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Letters to the Editor  |   May 2010
The Anachronistic Fight for Osteopathic Distinctiveness
Author Affiliations
  • Eric E. Shore, DO, JD, MBA
    Philadelphia, Pennsylvania
Article Information
Medical Education / Being a DO
Letters to the Editor   |   May 2010
The Anachronistic Fight for Osteopathic Distinctiveness
The Journal of the American Osteopathic Association, May 2010, Vol. 110, 299-300. doi:10.7556/jaoa.2010.110.5.299
The Journal of the American Osteopathic Association, May 2010, Vol. 110, 299-300. doi:10.7556/jaoa.2010.110.5.299
To the Editor:  
For many years, I have read article after article about the desire for and the wisdom of changing the DO degree to an MD degree, or some variation thereof. It has been an ongoing controversy since long before I was in medical school in the 1970s. Even a cursory search in the archives of JAOA—The Journal of the American Osteopathic Association1-4 reveals that this debate continues to rage. 
I have practiced medicine for more than 25 years, and I was trained in both osteopathic and allopathic postgraduate programs. I have also practiced in both osteopathic and allopathic clinical settings. Following are some observations I have made during the course of my training and practice: 
  • Any differences in knowledge, training, or approach regarding patient care between osteopathic physicians and allopathic physicians are marginal at best and would be largely invisible to an objective observer.
  • Although the DO degree designation is essentially irrelevant to MDs and patients who have experience interacting with osteopathic physicians, there remains a profound lack of recognition of DO qualifications and professional identity (eg, “Are you an eye doctor?”) among those with little or no experience with DOs.
  • Unlike allopathic medical training, the training that DOs receive in other countries, including the United Kingdom, is dramatically different than training received in the United States. Most countries do not recognize a DO as a fully competent, fully qualified physician and, therefore, authorities in those countries will not grant full licensure or recognition to DOs. As a result, international opportunities for DOs are limited.
  • Even some allopathic specialty organizations continue to refuse to recognize osteopathic specialties—perhaps to protect their own “turf.”
Andrew Taylor Still, MD, DO, founded the osteopathic medical profession after the American Civil War, at a time when conventional medicine was largely ineffective and the application of the scientific method to medicine was relatively recent. After losing his family to such ineffective therapy, Dr Still began searching for a better way of treating people. His search led him to the use of manipulation as an alternative to the powders, ointments, and rudimentary surgical procedures of the day.5 
We need to ask ourselves the following question: If Dr Still had been able to observe the amazing progress of medicine during the 20th and 21st centuries, would he have felt to need to found a new medical profession? 
Dr Still founded the first osteopathic medical school in 1892, and he decided to award the DO degree rather than the MD degree in order to separate the graduates of his school from the practitioners of medicine that he considered to be ineffective and occasionally harmful.5 Since then, osteopathic physicians have been fighting for recognition by both the public and their allopathic colleagues. After 118 years, “conventional” allopathic medicine has matured into a serious scientific discipline, while osteopathic medicine has become largely indistinguishable from its conventional counterpart. Both osteopathic and allopathic physicians are taught to consider the “whole patient,” not just the disease. Nevertheless, the osteopathic medical profession still finds itself fighting for recognition. 
Perhaps it is time to recognize that the reasons for the founding of the osteopathic medical profession no longer exist—and the need to continue the “fight” is anachronistic at best. Moreover, the government is unlikely to continue providing education funds for two separate but indistinguishable schools of medicine in the United States—the country simply cannot afford it anymore. 
Let's accelerate the process of professional unification by either changing the DO degree to an MD degree, or by awarding both a DO and an MD degree at graduation. With such an action, we would remove any remaining lack of recognition of osteopathic physicians while continuing to emphasize the small but residual uniqueness of our profession. 
Bates BR, Mazer JP, Ledbetter AM, Norander S. The DO difference: an analysis of causal relationships affecting the degree-change debate. J Am Osteopath Assoc. 2009;109(7):359-369. http://www.jaoa.org/cgi/reprint/109/7/359. Accessed May 13, 2010.
Hernandez MB. The DO difference: an analysis of causal relationships affecting the degree-change debate. J Am Osteopath Assoc. 2010;110(2):45-46. http://www.jaoa.org/cgi/reprint/110/1/45. Accessed May 13, 2010.
Bates BR, Mazer JP, Ledbetter AM, Norander S. Response. J Am Osteopath Assoc. 2010;110(2):46-47. http://www.jaoa.org/cgi/reprint/110/1/46. Accessed May 13, 2010.
Boling FW. Discrimination against DOs alive and well. J Am Osteopath Assoc. 2010;110(4):247. http://www.jaoa.org/cgi/reprint/110/4/247. Accessed May 13, 2010.
Our founder. A.T. Still University Web site. http://www.atsu.edu/about/our_founder.htm. Accessed May 13, 2010.