If it ain’t broke, don’t fix it!

The following letter to UNT Board of Regents dated on March 29, 2009 by Edward A. Luke, Jr., D.O.

I am writing out of my concern over the Proposal to create an MD degree option at the UNTHSC.

I may have some unique experiences that have shaped my view regarding this Proposal. I grew up in Fort Worth. My father was Edward Luke, Sr., M.D. I graduated from TCOM in the class of 1981. While in school I was the Class President for 2 years. I was a previous President of the Alumni Association. In my residency I spent 2 years at Michigan State University in a Psychiatric residency. I served on the faculty of TCOM for 3 ½ years before opening my private practice here in Fort Worth for 8 years. I served as the Chief Psychiatrist for Geriatrics at the North Texas State Hospital during 10 ½ years I was on their staff.

I chose to enter the Psychiatric residency at MSU because it was affiliated with major medical schools, and was jointly approved by the Osteopathic and Allopathic medical professions.
While the residency was accredited by both professions, the medical schools at MSU were not duly approved. Each profession had worked to have a separate medical school chartered and sponsored by the University. Each school had it faculty, its curriculum, and at the end of matriculation offered its own degree. Each school has it own admissions committee, and admission requirements and criteria. There is not an admissions process that allows students to apply to the “medical schools” and after acceptance choose which degree they would select. The schools, the processes, the philosophies, and the degrees are separate, not shared, despite what you may have been told.

As a former state employee, I worked at the time the legislature consolidated the many different state departments into the limited number we have today. This was done in an attempt to “save the state money”. What they found out later was that it would take an increase in these departments’ budgets to be able to consolidate them so that at a time in the future, the budgets would be able to be cut. I believe, at best, much of these savings are still in the future.

I completed a fellowship in Geriatric Psychiatry at what was then known as TRIMS, the Texas Research Institute for Mental Science. I was in the last TRIMS class of fellows. The State was in another time of budget cutting, and decided to close TRIMS, one of only 3 such research facilities in the world, saving $14 million. What was not disclosed was that the state lost over $20 million in research grants that came to the state through TRIMS. When someone professes that “it will not cost any more or will even be a financial savings to make a change”, we should have long ago learned to be leery of the “pipe dreams”.

For many years I heard my father talk about the MD’s and DO’s practicing on opposite sides of town. This division seemed to resolve of late. It was my father who suggested that if I still thought about going to medical school I might look into the school that had begun in here in Fort Worth. But I might question this resolving in view of the Proposal being put forth. There was an attempt in the early years of the school to give graduates a choice of degrees their diploma would indicate, D.O. or M.D. Those making that Proposal were not successful. This was seen at the time as a blatant attempt to change the School from Osteopathic to Allopathic.

There was a small group of local Osteopathic Physicians who had put energy, time, and money into bringing their dream of having a Medical School dedicated to the Osteopathic philosophy into reality. They were able to enroll other DO’s from around the State in their goal. The School opened and went on to graduate new Osteopathic Physicians. After much discussion, they choose to give their school and their dream to the State of Texas to help it grow into what they dreamed of, a premier School of Medicine that is arguably one of the best Medical Schools in the Nation dedicated to the philosophy of the practice of Osteopathic Medical healing arts. The physicians had seen the Osteopathic Medical School in California be stolen from the Profession, and had protected their school from being taken through the enabling legislation that made the school a State Institution. The Osteopathic physicians, in this state and the nation, have voiced their dedication to not have another School taken from this profession. That idea has already been discarded and legally resolved when the school was given to the State of Texas. To even bring this proposal up indicates a lack of knowledge and appreciation for history of the school, the work the Osteopathic physicians have done to make the school what it is today, the work to they have done to be recognized as equal to all physicians and to forge a relationship that allows all of the physicians, MD’s and DO’s to work together for the betterment of the patient care.  Attempting to alter the mission of this school that was founded by proud, dedicated Osteopathic physicians is sure to open wounds what were once healed on both sides of the Medical Communities. To persist on this fool’s errand can only come from a failing understanding, inadequate vision, and an absence commitment to an outstanding Institution, and a dedicated Profession.  

It is well known that a majority of Osteopathic Medical students go on into a primary care practice, and the numbers of allopathic students going into primary care versus specialty practice are almost reversed. Most Osteopathic physicians practice in smaller communities and that is certainly true for UNTHSC graduates here in Texas. When this state has many counties that have no physicians at all, and even more counties have only one physician for the entire county, why would we take state funds and resources to help create a greater shortage by producing graduates, who for the most part, will not fill the gap in physician needs in our rural communities?

While my father was a non-osteopathic physician, in 1977 I had only applied to TCOM. The education I obtained has been 2^nd to none. I have never had to apologize for my medical education, or the knowledge I received.  It is unconceivable to try to change the mission and philosophy of a Medical School with an unquestionable result. In Texas we have a saying, “If it ain’t broke don’t fix it.”