The real future of Osteopathy

[allendo]

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To be fair, the report only ranks U.S. schools...that doesn't say anything about the relative quality of medical education at Carribean schools.

Exactly why should you rank something that's not regulated!

 

[Portier]

Here's a funny truth about medical politics.

A doctor I know (DO) is part of a group practice in his specialty (let's say left pinky surgery [LPS] for a euphemism).

He and his partners were looking for a new LPS to join their practice and share some of the load. Two of the physicians are US MD's, two are FMG MD's, and then there's him...DO.

So, a DO applies who went through AOA boards for LPS specialization. All the docs think this is cool, except one FMG. He says that the AOA board specialized LPS isn't good enough to be in their practice beause he doesn't respect the AOA standards.

Funny thing is the only guy who whined about his specialization FAILED the AMA LPS boards the first time he took them.

How's that for hypocritical?

 

[jintonic5]

Exactly why should you rank something that's not regulated!

hmmm i'm just a lowly lurkin' pre-med student who's looking into all of her options for medical school... but i always thought that the doctor is as good as their breadth of knowledge and ability to treat patients, as opposed to whether they are an FMG, MD, or DO. i don't see the point in counter-dissing FMG med students who diss the OMS's. call me naive, but i'd rather have a competent FMG than an incompetent USMD or DO.

 

[USArmyDoc]

This is an interesting topic to me, I don't think the OP is slamming anyone.

I have been wondering some of the same things. There are now post-graduate programs out there for MDs to learn OMM (can't locate the info at the moment, but its out there.) If MDs can learn to use the few effective OMM techniques, then how will the AOA continue to consider osteopathy to be a distinct profession in the future? If there are is no longer an obvious distinction between the two (and I DON'T by into the purported philosophical differences), then doesn't it stand to reason that down the road we will face a consolidation of some sort?

Is it possible that DOs could lose their practice rights, or suffer a demotion in their licensure, in the next 50 years? Probably not, but what do you guys think about it?

This will not happen. Osteopathic physicians will not lose their right to practice. WTF? 😕

 

[allendo]

[/B]

This will not happen. Osteopathic physicians will not lose their right to practice. WTF? 😕

We will never lose practice rights b/c we take the same classes and take our set of boards that are regulated. Anyways many D.O.s teach at M.D. residencies so they would have to get rid of the people that work in their programs. Plus, in the south there are alot of D.O.s especially in TX and the state depends on them to deliver health care in the numerous rural areas.

 

[VentdependenT]

The degree has been around for a loooooong time. Its not going down.

 

[Old_Mil]

Give the OP a break. Is he not allowed to think for himself and question the dogma of osteopathy?? Or will the gods of osteopathic medicine strike him down for falling out of line b/c he is not a yes man?

If the gods of osteopathy were in the business of striking people down, I would have been dead two weeks after classes started.

 

[bones]

I've been trying to stay above the fray, but this discussion is getting a little silly. ACGME residencies won't close to DO's now or anytime in the future. There would be huge anti-trust law suit issues. The DO's of 1950-60's fought the hard political battles that helped pave the way for today's DO's to apply and potentially match into any specialty they choose. Born of neccessity, DO's created and maintained their own hospitals and post-graduate residency training programs. These programs, along side their ACGME-accredited counter-parts, are legitimate pathways for DO physicians to become board-certified in a given specialty. Again, the AOA, the specialty colleges, and earlier DO pioneers fought the hard political battles that helped policy-makers and payors see that these programs are bona-fide residency training programs. This is good.

There are problems with the current situation in osteopathic graduate medical education, but these problems are not insurmountable. They do require conscientious attention. One positive trend is the ever increasing collaboration between ACGME and AOA-accredited programs. BTW, you have to remember that DO's are *RECRUITED* into ACGME programs! It's not like DO's go begging. These programs recognize that DO graduates are well-prepared, knowledgable, hard-working physicians and are generally very welcoming to us. Within the primary care arena, ACGME training programs gobble up DO's just about every chance they get.

Due to the vagaries of the medicare reimbursement system for resident education, many OPTI's are retooling and redistributing their slots to offer more specialty and sub-specialty training opportunities for DO's. I think that this is good. DO specialists are needed in order to 1) teach DO medical students and generalists; 2) sustain the osteopathic profession as a full-service enterprise and not a "feeder route" to MD programs.

Almost 10 years ago I applied and was accepted to osteopathic schools. I had some of the same concerns and worries as do many people posting here. Was I as good as my MD colleagues? Would I be able to get into the residency of my choice? Will patients accept my authority as a physician? Will I be able to find a good job or join a lucrative practice. I remember meeting and speaking to recent DO grads at that time. They said something that has turned out to be true: "Things get better in this profession all the time."

10 years hence (about the time many of you will be coming out residency) these issues will seem trivial. Opportunities will abound. Concentrate on your own personal and professional development as a physician. Study and work hard. Keep abreast of changes in the field and advances in osteopathic research. Be confident and humble when dealing with patients and colleagues and the rest will fall into place.

thanks for the insight drusso.

 

[bones]

hmmm i'm just a lowly lurkin' pre-med student who's looking into all of her options for medical school... but i always thought that the doctor is as good as their breadth of knowledge and ability to treat patients, as opposed to whether they are an FMG, MD, or DO. i don't see the point in counter-dissing FMG med students who diss the OMS's. call me naive, but i'd rather have a competent FMG than an incompetent USMD or DO.

you are quite right. Keep in mind that many of the people insulting various schools and educations on both sides are pre-meds as well (...at least i hope), and it is human nature to be defensive when you feel attacked (especially if insecure about your own options). I think the anti-FMG stuff started with someone pointing out that a pre-med FMG applicant has little grounds to say whether there is anything to osteopathy or OMM- which is actually probably true. Thats not to say there arent some fantastic FMG MD's out there. The best medical clinician i ever met was an FMG internal med postgrad from the phillipines and then did neurology residency at the cleveland clinic. He was amazing. Of course, he knew very little about OMM when i started my preceptorship with him, but was excited when he saw its potential in the worst of his musculoskeletal headache patients- and has since started referring some of his patients to OMM specialists. A DO in neurology could do this work in their headache clinic without referral, and could use their hands to aid in diagnosis of related musculoskeletal triggers for the headaches- offering the most comprehensive care possible. However, so long as an MD knows enough to know when to refer- patient care doesnt greatly suffer. On the other hand, great hands without enough knowledge to make an accurate diagnosis (and rule out serious pathology early) are worthless and even dangerous in neurology. Knowledge comes first- no matter the degree, as you so elequently stated.

I hope we can all try to keep a healthy respect for our medical colleagues.

thx
michael

 

[bones]

It seems as if OMM is on its way out, with fewer and fewer DOs using it after completing med school. In addition, more and more DOs are opting for allopathic residencies, even in primary care.

Given this, it seems only a matter of time before DOs and MDs truly are exactly the same, as many people on these forums routinely profess.

The OP presents a valid concern. So long as the AOA tries to distance itself from its roots in AT Still's philosophy and OMM in favor of pushing rural family practice and "compassion" as what makes us different and pushing OMM into specialty care- they are really shooting themselves in the foot. There are many DOs that are truly different than thier MD colleagues... a distinct, more holistic thought process, more knolwedgeable hands, more comprehensive cause-based medicine, and the idea of looking for long term solutions that make use of the body's natural mechanisms rather than permanent exogenous influence. When you see these docs in practice there is no doubt something very different is happening, and i believe a different degree has merit- if for no other reason, to show to patients what kind of care they can expect to get.


However, there are areas where DO's are trained only by MD's in their 3rd and 4th year (where they do the majority of their learning), and they naturally model the best of what they see there. There are also some students that blow off OMM and osteopathic philosophy and dont take the time to learn it outside of class. So- now patients dont know what to expect when they go to a DO. I get asked my opinion all the time regarding DO referrals because patients (and docs) are uncertain which DO's still "practice like DO's" and just want to find a good osteopath in a given specialty (very hard to find and in very high demand).

My question is, what will happen to the dual-degree system when it is finally realized by the public and legislators that we are all in the same family? Will the DO degree fall by the wayside? Will osteopathic schools need to gain allopathic accreditation or face closure? Will DOs lose their licensure, or will they become MDs ala the California Merger?

Any thoughts, guesses, speculation?

The AOA is very entrenched in their power. From a big picture perspective, if docs are practicing exactly the same, they SHOULD all have the same degree... for simplification. This will not happen anytime soon- for political, not philosophical reasons.

DO's are accredited physicians- they will not lose their license, and the schools will not lose accredation. The allopathic world has been trying to absorb us for decades now, and they would be happy to award MD accredation to all DO schools and MD degrees to all DO physicians, but the AOA will block it so they can continue to exist.

I seriously doubt it will happen again, but if it does- it would probably only happen at the state level, and there is little to worry about in terms of your practice rights as a DO. The worst that could happen is that you'd have the option to switch to an MD and that some of your DO colleagues might go over. 🙁