Should DOs and DO students be involved in the AMA?

[TCOM-2006]

hi everyone

i'm pretty new to the whole "blog" thing (just started reading through this site this past weekend)... but i think there is some pretty interesting discussion going on about the future of our profession (and by that i mean the osteopathic profession, and the larger medical profession), and the future of healthcare in general. so i would like to pose a question for discussion which i am particullary interested in:

should DOs and DO students be involved in the AMA?
why or why not?

now - if you read my other two posts - you will see that i feel a certain way about this, but i want to give those of you who have not an opportunity to respond based on your gut feeling.

i also think that another very important topic is being discussed in the "reinventing osteopathic medicine" thread - that is the current and future role of the AOA. i'm going to try and add to the discussion there (next week when i get some more time) - and i would encourage anyone interested to help continue this discussion.

thanks!

bl

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[raptor5]

If you mean in regards to a voice or being able to gain the ear of someone in legislature, my answer is yes. One large voice is better than one big voice and one little voice.

Are individuals other than MDs and DOs able to participate?

 

[Robz]

simple answer....yes


I don't always agree with the AMA or the AMSA but its always good to get your point across or at least heard.

 

[jhug]

I don't always agree with the AMA or the AMSA but its always good to get your point across or at least heard.

amsa is VERY MUCH NOT A PART OF THE AMA!
it was started by the ama (http://www.ama-assn.org/ama/pub/category/14.html) and once it began to push left-wing liberal agenda the AMA started the AMA-MSS (medical student section) and gave students/residence voting power. This last june the AMA-HOD passed 17 of the 19 items we sent them...so the AMA is definitely listening to medical students throughout the country.

Should we be involved...YES!!!! this is the only professional group that represents ALL physicians. As far as the AMA is concerned, that is all there is...physicians...doctors treating patients.
The AOA is there to represent DO specific issues (as soma is with osteopathic student issues).
In my utopia, the AOA would be more friendly/united with the AMA to strengthen the voice of ALL physicians in the US. I've always felt that by joining forces/resources, everyone wins...it should be a synergistic relationship.

 

[Robz]

amsa is VERY MUCH NOT A PART OF THE AMA!

dude.. i know. i was making a generization....no need to yell.

In my utopia, the AOA would be more friendly/united with the AMA to strengthen the voice of ALL physicians in the US. I've always felt that by joining forces/resources, everyone wins...it should be a synergistic relationship.

In a utpoia the AOA would listen to students and other DO physicians and know that the most important things arn't opening more schools or changing the slang name of M1's to OM1's

It seems like there is a ol school us vs them mentality that most of the newer students and doc's don't seem to have as much. (for mainly generational reasons now)

 

[Wahoowa]

should DOs and DO students be involved in the AMA?

Absolutely! This is our field and the future of it depends on us. Doctors need to be politically active and be pushy about their needs and desires in medicine. If not, doctors as a whole will not be happy with the results while the forces are pushing and pulling against us.

 

[daria]

amsa is VERY MUCH NOT A PART OF THE AMA!
it was started by the ama (http://www.ama-assn.org/ama/pub/category/14.html) and once it began to push left-wing liberal agenda the AMA started the AMA-MSS (medical student section) and gave students/residence voting power. This last june the AMA-HOD passed 17 of the 19 items we sent them...so the AMA is definitely listening to medical students throughout the country.

Should we be involved...YES!!!! this is the only professional group that represents ALL physicians. As far as the AMA is concerned, that is all there is...physicians...doctors treating patients. ...

Hm, apparently someone touched a sore spot... It's true that in 1967 AMSA did become independent from the AMA, which later started the AMA-MSS. AMSA definitely tends to be more progressive (or left-wing liberal if you prefer) while AMA-MSS tends to be more conservative (or right-wing neocon if you prefer). However, they are both student-governed, and both work together quite comfortably on numerous issues including medical student debt (c.f. your comment on synergy). And, both represent osteopathic students; of course with the AMA-MSS there is the advantage of same-organization continuity once you graduate. My view is, as a student if you can voice your opinion effectively through TWO organizations instead of one, do it.

The sad truth in politics & healthcare policy is that the squeaky wheel attached to the cartload of money gets the grease. Consequently doctors absolutely have to be vocal, and have to take a role in educating legislators and policymakers. Most of them don't know beans about health care delivery or medicine, and while they have their aides to help them develop positions, politicians especially at the local level are often willing to listen to well-reasoned policy suggestions. At state and national levels, you definitely need that big voice (and, let's be realistic, $) behind you - so definitely take an active role in your professional organizations (AMA, AOA) to make your voice heard.

[Descends from soapbox]

 

[Wo1verine7DO]

It's good to be in the AMA...the AOA just sits around all day creating DO schools and no DO residencies in specialties...I wish they would listen. If they want DO's to do their residency programs with the rotating internship, they should open more residency programs that have decent pass rates...I found out one residency program had a 30% pass rate in IM...that's bad in my opinion. Sorry, I just don't like the AOA right now...although I'm in both organizations...the AMA gives a lot of useful tools like websites, discounts and stuff.

 

[TCOM-2006]

Anyone think there will ever be a DO on the AMA board of trustees?

please note - this is x-posted from the "MD V DO" thread under clinical years:

to answer your question - yes. now- there are many points to be made here (and this related back to the discussion started on another thread "Should DOs be involved in the AMA?" which i have not fully explained my position - but will try to do so soon).

while the AMA's history is certainly that of a purely 'allopathic' organization (and infact, as we all know - has fought against DOs gaining practice rights in the past), today it is a very different organization. while DOs are still 'underrepresented' in the AMA both in terms of membership and leadership, i believe the organization is slowly starting to make the transition to an organization that represents all of medicine - and i strongly believe that is in the interests of both branches of the medical profession to push forward with this vision.

many in the AMA leadership (infact all that i have talked to) are supportive of this vision and welcome DOs to get more involved. i have extensive personal experience with the AMA and, as a DO student, have been treated with nothing but respect from my MD student friends and the AMA physician leadership. these people understand the value in coming together as a unified voice for the medical profession.

however - many of the 'old school' DOs do not share this vision and still view the AMA for what it was - not what it is. this results in missed opportunities that are contrary to our interests. i can give you some concrete examples if you would like me to. it will be our generation that will make the change. many DO students are involved in the AMA medical student section (and i can list examples of leadership here). the relationships that we build as students through our involvement and the experience that we gain by being involved - will bring about future DO leaders of the AMA. this will take some time (years).

let me also say that it's very difficult to get to the AMA board even if you're an MD physician. it requires many years of experience (and networking) at the county, state, and national level. it requires a a great deal of organizational knowledge base as well as leadership skills and tremendous dedication. there are always more candidates than spots available when open seats are elected at the AMA's june meeting. so far - i think i'm safe to assume that a DO has never run for AMA trustee because a DO has never advanced to the point where they would be a worthy candidate. one day that will change, and when it does, i have confidence that the AMA will give a DO a fair shot.

questions? thoughts?

bl

 

[PACtoDOC]

I agree with my fellow schoolmate TCOM-2006. AMA and MD's in particular no longer care whether we are part of their circle or not. They just want active physicians and future physicians to take part in the process and shapre the future. The AOA is too busy sending out fliers asking its members to write in to TV shows and request that a DO be put on TV as a character for a physician. How laughable is that? Talk about our dues dollars at work!! I am a DO student on a huge allopathic state committee that represents over 5,000 physicians in my state. I was selected over many other qualified MD and DO students to be one of 2 students on this committee. I have spoken with PD's at some top-tier programs about coming for residency and I am always amazed at how well the receive me, and begin to engage in the recruitment of me. I was not really ready for this, but I have been pleasantly surprised by it. Bottom line, when the old farts in the AOA finally die from their horrid obesity and old age, we will once again have mainstream modern DO's running the show, like the DO's running my school. These gentlemen will unite the AOA with the AMA to make one ever so powerful organization, and the DO degree will merely be looked upon as one of two undergrad degrees that leads to board certification recognized by the AMA and ACGME. AOA residencies will and probably should fall by the wayside to make room for dual MD/DO programs that offer a few tiny differences in curriculi for DO's if they choose to receive AMA granted "special recognition and certification" as DO's. Good DO programs will sense the impending doom and align themselves with big teaching hospitals and fellow ACGME programs to survive, and the weak ones will die an unpleasant death. But this is survival of the fittest, and makes sense. One day soon there will literally be a DO on every faculty roster for every specialty in the country. And when that happens more DO's will start heading to allopathic residencies. Just look at my own school where we have about a 70% match through the ACGME programs, whereas the other 30% go to AOA programs. With ACGME programs becoming more and more accepting of DO's, more will want to go there. And when DO programs can no longer come close to filling, DO programs will have to close. The AOA has brought this upon themselves through years of isolating itself and claiming to "treat patients, not just symptoms". How offensive is that to all other physicians who care about the "whole person"? The AOA is destined to be no more than an Oxbow Lake, finding itself, stagnant and irrelevent away from the main river flow!!

Yes of course we need to be involved with the AMA, because it represents all of us as physicians.

 

[DireWolf]

I agree with my fellow schoolmate TCOM-2006. AMA and MD's in particular no longer care whether we are part of their circle or not. They just want active physicians and future physicians to take part in the process and shapre the future. The AOA is too busy sending out fliers asking its members to write in to TV shows and request that a DO be put on TV as a character for a physician. How laughable is that? Talk about our dues dollars at work!! I am a DO student on a huge allopathic state committee that represents over 5,000 physicians in my state. I was selected over many other qualified MD and DO students to be one of 2 students on this committee. I have spoken with PD's at some top-tier programs about coming for residency and I am always amazed at how well the receive me, and begin to engage in the recruitment of me. I was not really ready for this, but I have been pleasantly surprised by it. Bottom line, when the old farts in the AOA finally die from their horrid obesity and old age, we will once again have mainstream modern DO's running the show, like the DO's running my school. These gentlemen will unite the AOA with the AMA to make one ever so powerful organization, and the DO degree will merely be looked upon as one of two undergrad degrees that leads to board certification recognized by the AMA and ACGME. AOA residencies will and probably should fall by the wayside to make room for dual MD/DO programs that offer a few tiny differences in curriculi for DO's if they choose to receive AMA granted "special recognition and certification" as DO's. Good DO programs will sense the impending doom and align themselves with big teaching hospitals and fellow ACGME programs to survive, and the weak ones will die an unpleasant death. But this is survival of the fittest, and makes sense. One day soon there will literally be a DO on every faculty roster for every specialty in the country. And when that happens more DO's will start heading to allopathic residencies. Just look at my own school where we have about a 70% match through the ACGME programs, whereas the other 30% go to AOA programs. With ACGME programs becoming more and more accepting of DO's, more will want to go there. And when DO programs can no longer come close to filling, DO programs will have to close. The AOA has brought this upon themselves through years of isolating itself and claiming to "treat patients, not just symptoms". How offensive is that to all other physicians who care about the "whole person"? The AOA is destined to be no more than an Oxbow Lake, finding itself, stagnant and irrelevent away from the main river flow!!

Yes of course we need to be involved with the AMA, because it represents all of us as physicians.

what he said.

question: with all this talk of future dual MD/DO residencies, what makes people think the ACGME will allow this to happen? They have spent countless time, energy, and money setting these programs up. Why would they let DOs move in and reap the benefits? I know that I wouldn't.

 

[Ypo.]

My understanding was that there are already many dually accredited MD/DO residency programs in hospitals and clinics around the country.

 

[DireWolf]

My understanding was that there are already many dually accredited MD/DO residency programs in hospitals and clinics around the country.

Maybe in Family Practice. Other than that, these programs are a rarity.

 

[docbill]

I am going to go out on the edge here and say they probably do want integration.
Even at a big cost. They benefit from having DO filling their positons... since IMG have a harder time to get them now... they need to fill their residencies or they will be cut.

Also, with the expanssion of DO schools and more and more graduates being produced, the risk is that AOA will get their act together and lobby for better rights. If we have join program than there would be no need or grounds to lobby for more residencies.

Also, personal observations, is that MD schools would like to begin incorporating a healthier, preventative, whole bady approach to medicine. Even limited ability to repair injury is being deminstrated by research.

Would all of that lead back to merger attempts?

 

[TCOM-2006]

Bottom line, when the old farts in the AOA finally die from their horrid obesity and old age, we will once again have mainstream modern DO's running the show, like the DO's running my school. These gentlemen will unite the AOA with the AMA to make one ever so powerful organization, and the DO degree will merely be looked upon as one of two undergrad degrees that leads to board certification recognized by the AMA and ACGME.

I appreciate the reply and thoughts from my schoolmate here - but i should clarify my perspective on one issue mentined. i do *NOT* believe that the AOA should merge with the AMA and form one organization. why?...

even though practice rights battles in the U.S. have been fought and won by the AOA (and state osteopathic orgs) - there are still many osteopathic-specific issues, especially in the areas of medical education, and will be for the forseeable future. i attended the AOA house of delegates last year and was suprised by the number of resolutions that involved DO specific issues.

the AOA (and state osteopathic orgs at the state level) are the strongest voice we have for the advancement of these issues - the AMA would not be able to effectively address these issues, even if it had policy supporting them - because they are not the common overarching issues of medicine and healthcare such as medical liability reform, student debt, the uninsured, etc. in other words, the percentage of physicians affected by osteopatic specific issues is very low.

the same logic is true for issues that are specialty-specific. for example - AMA would clearly not invest a large portion of it?s political resources into an ophthalmology-specific issue. If AMA could adequately address all specialty specific issues for all specialties... then there would be no need for specialty society lobby efforts. specialty societies exist, in part, for this very reason.

now - i'm *NOT* saying that osteopathic medicine is a specialty of allopathic medicine - i support the idea that osteopathic medicine is based on a seperate philosophy and view the system as two branches of the same tree.

the only way that the AOA should be merged into the AMA - is if there comes a day when the DO degree essentially no longer exists. i do *NOT* support this and i believe that the AOA should always exist and will have a role to play. the AOA, however, needs to undergo some fundamental change - as i have pointed out in my other post under "Does the AOA represent you" thread. i think all DO physicians and student should be members of both the AOA and AMA.

i have some more things to respond to - but i'm out of time and will have to do so in another post.

bl

 

[Paul1441]

So how do we as students get the AOA to increase the number of DO/MD residencies, especially in specialty areas, since this is where DO's have the most difficulty?

 

[DrMom]

They are working on this, but many residency programs don't really want to deal with 2 separate accrediting bodies.

 

[jhug]

would the potential changes to the match improve on that?
or is this a completely different issue?

 

[DrMom]

The match is a separate issue from the 2 accrediting organizations, although a combined match wouldn't hurt.

I'll post some info from my meeting before too long to give a better update.

 

[Robz]

They are working on this, but many residency programs don't really want to deal with 2 separate accrediting bodies.

I personally think they shouldn't have to deal with two seperate bodies.

I am in the camp for a mixed match, as I think it is the best for both ideals.

 

[DrMom]

Osteopathic programs have some different criteria than allopathic ones, so that's why there are two accrediting bodies involved. Most things are the same or very similar, though.

 

[TCOM-2006]

hi everyone--

--ok, concerning the overarching issue posed as a question in the title of this thread, i have made the points that:

1> the AMA and AOA should *not* be merged - the AOA has a clear role in protecting and promoting osteopathic-specific issues.

2> the AOA should re-examine its own structure and internal politics to make sure that it is best representing the views of the majority of DOs and DO students in this country.

3> the osteopathic profession faces some important issues, especially in medical education, and the AOA needs to actively address these. i have pointed out a mechanism and posted resources to cause change in AOA policy and priorities (ie - the resolution writing process).

<<anyone disagree, agree or would like to comment on these points? - if you want to comment on point #2 or #3 - please post under "does the AOA represent you?" thread>>

So ? now let me address why I think it?s important for DOs and DO students to be involved in the AMA (modified from previous post on AMSA/SOMA thread):

First, it's important to recognize that, while the AMA has lost membership recently, it's still the most influential physician/student organization, and the actions it takes (which is based on its policy) therefore has a larger potential to influence the outcome of legislation and policy which will affect everyday life for physicians and patients than any other physician or med student org. for example, the AOA Washington's lobby budget for 2000 was $400,000 while the AMA's was $16,580,000 and, in 2002 - the AMA gave ~ $2.5 million in political contributions while the AOA gave ~ $190k. my point is that we (DOs/DO students) should seek to gain influence over what will ultimately affect us - it is in our interests to get involved (involvement = influence)

\\\
http://www.opensecrets.org/lobbyist...e=H01&year=2000
http://www.opensecrets.org/pacs/ind...=H01&cycle=2002
///

second, many of the big issues (medical liability reform, the uninsured, etc) are not osteopathic specific issues - and we as a medical profession need to come together and debate - pass policy - and take action on these big issues. while some may call the AMA "that allopathic organization" (and that is certainly its background) - the truth is that the AMA is moving in the direction of becoming an organization which represents all of medicine (both the allopathic and the osteopathic branch). how fast this change occurs is up to us ? as I have mentioned before, I believe that a DO can be elected to the AMA board of trustees.

third, our involvement within the AMA fosters opportunity for advances in mutual understanding, respect and cooperation between the two branches.
we have more important battles to fight than with each other.

fourth, regarding students specifically - the MSS (= medical student section) of the AMA is very very effective in getting what it wants through the AMA house of delegates. for example - at the most recent meeting in june 16 of 19 resolutions submitted by the MSS were passed, and the other 3 were referred for further study. the physicians really listen to students, and we benefit from learning from their experience and knowledge.

i could go on and give you more specific examples or info - but that should do for now. questions / thoughts?

bl

 

[TCOM-2006]

i need to update a couple of the links i referenced in my previous post.

**to view a comparison of contributions to monitary candidates for federal office from different health professional political action committees (PACs) - including the AOA and AMA for 2002, see:

http://www.opensecrets.org/pacs/industry.asp?txt=H01&cycle=2002

if you need an overview of what a PAC is - there is some information on this website, or ask me if you have a question.

**to view a comparison of lobbying dollars spent by different health professional organizations (including the AOA and AMA) for 2000, see:

http://www.opensecrets.org/lobbyists/indusclient.asp?code=H01&year=2000

there is all kinds of interesting stuff on this website. also - it's worth noting that the AMA is consistently ranked in fortune's "power 25" - the 25 most powerful groups in Washington DC. it's usually toward the middle (11 or 12). i would reference the site, but it requires a subscription

all this is to say that the AMA is a influential group that can make change happen. i say it's best for DOs and DO students to become an active part of the AMA to help shape what the AMA stands for rather than be shaped by it (or waste resources fighting the AMA unecessarily after the organization takes a position on an issue).

bl

 

[TCOM-2006]

ok - one more interesting stat on the AMA - the data's a little old - but it illustrates the point:

http://www.opensecrets.org/pubs/lobby00/topspenders.asp

this compares the AMA lobby spending with all other industries. The AMA has the 2nd biggest lobbying budget of any organization or company. there are no other physician groups in the top 100.

 

[jhug]

we have more important battles to fight than with each other.

THIS IS SO TRUE!!!!
I can understand (or at least try to) why some DO's would be upset if they were directly effected by the great medical coup of the 70's when MD's tried to merge our professions...thing is...that was 40+ years ago!!!! it's time to move on to new battles...like med liability, expanding our grossly inadequate post grad education, student debt, etc...i find it so odd when mature, educated, capable professionals turn into trembling children any time the AMA is brought up in conversation...granted, the majority of those are older, but you still see it being passed on to some now.

 

[newyorkcougar]

In "The DO's: Osteopathic Medicine in America," Norman Gevitz (who is interestingly not a physician and therefore theoretically unbiased) asserts that the AMA has changed its strategy for the elimination of DO's from legal erradication of the profession to incorporation of DO's on a national level in a manner similar to the infamous California merger of 1961. He furthermore asserts that the AMA is actively persuing DO membership in the AMA to encourage this potential subsumption.

I am not sure that the AMA is quite so insidious. I think that the national leadership of both the AMA and OAO rightly believe that there should be complete professional partnership between allopaths and osteopaths. Incorporation of both in each professional organization furthers this cooperation.

The two organizations clearly have much in common, and can draw strength from each other's numbers. Common battles such as malpractice legislation and insurance, public health policy, etc., make a partnership and even integration a must.

Do you think the AMA is really trying to subsume all DOs to eliminate the profession? Do you feel that membership of DO's in the AMA weakens osteopathic independence?

 

[TCOM-2006]

In "The DO's: Osteopathic Medicine in America," Norman Gevitz (who is interestingly not a physician and therefore theoretically unbiased) asserts that the AMA has changed its strategy for the elimination of DO's from legal erradication of the profession to incorporation of DO's on a national level in a manner similar to the infamous California merger of 1961. He furthermore asserts that the AMA is actively persuing DO membership in the AMA to encourage this potential subsumption.

I am not sure that the AMA is quite so insidious. I think that the national leadership of both the AMA and OAO rightly believe that there should be complete professional partnership between allopaths and osteopaths. Incorporation of both in each professional organization furthers this cooperation.

The two organizations clearly have much in common, and can draw strength from each other's numbers. Common battles such as malpractice legislation and insurance, public health policy, etc., make a partnership and even integration a must.

Do you think the AMA is really trying to subsume all DOs to eliminate the profession? Do you feel that membership of DO's in the AMA weakens osteopathic independence?

i don't have to much time to eloborate here, but my answer to your two final questions would be *NO* and *NO*.

it's important to realize that the AMA is no longer the organization that represents "allopathic medicine" - although that is certainly it's *history*, as i have mentioned previously. in other words:

AOA is to osteopathic (DO) profession as
AMA is to allopathic (MD) profession

is an *incorrect* analogy (flashback to taking the SAT )

the AMA is becoming an organization that represents all of medicine - MD and DO, generalists and specialist, etc. just wanted to make that point clear (as i have described before), before making the next key point that starts to answer your question:

the AMA is a **policy based organization** it takes actions based on what policy is passed by it's "house of delegates".

by he way - several DO students and physicians have served/are serving as voting delegates to the AMA house of delegates - therefore - they can influence the outcome of any policy proposed. also - the AMA has given the AOA the ability to send voting delegates to the AMA-HOD - an opportunity that the AOA has, in my view, foolishly ignored.

anyway, if the AMA wanted to absorb/eliminate the DO profession - it would have to be stated as such in its policy, and it is not (i have previously posed a link to the searchable database of AMA policy - check it out for yourself). also - the leadership of the AMA (the board of trustees, etc) are all elected by the AMA house of delegates - and voting DO students or physicians can therefore have influence in these elections, or run themselves.

i have also had the opportunity to interact personallty with AMA leadership (including members of the board of trustees), and have discussed with them some of these issues - and have found there to be strong support both for DO membership and participation within the AMA and our continued involvement as a distinct branch of the medicine tree through the AOA.

i think my above and previous comments speak to the second question you proposed.

one other point that i wanted to add about your comment regarding the national leadership of both organizations believing in parternship. clearly the AMA and AOA (as well as many other medical and sometimes nonmedical organizations) can share agenda items in common - and they do cooperate with each other through coalitions in Washington (eg - HCLA). that's very good an should continue. both AMA nad AOA leadership recognize and support this. where the difference becomes is that the AOA leadership (generally) does *not* support DOs joining the AMA because they mistakingly view the AMA as "that allopathic organization". they view the above analogy as correct (and would therefore get this SAT question wrong if i were writing it).

good discussion!
questions / thoughts?

bl

 

[Docgeorge]

TCOM-2006,
Very eloquently stated. Some of the issiues that the "old school" osteopaths have is still alive and present at my school esp by certian faculty. This came to light when we tried to get a chapter of the Iowa Medical Society started on campus. You should have seen the hollering and screeming that went on here by the aftermentioned faculty. Luckily the powers that be sided with us and we now have a large IMS chapter on campus. The Profession (DO and Medicine as a whole) is in a period of transition it makes much more sense to be involved in large organization that present a unified front to the government and the public. An orginization that can better lobby and better repersent views that are important to all of us. I think that one day soon we will see the AOA take a seat on the house of delagates of the AMA. It still boggles my mind at the resistance put up by some people about takeing the seat. Are they wearing blinders, not able to see past their own prejudices and misconseptions?

One of the things that doesnt sit well with me is the fact that the AOA has accredidation powers. It kind of unsettles me that they have these powers I would much rather see these powers in the hand of some other body much the LCME and the ACGME.

gotta go I'll finish this thought later.

 

[H0mersimps0n]

In a world where scientific fact trumps experience or professional opinion it is obvious the Osteopathic profession needs to increase it's research 1000x's into our techniques and practices. The AOA needs to spearhead this movement or else we will be consumed (and rightfully so).

It's very clear that physicians no long have the honor nor respect from the general public and people demand proof and aren't afraid to ask WHY when it comes to treatments- "because Dr. X told us he cured 100000 people with this technique in OMM lab" just doesn't quite fit the bill anymore.

My fianc?e went into allopathic medicine because of the lack of [legitimate] research in our field which I totally understand because she is seriously considering doing clinical research someday.

I see that a few schools are making a stronger push to get some research going but after attending the international research conferences at LECOM I must say I'm disheartened that DO's will be able to escape inevitable consumption due to gross lack of research technique, stastical analysis and inability to make logical conclusions (correlation without causation is #1 enemy of DO's).

I'm not down on Osteopathic medicine, I love it, I love (some of) the techniques and thing how we are taught to touch and treat and think of the human body is an essential part of medicine, no matter what specialty. I just think this profession is being self destructive and the AOA is at the helm of the sinking ship...

 

[newyorkcougar]

TCOM makes an interesting point about the reluctance of the AOA to get too involved witht he AMA. The AMA has designated two seats in its House of Delegates for AOA representatives, but the AOA has refuesed to accept them. The AOA is still fighting to remain wholly independent of the AMA while cooperating as "separate but equal" peers on certain issues.

 

[TCOM-2006]

TCOM makes an interesting point about the reluctance of the AOA to get too involved witht he AMA. The AMA has designated two seats in its House of Delegates for AOA representatives, but the AOA has refuesed to accept them. The AOA is still fighting to remain wholly independent of the AMA while cooperating as "separate but equal" peers on certain issues.

i believe that the participation in the AMA house of delegates by the AOA does *not* compromise it's independence and it's ability to act independently.

although the AMA has individual membership - it's house of delegates (policy formation and leadership-electing body) is composed mostly of delegates from independent state and specialty societies (these organizations are given representation based on the # of AMA members per state/specialty). although not officially - the AMA is in many ways like an "organization of organizations". let me give you an example of what i'm talking about:

let's say that family practice doctors want to delete federal law "x". so - a resolution is passed in the AAFP (american academy of family physicians) house of delegates that says AAFP supports deleting law "x", and - will ask the AMA to support deleting law "x".

the "AAFP delegation to the AMA" then submits a resolution calling for the AMA to support the deletion of law "x" to the AMA house of delegates. let's look at the two possible outcomes:

1> the AMA passes the resolution --> so now both the AMA and the AAFP have the same policy and can both lobby for the deletion of law "x". perhaps some other specialty societies think it is a great idea to delete law "x", so they take it back to their own HOD for consideration. pretty soon - you have most of the "federation of medicine" on board with the idea, and lobbying for the deletion of law "x"

2> the AMA defeates the resolution --> AAFP is *still* going to lobby congress to delete law "x", even though the AMA will not because it is an *independent* organization and it is not bound by AMA policy.

the same could be true with the AOA. by not sending their delegates, they are loosing the opportunity to bring on board the political might of the AMA in their direction... and the AOA loses *nothing* in trying to do so - because it is an independant organization that is not bound by AMA policy. the other specialty and state medical organizations realize this - the AOA leadership apparently does not. this stems from a fundamental misunderstanding of what the AMA is.

now - let me make a loose analogy to help illustrate (and i say loose, because the analogy does not corretly explain some other things). the view that the AMA and the AOA are "seperate but equal" is like comparing two soverign nation states - like canada and australia. what i am saying - is that the AMA is more like the "united nations" of medicine in many ways - where many nation-states participate, but retain their soveringty to self-govern and act alone. does this make sense?

hope this helps explain my perspective on this whole complex issue. ...back to studying...

bl

 

[TCOM-2006]

TCOM-2006,
Very eloquently stated. Some of the issiues that the "old school" osteopaths have is still alive and present at my school esp by certian faculty. This came to light when we tried to get a chapter of the Iowa Medical Society started on campus. You should have seen the hollering and screeming that went on here by the aftermentioned faculty. Luckily the powers that be sided with us and we now have a large IMS chapter on campus. The Profession (DO and Medicine as a whole) is in a period of transition it makes much more sense to be involved in large organization that present a unified front to the government and the public. An orginization that can better lobby and better repersent views that are important to all of us. I think that one day soon we will see the AOA take a seat on the house of delagates of the AMA. It still boggles my mind at the resistance put up by some people about takeing the seat. Are they wearing blinders, not able to see past their own prejudices and misconseptions?

One of the things that doesnt sit well with me is the fact that the AOA has accredidation powers. It kind of unsettles me that they have these powers I would much rather see these powers in the hand of some other body much the LCME and the ACGME.

gotta go I'll finish this thought later.

interesting thought about the AOA and accredidation. i have wondered why the AOA and AACOM have not formed a joint-committee for accredidation of osteopathic schools (like the AMA and AAMC have via LCME). to answer this some of this i would really need more of an in depth understanding of funding mechanisms behind all of these organizations - and the advantages/disadvantages of somewhat removing the accredation process for the primary professional organization. i'm not a med-ed expert. i would be interested in hearing your thoughts on this issue.

bl

 

[TXsongdoc08]

Congrats to all, these are some of the first meaningful threads I have found on SDN in AGES, I had almost given up on this site. I thought every thread got reduced to pointless name-calling and BS...but happy to see this is not the case!

I'm wondering if the AMA or the AOA really have patient's interests at heart. I have serious doubts that the AMA does, and I don't know much about the AOA's policy stances yet...but from what I gather, they don't have many policy stances, and those they do have don't carry much weight.

The problem I see is this...to be a hot shot politico/physician-bureaucrat delegate with the AMA or AOA you have to be...a hot shot politico/ bureaucrat. One only has to take a glance at our current national healthcare meltdown to see what bureaucrats and professional politicians, even physician-bureaucrats can do with healthcare. AMA does not and has almost never supported meaningful, proactive healthcare reform, and there are reasons for this---wealthy physicians linin' those pockets and protecting their pocket linin'. So, what do we do about it? Do we support the AMA by joining and giving them money to press their agendas that have little to do with the advancement of good healthcare, or do we not support them? Do we join just so that we can have a voice...a voice that will probably mean very little in the grand scheme? Do we express our own poltical healthcare concerns directly to our representatives-- do they care? Do we join the AMA/AOA, and slowly climb to the top, finally emerging with our bright-eyed and well-intended idealism still intact?---in a perfect world, the latter seems best, but does it ever happen?

Another problem I see is accountability. How do we express ourselves to these organizations? In politics, its ultimately done with a vote. If we disagree with what our representative is doing, we stop supporting them. So many feel that if we disagree with the AMA, we should stop supporting them. This is not an unwarranted approach. It is a political organization, who plays a large role in healthcare policy. The problem with this reasoning is that the AMA is never going to step down...their term is never over. So, it must be changed by active involvement from its members, especially those that disagree with its stances. Physicians are a meaningful lobby...perhaps not nearly as powerful as insurance and pharmaceutical companies, but meaningful nonetheless. And any organization that attempts to press OUR agendas with the same voracity as those wealthy corporate-centered groups do should be supported.

So, to sum up. DOs are physicians...therefore the AMA represents us, whether we like it all the time or not. If we are dissatisfied with the direction healthcare is taking in this country, we have no choice but to be involved with the AMA...they are the group with the means to bring about change. In fact, they will bring about change, we just have to make sure they are pushing the right policies and agendas. A complacent membership is likely the reason their current policies do not align well with what DOs and DO students are looking for in a professional organization. Who can change that?

P.S. It was hard for me to join the AMA, because I have disagreed with so many of its policies. But, I finally realized that not joining is to uphold the status quo, and lets face it, the status quo sucks. Power to the people. Oh?btw, I know very little about very little, so, take as directed: prn w/ grain of salt.


-CW, TCOM 2008

 

[TCOM-2006]

Congrats to all, these are some of the first meaningful threads I have found on SDN in AGES, I had almost given up on this site. I thought every thread got reduced to pointless name-calling and BS...but happy to see this is not the case!

I'm wondering if the AMA or the AOA really have patient's interests at heart. I have serious doubts that the AMA does, and I don't know much about the AOA's policy stances yet...but from what I gather, they don't have many policy stances, and those they do have don't carry much weight.

The problem I see is this...to be a hot shot politico/physician-bureaucrat delegate with the AMA or AOA you have to be...a hot shot politico/ bureaucrat. One only has to take a glance at our current national healthcare meltdown to see what bureaucrats and professional politicians, even physician-bureaucrats can do with healthcare. AMA does not and has almost never supported meaningful, proactive healthcare reform, and there are reasons for this---wealthy physicians linin' those pockets and protecting their pocket linin'. So, what do we do about it? Do we support the AMA by joining and giving them money to press their agendas that have little to do with the advancement of good healthcare, or do we not support them? Do we join just so that we can have a voice...a voice that will probably mean very little in the grand scheme? Do we express our own poltical healthcare concerns directly to our representatives-- do they care? Do we join the AMA/AOA, and slowly climb to the top, finally emerging with our bright-eyed and well-intended idealism still intact?---in a perfect world, the latter seems best, but does it ever happen?

Another problem I see is accountability. How do we express ourselves to these organizations? In politics, its ultimately done with a vote. If we disagree with what our representative is doing, we stop supporting them. So many feel that if we disagree with the AMA, we should stop supporting them. This is not an unwarranted approach. It is a political organization, who plays a large role in healthcare policy. The problem with this reasoning is that the AMA is never going to step down...their term is never over. So, it must be changed by active involvement from its members, especially those that disagree with its stances. Physicians are a meaningful lobby...perhaps not nearly as powerful as insurance and pharmaceutical companies, but meaningful nonetheless. And any organization that attempts to press OUR agendas with the same voracity as those wealthy corporate-centered groups do should be supported.

So, to sum up. DOs are physicians...therefore the AMA represents us, whether we like it all the time or not. If we are dissatisfied with the direction healthcare is taking in this country, we have no choice but to be involved with the AMA...they are the group with the means to bring about change. In fact, they will bring about change, we just have to make sure they are pushing the right policies and agendas. A complacent membership is likely the reason their current policies do not align well with what DOs and DO students are looking for in a professional organization. Who can change that?

P.S. It was hard for me to join the AMA, because I have disagreed with so many of its policies. But, I finally realized that not joining is to uphold the status quo, and lets face it, the status quo sucks. Power to the people. Oh?btw, I know very little about very little, so, take as directed: prn w/ grain of salt.


-CW, TCOM 2008

very good and insightful post - you bring up some important questions and i have a lot of things i would like to comment on here. for now, let me just reference a site where those that are interested can become familiar with the policies of these organizations.

AMA
http://www.ama-assn.org/ama/pub/category/12842.html
http://www.ama-assn.org/ama/pub/category/2625.html
http://www.ama-assn.org/ama/noindex/category/11760.html

AOA
http://do-online.osteotech.org/index.cfm?PageID=gov_priorityprof
http://do-online.osteotech.org/index.cfm?PageID=ps_yearbook

also - i would just note that the AMA is again, a democratic, policy driven organization - and it's policies have and can be changed. as i have mentioned before, medical student representation in the AMA is quite large (with aprox 20 student delegates ... larger than most state and specialty societies) and it's structured in a way that allows us to be effective (16 of 19 resolutions introduced from the MSS were passed in the HOD - and the other 3 were referred for further study at the last meeting).

i'll post a more extensive reply when i get some more time

bl

 

[TucomDoc]

I was a student delegate to both the AOA (as student body president) and AMA. It is ridiculous and misguided to think that we need to keep the AMA away from students and off campuses. Look at what happened with the physical skills exams - the AMA came out completely opposed to it, with a resolution that came through the Student House of Delegates. The AOA heard exactly the same message from the students, and came out in support of it. That's ridiculous. Now I, you, and all those who come after us will pay for this lack of foresight. The AMA is infinitely better at its mission than the AOA, and must be allowed, even encouraged, on osteopathic campuses.

I'm a strong believer in the AOA and the difference and benefits that an osteopathic physician has. But the AOA can never become as effective a body for change and voice of the physician and here's why:

The AOA is attempting to act both a advocacy group for physicians and patients, and as an oversight body.

(For example, who determines what colleges can be formed, what it takes to be a DO, etc?) The AMA is solely an advocacy group. A group can never simultaneously espouse advocacy and oversight and be effective. Remember how well that worked with the SEC? The Nixon government? Why do you think we have, constitutionally at least, established a division of powers (and authority). Until and unless the AOA splits itself into those two essential divisions, the AMA wins every time. And no one in power at the AOA seems to comprehend that it's possible to gain power be dividing it.

 

[TCOM-2006]

I was a student delegate to both the AOA (as student body president) and AMA. It is ridiculous and misguided to think that we need to keep the AMA away from students and off campuses. Look at what happened with the physical skills exams - the AMA came out completely opposed to it, with a resolution that came through the Student House of Delegates. The AOA heard exactly the same message from the students, and came out in support of it. That's ridiculous. Now I, you, and all those who come after us will pay for this lack of foresight. The AMA is infinitely better at its mission than the AOA, and must be allowed, even encouraged, on osteopathic campuses.

I'm a strong believer in the AOA and the difference and benefits that an osteopathic physician has. But the AOA can never become as effective a body for change and voice of the physician and here's why:

The AOA is attempting to act both a advocacy group for physicians and patients, and as an oversight body.

(For example, who determines what colleges can be formed, what it takes to be a DO, etc?) The AMA is solely an advocacy group. A group can never simultaneously espouse advocacy and oversight and be effective. Remember how well that worked with the SEC? The Nixon government? Why do you think we have, constitutionally at least, established a division of powers (and authority). Until and unless the AOA splits itself into those two essential divisions, the AMA wins every time. And no one in power at the AOA seems to comprehend that it's possible to gain power be dividing it.

insightful post, and i agree with most of what you have said - re: this issue of AMA chapters not being allowed to form on DO campuses - how do you think we can address the issue? a resolution to the AOA? to the AACOM board of deans?

i believe that there has to be come kind of top-down approach to the situation that would give protection to students who might want to form a chapter at schools where administration currently is in opposition. once this protection is achieved - then students at the individual schools will be able to decide for themselves whether or not they want to form an AMA chapter, according to the school's individual existing guidelines about forming any new organization.

and of course - the formation of an AMA chapter still leaves the individual students the choice to join or not to join - a chapter simply provides them with the ability to make an informed decision - and to represent those that choose to join at the state and national levels.

even if such an issue is voted down - it will force discussion and recognition of this problem.

 

[newyorkcougar]

Im am confused. Which schools are we talking about here? Are there osteopathic schools with no AMA chaper? PCOM has one, not to mention a chapter of AMSA...here is the description of the AMA-MSS from the PCOM website: http://www.pcom.edu/Student_Life/Student_Organizations/Student_Organizations.html

AMERICAN MEDICAL ASSN. - MEDICAL STUDENT SECTION (AMA/PMS-MSS)
The core purpose of the AMA-MSS is to represent medical students, improve medical education, develop leadership, and promote political awareness and activism to further the health of America. As a student member of the AMA you do have a voice! Aside from our above purpose, this organization was designed to give students the opportunity to have meaningful input into the decision making process of the larger association (AMA). PCOM has historically had a strong presence within AMA-MSS, our members holding positions at the state, regional, and national levels. Currently, we also have the largest membership of all the schools in the Medical Student Section in the state of Pennsylvania. As an osteopathic chapter of the AMA/PMS-MSS, we are dedicated to promoting osteopathic medicine within the medical community. Our voting presence at the local, state, and national levels provides the opportunity to increase the awareness of our profession and to play an active role in the establishment of medical policy.

In response to an earlier posting about DO representation in AMA leadership, the immediate past president of the Colorado Medical Association (CMA) was Christopher J. Unrein, DO. Obviously, the CMA is the traditionally allopathic analogue of the Colorado Society of Osteopathic Medicine. It is interesting that the CMA had a DO president because Colorado is not a state with a strong osteopathic presence. In fact, there is only one AOA-approved residency in the entire state. I think--or at least I would like to think-- that this example in Colorado shows a greater degree of cooperation between the two schools of medical training.

Another thing that bothers me is reference to allopathic and osteopathic medicine as different professions. This happens a lot in the literature. This strikes me as absurd. We are both physicians with only subtly different philosophies. One profession, two philosophies. What do you think?

 

[Ice-1]

hi everyone--
fourth, regarding students specifically - the MSS (= medical student section) of the AMA is very very effective in getting what it wants through the AMA house of delegates. for example - at the most recent meeting in june 16 of 19 resolutions submitted by the MSS were passed, and the other 3 were referred for further study. the physicians really listen to students, and we benefit from learning from their experience and knowledge.
bl

I wonder how this stacks up with the statistics of the AOA acceptance of SOMA resolutions. Not very well, I'd guess especially considering the way they stomped the joint match. But if anyone knows those stats for comparison put 'em up!

 

[Docgeorge]

Lets not forget the current natl president of the ACEP is a DO.

 

[BlondeCookie]

AOA is for DO professionals.
AMA is for MD professionals.
Correct?

 

[Dies Irae]

AOA is for DO professionals.
AMA is for MD professionals.
Correct?

AMA has power. AOA doesn't.

 

[TCOM-2006]

AOA is for DO professionals.
AMA is for MD professionals.
Correct?

basically (the short answer)...

--AOA is for DO professionals

--AMA is for MD and DO professionals (although in the past the AMA used to be only for MD professionals - and many continue to make the mistake of viewing the AMA for what it once was instead of what it currently is).

--also - the CMA (colorado medical assn) accepts both MDs and DOs as members - and, like the AMA, cannot therefore be considered an "allopathic organization." it's also worth mentioned that the president of the iowa medical society is a DO. the pennsylvania medical society has a DO on their board. there are growing examples of DO leadership within organizations that represent all of medicine, and this will continue to increase.

the long answer...

active membership in DO organizations (AOA, state DO organizations) should remain the number one priority of every DO and DO student. Our osteopathic profession has come a long way – and we should be very mindful and appreciative of the physician and staff leadership that has brought us this far, and continues to advocate on behalf of the profession. however, DO physicians and students have a responsibility to become directly involved within the larger context of the medical profession – and the national vehicle for that opportunity is the AMA.

the AMA cannot continue to be viewed for what it was – it must be viewed for what it is, and what it has the potential to become. That is – the AMA is no longer a purely “allopathic” organization: DO and DO student members have all the rights and privileges as any other member, DOs have the opportunity to become involved in the leadership (this is currently starting at the state levels – e.g. Iowa and Colorado – and specialty societies and will move up to the AMA over years to come). I have zero doubt that a DO could be elected to the AMA-BOT given the right experience, knowledgebase, and connections. it’s difficult from some DO physicians – who fought against the AMA and state allopathic organizations for practice rights – to grasp this new concept of what the AMA has now become and has the potential to become with continued DO involvement, but it does not change the fact that this change within the AMA is and will continue to evolve.

the AMA is still undeniably the largest, most influential physician group in the US. This is true from a standpoint of lobbying resources (the 2000 numbers are available at: http://www.opensecrets.org/lobbyists/indusclient.asp?code=H01&year=2000), name recognition, and PAC dollars (see: http://www.opensecrets.org/pacs/industry.asp?txt=H01&cycle=2004)for 2004 numbers.

Issues such as the uninsured, PLI, SGR, student debt, etc are not limited just to one branch of the profession, as you well know, so the simple question is – if we want to achieve the goal of influencing the legislative and regulatory context in which we practice - it is in our best interests to join and get involved in the AMA - this influence does not come with isolation. It also gives us an ability to advocate for specific issues – or for specific angles / provisions within issues within the AMA, so the AMA won’t advocate for something that DOs oppose (It’s much easier to solve these problems in the AMA-HOD than to have to waste any AOA resources and political capital that could have been spent in advocating our specific issues, and adding their influence to the common, overarching issues such as PLI).

the AOA is not a specialty college. I would further state that osteopathic medicine is not a specialty of allopathic medicine – but rather they are two separate branches.

the AMA is like a “united nations” of medicine and the AOA is like a “soverign nation-state” (I think this analogy helps illustrate the true nature of the relationship between the two organizations). this “UN” is not allopathic. I think many still view the AMA for what it once was (a purely allopathic organization - making the past relationship one of two co-equal “nation states” – e.g. Canada and Italy, where you are basically either a “citizen” – member – of one or the other).

more later...

 

[TCOM-2006]

AMA has power. AOA doesn't.

well - the AMA does have a much larger lobby budget, and contributed much more PAC dollars to elections. however, the AOA, i believe, does do a good job with the resources they have, do a great job at mobalizing their grasroots (eg - DO day on the Hill, and their email advocacy network) - and do collaborate with the AMA on common issues at the staff level in DC. it's important for DOs to join and support both the AOA and AMA. take this from someone who has completed health policy internships in both the AOA and AMA Washington offices.

 

[TCOM-2006]

Im am confused. Which schools are we talking about here? Are there osteopathic schools with no AMA chaper? PCOM has one, not to mention a chapter of AMSA...here is the description of the AMA-MSS ... What do you think?

please see my reply to this question at:
http://forums.studentdoctor.net/showthread.php?p=2784721#post2784721

 

[Doc Oc]

Maybe in Family Practice. Other than that, these programs are a rarity.

I recently did a search on the DO-Online opportunities database looking for internal medicine residency programs that are dually accredited. The results were interesting, so I thought I'd post them here.

First, I just searched for internships in general. There were about 280 of them.

Internships can be traditional rotating internships, or they can have a "specialty track" in another discipline, one of those being IM. I then saved to my folder only the internship programs that also offered an IM specialty track. There were about 65 of these.

I went to all 65 websites, and noted the programs where this internship year was AOA/ACGME accredited. There were 48.

Of the 48, how many do you think had AOA residency programs? Most of these places with internship years also had /a/ residency program, but it was usually an ACGME program. There were only 5 internal medicine residency programs that were AOA accredited.

There are obviously more than 5 osteopathic internal medicine residency programs, but this just adds to the previous point that although there are programs that are dually accredited, there are very few even in a large discipline like IM.

A friend of mine went into neurology, and did a similar search to find programs to apply to. There was one neurology program that was dually accredited.

What does this mean? I don't know. I thought that those discussing the topic of dual accreditation might be interested since I knew some real numbers offhand.

 

[TCOM-2006]

I recently did a search on the DO-Online opportunities database looking for internal medicine residency programs that are dually accredited. The results were interesting, so I thought I'd post them here.

First, I just searched for internships in general. There were about 280 of them.

Internships can be traditional rotating internships, or they can have a "specialty track" in another discipline, one of those being IM. I then saved to my folder only the internship programs that also offered an IM specialty track. There were about 65 of these.

I went to all 65 websites, and noted the programs where this internship year was AOA/ACGME accredited. There were 48.

Of the 48, how many do you think had AOA residency programs? Most of these places with internship years also had /a/ residency program, but it was usually an ACGME program. There were only 5 internal medicine residency programs that were AOA accredited.

There are obviously more than 5 osteopathic internal medicine residency programs, but this just adds to the previous point that although there are programs that are dually accredited, there are very few even in a large discipline like IM.

A friend of mine went into neurology, and did a similar search to find programs to apply to. There was one neurology program that was dually accredited.

What does this mean? I don't know. I thought that those discussing the topic of dual accreditation might be interested since I knew some real numbers offhand.

thanks for the numbers. while not really related to this thread title, this is helpful to understand the current situation with osteopathic GME. although dual-accred is great, and i hope it continues to grow - i think there is limited potential for growth - and it certainly will not be solve the problem of inadequate AOA GME (which will become a even more difficult challenge with the opening of new schools - and more DO grads in the pipeline). as we know - even though there is fewer osteopathic GME slots than DO grads - there are many programs that don't fill. could we fill more AOA slots via a combined match? this is the million dollar question...

 

[TCOM-2006]

also - somewhat relating to this issue, is whether or not the AOA should fill it's seat in the AMA house of delegates. the AMA has created a voting seat for the AOA, but the AOA has chosen not to send representation. since the issue was mentioned on the AOA blog (and also in the latest "DO"), i posted a reply to the blog at:

http://www.do-online.osteotech.org/blog/index.php?itemid=642#comments

that might interest some of you...

thoughts?