Introduction to Osteopathic Medicine for Non-DO Faculty: What Makes an Osteopathic Education...

Introduction to Osteopathic Medicine for Non-DO Faculty:

What Makes an Osteopathic Education Different?

Educational Council of Osteopathic Principles

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19th Century America

Age of Heroic Medicine Rise of Allopathy

Phlebotomy

Medicinals

Surgery

Founding of American Medical Association

1847


Becoming a Physician in 19th Century America

Attend medical school

1760 William Shippen, Jr. lectures on anatomy in Philadelphia

1765 Morgan funds first U.S. medical school in Philadelphia

1790 medical journal published in New York

Set up practice

Generally richer patients

More urban practice

Apprentice with a registered/ licensed physician

One – several years

Learn medicinals, midwifery, surgery

Mentor would sign statement

Sometimes involved test,sometimes just mentor’s statement

Set up practice

Common people as patients

More rural practice


19th Century America

Reactions to Age of Heroic Medicine

Alternatives to Contemporary Medicine:

Thompsonism

Grahmism

HydroTherapy

Lightning Bone Setters

Chiropractic

Homeopathic


A.T. Still, MD

Rural farmer, hunter, inventor, local politician

Civil War abolitionist

Personal tragedy 1864

Denounces medical treatment

Becomes a medical reformer


June 22, 1874

Flies high the banner of osteopathy.

Relocates to Kirksville, Missouri.

PATHYPATHYOSTEOOSTEO


May 10, 1892

Obtains charter for the first school. American School of Osteopathy (ASO)

“To improve our systems of surgery, midwifery, and the treatment of diseases in which the adjustment of bones is the leading feature of this school of Pathology. Also to instruct and qualify students so that they may lawfully practice the Science of Osteopathy as taught and practiced by A.T. Still, the discoverer of this philosophy.”


Tenets of Osteopathy

1. The human body is a functional unit. Mind, body, and spirit are interconnected.

2. Form and function are inter-dependant.

3. The human body has the innate ability to heal itself.

4. Osteopathic Manipulative Treatment is based upon individualized, rational application of the above tenets.


Anatomy/Development Module


“It is impossible for an osteopathic physician

to perform a physical examination without knowledge of anatomy.”


The body’s numerous and complex anatomic structures

The interrelationship between anatomy and physiology

The critical importance of the neuro-musculoskeletal system in human function

That the knowledge of anatomy is essential to the practice of medicine and surgery

The practicing osteopathic physician needs to understand:


Surface Anatomy Visualization

Palpation

Functional Anatomy Anatomic elements related to the body’s

biomechanical functions

Surgical Anatomy Knowledge required for surgical diagnosis and

treatment

Cross-sectional anatomy

“All osteopathic physicians use their knowledge of anatomy in practice”


Knee Pain Case

A patient presents with knee pain.


Differential Diagnosis Basic Categories

Infection

Inflammation

Tumor

Trauma

Genetic

Somatic dysfunction

Psychological


Differential Diagnosis of Knee Pain Includes:

Patellofemoral syndrome

Iliotibial band syndrome

Patellar tendonitis

Anserine bursitis

Meniscus tear

Collateral ligament tear – medial or lateral

Cruciate ligament tear – anterior or posterior

Osgood Schlatter

Osteochondritis dessicans

Neuropathic arthropathy

Charcot Joint

Tumor (osteosarcoma)

Referred pain (hip = avascular necrosis)

Prepatellar bursitis

Baker’s cyst (popliteal)

Septic Joint Gonococcal

Arthritis Osteo Rheumatoid Gout Septic Pseudogout Reactive arthritis (Reiters)

Medial Plica syndrome

Referred pain from back Sciatica

Fracture


Applied Anatomy and Knee Pain

Surface and functional anatomy are required for examination and treatment of the painful knee.

Surgical anatomy may be required for the treatment of the painful knee.


Osteopathic Considerations

Discussion of likely anatomic involvement in the knee pain case.

Probably will focus on functional vs. surgical possibilities.


Medicine and A.T. Still

“Man should study and use the drugs compounded in his own body.”

Autobiography of A.T. Still, p. 89

The basis of scientific medicine


Not all of osteopathic principles and practice is osteopathic manipulative

medicine.

Osteopathic medical students study all of medicine, surgery and obstetrics.

In addition, they study osteopathic philosophy, principles and practice for

about 200 hours.


OMM Perspective for Analyzing Patient Problems

1. BiomechanicsIs there a biomechanical component to the patient’s condition?

2. Fluid flowAre there issues with fluid flow that could be solved by releasing tissue tension and enhancing movement and respiration?

3. Nervous system, including autonomicsIs the sympathetic nervous system up regulated to a level that impedes organic or systemic function?

Are there peripheral nerve issues that can be improved by releasing tissue tension and compression?


Osteopathic Manipulative Treatment (OMT)

OMT is used to: Lengthen hypertonic muscles and

connective tissue.

Help joint surfaces glide more normally in physiologic motion.

Decrease pressure on sensitive small vessels and lymphatics.

Decrease nociceptive input to the CNS, which may decrease level of sympathetic nervous system activation.


Current Numbers

26 osteopathic colleges at 32 sites in 23 states.

About 60,000 DOs in practice.

Projection: by 2020, ¼ of all medical students will be osteopathic medical students.

Doctor of Osteopathic Medicine

Introduction to Osteopathic Medicine for Non-DO Faculty: What Makes an Osteopathic Education...

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