JSNMA SUMMER 2019 Sneak Preview

48 Commentary
WHAT WE “DO”:
UNDERSTANDING
OSTEOPATHY
SARAH K. GREWAL, OMS-II , YASMEEN R. DAHER, OMS-II
A. T. STILL UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE IN ARIZONA
Since 1990, the number of osteopathic physicians
(DOs) has increased by 250%. Despite this
massive expansion of the DO profession, many
are still not aware of the similarities and differences
between what a DO and MD can offer.
Founded in 1874, osteopathic medicine is an
evidence-based practice that is compatible with and
complementary to traditional allopathic medicine.
The founder of osteopathy, Dr. Andrew Taylor Still,
was an allopathic physician (MD) who envisioned
a new kind of physician—one who practiced
healing rather than the false or even harmful
practices that many “doctors” of the 19th
century employed. In particular, Dr. Still
explored the musculoskeletal system and
how it could be manipulated to promote the
body’s overall wellbeing. This came to be
known as osteopathy, a word that combines
the Greek roots osteo, meaning bone,
and pathos, which means suffering. 1 Dr.
Still’s work lead to the 4 tenets of osteopathic
medicine, the principles that all DO students learn
to practice:
1. The body is a unit; the person is a unit of
body, mind, and spirit.
2. The body is capable of self-regulation,
self-healing, and health maintenance.
3. Structure and function are reciprocally interrelated.
4. Rational treatment is based upon an
understanding of the basic principles of body
unity, self-regulation, and the interrelationship
of structure and function. 2
These tenets encompass the underlying values of
osteopathic medicine. Perhaps the most defining
characteristic of osteopathic medicine is relayed in
the first tenet—the principle of unity. Instead of solely
reducing the body down to its constituents, osteopathy
values the fact that the body is integrated in all respects.
Viewing the body as a unit of body, mind, and spirit
allows osteopathic physicians to better treat and even
prevent disease. For example, an obstruction could be
treated or prevented with a lymphatic pump technique
which enhances the flow of lymph throughout the body
allowing for enhanced circulation and venous drainage.
The last three tenets stem from the first tenet of unity,
thus creating a foundation for osteopathic physicians
that is rooted in holistic care. 3,4
In 2018, there were over 28,000 students enrolled in
osteopathic medical schools, making up over 25%
of medical students in the United States.5
The path of obtaining a DO degree shares
many similarities to the MD curriculum.
Both MD and DO students take a similar
path that includes obtaining a bachelor's
degree, taking the MCAT, and being
accepted through a competitive admissions
process. In medical school, both the DO and
MD curriculums contain the same core of
basic science, anatomy, pharmacology,
etc. After medical school, osteopathic
students obtain residencies and practice in
every specialty of medicine alongside their
allopathic counterparts. Uniquely, 56% of
osteopathic physicians choose to pursue primary
care specialties like family medicine, pediatrics,
and internal medicine. 5,6 This is not surprising
considering the four tenets and underlying
values of osteopathic medicine. Furthermore,
osteopathic physicians are thereby helping to
fill the gaps of the increasing medical shortage
in rural and underserved areas. 7
The largest difference is that osteopathic students
complete an additional 200 plus hours studying
osteopathic manipulative medicine (OMM) during
medical school. 8 OMM is a hands-on approach to
diagnosis, treatment, and prevention. Students learn
to use the musculoskeletal system to effect change
throughout the body. This relies on the tenets of
osteopathic medicine, most specifically that structure
(anatomy) and function (physiology) are intrinsically
related. Osteopathic physicians use OMM in addition
to medication, surgery, etc. It is a tool that osteopathic
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