BODY, MIND & SPIRIT
July 1, 2013
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Osteopathic medicine was created in the 1800s by a man who refused to believe the common way to practice medicine at the time was the only way. The fruits of his labor continue to grow today ...
BY BILLY LIGGETT
Andrew Taylor Still’s life was fraught with tragedy.
As a boy in Virginia, Still learned everything he knew about medicine from his father, a physician and Methodist preacher who moved his family to the plains of Kansas in 1853 when Andrew was 25 years old (and married with two young children).
In his 30s, Andrew enlisted in the 9th Kansas Cavalry and would become a captain and major in the Kansas Militia during the Civil War.
His grim experiences as a war medic did little to prepare him for what awaited at home after his service. An epidemic of spinal meningitis killed three of his children. His first wife had died during childbirth, and a daughter from his second wife died of pneumonia at a young age.
Shaken by war and his inability to save his wife and children, Still rejected most of what he had learned about medicine.
There had to be another way.
“When Andrew Still first began to practice medicine, even before the war, he was disappointed in the practice as a whole,” says Dr. John Kauffman, founding dean of the Campbell School of Osteopathic Medicine. “At the time, bloodletting [the practice of withdrawing blood in small quantities to cure an illness or prevent disease] was used heavily. Heavy metals like mercury were common. Some believed if you gave someone diarrhea [using mercury], it forced the ‘bad stuff’ out of you. What better way to make you feel better than to give you diarrhea and burn your intestine with a poison like mercury?
“Still knew this wasn’t right,” Kauffman adds. “The body has the ability to heal itself. The role of the physician should be to help the body do just that. The doctors of his day were poisoning their patients. Of course, that’s not good medicine.”
Still decided to dedicate his life to finding alternative ways to cure disease. In 1870, he completed a short course in medicine at the new College of Physicians and Surgeons in Kansas City, and would begin investigating treatments such as hydropathy [using water in therapeutic treatments], improved diet, bonesetting and magnetic healing. He imagined a day when rational therapy would include manipulation of the musculoskeletal system, surgery and less use of drugs.
He named his approach "osteopathic medicine" because of his focus on the musculoskeletal system. He founded the first school of osteopathic medicine — the American School of Osteopathy [now A.T. Still University] — in Kirksville, Mo., in 1892 at the age of 64.
“An osteopath is only a human engineer,” Still later said, “who should understand all the laws governing his engine and thereby master disease.”
OSTEOPATHIC vs. ALLOPATHIC
As a recruiter for the Campbell School of Osteopathic Medicine, Shelley Hobbs deals a lot with students and others who have never heard of or are mostly unfamiliar with the term “osteopathic.”
She has her answers down pat.
"Osteopathic medicine is 'whole-person' medicine," Hobbs says. "It’s all about treating the whole person (mind, body and spirit), and not just a set of symptoms or disease. Osteopathic medicine places the emphasis not just on treating the problem at hand, but also on promoting health and wellness."
Osteopathic graduates (DOs) have the same training as allopathic graduates (MDs). Legally and professionally, they’re equals and can apply for the same residencies nationwide [and actually, some MDs aren’t suited for residencies requiring extensive musculoskeletal training]. MDs have been around longer. DOs are newer, but growing. Currently, 1-in-5 physicians in the U.S. are DOs. By 2020, it’ll be 1-in-4.
Osteopathic medicine is on the rise. More and more DOs are making their way into the world of medicine, serving in medically underserved areas.
Hobbs has said these lines more times than she can remember. She returned home in the spring after spending four months traveling the country and visiting colleges and job fairs to promote Campbell’s new medical school. Her selling point is simple.
“As a medical student, it’s all about finding which path is right for you,” Hobbs says. “When I explain osteopathic medicine and Campbell’s goals, I see the light bulb go on above these students’ heads. They say, ‘That sounds more like the kind of physician I want to be anyway.”
The AACOM describes DOs, or doctors of osteopathic medicine, as physicians who work in partnership with their patients. They consider the impact that lifestyle and community have on the health of each individual and work to “break down the barriers to good health.”
DOs tout that they spend more time in personal contact with their patients — a claim supported by the 1999 National Ambulatory Medical Care Survey, a summary that compared the practice of DOs and MDs in the family practice setting. According to the survey, osteopaths spent an average of 19 minutes with their patients per visit, as opposed to 15 minutes by MDs.
“There’s a reason why many people say osteopathic physicians are just nicer docs,” says Dr. William Morris, professor and director of Campbell’s manipulative medicine department. “It’s all about human contact. You’re a human being, and I’m a human being, and I’m here to help you get better. There’s a powerful message there.”
Patients who visited osteopathic physicians were more likely to be middle-aged and referred, according to the survey. In addition to spending more time with patients, DOs ordered a greater number of “non-traditional” tests and provided more manual and complementary modes of therapy. In contrast, MDs had a greater number of patients who were minorities, and they ordered a greater number of traditional diagnostic tests and prescribed more medications.
DOs are more likely to go into solo practice and are more commonly found in the midwest region of the U.S., while MDs are more likely to be primary care physicians with hospital-owned clinics more likely to be equipped with lab facilities.
“DOs tend to serve in more rural and underserved areas,” says Kauffman. “They’re both good models, and they’re complementary. MDs create more sub-specialists, and we create more general specialists.”
There are still critics of osteopathic medicine. Some believe DOs exaggerate the value of manipulative therapy. Others claim MD programs require better grades from incoming students than schools of osteopathic medicine. Other published criticisms say osteopathic schools are more focused on practical application and less focused on research and scientific discovery.
Kauffman is well aware of the criticisms, but he says DOs have battled them for over a century.
“MDs spent years trying to get rid of us,” he jokes. “DOs couldn’t even serve in the military during World War II. The military put politics above saving lives.”
Today, the two practices have become better partners. MDs and DOs share many of the same residencies and work side-by-side in hospitals and clinics across the nation.
And DOs today are one of the fastest growing segments of health care professionals in the U.S., according to a 2012 professional report by the American Osteopathic Association. At the current rate of growth, it is estimated that more than 100,000 osteopathic physicians will be in active medical practice by the year 2020. In May 2012, that number was estimated to be around 69,000.