Osteopathic medicine in the United States
Osteopathic medicine is a branch of the medical profession in the United States that promotes the practice of science-based medicine, often referred to in this context as allopathic medicine, with a set of philosophy and principles set by its earlier form, osteopathy. Osteopathic physicians (DOs) are graduates of American osteopathic medical colleges and are licensed to practice the full scope of medicine and surgery in all 50 U.S. states. The field is distinct from osteopathic practices offered in nations outside of the U.S.—in which practitioners are generally considered neither parts of core medical staff nor of medicine itself; rather, they are considered alternative medicine practitioners. The other major branch of medicine in the United States is referred to by practitioners of osteopathic medicine as allopathic medicine.[1]
For the restricted-scope form of alternative medicine practice, mostly outside of North America, see Osteopathy.
By the middle of the 20th century, the profession had moved closer to mainstream medicine. American "osteopaths" became "osteopathic medical doctors", ultimately achieving full practice rights as medical doctors in all 50 states.[2][3]
In modern medicine in the U.S., any distinction between the MD and the DO professions has eroded steadily. The training of osteopathic physicians in the United States is now virtually indistinguishable from the training of allopathic physicians (MDs).[4] Osteopathic physicians attend four years of medical school like their MD counterparts, acquiring equivalent education in medicine and surgery; DOs also attend the same graduate medical education programs (ACGME-accredited residencies and/or fellowships) as their MD counterparts to acquire their licenses as physicians. DOs use all conventional methods of diagnosis and treatment and practice across all specialties of medicine and surgery. Although osteopathic physicians are still trained in osteopathic manipulative treatment (OMT),[5] the modern derivative of Andrew Taylor Still's techniques,[6][7] during medical school, the majority of practicing physicians with a DO degree do not practice OMT in their daily work.[8] There are ongoing debates about the utility of maintaining separate, distinct pathways for educating physicians in the United States.[9][10]
Nomenclature[edit]
Physicians and surgeons who graduate from osteopathic medical schools are known as osteopathic physicians or osteopathic medical doctors.[3] Upon graduation, they are conferred a Doctor of Osteopathic Medicine (DO) medical degree.[11][12][13]
Osteopathic curricula in countries other than the United States differ from those in the United States. European-trained practitioners of osteopathic manipulative techniques are referred to as "osteopaths": their scope of practice excludes most medical therapies and relies more on osteopathic manipulative medicine and alternative medical modalities.[14] While it was once common for DO graduates in the United States to refer to themselves as "osteopaths", this term is now considered archaic. Those holding the DO degree are commonly referred to as "osteopathic physicians", and they learn, train in, and practice the full scope of mainstream evidence-based medicine and surgery.[15]
As of 2023, there were 40 medical schools that offer DO Degrees in 64 locations[17] across the United States, while there were 155 accredited MD medical schools (2021–2022).[18]
Osteopathic physicians are not evenly distributed in the United States. States with the highest concentration of osteopathic medical physicians are Oklahoma, Iowa, and Michigan where osteopathic medical physicians comprised 17–20% of the total physician workforce in 2011.[26] The state with the greatest number of osteopathic medical physicians is Pennsylvania, with 8,536 DOs in active practice in 2018.[23] The states with the lowest concentrations of DOs are Washington, DC, North Dakota and Vermont, where only 1–3% of physicians have an osteopathic medical degree.[25][26] Public awareness of osteopathic medicine likewise varies widely in different regions. In 2003, people living in the midwest states were the most likely to be familiar with osteopathic medicine.[27] In the Northeastern United States, osteopathic medical physicians provide more than one-third of general and family medicine patient visits between 2003 and 2004.[28][10]
Between 2010 and 2015 twelve states experienced greater than 50% growth in the number of DOs—Virginia, South Carolina, Utah, Tennessee, North Dakota, Kentucky, South Dakota, Wyoming, Oregon, North Carolina, Minnesota, Washington.[23]