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Unified medical profession?

Discussion in 'Medical Students - DO' started by muonwhiz, May 26, 2001.

  1. muonwhiz

    muonwhiz Senior Member
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    Informal poll: Do any of you out there in medical land think that the osteopathic and allopathic profesions will merge as one within the next 25 years? Would you favor such a move (providing that medical professionals would have the option to learn/practice OMM as desired)? Is there any real reason for the professions and the degree designations to remain separate? How does managed care affect your response? We aren't in medical school interviews now, so let it all hang out! Post up here!
     
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  3. Brennan

    Brennan Senior Member
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    A merger eh.
    The MD's would get OMM, and we would get more schools...... unified, we would both benefit by having a larger # of members, which would increase our effect upon legislation.....
    But, what would we be - DO's or MD's.....
    what about our differences in our philosophies?
    would not the public be served better by the current bicameral medical system?...it can act like a checks and balances system.
    And before we think about that should we not work together, or try to, to change some of the current problems?
    Just a little bit of rambling with a few things to think about.
     
  4. muonwhiz

    muonwhiz Senior Member
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    I came up with this because of a discussion at an interview session at an osteopathic school. One of the local DO practicioners was there and said that she believed that professional unification would take place, and that the younger DOs would push for it. I don't know whether under such situation we would be called MDs or not ,but since that is common usage I would think so.
    The question is also whether or not there are any real philosophical differences between the professions anymore. More and more allopaths are learning OMM, and they are also espousing the treatment of the whole person now as well. Is there still a distinct osteopathic philosophy? Are we all but merged now except in name and deed only?
     
  5. bluphilosopher

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    My thoughts: No!
    More than likely the two will never unify with each other. While I do agree they collaborate with each other more and more, you can't look past the fact that there is no reason for unification. Also, all past attempts to unify with other medical organizations by the allopathic community all were more like absorbtion than unification. I don't believe the AOA is willing to sacrifice itself merely for the privelage of nonexistance. Nor does the allopathic community ( I say allopathic community because MD's and MD medical students do not fall under the umbrella of one organization like DO's do) wish to incur the additional headaches of having to regulate and ensure any more than they already have to.
    While I will admit that the two professions are very much alike, there just isn't any logical reason for the two to become one. It sounds good and may in fact release some anxiety from a few. However, the past instaces of both medical professions is too much to ignore. Look to the merger in California as proof alone. I won't go into the specifics, but I will say that the ex-DO's benifited little and were quickly ignored as for as having a administrative voice went. Not to mention, the Osteopathic hospitals suffered greatly from the whole thing. Main benefit conferred: an ego boost.
    Although, the osteopathic/allopathic relationship today is far better than during that time period. An overall merger would only allow a few osteopathic people to feel better about themselves and their ability.
    Of course, there is the residency argument. Couldn't a MD degree increase oppurtunities for DO students to more competitive specialties? Well in my, and only my, opinion I can't see it. In spirit yes, but actuality no. No matter what degree they grant DO schools will still not have any prestige associated with them. Less people care about the degree than the students resume, board scores, and sometimes school of origin. Maybe there could be information spread that correlates the scores between the COMLEX and the USMLE or something? But this hardly justifies a merger. Not to mention the easier oppurtunities lost for DO students in specialties like General Surgery.
    In my opinion, more professional cooperation is the key. Unification doesn't present any point or purpose than to say that we are unified.
    In summary, there will always be different approaches to reaching the same end in all walks of life. And to reinforce what Brennon said, the more varieties of thought that are available the better off everyone is. Try to imagine allopathy with out the holistic approach and osteopathy without pharmacological intervention. Scary huh?

    In good faith,
    bluphilosopher
    PCOM 2005

    PS. my info on the California merger came from "The DO's" by Norman Gevitz.

    PSS. Sorry for the mass unnecessary repitition. I just really wanted to get the point across that there was no logical reason for a merger.
     
  6. Brennan

    Brennan Senior Member
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    I think bluphlilosopher put it quite perfectly. Well said man.
     
  7. Popoy

    Popoy SDN Super Moderator
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    here, here!!!.... well said....

    I suggest reading:
    Osteopathic Medicine: A Reformation in Progress
    by
    R. Michael Gallagher, D.O.
    Frederick J. Humphrey, II, D.O.

    Here's a small quote in their book:
    "Many, including Norman Gevitz, PhD, medical sociologist and historian at the Ohio University College of Osteopathic Medicine, feel that we are at risk of merging by default if either we or those in allopathic medicine feel there are no meaningful differences between us. If we are absorbed into the larger world of allopathic medicine, osteopathic medicine certainly would relinquish its most important role - that of a reform movement. Over the years, osteopathic medicine has developed very successful models for community-based medical educaton in primary care. Now, medicine is benefitting from our experience." (p117)

    "This reformation is not yet complete." (p119)(I took a peek n the last chapter entitled THE FUTURE)

    Okay, I haven't read the entire book yet, but took a small time out to take a peak at the end.... Thought I'd share the quotes above. Later peeps.....
     
  8. muonwhiz

    muonwhiz Senior Member
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    I haven't read this book yet, but it sounds informative. I am having trouble visualizing how osteopathic medicine is an active reform movement today. I agree that at the time developed it was a radical departure from the allopathic norm, but is that truly the case today? Also, isn't alot of the antipathy toward a merger based on past history when the allopaths tried to prevent osteopathic physicians from gaining full privileges- and also a fear of some loss of power because osteopathic physicians are a minority numerically (thus the fear of being swallowed up). If these are the 2 major premises, I would say that those are also based at least in part on ego. I claim absolutely no special knowledge about this subject, but would like to know if there are real scientific or philosophical basis for the continued separation of the professions.
     
  9. turtleboard

    turtleboard SDN Advisor
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    Believe me when I say it would definitely be "M.D." and NOTHING short of that.

    The younger DOs who would push for such a merger or MD-wannabes, to be honest. Unification is a nice thing to think of for those MD-wannabes, but it's not really possible. The AOA is pretty die-hard in its mission to preserve osteopathic medicine, and I think because most of the allopathic world has come to accept DOs as colleagues, there wouldn't be any need to merge. Some may argue that we don't really need two separate, but equal professions but that's the funny situation we've got in the US and that'll be the case for a long time.
     
  10. muonwhiz

    muonwhiz Senior Member
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    An intersting choice of words, with the usage of "separate but equal." I seem to recall some pretty strong language by the US Supreme Court in the case of Brown v. Board of Education about that very subject, opining that there is no such thing as any equality in separateness. And I'm sure that you are right about some of the old and die hard members of both professions clinging to past prejudices. But this is not a topic that can just be blown off by classifying it in the realm of MD- wannabes. The root questions remain: Are there any basic philosophical differences between osteopathy and allopathy today? Is osteopathy now a reform or mainstream movement (it can't be both at one time)? I am not speaking of how individuals practice medicine, I am speaking of the base concepts of the two branches and in education. I don't think that it is insulting to either profession to determine the answers to these. This is not a value judgment on whether either could be said to be "better" in any respect. If there is no current philosophical difference, as has been used to justify separation, is there any other valid reason for having 2 branches of licensed physicians? I think the exercise of pinning these differences and reasons down (if any) is good for the understanding of osteopathy, and is not a threat to it.
     
  11. Brennan

    Brennan Senior Member
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    Turtleboards:
    Most young DO's would not push to be MD's....what would be the point...we are already equal on knowledge, and have an advantage with OMM.
    The Osteopathic physicians are gaining popularity b/c of the narrow minded leadership of the MD's. They started to (not all b/c i do not like to generalize, there is good and bad in everything) forget what the patient needed. We, the DO's offer friendship with care, we are people people Doctors. We look at an individual and say "hey thats a person, to know whats wrong with them, i need to really listen to them". Again, i do not speak for all DO's either, just a majority of whom i know.
    About saying we practice the same...well of course we do... As advances are made in medicine, that are neither MD or DO related, by biochemists, chemistist, microbiologists, and geneticists....should both of us not use the new technologies...or are these things just strictly for the MD's b/c they are the largest group of physicians....
    For example what are physicians without antibiotics....should both of us use them or should they just be for MD's to use...and why?....well if we go by who they were discovered by then that would be, Sir Alexander Fleming, he was niether MD nor DO....
    And just b/c DO's have methods and practices that MD's now find useful, why do we need to merge to make them all one program or as you put it "definitely be M.D.
    No...i dont think so....I think we should keep on sharing idea's and methods. And keep working together to uphold the hippocratic oath and the health of individuals.....Thats what it is all about..Not arguing like kids...your thinking and ideas are narrow-minded and i do not think you will benefit anyone in your life more than yourself.

    that disappoints me....
     
  12. Brennan

    Brennan Senior Member
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    Muonwhiz: refer also to message to turtleboard

    Yeah Yeah Yeah Brown vs Board of Education in Topeka, KS.....I think we have all heard that one. That amended the constitution and repealed the law "Seperate but equal",... in accordance to individuals, not institutions. With Institutions, Seperate but Equal still stands. I think it was Teddy Roosevelt who said a monopoly uses their dominance to exploit individuals and limit competition. And since laws like the Sherman Anti-trust have been used to limit them, why would we merge and create one?
    Our laws insist that there be competing institutions in order to help regulate each other for the common good of our society.
    Our other option could be " yeah lets merge and than become a monopoly"....you know what the government does with monopolies dontcha...they make them public utilities and/or regulate them heavily, yeap thats right a federal controled medical system...hmmm is that what you want? Someone other than doctors controling the health care system and making the calls on what your patients need...
    isnt that what HMO's tried to do...
    No....we/they should work together and give everything we have in a combined effort to make individuals healthy and happy....
    Two organizations working together is better than just one large one....nuff said
     
  13. Brennan

    Brennan Senior Member
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    yeah its me again...i need to ask this..Turtleboard & Muonwhiz......Are you two for or against the osteopathic profession?
     
  14. Dr JPH

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    Just wanted to throw my two cents in...

    I agree with some of the others here when they say that a merger is not only unlikely, it would be pointless.

    Businesses merge when there is a chance that "joining forces" would mutually benefit both parties involved.

    As it lies now, people have a choice. Those who are knowledgable about medicine know they can choose a D.O. either for specific reasons such as OMM or just because of the underlying theme of their medical education and practice.

    Neither school, allopathic or osteopathic, would benefit from a merge. I could only help but think that such an act would cause a greater degradation of medical education in specific areas, such as OMM.

    They key to a stronger US physician base is through mutual understanding and respect of both schools of medicine. I believe that a great deal of this is being accomplished through younger physicians, both MDs and DOs.

    Also, educating the public about both schools of medicine can only help in the growth of the osteopathic profession.

    One final note, Brennan asked whether Turtleboard is "for" or "against" Osteopathic medicine. I have read a great deal of Tim's (turtleboard) posts...more than I want to recall( :D ) . Of all the allopathic students that post here, he is probably the biggest supporter of osteopathy and the mutual respect across all lines.

    Peace
     
  15. muonwhiz

    muonwhiz Senior Member
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    There is no "for or against" the osteopathic profession except in the minds of those who react in a defensive manner to the asking of core questions. You may wish to recheck the Brown opinion, as the institution that was changed in that decision was public education. Also, whether or not the professions are merged as one has little effect on how much the government or corporations control medicine. Physicians have not been in primary control of it for quite some time, but that is another subject. And the issue of control is extraneous to this question. The justification for 2 separate branches has been based on an alleged philosophical difference. If this difference no longer exists, then either the justification collapses or there is another justification. It is always possible to have 2 separate branches even if there is no definite reason to do so, but we should all be clear about which way it is.
     
  16. Brennan

    Brennan Senior Member
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    Josh...you have a way with words....i agree with ya 100%
    turtleboard: much respect is due to you than, i didnt know what ya were.....but i agree respect both ways is best
    munowhiz.....brown..it was segregation....public schools are state intitutions and we are not so a monopoly could exist.....
    power should be shifted to the physicians,and could be with unions (good or bad? who knows), but thats a whole other story and conversation.
    But either way...just b/c their may not be as you like to say distinct philosophical differences anymore...both have leaned towards each other.....doesnt mean they should merge.....i am against it...and thats just my opinion.
     
  17. turtleboard

    turtleboard SDN Advisor
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    Yes there are basic philosophical differences between allopathic and osteopathic medicine. In a perfect world a DO would practice as he was supposedly taught by his osteopathic medical school and an MD would practice as he was taught by his medical school.

    It can be both a reform and a mainstream movement if it's in transition from one to the other, couldn't it? Osteopathic medicine started as a reform movement by Still that failed to pick up enough steam. He went ahead and started another system of practice that, to this day, is still trying to shed its reform roots and become a mainstream form of practice.
     
  18. turtleboard

    turtleboard SDN Advisor
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    Are you kidding me? While I'm sure a certain portion of young DOs really do share your perspective, I'm willing to bet the MAJORITY of young DOs are MD-wannabes and see OMM as an adjunct to traditional practice -- not a distinct advantage over the MD. Read over the old threads in the archive about the changing of the DO degree to DOM or MDO, and you'll understand what I mean.

    Have you been brainwashed? Have you become part of the osteopathic collective? I heard an OMM professor say the same thing at NYCOM one year as an undergraduate, and I thought it was the most ridiculous comment. To suggest that DOs are good because they "listen" while MDs poked, prodded, and basically didn't give a flying rat's butt about the patient shows that perhaps the osteopathic collective have gotten you too.

    If you're going to argue that DOs really do practice differently from MDs, please cite a source and don't re-hash the same rhetoric that's been thrown around DO classrooms for years. Gevitz and many leaders of osteopathic medicine concede to the fact that more and more DOs are practice like MDs. The reasoning behind this is simple: DOs learn to be DOs in med school but learn to be MDs while in residency. Fully 2/3s of DOs will complete an MD residency. Ask the DOs on this board how many of them are or have completed a true DO residency.

    The philosophical differences between MDs and DOs would dictate that their respective practices would be inherently different. The fact that DOs don't practice like DOs and practice more like MDs (read Gevitz again if you missed his comment on this) is a detriment to the osteopathic profession.

    Since I think you're a DO student, would you care to elaborate on the philosophical differences between my evil MD world and your DO world? Forgive my arrogant presumption, but I bet you couldn't.

    Be a little more accurate in your statements. SOME members of the MD community find OMM a useful adjunct in specific therapeutic regimens. What other methods and practices were you referring to?

    I find no need to merge the two professions. You missed my point. My argument was that should the two professions ever merge, the new title assumed would be MD and not DO, MDO, or DOM. The basis for that argument was that too many young DOs today are MD-wannabes, an unfortunate scenario that's been repeated time and again in osteopathic history. Re-read The California Merger chapter in Gevitz's book.

    This is a minor point, but the last time I checked DOs took the Osteopathic Oath and not the Hippocratic Oath.

    What disappoints me is that you, oh righteous osteopathic student you are, have decided to defend your profession in the most unchallenging of manners ever. I am a strong supporter of the osteopathic profession and would love to see it become more than it is because it has that potential. I'm disappointed in the profession because, after 60+ years of building a solid reputation for its practioners, it has decided to lose what made it so unique in the first place.

    If you really think DOs are so unique, good for you. But to be perfectly honest with you, the majority of them don't use the "DO advantage" and the majority don't practice as if they were trained with the osteopathic principles fully intact. Save for the letters that you and I will have at the end of our names, you will be no different in true practice. You will join the Dark Side.


    :eek: :D
     
  19. turtleboard

    turtleboard SDN Advisor
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    Quite the contrary, as I've stated in my previous post.

    What you need to understand is that it's okay to be critical of the profession. DOs have had little advancement in the way of professional practice and development of its philosophy. In order to achieve parity with the MDs they've lost what once made them unique. This came in many ways: the fight to update their curricula to reflect, more wholly, that administered by MD schools, the fight to get DOs admitting privileges at MD hospitals, the closing of most DO hospitals, the push to get DOs into MD residencies, the active recruitment of premedical students applying to MD school. DOs have lost what once made them special. To claim that DOs are special simply because of OMM and some (hand-waving) an impractically applied philosophy is utter crap.

    The only way to have your profession succeed is to force it to become better. To blindly go about this attacking someone who has read almost everything to date on the subject by using nonsense spewed by your osteopathic history professor is a waste of time.
     
  20. bluphilosopher

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    Thanks Brennan. You just put a big ol' smile on my face. Appreciation!!! I love it

    in good faith
    bluphilosopher
    PCOM 2005

    PS. :D
     
  21. bluphilosopher

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    I don't know if Brown is a good example to use in this particular debate. It makes a flawed comparison on very many levels. Basically, segregation was forced seperation for seperation's sake during a child's most important learning years ( for intellectual and social stimulation. Thus, segregation prevented our country from moving forward as a society. The DO/MD thing is more or less a desired seperation. Where the only negatives are in theory, not in practice. DO's have all rights as MD's with similar pay to boot. The issue is there is a good portion ( not as big as it seems, but much larger than desired)who think the grass is greener on the other side. When in fact, to quote a SDN regular whose name escapes me, it's just different grass.
    I will be the first to admit that the two professions have learned much from each other and from other areas of the medical and research communities. Thus, they have become pretty similar. But, I will also say that medicine as it is required several trains of thoght to reach its current level. DO's did have a seperate philosophy and still want to have one. However, it's best for everyone that individual physician, regardless of degree, adopt whatever is best for their particular practice. Ie. An allopathic family physician in a rural community is going to do use the modalities of an osteopathic physician in a similar setting, if its best for his patient. ( Oh, and the training situation that turtleboard brought up is quite true.)
    Also, I'll attempt to be childish for a moment. For every time you say why remain seperate, I'll say why merge. I don't say this to be insulting or anything. It's just that your asking for justification for not doing an action, when there is no justification for doing it. I believe you mean well, but think about it.

    Plus, I would like to add that the allopathic community is not really a community parsay. They're the predominant group of physicians in the US. If there where no DO's we wouldn't be calling them allopaths, a misnomer at best. Each MD is different from the rest, and there is no collective effort for them to establish a unifying identity. In fact it's silly. This would make assimilation very weird, since it would mean that osteopathic physicians would just be accepting defeat in their never ending quest for identification.

    in good faith
    bluphilosopher
    PCOM 2005

    PS. OMM in itself is worth keeping alive and well. It just needs better PR.

    PSS. I should elaborate on my earlier post. The California Merger was a mutual effort that lead to unmutual effects. And still didn't benefit anyone. The absorbtion I was speaking of was other forms of medicine. ( ellectic sp?, homeopathic, etc.)

    PSSS. There's no point in unification. :cool:
     
  22. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    Tim "TurtleBoard" Wu,

    I could not have said it better myself. In fact, one of the weakest aspects (which you lightly touched upon)of DOs & their own concept of 'identity' is that precious few can actually articulate anything beyond what they are instructed to parrot from their DO Hist Professors. Of all the people I have talked about DOs, who we are and where we are headed...the two people who have been able to objectively assess and articulate "What is a DO?" have been MDs...and now you makes 3.

    DOs are awash in paranoia over trying to firmly establish an identity that is "equal; but different" to our MD colleagues. Unfortunately, there has never been any consensus on a cogent definition of "DO" or "Osteopathy"...so, while crusading for recognition, many neglect to have planned out what they will say when asked...Who are you? Nor has it been taken into account that IF something is to be our identifying characteristic, maybe we should all, more or less, have a similar definition???

    What will make me an osteopathic physician allegedly encompasses far more the ability to manipulate or espouse 'DO-speak' when asked a question. Now, are the characteristics that I feel make me "osteopathic" real & substantiable in the context of significantly differing from an MD who embraces the benefit of OMM an an adjuct to therapy? I can't honestly answer that until I have been out there in practice a suffifient amount of time to know...anymore than can any other student, DO or MD. If you claim to know as a student, I feel that you are most certainly simply parroting what you have been told in class...you are not speaking from experience.

    Long & short...DOs & the AOA frequently come across as not knowing who we, ourselves, are and appear to be insecure in our own ill-defined identity. I generally feel that the AOA has fought the "evil MD empire" for so long (and over issues now essentially moot) that they have forgotten how work in peace and cooperation.

    my thoughts...

    ;)
     
  23. bluphilosopher

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    Wow, OldManDave! That's very deep.
    It really is hard to explain what a DO is. Especially for me, since I come from a DO deficient area in the bottom Mississippi.
    In fact I remember reading a book ( MDs DOs: Current Clinical Challenges) which was basically a writeup of a meeting of prominent MDs and DOs to discuss well, current clinical challenges. During the meeting one of the MDs asked the DOs to describe osteopathic principles to him and what makes it unique. One of the prominent DOs responded by saying that he knows that there is a difference but he didn't feel comfortable explaining it. In fact, one DO spent an entire chapter of the book explaining the philosophical differences to the group. My analysis of his presentation.............. I'm still lost but I have a greater sense of a difference as a result.( Also, I know that there is something different about the T10 vertebrae during an appendicitis attack.)
    However, this doesn't bode well for the lay person. In fact, trying to say more than the DO degree signifies a physician with additional training in OMM, which is a bit easier to describe, is bound to lead to wasted effort and a good bit of "quackery" labeling.
    If it was seventy years ago, this would be a mute point. But it's not.
    However, the physicians in the book believed, as do I, that osteopathic medicine is best viewed by its potential. In fact many of the MDs were proposing that OMMs usefullness in lower back problems, could indicate a bit of salvation in cevical dislocation injuries like whiplash. Particulary, the lower costs of treatments and shorter rehabilitation time could save bundles to hospital. Then,the group jointly proposed a large scale research effort from this concept.
    Great!!! But that doesn't help explain. " I'm entering a seperate practice of medicine that used to have a leaning towards its own philosophy, has all the potential to revolutionize medicine as it is practiced in the US, but is coincidentally going through an identity crisis." Not the sort of PR that you want floating around.
    So far I've been succesful describing what I am going to do to my friends back home. And I have gone deeper than MD+OMM to great effect.( Especially when you take into account that me and my friends are a bunch of "ghetto rednecks".) Nonetheless, it can present difficulties. Most noticably, when you have to defend the profession's independance as right now. Your best defense in theory is the normal AOA propaganda. But in practice..... 70 years ago?
    Maybe if the propaganda would adjust to us instead of the other way around. Perhaps we should choose virtues closer aligned to where osteopathy is making positive strides.
    Examples:
    1. More realistic proportion of primary care and community health to specialization ( 60/40)
    2.Greater focus on research( not related to allopathy, but to ourselves and our past.)
    3. Manipulative medicine and its investigative properties. ( OMM is more than treatment)
    4. Family Medicine,Orthopedics, PM&R, and Emergency ( these are osteopathy's strongest specialties but noone ever presents this when recruiting)
    5. Varience between the different schools. (lumping them together is foolish)
    6. Bedside manner, people skills, and humbleness.

    OK. Number 6 is skating on thin ice. But that's something that some of the professors and students won't shutup about. Anyway, there is an inherent danger in presenting our desired characteristics as something DO's have a monopoly on. I prefer just saying what we strive to be and leaving it alone.

    Honestly, I haven't begun medschool yet, so if I am off with my assumptions, then I stand corrected. Nonetheless, I am reading everything that I can so that my knowledge base on what I am going towards is sufficient. Without doubt,I feel that I am aware of a great number of the DO world's strengths and weaknesses, and can't see myself doing the alternative route. ( Never applied. Honest!) Hopefully, when I'm "inside " my thoughts will stay with me and I can be a part of a positive movement for the profession.

    In good faith,
    bluphilosopher
    PCOM 2005

    PS. Say what you want. Brennan is right. Down with unification!
     
  24. prolixless

    prolixless Senior Member
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    What exactly would osteopathic medicine be merging into? After all, allopathic medicine does not really have a well-defined philosophy and this is what probably makes it so adaptable. Basically osteopathic medicine would be merging into a title (MD) and not a new philosophy of treatment. However the problem with this (if it is a problem at all) is that the osteopathic philosophy would be dispersed among the hundreds of other unorthodox philosophies that some MD's practice by (for instance some MD's incorporate acupuncture and eastern philosophies into their practice). And consequently, OMT would probably no longer be a required teaching in med school. A very central and guiding philosophy in osteopathy--namely that anatomy and physiology are reciprocally related--would be lost in the crowd among the many other unorthodox philosophies. Of course if OMT and the philosophy it stems from is nothing but a bunch of hog-wash, then merger would be the best thing that ever happened to the profession. But that's a whole 'nother argument.
     
  25. Brennan

    Brennan Senior Member
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    This argument is sometimes just ******ed.....listen guys A. T. Stills was an MD......and he tried to improve it and came up with OMM....Which is being accepted by MD's for use in lower back pains and ETC ---as stated earlier by someone.....Now think, when he started this do you think he did not want his students to be full physicians or MD's...yes of course he did, but with something a little extra...OMM....so now that there are two systems, so what....why argue...the MD's have always (maybe not now, but in times past) wanted DO's to be radically different in some way and if they were not, then immediately they say, merge your not needed than....Hey maybe we are not that different, so what..the important thing is the patients, and working together to help them....
    I think MD's and DO's should have open residencies for the benefits of both students...There are not that many DO's so it is easier for us to get an MD residency...but think if more MD's wanted an OMM residency...good...that would create more of a demand, which would improve the number of training facilities...like i said both should have options...and if we can work together, who knows maybe we will be exactly alike one day----if thats what benefits our society the most, than so be it....BUT FOR THE LOVE OF WHAT EVER GOD YOU BELIEVE IN QUIT ASKING DO'S TO EXPLAIN THEMSELVES...its rather annoying and petty....we are both physicians, who may or may not have the same philosophies...but who will care for you with every resource we have......
    This is not a cut but a mere reference>>>.... to be honest the term MD has been around longer and there are very many more of them...you know its kinda like Kleenex (the biggest name in facial tissue)...you dont know if you are wiping your nose with a kleenex, you just call it that b/c you are used to it...similiar situation, people may not know if their doctor is an MD or DO...but they are still getting quality care, by the best physicians in the world...I, like probably most other physicians to be, - just want to know as much as i can to be able to help as much as i can.....I applied to one school and one school only for 2 years before getting in (west virginia school of osteopathic medicine), and i did so b/c it is a very good school and considered the best in my state.....and especially b/c it was the only one (the other two being MD) that offered OMM, which i value highly, especially since our state is still very much a state that survives by labor. If you shadowed like i did and seen coal miners and loggers coming in (these men are worked like dogs, till this day), barely able to stand and walk and then see them walk out that door without even so much as a small spasm, you would defend it with a passion also.
     
  26. Brennan

    Brennan Senior Member
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    yeah i know its the osteopathic oath...but i thought that was easier to get the point across by using hipps.......i do admit i just started on this board not to long ago...and even though we bicker, this is damn fun...helps us understand where each of us are coming from......i look forward to years of it ;)
     
  27. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    Here here...that certainly gets my vote!! We, MDs & DOs, are in this for the same goal...why not treat one another in this context?!?!?

    Such sage words of advice!

    :cool:
     
  28. nathan

    nathan Member
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    I was originallly going to skip over this thread thinking that it was going to be just one of the hundreds of MD vs. DO title-weight bouts that occur so often in the SDN-Grand Hotel and Casino. However, since the St. Louis Cardinals couln't be picked up on my cable television tonight, I decided to go ahead and spend the time to read it and quite frankly, I'm glad that I did because you all brought up some very interesting comments, questions, and insights. I'm starting at UHS-COM this year and I chose it because osteopathic medicine suits me and me only. Believe me, I work for a group made up of all MDs. One told me awhile back that if I was a DO cardiologist right now, they would hire me in a wink of an eye. The other group of cardiologists and surgeons at the other hospital in town are starting to do much better than we are- as far as patient load, and guess what- they have quite a few DOs on staff. This particular MD even stated that he wanted his own daughter to go DO. When I was applying to med schools, he asked me when he was writing me a LOR- "Okay, it says here why the applicant wants to go into osteopathic medicine... Do you mind if I write what's the difference?". I know there truly is a difference between allopathic and osteopathic, but none worth arguing and arguing and arguing (you get the picture) about. I found his statement to be pretty cool coming from an older "allopath" that was trained in a top-notch residency and subsequent fellowship. Like I said, good comments. Keep it up. Later!

    -Nathan (UHS-COM '05)

    "Nothing ventured, nothing gained."
     
  29. muonwhiz

    muonwhiz Senior Member
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    To Tim Wu-- you state that there are basic philosphical differences between the professions per above. Are you stating that as a historical fact (which I agree with) or as a present fact (if present, please elaborate the specifics- the generalities of holistic treatment and OMM are now no longer unique to osteopathy).

    To Blue philosopher-- why would a merger with allopathy in whatever form it might take, be a defeat for osteopathy? It isn't a contest. Can osteopathy now define a unique identity (other than historical heritage)? There is an article in the New England Journal of Medicine which can be found at: http://www.nejm.org/content/1999/0341/0019/1465.asp which states this whole issue well. During my interviews at osteopathic medical schools, I asked the panel members (consisting of professors, physicians and students) to explain the present difference in philosophy between allopathy and osteopathy. Not one of them could do it. I would like to know exactly what it is, if it presently exists. If osteopathy can no longer claim a sound basis for differentiation from allopathy, then what is the ratioanle for continuance as a separate entity?
    Hopefully this will not get me accused of being tautomeric as it has in other forums!
     
  30. Popoy

    Popoy SDN Super Moderator
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    Very good points,.... So, does anyone care to share the exact "philosophies" of allopathic medicine?

    The New England Journal of Med article "The Paradox of Osteopathy".... You still a password....I'm sure it'll be an insteresting read.... Thanks for sharing that....
     
  31. Popoy

    Popoy SDN Super Moderator
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    I just noticed something.... You have to subscribe to see the full text of the article.... for $10.00.... yikes!!!
     
  32. prolixless

    prolixless Senior Member
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    Muonwhiz,
    That's a great article and we've discussed it on another thread before. Notice how your question can go the other way also: if allopathy does not differ from osteopathy, then why ought allopathy continue to exist? Because it is the majority branch of medicine is not a very solid reason.

    Remeber that a very central philosophy to osteopathy is that body-structure and body-function are interrelated. From this philosophy stems the practice of OMT. Allopathy does not make this a guiding principle in medical treatment. The few guidig principles that allopathy currently practices by are to do no harm to the patient and, implicitly, to utilize empirically testable medical treatments. But these are pretty broad and perhaps vague guiding principles, and aside from them, allopathy has no explicit philosophy. In the end, the osteoapthic philosophy really doesn't have much of a philosophy to compare itself to.

    With respect to the article, it asks: if OMT and its guiding philosophy is as effective as osteopaths say it is, then why should allopathy continue to exist? And, on the other hand, if most DO's are abandoning OMT because of lack of proof of it's effectiveness, then why should osteopathy continue to exist? They are critical questions that only time will answer for us.

    We can know this much, though: if OMM proves to be an empircally effective mode of treatment, then we would rather have a globally trained physician (e.g., a DO) practicing it rather than a specialist (e.g., DC) who SOLEY knows OMM. And even if OMM is showing little empirical evidence for its effectiveness, and yet a significant number of patients continue to benefit from it (which is probably the way it's going now for osteopathic medicine), then we still would want a physician practicing OMM instead of an OMM specialst (liike many chiropracters and acupressurists) who has no global perspective on health. This reason in itself may be enough to maintain the branch of osteopathy.
     
  33. kidterrific

    kidterrific Senior Member
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    In the osteopathic world, there are two types of people: The purists and the non-purists. The purists believe in the osteopathic philosophy of whole body approach and physical diagnosis and treatment. They have practices that are dedicated purely to OMM and patients go there for OMM only. They believe in the osteopathic principle that DO's are for primary care, rather than specialization, and only during primary care can they perform the duties that are taught to them.

    The non purists aren't like that. While they understand osteopathic philosophy, they simply agree to it and act differently. They practice medicine the way they know how. They only do OMM on their spouses. As specialists, they hardly can take a 'whole person approach' simply because the situation doesn't call for it.

    True, there are allopaths that do the same. However, you must understand that there are purists and non purists no matter the profession, and just because some people don't do it, and others do, doesn't negate the fact that that's what the profession represents. If my father is a civil engineer and he decides to do some electrical work, does that make him an electrician?
     
  34. turtleboard

    turtleboard SDN Advisor
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    Actually what he understood as an MD was exactly what he didn't want his students to become. Read Gevitz.

    It's not the MD community that necessarily requires an explanation of the osteopathic profession, it's actually the AOA and its members who want to be distinct. The MDs have, at least since the late 1960s, embraced the existence of the osteopathic profession and acknowledge that there is a difference although most couldn't put their finger on it. The DO profession is the one with the identity crisis.

    We aren't asking you to explain. You're asking yourselves to explain your profession. Get it straight. It's only MDs who have completely no stake in the profession who bring this up all the time. :)

     
  35. turtleboard

    turtleboard SDN Advisor
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    It's both a historical and a current fact. If there weren't basic philosophical differences between the two professions, to justify the continued existence of two "separate, but equal" medical professions would be futile.

    If a DO was really not different AT ALL from an MD, why are there DOs in the first place?

    Why don't you operate on the idea that there's no difference between our two professions and then explain to me why you're a DO student and I'm an MD student.

    Do I just like the way the letters look at the end of my name? :)
     
  36. bluphilosopher

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    I actually hope not. You have started a very interesting debate. My brain has been whirling with all types of thoughts on medicine in general and what I am looking to begin. This discussion may prove beneficial to many who frequent this board. Anyway, it is possible to have a difference of opinion without confrontation. Isn't it? It's not as if any one of us could unify or prevent unification of the two professions.
    Let me end with a question. Should the two dental "professions" merge into one? Why should there be a DMD and a DDS? Aren't they exctly alike with identical ideals? I ask this not to be a smart aleck, but because I wonder is it possible for the DO and MD world to exist similarly? Maybe the issue is merely perspective of the two and perspective alone.


    In good faith,
    bluphilosopher
    PCOM 2005
     
  37. turtleboard

    turtleboard SDN Advisor
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    Ahh... But while the MD and the DO represents two SEPARATE professions, the DDS and DMD are one in the same and belong to the SAME profession. Those are just two different degrees with NO DIFFERENCE in scope of practice OR philosophy.

    MDs and DOs, on the other hand, supposedly have different philosophies.

    Of course it's possible. In fact that's the case today. But the point of this thread, I believe, was to offer an explanation as to why there are two separate medical professions and to, at least for those participating in this discussion, the continued existence of the osteopathic profession as a wholly unique branch of medicine.
     
  38. Brennan

    Brennan Senior Member
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    Turtleboard.....Did you miss my part about both being physicians, with or without different philosophies......
    and about WVOSM the quote came from Jae Spears a congresswoman, longest elected woman in our state, now retired... from west virginia who was on the appropriations committee that made the school what it is today...
    I read the book, but thats not what i got from it...what i want to know is if stills didnt want his students to be physicians..how did he want them to fully understand the human body?

    Also, you say the MD's do not want us to explain ourselves...but at the meetings i have read about --Its the MD's that bring up the ? ---- i personally think it bothers some of them that they have equals without the precious MD after their name...but i must agree that there are DO's that want to be MD's...and its not for the knowledge..its for the prestige...and those people on both sides that do it for money or prestige, have an enemy right here.
    Now you ask for differences..well if they were exactly the same then i would of applied to MD also...but it was for this certain school (WVSOM) and OMM and the fact that they fully live up to the fact that they train small community based physicians that i chose the school i did.
    But wait...i just looked from where you are from..NY....so its not like your going to understand where i come from...i was born and grew up in west virginia..and community based medicine is really important considering we do not have very many heavily populated areas with big hospitals....

    Hey why are you so interested in DO's anyway?

    Oh yeah and for the reasoning that if they are alike there shouldn't be two...welcome to america baby, the land of the free market capitalists.....the land of more choices than you could want..... if we only have two of something is when you should take notice!
     
  39. turtleboard

    turtleboard SDN Advisor
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    Part of Still's motivation in founding osteopathy was his frustration with the then-current state of medical practice in the US. MDs of Still's time and MDs of today are vastly different, although both are guided by the same philosophical principles. Still wasn't necessarily interested in producing what we call "complete" physicians (MDs and DOs alike); he was interested in producing osteopaths who would find that much of the pathology his practitioners would encounter had something to do with the musculoskeletal system and its interaction with the other organ systems. Being a physician, an MD, is not the only way one can understand all the body systems. Ask any physiologist.

    The greater MD community really couldn't give a fuzzy rat's butt what DOs do, who they are, and where they're headed. A smaller fraction of the MD community, however, takes interest in their DO colleagues and raise questions to challenge the osteopathic profession in helping it build a foundation on which the DOs will advance.

    To not challenge the osteopathic profession and leave it as is will ultimately result in a profession that's ENTIRELY the SAME as the allopathic profession. While some DOs may want that, the continued existence of another profession would be unjustifiable (yes, even in capitalist America).

    Some older MDs who view DOs as inferior physicians are bothered by the fact that DOs continue to exist as MDs without an MD. But these old stodgy fogeys won't have anything to say once the DOs can say, "THIS is what makes us different from MDs" without resorting to hand-waving and catch-phrases.

    Your reasons may be valid, but that's not proof that the osteopathic and allopathic professions are different.

    I became interested in osteopathic medicine as an undergraduate in college. I was intrigued that there was an entire section of medicine whose practitioners could do something to help patients with nothing more than their two hands. I read up on it and have been reading a lot of material on osteopathy and osteopathic medicine ever since. I decided to go to an allopathic school for various reasons, mainly financially related (I go to a state MD school in New York), but have not lost my interest in OMM and certain osteopathic concepts. I also have many, many friends in osteopathic colleges and have taken an interest in their curriculum.

    That may be all fine and dandy for a free-market enterprise (i.e., a business), but unless you're suggesting that medical education is a business venture for some, the same principles don't apply to medical schools. Unless you're opening a med school on an island somewhere, the number of med schools we have today has been clearly thought-out and planned. You don't mean to say WVSOM is a for-profit institution, do you? :)
     
  40. bluphilosopher

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    by turtleboard
    Ahh... But while the MD and the DO represents two SEPARATE professions, the DDS and DMD are one in the same and belong to the SAME profession. Those are just two different degrees with NO DIFFERENCE in scope of practice OR philosophy.

    MDs and DOs, on the other hand, supposedly have different philosophies.

    Actually, I was being rhetorical with my question. I know the two Dental degrees go hand in hand. But listen to yourself.

    Of course it's possible. In fact that's the case today.

    Isn't that similar ( I know not quite) to the dental profession by your own admission. The point I wanted to get across is that maybe osteopathy has come to be accepted as supposed to be vastly different from allopathy. However, it is quite possible for DO's to have a philosophy and treatment modality, yet not have a monopoly on either one. Which is the current situation that we are moving towards.
    The DMD/DDS thing does offer a compelling argument for seperativity. Think about it they are able to be "seperate but equal" without any harm to society. While simultaneously, the two have the ability to initiate different ideas on how to move the profession forward by virtue of being independant. Yet, when they collaborate the whole comes together for a mutual benefit to all parties involved.
    The MD/DO thing is similar to this scenario. Just noone ( particularly the DOs) thinks of the two professions along these lines. Also, unlike dentistry there is a gross size difference between the two.

    In good faith,
    bluphilosopher
    PCOM 2005
     
  41. Brennan

    Brennan Senior Member
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    Hey turtleboard...i think your right when you say most of the concern is with the old foggeys.....what you said is so true...but i think that is the case for both sides....old guys on both sides are dwelling on this way to long......

    Back to justifying DO's.....no i dont think i will, im tired of that already....What it is, is what it is......Why doesn't everyone tru to unjustify the 19 accredited medical schools of osteopathy...they are here, they train good physicians, so why would you tamper with that. Most medical schools get more than enough applicants to fill every spot 10 times over.......if ever the day comes that we have to many physicians, hopefully we can pay to send some to other countries where they are scarce......which leads me to another ? that bothers me....I know this is completely unrelated....but what do you think of the situation where several countries are working towards a one world economic system (mostly NATO countries)...why would we worry about that first..dont ya think we should work towards a one world health care system first.....where everyone has medical within reach?
    just wanted your opinion on that.....even though you beat the DO thing into the ground i think that you are intelligent and honest, and have good answers to some things :D
     
  42. drchrislareau

    drchrislareau Member
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    The Fat Lady has sung, folks. We are a complete and equal school of medicine now. Read about it at http://www.dohealthnet.com/article1171.html. Let's stop obsessing about MD vs. DO. It's as obnoxious as whether Yale is better than Harvard. They are both great schools and allopathy and osteopathy are great schools too.
     
  43. muonwhiz

    muonwhiz Senior Member
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    this is not about "who is better" or other such testosterone laden values, it is about whether a true separate identity does really exist for osteopathy, and, even if it does, is that sufficient to continue as a separte profession. is the public better served by separate professions or by one unified profession?
     
  44. Michael

    Michael Member
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    I don't see why MD's and DO's can't merge. Of course MD's will have to take 2 years of OMT, change their philosophy of care, and switch from MD to DO. No big deal.

    Michael
     
  45. Medic171

    Medic171 Senior Member
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    How could you be an M.D. and a D.O. You practice one way or the other. You believe in MD philosophy or DO. I love osteopathic medicine, I will not need to pretend I am a MD. When I am done, I will be a DO and proud of it. If you do not like it, do not come to my practice If you prefer an MD, go see one; it will not hurt my feelings, I will have plenty of patients.
     
  46. docflanny

    docflanny Senior Member
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    I agree with Michael's points.

    I think that a unification of the medical professions would be fantastic for our future patients if the following contingencies were adhered to:

    1) MD students learn OMM skills for the first two years of medical school.
    2) MD students embrace more of a holistic approach to health care. I concede at least at Michigan State CHM, an MD school, and several other MD schools are working toward.
    3) MD school have their curriculum revamped to highlight the importance of the Neuromusculoskeletal system.

    As a MSUCOM student, our curriculum has significantly more contact hours and clinical exposure than our neighboring school. Many of our colleagues at CHM, MD students, recognize this difference in curriculum and respect the additional effort that is expected of us.

    Therefore, I think it would be great if all physicians learned manual medicine skills, OMM specifically, and had increased exposure to the importance of musculoskeletal dysfunctions that affect a person's overall health and well-being.

    For the record, I don't perceive that unification will occur in the future. I believe that the Osteopathic profession will thrive in the next ten years, by opening new schools and having an increased recognition and acceptance by the public. I hope that most Osteopathic Medical Schools are like my current class at MSUCOM--supportive of the Osteopathic profession and eager to learn OMM skills.

    BTW-a great OMM book that has wonderful diagrams is OMT REVIEW, by Robert Savarese, D.O. ISBN: 0-9670090-0-6
     
  47. Popoy

    Popoy SDN Super Moderator
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    Alright will all that said and done, it seems like the MD's are moving towards becoming more like DO's.... So if there's a merger that will happen (which I agree will probably not occur) why not turn MD's into DO's ;) :D
     
  48. muonwhiz

    muonwhiz Senior Member
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    I have no problem with that, but since the MD initials are more recognizable with the public, it would seem that the reverse would be more likely.
     

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