Letter to the Editor...

Discussion in 'Medical Students - DO' started by Pansit, May 29, 2008.

  1. Pansit

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    I thought this was was an interesting letter to the DO Magazine and I think it's completely accurate and true. I am glad more and more people are speaking out and letting the AOA know the true realities on ground instead of having them think of what it is for all DO's. I think the greater the DO numbers become in the years to come the more people will voice their opinion. Let me know what you guys think:


    Enfranchising DOs
    I am writing in response to the article by AOA Executive Director John B. Crosby, JD, in the February issue. In my brief career as an osteopathic physician, I have been witness to the pessimism discussed in this article. Unfortunately, the AOA contributes to disenfranchisement by narrowly focusing on primary care physicians, as well as by attempting to maintain the distinctiveness and exclusivity of osteopathic medicine. I have never read any blogs concerning this matter much less posted my opinion on one. I am not hiding behind anonymity because I want to actively participate in the direction the AOA takes. In his article, Mr Crosby says, "We value your opinions. We want to meet your needs." However, I need to perceive actual changes and not feel as if my suggestions fall on deaf ears. Apparently, many disenfranchised DOs feel this is already occurring.

    The AOA needs to alter its direction and focus and adapt to the changing landscape of medicine, or it risks becoming a defunct organization.
    Mr Crosby proposes a number of factors that may contribute to the feeling of separation many physicians feel between themselves and the AOA. He suggests training in residency programs accredited by the Accreditation Council for Graduate Medical Education and acquiescing to the "vocal minority" that advocates "changing the DO degree" to an "amalgamation of DO with MD" as possible causes. However, because the separation is real, not myth, between the leadership and those who would otherwise participate wholeheartedly in the AOA, I offer two suggestions to increase inclusion. First, the AOA, and osteopathic medicine in general, must cease having its main focus be primary care. I expect this to sound like heresy to the more "seasoned" DOs, but our profession's leaders need to come to terms with the changes occurring within its members. In her article "Slumping OGME Piques Educators At Summit," AOA Senior Editorial Project Manager Carolyn Schierhorn states, "52% of the DOs who graduated in 2007 are training in non-primary-care specialties." I am one of those graduates who chose to narrow the scope of my medical practice and become a specialist. Ms Schierhorn also described one of the objectives of the second Medical Education Summit, which was to "wrestl[e] with the specifics of how to induce more osteopathic medical students to choose primary care." There shouldn't be any inducing, encouraging or coercing of students to choose one specialty over another.

    Clearly, and despite the pressure placed on them to
    enter primary care, medical students are increasingly selecting non-primary- care specialties. Osteopathic medicine has a long history of service in primary care, and it is this tradition on which our profession has been built. However, if osteopathic medicine and the AOA continue to look to the past, they will not be able to adapt to the future. As DOs, we are permeating every specialty within medicine and need not be pigeonholed into primary care any longer. The AOA perpetuates disenfranchisement by "rebranding" itself but continuing to focus on issues surrounding primary care to the exclusion of the vast number of specialists who will soon dominate its membership.

    Second, the AOA should promote homogeneity with our allopathic counterparts. I feel the US Supreme Court decision in Brown v Board of Education has application on this point. In this landmark ruling ending racial segregation, the justices found the concept
    "separate but equal" really meant "inherently unequal." Similarly, if we as osteopathic physicians continue to promote separation from our allopathic counterparts due to our exclusive distinctiveness and uniqueness, we forever will be considered inherently unequal. Would not patient care improve if we shared our knowledge of manipulation with MDs or allowed them access to osteopathic residency positions? Acrimony between allopathic and osteopathic physicians is virtually nonexistent in the recent generations of physicians.

    The self-aggrandizing behavior of continually pointing out how different and better DOs are compared to allopathic physicians exposes an inferiority complex within the profession. For example, Mr Crosby states, "it signals a more fundamental problem when the most completely trained physicians in the world seek to identify themselves with MDs rather than their own professional colleagues." This statement reeks of a haughty air of superiority designed to be divisive and promote disunity between physicians, the larger classification to which all DOs and MDs belong. My allopathic counterparts are, in fact, my professional colleagues. I treat my patients with the same acumen and prowess as my coworkers do, and I don't feel the need to inject the word
    osteopathic into every sentence I speak. I have yet to hear anyone claim to be an "allopathic anesthesiologist." We are similar in almost every way and are treated as such.

    The AOA should cease stressing nearly minuscule differences between professions and focus on the overwhelming number of similarities. The AOA can increase its appeal to DOs by catering more to specialists and by focusing on ground held in common with our professional counterparts. Because significant needs are not being met, "the AOA is losing valuable members who choose to train inACGME-accredited programs" and many DOs are "break[ing] away from the profession they chose to join." In the near future, recent graduates will start assuming leadership roles within the AOA and will bring with them predominant ideas such as these. If the AOA does not recognize the changes occurring within its membership and adapt to meet the demands required by the new paradigm, it runs the risk of becoming a footnote in medical history. Let's not have any disenfranchised DOs!


    Capt Daron E. Olmsted, DO, MC,

    USAF
    Dr Olmsted graduated in 2007 from
    the Nova Southeastern University College
    of Osteopathic Medicine in Fort

    Lauderdale, Fla.

    https://www.do-online.org/pdf/pub_do0508letters.pdf
     
    #1 Pansit, May 29, 2008
    Last edited by a moderator: Jun 9, 2008
  2. DrMidlife

    DrMidlife has an opinion
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    Yeah, good letter.

    DOs going into specialties, which is not a problem per se, is substantially due to debt loads at graduation. If the AOA, AMA or USA want more primary care physicians, then pushing for free or heavily subsidized med ed is how to do it. Did anybody else notice that the NHSC stands to lose its scholarship funding, again? Did anybody else notice that there's a new push to import more IMGs to staff underserved areas, as was done in the 1970's under Johnson's Great Society?

    It's completely asinine for the DO educational system to identify as oriented toward primary care, when it turns out physicians with $300k in debt.
     
  3. JadinSleeper

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    Amen to that.

    I remember when the AOA president came to my school to berate us about signing our names as "OMS-x" instead of "MS-x". That is the kind of trivialities that the AOA gets hung up on instead of the massive problems glaring them in the face.

    In fact, back around 2003 or 2004, a med student wrote a very eloquent letter to the editor of the DO magazine (or maybe it was the JAOA) about some of the serious issues facing rising DOs.

    Guess what the first paragraph of the response letter from the AOA prez the next month was about - yeah, nagging him about how he didn't append his name as "OMS".
     
  4. PistolPete

    Physician 10+ Year Member

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    Excellent point. I don't know much about the AOA, but from what I've read, it seems they're a stubborn bunch, and it doesn't look like AOA residencies will be opened up to MD's anytime soon.
     
  5. PistolPete

    Physician 10+ Year Member

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    I completely agree. I'm pretty sure the primary care shortage in this country would be alleviated (maybe not totally fixed) by simply paying primary care physicians more. I know a lot of people that started out wanting to go into family medicine or pediatrics, but elected for other specialties simply because as 4th year rolled around, the reality of their financial situation kicked in.
     
  6. sexyman

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    paragraphs are your friend
     
  7. Kubed

    Kubed Mostly Harmless
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    Haha! As if on cue today, my school announced that they were converting a month of FM to an open sub-i.
     
  8. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty
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    It was copied from a PDF, so the spacing was a bit off. I threw in a few paragraph breaks, as I thought it was a good read and hopefully others can read it more easily now.
     
  9. bth7

    bth7 It's worth it in the end . . .
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    I saw this letter when it came out. Olmsted is spot on. Agree 100% with every word. This may very well be a generational thing. I think almost all of in the youger generation feel similarly to Olmsted.



    bth
     
  10. sexyman

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    much appreciated
     
  11. AmoryBlaine

    AmoryBlaine the last tycoon
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    *MD here, just cruising the forums.

    This is an excellent point and one that is not unique to osteopathic schools. I went to a relatively expensive allopathic school that is still trying to preach this sacred gospel of primary care and underserved medicine. I spent the last 3 years there wanting to scream "give us some scholarships and maybe more of us can look at Family Med!"

    Why do some of the powers that be insist to act like the main reasons that people don't go into primary care can be found by examining medical students?
     

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