Opinion Thoughts on defending the osteopathic medical profession Let’s examine how the osteopathic medical profession has overcome past struggles and challenges, and let’s talk about what those fights can teach us about defending the profession today. Oct. 1, 2022SaturdayOctober 2022 issue The DO Distinction Brian Loveless, DO Brian Loveless, DO, is the chief medical officer of WesternU Health. Contact Dr. Loveless
DO will explore the stigma of mental illness in the medical profession in upcoming webinar Michael Foti, DO, will discuss his own struggles with depression and anxiety and also share strategies to prevent physician burnout in a Sept. 10 AOIA webinar.
Making your mark: Networking do’s and don’ts for medical students at conferences Maximize your networking at OMED 2024 and other medical conferences by following these essential do’s and don’ts to forge meaningful connections and avoid pitfalls.
I agree wholeheartedly with Brian! I have been an osteopathic physician, family practice with a specialty in OMT, And I spent the last 40 years perfecting more efficient and effective OMT techniques. They are safer, use less force, and can be incorporated into a 15 minute regular primary care visit. One of the biggest complaints that I hear from residents is that the techniques take too long, And we have to change that. We also need more osteopathic physicians practicing manipulation in their practices, as an example to the medical students and medical residents. Oct. 4, 2022, at 6:58 am Reply
Thank you, Dr. Chin, for the support. I agree that there are many lost opportunities in our clinic time to practice hands-on treatment. Oct. 17, 2022, at 12:02 pm Reply
In the Top Gun 2 scene, you are referencing, both men were correct. And the understanding was that the age of unmanned fighter jets was, in fact, inevitable. Is that the point to make about a practice you would like to see continue and grow? Perhaps a more appropriate movie reference would be from “Up in the Air” — specifically the line “sell it to me; I want you to SELL me osteopathic manipulation.” The point is that to sell the value of something objectively (in the language of science), emphasizing that you believe in it doesn’t, by itself, work. That’s faith-based thinking or moral reasoning and is, in fact, outdated and has fallen out of favor in the house of medicine and for good reason. Oct. 6, 2022, at 11:56 am Reply
Thank you for the feedback, Dr. Schmitz. I do not think that the key points of osteopathic philosophy: patient-centered care, a focus on health rather than disease, the unity of mind, body, and spirit (and structure/function), and the self-healing ability of the body are outdated. I think they are becoming more relevant in contrast to today’s overly reductive model of medical care. Oct. 17, 2022, at 12:05 pm Reply
I agree that the Osteopathic profession is unique and in many ways better. Many ways we are equal and inferior. I do not believe we are inferior on the patient care front. We just don’t have the numbers or the research number of colleagues. As far as our approach to the sick patient I believe with all my heart that we are better prepared to care for them. What the AOA did to our residency programs is, in my opinion, NOT GOOD. I may be paranoid but it seems to me we are on the way to a three tiered system. NP’ and PA’s in tier 3, DO’s in tier 2, and MD’s in tier 1. I cannot think of one good reason that we did away with our residency program system. It truly breaks my heart. Oct. 6, 2022, at 12:56 pm Reply
Dr. Farmer: I believe the jury is still out on the overall results of the SAS on residency training. I do agree that in the short term we lost some strong osteopathic training. It is totally within our control, however, whether we make a strong case for Osteopathic Recognition within the ACGME. Oct. 17, 2022, at 12:07 pm Reply
I completed a career in the military as a DO physician. I like the Top Gun reference, but DOs are not going away. PAs and NPs are increasing in responsibility and autonomy, and many are outstanding providers, but I don’t think they will replace physicians. I appreciate the precedent of excellence set by previous DOs in the military. Myself and other DOs were respected among physicians and patients as equals with MD physicians. I did a military MD residency in Family Medicine. I found that our (DO) approach to the patient and OMT skills differentiated me in a positive way from my MD colleagues. In residency we set up an OMT Clinic run by the DO residents and we trained interested MD residents. This enabled me to practice and develop my OMT skills. Of course, we needed a DO on the faculty to precept our OMT patient care. I think: 1. DOs should promote their uniqueness and apply it in their residencies, even if they are not doing an Osteopathic residency. 2. There should be both DO and MD residencies, but this complicates standardization and promotes duplication of effort. I think more investigation is required to determine the right courses of action. 3. DOs are respected as equals to MDs in the US medical profession. They are not considered equals in many areas outside the US. Thanks for reading this long comment. Oct. 7, 2022, at 11:14 am Reply
Dr Hoffman, I agree with your sentiments. Thank you for your service and providing unique care to the soldiers under your watch. Oct. 17, 2022, at 12:09 pm Reply
Please define a DO without referencing MD’s. The author of this article and those who responded with their enthusiastic support in fact prove my point. Their reference to MD’s in describing and explaining DO’s is fundamental to their arguments. It’s like a MAC team coming along and beating Michigan or Ohio State or Alabama in football on some given Saturday, and declaring to the world “see I told you we are just the same as Michigan or Ohio State, or Alabama.” No, they are not. A residency at a consortium of three, forty bed hospitals is not the same as a residency at a university academic medical center with a thousand bed hospital. God bless the DO’s who came before me and fought the battles for recognition, licensing, and practice rights. I am indebted to them pure and simple. But also God bless the DO students who entered the large MD university speciality residencies and not only survived but excelled. It is my unvarnished belief that those young, bold DO physicians are the ones who cemented the Osteopathic professions legitimacy. It’s hard to turn your nose up at DO’s when the Chief Resident of your heretofore all MD Department is a DO! Oct. 7, 2022, at 3:54 pm Reply
Dr. Highley: I agree with your first statement. Please see my previous column https://thedo.osteopathic.org/columns/what-is-osteopathic-medicine-a-unified-definition-is-desperately-needed/ for a more full explanation of my position. As to your second paragraph, I fully agree. I love to see our amazing young physicians taking positions of leadership in all areas of medicine. It is a testament to the quality of their training and all of their hard work. Oct. 17, 2022, at 12:11 pm Reply
Thanks for the reminder of the value that we bring to the practice os Osteopathic Medicine. As one that graduate from an Osteopathic Medical school when we as a profession were veery small and considerated as almost PT, We have come a long ways as I was a part of this OUTSTANDING GROWTH. I would be pleased to share these experiences with students of osteopathic Medicince. William G. Anderson, D.O., FACOS Sr. Adviser to Dean MSUCOM Oct. 8, 2022, at 8:17 am Reply
Dr. Anderson, thank you for your comments. We are all humbled by your contributions and are indebted to the work you and your colleagues did to bring us equality. Oct. 17, 2022, at 12:13 pm Reply
I am a recent DO grad, and I’d like to offer a different perspective. Our profession throws around this idea that AT Still was the god of whatever as evidence for all the pseudoscience that is OMT. Working closely with my MD colleagues now I am happy to say there really is quite a lot more in common than different between our professions. And there are ample students like me who are graduating feeling there is essentially no distinction between MD and DO but rather the osteopathic components of our profession are more a nuisance, a hurdle to overcome and focus on the stuff that actually matters or has evidence to support us learning it. I write this today to say that what you are speaking does not resonate with me or many in our field. There has to be a reconciliation for that discrepancy between believers of OMM and the vast majority of DO grads who do not feel that way. Oct. 8, 2022, at 8:27 am Reply
So, having been in AOGME for the last 35 years and now to have transitioned to ACGME post doctoral education the last 3-4 years, I find that the AOA has simply shot DOs that actually care about Osteopathic Medicine, Philosophy and treatment ideals, in the foot. Seems like it was really not the way to go and we have diluted ourselves to be complacent with “bean counter” type site visit inspections. Virtual still at this point, but, even our last site visit (inspection in the old AOGME terms) the “inspector” referred to the ACGME protocol as “bean counting”. This means that by far, ACGME considers what you have on paper regarding evaluations, didactics and especially “research” has become so much more important than actual clinical acumen. Our older an much wiser osteopathic approach to inspections was to establish the link between faculty, residents and their adaptation to clinical abilities, whether it was how they thought, were able to create a plan of care, use their hands, or perform procedures. It does not seem this way anymore. OMG, if you didn’t write down that you met with the resident to discuss a case, and get the resident to understand why and how the treatment may have been better done, it simply did not exist and the resident did not learn anything from the experience. But, if you put on paper that the resident learned something, according to ACGME standards, then they did. It has become a very frustrating and compromised situation with training. Oct. 8, 2022, at 6:55 pm Reply
California has taken over Michigan in having the most DO’s of any state?. So fascinating. Every 2 years, when u go to renew my California license, I get to fill out the California Osteopathic Board questionnaire. I especially love the part where they ask me my specialty. I’m 100%, traditional , hands on Osteopathic manual medicine. Yet, in the 60 or so multiple choice options I have to describe my special area of medicine, let’s see, pediatric oncology? No. Neuro ophthalmology? No. Nuclear medicine? No. Interventional cardiology? No. Hmmm. Osteopathy? Anything about practicing osteopathy as a specialty ? No there isn’t. For the last 27 years as an Osteopathic physician, practicing 100% Osteopathy, I have to check “ other”on the California Osteopathic Medical Boards. “Other”. And you wonder about the future of this profession? I hope you are as infuriated about this as I am. And if you are an “MD wanna be” Osteopath, I wonder if you even care. Oct. 9, 2022, at 12:39 pm Reply
Dr. Trafeli: Your question made me go back and look at the data again, but yes, based on AOA data, CA has 11,101 practicing DOs while MI has 8,910. It’s been a long time coming for CA to regain that spot after the merger of the 1960’s. As to your second point, I can’t agree more. I have the same frustration as you with the list of specialties provided by the OMBC. It shows how much further the osteopathic profession has to go in it’s fight. Oct. 17, 2022, at 12:27 pm Reply
As a current DO student, I can’t say that I have seen or experienced anything in my education worth defending or preserving. We are learning the same things as our MD peers with the added burden of OMT, but at the same time we deal with generally worse facilities, fewer faculty, poor research opportunities, and the onerous task of taking two sets of board exams if we want to match into anything resembling a competitive specialty. Instead of anything meaningful like advocating for a single licensure exam or disavowing cranial therapy as quackery, all we are given is platitudes about “patient centered care” and our “distinct approach.” I am grateful to be able to study medicine, allopathic or osteopathic, and I will be proud to be a DO, but I really have not been convinced that we bring anything unique to the table. Oct. 9, 2022, at 6:36 pm Reply
Maxwell, hang in there. When you graduate (actually before of course) get yourself an MD residency at the best place you can. And don’t be afraid to apply to the top places, Mayo, Harvard, Hopkins, any major university. etc. Get in, get trained and never look back! Oct. 14, 2022, at 1:41 pm Reply
Student Doctor Spence, thank you for your comment. I am disheartened not only by your experiences with OMT training but in your inability to discern a difference in the way your faculty are preparing you to practice. Perhaps it is simply a factor of being immersed in osteopathic school and not truly knowing what allopathic training is like (the fish who doesn’t know it’s living in water) or perhaps it hasn’t been made clear enough in the first year of school. My hope for you is that when you are out on your clinical rotations your distinctiveness will be more evident. Oct. 17, 2022, at 12:32 pm Reply