Osteopathic doctors are happy to share their techniques, but most could stand to receive a little more credit for their contributions. In recent years, M.D.s have gathered scientific evidence that supports osteopathic claims, but often without referencing those osteopathic origins. For example, D.O.s contend that the growing interest in fascia—tissue that sheaths and supports muscles and organs throughout the body—and the 2012 “discovery” of the glymphatic system, which drains waste away from the brain, both correspond to concepts Still described more than 100 years ago. Some osteopathic doctors feel validated by these developments. For others, the sense of disrespect runs deep. My D.O., whom I visited roughly every three weeks prior to the pandemic, teared up when talking about scientists who say that the glymphatic system was “previously unknown.”
In the past decade, professional organizations and academic institutions have begun to invest more heavily in osteopathic research. But at this point, the most compelling evidence for the continued practice of osteopathic medicine are the studies showing that, in certain cases, there’s no significant difference in patient outcomes, whether they’re managed by a D.O. or an M.D. It sounds like a low bar, but Gevitz argues it shows that different patients benefit from different kinds of care. Some people hate touch; for others, it’s restorative. “There are different paths to healing,” Gevitz says, and the opportunity to choose is itself important.
My grandfather died of multiple myeloma in 2014, and a few months later, the meniscus in my jaw dislocated. Achy and tired, at one point I Ubered around Seattle looking for a TMJ specialist until, finally, my mom set up an appointment with an osteopathic physician. As the doctor’s big hands cupped the base of my head, I felt like a time traveler coming home.
Still defined the osteopathic tradition, from its inception, in opposition to the mainstream medicine of his day. It was only natural that mainstream medicine shunned osteopathic doctors in turn, relegating them to their own hospitals and refusing to refer patients their way. But today, osteopathic and allopathic doctors are difficult to distinguish, and the curricula at osteopathic and allopathic schools have largely synchronized, because D.O.s and M.D.s must ultimately pass the same licensing exams in order to practice.
“D.O.s are having an identity crisis,” Gevitz says. “Because who are they? What is the rationale for being a separate profession of medicine?”
The two disciplines are only growing closer. This spring, after years of negotiations, allopathic and osteopathic organizations agreed to sort their students into residency programs through a single, unified competency-based system, which evaluates all residents on six domains, including medical knowledge and systems-based practice. Although the majority of the programs are allopathic, some pursued a special osteopathic recognition, which signals their commitment to continuing education on osteopathic principles and manipulative medicine.