American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

AOA Interprets Sections of Code of Ethics (1996 - PRESENT)

Interpretation of Section 3

This section notes that a physician-patient relationship must be founded on mutual trust, cooperation and respect—a patient must have complete freedom to choose his or her physician, and a physician must have complete freedom to choose patients whom he or she will serve.

Section 3 does not address a patient’s discriminating against a physician based on the physician’s race, creed, color, sex, national origin, sexual orientation, gender identity or disability; and a patient may express a desire to not be treated by a particular physician or by a physician with certain characteristics.

Therefore, the AOA interprets section 3 of its code of ethics to permit but not require an osteopathic physician to treat a patient when the physician reasonably believes the patient is experiencing a life- or limb-threatening event, even though the patient may have previously expressed a desire to not be treated by a physician based on the physician’s race, creed, color, sex, national origin, sexual orientation, gender identity or disability. (July 2014)

Interpretation of Section 7

This section is designed to discourage practices, which would lead to false, misleading or deceptive information being promulgated.

Section 7 does not prohibit advertising, so long as advertising is designed as making proper factual information available to the public. People seeking health care are entitled to know the names of osteopathic physicians, the types of practices in which they engage, their office hours, place of their offices, and other pertinent factual information. On the other hand, the public should be protected from subjective advertising material designed to solicit patients, which is essentially misleading. Such material would include attempts to obtain patients by influence or persuasion, employing statements that are self-laudatory and deceptive; the result of which is likely to lead a patient to a misinformed choice and unjustified expectations. (July 1985)

Guide to Section 8

This guide applies to AOA members' professional (as opposed to organizational) stationery, office signs, telephone directories, and to other listings referred to by the general public. (July 2016)

Part I - Indications of Specialty Practice

Osteopathic physicians who are certified by the AOA or who devote themselves exclusively to a specialty may designate such specialty in one of the following ways:

  • Practice Limited to Internal Medicine (or other practice area)

  • Internal Medicine

The listing of terms in each of the two categories is illustrative and should act as a guideline.

Part II - Membership in Professional Organizations

The public has little or no knowledge of what membership in various professional organizations entails. Accordingly, use of the names or initials of such organizations tends to indicate unusual professional competence, which is usually not justified. Professional stationery should contain no indication whatever of membership in professional organizations or of any present or past office held in any professional organization.

Designation of membership in various professional organizations is permissible on organizational stationery (AOA, divisional and district society, practice organizations, etc.) provided the organizational stationery is not used in practice correspondence.

The above guidelines apply with respect to written signatures of physicians. For example, a physician should not use FACOI or other appropriate fellowship designation in signing a letter or other communications that will go to a patient. The physician may use such designation in correspondence with other physicians or third parties.

Part III - Osteopathic Identification

The following, in order of preference, are considered proper on practice stationery and office signs:

  • John Doe, DO

  • John Doe, Osteopathic Physician & Surgeon

  • John Doe, Doctor of Osteopathy

The following are not considered proper on practice stationery or office signs:

  • Dr. John Doe (this is considered improper even if the doctor signs his name John Doe, DO). The osteopathic identification should be printed.

  • Dr. John Doe, Specialist in Osteopathic Medicine. The term specialist should be avoided in this circumstance.

Part IV - Degrees (other than DO)

It is strongly recommended that only the degree DO appear on professional stationery. However, the following additional guides are offered: No undergraduate degree (BA, BS, etc.) should be used.

Graduate degrees (MA, MS, PhD, etc.) should not be used unless the degree recognizes work in a scientific field directly related to the healing arts. Therefore, advanced degrees in scientific fields such as public health, physiology, anatomy, and chemistry may be used but their use is not recommended.

Honorary degrees relating to scientific achievement in the healing arts or other achievements within the osteopathic profession (such as administrative excellence or educational achievement) may be used if the honorary nature of the degree is indicated by use after the degree of the abbreviation "Hon."

Law degrees may be used if the physician carries on medical-legal activities.

Part V - Telephone Directory Listings

  1. It is desirable for divisional societies to have an established program to implement these guidelines and, where necessary, to meet with representatives of the telephone companies in furtherance of that objective.

  2. In classified directories, it is recommended that DOs be listed under the heading "Physicians and Surgeons-(DO)" and that there be a cross-reference to that heading from the heading "Physicians and Surgeons-Osteopathic." This letter heading is also acceptable as the main listing if it has long been the heading customarily used in the community.

  3. In telephone directory listings of doctors, it is recommended that the doctor's name be followed by the abbreviation DO.

  4. The abbreviation "Dr" is not recommended because it is misleading. "Dr" can refer to dentists, doctors of medicine, etc. "Phys" is also misleading because it can refer to MDs.

  5. In telephone directories, no indication of certification or membership in any osteopathic professional organization should appear by initials or abbreviations, because such would generally be confusing.

  6. In classified telephone directories it is not improper to indicate "Practice limited to" or simply to name the field of specialty.

Interpretation of Section 17

Section 17 relates to the interaction of physicians with pharmaceutical companies.

  1. Physicians’ responsibility is to provide appropriate care to patients. This includes determining the best pharmaceuticals to treat their condition. This requires that physicians educate themselves as to the available alternatives and their appropriateness so they can determine the most appropriate treatment for an individual patient. Appropriate sources of information may include journal articles, continuing medical education programs, and interactions with pharmaceutical representatives.

  2. It is ethical for osteopathic physicians to meet with pharmaceutical companies and their representatives for the purpose of product education, such as, side effects, clinical effectiveness and ongoing pharmaceutical research.

  3. Pharmaceutical companies may offer gifts to physicians from time to time. These gifts should be appropriate to patient care or the practice of medicine. Gifts unrelated to patient care are generally inappropriate. The use of a product or service based solely on the receipt of a gift shall be deemed unethical.

  4. When a physician provides services to a pharmaceutical company, it is appropriate to receive compensation. However, it is important that compensation be in proportion to the services rendered. Compensation should not have the appearance of a relationship to the physician’s use of the employer’s products in patient care.