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Letters to the Editor  |   February 2011
Communication by Degrees
Author Affiliations
  • Arnold Melnick, DO
    Aventura, Florida
Article Information
Psychiatry
Letters to the Editor   |   February 2011
Communication by Degrees
The Journal of the American Osteopathic Association, February 2011, Vol. 111, 124-125. doi:10.7556/jaoa.2011.111.2.124
The Journal of the American Osteopathic Association, February 2011, Vol. 111, 124-125. doi:10.7556/jaoa.2011.111.2.124
To the Editor:  
There has been considerable discussion recently of the advisability of changing the DO degree. Good-willed, well-intentioned DOs have strongly suggested a change, and equally well-meaning and competent osteopathic physicians have opposed it. Admittedly, there are a few—very few, I believe—MD-wannabes, and any discussion of degree modification would not satisfy this extreme group; I am not addressing that here. 
I would like to explore this topic as a communication problem, a different perspective than usually offered. 
But what is a degree anyhow? It is the academic title conferred after completion of a prescribed course of study. But it does not tell anything about the quality of the bearer's work. Mostly, we are dealing with the abbreviation of the academic degree: initials that communicate instantly the professional field of the bearers and the actual academic degree and license (eg, PharmD, doctor of pharmacy; DPM, doctor of podiatric medicine). It is a strong communication tool. What connotation that degree communicates is another story. Much depends on the background and experiences of the reader or listener. So, in the long run, we are really concerned about connotation of the abbreviation. Does changing a degree change its connotation? 
Historically, we changed our degree some years ago from doctor of osteopathy to doctor of osteopathic medicine, but maintained DO as its abbreviation. The disagreement is really about the abbreviation. 
Let's look at the arguments. One of the ubiquitous premises is that several professions changed their degrees without difficulty. But is that analogous to the osteopathic situation? No, it is not. All the degree changes were within the same professional group, and with almost unanimous agreement of its practitioners. 
Lawyers, for example, had been using (sparingly) their actual academic degree, LLB, or the commoner nondegree, Esquire. In order to eliminate these unacceptable designations, establish uniformity, and eliminate any confusion, the legal profession adopted the juris doctor (JD) for all attorneys, allowing every lawyer, both in practice and those to follow, to use that degree. It was within the same profession. 
Pharmacists did not really change their degree—they upgraded their professional classification. It was realized that the profession of pharmacy was taking on a new and wider role in clinical specialization and dealing with patients clinically more and more. They were becoming involved with patient counseling, compliance, and education. On the basis that this increased emphasis met the standards for a doctorate, from about 1994 forth, all colleges of pharmacy conferred the PharmD degree—and holders of the BS in Pharmacy were not entitled to use the PharmD designation. A different situation. 
Similar descriptions apply to the other professions that have been mentioned as changing their degrees. 
However, in the healing arts, there are 2 professions: Allopathic Medicine and Osteopathic Medicine. Both are recognized by each other, by all government agencies, and by almost all of the population. These are 2 separate (not as much as previously), rather distinct, almost parallel, and in some aspects “competitive” professions offering complete healthcare to the public. Most practitioners in each group want the public to be able to recognize what they are instantly—by means of a degree. Would changing the degree alter the public's conception of what each is or does? Hardly. It would not alter what I, and many others, have experienced after osteopathic medicine began to gain a foothold: Hearing of Dr So-and-so, the puzzled answer (an actuality) was, “Who? Oh, you mean the osteopath!” No change of degree would change ignorant or prejudiced mind-sets. 
What it would do is create a new problem—explaining to believers and non-believers alike what the new ABC is (I use that to avoid endorsing any degree change and to increase recognition of the problem). What is an ABC? Is it the same as the DO? Or is it the same as an MD? Or is it something new? We would have to explain carefully this change to all our patients (with patience!)—taking a lot of valuable time. It will not be “Oh, my doctor is now an ABC—that's great!” And we would not be able reach all those out there we do not reach now. 
But it would create more questions, more doubts, and more controversy among the rest of the world. We've already arrived—why stir things up? 
Let's look at the 1 time our profession changed its degree. When California offered DOs an MD degree for $65, those who accepted became MDs. At last! But just to make sure, the California Medical Association did not integrate them into the medical society, but instead isolated (try Ghetto-ized) them into a single “District” society that was statewide and contained all, and only, former DOs—thereby limiting their possible influence in any important matters. It was no longer, “Oh, those DOs,” it was “Oh, that's just District X talking.” What did we gain except loss of identity? 
Connotations, assumptions, and lack of knowledge would not be changed by the communication of a new degree. Only new problems would be created, including possible snide offerings of any of our “enemies.” So, it serves no real communication purpose. 
A homely analogy: zebras, seeing the greater popularity and acceptance of horses and the many ways they resembled horses, might opt to change their names to “horses.” They would still be zebras but would continue calling themselves “horses.” Those people who knew what a horse was and what a zebra was would be totally confused. Those who didn't know what a horse was and what a zebra was really wouldn't care. 
Allow me a purely personal commentary. For the past 65 years I have carried the DO degree, while the profession went from isolation, prejudice, discrimination, exclusion, and lack of recognition and acceptance to today's position of widespread acceptance and recognition in so many quarters (allopathic hospitals, MD medical schools, the US Armed Forces, almost every health department, all government agencies and, to a much greater extent than before, even the public). All this on the DO degree. For myself, I would not trade my DO degree—even for an MD degree—for anything. There will always be disbelievers and skeptics. Better to build on the great progress that has been made over the past 50-plus years. 
FOREVER, I want to be able to sign my name, as I always have, with so much recognition, acceptance, and success—