FREQUENTLY ASKED QUESTIONS
What is Osteopathic Medicine?
When deciding to embark on the long process of becoming a doctor, you can choose to become a medical doctor (M.D.), or a Doctor of Osteopathic Medicine (D.O.). Both are licensed in all 50 states, both serve in all branches of military service, and both are equal in the eyes of the law. Both have their own accreditation organizations: the American Medical Association for those with the Medical Doctor degree, and the American Osteopathic Association for those of us with the Doctor of Osteopathic Medicine degree.
Osteopathic medicine was founded in 1874 by an American named Andrew Taylor Still, M.D. Dr. Still was disappointed with the medical treatment being practiced by medical doctors, also known as allopathic physicians. Dr. Still served in the Civil War as a soldier first, then after being wounded, he began to perform the duties of a surgeon in the Union hospitals. It was here where he grew disgusted at the ineffectiveness of physicians who amputated limbs and readily prescribed calomel (a mercury-based drug which rotted the teeth, gums, and cheeks of the patient). His faith in medicine was lessened further as he watched three of his children die from meningitis, despite allopathic medical treatment. He then dedicated his life to finding other, alternative means of healing. Through the laborious study of anatomy and other “materia medica,” he devised “osteopathy” (pronounced: AH-stee-oh-path-ee).
This is a combination of the words “bone” and “suffer,” which literally means “bone suffering.” At the time of its founding, the system did not include medical pharmacology; only manual manipulative “medicine” was practiced by its students.
Dr. Still studied the ideal structure of the body’s musculoskeletal system and believed that the occasional manipulation of soft tissues enabled the body to function properly and to resist disease by empowering the immune system. Medications had no part in the early days of this philosophy. It was not until the early 1900s that medication and surgery – now better researched – became a part of what is known now as osteopathic medicine. What Dr. Still provided was a philosophy, and from this holistic philosophy, D.O.s have developed new and effective means to treat and care for patients, which are then shared with the entire medical community.
Osteopathic physicians (D.O.s) can prescribe all forms of medication, perform all manner of surgery, and pursue all medical specialties. They have had identical training as M.D.s and work alongside their M.D. colleagues in most hospitals. However, they have had additional training in the musculoskeletal system. In the eyes of the law, D.O.s and M.D.s are equal.
No. Dr. Still originally intended for osteopathy to be a drugless form of healing because the drugs of his time were incredibly dangerous – drugs such as calomel, opium, arsenic, and methamphetamine. Sigmund Freud extolled the virtues of cocaine for its supposed ability to treat depression and impotence. Bayer Pharmaceutical Products invented heroin (diacetylmorphine) and started selling it in 1898 as a cough suppressant. However, during the early 20th century, less toxic pharmaceuticals began to be comprehensively tested and became accepted as the Standard of Care. At that point, D.O.s began to incorporate pharmaceutical medications into their practice.
Osteopathy was founded to be a complete system of healthcare. And to do so, it must be dynamic, and thus ever-changing in the face of new scientific findings.
People who live in Europe, South America, and Australia have a different experience of a D.O. In their countries, D.O.s are only instructed in manipulative medicine (osteopathic manipulation) and are NOT trained in pharmacology, surgery, etc. Their practice is limited to osteopathic manipulation. (Similar to chiropractors in the U.S., but not the same). Unfortunately, this adds some confusion to the degree.
The early years of osteopathic medicine were marked by staunch opposition from the allopathic (M.D.) community. There are many reasons for this opposition, one of the biggest was that osteopathy initially rejected the hallmark of allopathic treatment: the use of toxic medications. Allopathic practitioners, being taught that medication and invasive procedures were the only legitimate form of therapies, found osteopathy to be an attack on their livelihood. Worse yet, these osteopathic practitioners were actually succeeding. Thus, osteopathy became viewed as competition that needed to be annihilated.
Additionally, Dr. Still was an early supporter of equal rights for women and minorities. A fascinating example of the dichotomy between the early allopathic and osteopathic perspectives on the acceptance and employment of women can be seen in an event that occurred in 1946. A large city placed the following advertisement in the New York Herald Tribune: “Doctors Wanted: Women Need Not Apply.” In a response to this discrimination, an article in the Forum of Osteopathy appeared entitled: “Doctors Wanted: Women Urged to Apply.” Yet, Dr. Still did not stop at the mere acceptance of women as students; he employed them as instructors as well. Jenette Bolles, D.O., a graduate of the University of Kansas, was hired to teach anatomy during the school’s second year of classes. She later went on to serve as vice president of the American Osteopathic Association (AOA), osteopathic medicine’s equivalent to the American Medical Association.
Dr. Still also instituted a practice of keeping female doctors on staff at the school’s hospital to see female patients who were uncomfortable sharing their gynecological problems with male doctors. (For more information on this subject, see Georgia Walter’s 1994 book “Women and Osteopathic Medicine: Historical Perspectives.”) Thus, Dr. Still challenged the status quo of medicine by his willingness to teach women and minorities to become physicians. And again, individuals whom allopathic medicine had turned their back on were actually succeeding.
Today, there is no organized opposition of osteopathic medicine. M.D.s and D.O.s work together as colleagues, and neither is barred from the other’s institutions. Over the years, the two professions have actually grown closer together. The D.O.s have grown closer to M.D.s through their presence in highly specialized medical fields. And the M.D.s have grown closer to D.O.s through their recent push toward primary care and more holistic healing.