Osteopathic Principles and Philosophy?

[Lexmark]

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Could someone tell me plain and simply what the Osteopathic Principles and Philosophy are?

 

[DoctorInSpace]

The principles and philosophy are the basic core beliefs of the profession, which originated from AT Still. It includes things such as: the body has the innate ability to heal itself, the body is a functional unit, optimal health is optimal functioning. It also includes the philosphy behind the actual practice of osteophathic manipulation. Each technique has "medical philosophy" behind it.

I hope that helps a little bit. I'm sure others will add their thoughts.

 

[Adapt]

Lexmark,
If I remember correctly you are a 3rd year DO student and as such should already know this. What is the intention of your thread?

 

[Lexmark]

Correct. I am a 3rd year DO student. I'm currently doing a rotation at a clinic that has a mix of MD's and DO's. The clinic is owned by an osteo physicians group. In various places posters are displayed that outline the aims of the group / clinic. One of these aims is to adhere to osteo principles and beliefs - the poster doesn't say what these are, and there is no difference between the way the MD's and DO's work in the clinic.

We are all familiar with various offerings from the AOA but I realized that if someone asked me that I had no idea what osteo beliefs really are.

Quite simply, I have yet to hear an answer that has any validity - consider the AOA's ideas:
(1) "whole person" approach to medicine - no more or less than an MD.
(2) focus on preventive health care - ditto.
(3)emphasize training students to be primary care physicians - ditto, and not that's not true anyway.

And, according to the AOA "Osteopathic medicine is a unique form of American medical care" - well, how so?

So, my intention is to see if someone can state what osteo beliefs are without sounding like FM, without sounding off-the-wall.

 

[DireWolf]

The reason you can't find a difference is because there is no difference. The only thing different is OMT. And that's not a philosophy, it's manual medicine- nothing more, nothing less.

 

[Lexmark]

Swandive - all that test taking and you still haven't learnt the basics - read the question then answer the question.

Anyway, shouldn't be too difficult as you seem to have access to "TONS of literature on these subjects written by many brilliant DOs"

So, why don't you look them up and educate us both?

>>What school do you go to?
- CCOM

>>Do they teach OMM there?
- I'm sure they think so.

 

[Cowboy DO]

Lexmark,

I'm not sure what you are asking. If you are asking how is a good way to explain the philosophies to someone DoctorInSpace stated it pretty well i thought. Or is it that you truly dont know?

 

[Lexmark]

CowboyDO,

Let me paint you a scenario ... patient asks you what DO is - how do you respond?

To say "It's the same as an MD except ..... " simply acknowledges that MD is the gold-standard. To start talking about Dr Still will simply confuse and avoid answering the question. To talk about OMM will make you sound like a chiropractor.

If you ask someone to explain MD, RN, PhD, DMD, or the work they do, I think they could do so within a minute. Within that time you would have a reasonable understanding of what they are / do.

I'm looking for a simple and straightforward response to what is a simple and straightforward question. As I said earlier the AOA states "Osteopathic medicine is a unique form of American medical care". A response should reflect that.

You ask if I truley don't know. I admit that I like to play devil's advocate but reading the poster made me realize that I don't really have a clue. The point of this post is that I don't think anyone else does either.

And, if that's the case .... well, I think we all know what that means.

www.eastoftheweb.com/short-stories/UBooks/EmpNew.shtml

 

[H0mersimps0n]

I think it's intriguing how your sample response includes "like an MD but..." because it really shows your true perception of what osteopathic medicine is: you think of yourself as a MD-wannabe...

If you understood, which clearly you don't but it's good you came to us, what profession you are a part of you would be able to intelligently respond:

"Well, we are physicians that decided traditional medicine wasn't quite hitting the nail on the head enough for us and needed perspective beyond a textbook when it came to patient care. In addition to recognizing the need of treating the patient and not merely focusing on the disease, we learned physical manipulative therapies which can be used with medicines to help your body maintain it's alignment and functionality..." (not perfect but it's a start- other's surely will elaborate)

Notice how I refrain from using BUZZ words like MD, chiropractic, alternative, homeostasis, the whole person (meaninless to lay), etc. which people will tend to focus on and tune out the rest of your quick speech.

You make it sound like CCOM has lost it's roots and I'd be interested in hearing from other CCOMer's before I judged them as so.

Maybe you just serve as an example for that other post floating around on reasons to go to class?

I'm sorry you missed the point of the first two-years of your education, I don't mean to be offensive and also hope to get to the bottom of this...

 

[Lexmark]

HomerSimpson,

At last a genuine attempt. Thank-you. And it was going so well until "maintain it's alignment and functionality" - remember, I said nothing too off-the-wall. What sort of response do you think that phrase will elicit? Eyes glazing over ... pointing and sniggering? Make those sorts of comments and the patient might request that you no longer see them - I was on a rotation where that happened.

As for CCOM and it's roots etc. I have had a reasonable amount of exposure to visiting students from other COMs. Quite frankly, CCOM seems to do a pretty good job compared to some of the stories I have heard so far.

What would you suggest CCOM (or any other school) should do to maintain it's osteo roots? The first 2 years was basic science with 3 hours of OMM a week. Most students treated OMM like any other class - just take it and pass. There was no attempt to instill an osteo philosophy - the OMM department stood alone and was not integrated into other departments.

If your view is correct, them shouldn't we see more DO physicians using OMM? Take a look at the OMM usage survey in this months JAOA.

 

[H0mersimps0n]

Lex,

Typically I would follow that statement up by mentioning one of my favorite (and what I believe is most effective) OMM techniques as an example, usually because I can explain well what I understand and like the most...

Such as Pedal Pumping:

It's very easy to explain to a person that there is a "hose-like" tube that runs up and down the inside of your spine and by laying you on your back and pushing at your feet you can actually use the weight of your belly to pump that bad fluid out of the hose

Explain to them any muscle energy technique and even demonstrate, of all the techniques that probably has THE most clearly-seen results...


And to answer your question about why the dec # of OMM use (speculation):

1.) The field is finally beginning to open up (give or take 10 years), freedom to practice in the specialities is appealing and attractive to many new-comers to the profession where before it used to take real-go getters to go after those speciality residencies- it's preceived as much easier now. In turn, it's hard to use OMM on an every day basis as a DO radiologists.

2.) It's not cheap to become a physician. No matter how many times I punch the numbers through my calculator there is just no way to live comfortably as a FP making $70-90k (which after taxes and malpractice in some states is squat) when I'm leaving school with $215,000 debt (about $2500/month loan payment)... Hello speciality and goodbye OMM (at least in my practice)...

sad but true...

 

[million]

IF I HAD A NICKEL FOR EVERY TIME A PATIENT ASKED WHAT IS A D.O. , RIGHT NOW I WOULD HAVE TEN CENTS. WHETHER YOUR AN MD OR A DO , YOU ARE A DOCTOR, AND THAT IS HOW YOUR PATIENTS WILL REFER TO YOU.

 

[DOSouthpaw]

Guys, the thread was about OPP and not about the difference between MD's and DO's. The functional difference between the two usually is OMT, but that is not what OPP really is. OPP is a set of Principles and a philosophy that is unique to Osteopathic Medicine (that does not mean that MD's can't buy into it) but it is unique to Osteopathic Medicine because we offically (at least the AOA) say that we hold to the Principles of Still that:

1) The Body is a Unit
2)Structure and Function are Inter-related
3)The Body Possesses Self Reg. Mech.
4) Rational Therapy is based on 1-3

Usually this means that we do OMT. But Dr. Still did not come up with these Principles, but rather, later Osteopaths came up with them as a synopsis of his writings. Dr. Still had a more philosophical view of medicine, it was vitalistic in nature. That's why his writings are full of references to God, Nature, the Master Architect, etc. Most DO's today aren't philosphically minded, but rather just want to be docs. Some are, an example is Sutherland, and then Becker, and then Fulford. Some of these guys took Osteopathy to the next level by trying to find, like Dr. Still did, a higher truth to what they were doing. Some of what they believed I believe, and some I so not because that is what Philosophy is, the study of truth. Still wanted us to keep "Digging on" to new and greater things and always admire the Creation and it's Creator.

If you want it delve into it a little deeper, I suggest reading some of Still's stuff, also, "Contribution to Thought" by Sutherland, and then some Becker. As far as people who are alive that are into the OPP, look to Dr. James Jealous and Dr. Paul Paulus (who used to be the editor of the Osteopathic Philosophy Journal Inter-Linea).


Also, for Homersimpson, I sugest you read the Scott Memorial Lecture by Dr. van Birskirk in the latest edition of the AAO Journal, it will brighten your day as far as intergrating OMT into your practice; it sure made me happier!

Have a good one y'all!

 

[Goofyone]

Originally posted by Lexmark
Could someone tell me plain and simply what the Osteopathic Principles and Philosophy are?

Here's an honest attempt, Lexmark. BTW, I don't think you are stupid for asking this because I think most DO students only know the conditioned response using buzzwords that don't really mean anything (i.e. holistic, structure-function, etc). Also, I think everyone was hard on you. I agree with what you say. Maybe you don't know how to explain it but at least you are thinking about it and not trying to give some canned answer.

This is a typical conversation that I've had with my friends, and have envisioned myself having with my patients in the future, should they inquire.

STEP 1
Patient: So Dr. Goofy, What is a D.O.?

Dr. Goofy: Well, a D.O. is a physician who has earned the degree "Doctor of Osteopathic Medicine" instead of "Doctor of Medicine." We are trained both in medicine and in using our hands for diagnosing and treating certain problems.

STEP2
Patient: So does that mean you're not a medical doctor?

Dr. Goofy: Strictly speaking, no. They are different degrees, but our training and certification is so broad (like a Medical Doctor) that we are qualified to go into any specialty and treat all diseases.

STEP3
Patient: Oh, ok. Well, I heard something about Osteopathic Principles and Philosophy; what is that?

Dr. Goofy: It's basically the idea that when one part of the body has something wrong with it, the rest of the body will be "not quite right." For example, think about the last time you had the flu--even though the infection was just in your lungs and airway, your whole body probably felt bad, right? Your muscles probably ached, your head hurt, and you were very tired. Well, osteopathic physicians are trained to address ALL of these problems. Sometimes we might use our hands to do this, which we call OMT--osteopathic manual therapy.

This usually answers the questions right here. But some people ask:

Patient: I get it now. So, how are you different than a chiropractor?

Dr. Goofy: Well, one thing we have in common with chiropractors is the fact that we both use manual therapy. But D.O.s are also trained in medicine, and use standard medical treatment. We may use manual therapy to help, especially if what you have is mostly a problem with your bones or muscle. On the other hand, a chiropractor is not trained in medicine, so they are not qualified to treat all diseases or go into medical specialties. Also, some chiropractors believe that all diseases are caused by physical abnormalities, and can be cured by manual therapy--which D.O.s do not.


I think that's a pretty straightforward explanation, don't you all? That's my approach. 🙂

I think this works a lot better than trying to downplay our training and say something like "We're like M.D.s that use manipulation too." If you're enthusiastic and confident in your response, it looks better for all of us (even if we are just MDs that use manipulation).

 

[Claymore]

Originally posted by DOSouthpaw
Guys, the thread was about OPP and not about the difference between MD's and DO's. The functional difference between the two usually is OMT, but that is not what OPP really is. OPP is a set of Principles and a philosophy that is unique to Osteopathic Medicine (that does not mean that MD's can't buy into it) but it is unique to Osteopathic Medicine because we offically (at least the AOA) say that we hold to the Principles of Still that:

1) The Body is a Unit
2)Structure and Function are Inter-related
3)The Body Possesses Self Reg. Mech.
4) Rational Therapy is based on 1-3



Hello, another CCOMer here to help out Lexmark, who I think posed some good questions. With regards to the above mentioned "philosophies", how do practicing these beliefs differ from the allopathic way of thinking? Or more importantly, how does holding these so-called "unique" beliefs change the way you treat your patient? The only thing that stands out to me is if you use OMT, then yes, you may be treating pathology in a unique way. But are you going to prescribe some different drugs, or perform a different surgery because you believe "the body is a unit"? What does that mean, in terms of clinically relevent outcomes? And how is it different from modern allopathic medicine?

The bottom line, in my opinion, is that the osteopathic philosophies may indeed be true, but unless you are practicing OMT, I don't see how they differ from the allopathic way of treatment.


MS-2
Midwestern University-CCOM

 

[EastCoaster78]

I believe this is what you're looking for...


Osteopathic Philosophy

 

[Lexmark]

EastCoaster78,

Thanks for the reply, but that's exactly what I'm not looking for. When someone (a pt for example) specifically asks me what a DO is or what are osteo P&P then I need a concise straighforward answer.

I can think of answers for the difference between a chiropracter and physician, a OT and PT, a NP and PA.

If a difference really exists, as the AOA maintains it does, then a straighforward answer should be available. I can't even see a good answer on the AOA website.

I have done rotations at ACGME programs where there was a 50/50 mix of MD/DO residents. In terms of working and attitudes there was no difference.

When I rotated at the osteo hospital the H&P had an OMM / musculo component - 99% residents and students blew that section off - we have had an email telling us to ensure that section is filled in - obviously most people don't think it's important but the department wants it filled in as it was an osteo hospital.

It's starting to look to me as if a DO is simply a medical degree - nothing more, but sometimes less.

 

[H0mersimps0n]

- Take 2 *click* -

I think you're looking too hard for this huge banner flying around somewhere to help you see the difference between MD and DO's.

If you can't understand the difference between a FP DO using OMM to treat a patient and an FP MD not and being able to explain that no one can help you...

BUT, if what's eating at you is how exactly the osteopathic principles and philosophies make us different from our coherts, then maybe I can offer a few examples as to how the DO P&P emerge and differ from MD non P&Ps.

For the slight majority of DO's who have subscribed to osteopathic P&P I don't think you'll see the difference because it is so subtle. A main example I can think of is a simple physical examination of the patient. If the body is a unit and the patient complained of tooth pain or foot pain would you tunnel your energy directly at that spot of the pain? Would you stop and think twice about muscles? bones? fascial connections? viscerosomatic DDX's? Can you see the DO's thinking that more than the MD's? no. why, because IT'S A PHILOSOPHY, a way of life and just for things to be true doesn't mean they are seen. True it makes them harder to explain but if anything fall back on the classic medication example: SOME DO's will prefer to use the minimum dosages within the protocals and treat the patient psychologically (imagine that, sitting and talking with a patient) in the process allowing the bodies natural healing processes to go hard to work. The mind is a heavily underestimated tool for healing, don't believe me go watch a patient die that wants to die and then watch a patient fight the odds and come out on top. It doesn't always happen that way but it's pretty incredible watching and helping people fight mentally when the physical battle is near over.

I'm having a hard time answering your question so if any of the babble I mentioned above even comes close to what you're looking for pluck it out and let me know if I can delve deeper into answer your questions...

Good luck

 

[dollarbincommon]

Nobody in my family knows what a DO is after explaining it to them. So I came up with an answer. I just wanted a simple and straight-forward answer. If anyone can tell me if this is all right or needs tweeking.

>There are two types of medical degrees in the US: DO and MD. The difference is just the curriculum of the medical schools.

>But why two instead of one? because the USA is rich and can afford it.

 

[H0mersimps0n]

I'll admit my responses aren't the best ever, but PLEASE, I beg you PLEASE at least read Gevitz book before your first interview. I had the fortune of going to a University that offered a history of medicine course (allopathic medicine) and I wrote my paper for the class on the parallels and differences of the development of the two medicines. Taking that course and reading that book were the best things I could've ever done to prepare for admissions and my career. Do your family a favor and buy the book for your family members too..

The reason osteopathic medicine came about was 1000% NOT because we are a rich country and have nothing better to do..

THere is a strong historical correlation with allopathic medicine of the late 19th and early 20th century doing more harm than good and this occured around the time when AT Still was discovering the hidden secrets of the body.

That attitude and EDIT: misinformation is the kind of stuff that will kill you in an interview. Hopefully admissions committee's will see right through that kind of ignorance about the field and your lack of true desire to understand the field and enter it... Luckily it looks like there's still time for you...

 

[DireWolf]

I came to my interviews armed with the knowledge of how good Guinness is and how the Cardinals could improve their pitching staff. Got accepted to every D.O. school I applied to. Bottom line - learn a few lines of info and relax.

 

[H0mersimps0n]

...or you can skate through life representing yourself and your profession poorly...

both work

good luck

 

[bigmuny]

Homer,
The word you are looking for is "misinformation." There is nothing that perpetuates the myth that we are not that bright more than misuse of the english language. However, you could just skate by your whole life....Isn't it fun to be condescending?

 

[H0mersimps0n]

Hey, I'm just trying to defend and encourage the autonomy of osteopathic medicine. I don't see you helping the effort. If, as a whole this profession decides they want a merger (official or unofficial) I'll just ignore threads like this in the future.

But when people post that they care very little about being informed eats at me a bit and a misspelling indicates little more than lack of spell checker than being condescending about being informed about osteopathic medicine. Show me an MD that's never made a single spelling error. If you don't like what I'm saying then out with it, don't be hypercritical about my grammar that's not going to get anyone anywhere and just starts fights.

 

[DireWolf]

Originally posted by H0mersimps0n
...or you can skate through life representing yourself and your profession poorly...

In the future please refrain from attacking my character. You don't know me from your own ***hole. The statement accusing me of representing myself poorly is ignorant.

The statement about me representing my profession poorly is also ignorant but more fair. So I will kindly rebut.

The belief that osteopathic medicine is truly unique when compared to allopathic medicine is ridiculous. On paper there are philosophical differences that we can debate ad nauseum. I can lecture on the Philosophy of Osteopathic Medicine, while an allopath can lecture on the Philosophy of Allopathic Medicine. On paper there is a distinct difference between the two philosophies. However, when you step away from the philosophical world and step into the real world, the difference becomes miniscule at best.

When I applied to medical schools I didn't discriminate between allopathic and osteopathic. I got accepted to three MD schools and five DO schools. I chose my particular school because I believe it to be the "best" school that I got accepted to. It didn't matter whether it was MD or DO. And it shouldn't. I would be in an allopathic school right now had I not gotten waitlisted at my number one choice. And I am 100% certain that I would have graduated as the same physician that I will at my current school.

Did I enter osteopathic medicine ignorant of the philosophy? No. My family doctor for the past 13 years is a DO, so I was familiar with OMT. But does he treat me "differently" than any of my other doctors? Of course not. A physician is a physician.

When we graduate medical school and work along side our allopathic colleagues, do you honestly believe that your approach to the patients is going to be unique? I frequently discuss these issues with my friends in allopathic institutions. We are all learning the SAME stuff here. It's not like the osteopathic schools are teaching this secret approach to medicine that makes us unique.

The only tangible difference in the "real world" of medicine is the use of OMT by osteopathic physicians. While this tool is unique, it is nothing more than manual medicine. It is a tool that MDs can learn as well.

As far as defending and encouraging oseopathic medicine- there are several ways to do this. Personally, I plan on getting into the best residency program that I can. I plan on working my *** off and learning the skills necessary to be the best physician I can. That is how I plan on "encouraging" the profession.

As far as merging, that is the smartest thing you've said. The differences are so negligible that the two institutions should merge. The AOA can't survive without the AMA anyway. We don't even have enough residency spots to cover all of our graduates. They keep opening up DO schools without increasing the quality and quantity of our training programs. We should be focusing on building better programs rather than blowing hot air trying to tell everyone how unique we are.

As I stated before, the reason Lexmark can't find a difference is because there is no difference. The only thing different is OMT. Is it a useful tool? I believe it is. However, that's not a philosophy, it's manual medicine- nothing more, nothing less.

Adios.

 

[H0mersimps0n]

yeah, I've seen your posts and read your thoughts on the profession which is why your original statement upset me (nothing good to say don't say anything at all- I'm guilty too)...

Your response and points are good, I guess we're arguing the impossible-to-answer-question...

I agree to disagree- I think there is "a" difference, big or small...