Dr. Carlisle Holland sent us a look at the history of Osteopathic board certification:
I was a professor at TCOM during the period when board certification in general-family practice and OMM were developed. Even then, there was discussion about whether or not such certifications could be used against physicians to deny or restrict privileges to practice or gain privileges to use some hospitals. During that period the AMA was still denying full reciprocity with DOs and DO post-doc education programs, so our profession created boards that were of comparable academic rigor to be certain that DO boards were at a parity with MD boards in specialties, BUT with the recognized need to include Osteopathic information and practice methods in addition to the MD material.
With the rapid expansion of schools and the loss of Osteopathic hospitals and training programs, more DOs went into Allopathic training and pressure was on to grant them full parity with DO programs despite their lack of Osteopathic elements in the programs.
At no time was this deficiency in allopathic training ever omitted from the discussions about trying to reciprocate these credentials. Some states, like California, even made a practical examination for all DOs part of their licensure exam to deal with these deficiencies in training.
The boards were not to be used to restrict practice rights.
The boards and CME were voluntary and did not jeopardize licensure or practice rights already held by the physician.
CME was a intellectual endeavor that QUALIFIED physicians took to enhance their comprehension of their area of practice and was voluntary and no requirements for hours were needed. The physicians WANTED to be smart and keep up and went to learn and share information. It was supposed to be an intellectual endeavor for physicians who already had rights to practice, not a mechanisms to GRANT the rights to practice.
They physicians had those rights and they could not be taken away as their studies and achievements had proven they deserved the rights. The boards were to show mastery of
the information, not adequacy with the information. They had already earned that right with their licensure and completion of post-doc training. The National Board was what you took
at the end of your education and proved your competency and granted the rights to practice that specialty. The idea of recertification was imposed by the MDs and copied by DOs.
Initially, we were reassured that if it was too much hassle for physicians in the field, that we could go back to life certification, but of course, the AOA made a lot of money with REQUIRED CME and REQUIRED recertification they did not make in the old physician rights paradigm. And because the certification was earned, if earned once, it was supposed to mean they had passed a board in their specialty to demonstrate mastery of
the material. But it was not ever supposed to be a device to force physicians to learn or limit their rights. It was a way to demonstrate mastery of the area of medicine. And it was
earned and once earned could not be taken away. And if you taught the material and used it daily, there was no reason to assume incompetency would result if they did not take
a test to prove mastery over and over. Mastery is mastery.
And not subject to reassessment later. Initially, claiming Board certification only meant you had passed a board in your specialty. With recertification requirements this claim of Board Certification was redefined. Passing them once, twice or ten times in the past no longer matters. Now the certification is only good for 8 years. The old ‘What have you done for me lately?’ approach replaced the respectful approach that had carried the whole profession to that point.
And this has not been turned into EXACTLY what we were told it would never be, a tool to limit and take away our rights to practice. THEY SAID THEY WOULD NEVER DO THIS WHEN THEY SET UP THESE BOARDS. A statement of intellectual achievement WAS NOT the same as licensure and was not to be used to restrict our rights.
These stunts were EXACTLY what we feared when we learned about these MD programs. We were promised that board certifications would never be misused this way.
So much for historical perspective. These are not DOs doing this. These are educational bureaucrats whose jobs depend on creating and critiquing such boards. The DO boards were NEVER considered the SAME as MD boards. Parity did not mean SAMENESS.
I think we should call them on what their real agenda is.
They want to eliminate the Osteopathic profession and make us all one big happy allopathic pharmaceutical insurance dream.
I have come to the conclusion that our ‘leaders’ do not want the profession to survive and are deliberately destroying it. I don’t think they care at all about our concerns. They do not want us to survive. They want the SAME rights for DOs as MDs, not parity, sameness.
And THEY DO NOT HAVE THE RIGHT TO DO THIS, NOR IS WHAT THEY ARE DOING CONSISTENT WITH THE AOA CHARTER. We are watching them destroy our profession on purpose.
What other conclusion can be drawn from their actions and behavior?
Body language…. what is THEIR agenda? They have demonstrated that it is NOT OSTEOPATHY, NOT DOs in the field, NOT patients.
So WHO are they doing this for? Have they signed agreements with these other entities that prevent their disclosing that they have taken money and agreed to publish no materials against the ACA? Did our own AOA take what amounts to a bribe to keep our voice out of this discussion? If so they are over into conflicts of interest that may involve criminal behavior, as they acted opposite to the charter of the AOA which they pledged to uphold and have not. I believe the AOA and JAOA are ENEMIES of the profession and have the agenda to destroy it softly from within via these amalgamations and surrender of our RIGHTS which we and our predecessors fought so hard for. And who is selling out our RIGHTS to a totalitarian regime’s agenda? This is the deliberate destruction of out profession, pure and simple. And our pleas are like a person pleading on a gallows to these people. They want us dead and gone. They want only DOs who will play their control games and surrender their rights so they can usurp their rights to practice.
THE INSURANCES CANNOT PRACTICE MEDICINE. ONLY LICENSED PHYSICIANS CAN PRACTICE MEDICINE. They have to get the doctors to do it their way, so they format it their way and force all physicians to do it their way or ? They have no rights? They no longer matter? That they have a right to keep records as THEY see fit? Practice as THEY see fit.? and that conformity to these EHR methodologies IS NOT SUPPOSED TO
SUPERCEDE THE RIGHTS OF THE PHYSICIAN AND PATIENT.
Who invited all these people into the room with my patients?
Who do they think they are that they can force me to practice as THEY see fit?
And how can the AOA hand over our licensure and rights? Because they no longer want the AOA to survive, except as a CME money making program and public relations device. But seeing that EHR forces me to chart like an MD and that it lacks so many Osteopathic elements that it is very difficult and cumbersome to use during a visit. Instead of my patient having my full attention, as they have for the past 37 years of practice, now I find that I have to appease my iPad and instead of talking to my patient I have to run down a ridiculous list of elements that an MD who cannot palpate or diagnose with palpation might
need to be sure they had not forgotten anything in the evaluation, I have to deviate from the relevant information to answer questions about aspects of their care more relevant to an MD Internist than to me. The neurology questions are equally inappropriate for Somatic Dysfunction elements and lack Viscero-Somatic correlations.
I rely on palpatory criteria to decide tests or lab or treatments, yet I have to back up and state each of these as though it was a chief complain in a family practice setting. That is not appropriate either, but there are no Osteopathic EHR programs worth a flip any of my
colleagues have found. All are MD EHR programs and none are designed for real Osteopathic care plans.
So these ‘leaders’ have put us in a no choice situation that forces us to chart like MDs, and de facto BE MDs. So what are they forcing the DO profession to do? Be MDs or not practice at all?
These people do not want the profession to survive. They think DOs and MDs are the SAME. And they want to force that on us. Make us be the same. They do not want a separate profession. They want to be the SAME as MDs. They are not real DOs, or
they could never do this. But since they are already likely comfortable signing MD after their names, if they pull this off, no one will ever criticize them for doing it again, and they
can let go of their SHAME for being DOs.
These are the MD trained DOs doing what we feared they would do when their numbers grew sufficient. To claim that an MD DO was the SAME as an MD. And the DO part did not matter.
And now they are demanding that all DOs do it the MD way or have no rights to practice at all. And we are back to where we were when AT started the profession, all over again.