The following letter dated on December 22nd, 2008 by Adam B. Smith D.O., FACOS
I am writing this letter in response to the “study group” appointed by the President of UNT-HSC to consider granting the MD degree at the institution which houses the Texas College of Osteopathic Medicine.
While this is an extremely emotional issue to me personally I will try to keep my points factual. In order to provide background on myself I have included a Curriculum Vitae in additional to the personal points I will provide.
I grew up in Ardmore, Oklahoma which at the time was much smaller than it is now. In my town I witnessed firsthand professional prejudice against Osteopathic physicians up until the late seventies and early eighties when there were just not enough qualified MD physicians to keep the hospital viable at which time the Osteopathic physicians in town who had quite successful practices were allowed to obtain privileges at the hospital.
I attended the Oklahoma State University College of Osteopathic Medicine which was a significantly smaller school than TCOM and received a completely osteopathic education including a traditional rotating internship and then enjoyed the opportunity to complete my surgical training at the Osteopathic Medical Center of Texas which partnered with TCOM. My trainer and mentor W.R. Jenkins D.O. taught me to be tenacious in my pursuit of excellence but to never forget where I came from and to be loyal and supportive of the Osteopathic background where I was taught to care for the whole patient and not to be disease centered.
I was so enamored with the collegiality and excellence of TCOM that after only 2-3 years of private practice in Oklahoma City I returned to teach at TCOM and carry on the tradition of surgical excellence in clinical practice and education. In fact many of the surgical residents I trained at OMCT/TCOM went on to obtain awards for scholarly excellence, clinical achievement, and some “Resident of the year” which is the highest award offered to a resident by the American College of Osteopathic Surgeons.
Many of the benefactors and graduates of TCOM have gone on to achieve high levels of distinction both within the communities where they practice, the professional organizations they belong to, or in corporate America where the sound clinical instincts and “people” skill which typify many osteopathic graduates shine through. Sadly almost none of these are represented on the “study group” put together by Dr. Ransom.
In fact right here in Fort Worth are board members, and or Presidents (either past or president) of the American College of Osteopathic Family Practitioners, American College of Osteopathic Internists, American College of Osteopathic Surgeons, American Osteopathic College of Proctologists, American Academy of Orthopedic Surgery, and American Academy of Osteopathy.
I have reviewed the published members of the study group and it is quite clear that the outcome of the study has already been decided simply by the makeup of the group.
I will not engage in character assassination, however, it would be patently unfair to not point out the perceived biases of certain members of this group.
The MD members of the group I know by casual acquaintance and reputation only so I cannot comment.
Sam Buchanan was one of my trainers who I care about deeply, I actually worked with him for ten years in the surgery department prior to its implosion which started with the change in direction of TCOM initiated under Dr. Blanck and championed by Dr. Ransom. Under that leadership we went from a clinical department of at one time twelve board-certified osteopathic surgeons many of whom served as officers or board members in their specialty colleges to the department as it exists today which includes some surgeons who are not even board certified.
Dr. Deluca is probably the only member of the committee in active clinical practice who is not financially beholding to the School. He actually probably represents mainstream osteopathic physicians.
Todd Richwine is a young osteopathic primary care doctor who I trust will do the right thing despite his relative inexperience.
Dr. Schranz and Dr. Troutman are in the employment of UNT.
With the possible exception of Dr. Peska, none of the study group staff see patients in active clinical practice.
The potential advantages espoused by Dr. Yorio are patently obvious that he is of the opinion that he might be able to wrestle additional funding because of the additional degree program and potential additional enrollment, this is clearly self serving. If Dr. Yorio and his non-clinical faculty cannot produce enough quality research to generate their own funding they really should be replaced by higher quality, more motivated faculty members. The fact they practice in an institution associated with quality Osteopathic medical education has no bearing on the scope, quality, and consistency of the research he and his cohorts should be producing.
I would suggest a glance at the previous clinical productivity, scholarly productivity, and national prominence of the members hand selected for this group. An additional comparison of the faculty now compared to only eight years ago would be very insightful.
A superficial perusal of the lay members of the study group includes many people who represent entities that have historically been quite unfriendly and in some instances hostile to osteopathic physicians.
I will not dwell further on the composition of the study group but it is consistently not what I would consider in any way shape or form a balanced group.
Why the need for an additional degree? Osteopathic medical education is experiencing its largest growth in decades. We provide graduates centered on the patient the majority of who still enter primary care related fields. TCOM itself has produced nearly 3000 graduates, 65% practice in primary care fields. A large proportion of the graduates of TCOM remain to practice in the state of Texas. In fact when you look at the smaller towns in the state many of our graduates are there “in the trenches”. Many osteopathic physicians historically take care of those who would otherwise be without care.
TCOM has historically represented some of the best and brightest faculty and leaders in the osteopathic profession, sadly that star has lost its shine as under the current and recent former leadership many excellent faculty members have left the institution to pursue educational careers at other schools. While this exodus can be “spun” that they were furthering their careers, in fact the hostile work environment that has developed over the years is the real culprit. I myself could see this change coming in 2003 and 2004 which facilitated my departure from the faculty to pursue private practice.
I left TCOM in part because I could not stand by and watch an excellent clinical faculty be destroyed by policy change causing attrition one person at a time. I have committed ten years of my life to osteopathic education; serving as General Surgery residency director, teacher and facilitator of many undergraduate courses, serving for over ten years as chairman of the General Surgery In-service exam for the entire country, and currently serving the 4th year of a 6 year tem on the American College of Osteopathic Surgeons Board of Governors.
The manner in which previous faculty members including department chairpersons and even deans have been terminated is shameful and sheds a very unfavorable light on the University. The most prominent recent terminations are Osteopathic physicians who have earned the respect of their colleagues locally and nationally and certainly deserved better treatment at the hands of the current administration.
In a changing environment we should never be afraid to look at options, but if we really want to look at a realistic validity of this option then we should include people who might actually have an opinion and express that opinion without fear of retaliation in the work place. We should also include people who have practiced and committed their lives to the promotion of osteopathic medicine and education.
TCOM is too important to our profession and our community to allow Dr. Ransom to set forth a hypothesis and then set out to prove its accuracy by stacking the committee with people he knows will promote his idea.
I will continue to support Osteopathic medicine and education in this community and throughout the country wherever I might no matter what result this so called study group comes up with. The Osteopathic profession remains strong with or without the University of North Texas but we surely benefit most from a cordial inclusive relationship rather than the current adversarial one.
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