"So, You Are a Chiropractor?": Unpacking the Often Unintentional Blows of Unawareness of Osteopathy
Author: Emma Fenske, DO
“What brought you to Las Cruces?” the hair stylist asked my spouse. “Oh, she is in medical school,” my spouse proudly exclaimed. “Great! At Texas Tech?” She shot back. “No, actually at Burrell College of Osteopathic Medicine,” my spouse indicated. “Oh, yeah! They are like chiropractors!”
While this example was fairly benign, it certainly resonated with me and had me considering the worth of my biggest investment: my medical education. Osteopathic medicine is becoming more mainstream and a mechanism for thousands of well-deserving and open-minded students to obtain a medical education and later pursue training among other interdisciplinary professionals, including MDs. As of May 2022, there were 38 osteopathic medical schools producing over 30,000 future physicians into fields where they are desperately needed. Regardless of a rather impressive number of osteopathic physicians produced yearly, there is still stigma, unawareness, and disrespect surrounding osteopathic medicine that can certainly overwhelm the minds of those training and practicing in the field.
What is osteopathic medicine?
Admittedly, I have become well-versed in this explanation since introducing osteopathic manipulation to both patients and those unfamiliar with the field often requires this dialogue. The way that I explain it is that there are two types of doctors that practice medicine: MDs and DOs. DOs practice osteopathic medicine which involves looking at the patient through a holistic lens or as a unit of mind, body, and spirit.” So, what does this mean? Osteopathic physicians can and often will address the root-cause of your headaches. As opposed to solely dampening symptoms associated with them, perhaps considering whether there is a psychosocial or postural consideration to be addressed during that visit so that the headaches can be relieved proactively as opposed reactively. Will osteopaths often reach towards pharmaceuticals when developing their assessment and plan? Absolutely. Though this is just one tool in many osteopathic physicians’ arsenal.
My favorite aspect of osteopathic medicine is the ability to affect both the structure and function of the body to alleviate a patient’s symptoms through implementing osteopathic manipulative medicine. This technique pinpoints “somatic dysfunction” or areas of the body that have gone awry and uses hands-on, often gentle techniques to fix them. As a medical student, I was eager to be a subject to my colleague’s practice sessions as I was inundated with somatic dysfunction myself.
At the end of the day, osteopathic medical students have a mirror-image curriculum of allopathic medical schools, as evidenced by similarities in board exams outlined by the National Board of Osteopathic Medical Examiners (NBOME) and National Board of Medical Examiners (NBME). As the name would suggest, the difference in examination largely lies in the incorporation of osteopathic principles. After four years of medical school, osteopathic students will also enter the NRMP among other medical students in the country, both MD and DO, to apply to residency programs in their specialty of choice.
Is There a Problem?
So, in medicine where structures are often innately hierarchical based on your level of training, where do osteopathic physicians lie? The answer is at similar positions as their allopathic counterparts. In many residency programs, whether MD or DO, residents make the same amount, have the same benefits, and undergo the same training with identical challenges. Regardless of this, due to a lack of unawareness, DOs are often met with less respect than MDs and are targets of insensitive clothing advertisements or labels such as “off-brand doctors.” Some companies marketing also delineates between MDs and DOs, placing osteopathic trainees and physicians after that of their allopathic counterparts or feel the need to delineate the two by stating “which is better.”
Addressing the question at hand, oftentimes there is tension surrounding the training of osteopathic physicians and credibility of their practices. Along those lines, the biggest blow in many instances can be after investing both extensive time and finances into an education, later having that very education and training come into question. Comparing MDs and DOs is like comparing a traditional coffee pot and a french press: they both provide coffee for the user but take different routes to getting there. Moral of the story being that there is no one correct way to get to the end goal and as physicians, being a product of our experiences justifies just that. Medical students learn that there are different “styles” to practice medicine and they may correspondingly see their attendings approach a problem in different ways. That being said, osteopathy has grown exponentially over the years and advocacy for the field remains steadfast. Needless to say, like most things deserving attention in medicine, it will take time to see considerable change which starts on an individual level.
Where Do We Go From Here?
Undoubtedly good things take time, though there is no justification for sitting back and waiting for good things to come. Whether you are a patient, MD, DO, or other healthcare professional, approach any doctor with an open mind. Let their experiences permeate patient interactions and healthcare outcomes. Preconceived notions about professionals in medicine should be checked at the door since at the end of the day, our biggest goal is to help our patients, the reason we entered medicine in the first place. So no, osteopathic physicians are not chiropractors or “off-brand doctors” or lesser than, but another provider invested in the well-being of their patients through a slightly different approach.
About the Author: Emma Fenske, DO, is a current internal medicine resident at Oregon Health & Science University. She has a passion for medical education, patient advocacy, and narrative medicine. She is an avid motorcyclist and runner, currently training for her first marathon. In her free time, she is likely wrangling her near-basketball team of dogs, trying breweries around Portland, or eating something healthy.
