Osteopathic physicians emphasize that all body systems, including the musculoskeletal system, operate in unison, and disturbances in one system can alter functions of other systems. By recognizing the close relationship between body structure and organic functioning, the DO has a broader base for treating the whole patient.
DOs follow a holistic, common-sense approach to health care that views each patient in his or her entirety.
Osteopathic physicians not only recognize the interdependence of all parts of that complex machine called the human body, but they also consider the patient's mental and emotional status. In addition, the DO pays attention to the relationship of the patient to his or her home environment, job, and other factors that affect health.
For example, the surgical removal of a diseased gallbladder is a valuable and acceptable practice of osteopathic physicians. However, DOs believe that medicine must be more than an attempt to repair, relieve, or remove the end-product of disease processes. The gallbladder does not malfunction independently; its nerve and blood supply and the chemical balance of body fluids also may be implicated. Besides arresting an acute episode of illness, the DOs underlying concern is to return the patient to a state of optimum health by dealing directly with the internal conditions that caused the disease in the first place.
The holistic tradition of osteopathic medicine is reflected in the fact that a great percentage of graduating DOs enter primary care, where they view the patient as a total entity. In addition, the majority of today's osteopathic physicians practice in smaller towns and rural areas, where the need for primary health care is greatest. Even when a DO becomes a specialist, such as a neurosurgeon, cardiologist, anesthesiologist, or psychiatrist, he or she still sees each patient as a whole person and stresses that illness can have its origin in another part of the body.
This system includes the bones, muscles, tendons, tissues, nerves, and spinal column -- about 60% of the body mass. The musculoskeletal framework, DOs point out, is far more than an anatomical rack on which other organs are hung. It works in concert with all other organs. It may respond -- properly or improperly -- when a breath is drawn or body movement occurs. Besides being prone to mechanical disorders, the musculoskeletal system reflects many internal illnesses and may aggravate or accelerate the process of disease in the circulatory, lymphatic, nervous, and other body systems.
Osteopathic physicians utilize all of the recognized procedures and modern technologies for prevention, diagnosis, and treatment of disease, including drugs, radiation, and surgery. But the DO also has another pair of tools that enable him or her to accurately diagnose areas of dysfunction and treat them effectively: these tools are his or her hands.
Osteopathic manipulation of the musculoskeletal system is a viable and proven technique for many hands-on diagnoses and treatments. Often, it can provide an alternative to more intrusive therapies involving drugs and/or surgery.
Manipulation brings an added dimension to the osteopathic physician's diagnostic and therapeutic armamentarium. Sometimes it is in the form of palpation (touch) as a diagnostic procedure to detect soft tissue changes or structural asymmetries; other times it's in the form of corrective manual forces to relieve dysfunction or restrictions of motion in joints. Because musculoskeletal dysfunction can mimic other disease syndromes, osteopathic manipulation is an important component in different diagnoses as well as a means of correcting structural problems.
It has been well-documented that diseases of the specific organs can produce pain in distant parts of the body. Stomach ulcers consistently cause areas of paraspinal pain and irritation just below the shoulders in the back. The radiation of pain to the loin from a diseased kidney is another typical example as is the reflection of pain and disability to the left shoulder following heart disease. In diagnosing such diseases, DOs recognize that symptoms can be produced without actual disorder in organs to which pain has been referred.
Conversely, disturbances affecting the musculoskeletal system can cause symptoms that simulate the onset of other illnesses. Among the most common causes of recurrent tension headaches, for example, are disorders of the cervical (upper) portion of the spinal column. Consequently, properly applied manipulative treatment, particularly directed to the neck and head, often affords relief of headache symptoms when all other remedies have failed.
The body's own healing power, vis medicatrix naturae, is a main principle of osteopathic medicine and a basic condition of all diagnosis and treatment. Therefore, osteopathic practice is designed to support, stimulate, and, in some instances, initiate the body's trend toward health.
In addition to treating specific health problems, the goal of the DO is to help every patient function at his or her highest level of efficiency. There is a fundamental concern with preventive medicine, proper nutrition, and keeping a patient fit.
DOs pioneered the concept "wellness" 100 years ago. In today's terms, personal health risks -- such as smoking, high blood pressure, excessive cholesterol levels, stress, and other lifestyle factors -- are evaluated for each individual. In coordination with appropriate medical treatments, the osteopathic physician acts as a teacher and guide to help patients take more responsibility for their own being and change unhealthy patterns.
Sports medicine also is a natural outgrowth of osteopathic practice, which focuses on the musculoskeletal system, manipulation, diet, exercise, and fitness. Many professional sports team physicians, Olympic physicians, and personal sports medicine physicians are DOs.
However, it maintains its professional independence in order to sustain and develop osteopathic medicine as a unique and comprehensive system of health care.
Osteopathic medicine plays a distinctive role in the nation's health care delivery system. DOs hold the same unlimited practice rights as MDs in all 50 states; they serve as commissioned officers in the medical corps of all armed forces plus the Veterans Administration and Public Health Service, and they are recognized by the AMA as full-practice physicians.
DOs admit and treat patients in both osteopathic and allopathic (MD) hospitals and clinics. Many DOs and MDs work as colleagues in a range of medical settings, and patient referrals between the two professions are common. Many MDs have DOs as personal physicians, especially for the philosophical concepts and manipulation. Participation in federal Medicare and Medicaid programs is also on an equal basis.
Although osteopathic medicine represents only five percent of the U.S. physician population, it is a fast-growing segment of the health care field. The number of osteopathic medical colleges has more than tripled since 1975.
By combining unique osteopathic principles with traditional diagnostic and therapeutic procedures, DOs offer a balanced system of health care to both prevent and cure disease. In fact, the osteopathic approach is philosophically the only true system of preventive medicine. And by treating the whole person, not just the disease, the DO actively seeks to improve the quality of life of each patient.