The future of our profession lies in our ability to come together with a unified voice. We must also recognize that the practice of osteopathic medicine, and the training of osteopathic physicians, has evolved significantly since A.T. Still, MD, DO, created osteopathy.
The AOA recognized this when its Board of Trustees announced that the AOA will start providing two pathways for board certification. DOs will be able to choose to become board certified:
- In the osteopathic practice of their specialty, or:
- In their specialty only by taking an initial certification exam without osteopathic content.
A different generation
We are a different generation of DOs. The vast majority of graduating DOs entered osteopathic medical school far more interested in earning the “Dr.” in front of their name than the “DO” after it, and almost 75% of applicants to DO schools even applied to MD schools the same year or the year before.
Following graduation from DO school, the majority of DOs enter residencies without osteopathic recognition, obtain board certification through ABMS rather than the AOA, and rarely (if ever) use osteopathic manipulative treatment in their daily practice of medicine.
This isn’t to say we aren’t a different breed of physicians than our allopathic colleagues. We still pride ourselves on less objective measurements of “The DO Difference” like empathy, bedside manner, communication skills and our holistic approach to healing the patient.
However, we no longer have a patent on this approach to patient care. MD schools and ACGME standards are now emphasizing these characteristics more. While some may choose to further validate these skills—along with OMT—by choosing board certification in the osteopathic practice of their specialty, this “DO Difference” is instilled in us mostly as we earn our Doctor of Osteopathic Medicine degree. Once a DO, always a DO.
I am a third-generation DO from a family with more than 15 osteopathic physicians. I completed an AOA residency and am board certified by the American Osteopathic Board of Internal Medicine. I seek OMT above all else as treatment for my personal chronic musculoskeletal conditions.
The realities of modern osteopathic medicine
I’m proud to adhere to osteopathic principles and practice (OPP) as a physician, but I do not use OMT in my daily practice as a hospitalist. It simply was not emphasized in my training program. I consider myself to be an “osteopathic physician who is board certified in internal medicine” as opposed to a “physician board certified in osteopathic internal medicine.” Osteopathic medicine is integral to how I practice, but I don’t feel the need to validate that beyond my DO degree. On the other hand, those who wish to do so will have the option to take an exam that’s even stronger than ever before.
Simply put, the two pathways for AOA board certification will accommodate the realities of modern osteopathic medicine by more accurately validating how physicians practice.
Additionally, these two pathways will allow the AOA to further advance its mission and vision by offering board certification services to physicians who don’t hold the DO degree. MDs across the country are engaged with osteopathic medicine in clinical practice and in training. Those enrolled in ACGME training programs with osteopathic recognition deserve the opportunity to validate their learned skills in OPP and OMT, and the AOA is right to open osteopathic board certification to these individuals.
Providing a pathway to specialty certification that does not validate osteopathic knowledge or skills also provides physicians, both DO and MD, who are seeking a more focused specialty certification (either by choice or by virtue of their training) with a nationally recognized alternative to ABMS. This is a tremendous opportunity for the AOA to expose an entirely new demographic to the culture, philosophy and practice of osteopathic medicine.
Join me in this exciting time of change by supporting the two pathways for AOA board certification with a unified voice.
Seger Morris is chair, American Osteopathic Association’s Bureau of Emerging Leaders and the New Physician in Practice member, AOA Board of Trustees. This article originally appeared in The DO.
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