The American Association of Colleges of Osteopathic Medicine (AACOM) leads and advocates for the full continuum of osteopathic medical education to improve the health of the public. Founded in 1898 to support and assist the nation's osteopathic medical schools, AACOM represents all 35 accredited colleges of osteopathic medicine—educating nearly 31,000 future physicians, 25 percent of all U.S. medical students—at 56 teaching locations in 33 U.S. states, as well as osteopathic graduate medical education professionals and trainees at U.S. medical centers, hospitals, clinics, and health systems.
Osteopathic medicine like allopathic (western) medicine has gone through several ‘structural changes’ since its inception in 1892. The practice of osteopathic medicine started as a vision of A.T. Still, MD. As a practice of American frontier medicine it is based on the tenets of structure/ anatomy affecting function/ physiology of the individual person with medical symptoms. In Still’s paradigm of medicine, disease state was secondary to treating the patient; found within the body was the patients’ own ‘healing’ response. (The immune system had yet to be discovered.) The philosophy was born at a time when pharmaceuticals, even aspirin, had not been discovered and “medications” of the time were mostly detrimental to the patient’s chances of survival/recovery. The osteopathic physician made a physical diagnosis based on touch. Paying attention to the patient’s specific anatomy/physiology while reasoning that through osteopathic manipulation/adjustment we improve the ability to fight disease and improve function. The study of anatomy was key to the reasoning behind disease and health. As an example, the Spanish flu epidemic of 1918-19 killed 50-100 million people world-wide with nearly 1/3 people were infected – the mortality rate (2.5% in the US) among patients treated with osteopathic physicians was significantly lower than those treated by M.D.’s.
Although this philosophy is still pervasive in U.S. osteopathic medical school teaching and training, it has been placed into the background of a fully licensed physician who practices in an enlarging and demanding specialty- driven health care paradigm. Currently 25% of physicians in training (125,000 total) are in osteopathic colleges (31,000). Many practicing osteopathic physicians currently relegate osteopathic manipulation to its’ historic merits without following its original tenets or using any specific manipulation in “treating disease” (cultivating health). In distinction, European osteopathic programs that do not grant full medical licensure, have also grown exponentially and keep the physical medicine priority to patient care. The European system does not, however, train its students to prescribe medication or preform surgery, nor does it provide a full spectrum in the study of disease. There is an obvious advantage and disadvantage to each system of training.
Currently a board-certified medical specialty exists within the practice of osteopathic medicine, neuromusculoskeletal medicine. It emphasizes the importance of simultaneously diagnosing and treating the body with osteopathic evaluation and treatment modalities. Then, based on a treatment plan specific to the patient diagnosis, implementing care. Addressing structural or anatomic variance from trauma, birth, infection, or disease process becomes the priority of neuromusculoskeletal trained practitioner. With the study of anatomy in mind, the practitioner uses anatomy as a specific guide while palpating variations of ‘normal’ tissue directly in the patient. These variances are accessed and altered in real-time through neurologic and muscular ‘feedback’ from the patients’ physical response to treatment. The osteopathic physician skilled in neuromusculoskeletal management is “triaging” tissue changes and anticipates those that affect vascular, nerve, ligament, and joint function. Supporting postural stability that may result from the supportive links of “co-mingled tissues” can be of significant therapeutic benefit and even address some of the bodies’ inherent mechanisms of healing which address manifestations of disease. The practice of Osteopathy is inherently patient-centered, responsive to the individuality within the person seeking medical care. Its vision is not limited to the body, including both mind and spirit. Osteopathic care addresses the nature of the human being who expresses suffering as triune: body, mind and spirit.
The Temporal bone re-assembled after disarticulation of the skull. Anatomy suggesting relationship between form and function.