New Beginnings for D.O.s in California

Dr. William Ryan, DO, interviewed by Dr. Michael A. Seffinger, DO

Dr. Seffinger: Who are you? Please state your name and date of birth.
Dr. Ryan: William J. Ryan, D.O.; January 30, 1933
Dr. Seffinger: How did you become involved with the Osteopathic profession?
Dr. Ryan: Several members of my family were Osteopathic physicians including my father, John Ryan, and two of my great uncles. I attended what was then referred to as the Kansas City College of Osteopathic Medicine and Surgery. I graduated in the class of 1962. My daughter, Susan Mackintosh, is also a D.O. I did my pre-medical education at Southern Methodist University (SMU) in Dallas. (We just celebrated our 50 year reunion). I applied to the University of Southwestern Medical School in Dallas, but was not accepted. I then applied to the Kansas City College of Osteopathic Medicine and Surgery and was accepted.
Dr. Seffinger: What did you notice that was unique or different about DO’s and the osteopathic profession at the time you began your association with them; did that perception change over time?
Dr. Ryan: The profession was so small in 1958; there were only 6 schools compared to over 23 now in 2007. I felt that DO’s practiced medicine to include osteopathic manipulation. It became obvious later that DO’s treated the whole person. I did my internship in Oklahoma City, then went into practice with my dad in Garland, Texas, as a General Practitioner. He liked to do a lot of injections. Neither of us did osteopathic manipulation. I did that for four years. There were no D.O.s commissioned as medical officers in the U.S. Military until about 1966-7. In 1967, I was able to voluntarily enlist into the U.S. Navy and be commissioned as a Lieutenant in the medical corps. I was one of the first 100 D.O.s to be commissioned as a medical officer in the U.S. Armed Forces. The AOA invited me to a commemorative ceremony to be held in Chicago in July 2007, but I won’t be able to make it due to previous family commitments. Now I understand that the Dean of COMP is a retired Rear Admiral in the U.S. Navy!
Dr. Seffinger: What was your role in the history of Osteopathy in CA?
Dr. Ryan: I came to California in July of 1967 as one of the very first military physicians where I was stationed in San Diego as a Navy physician. I was then one of the very first DOs hired by Kaiser Permanente in November of 1974. When I got into the Navy, I wanted to do a residency in internal medicine, but they would not accept D.O.s in their residencies. So, I transferred to the Air Force, but they would not give me credit for doing an osteopathic internship and said I would have to do my internship over before doing the residency. At least they accepted D.O.s into their residencies, but I didn’t want to do my internship over again. I had a 3 or 4 year commission, so stayed through its term, then transferred back to the Navy. An MD friend and colleague from the Air Force, Dr. Turay, and M.D., had ended his commission and moved back to southern California taking a job with Kaiser. Through letters, he introduced me to his work and recommended I consider joining him. I let him know that I was interested. Well, on Sept. 4, 1974, I received a letter from Ray Pickering, M.D. Chief of Family Practice at the Kaiser Fontana clinic stating that Dr. Turay had told him that I might be interested in joining the group. Dr. Pickering asked me to write or phone him regarding my interest in joining the Fontana Southern California Permanente Medical Group. I resigned my commission in the Navy, and by November, I became the first D.O. to be hired by Kaiser Permanente in Southern California. They initially gave me a name tag with an M.D. on it, which I returned in exchange for one with a D.O. degree after my name, which they took care of for me without a fuss. They embroidered my name, followed by D.O., on my lab coats as well.
Dr. Seffinger: What events were you personally responsible for that had an impact on the history of this profession?
Dr. Ryan: I was well respected by my MD and ancillary staff and administration as one of the first DOs in the military and the very first DOs hired by Kaiser Permanente. I set a good example for them to feel comfortable and encouraged to hire and work with future D.O.s. They didn’t hire another D.O. however until forced to by legislation in the mid-1980s. I was not, however, granted partnership in Kaiser after the customary 2 years for M.D.s. They stated their policy was to grant partnership to M.D.s, and there were no provisions for D.O.s. in their bylaws. It wasn’t until October 1, 1987 when I received a plaque commemorating acceptance as a partner, 13 years after I started working there. On the plaque, they put M.D. after my name, though. I wasn’t going to make waves over it, so just accepted the award with gratitude. I am probably the first D.O. to be accepted as a partner in Kaiser, too. I was a member of OPSC, and OPSC was responsible for getting an anti-discrimination law, specifically related to the practices at Kaiser, passed around 1985 or so, enabling D.O.s to be hired at Kaiser, besides me, and probably led to me being able to finally become accepted as a partner in Kaiser. Patients sought me out at Kaiser, because I was a D.O.
Dr. Seffinger: What were your responsibilities, goals, challenges, failures, and successes in your career within and/or outside of the osteopathic profession?
Dr. Ryan: My responsibility was family practice medicine. My goal was to do the best of my ability in relation to the above. One of my challenges was proving that I was a competent physician in the presence of medical personnel who were not accustomed to working with DOs. I was unable to become a partner with Kaiser until 1987 as their by-laws at the time restricted partnership to M.D.s. I was not able to maintain AOA membership while I was in the armed forces since I couldn’t get release time to attend osteopathic Continuing Medical Education (CME) Courses. But, once I started up at Kaiser, I could attend CME and I was able to rejoin the AOA. When I joined the Navy and in my early days with Kaiser, we did not have appropriate equipment to perform manipulation. Manipulative therapy was not a common procedure. I retired with 20+ years from Kaiser and also retired from the US Navy (including both active and reserve time). In my Navy career I served during the Viet Nam conflict as well as being recalled to Desert Shield/Desert Storm when I took back my Navy commission in the 1980s.
Dr. Seffinger: How were you able to accomplish your goals?
Dr. Ryan: I had taken and passed the American Board of Family Practice exam in 1974. I also became in the Osteopathic Board of Family Medicine. In addition attend numerous continuing medical education meetings.
Dr. Seffinger: Who were your mentors? Who were your supporters? Who did you mentor?
Dr. Ryan: In the Navy we were mentored by the senior medical officers. My fellow medical officers were very supportive. At Kaiser I was not aware of any mentors. Many of the physicians at Kaiser were supportive of my medical decisions and capabilities. I mentored some of the Osteopathic students while at Kaiser. Interestingly, Dr. Turay’s son applied to Osteopathic Medical School and I wrote him a letter of recommendation. He was accepted.
Dr. Seffinger: What were some of the greatest challenges in relation to the Osteopathic profession in California?
Dr. Ryan: While I was in the military in the early years DOs were not allowed to be licensed so my practice was limited to the military.
Dr. Seffinger: What advice do you have for future Osteopathic physicians in training?
Dr. Ryan: Support the fact that they are Osteopathic students. They should set their goals and stay with them.
Dr. Seffinger: What advice do you have for future allopathic physicians?
Dr. Ryan: They should follow their professional goals but they should also learn to respect the ability and judgment of the Osteopathic students and physicians.
Dr. Seffinger: What documents do you have or know about that we should look up or reference to corroborate the facts you mention in your replies.
Dr. Ryan: I have my diploma from Osteopathic school I have my CA licenses expiring in 1976 to 2009 I have my board certification certificates I have my commission into the Navy I have a set of bookends engraved with 20 years of service presented at the 1995 Kaiser awards ceremony I have the program from the awards dinner recognizing retiring partners from Kaiser in 1995 I have been notified by the AOA that I am to be among those Osteopathic physicians honored as the first 100 DOs to serve in the military. I have the plaque presented to me, inscribed “William J. Ryan, M.D.,” commemorating my acceptance as a partner in Kaiser Permanente dated October 1, 1987.
Dr. Seffinger: Who else should we contact that was instrumental in the historical development of osteopathy in CA?
Dr. Ryan: I don’t know.
Dr. Seffinger: Is there anything else you would like to talk about or discuss in relation to osteopathy in CA?
Dr. Ryan: I am very proud to say that my daughter, Susan E. Mackintosh, D.O. is a graduate of Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, and that I am very proud of her accomplishments. She also graduated from a southern California Kaiser Family Medicine Residency program in the 1990s. She is now on the faculty in the Family Medicine Department at the College of Osteopathic Medicine of the Pacific at Western University of Health Sciences in Pomona, CA. [Susan was a well respected and highly competent family practice resident at Kaiser. She vividly recollected a scenario when she was a third year resident at Kaiser: She was talking with one of the MD attending physicians about two interns. One was an MD and the other was a DO. The MD intern was not as skilled as the DO one but the attending didn’t know which one was an MD or DO, but Susan knew. The attending commented to her that the less skilled one was probably a DO, and was surprised when Susan stated that no, the more skilled one was the DO, and by the way, since he didn’t seem to know, she was also a DO.]