AOA commits DO member money to lobby for MOL requirements, but why?

A friend of IP4PI writes in:

The AOA just passed a resolution committing our membership dollars to lobby for Maintenance of Licensure requirements [overseen by the AOA].  I was not able to be in the committee hearing, but in our state meeting we voted against it.  On the floor of the house, when I expected our leadership to speak the will of the caucus, they did not speak at all. All states were silent as to the issue and it passed quickly without any objection.  In fact, it appeared that most delegates were not yet awake.  The only comment I got when I asked why we did not defend ourselves was that MOL is inevitable, and we have to vote for it if we want a place at the table. When will doctors learn that if they are told to advocate for their own destruction in order to make it less painful, it means they were never at the table.  We just helped by marinating ourselves for our place ON the table?

[Note from editor: Further demonstrating the AOA’s disregard for members, a provision in the resolutions directing the AOA to “make OCC more manageable and economically feasible was struck.]


H-627 MAINTENANCE OF LICENSURE (H638-A/14) Resolution No. H-627

Be it resolved: The American Osteopathic Association (AOA)

(1) supports the development of state level maintenance of licensure (MOL) programs to demonstrate that ALL physicians are competent TO provide quality care THAT INCORPORATES RELEVANT TECHNOLOGICAL AND SCIENTIFIC ADVANCEMENTS over the course of their career. Flexible pathways for achieving MOL should be maintained. The requirements for MOL should balance transparency with privacy protection and not be overly burdensome or costly to physicians or state licensing boards; 

(2) Continues to address and promote physician competency through the teaching of core competencies at the predoctoral and postdoctoral levels as well as ongoing physician assessment through Osteopathic Continuous Certification (OCC) and the AOA Clinical Assessment Program (CAP) or its equivalent;

(3) Continues to work with State Osteopathic Affiliates, the American Association of Osteopathic Examiners and other stakeholders to establish, AND implement MOL policies that promote patient safety and the delivery of high quality of care;

(4)WILL THROUGH ITS BUREAUS, COUNCILS AND COMMITTEES, CONTINUE TO ENSURE THAT OCC IS RECOGNIZED BY THE FEDERAL GOVERNMENT, STATE GOVERNMENTS AND OTHER REGULATORY AGENCIES AND CREDENTIALING BODIES AS EQUIVALENT TO OTHER NATIONAL CERTIFYING BODIES’ “MAINTENANCE” OR “CONTINUOUS” CERTIFICATION PROGRAMS.;

(5) WHILE SUPPORTING THE USE OF BOARD CERTIFICATION AS A  RECOGNITION OF QUALITY AND EXCELLENCE, SIGNIFYING THE HIGHEST PHYSICIAN ACHIEVEMENT IN A PARTICULAR SPECIALTY; OPPOSES ANY EFFORTS TO REQUIRE OCC AS A CONDITION OF MEDICAL LICENSURE.;

(6) THE AOA COLLABORATES WITH ENTITIES PROPERLY QUALIFIED FOR AND TASKED WITH DECISION-MAKING REGARDING INSURANCE PAYMENT, HOSPITAL PRIVILEGES, NETWORK PARTICIPATION, PAYMENT MALPRACTICE INSURANCE COVERAGE, PHYSICIAN EMPLOYMENT, TO DETERMINE THE ROLE OF PHYSICIAN BOARD CERTIFICATION AND OCC OR OTHER “MAINTENANCE” OF CERTIFICATION” PROGRAMS IN SUCH DECISIONS.;

(7) CONTINUES TO INNOVATE AND IMPROVE THE OCC PROCESS.

APPROVED

https://osteopathic.org/wp-content/uploads/2019-Ad-Hoc-Committee-Report-WITHACTION.pdf

The AOA is MIA as Insurers Marginalize Osteopathic Medicine

For more than a decade insurers have been implementing discriminatory policies that result in the automatic downcoding of claims filed by osteopathic physicians.

An official journal of the American Osteopathic Association recently published on this topic, but the osteopathic physicians on the front lines are asking the AOA to explain why it has been largely silent to this point and not taken meaningful action to stand up for the best interests of its members.

Here is a letter to the AOA Richard Koss, D.O. shared with IP4PI:

I hope you find the article in the recent DO magazine, dated November, 14, 2018, regarding the major insurers pushing back on the use of the modifier 25 as disturbing and discriminatory as I do.

What is the AAO’s policy, and plan to keep OMM specialists from being marginalized and discriminated out of existence? What is the economics committee doing to prevent this from happening? This has been going on for so long now (about 18 years) that there should be regular updates in all AAO communications about the membership’s ability to earn a living at their chosen profession. Where are these updates?

Yes I know that the AAO is under the AOA, but the AOA has no interest in protecting its members who practice OMM.

If you can’t get paid for your services than you do not exist. As OMM is being wiped off the payment rolls, the upcoming students and residents will have no way to pay back their loans, or make a living. So the existence of the AAO is also at stake here.

The beginnings of this trend started back in the 1950’s when the AOA leadership fought and pushed for full practice rights. That is to prescribe drugs and surgery. To do so they had to put OMM in the closet and denigrate it as a pseudoscience. This began the official death of Dr. Still’s Osteopathy. Now there are no Osteopathic hospitals, and all postgraduate programs are ACGME. Dr. Still is not even mentioned in the Academy Programs.

The AOA has known about the billing problems for 20 plus years and continues to be reactionary bending to the dictates of the AMA, and Federal Government, Insurance company mandates without any fight. This I can speak from personal experience. The modifier 25 issue has been going on for at least 18 years. Most recent in 2010 in Vancouver, Washington and Portland, Oregon. Then came the CMS illegal denial of the modifier 25 in the northeast in the last 2 years. Now this article in the DO……

I asked Mr. Goldman the head of the AOA PAC when he asked of PAC donations: “What is AOA policy and plan to support legislators and programs who support OMM?” His answer: “There is none.” The AOA has no plans or policies to keep OMM in its future business model (especially the “Branding advertisement”). Therefore it is up to the AAO to fight for our right to practice.

Please submit this communication to the board of trustees, governors, and I hope you publish this as an OP ED piece or letter to the editor of the AAO newsletters. To continue to be silent in this matter will condone the AOA’s current path.

Osteopathically,

Richard W. Koss, D.O., C-SPOMM, C-ACOFP

P.S. I hope I am not the only one who finds this disturbing. Is this even addressed in the “Five Year Plans” of the AAO? Because if it is not then we really are in trouble.

P.P.S. Of course the AOA is asleep at the wheel and has not done anything to help their members ability to make a living in their chosen profession. The AAO, our OMM specialty organization, also does not want to get involved. I pointed this out to both organizations on several occasions over the years and never gotten acknowledgement or communication on these issue, only “Crickets”. Thus I expect the same response to this letter.

What’s the AOA doing to combat insurer discrimination against OMM/NMM?

Friend of IP4PI Dr. Domenick Masiello shares correspondence with the AOA:

From: Domenick Masiello
Date: February 26, 2017
To: “Doss, Yolanda” <ydoss@osteopathic.org>
Cc: “Wooster, Laura” <lwooster@osteopathic.org>

Subject: Re: Issues in OMM/NMM

Well, I guess now I have to respond point by point. I am staring at my wall, looking at the 2 AOA board certifications that I have. One is Family Practice and osteopathic manipulative treatment and the other is a separate, different certification called Special proficiency in osteopathic manipulative medicine, C-SPOMM. So, Yolanda, there are actually 3 certificates flying around NOT two. Now we have a residency so there is also Neuromusculoskelatal medicine/OMM. the Special Proficiency is NOT a FP certification. I should know, I didn’t just speak to somebody with 20 years experience, I actually possess these certificates and have been in practice for 30 years! there is no gold standard, just confusion created by the AOA and its various certifying boards. I didn’t say that insurance carriers or hospitals recognized any DO claiming to be a specialist in OMM, I just said that some FPs advertise themselves as such, thereby adding to the confusion for the public.

Yolanda you did offer to help with Aetna over a year ago – it just would have been nice to hear back on the issue. You sort of kept that to yourself until recently about 9-10 months later. Aetna is not the only insurance company that doesn’t recognize our OMM specialty. I have had problems with Connecticare, Empire in NY, Oscar/magnacare in NY in addition to Aetna in NY and CT. In fact none of the exchanges in NY recognize OMM but they do have acupuncture and chiropractic listed in EVERY exchange! Recently I even tried Liberty Health Share, a Christian healthcare cost sharing provider. They would have me contact them for approval first before every visit and then submit treatments plans like a PT because they don’t know what I do.   You haven’t heard about other instances of this insurance problem because many DOs who do manipulation are not members of the AOA. Some doctors who completed their OMM residencies chose not to sit for the exam and many more have cash businesses as I did for the past 29 years. You also don’t have any outreach to folks like me so why would you hear from us. last summer I begged and pleaded for a specialty specific email blast for AOA members to no avail. You assume we will be contacted by our specialty boards but we are not and you assume that we will be contacted by our state societies but many of us are not members of those societies because they don’t serve our needs as traditional osteopaths.  recently, at a meeting of the Bergen County osteopathic Society in NJ, it was suggested that perhaps this less than ideal treatment of physicians board certified in OMM might be because of our minority status within our own profession. Most AOA members are FPs and they have the loudest voice and the rest of us are a minority within a minority profession. Also that the creation of a board certification for manipulation may have been experienced by the FPs as a threat to their insurance reimbursement. Ultimately, the point is not that you are working on it but how does this kind of thing happen in the first place? OMM should be your top priority because that is what makes us different despite our small numbers. Continue reading

I should not be mandated to PAY-to-Practice this great noble profession of Osteopathy.

IP4PI supporter Gina Reghetti, D.O. shares correspondence regarding continued attacks on the osteopathic profession.

Just a note to let you know that I received a letter today from the AOA, dated 1-9-2017 and signed by Jeffrey L. Weaver, O.D., yes, OD, not DO, an Optometrist who is the Vice President, Certifying Board Services, and from Eunice Lee, Associate Vice President, Client and Member Services, informing me that I have until February 1, 2017 to renew membership to keep my AOA board certification active. My board certification is wrongfully time-dated to expire in December 31st, 2022.

My scanner isn’t connecting to my PC wifi so I am unable to email the letter to you currently.

I called Jeffrey L. Weaver, O.D., this morning to confirm that he is not a DO, and I had a conversation with him for more than an hour regarding my views and concerns of the wrong agendas that the AOA has enforced on their doctors, such as re-certifications, and OCCs and membership dues connected to certifications. Continue reading

No Mandatory MOC – A physician pushes for reform in Maryland

Received from Maryland physician Jef Fernley, DO:

I have just got off the phone with Mary Beth Carozza, my State Delegate. Following in the wake of legal actions against MOC in OK, MI, Florida, and others, I expressed to her that I wish to have her champion legislation ending compulsory MOC in Maryland. The bill I’d offer basically says, if you wish to participate in Maintenance of Certification efforts, you are welcome to, if you do NOT, no employer, payer, etc. can use your board certification status to hire, fire, pay, not pay, promote, demote, etc. you. It makes MOC voluntary.

If you love MOC, truly believe that it’s improved the quality of your patient care, made you a better doctor, and that it’s completely worth the time, effort, and $$ you’ve invested, and you care not one bit how your board has used that tremendous surge in their income, then I apologize for having bothered you with this, feel free to delete without reading further. Continue reading

Quality of U.S. Medical Residents is In Steady Decline – What Must Be Done!

 

Guest Post From David R Schwartz MD:

As a physician educator practicing in the ICU/hospital environment for >15 years, I have noted a steady decline in the average resident’s knowledge base, clinical skill and efficiency, bedside manner and overall motivation. I am a harsh critic with extremely high standards, though I’ve supervised and been responsible for student/resident/fellow ICU rotations from an educational standpoint throughout.  The vast majority of my colleagues throughout the nation have supported this observation. More telling, daily report from the ICU nurses has chronicled a perennial erosion of their confidence in housestaff!

If true, this poorly documented but worrisome phenomenon combined with the anecdotal, but near universal, acceptance of increasing complexity and acuity of hospitalized patients is a prescription for failure. Explanations are numerous and pervasive.

THE STUDENTS

1) The public regard and economic rewards classically afforded physicians have dwindled dramatically.  While this may select for a less gifted cohort entering our medical schools, I believe the effect on the finished “product” far exceeds any deterioration in raw materials. Our new medical students and young physicians are still gifted.  Continue reading

Rowan Univ. School of Osteopathic Medicine Remembers Dr. Robert Maurer’s 39 Years of Service

Dear Faculty, Staff, Residents, and Students,

With sadness, we share the news of the passing of Dr. Robert Maurer on September 11, 2016.

Dr. Maurer served as a faculty member in the Department of Family Medicine with the School of Osteopathic Medicine (SOM) for 39 years. During his time of service, he held a number of administrative and clinical roles. He retired from active employment at SOM in 1997, but continued in a volunteer role as an adjunct associate professor until his passing. Continue reading