I would like to attempt to steer this thread back to a discussion of the supposed differences between allopathic medicine and osteopathic medicine without it degenerating into a "pissing match." I am very interested in this topic and always seek to get each osteopathic student's opinion on whether or not there exist any differences.
I believe that the osteopathic profession serves a purpose distinct from the allopathic profession, but question whether this distinction really lies in what today's osteopathic medical student calls a "philosophical difference." Time and again the community of physicians is told that there are dissimilarities in the way MDs and DOs practice, based solely on the way each has been educated, but I struggle to see these in practice on the wards where MDs and DOs share space. I have repeatedly asked osteopathic medical students to define the differences between our two professions, but none have ever given me anything satisfactory. I recall only a lot of hand-waving and use of the word "holism" and the phrase "treating the person, not the symptoms."
Osteopathic medicine has clearly documented origins in a philosophical rift within "orthodox," or as Hahnemann liked to call, "allopathic" medicine lead by Andrew T. Still, MD, in the 1870s. And for decades the osteopaths fought for a place for the practice of their art, and the teaching of their art, to those who would listen and believe. They had a different way of practicing and truly believed in it, and wanted the world to listen and for patients to see things they way they saw them. For the most part the early DOs rejected anything having to do with the traditional practice of medicine, that learned by the MDs.
But then something happened to osteopathy.
Osteopaths seemed unhappy with being osteopaths. More and more DOs sought the unfettered practice rights and privileges of the mainstream MDs. DOs were locked out of hospitals, were constantly being questioned as to the validity of their profession, and were faced with a growing internal resentment for having chosen osteopathy in the first place.
To remedy this situation, the American Osteopathic Association, an organization founded in the 1900s to champion the education and practice rights of the osteopaths decided to re-tool the curricula offered by their accredited colleges of osteopathy. In fact, much of the re-tooling by the AOA was done to update the scientific aspects of osteopathic practice. Things which Andrew Taylor Still rejected as having absolutely no place within osteopathy, all of a sudden found a home in each and every osteopathic college in the country.
Since that happened it seems osteopathic physicians have lost much of their original identity. Whereas the early osteopaths used manual therapy as their primary tool, contemporary studies show that osteopathic physicians hardly ever employ "OMT" in their daily practice. Some studies even show osteopathic physicians using medication more frequently than their allopathic colleagues.
Perhaps some of Andrew T. Still's original teachings are indoctrinated in the DOs during medical school, but these philosophical pearls appear to lose much of their significance as a great majority of DOs train in programs without any osteopathic component. This would lead us to believe that osteopathic physicians, in post-residency practice especially, are several years removed from any sort of teaching of the philosophy of osteopathic medicine and that these DOs' practice of medicine will be incredibly similar to that of the MDs.
In my limited experience with clinicians of both schools, and with students from NYCOM, I fail to see the difference in approach to a patient. The NYCOM students I have rotated with will perform some OMT on occasion, but other than that, they will consider the same points I do in evaluating the patient. Their patient presentations are also very similar to my patient presentations. I have never met an osteopathic physician or medical student who considered the "person" rather than the chief complaint.
Just to reiterate, I see that there is a need for osteopathic physicians in the United States. Osteopathic physicians provide for a lot of the healthcare in areas not prone to attracting many physicians of either school. Osteopathic college also have a very strong primary care bent, and fully two-thirds of osteopathic graduates choose to become primary care physicians. None of these unique aspects of osteopathic medicine, however, are based in some philosophical difference that has yet to be defined by a contemporary DO.
