Friend of IP4PI, Richard Koss, D.O., writes:
The current issue with Resolution 17 points to a larger issue facing the American Osteopathic Association (AOA) and osteopathic physicians.
I was about to send the American Academy of Osteopathy (AAO) a four-page letter outlining the dilemma of the future of osteopathy. However in this current crisis I will try to simplify and outline the issues and hope that the leadership will take an aggressive, proactive role in fighting for the existence and future of osteopathy. I am pleading to the AAO leadership to keep their membership fully informed and transparent as to the issues we currently face! This will not be solved from a top down decision/solution. The solutions will be like the very beginning is of our profession. It will come from the people, and membership who will force the change at the political top.
I hope the AAO leadership can see the larger implications of Resolution 17 and what it means to the future of osteopathy.
From the 1950s when the AOA pushed for full practice rights (prescribing privileges), the focus of osteopathic principles and practice and the primacy of the neural muscular skeletal system was denigrated and marginalized. The purpose of this to prove that the DO’s can be like the MDs. THIS HAS BEEN THE UNDERLYING PREMISE OF THE AOA AND IS THE BASIS OF ALL POLICY! The California decision of the 1960s where overnight a DO could become an MD for a small fee was the first evidence of their policy. Since this overt conversion failed in California, this unwritten policy of the AOA then became the slow marginalization and exclusion of Osteopathic Manipulative Medicine (OMM) in the curriculum in favor of the allopathic model of drugs and surgery for the relief of symptoms.
The gradual focus of osteopathic research to now apply OMT techniques only to the musculoskeletal system symptoms like a drug . Yet even now allopathic research does not include the osteopathic research in their bibliography unless it is of a negative result. The AOA/AAO is silent on pointing out the failure and bias in their research. Within the last two years the American College of internist published a 60 page paper on the diagnosis and treatment of low back pain. The AOA failed to respond and they failed to publish their own white paper on low back pain commenting that they did one way back in 2009. Silence has followed ever since. This demonstrates the AOA‘s position on the neuro- muscular skeletal system and the primacy of the neuroMusculoskeletal system has taught in the colleges of osteopathic medicine. That is, it is not important at all and needs to be silenced!
More and more OPP curriculum hours and OMM staff has been continually cut in the colleges of Osteopathic medicine in favor of allopathic curriculums subjects. The AOA or COCA Support this gradual extinguishing of osteopathy is demonstrated by their silence and condoning the practice.
OMM specialists cannot bill for OMT according to federally excepted guidelines without a time consuming and practice crushing expenses from audits. The AOA is silent in support of osteopathic physicians who do OMM. If you can’t get paid for your work you don’t exist. The AOA/AAO is supportive in lip service only in helping our profession to get reimbursed for their work. Furthermore because DO’s who do OMT can’t get paid for their services for trying to provide a federally recognized practice of medicine, this is “restraint of trade.“ The AOA will not support any DO who tries to perform the services for which they were trained. So they are complicit in this gradual removal of osteopathy from medical practice.
Now comes the merger of the AOA and ACGME. In the lead up to the merger the AOA has not provided policy, guidelines, or leadership on how to get the interested MDs acceptable to take the DO boards. I recently had a conversation with a COM president asking how to talk to the allopathic community as to what osteopathy is. Secondly I have been asked recently to precept an MD student to get them to an acceptable level to participate in a DO post graduate program. as far as I know, there is no such policy, guideline, or academic parameters on how to inform the allopathic community as to what a DO is or how to get an MD student up to speed to apply to a DO program.
This is the constitutional duty of the AOA , is it not? Is the AAO holding them accountable?
Now to Resolution 17: since the allopathic community does not have palpatory skills or the psycho-motor training to perform osteopathic manipulative treatment, and since all of their training and CME is done by lecture and PowerPoint only, it is necessary to extinguish any osteopathic hands-on training that is critically necessary to perform osteopathic medicine. The easiest way to accomplish this is not to pay for table trainers in any CME program. No one will volunteer to teach, and those dedicated Osteopaths who will do it gratis will soon die off and what is left is the “allopathic osteopathy” and one can be certified to do OMT by lectures only! So again like getting reimbursed for OMT. If you can’t get paid for being a table trainer for providing the critical OMT palpatory experience then it will soon fade. And the goal of proving that OMT is “not real medicine” has been accomplished because one can be certified by attending a lecture.
If the AAO will not take a hard stance against this resolution and against the AOA then this Academy to will be the next casualty of the allopathic push and the take over of Osteopathy will have been accomplished.