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Looking Forward

What impact do resolutions have on the profession?

Perspectives on advocacy and policymaking within osteopathic medicine

By William Rinaldi, OMS III


The annual meeting of the AOA’s House of Delegates (HOD) is just around the corner, and advocacy is in the air. The resolutions that will be presented at the HOD affect us all—from medical students, residents, and fellows to new physicians in practice, attendings, and most importantly, our patients.

Mahi Basra, OMS II, and Maria Jones, DO, recently chatted with three individuals at different stages of their careers to learn more about the policymaking process and how getting involved can help medical students, residents and new physicians in practice influence the future of the osteopathic profession.

What is your current role/position?

Jonathan Byrne, OMS II: I’m the current outgoing Student Osteopathic Medical Association (SOMA) Chapter President at Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine.

Sara Lohbauer, DO, PGY-2: I’m the current BEL Resolutions Workgroup chair and a PGY-2 UCF/HCA FM Residency Consortium at North Florida Hospital in Gainesville, Florida.

Chelsea Nickolson, DO: I practice osteopathic internal medicine in Dayton, Ohio. I am also the associate program director and director of osteopathic education for the Internal Medicine Program at Kettering Health-Dayton, as well as the osteopathic medicine department chair at Kettering Health- Dayton. I am adjunct clinical faculty for Ohio University Heritage College of Osteopathic Medicine and serve on the Dayton District Academy of Osteopathic Medicine Executive Board, Ohio Osteopathic Association Board of Trustees, and the Alumni Association Executive Board for Lincoln Memorial University-DeBusk College of Osteopathic Medicine.

Why do you think the resolution process is important?

JB, OMS II:  A few years ago, I became an American citizen. I was never interested in policy or politics beforehand, but it was through the citizenship process that I learned the immense privilege it is to have a voice and advocate for what you believe in.  Resolutions in SOMA give students a tangible way to advocate for ourselves, our colleagues, our profession and our future patients. It is meaningful to see how writing a policy resolution can eventually lead to actual change, and being able to empower fellow students by showing them that their voice matters has made my time in SOMA rewarding.

SL, DO, PGY-2: Resolutions are important because they are one way we can ensure our views are aligned with the AOA. Through resolutions, our vision can be made into AOA policy that supports the interests of medical students, residents, physicians and our patients.

CN, DO: It is important to have policies in place that represent the collective opinion of osteopathic physicians and students. Resolutions offer a position to guide administration, staff, Board of Trustees and each of the bureaus/councils/committees (B/C/Cs) on how best to support the osteopathic profession and those we serve.

The compendium of policies voted on by the AOA HOD is an expansive reference that is easily searchable to learn the opinions and goals that represent the entire profession. These policies are used to guide and support the osteopathic profession and the AOA works daily to actualize the resolved statements in our policies. It is the work of the HOD that creates these opinions, which forms a blueprint of where we want to go as a profession to best serve our patients in a sustainable and effective manner.

Which part of the resolution process do you believe is most integral to developing effective policy?

JB, OMS II: It’s hard to pinpoint one specific part because the entire process of resolution writing—from formulating the idea and finding evidence to developing your argument, seeing it discussed on the floor and either celebrating a success or dealing with failure—has been important and has helped me learn how to write effective legislation.

In particular, writing policy that doesn’t get passed is a difficult but an important lesson. Seeing something you are passionate about get dismissed hurts, but the approach you take after failing can ultimately be the most integral part of developing policy.

Everyone fails, but learning through that process has allowed me to understand what goes into writing effective and compelling resolutions.

SL, DO, PGY-2: It’s very important for the “ask” or Resolve Statement in your resolution to be very specific, so the readers understand what you want. From my years of resolution writing, I’ve come to learn that if you do not have a clear picture of what you want then policymakers do not know what you want.

It’s important to be clear and concise, simple and short — too long is too much. However, also important is your research into resolutions: if the research is not there or not interpreted properly, it negates everything and takes away the resolution’s credibility; therefore, no one will support the policy.

CN, DO: It all comes down to the creation of the core idea for change. What challenges do you experience in your role as a student or physician yourself, or observe for your colleagues, patients, and community? These transform into whereas statements and then what you envision may be done to lessen those challenges become the resolved statements.

There is an art to writing resolutions, and by reading previous resolutions, especially while attending the HOD at the national and state levels, it will assist in the drafting process. You will begin to identify patterns in established resolutions: topics, types of resolved statement asks, financial impact, and even specific language forms. These patterns can be utilized to create well-written resolutions that will then be considered by readers for their core idea of change itself.

The task of resolution writing itself is a skill that takes time to develop, and I recommend always discussing your ideas for resolutions, and then asking for critiques from several people that are well-versed in the process.

What resolution has been most impactful to you and why?

JB, OMS II: I recently wrote a resolution titled “Reevaluating the Language Used in Technical Standards for Osteopathic Medical Students with Disabilities” that was passed at the most recent SOMA Spring HOD. Initially, it was rejected last Fall, which was devastating, but the immense amount of support from my colleagues helped me understand what needed to be fixed and gave me the confidence to resubmit it.

As an advocate for all individuals with disabilities, from volunteering with Special Olympics and Wounded Warriors to seeing how my own loved ones with disabilities, we have been affected by certain policies and this resolution gives me hope that we can continue to push for equality.

SL, DO, PGY-2: It’s one I authored about PPE, primarily because it was incredibly eye opening to the universal lack of preparedness for a global pandemic. It exposed a lot of the unpreparedness in the health care field and everyone’s confusion surrounding the pandemic. The country, the states, the AOA, the AMA, and the federal government had to manage the issues from the pandemic to support DO physicians, residents, and students. So, through this resolution we could really make a difference.

CN, DO: The adoption of the resolution endorsing Single GME Accreditation in 2014 has been the most impactful. This was presented to the AOA HOD when I was serving as a delegate for the Council of Interns and Residents (which has been reorganized as the current Bureau of Emerging Leaders). It is by far the most memorable House of Delegates that I have attended.

The intense emotions in the room were palpable and the discussions in the reference committee, as well as on the house floor, were passionate and moving. I felt an enormous sense of duty to communicate the wishes of the postgraduate trainees in which I represented a topic that was of utmost relevance. Regardless of outcome, it was during this AOA HOD meeting that I truly felt and understood the abundance of devotion and pride that my colleagues have in the osteopathic profession. That sole decision of the AOA HOD has impacted my work daily, from my roles in medical education to leadership positions within the osteopathic community.

My current position as an associate program director was created in response to better lead a residency program in the single accreditation system, and my role as Director of Osteopathic Education was created after this monumental decision by the AOA HOD.

How can more people become involved with this process?

JB, OMS II: Run for local SOMA chapter leadership, apply for a national SOMA task force position, go to DO Day (virtual and in person), and reach out to your local SOMA Chapter leaders! They are there to represent the students and to help you in any way they can.

SL, DO, PGY-2: There are sooo many ways! (1) For pre-meds, you can join a local pre-SOMA chapter. If you are a student, join your school’s SOMA chapter, which can provide opportunities to get involved in federal policy. (2) Join your local district or state DO society to get involved in local legislation. (3) Join the BEL as a workgroup member—most workgroup members are not BEL members, so you do not have to be a BEL member to get involved in a workgroup. (4) Some medical schools have groups that focus on health policy. If your school offers a masters in health services, that is also a great opportunity to get involved. (5) AOA Training in Policy Studies (TIPS) and AACOM Osteopathic Health Policy Internship/Fellowship are additional opportunities for residents/physicians who want to become even more involved with health policy. (6) AACOM’s EDtoMED is an opportunity to get more involved/follow along with policy without a huge time commitment needed to be part of the organization. (7) Omega Beta Iota is the national osteopathic political advocacy honor society that presents opportunities for growth in policy, too. (8) Last but not least, join in local and national advocacy days with opportunities to lobby your elected representatives, i.e.: AOA DO Day, AACOM National Advocacy Day and state local legislative days.

CN, DO: Anyone can develop that core idea for change. There are several avenues to help draft, format, edit and ultimately submit resolutions to the AOA HOD. Students, post-graduate trainees, and early career physicians can submit ideas directly to the BEL. Additionally, you can submit resolutions through other AOA B/C/Cs, SOMA, state organizations, specialty colleges, and other formally recognized groups of the AOA HOD.

For those that are interested, you can also volunteer to join the BEL resolutions workgroup or other osteopathic organizations that hold representation. While the members of the BEL are appointed by the AOA President, we encourage others to volunteer to participate in BEL workgroups to best engage more members, support the BEL efforts and utilize the vast skills that are abundant within the osteopathic profession.

Email if you are interested in joining any of the BEL workgroups, have a resolution or a core idea for change that you would like transformed into a resolution.