US Trained Doctors of Osteopathic Medicine (DOs)

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1 Adrienne White-Faines, MPA, FACHE Chief Executive Officer of American Osteopathic Association Margaret Aguwa, DO, MPH, FACOFP Associate Dean and Professor Emerita Michigan State Univ-COM US Trained Doctors of Osteopathic Medicine (DOs)

2 What is Osteopathic Medicine? Distinct branch of medical practice Whole-person philosophy All systems of the human body are interrelated and work together to heal the body in times of illness. Pioneered by Andrew Taylor Still, MD, DO at the end of the nineteenth century. Dr. Still developed a holistic approach to medicine. His philosophy stressed the importance of preventive medicine and used a set of manual techniques, now known as osteopathic manipulative treatment, to help diagnose, treat and prevent illness and injury.

3 Who Are DOs? DOs are one of two types of fully licensed physicians in the U.S. (DOs & MDs) and practice their patient-centered philosophy of medicine in every medical specialty It is projected that before 2025 DOs will comprise over 20% of the US physician population. Today, 1 of every 4 (25%) of US medical students are enrolled in Colleges of Osteopathic Medicine (COM). DOs focus on prevention, considering how a patient s lifestyle and environment can impact their wellbeing.

4 Typical US Physician Training Timeline (DO and MD) 4 Years Undergraduate (Bachelors Degree) 4 Years Osteopathic Medical School 3-7 Years Internship Residency 1-3 Years Specialty Fellowship 11 to 18 years total Board Certification/Licensure Both DOs and MDs must be licensed in their state(s) before they can practice medicine DOs and MDs both practice in licensed hospitals and/or healthcare settings

5 DO Specialty Choice Family Medicine remains the largest specialty of DOs in the US (31%) 56% Primary Care 44% Specialty Care Breakdown by Specialty Next Top 5 Specialties Pediatrics 5,259 7% Internal Medicine 12,629 16% Family Medicine 24,030 31% Emergency Medicine 7,523 (10%) Anesthesiology General Surgery 3,478 (4%) Psychiatry OB/GYN 3,318 (4%) 2,545 (3%) 2,438 (3%) Source: AOA Masterfile Data May 31, 2016

6 Our Journey The History 1890s 1 st osteopathic medical school/ AOA founded 1901 California 1 st state to grant DOs unlimited practice rights 1910 FLEXNER Report- Assessment of ALL US Medical Schools st AOA residency programs 1952 AOA COCA became federally recognized accrediting body 1961 California Challenge - California Medical Association (creates proof of equivalency to MDs) 1966 DOs accepted into military as equivalent to MDs 1970s Payment reform leads to merge/buy OM and other hospitals 1972 DOs enter ACGME residencies Increase from 5 schools to 15 schools 1980s Population Growth and Healthy People 2000 Project physician shortage leads to growth of COMs Explosive growth in DO schools to (15 to 48) and 300% growth in number of practicing DOs in US AOA/ACGME approve Single Accreditation System

7 US TRAINED DOs - IMPACT TODAY

8 The AOA : Accreditation/ Membership/ Advocacy/ Public Health Accredit Medical colleges Accredit Post Grad Residency Provide Board Certification Membership Public Policy Research / Public Health

9 AOA International Affairs Division Practice Rights & Equity / Licensure Affiliation Expansion Research Collaboration & Global Health Mission (DOCARE/ Medical Education Exchange) Medical College Accreditation

10 DOCARE & Global Health Outreach DOCARE International is a medical outreach organization dedicated to providing medical education and healthcare to under-resourced communities around the world. DOCARE works with local healthcare personnel and carefully considers the needs of the community as voiced by their representatives. DOCARE supports sustained continuity clinics by helping to fund local providers and then growing outreach to surrounding communities. DOCARE provides all-volunteer trips for both DOs and MDs, students, nurses, dentists, pharmacists and lay people, to support mission efforts throughout the year.

11 The DO Connection to Africa

12 DOs from Africa In 2016 data indicate 90 students of African origin were matriculated at US Colleges of Osteopathic Medicine Cameroon D.R. Congo Egypt Ethiopia Ghana Kenya Liberia Morocco Namibia Niger Nigeria Senegal Somalia South Africa Sudan Swaziland Tanzania Uganda Zambia Zimbabwe

13 DOs At Work on the Continent: We currently have research and clinical mission outreach ongoing in 4 African countries, and continual requests for licensure from DOs across the continent.

14 Perspectives on History of DO Physicians with Origins in Africa Perspective through personal history Student, resident and faculty presence in Medical Schools, such as Michigan State University College of Osteopathic Medicine Many prior episodic efforts to achieve practice rights in African countries (ex. Nigeria) With growth in US and growing global understanding of US trained DO physicians, it is the opportune time to clarify the practice rights confusion.

15 Discussion of AMCOA Opportunity Humayun Chaudry, DO, MS, MACP, MACOI CEO, FSMB Chair, IAMRA The AOA requests that AMCOA now consider a resolution to recognize UStrained DOs practice rights as equivalent to MD practice rights across your member regulatory authorities and health ministries.

16 Thank you for your commitment toward a world of wellness!

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