Supplement Article  |   February 2010
You call the shots
Article Information
Preventive Medicine
Supplement Article   |   February 2010
You call the shots
The Journal of the American Osteopathic Association, February 2010, Vol. 110, S2. doi:
The Journal of the American Osteopathic Association, February 2010, Vol. 110, S2. doi:
Welcome to the first issue of The Whole Patient as a supplement to JAOA—The Journal of the American Osteopathic Association.With the transition of The DO from print to online ( The Whole Patient also transitioned to JAOA. As in the past, The Whole Patient will continue to bring you details about some of today's leading medical issues along with approaches to total body health and disease prevention in adults. 
This issue of The Whole Patient is dedicated to adult immunization and how physicians can better incorporate immunization efforts into their practices. 
My computerized medical record system directs me to ask every patient I see if his or her immunizations are up to date. The only allowable answers are “yes,” “unsure,” or “[fill in blank] shots were provided.” Rarely does this elicit much thought from the patients whom we ask about immunizations. It usually isn't a patient priority, nor is it very often the reason for their visit. It is just the right thing to do for the health of the population as a whole. And with the public health-care provision largely provided by primary care physicians, it becomes important for us to be the ones to bring up the issue and to have the answers. 
But the answers have changed quite a bit over the past 10 years. There are new vaccines for herpes zoster, chicken pox, hepatitis A and B, human papillomavirus, as well as different flavors of flu vaccine. New issues have cropped up, as well, like which vaccines to give to whom and when. Furthermore, we must juggle varying recommendations from family practice groups, pediatric groups and public health authorities. 
Concerns about how many vaccines are given and when, and the possible other effects that these vaccines may have, are being brought up by reputable and disreputable sources. Our job is to be a voice of reason. To listen to our patients and their concerns, and to protect the public as much as we can so that our individual patients will be protected as well. 
The most important thing that we can do as osteopathic physicians is to keep ourselves educated—to read up on the new vaccines and decide which ones we want to champion in our patient populations, and to provide them to the patients. That way we can confidently follow up the computerized question of “Are your shots up to date?” with “Really, did you get the vaccines that are due at 25 years of age?” or, “Since you spend time in developing countries, how about we check your hepatitis titers to see if you are still immune?” 
There is always more that we can do for our patients—educating, partnering, vaccinating are just a few examples. Hopefully the articles in this supplement will give you ideas about what you can do for your patients to keep them healthy and to reinforce your practice with the most current information we have on prevention through the use of vaccines. 
Also inside this issue you will find the 2010 Adult Immunization Schedule and Guidelines. Take a few moments to look at the current recommendations. 
  Tyler C. Cymet, DO, is the associate vice president for medical education at the American Association of Colleges of Osteopathic Medicine. He is the president of the Maryland Association of Osteopathic Physicians and the Baltimore City Medical Society Foundation. Dr. Cymet has served as an assistant professor at the Johns Hopkins University School of Medicine. Dr. Cymet currently serves as a member of the DOCARE International's Board of Trustees. He can be reached at