Legal Action Against the AOA?

[Locke]

Has anyone (AMSA maybe) thought of suing the AOA for not allowing a combined match and thus artificially inflating the value of the AOA residencies and preventing fair competition?

How about for discrimination by preventing MD’s from entering AOA residencies? Theoretically and in actuality someone graduating from an ACGME residency in IM will have the same practice rights and responsibilities as someone graduating from an AOA accredited IM residency.

Any thoughts?

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[espbeliever]

i think the whole thing is patheic really. any case you could muster i would surmise would be lame. you chose the path in front of you, you were not forced to go DO. and like you said, the residencies do as promised, teaching ppl in the various specialties to be on par with the MD residencies.

i thought i read somewhere you could not be on the DO board anywhere unless you did a DO residency? maybe that would be something? nah... it wouldnt...

 

[studentdoc45]

i think the whole thing is patheic really. any case you could muster i would surmise would be lame. you chose the path in front of you, you were not forced to go DO. and like you said, the residencies do as promised, teaching ppl in the various specialties to be on par with the MD residencies.

i thought i read somewhere you could not be on the DO board anywhere unless you did a DO residency? maybe that would be something? nah... it wouldnt...

ESP boy-

You are a complete idiot. You have no idea what it takes to match. I am tired of pre-DO students acting like they know what they are talking about. We need a combined match.

 

[swaamedic]

we need a combo match! my top 2 picks are ACGME and then my #3 and #5 are DO residencies. by not having a combo match I am having to drop the DO residencies I would like to consider and only go ACGME....the devine wisdom of the AOA doesn't see the whole picture. More spots would fill if the match were combined than they do now.
my 2 cents

 

[TCOM-2006]

my initial thought here is that - while i do support a combined match - i don't really think legal action is a viable or appropriate way to go. i do believe that a combined match will happen - it may just take a few years. we can't expect change overnight - especially with the AOA - but we can begin to raise the issue again and again, until we are listened to, and leadership looks at the big picture.

 

[Ice-1]

In order for any suit vs. AOA or (anyone else for that matter) the parties bringing the action would have to prove damages and that the AOA's actions were the cause of them. There would need to be proof that the AOA actions resulted in lost opportunities in reality and not theoretically. I'm not saying it could not be done but that it would not be as easy as it sounds. I don't see many medical students being up for that kind of a fight.

 

[Locke]

It would have to be an intern or resident that would have to take it to court, but we would need the support of AMSA because it is not affiliated with either the AOA or the AMA. It is a body that represents medical students.

The purpose of the law suit would not really be to go to trial, but rather to express to the AOA members at large that the all is not as rosy and peachy as the leadership says it is.

 

[unk_fxn]

The lawsuit that needs to be filed is this:

An ACGME trained DO applies for licensure in Florida or an other one of the infamous 5 states and be subsequently denied because of the lack of AOA internship.

This physician has just been denied the right to practice his profession in the state; this constitutes damages.

The lawsuit alledges that the Florida Board of Osteopathic Medicine has conspired with the AOA to prevent non-AOA trained physicians from practicing in Florida, thus artificially inflating the value of AOA GME and limiting competition in GME for physicians who want to practice in Florida.

There are several issues raised here that seem to have interest to the legal system:
-Monopolistic Practice
-Restraint of Trade
-Restriction on the right to work

If you look at how far into the system that the baseless Daniel v ABEM got, this suit actually might have some merit.

Or maybe DO's who tire of the AOA's rhetoric need to form a separate organiation - put that in your Unity pipe and smoke it Dr. Thomas!

 

[espbeliever]

ok, so that sounds like a decent suit to me. i think it is dumb for those 5 states to do that. they should be like all of the other states.

but 2 points:

1) consider if they did change the law on that, we still do not nessesarily have a combined match.

2) this is almost never a problem since the aoa grants the resident the ok to practice using a non-aoa residency.

 

[unk_fxn]

2) this is almost never a problem since the aoa grants the resident the ok to practice using a non-aoa residency.

But why should I have to pay money and goto the AOA's conferences in they hopes they will approve me to work in certain states? Its like having to pay protection money to the mob to work in a certain neighborhood.

 

[docbill]

You guys and all this talk about lawsuit.

Its true what they say. In the US you sue everything that moves.

Remember this is the same mentality that leads every patient to sue whe something normal happens. Same reason why mal practice insurance is so high.

If you want to change the system get involve and suggest a change to these regulations. That is what interest groups and company do in Washington.

 

[swaamedic]

i think this is more of a hypothetical discussion than anything else....besides untill we get some young blood into the AOA not much is going to happen, and most of the young people are more interested in being Drs and paying off our loans than the politics of the AOA. Although I do see rocky waters ahead revolving around this issue.....

 

[espbeliever]

ESP boy-

You are a complete idiot. You have no idea what it takes to match. I am tired of pre-DO students acting like they know what they are talking about. We need a combined match.

hey dood, how do u like everyones responses? thanks for being a jerk.

 

[espbeliever]

But why should I have to pay money and goto the AOA's conferences in they hopes they will approve me to work in certain states? Its like having to pay protection money to the mob to work in a certain neighborhood.

do u have to do all of thaT? i thought it was a formal paper work request you submit to them?

 

[group_theory]

The lawsuit that needs to be filed is this:

An ACGME trained DO applies for licensure in Florida or an other one of the infamous 5 states and be subsequently denied because of the lack of AOA internship.

This physician has just been denied the right to practice his profession in the state; this constitutes damages.

The lawsuit alledges that the Florida Board of Osteopathic Medicine has conspired with the AOA to prevent non-AOA trained physicians from practicing in Florida, thus artificially inflating the value of AOA GME and limiting competition in GME for physicians who want to practice in Florida.

There are several issues raised here that seem to have interest to the legal system:
-Monopolistic Practice
-Restraint of Trade
-Restriction on the right to work

If you look at how far into the system that the baseless Daniel v ABEM got, this suit actually might have some merit.

Or maybe DO's who tire of the AOA's rhetoric need to form a separate organiation - put that in your Unity pipe and smoke it Dr. Thomas!

Monopolistic practice/restraint of trade will fall under the jurisdiction of federal courts but I dunno if any federal judge will want to take this up. It might be seen as a state issue since medicine/osteopathic medicine and regulation of professions fall under the jurisdiction of the state. What's worse - the 1 year internship requirement isn't some random requirement made up by the Board of Osteopathic Medicine but regulation defined by legislation. On issues regarding a regulatory board following state statues, the courts usually show a deference to state legislatures unless there are constitutional (state or federal) issues involved. And after years of pretrial motion and discovery, you finally go to court. If you win, expect years of lengthy appeals. Also keep in mind that while all this is going on, you'll have to deal with the everday stress of residency, fellowship, and finally private practice/academia (not sure if having an active lawsuit against a large medical organization will lower your values in prospective employers/partners eyes)

PS - the right to work will certainly fail since courts have long recognize the public need for state regulation of certain professions. Otherwise, you'll have random people working as doctors, lawyers, pharmacists, nurses, dentists, with no regulations whatsoever. That's "right to work". The state regulates this by requiring certain "stuff" such as attending and graduating a school of medicine, internship, passage of national boards, etc.

Take home point - it's easier and less costly to get rid of the AOA-internship requirement via legislation than court action

 

[TCOM-2006]

let me just respond to a few issues that have been raised for purposes of clarification...

all the following processes are seperate (and governed by different organizations)...

-medical school accred (AOA-COCA for osteo, LCME for allo)

-residency accred (AOA-COPT for osteo, ACGME for allo)

-residency application (ERAS for both - starting this year)

-residency match (AOA match for AOA programs, NRMP-SanFran-Urol-Military for ACGME programs)

-licensure (indiv. state medical boards - some of which are combined, some of which have seperate osteo and allo boards)

-board certification (one allo and one osteo for each specialty - ABIM / ABOIM)

-AOA "approval" of ACGME program training (via resolution 42 process)

the FL example given (which - by the way - this may seem theoretially plausable at first glance) addresses an issue that is seperate from the match issue (ie - it's an issue of licensure). the 4 states that *require* an AOA approved internship (just the first year) include FL, MI, WV, and PA (OK actually just requires DOs to complete a rotating internship - but it can be ACGME or AOA). one could argue that the requirements by these 4 states - in an innapropriate use of the purpose of licensure (ie - to protect the public). are the other 45 states endangering the public by not requiring DOs to complete osteo internships? of course not. but again - this is a seperate issue from the match

regarding whether or not AOA approval for ACGME training (via resolution 42) can make you elegible for licensure - i'm not sure. approval is not the same as accreditation, and i *think* that if you don't complete an AOA internship your first year - there is no way to get licensed in the states mentioned <i'm not sure about this - let me check>. i think "approval" does allow you to become board elegible through the osteo board organizations. let me check on this issue - and i'll re-post

hope this is not too confusing

 

[TCOM-2006]

let me just respond to a few issues that have been raised for purposes of clarification...

all the following processes are seperate (and governed by different organizations)...

-medical school accred (AOA-COCA for osteo, LCME for allo)

-residency accred (AOA-COPT for osteo, ACGME for allo)

-residency application (ERAS for both - starting this year)

-residency match (AOA match for AOA programs, NRMP-SanFran-Urol-Military for ACGME programs)

-licensure (indiv. state medical boards - some of which are combined, some of which have seperate osteo and allo boards)

-board certification (one allo and one osteo for each specialty - ABIM / ABOIM)

-AOA "approval" of ACGME program training (via resolution 42 process)

the FL example given (which - by the way - this may seem theoretially plausable at first glance) addresses an issue that is seperate from the match issue (ie - it's an issue of licensure). the 4 states that *require* an AOA approved internship (just the first year) include FL, MI, WV, and PA (OK actually just requires DOs to complete a rotating internship - but it can be ACGME or AOA). one could argue that the requirements by these 4 states - in an innapropriate use of the purpose of licensure (ie - to protect the public). are the other 45 states endangering the public by not requiring DOs to complete osteo internships? of course not. but again - this is a seperate issue from the match

regarding whether or not AOA approval for ACGME training (via resolution 42) can make you elegible for licensure - i'm not sure. approval is not the same as accreditation, and i *think* that if you don't complete an AOA internship your first year - there is no way to get licensed in the states mentioned <i'm not sure about this - let me check>. i think "approval" does allow you to become board elegible through the osteo board organizations. let me check on this issue - and i'll re-post

hope this is not too confusing

just an addendum to my previous post:

--if AOA "approval" of an ACGME program enables licensure in the 4 states mentioned - then this shows that exceptions are made based on the situation of the individual physician (ie - reasons they were not able to complete an AOA internship, such as completing a military internship/residency program) - and this is clearly not consistent with the purpose of licensure (ie - to set a uniform compentency stnadard in order to protect the public).

--if AOA "approval" of an ACGME program still won't enable licensure in the 4 states mentioned - then it is possible one could - complete and ACGME program - get AOA approval via resolution 42 process - become board certified by both the allopathic and osteopathic board organizations - yet not be able to legally practice medicine in those four states.

--i'm still searching for the answer - but either way - this rule seems crazy.

 

[TCOM-2006]

here's some more information on the 'resolution 42' pathway and other processes of the AOA:
http://www.do-online.org/index.cfm?PageID=sir_appforms

FAQ re: students:
http://www.do-online.org/index.cfm?PageID=sir_faqmain

i'm still not sure regarding if AOA 'approval' makes a DO eledgible for licensure in the states mentioned

 

[unk_fxn]

here's some more information on the 'resolution 42' pathway and other processes of the AOA:
http://www.do-online.org/index.cfm?PageID=sir_appforms

FAQ re: students:
http://www.do-online.org/index.cfm?PageID=sir_faqmain

i'm still not sure regarding if AOA 'approval' makes a DO eledgible for licensure in the states mentioned

It does, at least in Florida, per the Board of Osteopathic Medicine website. Actually if you dig deep into the FL administrative code (available on an other website) it actually says that ACGME and AOA training is educationally equivalent, which I think adds to the case that 5 state limitation is purely about money and inflating the value of AOA GME.

 

[Docgeorge]

If it's functionally equivlant then why the need for an AOA approved intership. It makes no sence.

On another note I noticed in the DO that the Leadership keep saying that they dont view ACGME GME as equivlant to AOA residency. They why rubber stamp miliatry residencies that follow ACGME guidelines and accepect that as equivlent.
It can be argueed that that you have an unequal application of regulation.

As for the lawsuit to force a combined match, I dont think that will work. A change like that needs to come from with in. But one for unequal aplication of GME regulations might have some merrit. A consiracy to restrict trade maby?