American Osteopathic Association (AOA) President Robert G.G. Piccinini, D.O., D.FACN, and Michigan State University College of Osteopathic (MSUCOM) alumnus, reflects on his new role and why osteopathic medicine must stay true to its values while embracing the future.
When I accepted this role, I became the 129th president of the AOA. I’m the first psychiatrist to serve, and the first graduate of Michigan State University’s College of Osteopathic Medicine. Those firsts aren’t just trivia — they’re proof of how far our profession has come, and how much more we can do.
MSU’s osteopathic college was born from crisis. When Doctors of Osteopathic Medicine (D.O.s) in California were stripped of their professional recognition, physicians in Michigan took action. They taxed themselves — about $20,000 each in today’s money — to build a school that would secure osteopathic medicine’s future. That sacrifice, that solidarity, was pure Spartan spirit.
That legacy lives in me. My job now is to honor our past while preparing for the future. We can’t cling to tradition so tightly that we resist progress. At the same time, we can’t run so fast toward change that we forget what makes us unique.
“We must honor our past while embracing our future.”
As a psychiatrist, I find it especially meaningful to be the first from my specialty in this role. Psychiatry teaches you to listen differently — not just to words, but to silences, body language and the subtle threads of a person’s story. That perspective aligns perfectly with osteopathic medicine, where the story behind the symptoms often matters as much as the symptoms themselves.
Why D.O.s Matter
Even today, I’m asked the question: “What’s a D.O.?” It’s a reminder that as far as we’ve come, our work isn’t finished.
We’ve broken barriers — D.O.s serve as the Army surgeon general, lead NASA’s medical division and care for the President of the United States. And yet, too often, patients still don’t fully understand the difference we bring to health care.
Here’s what I tell them: I’m not just here to listen to symptoms. I’m here to hear your story. That mindset changes everything.
What Makes D.O.s Different
• Treating the whole person
• Recognizing the body-mind-spirit connection
• Listening — really listening — to patients
• Using our hands, not just technology
That’s not a slogan. It’s good medicine. And in a system that often feels rushed and fragmented, it’s what patients need most.
I’ll never forget one patient who came to me convinced he was suffering from depression. On paper, the diagnosis fit: fatigue, irritability, poor sleep. But after listening, I learned he was working two jobs, living on a couch at his brother’s house and skipping meals to help his kids eat. His problem wasn’t just chemical — it was situational. The solution wasn’t only medication, but also connecting him with resources to relieve the real pressures he was under.
That’s the D.O. difference: we see the person, not just the chart.
Mind the Gap
There’s a phrase I’ve carried with me: mind the gap. I first heard it on the London Underground, where riders are reminded to watch the space between the train and the platform. For me, it’s a reminder to pay attention to the gaps in our profession — the places where we fall short and need to build bridges.
One gap is communication. Medical students today aren’t hanging out on the same platforms many of us older D.O.s use. If we want to connect, we have to meet them where they are.
Another gap is global recognition. We’ve made progress — Canada, Australia and the World Health Organization now recognize U.S.-trained D.O.s alongside M.D.s (allopathic doctors) — but there’s more work to do.
And perhaps the most urgent gap is in mental health. Too often, headlines reduce tragedy to a label: “the suspect had mental health issues.” That ends the conversation instead of starting it. In reality, studies show people with mental illness are far more likely to be victims of violence than perpetrators. If we stop at the easy answer, we fail to address the harder truths that drive these crises.
“If we stop at the easy answer, we fail our patients.”
Minding the gap also means looking inward. Burnout is real. After the pandemic, physicians across the country are struggling with mental health in ways we’ve never seen before. If we can’t take care of ourselves, how can we fully care for others? Part of my vision is making sure D.O.s have the tools, resources and community they need to thrive — not just survive — in today’s health care system.
A Doctor of Optimism
Some colleagues joke that in my case, D.O. stands for “Doctor of Optimism.” I’ll accept that. But optimism isn’t naïve — it’s a discipline.
Osteopathic medicine taught me that the body has the ability to heal if given the right support. I believe the same is true for our profession and for society. Optimism means recognizing the challenges, confronting them honestly and still believing we can solve them.
It also means remembering our history. We’ve been underestimated before. People doubted us. And we proved them wrong by growing stronger. We can do that again. “Optimism means seeing the problems clearly—and still believing we can solve them.”
Optimism also matters because medicine can be exhausting. We’ve faced a global pandemic, waves of misinformation and a crisis of trust in science. We’ve seen our colleagues burn out, and we’ve seen communities divided over basic public health measures. To keep going, physicians need hope — not blind hope, but grounded optimism in what we can accomplish together. That’s why I wear the title proudly.
Global Reach, Local Roots
As AOA president, I’ve been fortunate to see D.O.s making an impact far beyond the United States. In Malawi, South America and across Europe, Spartan D.O.s and their colleagues are serving in clinics, training programs and mission trips. Our advocacy has opened doors worldwide, from full licensure in Alberta to recognition by the World Health Organization.
That global growth matters because health care doesn’t stop at borders. My vision is that one day, no U.S.-trained D.O. will be limited by geography when it comes to practicing medicine.
At the same time, we can’t lose sight of our roots. Whether in rural Michigan or urban centers across the country, D.O.s are often the first line of care in underserved communities. That’s where our philosophy shines brightest — listening, serving and adapting to meet real human needs.
Looking Ahead
My hope for this year is simple: that D.O.s across the country feel more connected to the AOA and to one another. If members finish this year saying, “Yes, my voice matters, and this organization represents me,” then I’ll know I’ve succeeded.
Because at the end of the day, this role isn’t about titles or positions. It’s about service — to my colleagues, my patients and the future of osteopathic medicine. And it’s also about the next generation.
To every student entering osteopathic medicine today: your voice matters. Your training matters. And your future matters. You’re stepping into a profession built on resilience, service and vision. My advice is to carry those values proudly, even when others don’t fully understand them yet. Because you are the future — and the future needs you.
That’s the optimism I carry. And that’s why this role matters.
By Jim Peck
American Osteopathic Association (AOA) President Robert G.G. Piccinini, D.O., D.FACN, and Michigan State University College of Osteopathic (MSUCOM) alumnus, reflects on his new role and why osteopathic medicine must stay true to its values while embracing the future.
When I accepted this role, I became the 129th president of the AOA. I’m the first psychiatrist to serve, and the first graduate of Michigan State University’s College of Osteopathic Medicine. Those firsts aren’t just trivia — they’re proof of how far our profession has come, and how much more we can do.
MSU’s osteopathic college was born from crisis. When Doctors of Osteopathic Medicine (D.O.s) in California were stripped of their professional recognition, physicians in Michigan took action. They taxed themselves — about $20,000 each in today’s money — to build a school that would secure osteopathic medicine’s future. That sacrifice, that solidarity, was pure Spartan spirit.
That legacy lives in me. My job now is to honor our past while preparing for the future. We can’t cling to tradition so tightly that we resist progress. At the same time, we can’t run so fast toward change that we forget what makes us unique.
“We must honor our past while embracing our future.”
As a psychiatrist, I find it especially meaningful to be the first from my specialty in this role. Psychiatry teaches you to listen differently — not just to words, but to silences, body language and the subtle threads of a person’s story. That perspective aligns perfectly with osteopathic medicine, where the story behind the symptoms often matters as much as the symptoms themselves.
Why D.O.s Matter
Even today, I’m asked the question: “What’s a D.O.?” It’s a reminder that as far as we’ve come, our work isn’t finished.
We’ve broken barriers — D.O.s serve as the Army surgeon general, lead NASA’s medical division and care for the President of the United States. And yet, too often, patients still don’t fully understand the difference we bring to health care.
Here’s what I tell them: I’m not just here to listen to symptoms. I’m here to hear your story. That mindset changes everything.
What Makes D.O.s Different
• Treating the whole person
• Recognizing the body-mind-spirit connection
• Listening — really listening — to patients
• Using our hands, not just technology
That’s not a slogan. It’s good medicine. And in a system that often feels rushed and fragmented, it’s what patients need most.
I’ll never forget one patient who came to me convinced he was suffering from depression. On paper, the diagnosis fit: fatigue, irritability, poor sleep. But after listening, I learned he was working two jobs, living on a couch at his brother’s house and skipping meals to help his kids eat. His problem wasn’t just chemical — it was situational. The solution wasn’t only medication, but also connecting him with resources to relieve the real pressures he was under.
That’s the D.O. difference: we see the person, not just the chart.
Mind the Gap
There’s a phrase I’ve carried with me: mind the gap. I first heard it on the London Underground, where riders are reminded to watch the space between the train and the platform. For me, it’s a reminder to pay attention to the gaps in our profession — the places where we fall short and need to build bridges.
One gap is communication. Medical students today aren’t hanging out on the same platforms many of us older D.O.s use. If we want to connect, we have to meet them where they are.
Another gap is global recognition. We’ve made progress — Canada, Australia and the World Health Organization now recognize U.S.-trained D.O.s alongside M.D.s (allopathic doctors) — but there’s more work to do.
And perhaps the most urgent gap is in mental health. Too often, headlines reduce tragedy to a label: “the suspect had mental health issues.” That ends the conversation instead of starting it. In reality, studies show people with mental illness are far more likely to be victims of violence than perpetrators. If we stop at the easy answer, we fail to address the harder truths that drive these crises.
“If we stop at the easy answer, we fail our patients.”
Minding the gap also means looking inward. Burnout is real. After the pandemic, physicians across the country are struggling with mental health in ways we’ve never seen before. If we can’t take care of ourselves, how can we fully care for others? Part of my vision is making sure D.O.s have the tools, resources and community they need to thrive — not just survive — in today’s health care system.
A Doctor of Optimism
Some colleagues joke that in my case, D.O. stands for “Doctor of Optimism.” I’ll accept that. But optimism isn’t naïve — it’s a discipline.
Osteopathic medicine taught me that the body has the ability to heal if given the right support. I believe the same is true for our profession and for society. Optimism means recognizing the challenges, confronting them honestly and still believing we can solve them.
It also means remembering our history. We’ve been underestimated before. People doubted us. And we proved them wrong by growing stronger. We can do that again. “Optimism means seeing the problems clearly—and still believing we can solve them.”
Optimism also matters because medicine can be exhausting. We’ve faced a global pandemic, waves of misinformation and a crisis of trust in science. We’ve seen our colleagues burn out, and we’ve seen communities divided over basic public health measures. To keep going, physicians need hope — not blind hope, but grounded optimism in what we can accomplish together. That’s why I wear the title proudly.
Global Reach, Local Roots
As AOA president, I’ve been fortunate to see D.O.s making an impact far beyond the United States. In Malawi, South America and across Europe, Spartan D.O.s and their colleagues are serving in clinics, training programs and mission trips. Our advocacy has opened doors worldwide, from full licensure in Alberta to recognition by the World Health Organization.
That global growth matters because health care doesn’t stop at borders. My vision is that one day, no U.S.-trained D.O. will be limited by geography when it comes to practicing medicine.
At the same time, we can’t lose sight of our roots. Whether in rural Michigan or urban centers across the country, D.O.s are often the first line of care in underserved communities. That’s where our philosophy shines brightest — listening, serving and adapting to meet real human needs.
Looking Ahead
My hope for this year is simple: that D.O.s across the country feel more connected to the AOA and to one another. If members finish this year saying, “Yes, my voice matters, and this organization represents me,” then I’ll know I’ve succeeded.
Because at the end of the day, this role isn’t about titles or positions. It’s about service — to my colleagues, my patients and the future of osteopathic medicine. And it’s also about the next generation.
To every student entering osteopathic medicine today: your voice matters. Your training matters. And your future matters. You’re stepping into a profession built on resilience, service and vision. My advice is to carry those values proudly, even when others don’t fully understand them yet. Because you are the future — and the future needs you.
That’s the optimism I carry. And that’s why this role matters.
By Jim Peck