On a blustery Sunday afternoon when most people are outside enjoying the daffodils and cherry blossoms, 23 year old Danica Vargo, sits huddled in a library cubicle immersed in immunology.
Danica, is studying to become a physician, an osteopathic physician. She is one of 295 students who will graduate from the New York College of Osteopathic Medicine in 2014 as a DO., Doctor of Osteopathy.
The New York College of Osteopathic Medicine, nestled on the beautiful campus of New York Institute of Technology in Old Westbury, is the second largest medical school in the country. When it was built in 1977 with the help of then Governor Nelson Rockefeller whose personal physician was a DO, there were only five osteopathic schools in the country and only 400 DO’s in the state of New York. Now there are 28 osteopathic medical schools and 70,000 DO’s with close to 5000 practicing in the state of New York.
Long Island has almost 1900 DO’s in practice. So critical is the role that osteopathic physicians are in filling much needed primary care positions and underserved areas that Governor Cuomo has declared April 17-23 as Osteopathic Medicine Week in New York State.
The purpose of this legislation is to educate the state’s elected policymakers, state agency officials, and general public about osteopathic medicine.
I visited with Massapequa resident Martin Diamond, D.O. who was a family practitioner for 35 years in Massapequa and Amityville and was one of the founders of NYCOM.
This spry octogenarian is also responsible for establishing Touro College of Osteopathic Medicine, the first medical school in NY State in 30 years, in the heart of Harlem. It will graduate its first class this June. As the founding dean it was “Our mission to increase underrepresented minorities in medicine and to attract people who want to serve in underserved communities.”
We discussed how osteopathic medicine has changed since he graduated in l965 from Des Moines , Iowa.
The osteopathic profession was very strong in the Midwest where it was first established in the late 1800’s by an MD named A. T. Still, in Kirksville, Missouri. Dr. Still started the first school, focusing on developing a system of medical care that would promote the body’s innate ability to heal itself. He was in disagreement with some of the medical trends of the time that he felt were doing more harm than good.
Over the years the profession grew and today nearly one in five medical students in the US is training to be an osteopathic physician.
Osteopathic physicians go through a four year medical program, are licensed, boarded, can chose from any specialty, prescribe drugs, perform surgery, and practice medicine anywhere in the United States.
In addition to the same two years of basic sciences that MD’s (allopathic physicians) take, osteopathic physicians have an additional training in the art of manipulation. This system of hands on techniques help alleviate pain, restore motion, supports, the body’s natural functions and influences the body’s structure to help it function more efficiently.
Perhaps the most unique difference between the DO’s and the MD’s is the philosophy. DO’s are trained from the first day in medical school in a holistic approach, where they are trained to look at the whole person rather than seeing the person as a collection of organ systems and body parts that have become injured or diseased.
But this philosophy wasn’t always met with acceptance as Dr. Diamond pointed out. “There was discrimination against osteopathic physician in NY and other parts of the country where other doctors would say well, you’re not a real doctor, you’re not an MD," he said.
“The stronghold for the profession, especially in the 40’s, 50’s, 60’s was the Midwest. Now the northeast is very strong.” DO’s used to have their own separate hospitals, such as Massapequa General which closed. Now there is total acceptance of DO’s among other physicians, especially in NY where DO’s and MD’s train side by side in hospitals around the country. Dr. Diamond is currently the Director of Medical Education at the Nassau University Medical Center.
One person who can address discrimination is Barbara Ross-Lee,DO, VP of Health Sciences and Medical Affairs at NYCOM/NYIT. A native of Michigan, when she started medical school in Michigan, “women and minorities were woefully represented,” she said.
“In my graduating class of 1977 there were 25 students two females, and two minorities one male, one female. After practicing family medicine for 10 years Dr. Ross-Lee was recruited to be the Dean of the Ohio University College of Medicine where she stayed for 9 years until she came to NY to be the VP.
She holds the distinction of being the first woman osteopathic dean and the first black dean of a medical school in the country. She is proud that NYCOM boasts more than 50% women in its classes.
When asked about acceptance of osteopathic physicians in the profession she said there's still work to be done.
" It presents a challenge, not necessarily from the standpoint of other professionals, but from the community in understanding what osteopathy is,what we are and what we do," she said.
"Our students are our major ambassadors and are so actively involved in community endeavors. The most important is the clinical services we deliver to the community. We have produced over 50 percent of the physicians in primary care and most of your primary care physicians on Long Island are DO’s., That has an impact on the community."
Dr. Ross-Lee was on her way to China, where the school is working on an exploratory program to train Chinese physicians in osteopathic medicine so they can provide services in the non urban areas. “We are hoping that they will in turn be able to train us in their techniques and collaborate with the research they are making in healing through herbal medicines such as breast cancer.”
Sonia Rivera-Martinez, DO a graduate of NYCOM, is president of the New York State Osteopathic Medical Society and is beginning her second term. She is also a assistant professor of family medicine at NYCOM. When she graduated ten years ago there were equal numbers of women and men in class. Unique to NYCOM is its acceptance of older students. She was 40 when she started medical school having left a job as an internal auditor.
Dr. Rivera-Martinez is active in politics. She has returned from a trip to Albany where she met with legislators.
"I asked the Albany congressional leaders to recognize in fact that there is another state society and another set of physicians in New York State,” she said.
Along with meeting with lawmakers they have been trying to promote tort reform but have once again met resistance. She is concerned that more physicians will leave the state because of the high malpractice rates. She also feels that this is “draining the types of specialties, those that are at higher risk such as OB-GYN. and neurosurgery. More OB-GYNs are electing not to deliver babies.
“Some OB-GYN’s are paying $200,000 a year in medical malpractice insurance, and these are the ones who have not been sued.” Your malpractice can increase if you get sued," she said. “Can you image how many babies you would have to deliver just to recoup the cost of the malpractice insurance.” Even though Dr. Rivera-Martinez is capable of delivering babies she wouldn’t because it would quadruple her current malpractice rate.
So what does all of this mean for the future of new medical students, such as Danica Vargo? She no longer faces the discrimination as a woman in medicine nor as an osteopathic physician among other physicians. She is encouraged and hopeful about the world of osteopathic medicine and the new resolutions coming out such as National Osteopathic Medicine Week.
“I think it’s a great thing for the profession because it brings more awareness to osteopathic medicine and that’s what the public needs to hear ," she said. We are as qualified as our allopathic counterparts, so it’s getting the name out there and that is going to be a big help.”