GME, growth priorities for new head of osteopathic group

James Zini, DO, the new president of the American Osteopathic Assn., describes this year's agenda for the organization.

By Jay Greene, amednews staff. Aug. 27, 2001.

Despite funding and reimbursement problems facing medical education and rural medicine, James Zini, DO, newly installed president of the American Osteopathic Assn., sees bright days ahead for the profession.

"My top priorities this year are improving graduate medical education and promoting the profession," said Dr. Zini, an osteopathic family physician who has served rural Mountain View, Ark., for 28 years.

The Balanced Budget Amendment of 1997 "has made it very difficult for osteopathic hospitals and programs to survive," Dr. Zini said. "Osteopathic hospitals and programs have closed. To meet the growing demands of our graduates, we need more osteopathic residency training slots."

Since 1990, osteopathic medical school enrollment has grown 53% to 10,388 at 19 schools in 2000 from 6,792 at 15 schools in 1990, according to the American Assn. of Colleges of Osteopathic Medicine. In 2001, 677 residency programs serve about 2,400 osteopathic residents, the AOA said.

New residencies

"Our goal is to develop 100 new residency programs by 2005," said Dr. Zini, who also has served on the Arkansas State Medical Board since 1990. "Hospitals are eligible for residency programs if they never had one before and they are located in medically underserved areas."

With the number of osteopathic physicians increasing more than two times faster than allopathic physicians, the AOA projects that by the year 2010 there will be 70,000 osteopathic physicians, a 49% increase from the 47,000 now practicing.

While osteopathic physicians comprise only 6% of the nation's total physicians, some 64% are primary care physicians. They also represent 15% of the total numbers of physicians in towns of 10,000 or less, the AOA said.

"One of our primary missions is to serve in rural and underserved areas," said Dr. Zini, who also is an ordained Christian minister.

"Reimbursement in rural areas is getting worse. We will still go there because there is a strong need, but we need legislative and policy changes to address this problem," he said.

Another goal for Dr. Zini this year is to increase the number of consortiums of teaching hospitals and medical schools. Called Osteopathic Postdoctoral Training Institutions, each one of the nation's 18 consortiums includes at least one college of osteopathic medicine and generally multiple hospitals and residency programs. There are 19 osteopathic colleges with 10,700 students nationwide.

"These consortiums will help solidify osteopathic training and education in a variety of ways, including through distance learning with the Internet," Dr. Zini said. "They also will help us create a continuum of education for medical students, residents and practicing physicians."