Osteopathic Medicine in America 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 Dr. Andrew Taylor Still, who pioneered the concept of “wellness” and recognized the importance of treating illness within the context of the whole body (Rosenberg 1972). Andrew Taylor 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, he became a licensed M. D. in the state of Missouri (Gev itz 1982). Later, in the early 1860’s, he completed additional coursework at the College of Physicians and Surgeons in Kansas City, Missouri. Then 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 (Rosenberg, 1972).
He devoted the next ten years of his life to studying the human body and finding better ways to treat disease. 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 (American Association of Colleges of Osteopathic Medicine 2003). He also believed that by correcting problems in the body’s structure by 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 a new medical approach, osteopathic medicine. Based on this philosophy, Dr.
Still opened the first school of osteopathic medicine in Kirksville, Missouri in 1892 (American Association of Colleges of Osteopathic Medicine 2003). Osteopathic physicians known as D. O. s work collaboratively with their patients and are licensed to practice in all 50 states. They can practice in numerous fields from family medicine to obstetrics, surgery, etc. Since they are trained to look at patients as a whole person from their days in medical school, they see each person as an individual rather than a collection of body parts that are injured or diseased.
With this special training they got, D. O. s develop strong communication skills and sees people with diverse backgrounds. Due to the fact that they use this? whole-person approach to medicine, ? about 60% of osteopathic physicians choose to practice in family practice, general internal medicine and pediatrics and 40% of all doctors specialize in particular areas (AACO 2003). In the particular day and age as mentioned in the site at AACO (2003), one must graduate with a bachelor? s degree in order to apply for any of the 20 osteopathic schools in the United States. They must take certain prerequisite courses in science to be a qualified applicant.
The applicants must also take the MCAT, with average score of 24 or higher and a GPA of 3. 35 overall and 3. 26 science GPA in order to be considered for admission but varies among schools. Students that get admitted to osteopathic schools take a range of courses in all of the subject areas such as anatomy, physiology, microbiology, histology, osteopathic principles and practices (including osteopathic manipulative medicine), pharmacology, clinical skills, doctor / patient communication, etc. Also, numerous osteopathic colleges have students assigned to work with physicians beginning early in the first year and the process continues throughout the second year in conjunction with the basic science courses they have to take. In the third and fourth years, osteopathic medical students spend more time learning about the major specialties in medicine.
In addition to studying the typical subjects in medical schools, osteopathic students must spend 200 additional hours to train in the art of osteopathy manipulative medicine (OMT). It is a kind of treatment that was invented by Still and are sometimes included into the patient? s regiment to help patient alleviate pain, restores motion and supports the body? s natural functions to keep it functioning more efficiently. A key concept that osteopathic students learn is that structure influences function. Therefore, if there were a problem in one part of the body? s structure or function, than it would affect other areas. In an article by Dr. Brian F.
Degenhardt (Degenhardt 2000), he encourages the use of OMT and believes that by understanding the differences between the body? s structure and function and how that is interconnected with a person? s emotional or spiritual being, physicians can provide patient specific care that promotes health and treats disease. Through the uses of palpation and manipulation, doctors can accurately diagnose a patient because this relationship is through a patient-centered approach to health care. Doctors are more likely to take more aspects of their patient? s life into account when they are planning a treatment program or regiment for the patient to follow. In an account by Dr. Degenhardt, D. O.
, he encountered a patient who was a teenager that he was able to heal by using the methods of palpation and manipulation. The patient had suffered stomach pains for several months and had been to an allopathic doctor (M. D. ) for treatment but was unable to feel changes after taking the medication the allopathic physician had given her.
The doctor had diagnosed her for having irritable bowel syndrome but the medication did not help. Later, she went to visit Dr. Degenhardt and he gave her a similar examination a M. D had given her, but had discussed with her critically about her lifestyle to have her understand what changes she should make in her daily routine to be more healthy.
By using the technique of palpation, the D. O. determined a few aspects of her body that were not performing effectively and noticed that she had a few stressful situations in her life, thus, making some of her muscles growing too tight and joints that do not move well that were in the area effecting digestion. It was the areas in her lower rib cage, abdomen and lower back. Through the use of manipulation, Degenhardt was able to reduce the tightness of the muscles and her joints returned to normal. After the structural problems disappeared, her normal gastrointestinal function returned and the symptoms were gone.
Dr. Degenhardt believes that each individual experience different symptom and by understanding his patient, he was able to treat her properly. Another patient with similar symptoms may have different causes or different ways that stress can spread in the body. The case illustrates how osteopathic physicians were able to make a proper diagnosis by considering the individual as a whole person and give patients specific treatment plans rather than just focusing on the symptom or the disease process. There are currently 47, 000 D. O.
s in the United States and constitutes only 5% of this country? s doctors. Some statistics observed (AOA 2000) that there are only 44, 462 active D. O. s in the United States that are under the age of 65 years old.
There are approximately 26. 2% female doctors compared with 73. 8% male doctors. These data shows that there are a low percentage of female osteopathic doctors. Even though there are 44, 462 active D. O.
s, only 17, 737 of them are AOA certified, meaning that they perform the use of OMT if necessary. Other D. O. s choose not to perform OMT even though they went through osteopathic schools, so they do work similar to M. D.
s. In the data from 2000-2001, there are a total of 10, 817 students enrolled in the 20 osteopathic schools in the United States. Out of this total, 6, 374 students were male and 4, 443 were female, but only 2, 597 students were able to graduate from school and successfully become a D. O.
By looking at ethnicity in enrollment, 73. 4% of the students were white, 16% were Asian, 3. 7% were black and 3. 5% were Hispanics. Again, looking at these statistics, it can be noted that it is a continuous trend in statistics done on income level, education level, health level, etc (Weiss and Lonnquist 2003) that whites are often more privileged than other minority groups. By looking at the data at an age level, most D.
O. s are in the range of 35-44 because they constitute about 34% while the doctors that are 35 years of age or less constitutes 24% of the D. O. population.
Progressively as the age increases, there are less D. O. s in that category, with 30. 2% of D. O.
s that are 45-54 year old and 1. 3% that are 55-64 years old (AOA 2000). One of the major health providers of osteopathic medicine would be Dr. Po Long Lew, D.
O. who serves the San Gabriel Valley community (Lew 2003). He is a dedicated and responsible doctor who values patients and works with a patient-centered attitude. Unlike numerous D. O. s who do not apply OMT to patients, Dr.
Lew encourages the use of OMT, if necessary, and does apply the technique to patient? s that need it. He feels that with the proper use of OMT, patients and himself get the satisfaction and they both can be happy. Dr. Lew owns his own clinic and has been practicing family medicine for over 15 years. His father and grandfather had specialized in oriental medicine and had influenced him to become interested in medicine and the arts of the human body.
He studied and became a pharmacists in Hong Kong and later when he came to the United States in his late 20 s, he decided to go into osteopathic medicine because it would give him a chance to learn about something new a doctor can do than to just prescribe medicine to patients. A typical day for him starts at 9: 00 am in the morning at his office and lunch meetings or sometimes surgery in the afternoon. After work, he must go to the hospital to see his patients and comes home around midnight. Due to his hectic schedule, for him, the negative side of being a D. O. is that there is a limited amount of family time he has with his children.
Most of the time, he leaves his office around 9: 00 pm because patients come in after his normal business hours and comes in to chat with him about their health, especially the elderly. Due to his great communication skills, his patients feel trusted with him and are able to communicate with him about all health conditions they encounter and see him as their friend. Since he usually serves the Chinese and Hispanic communities, patients are unaware of the differences between D. O. s and M. D.
s but rather put trusts with the doctor if they feel that the doctor is identifying with their in their given situation. Another down side of being a physician is that they are always very busy and great amount of stress involve and often receiving numerous phone calls. Even though Dr. Lew is busy, he feels that seeing his patients happy and recovering from their illness gives him satisfaction that he was able to help them. He encourages his children and others who are serious about medicine and are dedicated in serving others to become physicians. Besides from Dr.
Lew, who has devoted all his time for his patients, Dr. Robin Watkins, D. O. , who is interested in children and infants feel that there is a need to address parents in preventive care (Watkins 2000).
As an osteopathic physician, he feels vaccines are not the best preventive care for infants and children. Through his research and study, he believed that certain vaccines provide neurological damage and even death to children. An idea known 100 years ago, children can have allergies to vaccines due to the multiple injections of the antigens. As a result, it may cause serious local and systemic side effects such as neurological damage. He believes that vaccines are ineffective in preventing infectious diseases and that they are composed of numerous substances, one being thiosernal that is made up of a mercury compound.
It also contains foreign proteins and contaminating animal proteins and viruses. There seems to be a contradiction between those who promote the vaccines and see it being? the ultimate weapon to conquer? and those who pay more attention to new and emerging research in immunology and neurology that reveals the ways in which vaccines can destroy the immune system and attack the nervous system. DTP vaccine, which? fights off? polio seems to have a link to sudden infant death syndrome. In a study conducted in 1975, when Japan had raised their minimum vaccination age to 2 years, it lead to a virtual disappearance of sudden infant deaths but in the 1980 s when they changed the law to allow infants to be vaccinated at 3 months or older, the sudden death of infants increased.
The United States Center for Disease Control and prevention has issued new guidelines for polio vaccinations because they believed that all deaths were due to oral polio vaccines. It seems that if doctors refuse to look at the? big picture? and believes that vaccines can prevent and immune people to diseases, then there is no solution because they are reluctant to learn about the damages it can cause to a person, especially children, who are suffering from the damages due to allergic reactions. Dr. Watkins wants parents to be aware of the negative sides to vaccines and want them to make an informed choice. Watkins (2000) believes that there are greater amounts of people in Germany that are suffering from vaccination damage than are people suffering from AIDS.
He believes that by using a small amount of money that are used in AIDS research, a more in-depth study of vaccine damage can be done and help numerous people, especially infants and children (Watkins 2000). Osteopathic medicine has progressed greatly since Andrew Still? s time. Through the use of his original techniques and incorporating it in modern medicine, doctors are able to give more to patient then just an impersonal diagnosis of their illness. Osteopathic doctors develop tighter doctor-patient relationships with their patients and are able to identify with them by understanding their lifestyles as well as their illness to give them a proper diagnosis by the use of medication and OMT..