Letters to the Editor  |   December 2012
Touch—More Than a Basic Science
Author Affiliations
  • François Lalonde, DOMP, MSc
    Department of Kinesiology, University of Montréal, Québec, Canada
Article Information
Neuromusculoskeletal Disorders
Letters to the Editor   |   December 2012
Touch—More Than a Basic Science
The Journal of the American Osteopathic Association, December 2012, Vol. 112, 769-770. doi:10.7556/jaoa.2012.112.12.769
The Journal of the American Osteopathic Association, December 2012, Vol. 112, 769-770. doi:10.7556/jaoa.2012.112.12.769
To the Editor: 
Modern technology—whether exemplified by smartphones, tablet computers, or desktop computers—is rapidly consuming a greater share of our lives. So too is technology redefining the way that physicians and patients interact.1-3 It can be helpful in the health care setting in many ways: assisting in prescribing medication, reviewing and updating medical records, and connecting patients with specialists. However, I fear there may come a day when a physician performs a full online assessment of a patient. When physical contact ends, I am convinced that the patient-physician relationship will end, too. Osteopathic physicians seem immune to this development; after all, assessing somatic dysfunction will always require touch. 
The article “Touch—More Than a Basic Science”4 by Elkiss and Jerome reflects on the importance of the art and science of touch in osteopathic medicine (and, by extension, in allopathic medicine). Relating to the whole body, the MINE (musculoskeletal, immune, nervous, endocrine) system underscores the complex network of the healing touch. I would add that beyond touching, a physician's demeanor, too, contributes tremendously to the relationship with a patient.5 Ideally, a physician should be positive and calm because a physician's touch can transmit stress as well as it can healing. A warm, relaxed, and joyful demeanor optimizes treatment and healing. Perhaps this attitude defines the osteopathic difference? 
As a DOMP—an osteopathic manipulative practitioner—in Québec, Canada, I work exclusively with osteopathic manipulative therapy (OMTh).6 Day after day, I feel my touch emanating through the different layers of my patients' bodies in the manner described by Elkiss and Jerome.1 When I suspect that something is wrong (other than somatic dysfunction) in my patient, I immediately refer him or her to an allopathic physician (MD) for a full physical examination, which may include magnetic resonance imaging or radiography. (Whereas legally, US-trained osteopathic physicians can practice in Québec, none to my knowledge do. Maybe having to take a French examination was too much of a hurdle?)7,8 In contrast, MDs often refer to DOMPs when they feel that their patients need OMTh. I believe that osteopathic medicine as practiced in the United States allows osteopathic physicians to have the best of both worlds: osteopathic and allopathic medicine. And the link between these worlds? Touch. 
It is important to preserve touch, the jewel that defines osteopathy and osteopathic medicine, as one of the building blocks of better patient-physician relationships. As Patterson captured in his editorial, “Touch: Vital to Patient-Physician Relationships,”9 it is time to rethink the role of touch in OMTh and osteopathic manipulative treatment. And, as ever, more research on OMTh and osteopathic manipulative treatment will prove vital if osteopathic medicine is to maintain its historical distinction from allopathic practice. 
Palsson T, Valdimarsdottir M. Review on the state of telemedicine and eHealth in Iceland. Int J Circumpolar Health. 2004;63(4):349-355. [CrossRef] [PubMed]
Kermode-Scott B. Canadian Medical Association launches online health consultations. BMJ. 2008;336(7648):794-795. [CrossRef] [PubMed]
Colias M. Virtual access: despite concerns, more physicians are realizing the value of online medical consultations. Getting reimbursed is another story [blog entry]. Mod Healthc. 2004;34(4):48-49. [PubMed]
Elkiss ML, Jerome JA. Touch—more than a basic science. J Am Osteopath Assoc. 2012;112(8):514-517. [PubMed]
Eckhart T. The Power of Now: A Guide to Spiritual Enlightenment. Vancouver, BC: Namaste Publishing; 1999.
Benchmarks for training in traditional/complementary and alternative medicine. World Health Organization Web site. Accessed September 1, 2012.
Règlement sur les Conditions et Modalités de Délivrance du Permis et des Certificats de Spécialiste du Collège des Médicins du Québec [in French]. Collège des Médicins du Québec Web site. Accessed September 1, 2012.
Canada-USA graduates. Collège des Médicins du Québec Web site. Accessed September 1, 2012.
Patterson MM. Touch: vital to patient-physician relationships [editorial]. J Am Osteopath Assoc. 2012;112(8):485. [PubMed]