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Neurogirl, Leotiger, Drusso, etc., your opinions are wanted!

Discussion in 'Medical Students - DO' started by RDJ, Apr 1, 2001.

  1. RDJ

    RDJ

    I have another question I want to ask osteopathic medical students and doctors...I have seen an awful lot of AOA bashing on this website over the past year. With that said, I have no experience regarding this topic; in fact, I am asking the question from ?an outside looking in point-of-view.? I am very interested to hear what you have to say.
    For all of you who hate the AOA and are not members, have you ever stopped to think that you maybe shooting yourself in the foot? The AOA is the ONLY organization on the planet that speaks collectively for DO?s at all levels of government and within the medical community. Without the AOA your schools would not exist, your clinicals would not exist and you would not have a medical license. If the AOA self destructed tomorrow, WHERE WOULD YOU BE?
    Is the right answer to abandon it? If so, what is your objective? What do you hope to accomplish? If the AOA goes away...so does everything osteopathic...so do you. Would a better strategy be to join the organization and change it from within? The individuals on this board are the leaders of tomorrow. If everyone participates in the AOA two things could happen: 1) you may start to appreciate it?s efforts more, and 2) When you see something you do not like, you could collectively speak out in order to change it.
    It works in government (for those who have given up on the process). If enough people do not like what the Mayor is doing, they organize a citywide campaign to have him/her voted out. If you do nothing, then those who like what he is doing, and those who actively participate, will ensure he stays in office. Is this not what you are doing by ignoring the AOA?

    Just curious?

    P.S. I am about halfway though the new book ?Osteopathic Medicine: A Reformation in Progress,? I was wondering if anyone has read it, or had plans to once the semester ends? It is short, only about 130 pages. I really think anyone interested/involved in the profession should read it. So far, it has done a good job of addressing the past, present and future. However, I do feel that I will not truly be able to appreciate it, or form my own opinions for at least 5-6 years...I simply need more experience.

    Thanks for time and opinions,
    RDJ [​IMG]

    P.S. x2, I do not want to imply that by singling out the screen names in the subject that I am saying those individuals are anti-AOA. That was just a ploy to catch the eyes of poster?s and get them to open and read my post. Thanks!



    [This message has been edited by RDJ (edited April 01, 2001).]
     
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  3. Kristi

    Kristi Senior Member
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    Dale,

    I couldn't agree with you more. The way to change it is to join it. There seems to be a surge in interest among students in osteopathic medicine. I'm attending "D.O. Day on the Hill" this month. We're going to lobby our representatives regarding fair representation of osteopathic physicians in legislation that affects medicine. Last year, across the country, there were 70 participants. This year I'm told there are 450, and they had to cap registration...I can't attest to the source of that info, but I'd believe it based on the interest from my school (TCOM). We have 14 students going.

    I really like the idea of the AOA's unity campaign (have you seen the ads--they're great!), although I think it should be more visible, but it's a start. I'm very surprised at how political medical education has turned out to be. I plan to be involved in the politics of medicine as it applies to the osteopathic profession as well as medicine in general. The only way to change things is to do it yourself.

    I do hear complaints from people who say the AOA isn't doing a good job of representing their interests, and I have to admit that I don't know enough about it yet to say whether they are or not. I think osteopathic medicine has reached a plateau recently, and that there's nowhere to go from here except up. In my lifetime, I know things will change because I'm surrounded by people in my class and in classes across the country to want to effect change and growth in our profession. People who share my professional interests will become involved in the AOA, and it will change.

    It's great that you're aware of these issues before you start school. I had no idea about most of this stuff, and I'm learning as I go along. Sounds like you might be AOA material someday...

    Good luck!

    Kristi W.
     
  4. Toran

    Toran Senior Member
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    I'll post more later, but did you know that only 15% allopathic are members of the AMA?

    TOran
     
  5. healthydawg

    healthydawg Member
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    hey, i wasn't called out in the subject line but can i add in my $0.02? i'm headed to DO school next year...

    let me preface this by saying i don't know too, too much about the AOA. BUT, i have read the book mentioned above (reformation) as well as gevitz and other stuff. (great book by the way, everyone should read it.) one of the points the book makes over and over is that the 60% of DOs who do an MD residency "may be lost to the profession forever" or some such similar wording. this strikes me as a funny attitude for a profession that is searching for unity right now. i mean, if i go that route, will my DO trained brethren view me as lost forever? i hope not because i'm choosing to go the DO route for med school. i keep hearing about all the hoops a DO who goes through an MD internship has to jump through to get recognition from the AOA. (i guess this has changed for the better recently.) to me, encouraging unity means the leadership of the AOA should reach out to the majority of DOs who pursue other training options, instead of pushing them farther away. after all, if the leaders of the AOA really believe osteopathy is a reform movement (as is argued in the book), why the historical hostility towards the very people who could lead that reform? i believe that history is why a lot of people are somewhat leery of the AOA. perhaps things are changing for the better but i think they have a lot of old history to overcome.

    anyway, IMHO, reformation can only occur by activity inside AND outside the majority system, unless we're talking about going back to the old days of completely separate hospitals, and everything else (which i don't think is viable these days).

    ok, i'm done ranting, i should really relurk now. later people.
     
  6. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    Lots of good questions, little time to respond. Basically, students like to bash the AOA simply because they can. It is kind of your God-given right as a medical student (MD or DO) to whine. It is true the that historically the AOA has not been very responsive to DO students' needs. In the last few years though this has been slowly changing mostly because anyone who looks at the demographics of the profession can clearly see that the bulk of the osteopathic profession is young physicians or physicians in training.

    AGE GROUP Percent of total
    <35 24.5%
    35-45 32.8%
    45-54 25.7%
    65-74 5.3%
    >75 3.3%

    To ignore the needs of current students, interns, and residents today would be folly to say the least. It is also important to keep in mind that the osteopathic profession is small. Several decades ago it was even smaller. This "coziness" created unparalled provincialism among AOA leaders that is only now beginning to, quite literally, die off. The old joke used to be, "Do you know the osteopathic definition of 'family practice'?" Answ: It's keeping the practice in the family.

    Kristi makes also makes a good point. Whether we be students, interns, or young physicians--this profession is OUR profession. Its future direction is ours to plot. While it is true that one does not have to complete an AOA-approved internship or residency in order to apply osteopathic principles and practices to patient care, the issue does get at the heart of the matter of whether the osteopathic profession can continue to be self-sufficient in producing its own particular brand of physician or will it have to depend on the allopathic for help.

    Peters' makes this point in their study of the academic cultures of osteopathic and allopathic medical schools. The flux of osteopathic medical graduates to ACGME-approved residency programs has led observers to speculate about possible unintended consequences: ?--this dilution of the osteopathic culture, along with the emphasis on high technology and subspecialty medicine practiced at allopathic residencies programs, may diminish the osteopathic residents? positive attitude toward primary care and align their attitudes more closely with the culture of allopathic residency programs. Other osteopathic educators warn that further blending of professional training of osteopathic and allopathic physicians may result in homogenization of two historically separate branches of American medicine and the diminution of osteopathic professional distinctiveness.

    Moreover, as Gevitz reminds us almost constantly, unless osteopathic medicine can contribute something unique to patient care, there is simply no compelling reason for us to exist. That is our challenge. It entails gathering evidence that manipulative interventions are beneficial, that the evaluation and treatment of the neuromusculoskeletal system can impact overall health status, and that the service-oriented, primary-care focused academic cultures of COMs produces a physician who is qualitatively different from that of the "standard model." This is especially difficult if one considers the fact that the first hundred years of the osteopathic profession have been almost exclusively driven by an agenda focused on showing the public how DOs and MDs are the same, not different. Different was bad. Different meant being labeled a quack and cultist. It meant being banished from hospitals, hounded by medical societies, and denigrated by your fellow MD "colleagues." It is not hard to see how DOs of yesterday did not want to be "different."

    Still, the bottom line is the bottom line. If you're in this profession on any level and don't like what you see, then work to change it. We need more good people. Not enough research to support OMT? Get involved. Not enough visibility at your college or university? Get involved. Remember, if you're not part of the solution, then you must be part of the _________.

    Peters, A.S., N. Clark-Chiarelli, and S.D. Block, Comparison of osteopathic and allopathic medical Schools' support for primary care. J Gen Intern Med, 1999. 14(12): p. 730-9.

    P.S. The Reformation book by Gallagher is indeed awesome. Spend the $30--you won't regret it!


    http://www.amazon.com/exec/obidos/ASIN/0443079919/qid=986253215/sr=1-5/ref=sc_b_6/002-1523752-3508055
     
  7. Neurogirl

    Neurogirl Resident Extraordinaire
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    The problem is, the AOA is led by a group of people, many of whom, are inflexible purists who care more about their own agendas than in aiding the profession. In my opinion, the "Osteopathic Unity" campaign is a joke. If our leaders were REALLY interested in uniting our profession they would invest in Graduate Medical Education, OMT research and would change some of the antiquated rules which do nothing but hinder us.

    Until reform occurs within the AOA you'll continue to see students abandoning the organization in droves. This level of reorganization will not occur until the current leadership retires. Many of those still in power were trained in the 60-70s when DOs were not widely accepted and there was alot of animosity between the AMA and the AOA. Unfortunately, many of them are still bitter and instead of moving into the 21st century, would rather maintain the old status quo.

    I wonder if they even understand what it's like to be a practicing physician in today's world. For example, when it comes to OMT, do they even understand the importance of "Evidenced Based Medicine"? Regarding GME, do they not realize the importance of being trained at an academic medical center? Obviously they don't since they make few efforts to form affiliations with university based hospitals or to seek funding for OMT research. A notable exception is the new group of dual AOA/AMA internships. However, these positions have so many additional GME requirements that they're not even worth the trouble. Internship is hard enough as it is.

    Two or three years ago, I listened to a recent past president of the AOA speak to a group of students. He was so bitter and uninformed that it was embarrassing. I wasn't the only one who got that impression and can only hope that the current president isn't such a poor representative.

     
  8. ADRIANSHOE

    ADRIANSHOE Senior Member
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    neurogirl,excellentpoints...theissue ofcourse isto dilutethe organizationwith peoplemore sympatheticto the reasonspeople goto medschool inthe firstplace: tobecome doctors...rarelyto becomesimply DOor MD.

    that said its very important to join the AOA and work from within to topple the infrastructure....its actually very ripe for toppling, if you consider that 90 percent of ostepaths arent traditionalists (and probably arent real involved either, i am guessing) that makes about 3000 purists to be toppled (nicely of course), opening up joint ventures with MDs, supporting instead of ostracizing our colleagues who do MD residencies (as some state boards currently attempt) and relegating OMT to the proper place of "extra" training for those who actually wish to learn it...i know that sounds harsh, but people learn a lot better when they aren't surrounded by 90% of their colleagues who are only there because they have to be...there are those who will argue that this destroys "our unique identity" but this self immolation is fitting, medicine must move on and improve and change...the fact that our degree might lose some meaning that 90% of the degree holders dont ascribe to ANYWAY is a small price to pay...besides Doctor of Osteopathy has already changed its meaning many times in the past hundred year, it will inevitably change more, better to control and guide this change (if possible)than be left in its wake.
     

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