American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Ray E. Stowers, DO, Inaugural Address

stowers-inauguration.jpgOn July 21, 2012, the AOA inaugurated Ray E. Stowers, DO, as its 116th president. Dr. Stowers' inaugural address appears below.

Challenges and Rewards

Shortly after earning my DO degree, I established my practice in north central Oklahoma and stayed there for 25 years. During most of that time, I served as the only physician in a 300-square mile county. I look back on those years with great fondness. It gave me a tremendous sense of how much we mean to our patients. My day would cover anything from delivering babies; caring for patients at nursing homes; or providing OMT to farmers for various injuries. You never knew.

I found being a DO to be very rewarding, but it had, and still has, its challenges.

I'd have to say that in the early part of my career, the Medicare program represented one of the biggest challenges of the day. It was a defining moment – if not THE defining moment – in medicine at the time. It set the stage for physician payment. And as a rural physician, I soon came to understand and personally experience the inequities when it came to reimbursement simply because of ZIP code.

It led me to become a major advocate for parity in payment. It also allowed me to serve on the AMA's Relative Value Update Commission as the AOA representative, as well as the Medicare Payment Advisory Commission. I also played a role in persuading the AMA to establish new OMM codes that are still used to this day.

Today, rural physicians are paid the same as those working in non-rural areas. And, in fact, rural physicians receive higher reimbursements when you factor in the bonus payments they receive for practicing in underserved areas.

I'm extremely proud of that fact and the work we did to help make that happen–to have the opportunity to be there for my fellow DOs.

Shaping the Future

For the past seven years, I've had the honor of interacting with osteopathic medical students on a daily basis as founding dean of Lincoln Memorial University-DeBusk College of Osteopathic Medicine in Harrogate, Tenn. It's been this role, training our future DOs, that's made me realize that I want to do more for them and for our entire profession, especially during this very challenging time in health care.

Today, I'm very humbled to be in the position to do that by serving as president of the American Osteopathic Association. As president, my first pledge to you and to the entire osteopathic family is that the AOA will be here for you...that I'll be here for you.

I didn't get to this point without a great support system around me – people who have been there for me for so many years starting with my wife, Peggy. I truly would not be here without your support. I also wouldn't be here without the encouragement from my entire family and friends.

There's also my OOA, TOMA and LMU-DCOM families that I want to recognize as well. Being part of these organizations has been a blessing. It has provided me with many wonderful friendships and an incredible amount of support, and I thank all of you from the bottom of my heart.

Our Changing Profession 

In medicine, we've been affected by unprecedented changes and challenges. Today is no different. In fact, the time calls for innovation. And let me tell you that I truly believe the AOA is ready. We're ahead of the curve. We're here for you to make sure you're ready, too.

Innovation – in ideas and action – is what our profession was built on. Nearly 140 years later, we must continue to be innovative.

We need to initiate new ways of thinking, from taking the lead in promoting new health care delivery system models; continuing to collaborate with other health care providers; supporting legislation that some consider to be controversial; and participating in discussions with White House officials and other key players. For example, we attended an event last month in D.C. to talk about these topics, including the Center for Medicare and Medicaid Innovation. We must be innovative because we face some major challenges these days–Medicare physician payments; the proposed ACGME policies; the need for more OGME training opportunities; the Affordable Care Act and others.

No matter what changes we now face or the challenges headed our way, I want you to know that the AOA will be there for you every step of the way. We're here for answer your questions and to offer a number of resources that can help you better understand today's issues.

But we need you, too, especially when it comes to the significant changes that could be today's defining moments in medicine.

Osteopathic Continuous Certification

More than ever, we need you to support programs and initiatives like Osteopathic Continuous Certification. I challenge every delegate here today and every member of the profession to embrace OCC. Even if you have a non-time-limited certificate, like I do, show your patients the commitment you've made to demonstrate that you are the best physician, that you provide top-notch care, and that you have the most current medical knowledge.

I have to say that one of the biggest misconceptions about OCC is that the AOA has been driving this initiative. Many of our members don't realize that other entities initiated it – health plans; state and federal governments; even the Federation of State Medical Boards and its proposed Maintenance of Licensure requirements.

But I believe that no other medical organization in the country is as prepared as the AOA, nor has the structure in place at this point to meet MOL requirements. In fact, we've been working with the Federation and state boards to ensure that OCC will satisfy these requirements.

Just a few weeks ago, Hank Chaudhry, DO, president of the Federation, stated at the AMA House meeting that several licensing boards have either accepted OCC or planned to for maintenance of licensure.

Maintenance of licensure – it's becoming a reality. Pilot programs are being developed and all of the participating boards license DOs. We, along with the specialty boards, are getting set to implement OCC by January 1. That's less than six months away.

And this is an important point, if not the most critical point about OCC. It is far better that our own specialty boards, along with the AOA, set the requirements rather than outside agencies.

We're ahead of the curve. We're here for you.

AOA Clinical Assessment Program

Take advantage of the Physician Quality Reporting System when there's still time to receive bonus payments for participating.

PQRS offers financial incentives for successfully reporting quality data related to covered services for Medicare Part B Fee-for-Service patients. What better way to show your commitment to quality care and improving the care you provide than by participating in CAP for PQRS?

Again, we've got you covered. The AOA's Clinical Assessment Program is recognized by CMS as a qualified registry for PQRS.

Submit patient data now and earn your bonus payment for 2012.

Leading Change

If you haven't already, make the decision this year to adopt electronic medical records. As long as you adopt an EMR in 2012, as an eligible user you'll be able to earn the maximum amount of $44,000 as part of the Medicare incentive program.

Now is the time to determine whether new health care delivery models are right for you. Does it make sense to transform your practice into a patient-centered medical home or for you to join an accountable care organization? Will these approaches that strive to strengthen the patient-physician relationship work for you? What about providing better health outcomes for patients and encouraging investment in health care infrastructure? Will these work for your case as well?

With all these issues, we see what's coming ahead. We're here for you, regardless of specialty, location or practice size, providing resources so you can make the right decision for you.

Now I'm not saying every one of these programs is meant for everyone. There is no one size fits all. In some instances, you have the choice to participate or not – EMRs, the medical home and ACOs. Others such as OCC and maintenance of licensure are clearly going to become the norm in the coming years.

I'm also not saying that these changes are going to be easy. I know that they often mean more work and more hours and sometimes even more cost. And this is very important! We must work together to assure an increase in physician income to more than offset these costs.

But what I am saying is that when it comes to these initiatives and programs, they boil down to this:

  • Promoting quality as well as efficiency and
  • Ensuring we provide top-notch care to our patients.

Today, as I begin my term as your president, I promise that every decision we make at the AOA will be made with improved quality in mind. I pledge to better position our association as a leader in transforming the house of medicine. I vow to ensure that we provide the information you need to make informed choices about the changes and challenges affecting you and your practice.

With all the issues we face today, we have the opportunity to redefine medicine. We have the chance to create our own defining moments – the full repeal of the sustainable growth rate formula; the implementation of Osteopathic Continuous Certification; or the transformation of your practice into a medical home.

I know there is no more critical time than today that the AOA must be ahead of the curve. There's no more crucial time than now when you need the AOA the most. And I assure you that we are all in this together and that the AOA will be here for you.


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