The following is a guest post by Donald Phillips, DO, FACEP, FACOEP.
I have worked with a variety of health systems in several states with both MDs and DOs. In every case (before moving back to Texas), no one cared what my initials were. It was when I was initially planning to move back to Texas that my degree became an issue. One recruiter for a prominent Central Texas health system stated that I had "the wrong initials and training". The American Osteopathic Association (AOA) stated that this is specifically forbidden by Texas law and offered to file a lawsuit on my behalf. I declined. I would point out that the health system involved has an allopathic training program and trains TCOM graduates, but due to a change in leadership for the emergency department, has decreased this commitment, again a discriminatory practice. While I was in my residency, I heard my program director state several times, "Remember; as a DO, you may be accepted, but you will always be seen as a black man in a white man's world." Naively I discounted this and never encountered it until trying to return to Texas.
It has been stated many times in testimony to the board of regents, and in this newspaper, that over many years osteopathic students more often choose to pursue primary care (family medicine, pediatrics, and internal medicine) versus their allopathic counterparts. It has also been proven that osteopathic students are more likely to pursue practices in rural and underserved areas than their allopathic counterparts. This is not meant to say that osteopathic students and physicians are morally superior, but everyone has agreed that Texas and the nation need more primary care providers, especially in the underserved and rural areas. If this is true, then why are we trying to reinvent the wheel? TCOM has been educating quality physicians for many years and has what Texas and the nation needs. Instead of trying to divide resources and faculty (there will be some parts that must be unique to each side), why not use the pledged funds to increase the number of osteopathic graduates from TCOM? Perhaps instead of debating the merits of adding an allopathic track at UNTHSC, we should be debating that one of the other medical schools starting up in Texas becomes an osteopathic institution complimenting TCOM.
It has been stated that the local hospitals do not want osteopathic students and graduates training in their hospitals. When I was in medical school, most of my rotations were not at the Osteopathic Medical Center of Texas. I worked in hospitals where MDs and DOs were all on staff. I never had a patient say they did not want a DO student or a DO caring for them. I did have a large teaching hospital in Ft Worth with an allopathic residency say I was not welcome due to my school. Fortunately, that has changed. Having trained at Grant Medical and Trauma Center and Columbus Children’s Hospital (now Nationwide Children’s Medical Center), I have been literally shoulder to shoulder with MDs while in training. In that case, they were from the Ohio State University, not a slouch of a school. Other than describing my training as more practical and skill oriented, we were seen as the same. Basically, only our home training program identification cards were different.
On a local and present level, I doubt most citizens realize that many of the students at JPS are osteopathic students or know that there is a difference. I doubt that patients at Plaza Medical Center realize that the students are osteopathic students or that the residents are DOs. In these cases, they are just glad that they have someone caring for them. In the rural and frontier counties surrounding where I presently work, there are many fewer physicians. My patients have never said they do not want a DO treating them. Most probably don't even notice it on my photo ID. They are just glad there is a doctor to care for them. If TCOM turns out more doctors that are looking to practice in these underserved areas, don't you think the responsible thing to do would be to increase the size of TCOM and/or duplicate TCOM in other parts of the state?
In my opinion, this really comes down to a simple case of degree envy and wanting to match the neighbor to the east. There is nothing wrong with the little school on the hill in Ft Worth; in fact it is nationally recognized. Unfortunately, as Jesus said, "Only in his hometown, among his relatives and in his own house is a prophet without honor." (Mark 6:4 New International Version copyright 1984). Sadly, TCOM fits this: Fort Worth is our hometown, the Tarrant County Medical Society and the local hospitals are our relatives, and Dr. Ransom and the DOs supporting this are our own house.
I hope that I have demonstrated to some of the readers and hopefully every legislator, that opening an allopathic track at TCOM is discriminatory, is demeaning to the graduates, and is just plain wrong for Texas, especially the rural and underserved in our state and nation. Instead of approving this change in legislation, our legislators should take action to charter at least one new osteopathic school in Texas instead of another allopathic program. After all, there are already eight allopathic schools in Texas now and one osteopathic school. Is this discriminatory? I will let the readers decide. I hope that those hospitals that did not want DOs training in their residency programs have a change in their perspective. Why not use the funding they were planning to use to start allopathic programs to open osteopathic programs?
It has been stated many times in testimony to the board of regents, and in this newspaper, that over many years osteopathic students more often choose to pursue primary care (family medicine, pediatrics, and internal medicine) versus their allopathic counterparts. It has also been proven that osteopathic students are more likely to pursue practices in rural and underserved areas than their allopathic counterparts. This is not meant to say that osteopathic students and physicians are morally superior, but everyone has agreed that Texas and the nation need more primary care providers, especially in the underserved and rural areas. If this is true, then why are we trying to reinvent the wheel? TCOM has been educating quality physicians for many years and has what Texas and the nation needs. Instead of trying to divide resources and faculty (there will be some parts that must be unique to each side), why not use the pledged funds to increase the number of osteopathic graduates from TCOM? Perhaps instead of debating the merits of adding an allopathic track at UNTHSC, we should be debating that one of the other medical schools starting up in Texas becomes an osteopathic institution complimenting TCOM.
It has been stated that the local hospitals do not want osteopathic students and graduates training in their hospitals. When I was in medical school, most of my rotations were not at the Osteopathic Medical Center of Texas. I worked in hospitals where MDs and DOs were all on staff. I never had a patient say they did not want a DO student or a DO caring for them. I did have a large teaching hospital in Ft Worth with an allopathic residency say I was not welcome due to my school. Fortunately, that has changed. Having trained at Grant Medical and Trauma Center and Columbus Children’s Hospital (now Nationwide Children’s Medical Center), I have been literally shoulder to shoulder with MDs while in training. In that case, they were from the Ohio State University, not a slouch of a school. Other than describing my training as more practical and skill oriented, we were seen as the same. Basically, only our home training program identification cards were different.
On a local and present level, I doubt most citizens realize that many of the students at JPS are osteopathic students or know that there is a difference. I doubt that patients at Plaza Medical Center realize that the students are osteopathic students or that the residents are DOs. In these cases, they are just glad that they have someone caring for them. In the rural and frontier counties surrounding where I presently work, there are many fewer physicians. My patients have never said they do not want a DO treating them. Most probably don't even notice it on my photo ID. They are just glad there is a doctor to care for them. If TCOM turns out more doctors that are looking to practice in these underserved areas, don't you think the responsible thing to do would be to increase the size of TCOM and/or duplicate TCOM in other parts of the state?
In my opinion, this really comes down to a simple case of degree envy and wanting to match the neighbor to the east. There is nothing wrong with the little school on the hill in Ft Worth; in fact it is nationally recognized. Unfortunately, as Jesus said, "Only in his hometown, among his relatives and in his own house is a prophet without honor." (Mark 6:4 New International Version copyright 1984). Sadly, TCOM fits this: Fort Worth is our hometown, the Tarrant County Medical Society and the local hospitals are our relatives, and Dr. Ransom and the DOs supporting this are our own house.
I hope that I have demonstrated to some of the readers and hopefully every legislator, that opening an allopathic track at TCOM is discriminatory, is demeaning to the graduates, and is just plain wrong for Texas, especially the rural and underserved in our state and nation. Instead of approving this change in legislation, our legislators should take action to charter at least one new osteopathic school in Texas instead of another allopathic program. After all, there are already eight allopathic schools in Texas now and one osteopathic school. Is this discriminatory? I will let the readers decide. I hope that those hospitals that did not want DOs training in their residency programs have a change in their perspective. Why not use the funding they were planning to use to start allopathic programs to open osteopathic programs?
Please see that this is not just what is best for Ft Worth, Texas, or the nation, but is best for the patients we serve.
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