There once was a doctor named Still
Who wanted to cure more than bill
He went out on his own
For the crunching of bone
But retained the scalpel and pill
Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. Assignments in Nome, Alaska, rural Iowa, and suburban Pennsylvania stretched into fall 2015. Since last winter I’ve worked in Alaska and western Nebraska, and taken time to deal with my wife’s (benign) brain tumor. After a moose hunt in Canada, and a couple of assignments in western Iowa, I’m back in Alaska. Any identifiable patient information has been included with permission.
In 1874, Andrew Taylor Still, MD founded osteopathy.
At the time, before the acceptance of the germ theory of disease, philosophical schools divided medicine. Allopaths, the dominant force, felt that illness came from outside the body. Homeopaths felt that illness came from inside the body.
Still felt that illness resulted from a misalignment of the boney elements of the body, but embraced the scientific method and rejected dogma.
Time has marched on. Homeopathy gave rise to our discipline of immunology and our approach to allergies, but in 1954 Hahnemann University School of Medicine officially stopped being a homeopathic school. Mainstream US medicine still calls itself allopathic, but recognizes autimmune diseases and medical problems arising from internal disregulation.
Osteopathy continues, distinguished only by teaching and use of osteopathic manipulation.
Michigan State, my medical alma mater, has programs for MDs and DOs. While I have an MD degree, my class was the first to cross the tracks to get instruction in osteopathic manipulation.
In fact, in my first undergrad career I had a roommate who had had a roommate who had been in chiropractic school, and via that long chain of learning, I acquired the skills to manipulate the spinal column. But I got those skills without the rest of medical school, so that I learned to manipulate without learning when or why or why not. Yet, to the best of my knowledge I never hurt anyone. I got a lot of practice on the young and the healthy.
(Daniel David Palmer, the founder of chiropractic, probably attended Still’s Osteopathic college in Kirksville, Missouri, for a short time.)
Osteopathy along the way evolved an approach to the patient that I find a good fit. The body, a complex system, functions as a unit. Ask why the patient got sick before asking what you can do for the symptom. Maximize the patient’s natural tendency to heal, and do your best not to interfere with it.
I still manipulate, but I recognize those who manipulate better than I do. I like to say that some chiropractors get better results than others, and if I don’t know the local talent pool I say so.
Yesterday I brought my skills into play, got the satisfying crunch so easily as to be humorous, and made the patient better before she left. (And she gave me permission to say more than I have.)
And the same day, I got praise for being thorough, digging through the layers of physiologic dysfunction to figure out the root source of the illness.
Both of those patients benefited from the osteopathic approach, more obvious for one than for the other.
In the 21st century, more and more MDs do manipulation, at a time when more and more DOs leave it behind. And more and more of the non-subspecialist physicians, regardless of training, take a holistic and humanistic approach to the patient as a whole human being.
I saw profit motive build a bridge between the doctors and the chiropractors, when the docs own an MRI and want the business.