Osteophathy

The big picture. Where the two schools of medicine differ is in philosophy. Doctors of osteopathy "treat people, not just symptoms," says Karen Nichols, dean of the Chicago College of Osteopathic Medicine. "The course list looks exactly the same, but the M.D.'s focus is on discrete organs. The osteopathic focus is that all of those pieces are interrelated. You can't affect one with out affecting another." That means paying more than simple lip service to the idea of the "whole" patient: It means that diagnosis and treatment rely on an examination of a person's environment and family and general situation as well as his or her body. Not surprisingly, about 65 percent of the nation's 52,000 licensed osteopaths (by comparison, the country boasts at least 900,000 M.D.'s) are primary-care physicians. The American Association of Colleges of Osteopathic Medicine has a description of osteopathic training, as well as short profiles of 20 schools, at www.aacom.org. The D.O. programs and their contact information are listed in the directory section of this book.

Besides their other medical studies, osteopathic students get 200 hours of training in "osteopathic manipulative medicine," a hands-on technique for diagnosis and healing. Limited motion in the lower ribs, for instance, can cause pain in the stomach that seems a lot like irritable bowel syndrome. Identifying the muscle strain in the ribs through manipulation, and then treating it, can relieve the stomach distress. An osteopath learns to apply specific amounts of pressure on a body part, attempting to relax it or stimulate it. While such an approach might have raised eyebrows in the profession a decade or two ago, these days almost no one--except perhaps the crustiest old M.D.'s--dismisses it as New Age nonsense. Manipulative medicine is based on the not terribly heretical idea that structures in the body influence function, and that a problem in the structure of one body part can cause problems in the function of other parts.

Nichols cautions students not to think of D.O. schools as a fallback plan. Some accept a greater percentage of applicants than do M.D. schools, but others are just as selective. And all D.O. schools are searching for a particular kind of person. "Students have to understand--the osteopathic schools are not looking for people who couldn't get into M.D. schools," says Nichols. "I want