Friday, August 20, 2010

Emotion vs. logic--where do you draw the line?

I spent most of yesterday and much of today reading proofs on a 40-year history of the Texas College of Osteopathic Medicine. I was reading an online pdf which to me is really difficult, and I wished for hard copy. Forty years ago, my ex-husband was founding faculty; soon after the college opened, I became director of communications. Later my brother was dean of clinical sciences. That school, that grew from nothing like Topsy, was our lives, except for our children. I wrote an early chapter for the book titled "Humble Beginnings" and reading about the early years was an exercise in nostalgia. Reading about the present status of the school was an eye-opening realization of how far it's come. Today it is the University of North Texas Health Sciences Center and includes several schools--public health, physical therapy, programs for physicians' assistants, etc.--and many research centers. It's nationally ranked well and has received great recognition for its research programs, especially in forensic medicine. What began on the unfinished fifth floor of a hospital, with an anatomy lab in a garage apartment, is now a large campus with at least five tall and sleek modern buildings (I may be miscounting). It's a remarkable achievement in forty years, and I am much impressed.
So it was bittersweet this morning to open the paper and read that the board of regents of UNT had okayed a plan to pursue adding the MD degree and another separate school for MD students to the overall health science center. All the remarkable growth, the great accomplishments from humble beginnings, have been built on the back of an osteopathic medical institution. And now they want to add an MD program?
I can't figure out whether my strong objection is logical or emotional. I am a child of the osteopathic profession--my father, brother, ex-husband, and countless uncles were DOs. I remember too well the days when DOs were second-class physicians, scorned by the MD community. Students, mostly young men from the East who couldn't get into an MD school, entered DO schools. Even today I know of a friend whose husband would never tolerate her seeing a DO. Once, in the 1970s, I ghosted a book for a doctor known as "Mr. Osteopathy of Texas." The title? The Quack Doctor. He said he was supposed to write a history of osteopathic medicine in Texas but that sounded dull and he wanted to write something that would get people's attention. Today, none of that is true--my nephew went through osteopathic medical school on an army scholarship and has trained at such institutions as Walter Reed; osteopathic students and graduates rotate through nationally prestigious MD hospitals as interns and residents. It's almost a level playing field.
The logical part of my objection is that if they've made such wonderful gains as an osteopathic institution, why add the MD program? The emotional part of me fears that the DO program will suffer and become second-rate, losing everything that has been gained.
Dr. Tom Yorio (PhD), provost of the health science center and a well respected research scientist, wrote the most compelling case for the MD program I've yet read, but I remain unconvinced.
The addition of the program still has to be approved by the Texas Legislature, which chartered TCOM to provide primary care physicians, especially those that would practice in rural communities. Osteopathic medicine has a record of educating primary care physicians; a much higher percentage of MD students go into research or specialties and sub-specialties. I don't know about writing my legislators or not--my small voice would be lost on the wind, but I may do it anyway. Meantime, I can envision my dad, longtime president of the Chicago College of Osteopathic Medicine, holding his head in his hands in dismay. See? I told you it's an emotional issue for me.

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