Very interesting. The attempted merger in the 1960's in CA was really a wake-up call for the osteopathic profession. I've always wanted to get the perspective of someone who was involved in the action to have a better understanding of the forces at work. Maybe you'll share with us more on the topic.
While I understand arguments about the "convenience" of such a merger at the time, it is undeniable the that California Medical Association sought "amalgamation" as a means of annihilation too. While many DO's had good relationships with many MD's (in fact the MD specialists depended upon the DO generalists for their bread and butter), the stance of organized allopathic medicine (the CMA and AMA) toward osteopathic medicine was hostile and antagonistic. Osteopathic physicians were simply deemed cultists and quacks. Period. I think for students today to have a full appreciation of the historical context in which this action occurred, they need to go back and read the old Morris Fishbein articles published in JAMA about the "osteopathic problem" and read the transcripts of the numerous hearings the AMA and state and county medical societies held about the "osteopathic problem." I've read these articles and transcripts as I fancy myself something of an osteopathic history buff. To read them today, it sounds almost Hilterian in scope. The AMA simply did not want DO's around anymore.
The merger, in classic "blowback" fashion for the AMA, did more to further the establishment of the osteopathic profession than the DO's at the time could have ever done on their own. It solidified the argument that osteopathic and allopathic medical training were on par and there was no compelling reason for professional discrimination based upon medical degree earned.
The crux of the argument, as I see it, comes down to this simple point: The osteopathic profession was founded as a reform movement in medicine. AT Still had a "big idea" about what the practice of medicine should be like. Yet today, manual medicine is really no big deal. A survey published a few years ago revealed that 20% (1 of 5) MD's had been to a chiropractor or massage therapist at some time in their life. PTs, OTs, athletic trainers, etc all incorporate aspects of manual medicine (and OMT) into their practice to varying degrees. So, if manual medicine is no longer "revolutionary", then what about the osteopathic approach to patient care is? Or, conversely, does the osteopathic profession still have anything unique to offer patients? Unless the osteopathic profession can demonstrate that it in fact does have something unique to offer patients, we become redundant. In the abscence of a truly unique osteopathic approach to patient care, there is simply no compelling reason for us to exist.
Each generation of osteopathic physicians has had it own particular battle to fight. Early generations fought battles for establishment, raising educational standards, professional parity, state and federal licensing, etc. Our generation of osteopathic physicians I think faces a different kind of battle. It is a battle for professional distinctiveness. What is different about this battle is that there is no clear enemy on the other side. The AMA, the insurance companies, the government, etc have all accepted MDs and DOs as equal. The battle for distinctiveness will involve fighting ourselves. If the osteopathic profession were a patient in psychotherapy, one could say it is facing deep existensial issues. We are either comprehensively trained physicians with a unique philosophy of patient care, or we're MDs with a different degree behind our name. Sadly, I see too many osteopathic students just throwing in the towel already convinced that the osteopathic approach to patient care is meaningless. I think most of these students never really understood the approach in the first place.
Any thoughts?
