ACOI - American College of Osteopathic Internists

American College of Osteopathic Internists

Letter From Dr. Sutton

When Opportunity Meets Preparation

A well-known osteopathic physician once told a tale of how to deliver a baby. She reminded us at our ACOI Convention in 2016 that we all learned how to deliver a baby in medical school. If this image is what you think of:







You might be the right doctor for the job. If this image is what you think of when asked to deliver a baby:

You likely need some help from someone with more skill in obstetrics. This does not make you any less of a doctor. This is not your field of expertise.

This tale was intended to indicate that as osteopathic internal medicine physicians, we do not have the skills to do everything in medicine. We all have something about which we are skillful. As an example, when I review a series of thyroid labs, I know the next step and then the next step. I know how to deliver a thyroid consultation. I know how to investigate a thyroid nodule, as well. I know what to do. I am the man for that job. On the other hand, the last time I delivered a baby was in 1989.

There was a report recently in the Wall Street Journal about “lucky” and ‘unlucky’ people as evaluated by Richard Wiseman, a psychologist. He gave self-identified lucky and unlucky people a newspaper that included images. These people were asked to report how many images were in the paper. The “lucky” people took a few seconds to get the correct answer, but the self-described unlucky people took about two minutes. The difference was that the “lucky” people found a note on page two of the paper that stated the image total.
I do not believe in luck. I am leery of saying to someone about an upcoming exam, “Good luck.” I am more like the Roman philosopher Seneca. He proposed that luck was when opportunity meets preparation. There is no luck at all, just action.

This is what the ACOI is all about. We are your home base for training and skills development in osteopathic internal medicine. Osteopathic internal medicine skills development is built on the structure of the Tenets of Osteopathic Medicine:

1 The body is a unit; the person is a unit of body, mind, and spirit;
2 The body is capable of self-regulation, self-healing, and health maintenance;
3 Structure and function are reciprocally interrelated;
4 Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the  interrelationship of structure and function.
The founding of the first osteopathic medical school in Kirksville, Missouri, 125 years old this year, was all about preparation meeting opportunity.  Skill, not luck.

Andrew Taylor Still experienced the loss of family members in the modern healthcare setting of that era, which pushed him to investigate and seek alternatives. Over the following 125 years, osteopathic physicians have built on those treatment skills and knowledge base. We have trained and continue to train and update our knowledge in osteopathic internal medicine and its specialties. We are continuously trying to dig to the bottom of any complicated medical diagnosis with sound medical science. Other specialties outside of internal medicine frequently look to us for the complicated answers.

We at the ACOI want to be home base for preparation in osteopathic internal medicine, in support of post graduate training and continuing medical education. We aim to be the Go-To place for osteopathic internists. Let us know how we can help and support you.

My year as President of the ACOI is coming to an end. I want to thank the ACOI membership and Board for allowing me to have the opportunity to serve. It has been a great honor. I have worked hard in the ramp up to this year, and I will continue to work hard in support of osteopathic internists. The ACOI is home base for me. It is family for me. It is about friends for me. Thank You, Thank You, Thank You for your trust in me.

God bless the general Osteopathic internist and thank you.
John Sutton, DO, FACOI
Osteopathic Internist in the Trenches

Marianne Holler, DO, FACOI, holds a BA from Georgian Court University in NJ and also attended Maywood University in PA.  She received an MSW from Fordham University.  Her DO degree is from UMDNJ-COM (now Rowan SOM).  Her internal medicine internship and residency were at Kennedy University Hospital/Lourdes Health System. Dr. Holler is certified by the American Osteopathic Board of Internal Medicine in Internal Medicine and in hospice and palliative medicine.  She is a Clinical Assistant Professor of Medicine at Rowan University SOM.  She is a Fellow of the American College of Osteopathic Internists.  Additional awards include:  the ACOI Humanism and Excellence in Teaching Award, 2006; the NJ BIZ Healthcare Hero Physician of the Year, 2013; South Jersey Magazine Top Doc, 2013–16; South Jersey BIZ Who’s Who in Healthcare Top 25, 2014; Excellence in Caring Award Community Medical Center, 2017.  She has been on the Alumni Board of Directors of Georgian Court University and has served on hospital committees, including chairing of the Ethics Committee at her institution.  She has served internationally in clinics in Honduras, Guatemala and Uganda. 
Dr. Holler is currently Chief Medical Officer for VNA Health Group in Holmdel, NJ.  She previously worked as Medical Director of Hospice and Palliative Medicine Programs with VNA Health Group-Ocean County Division.  Prior to that she was team physician/Palliative Medicine Fellowship Director at Samaritan Healthcare & Hospice in Marlton, NJ.

Dr. Holler has lectured as a visiting professor for the ACOI at multiple colleges of osteopathic medicine on palliative care topics.  She has given local community, national and international lectures in her specialty over the years.
Dr. Holler reports her story as follows: “ I am one of eight children (definitely shaped my world view). Additionally, we always had one or two foster children who lived with us the entire time I was growing up. Palliative/hospice was a natural choice for a career because I was raised as a team member. Palliative medicine is definitely a team sport. I rely on social work, nursing, pastoral support to help understand how my patients may be suffering in all its forms...physical, medical, spiritual, emotional, etc. My parents were strong proponents of the notion that everyone has something to contribute. Half of us went to college and half didn’t (by choice). Many of my siblings and their children are teachers. Remember, there would be no good doctors without good teachers. I was a social worker for 18 years and went to medical school at age 40. It was interesting to be in the classroom with students 15-18 years younger than me.
“I love what I do. In palliative medicine it is important that I understand all the different specialties, what they are trying to accomplish, what the family and patient understand, and what is the overall goal. I try to discuss the possibilities and the probabilities as it relates to prognosis and choices for treatment. “
Please, join me in celebrating Marianne Holler, DO, FACOI as the September Internist in the Trenches.  God Bless the Osteopathic Internist!

John Sutton, DO, FACOI, FACE, CCD