Law & Medicine

Inside advocacy: AOA lawyers protect practice parity

Despite parity in all 50 states, legal team finds dismantling discrimination is an ongoing effort.

Regardless of DOs’ prominence in government, education and health care systems, the AOA’s legal team regularly fields requests from osteopathic physicians needing assistance with credentialing, access to training and employment, as well as technical matters related to licensure and payment.

The AOA legal team is an effective advocate for members facing issues that adversely affect their ability to practice osteopathic medicine.

“It’s surprising that decades after DOs achieved parity with their MD colleagues, we still manage these types of issues on behalf of our members,” says Brian Kim, JD, AOA associate general counsel. “Legal advocacy is foundational to our mission. Without it, DOs would be paying out of their own pockets for legal consultation and it would be difficult for our physicians to find attorneys with this expertise.”

Confronting credentialing

Most cases involve recognition of osteopathic credentials, like that of osteopathic medical students who were being charged significantly more than allopathic students to apply for hospital rotations at the Medical University of South Carolina. AOA legal assistance, in partnership with the Edward Via College of Osteopathic Medicine–Carolinas Campus in Spartanburg, South Carolina, worked to overturn the discriminatory policy. The fees are now equal.

In a current case, an interventional cardiologist in California was unable to finalize employment in a high-level position with a percutaneous coronary intervention facility. AOA legal assistance, in conjunction with the Osteopathic Physicians and Surgeons of California, is working with the California Department of Health to revise state regulations that prevented the facility from accepting his credentials.

“These situations still occur because of a lack of knowledge about osteopathic physicians,” says Kim. “Even some in the health care profession are surprised when they learn DOs are fully licensed physicians, with equally rigorous education and training.”

Restoring access to training & employment

The AOA’s legal team works to efficiently resolve discriminatory practices like that of the American Head and Neck Society (AHNS), which expressly excluded DOs from participating in their fellowship match, even stating on their website that DOs need not apply.

In its communications with AHNS, the legal team pointed out that barring osteopathic physicians is a probable violation of antitrust laws. AHNS ultimately agreed to grant eligibility to DO graduates of AOA residency programs in otolaryngology, general surgery, and plastic surgery specialties if their training program has received ACGME accreditation.

Avoiding lawsuits is a primary goal, even in egregious cases, because they typically prolong the problem. Litigation is a lengthy process, Kim noted, and the goal is quickly resolve issues so physicians can serve patients.

Licensure and practice rights

Helping AOA members navigate technical matters related to licensure is a crucial role of the legal team, whether that entails providing information on physician re-entry and monitoring programs or educating public officials about the profession.

Take the case of the Harris County, Texas, judge who refused to accept commitment papers signed by osteopathic psychiatrists. AOA legal was asked to assist on behalf of the 9,500 DOs practicing in Texas. The judge’s directive not only infringed on their practice rights and appeared to violate the state constitution, it also put public health at risk because of the mental health care provider shortage.

More than 100 hours of legal work, plus strong coalition-building led by the Texas Osteopathic Medical Association, resulted in the Texas attorney general issuing an opinion in favor of the osteopathic physicians and their patients. The DO psychiatrists resumed normal practice days after the initial directive was issued, limiting disruption to mental health services in Houston.

“Nothing is worse than being in legal trouble and not being able to reach someone who can help,” says Kim, who encourages any AOA member in need of assistance, including osteopathic medical students, to contact the AOA’s legal team.

To reach the legal team, contact the AOA’s Customer Resource Center at (888) 62-MYAOA or by email at crc@osteopathic.org.

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