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The DO | Briefly | AOA at Work

AOA House reasserts preferred terms osteopathic physician, osteopathic medicine

Refining a policy last revised in 2005, the AOA House of Delegates on July 17 approved a resolution recommending that the terms osteopath and osteopathy be reserved for informal or historical discussions and for referring to previously named entities in the profession and foreign-trained osteopaths.

Tyler C. Cymet, DO

Maryland delegate Tyler C. Cymet, DO, defends the Glossary of Osteopathic Terminology on the House floor. (Photo by Patrick Sinco)

Titled “Osteopath and Osteopathy—Use of the Terms,” Resolution 301 (A/2010) (PDF) calls for members of the osteopathic medical profession to “preferentially use the term ‘osteopathic physician’ in place of the word ‘osteopath’ and the term ‘osteopathic medicine’ in place of the word ‘osteopathy.’ ”

The AOA has long used and encouraged others to use the terms osteopathic physician and osteopathic medicine. These terms reinforce to the public that U.S.-trained DOs are fully licensed physicians, according to the AOA.

But some members of the American Academy of Osteopathy (AAO) consider the AOA’s preference to be insulting to the profession’s heritage and even dangerous to the profession’s custody of the traditional terms, according to AAO President Richard A. Feely, DO.

Dr. Feely warned that if the profession were to repudiate osteopath and osteopathy, an outside entity could appropriate these terms. He noted that in Japan, a chiropractor copyrighted the term osteopathy in an attempt to limit competition in manipulation.

“Once we say that we are no longer going to use these terms—that they are no longer part of us—then we are giving them up and could lose the opportunity to use them again,” Dr. Feely said during a committee meeting of the AOA Board of Trustees a few days before the House convened.

AOA General Counsel Joshua L. Prober, JD, however, later assuaged such fears. “I wouldn’t infer that what happened in Japan under Japanese copyright and trademark law will also happen here,” Prober said. “While the big-picture purpose of the Japanese law—protecting intellectual property—is the same as ours, the two countries go about this differently.” He added that the AOA can contest inappropriate copyright and trademark registrations on the term osteopath and its variations because the AOA monitors those actions through an outside service.

Not preferred, but not archaic

While making its preferred terms clear, the AOA House stopped well short of casting aside osteopath and osteopathy for good.

Represented by Jane E. Carreiro, DO, the AAO successfully pushed for inserting “preferentially” into the policy to encourage greater flexibility in replacing osteopath with osteopathic physician and osteopathy with osteopathic medicine. Moreover, the House overwhelmingly halted a move to brand the traditional terms as anachronisms.

That motion started when the House Committee on Professional Affairs reviewed Resolution 301 and recommended adding definitions that described both osteopath and osteopathy as “archaic.”

During the House’s consideration of the resolution, Randy G. Litman, DO, of Kentucky was among several delegates who objected to the definitions. “Many of us in this room received a doctor of osteopathy degree versus a doctor of osteopathic medicine degree. I would like the doctor of osteopathy degree not to be considered archaic,” Dr. Litman said to the House’s applause.

Noting that the definitions were taken from the Glossary of Osteopathic Terminology and that she helped write them, Dr. Carreiro argued that the definitions are political and not scientific and shouldn’t be the basis of the profession’s policy.

While agreeing that the definitions should be struck from the resolution, Maryland delegate Tyler C. Cymet, DO, defended the Glossary, which was developed by the Educational Council on Osteopathic Principles of the American Association of Colleges of Osteopathic Medicine (AACOM). AACOM’s associate vice president for medical education, Dr. Cymet explained that anyone can suggest modifications to the Glossary and proposed mentioning this open process in the resolution. The House disagreed and easily defeated his motion.

After 10 minutes of floor debate, the AOA House deleted the definitions from Resolution 301 and unanimously approved it, renewing the profession’s preference for referring to its members as osteopathic physicians who practice osteopathic medicine.

Upholding tradition

Despite the House’s reaffirmation of the policy, several delegates voiced support for the currency of the traditional terms osteopath and osteopathy.

“I think that either one is perfectly acceptable,” said Massachusetts delegate Hollis. S. Coblentz, DO. “Most of the DOs in our state who are practicing probably don’t have a problem with either one.”

Alabama’s sole delegate, David Coffey, DO, agreed that the profession needs to distinguish DOs from foreign osteopaths. But he added that the traditional terms should not be exiled.

“ ‘Doctor of osteopathy’ has meant a lot to everyone who has gone before us, who has trail-blazed the profession,” said Dr. Coffey, a trustee of the AAO.

Those trailblazers include 88-year-old John A. Cifala, DO, a delegate from Virginia. “In my mind, we’re still osteopaths,” the longest continuously serving member of the House told the Committee on Professional Affairs.

“Osteopathy is a complete healing process,” Dr. Cifala said. “The word medicine in osteopathic medicine is superfluous.”

The DO’s managing editor, Patrick Sinco, contributed to this report.

cschierhorn@osteopathic.org

24 Responses

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  2. UFDO on Sept. 28, 2010, 1:25 p.m.

    I feel it is time for the profession to embrace what we are in modern day. Osteopathic medical doctors with a degree Osteopathic Medicine. It is not abandoning our past but instead allowing us to continually evolove our profession. As was done in the origins of the profession.

  3. John N Bode, DO on Sept. 28, 2010, 2:40 p.m.

    This discussion about the term Osteopath has gone on as long as I have been in the profession (1973). I believe it is a symptom of an inferiority complex that afflicts DOs. I don’t get it. Patients respond to competent, caring health care practitioners and are largely oblivious to your degree. I think many of us have repeatedly experienced the comment from our patients ” I didn’t know you were an Osteopath?” I tell patients and colleagues with pride and no apology “I am an Osteopath!” Don’t change the degree or title. Be what you are, do it with compasion and pride.

  4. I.Martin Kraus,DO on Sept. 28, 2010, 9:02 p.m.

    I agree with John Bode,DO who knows in his bones, pun intended, that it is the relationship, its the connection with our patient who experiences what you experience in yourself. Look inside yourself, not on the wrapper outside. Are we talking politics or professional efficacy? Those are two different issues.

  5. Thomas John D'Amico, DO, FAAFP on Sept. 28, 2010, 9:49 p.m.

    Please stop already! The battle is already over, the AOA leadership just hasn’t realized it. The sooner the public sees our profession merge with what they know and feel comfortable with (M.D. degree) the better.

    While on the topic of name changes…I’m not a, “practitioner”, I’m a physician. Nurses become “practitioners.” Let’s change “Family Practice” to “Family Medicine” and be done with it.

    The AOA has had decades to help our public image. Sorry to tell you, you’re efforts have been insuficient. MD-O will help and would be what most of us prefer.

    And while I’m at it, change “AOA” to “AOMA”. We all know it’s what the membership wants. Let the cranial people break off and start their own, non-EBM society and keep the antiquated terminologies. For everyone else, join the main stream.

  6. Mark E. Rosen, DO FCA on Sept. 30, 2010, 11:53 p.m.

    This profession was conceived by Dr. Andrew Still, for the purpose of expressing the practice of Osteopathy. The wisdom of these original teachings and the relief of suffering they provide speak for themselves. Like it or not, these are our origins. If you do not like being an osteopath, you should have gone to MD school. To “change with the times” is to sell out, to ignore deep wisdom, and to deprive our patients of profound care.

  7. Jonathan Terry, DO on Oct. 1, 2010, 5 p.m.

    As a recent graduate, my identity as an osteopath AND an osteopathic physician is essential. It is something I look for in the undergraduates I encounter who express a degree in osteopathic (medical) training; if they aren’t interested in this key distinction, I tell them to save their money and go to their state’s MD school. It is imperative that our profession maintain it’s distinctiveness for all those patients who actively seek it. Anything short of that is selling out.

  8. RJDavies,DO on Oct. 2, 2010, 9:25 p.m.

    The terms osteopathic medicine and doctor of osteopathic medicine more accurately define our complete and more encompassing training as physicians. I do not think the trend towards these terms in no way lessens the older terminology. I have had people ask me on a few occasions -are you a bone doctor – because they misunderstood the older terminology.

    Richard J Davies DO

  9. Thomas John D'Amico, DO, FAAFP on Oct. 23, 2010, 2:23 p.m.

    Why does terminology matter? Why is this important to address during the healthcare overhaul of our country? Because we can’t afford not to. How the public perceives us plays into whose left standing after the dust settles in the next 5-10 years.

    Who are the new players on the field? Non physician providers, specifically NPs and DNP riding the wave of the current environment. Their rate of manufacture is twice that of a physician and are much cheaper to employ. To underestimate the leverage and threat they hold over primary care physicians would be a catastrophic miscalculation for those who have 30 years of career ahead of us.

    I believe soon the DNP degree will be treated by payers and governments as the cheap alternative to physicians in order to fill the gap in primary care that medical schools failed to fill. The public will now have and alphabet soup of providers to choose from, e.g. MD, DO, PA, NP, DNP. Is that a good thing? Not for us! The physician “brand” must be upheld before we’re substituted for a degree that purports providing more “value” for our healthcare dollars.

    Now, where does that leave the osteopathic profession in the eyes of the public at large which grossly misunderstands or are completely unaware of what a DO is? The answer…on equal footing as advanced practice nurses. DOs would be just another set of letters in the sea of primary care providers. Our distinction as complete physicians with decades of training behind our DO degree will be smeared and diluted and seen as equivalent to NPs or DNPs.

    Therefore, I believe we need to run under the MD umbrella for safety’s sake. Hard to swallow, but unfortunately true. We can’t wait as the AOA muddles with anemic public awareness efforts and “What is a DO?” brochures. We must establish in the mind of the public the fact that physicians are integral and are not substitutable for non physician providers. In my opinion, adding MD to DO (e.g. MD, DO) is a potent insurance policy for professional survival.

  10. Osteopath Melbourne on Oct. 28, 2010, 12:31 a.m.

    Thanks for the great information about the osteopath. Its really good to know the importance of taking the osteopath. Good comments and advice too..

  11. florida osteopathy on Dec. 6, 2010, 9:03 a.m.

    Just change to MD-DO. It is the best name – You all know it.
    If you are a DO, you know we all have to explain what we are all the time, even to our families. The puplic does not know what a DO is all about, and yes even after 100 years, most people have no clue what being an osteopathic physcian is all about.

    With the recent changes in health care – New DNP (doctor of nursing), DPT (Physical therapsit), soon being called Doctor means nothing, and is very confusing. We could easily be confused with the above degrees since most people have no clue what a DO degree means.

    More than 90 % of the population know that MD means PHYSICIAN. Therefore, it would only make sense to add it to our degree since we are also medical doctors

    It make sense to change ours to MD DO, since MD is the most common accepted name for physicians due to the upcoming changes in health care.

  12. Tayson DeLengocky, DO on Dec. 7, 2010, 12:06 a.m.

    There was a formal resolution submitted by a group of DO students calling for formal polling among the osteopathic community regarding the change the degree to MD, DO.

    here is the link http://www.eyedrd.org/2010/12/resolution-calling-for-degree.html

  13. Tayson DeLengocky, DO on Dec. 13, 2010, 7:24 a.m.

    The results of a small survey posted at Sermo

    http://www.eyedrd.org/2010/12/survey-results-of-resolution-calling.html

  14. Tayson DeLengocky, DO on Dec. 23, 2010, 8:51 a.m.

    The debate over the DO title and osteopathic education reform

    http://www.eyedrd.org/2010/12/texas-budget-shortfall-and-medical.html

  15. Tayson DeLengocky, DO on Dec. 23, 2010, 8:51 a.m.

    http://www.eyedrd.org/2010/12/debate-over-do-degree-title-call-for.html

  16. Tayson DeLengocky, DO on Dec. 27, 2010, 11:38 a.m.

    Analysis of informal polling results of the resolution calling for degree change to MD, DO degree

    http://www.eyedrd.org/2010/12/analysis-of-informal-polling-results-of.html

  17. MS, DO on Jan. 21, 2011, 1:37 a.m.

    Please change it to MD, DO. We practice allopathic medicine in addition to the osteopathic component and we should be recognized for our hard work and not be depriciated in the eyes of the public as the unknown. There are many valid points above. Changing our title will change our image and wont let our students and colleagues be ashamed or scared to share what school they are from and what they are studying! Changing the title will take away all the insecurities we DOs have!

    All we ask is for change. If you dont like things after “change of titles”, you can always revert back. I am sure the change will be fruitful. Lets give it a try. How will it hurt us? It can only help. You know it and I do too.

  18. Echo on Jan. 27, 2011, 1:44 p.m.

    Why don’t they offer the DO’s and option to “change” their degree to MD degree for the purpose of public recognition? For example, some FMG’s with MBBS degrees are allowed to change their degrees to MD for this purpose.

  19. Future DO on Jan. 28, 2011, 2:02 p.m.

    As a future graduate from an Osteopathic Medical School, I completely support a change from just DO to MD DO. Although numerous students try to say they have no insecurities regarding the DO title, the fact of the matter is they exist. We are going to be physicians, doctors for crying out loud. We need to make a change that will make everybody proud and satisfied to be a DO. Furthermore, making the name an MD DO is better suiting. We are Doctors of Medicine AND osteopathy. The change will finally show everyone who is ill informed about the practice that we are not below MD’s but rather an MD with the ability to treat illnesses with OMT.Does anybody know when this change might take place?

  20. John R. Carbon DO, MS on Jan. 31, 2011, 3:50 p.m.

    I agree with Thomas John D’Amico.

    Back in 1991-92, I was the student council pres @UNECOM. I went to a number of national AOA meetings and was deep in the mix of changing the “TITLE” on the diplomae to “Doctor of Osteopathic Medicine” and getting rid of “Doctor of Osteopathy”. Apparently this was the 2nd or 3rd time this was attempted, but the 1st time it worked.

    Eventhough I did my residency in a large “MD” program qat Sinai/JohnsHopkins in PM&R and was board cert by the Am Board of PM&R, I always described myself as an “osteopath”.

    When asked: “what is the difference between an MD & DO?”, I would say it is some thing like the difference between a Roman Catholic and a Lutheran or Episcopalian. Or, it is similar to the differences in rules in MLB between the American & National Leagues. Realy meaning “no big diff what so ever”.

    The terminology of “osteopath” is archaic as well as misleading. It literally means “bone disease”, which has nothiong to do with a “wholistic” overview. The term “osteopathic” should go the same way as the terms way “homeopathic”, “naturopathic” and “allopathic”.

    These antiquated names mean little to an uninformed public which is still trying to figure out what “Obama-care”, “national health care”, etc is all about.

    The major difference I see between DOs & MDs is that DOs have 50% or greater as PCPs, whereas MDs are more of a specialty type.

    As for the DOs who think that they are providing a service or doing something “unique”, just consider the fact that DOs are similar to chiropractors in most of the rest of the world. In addition, other clinicians perform “manipulative therapies”, including: chiros, phys-therapists, MDs, etc.

    Worshiping A.T.Still does seem to be a trait which is somewhat prevelent with DOs. Personally, I prefer to “worship” Ignaz Semmelweis.

  21. David S. on Feb. 12, 2011, 1:32 a.m.

    I support changing DO to MD,DO (Doctor of Medicine, Diploma of Osteopathy). The main reason DOs want to keep the DO title is because of the pride for the knowledge of OMT. They want to be distinguished for their OMT training that MDs don’t have. Understandable. But any kind of pride is sin, in my opinion. For the sole sake of treating patients, we must let them know we’re just the same as the MDs if not better. Sure, it’s the patients’ fault if they don’t know who we are and their health gets worse because they refuse to be treated by us and wait a couple of month to see an MD. But if we truly care about the patients than ourselves, we must lower to meet the patients’ understanding. If we can make them feel secure and enhance their trust in us by letting them see those two letters, MD, which will surely be the case, we should do this without hesitation. We emphasize holistic approach. Considering patients’ “peace of mind” is a small yet necessary effort of adhering to our principles of osteopathic medicine. Therefore the name must be changed. It took several tries to change our degree from Doctor of Osteopathy to Doctor of Osteopathic Medicine. The MD,DO name change resolution was turned down last year, but we must press on for this change that can ultimately benefit patients.

  22. John Branch, DO, FAAFP on Feb. 14, 2011, 11:11 p.m.

    This argument has been tried and found wanting. In 1962, California DO’s permitted (and in some cases promoted) a referendum to abolish DO licensure, resulting in re-licensing DO’s in the state,
    after issuing them retroactive degrees, once COPS had been co-opted as an MD school. It took 13 years and a state supreme court decision to overturn the referendum. Adopting the MD,DO designation would be a kick in the teeth to those who have worked to re-establish Osteopathic Medicine in our state. I have not encountered difficulty in practicing as a DO, and neither have my DO partners, one of whom just completed his term as President of the county (MD) medical society. The best way to promote Osteopathic Medicine is to be engaged in our communities, our hospital staffs, and our medical societies as competent physicians, who are proud of who they are.

  23. osteopath Melbourne on Dec. 25, 2011, 5:31 a.m.

    This name change is a good step in solidifying confidence in osteopaths in general – by cementing that they are qualified medical practitioners rather than just 6 week trained wonders. This is a good step and should be welcomed.

  24. Osteopath Elsternwick Melbourne on March 17, 2012, 3:38 a.m.

    Thanks for sharing this article. It was an interesting read and good to be aware of.

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