My Take on Osteopathy
I went into medicine because I am passionate about people and promoting
the well being of individuals. I was attracted to the philosophies of osteopathic
medicine because it places the patient at the center of care. Osteopathic principals
stress the importance of seeing patients as whole individuals. In fact, the Osteopath
knows that in order to successfully treat the patient, he or she cannot disregard the
wholeness of the human experience. As such, I decided to attend osteopathic
medical school because I wanted to be the best possible physician for my patients.
As I journeyed through medical school, I began to notice that many of my fellow
classmates were unsure of what osteopathic medicine is. Many students defined
osteopathy based on the use of OMT. For me, the differences between osteopathic
medicine and allopathic medicine are the set of osteopathic principals. These
principals provide the framework for how we conduct our patient interactions, how
we diagnose disease and illness and how we promote wellness and treatment plans.
As such, to define osteopathic medicine on the basis of OMT is to have a superficial
understanding of what it means to be an osteopathic physician. As I delve deeper
into my medical training, I am reminded everyday of how incredibly lucky I am to be
trained as an osteopathic physician. If I had to do my medical training all over again,
I would still choose to receive my medical education from an osteopathic medical
school.
Dr. Andrew Taylor Still founded the principals of osteopathic medicine in
1874. Through these principals, Dr. Still highlighted the interconnectedness of all
the body systems and demonstrated that each body system is dependent on the
other for good health. In doing so, Dr. Still forged the concept of wellness and urged
for the treatment of the whole person instead of the specific disease process. The
philosophy of osteopathic medicine is based on 4 key principals: 1. The body is a
unit. 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 principals of the body unity, self- regulation and
the interrelationship of structure and function. These are the principals that set the
osteopathic physician apart from the allopathic physician. As such, the field of
osteopathy is founded on principles and not simply on OMT. In fact, OMT is a
treatment modality that utilizes these principals to treat the patient. An allopathic
physician who utilizes these principles in his or her practice is osteopathic in
practice while the osteopathic physician who does not utilize these principals
cannot be considered an osteopath.
The first osteopathic principle states that the body is a unit. I have come
across many patient encounters where pain at one location is caused by dysfunction
in another part of the body. As an osteopathic medical student, one of the most
important concepts stressed during anatomy class is the role of fascia and its
function in connecting all parts of the body together. It is through this
understanding of fascia that the osteopathic physician knows to never just focus on
the site of pain but to evaluate all parts of the patient’s body.
The second osteopathic principal states that the body is capable of selfregulation and self -healing. One of the most attractive aspects of osteopathic
medicine is a deep respect and faith in the human body to heal itself. Osteopathic
medicine does not vilify the use of medication or surgery. What it does do is
recognize the power of the body to heal itself. As physicians, we should promote
this process of self- healing and resist from relying solely on the use of medications
to do so. The danger of relying on medications to heal is nowhere more evident than
in the chemically dependent patient. Many of these patients were placed on large
dosages of opioids to address pain and discomfort. The overuse of pain medication
resulted in patients developing dependency and spiraling downward into a life of
addiction.
Through my interactions with the chemical dependency clinic, I witnessed
how osteopathic principals can be used to address these chemically dependent
patients. I discovered that the best way to address chemical dependency is to
provide patients with the resources to self heal themselves of their addiction.
This was done through counseling sessions, informative reading materials and
patient empowerment. What was interesting to learn was that for many patients,
the use of opiods was a way to numb emotional pain as well. As a physician, one
must always be aware of the emotional hurt the patient is experiencing because
deep seeded psychological and emotional hurt can translate into physical
symptoms, destructive behavior and pathological disease processes. Therefore, the
process of self-healing is not limited to the elimination of diseases or pathology in
the “medical sense” but also involves addressing issues of personal pain, self esteem
and self identity. As an osteopathic physician, I am grounded in the belief that in
order to truly succeed in treating my patients, I must always involve them in their
own self healing.
The third and fourth principals of osteopathic medicine further emphasize
that when treating patients, it is important to consider both interior and exterior
processes. The musculoskeletal system houses the organ system and any hindrance
of the musculoskeletal framework will manifest as pathological symptoms for the
patient. As such, the use of OMT is an invaluable tool for treating patients who
present with somatic dysfunction. OMT utilizes manual medicine to correct
musculoskeletal dysfunction to promote homeostasis within the patient.
The distinctness of patient interaction among osteopathic physicians versus
allopathic physicians was demonstrated in a study conducted by Timothy Carey and
colleagues from Maine. In the study, osteopathic and allopathic physicians were
evaluated based on their communication skills with patients. They examined the
way the two groups verbally communicated with patients and used the
communication of osteopathic principals to mark the difference between the two
groups. According to the paper, “the principles of osteopathic medicine were
adapted to elements that could be measured from an audio recording.” An example
of this was taking the principal of “the body is capable of self healing and self
regulation” into “ physician discusses what patient can do to improve own
condition.” The results of the study demonstrates that osteopathic physician were
consisting using osteopathic principals (11 vs6.9; P=.01) more than their allopathic
physicians and therefore highlighting the distinction between the osteopathic and
allopathic physicians.
As I transition from my role of medical student into family physician, I am
confident that my training in the principals of osteopathy will guide me in providing
the highest quality of care for my patients. Like Dr. Still, I will constantly strive to
promote the well being of my patients instead of simply eliminating their disease. I
will be curious about the different factors that may perpetuate their disease process
and aim to use different treatment modalities to address the diversity of needs
within each individual patient. I will consider my patient’s human experience, their
perspective and their background when providing care. I am proud of my training
and I truly believe that osteopathic medicine is the framework that all physicians
should use when providing care for their patients.
References:
1. JAOA. Do Osteopathic Physicians Differ in patient Interaction from Allopathic
Physicans? An Empirically Derived Approach. 2003. Available at:
http://www.jaoa.org/content/103/7/313.full.pdf
2. AOA: http://www.osteopathic.org/Pages/default.aspx