Soaring Growth

Delegates vote to cap size of AOA House

Profession’s rapid growth convinces even large states to support once-controversial measure.


Two years ago, the AOA House of Delegates defeated a contentious resolution to limit its size. This year, however, a similar measure sailed through the approval process.

The House voted Saturday to restrict its size to 473 divisional delegates—those representing the states, the District of Columbia and the military. Osteopathic specialty societies will continue to be represented by one delegate each.

The number of delegates allotted to each state will be based on the proportion of AOA members located in that state. The number allotted to the military will be based on the proportion of AOA members currently serving on active duty in the U.S. uniformed services.

The rapid growth of the profession, now more than 100,000 DOs and students strong, is what convinced even the House’s largest states—Michigan and Pennsylvania— to come around and support size limits. Unchecked growth would soon force the AOA to find an alternative venue for the annual House meetings, which have been held at Chicago’s Fairmont Hotel for the past 16 years. Expenses and inefficiencies would soar as well, say proponents of size restrictions.

Several Michigan delegates say that AOA Trustee Susan C. Sevensma, DO, a past president of the Michigan Osteopathic Association, rallied their delegation to support the resolution, which amends the AOA Constitution.

“I’m for limiting the size of the AOA House to control costs,” said Bruce B. Cunningham, DO, of Minnesota, a state with just four delegates. He noted that the size of the U.S. House of Representatives is fixed by law at 435.

“The U.S. House would have more than 10,000 members if there were no cap on its size,” Dr. Cunningham said.

Another amendment to the AOA Constitution will be considered for final approval at the July 2014 meeting of the AOA House of Delegates. If approved, this amendment would add a public member to the AOA Board of Trustees.

No change for specialty representation

The AOA House voted against a resolution to change the composition of the AOA Board of Trustees so that it would mirror the proportion of various medical specialties in the profession. Submitted by the American College of Osteopathic Emergency Physicians, the defeated resolution called on the AOA to “move to align its Board membership to more accurately reflect the practice patterns of its physicians by increasing the presence of specialists on its governing body.”

“That resolution won’t get anywhere,” predicted Michigan delegate Robert G. G. Piccinini, DO, the president-elect of the American College of Osteopathic Neurologists and Psychiatrists, before the vote was called on the House floor. “It isn’t necessary.”

Any DO specialist can work toward election to AOA Board by rising through the ranks of his or her state osteopathic medical association, said Dr. Piccinini, a psychiatrist and a Board member of the Michigan association. It can take 20 years to ascend to the AOA Board, which ensures that all trustees have substantial leadership experience in organized medicine.

While all AOA Board members have served as the president of their state osteopathic medical association, most also have held leadership positions in their osteopathic specialty society.

“We already have specialty representation on the Board because each trustee brings the perspective of his or her specialty,” Dr. Piccinini said. In recent years, the Board has included an orthopedic surgeon, two emergency physicians, three ophthalmologists, a gastroenterologist and a radiologist, among other non-primary-care specialists.

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