Osteopathic medicine in the United States

Osteopathic medicine is a branch of the medical profession in the United States. Osteopathic physicians (DOs) can be licensed to practice medicine and surgery in all 50 states and are recognized to varying degrees in 65 other countries.Andrew Taylor Still, 1874Mark Twain, 1901AMSA RECOGNIZES the equality of osteopathic and allopathic medical degrees within the organization and the healthcare community as a whole. As such, DO students shall be entitled to the same opportunities and membership rights as allopathic students.Our AMA, in collaboration with the American Osteopathic Association, discourages discrimination against medical students by institutions and programs based on osteopathic or allopathic training.In their assigned readings, students learn what certain prominent DOs have to say about various somatic dysfunctions. There is often a theory or model presented that provides conjectures and putative explanations about why somatic dysfunction exists and what its significance is. Instructors spend the bulk of their time demonstrating osteopathic manipulative (OM) techniques without providing evidence that the techniques are significant and efficacious. Even worse, faculty members rarely provide instrument-based objective evidence that somatic dysfunction is present in the first place.'We now find ourselves living at a time when osteopathic and allopathic graduates are both sought after by many of the same residency programs; are in most instances both licensed by the same licensing boards; are both privileged by many of the same hospitals; and are found in appreciable numbers on the faculties of each other's medical schools'.The inability to institutionalize research, particularly clinical research, at osteopathic institutions has, over the years, weakened the acculturation, socialization, and distinctive beliefs and practices of osteopathic students and graduates.If osteopathy has become the functional equivalent of allopathy , what is the justification for its continued existence? And if there is value in therapy that is uniquely osteopathic, why should its use be limited to osteopaths?within the osteopathic community, the growth is drawing attention to the identity crisis faced by . While osteopathic leaders emphasize osteopaths' unique identity, many osteopaths would rather not draw attention to their uniqueness.DO schools are currently expanding their class sizes much more quickly than are their MD counterparts. Unlike MD colleges, where it is widely known that academic faculty members—fearing dilution of quality as well as the prospect of an increased teaching workload—constitute a powerful inhibiting force to expand the class size, osteopathic faculty at private osteopathic schools have traditionally had little or no input on such matters. Instead, these decisions are almost exclusively the responsibility of college administrators and their boards of trustees, who look at such expansion from an entrepreneurial as well as an educational perspective. Osteopathic medical schools can keep the cost of student body expansion relatively low compared with that of MD institutions. Although the standards of the Commission on Osteopathic College Accreditation ensure that there will be enough desks and lab spaces to accommodate all new students, they do not mandate that an osteopathic college must bear the expense of maintaining a high full-time-faculty:student ratio.The simultaneous movement away from osteopathic medicine’s traditionally separate training and practice systems, when coupled with its rapid growth, has created a sense of crisis as to its future. The rapid rate of growth has raised questions as to the availability of clinical and basic science faculty and clinical resources to accommodate the increasing load of students. Osteopathic medicine is a branch of the medical profession in the United States. Osteopathic physicians (DOs) can be licensed to practice medicine and surgery in all 50 states and are recognized to varying degrees in 65 other countries. Frontier physician Andrew Taylor Still founded the profession as a rejection of the prevailing system of medical thought of the 19th century. Still's techniques relied on manipulation of joints and bones, to diagnose and treat illness, and he called his practices 'osteopathy'. By the middle of the 20th century, the profession had moved closer to mainstream medicine, adopting modern public health and biomedical principles. American 'osteopaths' became 'osteopathic medical doctors', ultimately achieving full practice rights as medical doctors in all 50 states, including serving in the United States Armed Forces as physicians. In modern medicine, any distinction between the MD and the DO professions has eroded steadily. Diminishing numbers of DO graduates enter primary care fields, fewer use osteopathic manipulative treatment (OMT), and increasing numbers of osteopathic graduates choose to train in non-osteopathic residency programs. An osteopathic physician (DO) is a fully licensed, patient-centered physician. DO has full medical practice rights throughout the United States and in 44 countries abroad. In the 21st century, the training of osteopathic physicians in the United States is equivalent to the training of Doctors of Medicine (MDs). Osteopathic physicians attend four years of medical school followed by an internship and a minimum two years of residency. They use all conventional methods of diagnosis and treatment. Though still trained in OMT, the modern derivative of Still's techniques, they work in all specialties of medicine. Discussions about the future of modern medicine frequently debate the utility of maintaining separate, distinct pathways for educating physicians in the United States. Physicians and surgeons who graduate from osteopathic medical schools are known as osteopathic physicians or osteopathic medical doctors. Upon graduation, they are conferred a professional doctorate, the Doctor of Osteopathic Medicine (DO). Osteopathic curricula in other countries differ from those in the United States. European-trained practitioners of osteopathic manipulative techniques are referred to as 'osteopaths': their scope of practice excludes most medical therapies and relies more on osteopathic manipulative medicine and alternative medical modalities. While it was once common for DO graduates in the United States to refer to themselves as 'osteopaths', this term is now considered archaic, and those holding the Doctor of Osteopathic Medicine degree are commonly referred to as 'osteopathic medical physicians'. Currently in 2018 there are 35 medical schools that offer DO Degrees in 55 locationsacross the United States, while there are 141 accredited MD medical schools. Osteopathic physicians are not evenly distributed in the United States. States with the highest concentration of osteopathic medical physicians are Oklahoma, Iowa, and Michigan where osteopathic medical physicians comprise 17–20% of the total physician workforce. The state with the greatest number of osteopathic medical physicians is Pennsylvania, with 8,536 DOs in active practice in 2018. The states with the lowest concentrations of DOs are Washington, DC, North Dakota and Vermont where only 1–3% of physicians have an osteopathic medical degree. Public awareness of osteopathic medicine likewise varies widely in different regions. People living in the midwest states are the most likely to be familiar with osteopathic medicine. In the Northeastern United States, osteopathic medical physicians provide more than one third of general and family medicine patient visits. Between 2010 and 2015 twelve states experienced greater than 50% growth in the number of DOs—Virginia, South Carolina, Utah, Tennessee, North Dakota, Kentucky, South Dakota, Wyoming, Oregon, North Carolina, Minnesota, Washington.