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Letters to the Editor  |   April 2009
Intent to “Teach” and Pay to Play in Osteopathic Medical Education
Author Affiliations
  • Jonathon M. Brown, OMS I
    Touro University Nevada College of Osteopathic Medicine Henderson
Article Information
Medical Education
Letters to the Editor   |   April 2009
Intent to “Teach” and Pay to Play in Osteopathic Medical Education
The Journal of the American Osteopathic Association, April 2009, Vol. 109, 211-212. doi:10.7556/jaoa.2009.109.4.211
The Journal of the American Osteopathic Association, April 2009, Vol. 109, 211-212. doi:10.7556/jaoa.2009.109.4.211
To the Editor: I read with much interest the letter in the January issue written by Paul G. Kleman, DO,1 expressing his opinion of current trends in osteopathic medical education. I have great respect for Dr Kleman and for all of the other current and previous osteopathic physicians who have committed themselves as educators in our colleges of osteopathic medicine. However, as an osteopathic medical student, I must take issue with some of his stated views. 
My own journey to osteopathic medical school afforded me the opportunity to explore and consider both osteopathic and allopathic medicine—and to make a career decision that was most in line with my own philosophy of medical practice. 
During my exploration, I was fortunate enough to live in Philadelphia, Pa, which is a bastion of osteopathic medicine where DOs are active in all fields, from family practice to neurologic surgery. 
In his letter, Dr Kleman1 laments what he suggests is a trend of osteopathic medical students pursuing interests in various medical specialties rather than—I assume—preparing to practice in the primary care fields. 
As a result of projected needs in medical care, I can understand the desire of all medical schools, both osteopathic and allopathic, to have their graduates enter primary care fields. However, I simply do not understand why anyone would think, as Dr Kleman1 apparently does, that being “osteopathic” means that one should not specialize. 
Intimately related to this discussion, Dr Kleman1 also describes his experience regarding the current lack of use of osteopathic manipulative treatment (OMT) by many osteopathic physicians. He expresses his dissatisfaction with DOs who eschew their skills and training in OMT and who, thereby, reduce the differences between the osteopathic and allopathic medical professions.1 
However, in my limited time as a member of the osteopathic medical profession, I have not noticed in the four basic tenets of osteopathic medicine that using OMT is a requirement for being a DO. On the contrary, the fourth tenet of osteopathic medicine states that “rational treatment is based on an understanding of body unity, self-regulatory mechanisms, and the interrelationship of structure and function.”2,3 Although the use of OMT, when deemed necessary, is implied in this tenet, OMT does not appear to be a tacit requirement for “rational treatment.” 
A letter written by George Mychaskiw II, DO,4 in the May 2006 issue of JAOA—The Journal of the American Osteopathic Association helps to illustrate my position in this discussion. Dr Mychaskiw4 states the following: 

OMT does not make one an osteopathic physician. A true osteopathic philosophy of practice is a far deeper thing, involving a holistic, patient-centered approach to care and excellence.

 
This statement sums up the role that specialists can play in the modern practice and evolution of osteopathic medicine. 
I find it difficult to believe that OMT must play a pivotal role in the osteopathic trauma surgeon's intraoperative management of a gunshot wound, or in the osteopathic pathologist's classification and review of a tissue specimen. Are these DOs any less “osteopathic” because they approach their chosen practices without the use of OMT? 
To limit the definition of osteopathic medicine to OMT and to imply that the practice of OMT is necessary in all facets of osteopathic medicine does a disservice to the philosophy and clinical practice of our profession. 
The osteopathic medical profession needs practitioners of all stripes to continue to survive and succeed in the modern medical world. Our philosophy is too far-reaching and comprehensive to confine us to being merely esoteric manual practitioners. 
It is a privilege to be educated in the process of becoming a complete osteopathic physician by the faculty at Touro University Nevada College of Osteopathic Medicine in Henderson. I have never once felt that I will be “forced” to use OMT in order to be in good standing with my colleagues. Rather, I am being taught that the philosophy of osteopathic medicine gives me a certain advantage over my allopathic colleagues because it will allow me to serve my patients in a distinct way—regardless of whether OMT is indicated in any particular case. 
Kleman PG. Intent to “teach” and pay to play in osteopathic medical education [letter]. J Am Osteopath Assoc. 2009;109:62. Available at: http://www.jaoa.org/cgi/content/full/109/1/62. Accessed March 25, 2009.
Modi RG, Shah NA. COMLEX Review: Clinical Anatomy and Osteopathic Manipulative Medicine. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2006.
Special Committee on Osteopathic Principles and Osteopathic Technic [sic], Kirksville College of Osteopathy and Surgery. Interpretation of the osteopathic concept prepared by committee at Kirksville. J Osteopathy. October(1953). ;60:7-10.
Mychaskiw G II. Will the last DO please turn off the lights [letter]? J Am Osteopath Assoc. 2006;106:252-253,302. Available at: http://www.jaoa.org/cgi/content/full/106/5/252. Accessed March 25, 2009.♦