Raising awareness

Overlooked and underplayed: Profession fights to promote itself better

Despite better press coverage of osteopathic medicine than in the past, slights and oversights persist. Take a look at what the profession is doing to boost its profile.

During his “60 Minutes” commentary on April 25, Andy Rooney bemoaned the overspecialization of physicians. Without acknowledging osteopathic physicians, he declared, “We need more medical schools that graduate doctors who specialize in everything and nothing—the whole body, not just one part.”

More vexing, a front-page article on the surge in U.S. medical schools in The New York Times in February failed to recognize the fastest growing element of medical education—osteopathic medical colleges. And in April, an article on the shortage of primary care physicians in The Wall Street Journal neglected to mention the osteopathic medical profession’s focus on family medicine.

Although both the AOA and the American Association of Colleges of Osteopathic Medicine (AACOM) report better press recognition of osteopathic medicine than in the past, oversights and slights persist, compelling the AOA and other osteopathic medical organizations to be vigilant and quick with letters of rebuttal to editors.

“Andy Rooney was describing what osteopathic physicians already do,” notes Pierre Bellicini, the director of communications and marketing for the Lake Erie College of Osteopathic Medicine (LECOM) in Erie, Pa. After viewing Rooney’s “What Happened to Family Doctors?” segment, Bellicini helped rally colleagues in the osteopathic medical profession to use Rooney’s remarks as a springboard for educating CBS and other media outlets about the DO difference and the profession’s traditional focus on primary care.

Part of the problem, according to Bellicini, is that layoffs at major newspapers have turned the remaining reporters into jacks-of-all-trades, making it less likely that a reporter covering health care will be aware of osteopathic medicine. In addition, many newspapers, magazines and broadcast news entities have style policies dictating that the generic Dr. title be used for all physicians, without noting their particular degrees. Such policies reinforce the misconception that the MD degree is the only one synonymous with physician.

But the osteopathic medical profession faces even higher hurdles, Bellicini notes. Despite the rapid growth in osteopathic medical schools, MDs still outnumber DOs 10-to-1. And osteopathic physicians are divided over whether to align themselves with or distinguish themselves from allopathic physicians.

The AOA’s 2006-07 president, the late John A. Strosnider, DO, understood this divide. In conceiving the AOA’s Greatness Fund, he envisioned that a significant share of it would be used for a national television advertising campaign, which would allow the AOA to trumpet a specific message about osteopathic medicine to a vast audience. But the recession, which prompted the AOA to suspend fund-raising temporarily, squelched this dream for the time being. Although the Greatness Fund has been reinstated and a Greatness Campaign task force last December recommended budgeting for a pilot ad program in one state, “there is no funding for any advertising initiatives at present,” says Karyn Szurgot, the AOA’s director of communications.

However, Kelli M. Ward, DO, MPH, a family physician from Lake Havasu City, Ariz., contends that advertising should be a funding priority for the AOA. “If the profession is ever going to do national TV advertising, now is the time because of the prominence of primary care in health care reform,” says Dr. Ward, the president of the Arizona Osteopathic Medical Association. She notes that nurse practitioners and physician assistants have done a better job than DOs in promoting themselves as the answer to the physician shortage.

Physicians in general tend to be uncomfortable promoting themselves, observes Ned Rosch, JD, the executive director of the Northwest Osteopathic Medical Foundation (NWOMF), agreeing that some nonphysician clinician groups have been much more aggressive in their marketing initiatives. “Why do people think of chiropractors first rather than DOs when they have backaches?” he asks.

Virginia M. Johnson, DO, is convinced that her profession’s internal identity struggles paralyze promotional initiatives. “Fundamentally, if we don’t get our own house clean—if our graduates don’t care about the heritage of our profession—how can we raise public awareness of osteopathic medicine?” asks Dr. Johnson, who practices neuromusculoskeletal and osteopathic manipulative medicine in Santa Monica, Calif.

“For years the profession has been trying to establish itself as different or distinctive,” says Al Turner, DO, an OMM specialist in Portland, Ore. “In reality, many osteopathic physicians are no different in thought or practice than our allopathic colleagues.”

Strengthening identity

Dennis J. Dowling, DO, who specializes in OMM in Syosset, N.Y., points out that many of his referred patients don’t even realize when their primary care physicians are DOs. “One key way to promote the profession is for DOs to talk about osteopathic principles with their patients—the importance of looking at the whole person, the interrelationship of structure and function, the body’s inherent healing properties,” says Dr. Dowling, a former president of the American Academy of Osteopathy and a member of the editorial advisory board of JAOA—The Journal of the American Osteopathic Association.

To educate new patients about the profession, Dr. Turner gives them the AOA’s “What Is a DO?” and “Osteopathic Medicine” brochures as a starting point for deeper discussions on how OMM can contribute to health.

A medical director for Arizona’s North Country HealthCare, Dr. Ward prints a custom version of the “What Is a DO?” brochure for patients. With a computer in each examining room at her clinic, Dr. Ward developed a screen saver that reinforces the profession’s identity with the phrase “Treating people, not just symptoms.” As a result, her patients see this catchphrase again and again.

Dr. Turner stresses the importance of DOs using their full name followed by DO on their signs, lab coats, name badges, business cards and Web sites. “A lot of osteopathic physicians try to hide their identity behind the Dr. title,” he says.

Besides using DO after their names, osteopathic physicians should use the term osteopathic physician instead of osteopath in accordance with AOA policy, Szurgot notes. “Often I hear DOs and osteopathic medical students using outdated terminology,” she says. “Using proper terminology when referring to the profession will go a long way in dispelling stereotypes.”

The AOA also supports the use of osteopathic medicine over osteopathy, with five AOA bureaus and committees recommending that AOA policy be modified to reflect this preference, already adhered to in the AOA’s brand and publication style guidelines.

Not every DO agrees with the AOA, however. The Cranial Academy, for example, debated changing its terminology but decided to keep its traditional descriptor osteopathy in the cranial field. The term osteopathy, as established by Andrew Taylor Still, MD, DO, reflects a philosophy and scientific approach that are distinct from conventional medicine’s, emphasizes Melvin Friedman, DO, The Cranial Academy’s president. “We take great pride in being osteopaths as opposed to being just physicians,” he says.

Words to actions

Strengthening professional identity goes beyond terminology and explanations to patients, however, says Dr. Dowling. He would like to see more primary care DOs perform at least basic OMT techniques for uncomplicated conditions. Doing so would improve patient health and satisfaction while spurring positive word-of-mouth publicity for the profession, he says.

“As DOs, we have to ‘try harder’ like Avis,” observes Robert S. Gotlin, DO, the director of orthopedic and sports rehabilitation at Beth Israel Medical Center in New York City. “We have to earn respect, not demand it, by being educated, being diligent, being proud and producing results. Unfortunately, DO residents and fellows often demonstrate insecurity about their distinctiveness and a lack of confidence in their OMT skills. As a profession, we need to turn this around.”

Dr. Turner attributes this insecurity to osteopathic medical trainees not having enough opportunities to perform OMT during their third- and fourth-year rotations and their residencies. Addressing the root of this problem is essential to advancing the profession, he maintains. For his part, Dr. Turner has two or three students at a time from around the country serving rotations in his three-DO practice. He also reaches out to DOs who are serving allopathic residencies in the Portland area, giving these residents the chance to hone their OMT skills in his practice.

Mentoring future generations of osteopathic physicians is critical to promoting the profession, notes Dr. Ward, whose mother, husband and sister-in-law are DOs. Striving to be a role model to students who rotate in her community health center, Dr. Ward has them stay at her house as guests during their rotations. “My husband and I immerse the students in the life of a DO,” she says. “We take them with us wherever we go, so they see how we interact with others in the community.”

Targeting premeds

The New York Times article on the emergence of new medical schools dismissed osteopathic medical education with one remark: “His premed adviser told him that with his 3.3 grade-point average, he should apply only to osteopathic schools.”

To counteract such misconceptions, staff members from the AOA Department of Communications have visited undergraduate college campuses to speak about DOs and osteopathic medicine.

Because they tend to be biased toward MDs, premed advisers are a major target of AACOM’s and osteopathic medical schools’ promotional initiatives. AACOM exhibits at the annual meeting of the National Association of Advisors for the Health Professions, and LECOM and other osteopathic medical colleges advertise in the association’s quarterly journal. Also recognizing the influence of premed advisers, the NWOMF invites them to its annual Confluence of Northwest States, which addresses issues facing osteopathic medicine in the Pacific Northwest.

But it is particularly important for premed advisers to meet practicing DOs, Dr. Turner says. “Osteopathic physicians in college towns need to contact premed advisers because they usually don’t know anything about us or they have misconceptions,” he explains.

Recruiting the right students into osteopathic medicine—those who truly want to become DOs—is integral to promoting the profession, Dr. Turner says. To that end, he gives an hour-long presentation on osteopathic medicine during the “Introduction to Health Careers” workshop at Portland State University. He also talks about the osteopathic medical profession to gifted high school students who take part in a program based at Oregon Health and Science University in Portland.

Similarly, for the past 10 years, Portland family physician John T. Pham, DO, has led monthly meetings for premed students that address the rewards and challenges of being a physician, as well as osteopathic philosophy and OMT. Twenty to 30 undergraduate college students from Oregon and Washington attend the two-hour evening meetings, which take place at the Portland office of the Osteopathic Physicians and Surgeons of Oregon.

The AOA’s 2007 Mentor of the Year, Dr. Pham encourages premed students who have attended at least three monthly meetings to shadow him in his practice and, depending on their interest and ability, take blood pressure readings and even help take patient histories. “How are you going to promote the profession if you don’t let kids shadow you?” he asks.

Dr. Pham will write letters of recommendation to osteopathic medical colleges only for students who have impressed him with their commitment to osteopathic medicine.

The premed and high school programs do more than recruit future DOs, Drs. Turner and Pham say, noting that even those students who choose not to attend osteopathic medical school are more aware of the profession and may speak well of it.

Better visibility

To promote the profession to the public, the AOA undertakes a variety of initiatives, including National Osteopathic Medicine (NOM) Week, during which the AOA organizes and encourages other organizations to sponsor attention-grabbing activities, such as fun runs and health fairs. During this year’s NOM Week, which began on April 18, AOA staff handed out 600 bottles of AOA-branded hand sanitizer on Michigan Avenue in downtown Chicago. And the AOA brought several DOs and osteopathic medical students to an elementary school in Warrenville, Ill., for a “mini med school” that taught children about medicine and good health habits.

The AOA’s Osteopathic Public Awareness Network (known as OPAN), available to AOA members on Osteopathic.org, provides resources that can be used to set up similar mini med schools and other events and promote them to the media.

According to LECOM’s Bellicini, the AOA has been especially successful at alerting the media to DOs who are expert sources on particular health topics—through news releases, phone calls to media outlets, Twitter updates and advisories on the AOA’s Media Center. For example, in conjunction with National Inhalants and Poisons Awareness Week in March, the AOA arranged for Baltimore family physician Jennifer N. Caudle, DO, to take part in a press conference on inhalant abuse at the National Press Club in Washington, D.C. She has been quoted by several major media outlets on “huffing” addiction, including FoxNews.com and CNN.com. The AOA’s Media Center maintains an updated list of osteopathic physicians cited in the media and links to the news items.

“When promoting yourself as an expert source to the media, you need to be prepared and available on a moment’s notice because of reporters’ deadlines,” Dr. Caudle says. To work around style policies that disallow the display of DO, osteopathic physicians can mention their medical credentials as they are being interviewed, she advises. For example, DOs can precede statements with “As an osteopathic physician, I understand that.”

Besides joining the AOA’s database of expert sources, DOs can write health-related articles for local newspapers to boost their own and the profession’s visibility, recommends Dr. Caudle, who interned at a local television station when she was an osteopathic medical student. She also suggests that osteopathic physicians consider getting involved in organizations such as the National Association of Medical Communicators.

Also on the AOA’s list of expert sources, Chicago general internist Laura M. Rosch, DO, promotes osteopathic principles and practice whenever she is interviewed by reporters about fitness, healthful diets and other aspects of preventive medicine. A part-time aerobics instructor, she makes a point of sharing with her classes osteopathic medicine’s emphasis on wellness and belief in the body’s inherent ability to heal itself.

“A.T. Still understood that structure and function are linked. I want to use his philosophy to empower people to take care of themselves,” says Dr. Rosch, whom the AOA has filmed for YouTube videos on working out at the office and parenting during the recession.

New opportunities

Being able to produce videos at a reasonable cost and share them online has enhanced the power of nonprofits to communicate with the public, observes Ned Rosch. The Northwest Osteopathic Medical Foundation has been promoting the profession and raising money for its scholarship fund with a polished seven-minute video depicting two DOs performing OMT, explaining OPP and talking to patients.

The AOA, AACOM and a number of other organizations in the profession have Facebook pages to keep “friends” updated on activities and issues. “The osteopathic medical profession is only beginning to tap the power of social media in getting out the message of osteopathic medicine,” notes Wendy Fernando, AACOM’s vice president for communications and marketing.

The AOA has already had success in using social media to increase awareness of the profession, Szurgot points out. The AOA’s Facebook page has more than 4,700 followers, many of whom post comments, she says. In February, for example, a link to a letter published in Chicago magazine by AOA President-elect Karen J. Nichols, DO, drew eight posted comments on the Facebook page.

The Internet has also changed the profession’s advertising practices. To build public awareness in the communities in which it has campuses, LECOM buys TV advertising in Erie, Pittsburgh and Sarasota, Fla. But in the past couple of months, the college also began advertising on Google, with its ad appearing on specific keyword searches related to medical education and osteopathic medicine.

Besides harnessing new media for promotional initiatives, the osteopathic medical profession needs to seize on current trends in health care favorable to osteopathic medicine, Fernando maintains. “With health care reform having passed, we have a particular opportunity,” she says. “I have heard over and over that health care reform is designed to produce physicians who provide patient-centered, community-focused care and can work as part of a team. This is what osteopathic physicians are already doing. This has always been the educational model of osteopathic medicine. As a profession, we need to work in concert to tell this story.”

9 comments

  1. Pingback: Tweets that mention The DO | Overlooked and underplayed: Profession fights to promote itself better -- Topsy.com

  2. What about a 30 second super bowl ad? I wish I were joking, but it seems like that would be a pretty effective way to get millions of people to know what a DO is and that we are real doctors.

  3. Until that 10-1 ration is significantly reduced, and until DOs consistently offer OSTEOPATHIC medical treatment to patients, what good is high profile advertising? First, finding a DO is difficult; then finding one really grounded in OPP and willing and able to use OMM is harder still.
    I feel grassroots promotion of the profession–news stories in local papers and on local radio stations–remains the best approach at present. People are still reading their community newspapers, and testimonials remain the best, cheapest, and most effective form of promotion. The American Osteopathic Association has many resources available to DOs to guide and aid in this effort.
    I know Byran is just joking, but you simply cannot convey the “DO difference” in 30 seconds…and every DO should convey that difference!

  4. *please clarify for my husband, AND THE REST OF THE WORLD- regardless of what i show him,or what other Dr’s,including MD’s/plastic surgeons,chiropractors, nurses,u name it,try to explain & educate him that DOCTORS of OSTEOPATHY ARE REAL DOCTORS…my HUSBAND is still convinced that DO’s r not’real doctors’,cannot write presciptions(well that would be a shock to mine!)& is convinced that DO’s r lower on the food chain than PA’s!!for the life of him he will not &/or cannot grasp the principles that DO’s practice,let alone that they are REAL practicing PHYSICIANS!**CONSEQUENTLY I TOTALLY agree that AGGRESSIVE ADVERTISING(INSTITUTIONAL in nature;targeted properly via demographics) 4 THE EDUCATION needed to PROVIDE THE NOW NECESSESARY WELL DESERVED POSITIVE IMAGE that DO’s deserve as well as providing the CLARIFICATION people need(re:D.O’s)& at least EDUCATE THE GENERAL PUBLIC;NO DOUBT A NEW POSITIVE OUTLOOK FOR THE PUBLIC AND ALL DO’S WILL ONLY RESULT IN GREAT THINGS FOR EVERYONE.
    SINCERELY, SUZAN BEENE

  5. As a board certified DO Ob/Gyn I did my residency in a M.D. program affiliated with Northwestern University Medical School. Only DO’s can train at both DO or MD residencies. This might help those who doubt the full practice rights of DO’s in America. If you want to learn more about the very exciting profession as a DO physician, go to my blog at ilovedoctoring.blogspot.com or contact me personally at http://www.nova.edu

  6. With regards to the above, I’d like to answer your questions with some I’ve heard that I’m tired of having to answer the following to my colleagues, patients and family members:

    “Are DOs that bad that they need an institution like the NBOME to “Protect the Public” from them? The MDs NBME is interested in SERVING the public and it’s membership; why is the Osteopathic field so different?”

    “If DOs are as qualified as MDs, why do they have to spend an extra year of residency training in certain states that their own leaders say is to make sure they’re competent and professional enough to practice medicine alongside the MD’s?”

    “If the COMLEX is really as valid as the USMLE, why do so many more Osteopathic students have difficulty with the COMLEX, while they actually do very well on the USMLE?”

    The trend for Osteopathic students is now to take the amateur-quality COMLEX as many times as it takes to pass all three steps, and hope you never get sued as the best evidence against you as a practicing DO will be provided by the NBOME saying that you’ve failed your licensing exams several times; instant win for the plaintiff. You’ll head to an Allopathic Residency program that you’re more competitive for after you graduate from your Osteopathic medical school because of your USMLE score and never look back at the DO world afterward. The Doctor of Nursing Practice degree-holders and the Certified Registered Nurse Anesthetists will indeed supplant the DO more than any other health professional, because as under-qualified as they are to do our jobs, they couldn’t possibly be as bad as we DOs make ourselves out to be.

    As we focus on relicensing standards and increasing the amount of visibility DOs have in the public eye, let’s make sure we’re not scaring them off in the process. Why would most news venues obviously shun the DO world when they talk of wanting to treat the whole person as if it’s something new? Our leadership is stubborn and incredibly difficult to deal with for a lot more people than Andy Rooney who has put up with quite a lot as he’s observed a lot in his career; I’m sure he knows we exist.

    Let’s act as a group and disband the NBOME so that we can focus on the real medicine again instead of on a juvenile copy of the NBME without any of it’s class or sophistication.
    Let’s act as a group and ALL DROP MEDICARE for the good of the profession and our patients.
    Let’s act as a group and stop taking referrals from providers that use DNPs, PAs or CRNAs to DIRECTLY REPLACE physicians.

    Osteopathy is very powerful but must be taught as an apprenticeship and if not continued into residency, it will cease to continue at all. If we’re ready to let Osteopathy die through attrition into the much more welcoming and logical MD world that our students are escaping to in haste to be reborn to also escape it’s leaders’ ignorance, so be it. Please prove me wrong if you’re truly doubtful; I promise it will be an exercise in futility that will incite the same feeling of rebellion in you. Isn’t a rebellion against a system that was harmful to its patients how our history was born?

    Sleep well tonight my fellow Osteopaths, for tomorrow must be a day of action before it’s too late…

  7. With promotion of our Osteopathic Profession comes the challenge of the AOA to produce what they promote.
    DO is Different…do we have enough DOs to give the public what they will expect…a different kind of healthcare?
    As I see it, the majority of DOs today are practicing allopathic medicine. The DIFFERENCE can only happen in our osteopathic schools and postdoctural training programs.
    We have a long way to go to produce the TRUE difference that our amazing profession has at it’s very core…a uniquely different identity…Osteopathy. Let’s teach that in our schools, and expect our students to practice it. Then we may well be able to meet the demand that NO DOUBT will come with more intense promotion. This is the real issue, isn’t it…why our leadership’s osteopathic feet are dragging along…holding back.

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