Excellence in osteopathic tenets, leadership, solidarity – New AOA president outlines vision

_{© American Osteopathic Association}

Osteopathic medicine is growing and that will continue as physicians strive for excellence in their tenets of medical treatment, in leadership and solidarity, said the new leader of the American Osteopathic Association (AOA).

Teresa A. Hubka, DO, FACOOG (Dist.), FACOG, CS, was installed this month as the 128th president of the AOA, and the second female president of the association. She assumes her leadership role as the AOA celebrates the 150th anniversary of Andrew Taylor Still, MD, DO, developing a patient-centered approach to care. Osteopathic medicine now accounts for more than 11% of all physicians and 25% of all medical students in the United States. AOA currently represents more than 197,000 doctors of osteopathic medicine and medical students. Hubka specializes in obstetrics and gynecology in private practice in Chicago, where she also serves as clinical professor and department chair at Midwestern University Chicago College of Osteopathic Medicine.

Hubka spoke with Medical Economics about her plans for her tenure leading AOA, a looming 2025 cut to doctors in the Medicare Physician Fee Schedule, and the importance of taking care of patients and physicians. This transcript has been edited for length and clarity.

Medical Economics: In your inauguration speech, you spoke about the importance of pursuing excellence in medicine. How will the association pursue that during your term?

Teresa A. Hubka, DO, FACOOG, FACOG, CS
_{© American Osteopathic Association}

Teresa A. Hubka, DO: I think what's so exciting about our profession is that 150 years ago – in 2024 we are 150 years old, or young, whatever you want to call it. But at that time, A.T. Still, who was an MD, he was not appreciating how health care was. Health care had many, many problems, many, many issues, and they were using toxins to take care of things, or bloodletting and so forth. So a lot of his family members died under the hands of physicians. That's all they knew, that's what they knew, that's what it was. And so he wanted to make a change and make it better. So 150 years ago, he developed the concept of the osteopathic tenets, and that those tenets still are amazing to this day. They are what we are all about. Over the last 150 years, we've solidified that, we've engendered that throughout different avenues.

Now what I'd like to see is bringing that again to the forefront, because health care has to change, medicine has to change, and we have opportunity. Bringing our identity and who we are as osteopathic physicians, understanding the distinct practice and philosophy of what we have as osteopathic physicians to health care, can only grow the profession and make us more involved in health care from all different arms. So, my thought on this is that we will bring excellence to our distinction, as far as an osteopathic profession, and then also excellence in leadership.

I think in general, physicians need to lead the health care team. We have fabulous nurse practitioners and physician assistants and pharmacists and physical therapists and individuals from all areas of the health care team. But the only one that knows health care and taking care of the patient from A to Z, inside and out, and has the training and the skill set, is the physician. Both DO, osteopathic physician, and MD, allopathic physician, and together, we need to team together and lead our profession of medicine, of health care, for our patients. I do think that we need to be the leaders of health care, that we know how to actually make health care, how do I say, more cost effective, more accessible for our patients, and touch every patient's life, from the perspective of both the osteopathic and allopathic care. So, leadership is what I think we need to do.

And then I just say solidarity, excellence in solidarity. We have so many areas of the osteopathic profession, from our osteopathic medical schools, from our certification, our licensing boards and our certification through our continuing medical education, and our state associations and our specialty colleges, and the whole branch of the osteopathic health care system. And that, we need to come together with a unified message and vision for the profession, for our patients.

My thoughts are that we will bring excellence in our distinctive osteopathic tenets. Secondarily, excellence in our osteopathic leadership, in line with our allopathic physicians. As well as then, osteopathic solidarity, bringing the whole profession together.

Medical Economics: What was your reaction upon hearing about the upcoming cut in the physician reimbursement in the 2025, Medicare Physician Fee Schedule?

Teresa A. Hubka, DO: I wasn't happy, obviously. I'm a solo private practitioner, and I've been that way forever, but I have my wonderful support individuals that help me do what I do. But as someone that has to look at the whole process of, how do we provide care to our patients? It's the physician that keeps getting the reduction. There's a wonderful graph that we have that shows that everywhere across the board, they're increasing their payment, OK, for our systems, our hospitals, our ambulatory cares centers, our hospice cares in our nursing homes and so forth. They're always getting more. Those are established entities. But think of the individual that provides the care: the physician. Without the physician, care isn't being provided to the maximum care. So of that, why do we cut the providers? Why are we being cut? And with inflation and post-COVID, and all of those cost factors, our costs are going up, but our reimbursements are going down. And to keep our doors open, with our reimbursements going down, it's very difficult. What's going to happen is, access for patients, we have to we have to think about, how are we going to keep our staff? How do we keep our doors open, pay our rent? Basics, basics. And so I really think that in Washington, they need to look at who they're really cutting, because when they cut physicians’ payments, they're cutting patient access, and that needs to change. We shouldn't be on the balanced budgets situation because that's not how we look at our patients, right? We're not trying to balance their health care financially. We need to look at, they need health care. Patients deserve that, and they need the best of health care, so we want to provide that for them.

Medical Economics: Our main audience is primary care physicians. What would you like to say to them? Or what would you like them to know?

Teresa A. Hubka, DO: I'd like them to know that number one, hang in there, where we are trying to make it better. Our mission, our goal, is to take care of patients, and so therefore, whatever we can do to help make ourselves accessible and available, but we need to have our voice heard in D.C. We need to let them know that by cutting physicians, those in practice, like us, in private practice, or small groups or so forth, we need to take the helm and lead health care and make sure that we can be there for the patient. We are the ones that are in, how do I say, in the grassroots. We are there. So, being that, we will be your voice. We will take your voice to Washington, D.C., or wherever we need to, to help in any way possible. But also, let us know what your needs are and what your concerns are. Because I know myself how hard it is at times when the checks don't come in from insurance companies or prior authorizations get in the way, or other systems make it difficult to care for our patients. But our mission truly is first and foremost, to take care of our patients. I also want to say to take care of our physicians. I think if physicians lead the health care system, there will be better patient care, better access for patients, as well as then better physician satisfaction, and therefore less burnout. But when physicians aren't in charge, and we're told – in health care records, and all the paperwork hassles and the prior authorizations and other individuals that don't even know what medicine is about – and they're telling us how we have to do it. The difficult thing is, it just makes it harder for physicians to do the job that we were trained to do. So we need to be back at the helm, making the decisions on behalf of our patients, for our patients.