AOA Needs to Reach Out More
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《美国整骨期刊》
Department of Neurology University of South Florida, Vice-Chief of Neurology and Director, Outpatient Epilepsy Clinic Tampa General Hospital, President, Willsey Research Inc Tampa, Fla
I read with interest the comments by Kenneth J. Steier, DO,1 and George Mychaskiw II, DO,2 in their separate letters in the May 2006 issue of JAOA—The Journal of the American Osteopathic Association. I agree with their expressed concerns about osteopathic graduate medical education, board certification, and the future of osteopathic medicine. The attempts by Drs Steier and Mychaskiw to provide "outside" information—by virtue of their allopathic affiliations—to American Osteopathic Association (AOA) constituents capable of effecting changes in policy should serve as a wake-up call.
As an allopathically trained surgical epileptologist specializing in the surgical treatment of patients with refractory epilepsy, I practice within a unique setting of both subspecialty private practice and academic affiliation. I support the AOA and understand the attempts to maintain a distinct and separately recognized professional organization. Yet, I feel that the AOA is not reaching out to those of us who have close affiliations with an allopathic environment.
Qualified osteopathic training programs for the primary care physician have been available for years. However, specialty training is more readily available from the greater number of allopathic institutions, which are capable of providing more opportunities within an individual's selected field of expertise than are osteopathic institutions. As such, more osteopathic physicians will be seeking separate board certification from allopathic credentialed boards after their training. Most allopathic residency directors (and fellowship directors) are inclusive of graduates of colleges of osteopathic medicine, by virtue of the osteopathic, patient-centered philosophy that characterizes our graduates.
Beyond the community hospital setting that provides many DOs with training, osteopathic manipulative treatment (OMT) will hopefully remain a part of osteopathic philosophy, regardless of whether we as individual osteopathic physicians use it. The use of OMT as a cornerstone to every treatment is difficult to substantiate when rigorous scientific methodology is applied.3 However, by focusing on valid scientific paradigms (ie, literature review4 and controlled clinical trials5), OMT may become more universally accepted as a useful adjunct to physical medicine.
It is imperative for those of us who have moved on to higher levels of specialty or subspecialty education to promote favorable public relations for these osteopathic physicians who will follow, regardless of their individual clinical or academic pursuits. We are ultimately judged not as "DOs," but by the knowledge and actions that we apply to help our patients. As a group, we must be inclusive and actively continue to pursue the involvement of all DOs—irrespective of their training, practice affiliation, or board certification. As individuals, we must participate to strengthen the AOA, our primary organization, if our profession is to evolve and prosper.
As more osteopathic physicians choose not to take the osteopathic pathway for specialty education, it is up to the AOA to reach out to the many who are fading away and not dismiss them because they "have chosen not to partake of the many benefits that the AOA has developed for them."6
References
5. Tatum WO IV, Johnson KD, Goff S, Ferreira JA, Vale FL. Vagus nerve stimulation and drug reduction. Neurology.2001; 56:561 –563.
6. Opipari MI. Response. J Am Osteopath Assoc. 2006;106:302–303. Available at: http://www.jaoa.org/cgi/content/full/106/5/302. Accessed June 20, 2006.(WILLIAM O. TATUM, IV, DO,)
I read with interest the comments by Kenneth J. Steier, DO,1 and George Mychaskiw II, DO,2 in their separate letters in the May 2006 issue of JAOA—The Journal of the American Osteopathic Association. I agree with their expressed concerns about osteopathic graduate medical education, board certification, and the future of osteopathic medicine. The attempts by Drs Steier and Mychaskiw to provide "outside" information—by virtue of their allopathic affiliations—to American Osteopathic Association (AOA) constituents capable of effecting changes in policy should serve as a wake-up call.
As an allopathically trained surgical epileptologist specializing in the surgical treatment of patients with refractory epilepsy, I practice within a unique setting of both subspecialty private practice and academic affiliation. I support the AOA and understand the attempts to maintain a distinct and separately recognized professional organization. Yet, I feel that the AOA is not reaching out to those of us who have close affiliations with an allopathic environment.
Qualified osteopathic training programs for the primary care physician have been available for years. However, specialty training is more readily available from the greater number of allopathic institutions, which are capable of providing more opportunities within an individual's selected field of expertise than are osteopathic institutions. As such, more osteopathic physicians will be seeking separate board certification from allopathic credentialed boards after their training. Most allopathic residency directors (and fellowship directors) are inclusive of graduates of colleges of osteopathic medicine, by virtue of the osteopathic, patient-centered philosophy that characterizes our graduates.
Beyond the community hospital setting that provides many DOs with training, osteopathic manipulative treatment (OMT) will hopefully remain a part of osteopathic philosophy, regardless of whether we as individual osteopathic physicians use it. The use of OMT as a cornerstone to every treatment is difficult to substantiate when rigorous scientific methodology is applied.3 However, by focusing on valid scientific paradigms (ie, literature review4 and controlled clinical trials5), OMT may become more universally accepted as a useful adjunct to physical medicine.
It is imperative for those of us who have moved on to higher levels of specialty or subspecialty education to promote favorable public relations for these osteopathic physicians who will follow, regardless of their individual clinical or academic pursuits. We are ultimately judged not as "DOs," but by the knowledge and actions that we apply to help our patients. As a group, we must be inclusive and actively continue to pursue the involvement of all DOs—irrespective of their training, practice affiliation, or board certification. As individuals, we must participate to strengthen the AOA, our primary organization, if our profession is to evolve and prosper.
As more osteopathic physicians choose not to take the osteopathic pathway for specialty education, it is up to the AOA to reach out to the many who are fading away and not dismiss them because they "have chosen not to partake of the many benefits that the AOA has developed for them."6
References
5. Tatum WO IV, Johnson KD, Goff S, Ferreira JA, Vale FL. Vagus nerve stimulation and drug reduction. Neurology.2001; 56:561 –563.
6. Opipari MI. Response. J Am Osteopath Assoc. 2006;106:302–303. Available at: http://www.jaoa.org/cgi/content/full/106/5/302. Accessed June 20, 2006.(WILLIAM O. TATUM, IV, DO,)