Editorial  |   November 2009
Realigning the JAOA to Sharpen Our Focus
Author Notes
  • Address correspondence to Felix J. Rogers, DO, 5400 Fort St, Suite 200, Downriver Cardiology Consultants, Trenton, MI 48183-4636. E-mail: 
Article Information
Medical Education / Practice Management / Professional Issues / Being a DO
Editorial   |   November 2009
Realigning the JAOA to Sharpen Our Focus
The Journal of the American Osteopathic Association, November 2009, Vol. 109, 577-578. doi:
The Journal of the American Osteopathic Association, November 2009, Vol. 109, 577-578. doi:
The osteopathic medical profession is in the midst of unprecedented growth. By way of perspective, when the American Osteopathic Association's editor in chief, Gilbert E. D'Alonzo, Jr, DO, JAOA Associate Editor Michael M. Patterson, PhD, and I were new to the profession, the nation had only a handful of osteopathic medical colleges, and JAOA—The Journal of the American Osteopathic Association reached a mere 16,000 osteopathic physicians.1 
Today, the profession has 26 schools with 31 sites (Andrea Williams, written communication, October 2009). In addition, the JAOA's print editions reach more than 35,500 osteopathic physicians, while the JAOA's online version reaches some 53,000 DOs, osteopathic medical students, and other members of the profession. 
Not only do we have more colleges and many more students than ever before, but the composition of the student body has changed, with women accounting for nearly 50% of current osteopathic medical students. In addition, research is becoming more prominent in osteopathic medical education,2 with even organizations such as the Student Osteopathic Medical Association3 and campus research clubs supporting research among the profession's youngest members 
These exciting times for growth within the profession call for reinvigo-rating and redefining the JAOA to meet the needs of our readers. 
Planning Around the Tenets
Currently, The Journal places its primary emphasis on publishing research articles, especially original contributions and systematic reviews. Although the number of submissions to the JAOA has been steady for the past few years, a dismal number of those submissions have focused on original research—despite efforts by the AOA editor in chief, the JAOA associate editors, and JAOA staff to streamline and improve the submission and publication processes. As a consequence, it is time for the JAOA to take the next step. 
At the JAOA Editorial Advisory Board's October 2008 joint meeting with the AOA Committee on Professional Publications, I proposed that we realign the JAOA to highlight certain tenets of osteopathic medicine,4 with the goal of using The Journal to better promote the profession. Using these tenets as a template for a “new” JAOA, I proposed the following general topics: 
  • Tenet: A person is the product of dynamic interaction between body, mind, and spirit.
  • Tenet: Health maintenance and recovery from disease are key values for osteopathic medicine.
  • Tenet: The musculoskeletal system plays a primary role in health and disease.
  • Principles for patient care: The patient is the focus of treatment, and he or she bears substantial responsibility for his or her own health. Osteopathic physicians use evidence-based medicine and implement all methods appropriate to optimize natural healing and to address the primary cause of disease.
Phasing in New Sections
For nearly 2 years, the JAOA's editors and publications staff have been discussing how best to realign the JAOA under these general topics. Unfortunately, just as the JAOA was making its initial recommendations, the nation's economy collapsed and AOA investments were subsequently devalued. We found ourselves making the case for additional financial support at a time when available resources eroded. 
Dr D'Alonzo, Dr Patterson, and I have, therefore, proposed that the JAOA be reconfigured in several budget-neutral phases. As we did with “The Somatic Connection” and “Book Reviews” sections in the JAOA, we will recruit expert volunteers to oversee eight new sections that will cover a broad range of interests. In the next few months, The Journal will unveil the first two of those eight new sections. 
One of the new sections will offer state-of-the-art evidence-based reviews that are highly relevant to the tenets and principles of osteopathic medicine. The section editors for this new JAOA component are osteopathic physicians recruited from top osteopathic and allopathic institutions in the United States. 
The second new section will focus on osteopathic medicine in the international arena—an area of considerable growth and developing interest. The editors for this section are based in the United States, Norway, the United Kingdom, and Australia. 
In subsequent phases, we plan to develop and debut two more sections each year for the next 3 years. Our current plans call for sections that focus on complementary and alternative medicine, developments in osteopathic medical education, advances in basic science that have clinical implications, health policy, and essays on cutting-edge medical topics. 
We also plan to add a large section devoted to the humanities. For several decades, the osteopathic medical profession has promoted the interaction of the body, mind, and spirit as a basic tenet. Yet, The Journal has not provided space dedicated to explore that idea through poems, essays, media reviews, articles on medical ethics, scholarly reviews of educational philosophies, and other branches of the humanities. 
Responding to the Evidence
The JAOA's success with this new approach will depend on several key features. 
First, we will need widespread support throughout the profession. 
Second, we will need a whole new cadre of volunteers, both to submit material and to provide expert reviews. 
Third, we will need ongoing feedback from our readers to gauge the effectiveness of these efforts and to guide us. We are seeking not only to promote the tenets of osteopathic medicine but to also modify and refine those tenets in response to new scientific developments. 
Finally, these new sections of the JAOA need to be relevant to our medical students, interns, residents, and new physicians in practice. These individuals represent the future of our profession. They are entering practice at a time that is unprecedented in terms of complexity. Among the domains of this complexity are that patients are more complex and have multiple medical problems; outside pressures tend to erode patient autonomy and physician professionalism; skyrocketing healthcare costs present daunting concerns for patient management; and practice management and reimbursement issues have a chilling effect on patients and physicians. 
Furthermore, given the constant changes in undergraduate and graduate osteopathic medical education, the JAOA needs to offer the profession's newest members clear and compelling evidence about the unique and progressive aspects of osteopathic medicine. 
 Dr Rogers is an associate editor of the JAOA.
American Osteopathic Association Yearbook and Directory of Osteopathic Physicians. Chicago, IL: American Osteopathic Association; 1977.
Pheley AM, Lois H, Strobl J. Interests in research electives among osteopathic medical students. J Am Osteopath Assoc. 2006;106:667-670. Accessed October 30, 2009.
Manion KM. Collaboration and excellence in osteopathic medical research [editorial]. J Am Osteopath Assoc. 2009;109:38-39. Accessed October 30, 2009.
Rogers FJ, D'Alonzo GE Jr, Glover JC, Korr IM, Osborn GG, Patterson MM, et al. Proposed tenets of osteopathic medicine and principles for patient care. J Am Osteopath Assoc. 2002;102:63-65. Accessed October 29, 2009.