JAOA article on DO name change

[SmokD]

So I was reading it, and the writer is arguing against a name change. Honestly as I was reading it, I thought most of what he was saying made sense. That stopped at roughly the 5th to last paragraph when he references the MD community as comparable to Nazi Germany. This was in reference to the "incident" in California.

http://www.jaoa.org/cgi/content/full/111/2/124?etoc

In my personal opinion, I really don't care about changing the name. I don't think its that important. However, I think this is crossing a line. Thoughts?

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[IDBasco]

So I was reading it, and the writer is arguing against a name change. Honestly as I was reading it, I thought most of what he was saying made sense. That stopped at roughly the 5th to last paragraph when he references the MD community as comparable to Nazi Germany. This was in reference to the "incident" in California.

http://www.jaoa.org/cgi/content/full/111/2/124?etoc

In my personal opinion, I really don't care about changing the name. I don't think its that important. However, I think this is crossing a line. Thoughts?

I don't know what article you read, but the one you linked mentions nothing about Nazis or Germany. Any connection you are making is a stretch at best.

 

[DocEspana]

So I was reading it, and the writer is arguing against a name change. Honestly as I was reading it, I thought most of what he was saying made sense. That stopped at roughly the 5th to last paragraph when he references the MD community as comparable to Nazi Germany. This was in reference to the "incident" in California.

http://www.jaoa.org/cgi/content/full/111/2/124?etoc

In my personal opinion, I really don't care about changing the name. I don't think its that important. However, I think this is crossing a line. Thoughts?

Well I think the use of the word ghetto and district, both pulled out of the general sentence for emphasis by the writer, were definitely meant to subtly make a germany reference IDK if it ruins the paper cause he doesnt quite dive into the deep end of Godwin's law.

Godwin's Law: "The longer something is debated on the internet the closer the odds of referring to someone or something as 'Hitler', 'a Nazi' or 'Nazi Germany' come to 1."

 

[JaggerPlate]

I didn't really think the 'Nazi' reference was too apparent or whatever, but I do think this guy is REACHING with some of his analogies, and I'm wondering whether or not we should consider the opinion of someone who graduated with a DO degree 65 years ago as the voice of what we want to be today.

I'm sure he's been a great advocate for DOs, and I'm not really interested in a name change, but I'd rather hear and comprehend the opinions of the generation going into practice tomorrow.

 

[SmokD]

On second read, I guess the germany thing was a bit of a stretch. Thats just where my mind went when I read it. But still seemed to be a bit of an imaginative comparison

 

[DrWBD]

How surprising...a long-retired osteopath who trained in an AOA program, and the founding dean of an osteopathic school (NSU-COM) labeling those who advocate merging of the professions as "MD wannabes". He's already profited handsomely (financially and professionally) from maintaining the distinction.

 

[JaggerPlate]

How surprising...a long-retired osteopath who trained in an AOA program, and the founding dean of an osteopathic school (NSU-COM) labeling those who advocate merging of the professions as "MD wannabes". He's already profited handsomely (financially and professionally) from maintaining the distinction.

Ironically enough, the current dean of NSU-COM (when I interviewed at least) was pretty vocal about wanting to change the name of the degree to MDO (Medical Doctor of Osteopathy).

 

[taylormade2006]

I still maintain that any degree name change that is not "MD" will only lead the same, if not more, confusion.

On the other hand, do you guys think there would be resentment and backlash from MD colleagues if, indeed, DO institutions began to offer MD's? Or since they'd likely be LCME accredited, they'd probably consider them equal on all grounds.

Additionally, if the change happened, would existing DO's change to MD, or just new DO's?

 

[JaggerPlate]

I still maintain that any degree name change that is not "MD" will only lead the same, if not more, confusion.

I agree. I'm 100% for not changing the degree, and my one and ONLY qualm is due to the large number of non-physician health care providers who appear like physicians in clinical settings and the ability for patients to be able to known 'physician' from 'non-physician.' In most people's minds, this is MD ... so the only logical change, as I see it, would be 'MD, DO.'

On the other hand, do you guys think there would be resentment and backlash from MD colleagues if, indeed, DO institutions began to offer MD's? Or since they'd likely be LCME accredited, they'd probably consider them equal on all grounds.

Additionally, if the change happened, would existing DO's change to MD, or just new DO's?

I don't think there would be any issue with MD, DO ... I do think there would be issue with simply changing it to 'MD.' However, any institution that applies for and passes LCME accreditation isn't going to be looked down upon by anyone, but COCA - unless it was their idea - would shut down any DO school that tried to seek dual cred (don't know if you remember the KCUMB controversy from last year, but essentially that's what happened).

If it was to change, it would be without the involvement of the LCME. Involving the LCME would rule the AOA/COCA worthless, and since they are in charge, it would really make no sense to shut themselves out like that.

However, like I've said before, don't count on a degree change ever. I'm 99% sure it won't ever happen. Additionally, I do see one possible avenue, based on something I remember from the past (that was shut down), but I want to mull it over mentally before really talking about it.

 

[Coastie]

Changing the degree name is idiotic.

DO has been slowly gaining recognition over the past decade or two, and changing it now would be a bad, bad move.

Far worst things are on the horizon for medicine in general, and osteopathic medicine in particular. We must focus firepower on what's important..

 

[DrWBD]

DO has been slowly gaining recognition over the past decade or two

Except that recognition has not all been positive (case in point: RVU-COM as the first for-profit medical school in America post-Flexner).

 

[DocEspana]

Wouldn't a much easier plan of action, if we are dealing with things that realistically cant happen (and thats what we are doing), be to just get a really good PR and information campaign nation wide.

Cause if it was evidently clear that our qualifications are equal then it will no longer be a debate except among the MD jealous, who's issues are more pathologic to them rather than based in reality. I'm well aware that the hubris of many of the AOA leadership has led to our public outreach campaigns being really crappy. Like really *really* crappy. But thats because they do not want to be compared to MDs and they refuse to spend money saying 'we're just like them!' because 1) they think they are better than MDs and 2) Its beneath them to aspire to be 'just like anyone'.

But lets say all the long in the tooth leadership are eliminated at once when a meteorite strikes the 2011 annual A.T. Still convention. You don't think the next in line (40 or younger DOs) would absolutely jump all over the opportunity to have a really strong campaign to be seen as full equals by the common man. They realize we already impressed everyone we need to in clinical medicine and academia. And they realize that pride comes before the fall in the case of advertising yourself to the masses, so they would swallow their pride and undergo a really strong campaign. People recognize DO as an alternative pathway to the same end of "physician" and we're all set.

We can then focus on defending our turf, should-to-shoulder with our MD brothers, from the mid-level providers.

 

[DrWBD]

They realize we already impressed everyone we need to in clinical medicine and academia.

This is a curious statement to be making. Do you honestly think it is true?

Have we impressed the residency program directors at Columbia, Mount Sinai, and New York Hospital? Because the last time I checked there were no DOs in any of their medicine or surgery residency programs (maybe your friend the trauma surgeon in the non-trauma hospital could look into that ).

Those of us who advocate merging the professions are not just, as you condescendingly put it, "MD jealous". We just understand that a different degree designation, no matter how much "education" occurs, is a barrier that keeps us out of the best training programs. And keeping DOs out of the best programs is the best way to continue the clinical mediocrity of the osteopathic profession. While MDs lead, we will continue to follow.

 

[JaggerPlate]

Except that recognition has not all been positive (case in point: RVU-COM as the first for-profit medical school in America post-Flexner).

All press is good press baby

 

[JaggerPlate]

This is a curious statement to be making. Do you honestly think it is true?

Have we impressed the residency program directors at Columbia, Mount Sinai, and New York Hospital? Because the last time I checked there were no DOs in any of their medicine or surgery residency programs (maybe your friend the trauma surgeon in the non-trauma hospital could look into that ).

Those of us who advocate merging the professions are not just, as you condescendingly put it, "MD jealous". We just understand that a different degree designation, no matter how much "education" occurs, is a barrier that keeps us out of the best training programs. And keeping DOs out of the best programs is the best way to continue the clinical mediocrity of the osteopathic profession. While MDs lead, we will continue to follow.

What about the ones at MGH and JHH??? Last time I checked, the head of PM&R at Mass was a DO and the chief gas resident at JHH was a DO from LECOM??

I'd be willing to bet that we could pretty evenly exchange these meaningless anecdotes all day long and not prove a thing.

 

[DrWBD]

What about the ones at MGH and JHH??? Last time I checked, the head of PM&R at Mass was a DO and the chief gas resident at JHH was a DO from LECOM??

I'd be willing to bet that we could pretty evenly exchange these meaningless anecdotes all day long and not prove a thing.

An attending position ≠ being accepted into a residency.

And I don't consider anesthesia and PM&R (especially not PM&R...most programs are practically begging for American residents!) on the same level as medicine and surgery.

 

[JaggerPlate]

An attending position ≠ being accepted into a residency.

And I don't consider anesthesia and PM&R (especially not PM&R...most programs are practically begging for American residents!) on the same level as medicine and surgery.

So anything that makes your point is valid, anything that goes against it 'doesn't count?' Makes logical sense ...

My point is that for every anecdotal situation you can provide where a hospital doesn't take DO residents, or a field that isn't 'DO friendly,' I can probably counter you with another ivory tower/well respected hospital that does and several other fields where they are just as prevalent (as long as we don't even consider the outlier fields like ACGME derm and integrated PRS which are essentially off limits to most of the MD world as well).

I'm not going to sit here and claim that DOs are on the cutting edge of research at the big academic ivory towers, but I'm also not going to sit here and listen to claims that DOs can't match into solid 'medicine' ACGME medicine programs.

As usual though ... your input of doom and gloom mixed with side of apathy is always welcomed.

 

[DrWBD]

So anything that makes your point is valid, anything that goes against it 'doesn't count?' Makes logical sense ...

I specifically said residencies in medicine and surgery. PM&R and Anesthesiology are not those fields. And "top" hospitals in the estimation of a medical student don't always correlate to the real world.

As usual though ... your input of doom and gloom mixed with side of apathy is always welcomed.

As opposed to the usual forum fare: a main course of self-delusion with a side of uninformed opinions?

 

[JaggerPlate]

I specifically said residencies in medicine and surgery. PM&R and Anesthesiology are not those fields. And "top" hospitals in the estimation of a medical student don't always correlate to the real world.

Agreed that the 'top' hospitals aren't always the ones individuals who haven't worked within the systems would assume. However, you threw out a well known and an ivy league ... I countered with a well known and an ivy league.

Furthermore, if you want to say there is a disproportionate amount of DOs in ACGME surgery programs, then I have no problem with that. It's a pretty well known anecdote that ACGME surgical residencies in a basic form (g-surg) are pretty DO-unfriendly due to a self-described 'good 'ole boy' mentality, and the fact that the sub-specializations are essentially just as competitive as the 'derm/PRS' examples I used earlier (ENT, Uro, PRS, etc, simply aren't a good indicator of anything because they are reserved for the elite).

However, any bias in an internal medicine program at an ivory tower is pretty pointless in my book, and I don't think ANYONE is going to boast that DOs have a hard time matching into solid ACGME IM programs. It simply isn't that competitive of a field. Anecdotally, I know it's popularity/competition is declining, but I was under the impression that it's still statistically harder/more competitive to match ACGME gas? If this is the case, and the DO representation is there in solid numbers, I really don't see why it 'doesn't count,' in your book, especially when it's traditionally a tougher ROAD than Internal Medicine.

As opposed to the usual forum fare: a main course of self-delusion with a side of uninformed opinions?

99/100 times, I completely agree, and medical students, pre-meds, etc, making assumptions in light of attending/resident's first hand knowledge is laughable. However, due to your very well known opinions on DOs, osteopathic medicine, the AOA, etc, I feel like nearly EVERY one of your posts on this board dealing with your opinion of osteopathic med should be met with a countered point of view and labeled with a HUGE 'grain of salt' disclaimer. Though maybe mine should be labeled with an 'overtly optimistic' disclaimer as well.

No offense intended by any of this, but it just seems unfair to have these opinions/biases broadcast out there without some sort of reasonable 'other' clarification/opinions.

 

[taylormade2006]

Jagger - "Princeod2583" ??????????

 

[JaggerPlate]

Jagger - "Princeod2583" ??????????

The guy from the OD forums??? Confused? What's up?

 

[taylormade2006]

When you split my quote in that post the second half of my comment showed up as princeOD, haha.

 

[Coastie]

Except that recognition has not all been positive (case in point: RVU-COM as the first for-profit medical school in America post-Flexner).

I agree. The answer is to shutdown RVU, not change the degree.

After all, RVU would also become MDO, DOM, MD,DO, etc etc..

 

[SmokD]

If DO's are not respected in academia, then we need to work towards becoming stronger in that. Putting a band-aid on our tittles isn't going to change that. I would say that about half of OMM can be thought of as reasonable science. But we lose respect because we cling to the other half which is pseudoscience.

 

[JaggerPlate]

When you split my quote in that post the second half of my comment showed up as princeOD, haha.

Hahah whoops, my bad. I must have copied and pasted it weird.

 

[bonsaipalmtree]

Changing the name would do nothing. The author specifically asks, "But what is a degree anyhow? It is the academic title conferred after completion of a prescribed course of study. But it does not tell anything about the quality of the bearer's work." Quality. Why do people think of the MD as a "quality" degree?

If the DO profession wises to better itself as a whole and be more widely known, a name change isn't going to accomplish that. What will do it are the exact same things that lend quality and prestige to MD schools and excellent medical schools abroad: research, education, and a reputation for compassionate and state-of-the-art care. DO schools need to invest time and money in attracting faculty, bringing in bigger research grants, and hence making names for themselves as academic centers that produce excellent clinicians and advance medicine. THOSE are brands that people trust. People would still go to UCSF hospitals, even if they changed their degree to Doctor of Awesomeness (DA); most patients wouldn't even notice the difference. They've heard of UCSF because of news reports about research and innovative patient care.

How much money does it cost to publish JAOA, which spends time on this stupid nomenclature debate? How does that, in any way, advance the osteopathic profession? I pray that the DO schools/the AOA aren't spending any real money on investigation into a degree name change. That money could help fund the salary for another faculty member.

Now, I'm going to go continue data analysis for my research project... that I had to find at another medical school. And dream of the day that the JAOA is on par with JAMA. Yes, I actually think that's within the realm of possibility, someday.

/soapbox

 

[Coastie]

Changing the name would do nothing. The author specifically asks, "But what is a degree anyhow? It is the academic title conferred after completion of a prescribed course of study. But it does not tell anything about the quality of the bearer's work." Quality. Why do people think of the MD as a "quality" degree?

If the DO profession wises to better itself as a whole and be more widely known, a name change isn't going to accomplish that. What will do it are the exact same things that lend quality and prestige to MD schools and excellent medical schools abroad: research, education, and a reputation for compassionate and state-of-the-art care. DO schools need to invest time and money in attracting faculty, bringing in bigger research grants, and hence making names for themselves as academic centers that produce excellent clinicians and advance medicine. THOSE are brands that people trust. People would still go to UCSF hospitals, even if they changed their degree to Doctor of Awesomeness (DA); most patients wouldn't even notice the difference. They've heard of UCSF because of news reports about research and innovative patient care.

How much money does it cost to publish JAOA, which spends time on this stupid nomenclature debate? How does that, in any way, advance the osteopathic profession? I pray that the DO schools/the AOA aren't spending any real money on investigation into a degree name change. That money could help fund the salary for another faculty member.

Now, I'm going to go continue data analysis for my research project... that I had to find at another medical school. And dream of the day that the JAOA is on par with JAMA. Yes, I actually think that's within the realm of possibility, someday.

/soapbox

Good post

 

[DocEspana]

THOSE are brands that people trust. People would still go to UCSF hospitals, even if they changed their degree to Doctor of Awesomeness (DA); most patients wouldn't even notice the difference. They've heard of UCSF because of news reports about research and innovative patient care.

I think everything you said was well put.

Though I probably wouldn't use UCSF for a few months as an example of anything. They had a rather embarrassing "huge percent of class didnt pass the boards" problem this year. I'm sure its a one year aberration, but this is a bad time to mention the UCSF system that is so into training future "physician scientists" that many of their students didnt qualify to be "physician physicians" on their first USMLE take.

 

[dangit]

I think everything you said was well put.

Though I probably wouldn't use UCSF for a few months as an example of anything. They had a rather embarrassing "huge percent of class didnt pass the boards" problem this year. I'm sure its a one year aberration, but this is a bad time to mention the UCSF system that is so into training future "physician scientists" that many of their students didnt qualify to be "physician physicians" on their first USMLE take.

interesting. do you have a link?

 

[DocEspana]

interesting. do you have a link?

don't need one (in this case). we sniped one of their main pathology teachers and he got a call right in lab some time last semester (october?). He took the call in lab (he was just hanging around lab at the time) and had this look of terror on his face after a minute or two of the conversation. As he's still on the on their education committee despite teaching on the east coast he was called for an emergency meeting because somewhere around 30% of their students failed step I on the first try. Which is an absurd departure from their usual massive success at all things medicine.

He came back in and told us it, and said that he was eating crow over it (he just gave a long speech on the importance of doing research a few minutes before). The general consensus was that the students became so research oriented that they missed opportunities to board prep. It was mentioned on SDN right around the same time in equally vague terms on the allo boards (around 30% was what i saw there. our doc actually said 'a little less than a third failed').

 

[taylormade2006]

don't need one (in this case). we sniped one of their main pathology teachers and he got a call right in lab some time last semester (october?). He took the call in lab (he was just hanging around lab at the time) and had this look of terror on his face after a minute or two of the conversation. As he's still on the on their education committee despite teaching on the east coast he was called for an emergency meeting because somewhere around 30% of their students failed step I on the first try. Which is an absurd departure from their usual massive success at all things medicine.

He came back in and told us it, and said that he was eating crow over it (he just gave a long speech on the importance of doing research a few minutes before). The general consensus was that the students became so research oriented that they missed opportunities to board prep. It was mentioned on SDN right around the same time in equally vague terms on the allo boards (around 30% was what i saw there. our doc actually said 'a little less than a third failed').

That is why you do need a link (in this case). Your second hand information would be hard for anyone else to swallow as fact without a link. Especially for a strong allegation against one of the best medical schools.

 

[DocEspana]

That is why you do need a link (in this case). Your second hand information would be hard for anyone else to swallow as fact without a link. Especially for a strong allegation against one of the best medical schools.

studying neuropharm for a test today. ill get you the link later today. Just dont have the time right now to comb through the allo forum for stuff that is months and months old now, especially if i cant remember if its in a UCSF specific thread or a general board pass thread so the 'search' isnt going to make this easy.

But yea. When I heard it from our doc I went on student doctor and a day or two later it was a topic of conversation on the allo forums. So its here *somewhere*.

 

[taylormade2006]

studying neuropharm for a test today. ill get you the link later today. Just dont have the time right now to comb through the allo forum for stuff that is months and months old now, especially if i cant remember if its in a UCSF specific thread or a general board pass thread so the 'search' isnt going to make this easy.

But yea. When I heard it from our doc I went on student doctor and a day or two later it was a topic of conversation on the allo forums. So its here *somewhere*.

Please don't find the link for me. I don't care at all. I just was explaining why someone else might want one.

 

[DD214_DOC]

Doing anything other than making it an MD defeats the whole point of why many people want it changed in the first place. It's because all the general public knows is that physician = MD, and (anything other than MD) = not a physician.

Either keep it DO or do away with all of it completely and go to MD. Anything in between is a waste of time.

 

[Old Grunt]

Doing anything other than making it an MD defeats the whole point of why many people want it changed in the first place. It's because all the general public knows is that physician = MD, and (anything other than MD) = not a physician.

Either keep it DO or do away with all of it completely and go to MD. Anything in between is a waste of time.

Look at the upside, if a third degree is created, the possibility for "MD v. DO v. <insert new degree here> v. Carribean" debates on SDN are limitless.

In all seriousness, I am an MD student with no dog in this fight, but I agree with your post.

The politics behind this issue are insane.