Loyalty to the Profession, Not the AOA: Evidence Base Necessary for Member Support of Association Policies
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《美国整骨期刊》
Adjunct Professor of Social Medicine Ohio University Athens, Ohio Adjunct Professor of Behavioral Medicine Midwestern University's Chicago College of Osteopathic Medicine Downers Grove, Ill
The exchange of letters among Drs Smith,1,2 O'Connor,3 and Hornbeck,4 with responses by Dr Opipari5–7 representing the American Osteopathic Association's (AOA) Council on Postdoctoral Education, shares opinions, policy, and few facts.
First, as osteopathic physicians, we all took an oath to support and "develop the principles of osteopathy which were first enunciated by Andrew Taylor Still" (see http://www.osteopathic.org/index.cfmPageID=ado_oath). We did not take an oath to support all policies as promulgated by the AOA. We are not disloyal if we disagree with the AOA's policies, nor are we necessarily loyal if we express no opinion at all.
Second, there is not one scintilla of evidence that a one-year rotating internship does or does not contribute to early postdoctoral training. Our opinions and beliefs are just that: opinions and beliefs. As the osteopathic medical profession and the larger medical community demand practices consistent with evidence-based medicine, we can demand no less of our educational system.
Medical education has, with few exceptions, ignored the principles of adult education and has continued a hysterical defense of our historical system. To that practice, I say: Stop! Prove that the rotating internship provides an intrinsic value to osteopathic interns—or stop defending it.
Third, state medical licensure requirements—including years of required postdoctoral training and, in states with a board of osteopathic medical examiners, an AOA-approved internship—touch upon the rights of all practitioners to direct their own future plans. If there is a shadow of a chance that a future osteopathic physician is going to move to a state that has internship requirements, that future physician obviously needs to be able to take that requirement into account.
Once studies are conducted to determine any intrinsic value to internship requirements, we can move on.
Editor's note: Dr Rodos served as associate executive director of the American Osteopathic Association from 1978 to 1979.
Footnotes
As the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at osteopathic medical colleges, and others within the healthcare professions to submit comments related to articles published in JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research.
Letters to the editor are considered for publication in JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication.
All accepted letters to the editor are subject to copyediting. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified.
Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that letters be e-mailed to jaoa@osteopathic.org. Mailed letters should also be sent electronically, in one of the aforementioned electronic formats on an IBM-compatible CD or a 3 -inch disk, and addressed to Gilbert E. D'Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864.
Letter writers must include their full professional titles and affiliations, complete preferred mailing addresses, day and evening telephone numbers, fax numbers, and preferred e-mail addresses. Authors are responsible for disclosing financial associations and other conflicts of interest.
Although JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless authors provide self-addressed, stamped envelopes with their submissions.
All osteopathic physicians who have letters published in JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5 hours of AOA Category 1-B CME credit. Authors of published articles who respond to letters about their research receive 3 hours of Category 1-B CME credit for their responses.
Although JAOA welcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.
References
7. Opipari MI. Chairman of COPT concludes debate on "hardship exception" [letter]. J Am Osteopath Assoc.2005; 105: 53-54. Available at: http://www.jaoa.org/cgi/content/full/105/2/53. Accessed August 30, 2005.(J. Jerry Rodos, DO, DSC)
The exchange of letters among Drs Smith,1,2 O'Connor,3 and Hornbeck,4 with responses by Dr Opipari5–7 representing the American Osteopathic Association's (AOA) Council on Postdoctoral Education, shares opinions, policy, and few facts.
First, as osteopathic physicians, we all took an oath to support and "develop the principles of osteopathy which were first enunciated by Andrew Taylor Still" (see http://www.osteopathic.org/index.cfmPageID=ado_oath). We did not take an oath to support all policies as promulgated by the AOA. We are not disloyal if we disagree with the AOA's policies, nor are we necessarily loyal if we express no opinion at all.
Second, there is not one scintilla of evidence that a one-year rotating internship does or does not contribute to early postdoctoral training. Our opinions and beliefs are just that: opinions and beliefs. As the osteopathic medical profession and the larger medical community demand practices consistent with evidence-based medicine, we can demand no less of our educational system.
Medical education has, with few exceptions, ignored the principles of adult education and has continued a hysterical defense of our historical system. To that practice, I say: Stop! Prove that the rotating internship provides an intrinsic value to osteopathic interns—or stop defending it.
Third, state medical licensure requirements—including years of required postdoctoral training and, in states with a board of osteopathic medical examiners, an AOA-approved internship—touch upon the rights of all practitioners to direct their own future plans. If there is a shadow of a chance that a future osteopathic physician is going to move to a state that has internship requirements, that future physician obviously needs to be able to take that requirement into account.
Once studies are conducted to determine any intrinsic value to internship requirements, we can move on.
Editor's note: Dr Rodos served as associate executive director of the American Osteopathic Association from 1978 to 1979.
Footnotes
As the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at osteopathic medical colleges, and others within the healthcare professions to submit comments related to articles published in JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research.
Letters to the editor are considered for publication in JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication.
All accepted letters to the editor are subject to copyediting. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified.
Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that letters be e-mailed to jaoa@osteopathic.org. Mailed letters should also be sent electronically, in one of the aforementioned electronic formats on an IBM-compatible CD or a 3 -inch disk, and addressed to Gilbert E. D'Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864.
Letter writers must include their full professional titles and affiliations, complete preferred mailing addresses, day and evening telephone numbers, fax numbers, and preferred e-mail addresses. Authors are responsible for disclosing financial associations and other conflicts of interest.
Although JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless authors provide self-addressed, stamped envelopes with their submissions.
All osteopathic physicians who have letters published in JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5 hours of AOA Category 1-B CME credit. Authors of published articles who respond to letters about their research receive 3 hours of Category 1-B CME credit for their responses.
Although JAOA welcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.
References
7. Opipari MI. Chairman of COPT concludes debate on "hardship exception" [letter]. J Am Osteopath Assoc.2005; 105: 53-54. Available at: http://www.jaoa.org/cgi/content/full/105/2/53. Accessed August 30, 2005.(J. Jerry Rodos, DO, DSC)