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We Have Met the Enemy and He Is Us

  • Arthur J. VanDerburgh
Published/Copyright: June 1, 2011
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 111 Issue 6

To the Editor:

Reading the letter section in JAOA—The Journal of the American Osteopathic Association has become as entertaining as reading the same section in my local newspaper. There have been a number of recurring themes in recent JAOA editions, including debates over the use and efficacy of osteopathic manipulative treatment (OMT),1-5 changing our DO degree designation,6-13 and the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) vs the United States Medical Licensing Examination (USMLE).14-19 All of these themes seem to be related to a crisis of identity in osteopathic medicine.

In addition to these JAOA letters, an article in a recent edition of the alumni newsmagazine of the A.T. Still University of Health Sciences-Kirksville College of Osteopathic Medicine20 discusses the diminishing use of OMT. According to the article, after osteopathic medical students get into their clinical years, they virtually never consider using OMT—and this avoidance of OMT apparently continues for the rest of their careers. Houston, we have a problem!

In the February 2011 JAOA, an osteopathic medical student suggests a method of improving the examination process by allowing osteopathic medical students to take the USMLE as the main competency examination and then take an adjunct test to cover concepts unique to osteopathic medicine.17 His letter is followed by rejoinders from other authors defending the COMLEX-USA.18,19 Incidentally, the Kaplan board review process is all about examinations—not competency. Good physicians are born with it, while the rest study their books so that “no child is left behind.” Examinations are mandated by political bodies to certify that we can practice medicine, but the examinations are no guarantee of professional competency.

The letter by Arnold Melnick, DO,12 also in the February JAOA, makes an interesting point regarding the public's confusion about what an osteopathic physician is. (Although osteopathic physician is the currently preferred term in our profession, I do not find the term osteopath objectionable.) Perhaps the public is confused about what DOs are because we are confused about what we are.

The various recent letters and articles on the apparent identity crisis in osteopathic medicine lead me to think of the cartoon character Pogo, who is famous for making the observation, “We have met the enemy and he is us!”

1 Sucher BM. Musculoskeletal dysfunction and drop foot: diagnosis and management using OMM [letter]. J Am Osteopath Assoc. 2010;110(4):223-224.Search in Google Scholar

2 Lavelle JM. Response [letter]. J Am Osteopath Assoc. 2010;110(4):224-225.Search in Google Scholar

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6 Hernandez MB. The DO difference: an analysis of causal relationships affecting the degree-change debate [letter]. J Am Osteopath Assoc. 2010;110 (1):45-46.Search in Google Scholar

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10 Comeaux Z. The anachronistic fight for osteopathic distinctiveness [letter]. J Am Osteopath Assoc. 2010;110(9):512 ,552.Search in Google Scholar

11 Shore EE. Response [letter]. J Am Osteopath Assoc.2010;110(9):552-553.Search in Google Scholar

12 Melnick A. Communication by degrees [letter]. J Am Osteopath Assoc.2011;111(2):124-125.Search in Google Scholar

13 Walkowski SA. Current and distinctive terminology: osteopath and physician [letter]. J Am Osteopath Assoc.2011;111(3):141-142.Search in Google Scholar

14 Parikh SP, Shiembob CA. New COMLEX-USA-to-USMLE conversion formula needed [letter]. J Am Osteopath Assoc. 2010;110(7):400-401.Search in Google Scholar

15 Slocum PC. Response [letter]. J Am Osteopath Assoc. 2010;110(7):401 .Search in Google Scholar

16 Gimpel JR. New COMLEX-USA-to-USMLE conversion formula needed [letter]. J Am Osteopath Assoc. 2010;110(10):577-578.Search in Google Scholar

17 Burmeister JD. New COMLEX-USA-to-USMLE conversion formula needed [letter]. J Am Osteopath Assoc. 2011;111(2):119 .Search in Google Scholar

18 Slocum PC. Response [letter]. J Am Osteopath Assoc.2011;111(2):119-120.Search in Google Scholar

19 Gimpel JR. Response [letter]. J Am Osteopath Assoc.2011;111(2):120 .Search in Google Scholar

20 Stroppel K. OMT challenges at the heart of a profession. Still Magazine. Fall/Winter 2010;5(4):36-44. http://stillmagazine.atsu.edu/?p=1704. Accessed May 20, 2011.Search in Google Scholar
Published Online: 2011-06-01
Published in Print: 2011-06-01

The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Articles in the same Issue

  1. AOA COMMUNICATIONS (REPRINT)
  2. OFFICIAL CALL
  3. Proposed Amendments to the AOA Constitution and Bylaws
  4. LETTERS
  5. We Have Met the Enemy and He Is Us
  6. EVIDENCE-BASED CLINICAL REVIEW
  7. Common Dermatologic Infections in Athletes and Return-to-Play Guidelines
  8. SPECIAL COMMUNICATIONS
  9. Support for the Osteopathic Graduate Medical Education Development Initiative
  10. ORIGINAL CONTRIBUTIONS
  11. Effects of Comprehensive Osteopathic Manipulative Treatment on Balance in Elderly Patients: A Pilot Study
  12. Nasopharyngeal Carriage of Methicillin-Resistant Staphylococcus aureus: Incidence and Outcomes in Pregnant Women
  13. MEDICAL EDUCATION
  14. Competency-Based Classification of COMLEX-USA Cognitive Examination Test Items
  15. CASE REPORTS
  16. Mitochondrial Myopathy Presenting as Rhabdomyolysis
  17. Aortic Dissection With Vascular Abnormalities
  18. BOOK REVIEWS
  19. Dancing With Medusa, A Life in Psychiatry: A Memoir
  20. From Death's Door to Disney World—Traumatic Brain Injury When You're NOT Rich and Famous: An Advocate's Story
  21. CME QUIZ
  22. CME QUIZ
https://doi.org/10.7556/jaoa.2011.111.6.370
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. AOA COMMUNICATIONS (REPRINT)
  2. OFFICIAL CALL
  3. Proposed Amendments to the AOA Constitution and Bylaws
  4. LETTERS
  5. We Have Met the Enemy and He Is Us
  6. EVIDENCE-BASED CLINICAL REVIEW
  7. Common Dermatologic Infections in Athletes and Return-to-Play Guidelines
  8. SPECIAL COMMUNICATIONS
  9. Support for the Osteopathic Graduate Medical Education Development Initiative
  10. ORIGINAL CONTRIBUTIONS
  11. Effects of Comprehensive Osteopathic Manipulative Treatment on Balance in Elderly Patients: A Pilot Study
  12. Nasopharyngeal Carriage of Methicillin-Resistant Staphylococcus aureus: Incidence and Outcomes in Pregnant Women
  13. MEDICAL EDUCATION
  14. Competency-Based Classification of COMLEX-USA Cognitive Examination Test Items
  15. CASE REPORTS
  16. Mitochondrial Myopathy Presenting as Rhabdomyolysis
  17. Aortic Dissection With Vascular Abnormalities
  18. BOOK REVIEWS
  19. Dancing With Medusa, A Life in Psychiatry: A Memoir
  20. From Death's Door to Disney World—Traumatic Brain Injury When You're NOT Rich and Famous: An Advocate's Story
  21. CME QUIZ
  22. CME QUIZ
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