one for a variety of reasons beyond platitudes about "underdogs." It's a far more substantive debate that wins on merit too, as far the public's interest is concerned. Listen, you and I probably don't disagree on the foundation of this argument. I'm actually all for more unity in the medical profession. I'm playing the other side in this debate only because I think that AOA has a winning argument in any debate about it's future, good or bad for the profession as a whole.

What exactly is winning? I think unifying closer with the MD side is winning. You think being more independent is winning.

Who are either of us to determine one or the other? We only can go along with what will happens and what will be and make the best of it.

 

[ChrisGriffen]

The sky is not falling. Its just going to be a real bumpy road for a couple years as this transitions. It does kind of blow my mind how many people think that on June 1, 2020 the DO bias will vanish.


But...props to everyone, because this thread is begging for some idiot to cite "brown vs board of ed"....but somehow that hasn't happened yet

 

[OCDEMS]

What exactly is winning? I think unifying closer with the MD side is winning. You think being more independent is winning.

Who are either of us to determine one or the other? We only can go along with what will happens and what will be and make the best of it.

I also think further unification is the best course. My point is really to create a counterpoint to the "sky is falling" argument that Chris references immediately above me. There are a lot of people who are acting like this merger is the end of osteopathic medicine in America, which is sensationalist. I'm only arguing that the AOA has enough power and political influence to effectively equalize the negotiations on the MOU in the coming months, not stage a coup.

Long term, I personally think you'll see an evolution among the two professions over the next 20-50 years. The merger will be the first step. As I've referenced above, MD schools will start introducing their students to OMT, if only for the reason that they'll want them to be competitive for these "osteopathically focused" spots. Over time there will gradually and slowly be a greater acceptance by both professions that their missions are, as they are even now, virtually indistinguishable. I think the DO degree will persists, as will some semblance of OMT. I would not at all be surprised if accreditation of both professions is housed under one roof, with separate committees to set standards on osteopathic principles. I also would not be surprised if accreditation remains separate but so symbiotic as to effectively make the arguments we're having now seem antiquated. The greatest victory for osteopathic medicine would be for all physicians, MD and DO, to embrace their history and unique contribution to American medicine.

 

[Bender B Rodriguez DO]

I'm glad that a future colleague has gone on this forum and openly said that he is selfish. What a good fit you are for a career in medicine.

I don't know how you or anyone could walk around the world without realizing people look out for their best interest first. That doesn't mean that I want to or actively undermine and dismiss my colleagues, but if it comes to my survival, I choose myself. You're in for a rude awakening if you haven't realized most people work this way. You know, it's all like evolution and stuff. Need for survival and so on.

 

[Drrrrrr. Celty]

I don't know how you or anyone could walk around the world without realizing people look out for their best interest first. That doesn't mean that I want to or actively undermine and dismiss my colleagues, but if it comes to my survival, I choose myself. You're in for a rude awakening if you haven't realized most people work this way. You know, it's all like evolution and stuff. Need for survival and so on.

Well there's an evolutionary purpose for selflessness too.. But yah, medicine is a job, you're doing it for yourself mostly.

 

[Elisabeth Kate]

MD attending to DO resident: how many times have you put on patient? what year are you again?
DO resident: once I will be a pgy 3 next july

What?

 

[MUSCULOSKELETAL23]

What?

oops my mistake

MD attending to DO resident: "how many times have u put central line on pt? what year are you again?"
DO resident: none I am PGY2

 

[Dr. Zombie]

oops my mistake

MD attending to DO resident: "how many times have u put central line on pt? what year are you again?"
DO resident: none I am PGY2

I read the AOA Opthalmology curriculum requirements in a lot (possibly all) of programs and they are much much lower than ACGME programs.

If executives listened to those against the merger, less-demanding programs would stay less demanding, and scenarios like the one posted above would continue to occur all in the name of "distinctiveness"

 

[Bacchus]

I read the AOA Opthalmology curriculum requirements in a lot (possibly all) of programs and they are much much lower than ACGME programs.

If executives listened to those against the merger, less-demanding programs would stay less demanding, and scenarios like the one posted above would continue to occur all in the name of "distinctiveness"

This is a perk of being in a dually accredited program. We follow the "stricter" of the standards so my requirements for some rotations are the ACGME requirements (overwhelmingly) and in others the AOA requirements.

 

[NurWollen]

I feel like the argument on this thread has at least five sides, not two.

1.) Those who are hell-bent on maintaining distinctiveness above quality and who want MDs to burn and who recite the Four Tenets of Osteopathy 10 times a day while kneeling to a golden statue of Still.

2.) Those who think that the merger will immediately caused all AOA PD's to become jobless paupers and that MDs will push DO's out of 'our' derm and ortho residencies.

3.) Those who think the merger will cause AOA PDs to become jobless paupers and don't give a sh**.

4.) Those who think that the merger will immediately end all DO discrimination because of course it will. Brown vs. Board of Education. Blah blah woot woot.

5.) Those who think the DO degree should never have existed, who agree with Gevitz' predictions and welcome it and who want all trace of osteopathy erased from the history books.

 

[Mad Jack]

Americans don't like underdogs. Americans cheer for those who are most likely to prevail because they don't like being wrong.

Americans love underdogs because they care a hell of a lot more about their feelings than being correct. When an underdog wins, it feels way more powerful than when the big guy takes yet another title- that just isn't exciting, it's expected. Look at any sports movie ever- they're all about underdogs. Recently, particularly among the youth, there has been more of a shift in backing the top dog (take, for instance, our recent love of Tony Stark and Bruce Wayne at the box office- but in a way, even Tony Stark is an underdog, just a guy in a tin can fighting demigods), but on the whole, America has always been all about rags-to-riches or nobody-to-champion stories. They hit is right in the feels, everytime. There's a lot of good papers out there about it on the internet, as it's a very interesting (and very American) sociological phenomenon.

That's why nurses are where they are today. People know that nurses aren't as smart as doctors, that they aren't as qualified, and that they probably don't provide the same level of care. But there's something about the idea of a nurse that's almost as good as the top dog doc, by virtue of hard work at the bedside, rather than a long time in school. Something that makes them say, "you know, maybe that nurse is just as good, maybe they just want to be free of the shackles of the man." And then they're so personable to boot, who wouldn't want someone that gives them the warm fuzzies rather than the clinical once-over as their caregiver. They will literally risk their lives on independent care that hasn't been thoroughly studied because nurses have good PR and the idea that somebody from the middle class like them, rather than some ivory tower doc, can provide them with care. Don't ever underestimate just how much logic an American will throw under the bus for a good narrative and some feelings. Logic will always take a back seat.

 

[D4C]

Americans love underdogs because they care a hell of a lot more about their feelings than being correct. When an underdog wins, it feels way more powerful than when the big guy takes yet another title- that just isn't exciting, it's expected. Look at any sports movie ever- they're all about underdogs. Recently, particularly among the youth, there has been more of a shift in backing the top dog (take, for instance, our recent love of Tony Stark and Bruce Wayne at the box office- but in a way, even Tony Stark is an underdog, just a guy in a tin can fighting demigods), but on the whole, America has always been all about rags-to-riches or nobody-to-champion stories. They hit is right in the feels, everytime. There's a lot of good papers out there about it on the internet, as it's a very interesting (and very American) sociological phenomenon.

That's why nurses are where they are today. People know that nurses aren't as smart as doctors, that they aren't as qualified, and that they probably don't provide the same level of care. But there's something about the idea of a nurse that's almost as good as the top dog doc, by virtue of hard work at the bedside, rather than a long time in school. Something that makes them say, "you know, maybe that nurse is just as good, maybe they just want to be free of the shackles of the man." And then they're so personable to boot, who wouldn't want someone that gives them the warm fuzzies rather than the clinical once-over as their caregiver. They will literally risk their lives on independent care that hasn't been thoroughly studied because nurses have good PR and the idea that somebody from the middle class like them, rather than some ivory tower doc, can provide them with care. Don't ever underestimate just how much logic an American will throw under the bus for a good narrative and some feelings. Logic will always take a back seat.