What is Osteopathic Medicine?


Osteopathic medicine is a distinctive form of medical care founded on the philosophy that all body systems are interrelated and dependent upon one another for good health. This philosophy was developed in 1874 by Andrew Taylor Still, MD who pioneered the concept of “wellness” and recognized the importance of treating illness within the context of the whole body.

Osteopathic physicians use all of the tools available in modern medicine incorporating pharmacology and surgery into patient care. They ALSO incorporate osteopathic manipulative treatment (OMT or “manipulation”) into their regimen of patient care when appropriate. OMT is a set of manual medicine techniques that may be used to relieve pain, restore range of motion, and enhance the body’s capacity to heal.

Physicians licensed as Doctors of Osteopathic Medicine (D.O.s), like our allopathic colleagues (M.D.s), must pass a national or state medical board examination in order to obtain a license to practice medicine. D.O.s provide comprehensive medical care to patients in all 50 states and the District of Columbia.

Currently, there are approximately 70, 500 D.O.s practicing in the United States. Approximately 50% of D.O.s serve in primary care often establishing their practices in medically underserved areas. We serve as health care policy leaders at the local, state, and national levels. D.O.s represent 6% of total U.S. physicians and over 8% of all military physicians. In addition, there has been increasing emphasis on biomedical research in several osteopathic medical schools.

A.T. Still, was born in Virginia in 1828, the son of a Methodist minister and physician. At an early age, he decided to follow in his father’s footsteps as a physician. After studying medicine and serving an apprenticeship under his father, Still became a licensed M.D. in the state of Missouri. Later, in the early 1860’s, he completed additional coursework at the College of Physicians and Surgeons in Kansas City, Missouri. He went on to serve as a surgeon in the Union Army during the Civil War.

After the Civil War and following the death of three of his children from spinal meningitis in 1864, Still concluded that the orthodox medical practices of his day were frequently ineffective, and sometimes harmful. He devoted the next ten years of his life to studying human anatomy and alternatives to conventional medicine.

His research and clinical observations led him to believe that the musculoskeletal system played a vital role in health and disease and that the body contained all of the elements needed to maintain health, if properly stimulated. Still believed that by correcting problems in the body’s structure, through the use of manual techniques now known as osteopathic manipulative treatment, the body’s ability to function and to heal itself could be greatly improved. He also promoted the idea of preventive medicine and endorsed the philosophy that physicians should focus on treating the whole patient, rather than just the disease.

These beliefs formed the basis of osteopathic medicine. Based on this philosophy, Dr. Still opened the first school of osteopathic medicine in Kirksville, Missouri in 1892.

Like MDs, DOs must complete four years of medical school, with admission contingent upon a bachelor’s degree, GPA, MCAT, etc. Our curriculum includes 300-500 hours of additional training in OMT. DOs must pass a 3 step licensing exam offered by the National Board of Osteopathic Examiners (NBOME). Historically, many DOs take the USMLE when applying for competitive residencies, though not usually required. State licensure is by the state medical board which licenses both physicians as “separate but equal.”

So WHAT’S the difference, then?

1. The DO has the additional training of OMT, which we believe is valuable in treating dysfunction of the musculoskeletal system that may affect other organ systems. 2. The DO has been conditioned to view the person as a whole and therefore, considers all the implications of the diagnosis and the treatment. The DO is trained to look for and treat the cause of the disease rather than just the symptoms.

Chiropractors and osteopathic physicians have differences in their training and education. They also approach the musculoskeletal system differently. Osteopathic medicine includes a focus on the need to optimize blood circulation to maintain or restore health. In contrast, the chiropractic approach focuses on the nervous system and adjustments of the spinal vertebrae to improve neurotransmission.

Basic Principles of Osteopathic Medicine

The body is a unit The body is self-healing Structure and function are interrelated Treatment is based on the above 3 principles Osteopathic manipulative treatment involves the use of manual procedures to optimize patient health and function. It should be emphasized that OMT is a distinctive medical procedure and should not be confused with services provided by non-physicians. OMT is a general term currently encompassing approximately twenty-five different types of physician-performed procedures.

OMT is often used to treat muscle pain. But it can also help patients with a number of other health problems, among them:

Asthma Sinus disorders Carpal tunnel syndrome Migraines Menstrual pain Structural diagnosis involves the use of expanded observation and palpatory examination of the neuro-musculoskeletal system with its venous, lymphatic and pulmonary interactions as part of the physical exam. The goal is to identify the presence of significant impediments to health and well being in the entire patient through an understanding of the interrelationships between the musculoskeletal system and all other body systems. This includes but is not limited to the identification of somatic dysfunction. The history and physical exam is not limited to isolated examination of the musculoskeletal system since many organ systems are examined. The definition of somatic dysfunction is correlated with the entire patient as follows. Impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures and their effect on the vascular, lymphatic, and neural elements.

During the process of diagnosis of altered structural function, somatic dysfunction is identified by one or more of the following physical findings: asymmetry of related parts of the musculoskeletal system, tenderness, range of motion and/or tissue texture abnormalities. Alteration in range of motion may be either restricted or increased. Alterations in quality and range of motion are the most common and often most significant findings indicating the presence of somatic dysfunction. Pain or tenderness can be of assistance in the diagnosis but their provocation is not diagnostic in and of itself. Somatic dysfunction is also made clinically relevant by interpreting the effects of personal injury history.

Key Steps in Osteopathic Manipulation

Diagnosis Treatment Retest to confirm treatment outcome Recipients of OMT can attest to the benefits:

Can result in less medication use Is essentially complication free Results are usually appreciated immediately References: Dr.Simmons.net Stephen Barrett, MD aoa-net.org “Osteopathic manipulation may effectively treat back pain,” WebMD 11/3/99. “A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain,” NEJM, 11/4/99. “Osteopathy,” WholehealthMD.com, http://www.medicalnewstoday.com/articles/201694.php