FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

OSTEOPATHY KEY TO SOLVING NATION'S FAMILY DOCTOR SHORTAGE

[Editor's note: October 9-15 is National Osteopathic Medicine Week. This column is our way of adding to the celebration.]

Question: I've noticed the letters "D.O." after your name in my local paper and that you work at an osteopathic medical school. Could you explain the meaning of these terms?

Answer: Osteopathic medicine is a distinct discipline within the healing arts. Doctors of osteopathy, or D.O.s, are trained to use all accepted methods of treatment and diagnosis including surgery, drugs, radiation and magnetic imaging. There are about 35,000 of them nationwide.

Andrew Taylor Still, a surgeon in the Union army during the Civil War, founded the osteopathic profession. He began the first osteopathic college in Kirksville, Mo., over 100 years ago in 1892. Today, there are 16 osteopathic colleges in the United States. Many of these are state supported, including schools at Michigan State, North Texas and Oklahoma State universities and here at Ohio University.

Question: Are there any differences between what you do and what an M.D. would do?

Answer: M.D.s and D.O.s are similar in many ways, but there are some important differences. The osteopathic philosophy says that the doctor is not a healer, but a facilitator, augmenting the body's natural ability to heal itself. Osteopathic medicine is based on the philosophy that the body is an interrelated whole, that no one part of the body can become diseased without disturbing other parts. The D.O. feels it's necessary to treat the person as a whole, not just the specific organ that may be malfunctioning at the time.

One of the differences between M.D.s and D.O.s is that an osteopathic physician's training puts more emphasis on the interrelationships between different body systems. The muscles and bones together are known as the musculoskeletal system, and the role it plays in health and illness underscore osteopathic precepts. D.O.s use osteopathic manipulative treatment, or OMT, as a means of improving the functioning of the musculoskeletal system and, indirectly, other body systems.

Another important difference is the degree to which D.O.s and M.D.s go into the primary care disciplines of family medicine, general internal medicine and general pediatrics. A 1993 study found that that 57 percent of D.O.s are in primary care compared to 30 percent of M.D.s. The practice gap widens further with regard to family medicine. Forty-eight percent of D.O.s are family doctors, compared to 11 percent of M.D.s. The osteopathic profession is serving as a national model for health-care reform because of its track record of training primary care doctors and because these doctors serve disproportionately in rural and other underserved areas.

Question: What kind of training do doctors of osteopathy have?

Answer: Before being admitted to a college of osteopathic medicine, students are required to complete a four-year bachelor's degree, with specific training in biology, chemistry, physics and behavioral sciences. Once in osteopathic medical school, it takes four more years of intensive study to obtain a D.O. degree.

In our program at Ohio University, students spend their first two years studying such subjects as microbiology, pharmacology, immunology, biochemistry, endocrinology, human anatomy and various body systems as well as having their first patient contacts. In their final two years, students work in hospitals and doctors' offices where they refine their skills in the diagnosis and treatment of a wide variety of medical problems. This fall a group of about 20 students will embark on a "continuum curriculum" featuring small-group case study. This innovative approach will also integrate the basic science and clinical areas of study starting in the first year and extending through the internship and residency years.

After receiving his or her degree, the D.O. will complete a one-year internship. This is followed by two to five more years of residency training most often in a primary care specialty. However, D.O.s can be found in all medical fields from pediatrics and internal medicine to psychiatry and neurosurgery.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.