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Continuity of Thought and Tradition in the Discipline Supported by Ongoing AOA Efforts
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     American Osteopathic Association Chicago, Ill

    I would like to compliment the timeliness of the May 2005 special focus issue of JAOA—The Journal of the American Osteopathic Association, titled "The Paradox of Osteopathy: Views on Thought and Tradition in the Discipline," particularly as it serves to highlight the "Pride in the Profession" theme of Philip L. Shettle, DO, the 2005–2006 president of the American Osteopathic Association (AOA).

    The editorial by Gerald G. Osborn, DO, MPhil ("Taking osteopathic distinctiveness seriously: historical and philosophical perspectives." 2005;105: 241–244), is likewise apt. In his editorial, Dr Osborn comments on the issue's three main articles by Leonard H. Calabrese, DO,1 Robert Orenstein, DO,2 and Felix J. Rogers, DO.3 However, I would like to note that the AOA is already working on most, if not all, of the issues raised by Dr Osborn.

    For example, Dr Osborn mentions the vision shared by A.T. Still, William James Mayo, and Charles Horace Mayo of a "`patient-centered' model of medical care." During his 2004–2005 AOA presidency, George Thomas, DO, promoted that same vision with his "Year of the Patient–Patient-Centered Quality Care." This vision of measuring and improving the quality of care given by osteopathic physicians has become a reality with the growth of the AOA's Clinical Assessment Program (CAP) in residency programs (see http://cap.aoa-net.org/) and the movement of CAP into osteopathic physicians' offices.

    Dr Osborn also notes how Dr Still and the Mayo brothers agreed that the medical establishment should focus on the patient instead of diseases. The AOA has long recognized this need, reaffirming its commitment by formally adopting the tag line "DOs: Physicians Treating People, Not Just Symptoms" in 1999 as part of the Unity I campaign.

    In regard to research, the AOA supports efforts to increase research within the osteopathic medical profession. As Dr Rogers3 noted in his article, the AOA was one of the founding organizations of the Osteopathic Research Center (ORC) in Fort Worth, Tex (see http://www.unthsc.edu/orc/about/). Since providing initial funding to the ORC in 2001, the AOA4 has continued to support the Center. Most recently, at its annual meeting in July 2005, the Board of Trustees approved a second grant to the ORC amounting to $250,000 over the next 4 years.5

    Although I am pleased to see that Dr Rogers supports the ORC, his implication that the ORC is tied to only one of the 23 osteopathic medical school campuses is troubling. While the ORC may be located at the University of North Texas Health Science Center at Fort Worth—Texas College of Osteopathic Medicine (TCOM), its reach spans to all of our colleges of osteopathic medicine and other research sites across the nation through multi-center national clinical trials.

    For example, the ORC is monitoring the Multi-Center Osteopathic Pneumonia Study in the Elderly, fostering collaboration among the following groups6:

    Doctors Hospital–Ohio Health Inc (Columbus, Ohio);

    Kennedy Memorial Hospitals/University Medical Center, Stratford Division (NJ);

    Kirksville College of Osteopathic Medicine of A.T. Still University of Health Sciences (Mo);

    Mount Clemens General Hospital (Mich);

    Northeast Regional Medical Center (Kirksville, Mo); and

    TCOM.

    In addition, in its June 2005 Annual Report, as presented to the Board of Trustees, the ORC released a nationwide call for collaborative research partners for the Developmental Center for Research in Osteopathic Manipulative Medicine.

    I agree with Dr Osborn and all three authors that more research will help establish the osteopathic medical profession's distinctiveness. However, the AOA's ongoing research initiatives should not have been ignored in that analysis. The structure and function of both basic and clinical research efforts within the AOA are now in proper alignment, thanks to the reorganization the AOA Board adopted 3 years ago for its Bureau of Osteopathic Clinical Education and Research and its Council of Research.

    At the end of his editorial, Dr Osborn poses the question, "To what extent is the distinctive osteopathic identity alive, well, and clinically demonstrable" I cannot say to what extent because I believe the state of the profession is constantly changing and growing. But I can definitely say that, through the work of the AOA's members and its many volunteer leaders, the distinctive identity of osteopathic medicine is indeed alive, as shown by our ever-increasing research efforts; well, as shown by the growth in the number and class sizes of colleges of osteopathic medicine7,8 and by the AOA's commitment to ensuring that such growth is responsible9; and clinically demonstrable, as shown by the success of CAP,10 which has been well-received by health insurance executives and federal health officials alike during collaborative meetings with the AOA.

    References

    7. Howell JD. The paradox of osteopathy. N Engl J Med. 1999;341:1465 –1468.

    8. Shannon SC. Osteopathic medical education in 2006: charting a course for the future. J Am Osteopath Assoc.2006; 106:48 –49.

    9. Griffin AO, Sweet S. Undergraduate osteopathic medical education: addressing the impact of college growth on the applicant pool and student enrollment. J Am Osteopath Assoc.2006; 106:51 –57.

    10. Thomas G, Snow RJ, Levine MS, Harper DL, McGill SL, McNerney JP; Agency for Healthcare Research and Quality. Clinical Assessment Program to evaluate the safety of patient care. Storming Media [serial online]. 2005. Available at: http://www.stormingmedia.us/89/8964/A896434.html. Accessed August 31, 2005.(JOHN B. CROSBY, JD, Execu)