What is Osteopathic Medicine?

I remember when I was first accepted into medical school. I couldn’t stop talking about it. Many of my family and friends were excited and had so many questions. After telling them I was going to Georgia Campus – Philadelphia College of Osteopathic Medicine (GA-PCOM), the follow-up question was always, “What is osteopathic medicine?” If I had a dollar for every time someone asked me that question, I’d be halfway done paying my student loans back. (Ok, not really.) I still giggle when I think about the first time I told my mom about osteopathic medicine. She said, “osteo-what?” The look on her face was priceless.
whatchu talkin bout meme

I was once clueless about osteopathic medicine, myself. I had heard of it before, but was not well informed of what it actually is until I went to graduate school in Philadelphia, PA. I was a member of the Minority Association of Pre-medical Students (MAPS) and was exposed to osteopathic medicine at a medical conference at the main campus of PCOM. I learned about the history, principles, and training of osteopathy. While there, I also saw osteopathic manipulation demonstrated and my curiosity was piqued. After shadowing physicians who practiced osteopathic medicine and seeing the benefit their patients received, I was convinced that going to an osteopathic medical school was just the thing for me.

To fully understand what osteopathic medicine is, you should know a little bit of history. Andrew Taylor Still, MD, DO, is considered the “father of osteopathic medicine.” In 1854, Still was granted the MD (Doctor of Medicine) degree at age 26 in Missouri. MDs were trained in American Orthodox Medicine (now allopathic medicine).
Dr. A.T. Still (Image from Missouri Digital Heritage)

Between 1859-1864, he lost his first wife and 3 of his children to the meningitis epidemic that hit the country during the time of the Civil War. Still also served in the Union Army, and as a surgeon’s assistant he saw that orthodox medicine wasn’t working. In fact, it was doing more harm. He wasn’t satisfied with drugs and unnecessary surgical procedures so he set out to study medicine again by reviewing chemistry, physiology and anatomical dissections. He believed that the human body had the ability to heal and care for itself. He used his hands to diagnose and treat his patients.

In 1874 when he tried teaching his new ideas to the traditional medical community he wasn’t well received. A.T. Still later founded his own school in 1892, the American School of Osteopathy (now A.T. Still University). Over time, his practices  gained traction and many other osteopathic schools begin to open around the country.

The field of osteopathic medicine faced opposition from the traditional medical community, but by 1973 osteopathic physicians were allowed full unlimited practice rights for the first time in all 50 states, with licensure in Mississippi.

In 1980, the first residency in OMM (Osteopathic Manipulative Medicine) began at the Philadelphia College of Osteopathic Medicine in Philadelphia, PA.

As an aside, Walter C. Ehrenfeuchter, DO, FAAO began training that year in the residency program and served as the first resident in the history of the profession in Osteopathic Manipulative Medicine. Dr. E (as we call him) has taught OMM for over 30 years. Currently, he is the Professor and Director of OMM at the Georgia Campus of PCOM and I am proud to have trained under him. He is awesome! Shout out to Dr. E!

Let’s move from the history of osteopathy to its training. There used to be a big stigma associated with DOs in the medical community. The MD vs DO comparison led some people to feel that DOs aren’t “real” doctors, and that they aren’t properly trained. That can’t be further from the truth! As a DO, I have the degree Doctor of Osteopathic Medicine. Just like someone with an MD behind their name, osteopathic doctors are fully trained, licensed to practice in all medical and surgical specialties and subspecialties, and are licensed to prescribe medicine. Additionally, DOs have 200+ hours of training in OMM incorporated into our curriculum. So if anyone tells you that DOs aren’t “real”doctors, you can now properly inform them of the truth.

So now that we’ve cleared that up, what exactly is OMM? I’m glad you asked. Well, from A.T. Still’s teachings, osteopathic medicine was born and 4 major principles emerged:
  1. The body is a unit.
  2. Structure and function are reciprocally related.
  3. The body possesses self-regulatory mechanisms.
  4. The body has the inherent capacity to defend itself and repair itself.
Those of us who train at osteopathic medical schools understand this and we learn to use our hands to diagnose and treat dysfunctions of the neuromuscular skeletal systems. We use a holistic approach to treating a patient, rather than just focusing on alleviating the symptoms of a disease. The best way to understand it is to look at an example:

Let’s say I have a patient who presents with shortness of breath but their lungs are completely healthy. Dysfunction of the muscles attached to the ribs can prevent the ribs from moving properly (called a rib dysfunction), which prevents the diaphragm from moving correctly. All of this can create a pressure gradient in the thoracic cavity that prevents the lungs from filling fully during inhalation. It’s an intricate and interesting concept, and as a DO I have the ability to diagnose this problem using only my hands. Because I know which muscles are attached to which ribs, I can use my hands to feel those muscles while my patient inhales and exhales. I can determine which rib is dysfunctional or out of place. After making this diagnosis, I can then use my hands to apply pressure and manipulate the problematic muscle and put the rib back in place. This is a simplified example, but hopefully it helps you to better understand OMM.

Knowing that I can provide this type of treatment option to my patient, along with traditional methods of medicine, is what makes me proud to be a DO. I like to tell my patients that as a DO I have a set of extra tools in my medical toolbox to use when providing them with the best care I can.

I remember when I first saw OMM being performed at that MAPS conference in Philly. Years later, I am still fascinated by osteopathic medicine and am proud to be among many others who have earned the degree Doctor of Osteopathic Medicine.

If you’re still wondering about osteopathic medicine, here are a few links that may be of interest:

**Much of the history provided in this post was summarized from one of my 1st year med school lectures:
 Ehrenfeuchter, Walter C. “Osteopathy’s Place in American Medicine.” Powerpoint Presentation. GA-Philadelphia College of Osteopathic Medicine. Suwanee, GA. 29 August 2011.

-thedoctorjb

 

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