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Health care delivery has evolved in reaction to scientific and technological discoveries, emergent patient needs, and market forces. A current focus on patient-centered care has pointed to the need for the reallocation of resources to improve access to and delivery of efficient, cost-effective, quality care. In response to this need, primary care physicians will find themselves in a new role as team leader. The American College of Osteopathic Internists has developed the Phoenix Physician, a training program that will prepare primary care residents and practicing physicians for the changes in health care delivery and provide them with skills such as understanding the contributions of all team members (including an empowered and educated patient), evaluating and treating patients, and applying performance metrics and information technology to measure and improve patient care and satisfaction. Through the program, physicians will also develop personal leadership and communication skills.

Background: Over the past 2 decades, numerous studies have demonstrated the existence of racial disparities in patient care in the United States. Specifically, African Americans with diabetes are less likely to have recommended process of care measures performed and outcome benchmarks for quality of care., Objectives: To evaluate the delivery of diabetes care (processes and outcomes) associated with racial categories using a national web-based registry-the American Osteopathic Association Clinical Assessment Program (AOA-CAP)., Study Design: A retrospective analysis of data retrieved from the AOA-CAP database on outcomes and process measures for diabetes., Methods: A total of 10,699 Caucasian and African American patients who received diabetes care had data entered into the AOA-CAP registry between July 1, 2005, and October 30, 2010. African Americans represented 3123 patients (29%), Caucasians 7576 (71%). Demographic, process of care, and outcomes comparisons between ethnicities were carried out using ?2 and t tests. Composite measures of process and outcomes of diabetes care were created to investigate the effect of race on care., Results: The process of care composite measure was significantly different among African American patients (P = .02) who were more likely to receive all indicated care than Caucasian patients (33.9% vs 31.6%). Evaluation of the composite outcome measure, which quantifies the percentage of patients achieving control of all 3 intermediate outcomes, was (P <.001) lower in African Americans than in Caucasians (8.1% vs 12.3%)., Conclusions: African American patients with diabetes were as likely or more likely to have recommended process of care measures performed. In spite of this, intermediate diabetes outcomes were still poorer in the same African American population.

Context: The policy of the American Osteopathic Association (AOA) on the approval of allopathic residency training has evolved since the mid-1980s, when such a policy became necessary because of the low number of osteopathic medical residency positions compared with the number of students graduating from colleges of osteopathic medicine. Resolution 42 (A/2000), the Approval of ACGME (Accreditation Council on Graduate Medical Education) Training as an AOA-Approved Internship, requires that trainees justify a special circumstance requiring them to seek ACGME-accredited training, and complete all rotational requirements of an AOA-approved osteopathic internship., Objective: To examine the evolution of AOA approval of allopathic residency training and to present the available data on Resolution 42 as it points to the future of osteopathic graduate medical education (OGME)., Methods: An electronic review of the literature was conducted using Medline, the search engine on the JAOA's Web site, and Google. Bibliographies from relevant articles were used to find related citations, and further searches were done using the names of authors of major articles on OGME. Finally, the AOA's database of Resolution 42 petitions was cross-referenced with the AOA's membership database., Results: Nine hundred thirty-seven trainees had applied for Resolution 42. Almost two thirds of the applicants were in family medicine and internal medicine residency programs, and most (55%) programs were in six states: New York, Illinois, Ohio, California, Pennsylvania, and Texas. The special circumstance most documented was location preference., Conclusion: The sustained advancement of the osteopathic medical profession is dependent on OGME and accreditation policy. By regularly assessing the achievements of policies and programs, educators can better shape the future of osteopathic medicine.