Planning for success

The Illinois Osteopathic Medical Society and its predecessors have been representing D.O.s in Illinois since 1899. Over its' last 112 years IOMS has grown from a small group of individual physicians; including the son of Andrew Taylor Still, MD, the founder of osteopathic medicine, as well as John Martin Littlejohn, PhD, D.O., the founder in 1900 of what is now Chicago College of Osteopathic Medicine. Drs. Harry Still and John Martin Littlejohn were American School of Osteopathy graduates. Dr Littlejohn was a graduate of the University of Glasgow and The American School of Osteopathy, now A. T Still University KCOM in Kirksville, Missouri. These practicing Osteopathic physicians, along with the small Chicago osteopathic college on Washington Blvd in Chicago began to advance Osteopathic principles and practice here in Illinois. They were rejected and considered outcasts by the powers that be, but they soldiered on with limited license practice rights until 1955. In that year the Illinois Supreme Court ruled that the Chicago College of Osteopathy and Surgery was qualified to graduate Osteopathic physicians with full practice rights in medicine, surgery and all its branches. Today, we number over 2000 D.O.'s practicing in the state with 201 D.O. residents in dozens of residencies across this state.

We are fortunate to participate in open, mixed staff hospitals, delivering the best medical care in the world, within the leading Illinois hospital systems. Our own college, at Midwestern University, continues to produce some of the most sought after students for clinical rotations who are entering highly competitive residencies around the country. We have earned this position in the healthcare community by consistently demonstrating knowledge, skill and the ability to deliver high quality, effective healthcare to the market place. That is why in a recent poll of managed care patients; one of the top five qualities they are looking for, in their primary care doctor is that they have these initials after their name: D.O.

But change is in the air and we need to plan for success. Fortunately, or unfortunately; our culture and society is changing some for the good and some not so good. Society is evolving and moving into a more progressive or socialistic state, we as Osteopathic physicians, have many challenges and opportunities ahead of us. To meet these challenges head on we need wisdom, discernment and desecration. We need to remember the old adages that: "all politics are local", as well as "all medicine is local."

The practice of medicine throughout history has always been reflected in the social moirés and teachings of the time, as well as the affluence and belief system of its habitants. Today the intellectual material, financial and delivery infrastructure of the country, state and local jurisdictions are under continual stress, metamorphosis and change. When the social moirés and customs change, the practice of medicine changes with them. We see changing demographics in population, aging, sex and race. There are challenges as well as changes, within financial systems, government agencies, new insurance and government mandates, as well as, professional, licensure, and specialty requirements. The relentless request/requirement for increased medical documentation, insurance requests for medical justification and the ordinary challenges of running a medical enterprise with accountants, consultants and lawyers increases the heavy burden our physicians and existing healthcare system practices under. All these regulations, requirements and requests stem from a third party (usually the payer) need for greater accountability to there superiors, so that justification(translate payment) can be more FINELY ( translate decrease pay) metered out. Based upon the Congressional Office on Management and Budget numbers for Medicare, the ultimate result will be less pay realized for more work done in the practice of medicine by physicians and their organizations.

We are moving away from the idyllic state of one patient and one physician, meeting together for the primary benefit of the patient, with the physician role of diagnosing and render treatment. This all occurs with mutual respect and gratitude, with payment rendered by the beneficial party, the patient. We are moving to a new, if not a revised healthcare system originating from the Obama Whitehouse and passed by Congress to take effect in 2013-14, unless something else stops it. Therefore, we need to plan for success.

Fortunately, we continue to have young, energetic and idyllic graduates of Osteopathic medicine who are entering the work force. These new physicians continue to move ahead with their optimism, idealism and desire; to touch and heal patients. Financial requirements and limitations that they operate under are much more constraining than previous generations of physicians. We see today, our young physicians are overwhelmingly opting to become a serial employed physician for the rest of their professional career. No longer do they financially have the ability to be independent practitioners/businessmen/businesswomen, but employed physicians of various medical systems from; multi-, or single- specialty group practices, academic physician groups and ACOs vertically organized University/hospital/ambulatory/laboratory/imaging/skill nursing services systems. Everything under one corporate roof, except an insurance company- excluding Kisser Permanente in California. These are the new practice sites for our new physicians that the Illinois Osteopathic Medical Society represents and will represent, more so in the future.

So, with them many anticipated changes let's plan to succeed. We are going to see many changes in qualifications, licensure, board certification, and the ability of individual D.O. to practice. We have EHRs that we will have to record our patient visit and procedure. We will have professional regulations that can limit their license; MLO, Re certification testing, quality measures, CAP, PQRI, working under an environment of an employed physician for an ACO, or hospital system/PHO, etc. During my term as President we will be leading guiding and educating you about these maintenance of licensure, continuous certification, business models that work for D.O.s from ACOs to concierge practices. We are planning to succeed and as a D.O. you have the keys of what you need to succeed.

With these real, concrete, working world changes occurring, relationships affecting patient care will occur, the nature of the profession and the attitudes of the D.O.s continue to evolve with society. The old system maybe dying away but the human need for that one trusted physician to answer the patients need will always remain. "Is it serious, Doc?" "Am I going to die?" "What do I need to worry about?" "What is wrong" "What do I need to know?" "What do I do?' "What is it going to be like?' and "Will you not leave me alone, help me, share with me this terrible experience?"," ease my pain?" That physician who can answer the call, the need to diagnosis and treat the whole person; body, mind and spirit, will always be in demand. Happily you have chosen the better half, this philosophical approach to health and healthcare not death and disease training. No, the training you have received from day one in an Osteopathic College has prepared you for this mission; "To touch, To Heal, To Serve" That is truly the new system of medicine. Fortunately, it is exactly these physicians that the Illinois Osteopathic Medical Society represents and has many ways to continue to help the practicing D.O. in Illinois.

• IOMS provides you, the practicing D.O., convenient, focused high quality AOA approved CME close to home.
• IOMS provides you, the practicing D.O., leadership in advancing the unique osteopathic contribution to healthcare in Illinois.
• IOMS represents you, the practicing D.O., at the AOA policy making boards, bureaus, councils and committees, including last year's AOA President, from Illinois, Karen Nichols, D.O.
• IOMS represents you, the practicing D.O. on state, licensing and disciplinary boards.

In short, IOMS represents you and provides you an organizational structure to touch these governmental bodies and agencies that affect your patients, your business, your profession and your practice rights.

With these unprecedented impending changes and challenges in the healthcare delivery system in America, now more than ever, you need to be an active part of the Illinois Osteopathic Medical Society because at IOMS, "We've got your back".

Sincerely,

Richard A. Feely, DO, FAAO, FCA, FAAMA, President