Careers in osteopathic medicine

CAREERS IN

OSTEOPATHIC MEDICINE

Institute Research Number 338 ISBN 1-58511-338-7 DOT Number 071.101-010 O*Net SOC Code 29-1069.99

CAREERS IN

OSTEOPATHIC MEDICINE HEALTHCARE IN AMERICA HAS BEEN GOING THROUGH UPS AND DOWNS FOR

several decades now as healthcare professionals try to make the kind of changes in a system that better reflects our fast-paced world. More and more we are looking at what we do to our body as a whole and not just the part of the body that may hurt or be injured. How does the food we eat impact on our health? How do our lifestyles affect our health? What affect do smoking, drinking, drugs and other excesses have on our health? Today many healthcare professionals look, examine and treat the whole person to determine what may be happening to our bodies and to our health, in what some are calling new-age medicine. This is not new to thousands of healthcare professionals and to hundreds of thousands of patients who have been treated in this manner for many years. Treating the whole body is a part of the practice of alternative medicine that has been around for more than a century, ignored and ridiculed for the most part by the established medical profession, but continuing to gain new respect and converts every day.

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Osteopathy is now a major part of this new-age medicine although it has been around since the end of the 19th century. Today, the osteopathic physician is one of the two major physician professionals – MD – Doctor of Medicine and DO – Doctor of Osteopathic Medicine. Not only is osteopathy now recognized and highly regarded as part of established medical practice, but osteopathic medicine is poised to make an even bigger mark in the 21st century. Doctors of osteopathy are fully-trained to be complete physicians and must be licensed in the state where they practice. Today there are more than 56,000 osteopathic physicians in the United States according to the American Osteopathic Association (AOA), and more than 65 percent practice in the primary care areas of family practice, internal medicine, obstetrics/gynecology and pediatrics. As one of our country’s fastest growing healthcare professions, osteopathic physicians are among the leading proponents of preventive medicine and primary care. Osteopathic medicine is a hands-on approach where the physician performs maneuvers and techniques manually on the joints and muscles to increase optimal health. Instead of caring for your symptoms one at a time and in a specific part of your body, osteopathic physicians treat the whole body to detect impairments in the musculoskeletal system. Osteopathic medicine has been at the forefront of treating the “whole person” for more than 125 years. In the words of world-renowned, British osteopathic physician, Leon Chaitow, from his 1982 book, Osteopathy, “Osteopathy is a system of healthcare which recognizes that the self-healing, self-regulating ability of the body is dependent upon a number of factors, including favorable environmental conditions (internal and external), adequate nutrition and normal structural integrity.” While using manipulative methods for medical treatment dates back to Hippocrates, the concept of osteopathy was founded in 1874 by Andrew Taylor Still, the son of a pioneer physician and minister, who received his medical education at the Kansas City College of Physicians and Surgeons in Missouri. He was dissatisfied with the medical treatments being offered to patients and searched for a better way to treat the human body. Dr Still was into the human anatomy as it related to the science of 3

healing. He viewed the body as a machine, and that if the machine was mechanically sound then it should function. Dr Still had three fundamental principles in his practice of medicine: (1) The body produces its own healing substances; (2) Health is dependent upon structural integrity; (3) Perverted structure is a fundamental cause of disease. He originated a system of manipulative therapy that he used in conjunction with other methods of his time, including drugs and surgery. His clinical experience using the manipulative therapy, in many instances, made drugs and operations unnecessary. These fundamentals have been refined and defined over the decades so that today DOs practice in all branches of medicine from allergists to psychiatrists and every specialty in between. The AOA notes “DOs are trained to be generalists first, and specialists second. The majority are family-oriented, primary care physicians. Many practice in small towns where they often care for entire families and whole communities.”

OSTEOPATHY DEFINED THE NAME OSTEOPATHY COMES FROM THE GREEK OSTEON MEANING BONE,

and pathos meaning to suffer. Dr Still named his specialty osteopathy in recognition of the importance that a properly functioning musculoskeletal system plays in the overall health of the individual. The study of human anatomy and physiology forms the basics for the practice of osteopathy. While osteopathy and traditional medicine have many things in common, such as the clinical methods of investigation and the scientific knowledge of the anatomy and physiology, they differ greatly in the ways patients are evaluated and treated. In traditional medicine, generally, the focus is on the illness or the end product of the problem with treatment centering on restoring the health through surgery and/or drugs. Osteopathic physicians focus on the changes in the function of the body that have occurred over a period of time to try and understand any events that may have altered the working of the body resulting in the complaint. Doctors of osteopathy know and understand how the body’s systems are interconnected and how each part affects the others. Our system of bones and muscles make up about two-thirds of 4

our body mass. The osteopathic doctor knows that this structure is vital to function and thus makes a careful examination and evaluation of these important structures in order to treat the patient as a whole. They use their eyes and their hands during the examination to identify any structural problems to determine symptoms or impairments that may affect the musculoskeletal system. Osteopathic medicine is a distinctive form of healthcare based on the philosophy that our body systems are interrelated and dependent upon each other for good health. This medical care emphasizes primary care and prevention using the interrelationships of the body’s nerves, muscles, bones and organs to treat the whole patient as it applies to the prevention, diagnosis and treatment of diseases, illnesses and injuries. Dr Andrew Still said: ‘Find it, fix it and leave it alone.’ These words sum up how the principles of osteopathy may be applied to treatment. As the path to cure lies inside the patient’s body, treatment is directed toward removing some of the obstacles that are stopping the healing process from taking place spontaneously. By acknowledging the uniqueness of each individual, in every treatment session there is a key point for the mind and body which, if properly corrected, will in time bring about a broad and deep change in that person’s situation. In order to find the key point, the osteopath must be, as much as possible, in tune with the patient. (Discover Osteopathy, by Peta Sneddon and Paolo Coseschi) Becoming a doctor of osteopathy is as rigorous as becoming a medical doctor. The education requires a four-year undergraduate degree with specific science courses, four years of academic study at a college of osteopathic medicine accredited by the American Association of Colleges of Osteopathic Medicine, a one-year rotating internship, and a residency of two to six years depending upon the desired specialty, such as pediatrics or surgery. Applicants must take the Medical College Admissions Test (MCAT). Upon completion of the educational process, the osteopathic physician must pass a state medical board examination, same as a medical doctor, in order to obtain a license and practice. Each state has its own requirements for the physician to practice in that state. 5

A HEALTHCARE CAREER FOR THE 21ST CENTURY “THE AMER I CAN PEO PLE ARE COMPLAINING BECAUSE THEY CANNOT FIND

the type of healthcare they need most – the services of a general family physician. What they want and need, and too often simply cannot find, is one doctor who will care for their total health needs and for all members of their families. Specialization in medicine, they complain, may be good for doctors, but it’s not good for people who are forced to find a new physician each time they develop a new kind of health problem.” (from a book on osteopathic medicine by L. E. Heffel) In today’s fast-paced, stress-filled world, osteopathic doctors are considered modern day medical pioneers on the cutting edge of medicine as they combine the best medical technology with their ears, eyes and hands to examine and treat each patient as a whole person. The American Osteopathic Association estimates that more than 100 million patient visits are made to DOs every year. And the number of medical students opting to study osteopathic medicine has more than tripled since the 1980s. The interest in and growth of osteopathic medicine have been phenomenal. Thirty-five years ago there were seven accredited colleges of osteopathic medicine, and today there are 23 accredited colleges in 20 states. As one of the fastest growing healthcare professions, osteopathic physicians are responding to the growing need for primary care and prevention in the populace. DOs bring extra training in the musculoskeletal system that helps them better understand how an injury or illness in one part of the body can and does affect another part of the body. They regard the body as an “integrated whole.” Osteopathic medicine is gaining in popularity and respect as more and more patients turn to the holistic approach to illness and treatment for their medical needs. In her book, Miracle Touch, Debra Fulghum Bruce writes, “The combination of treatments is curative for primary muscular and skeletal pain and can decrease symptoms (and possibly decrease the need for medications) in systemic diseases. Because osteopathic is holistic therapy, it treats the whole body, not just the affected part. By doing so, osteopathic manipulative treatment is often successful by reducing symptoms, improving outcomes, lowering direct and indirect costs (such as physician office visits), as well as decreasing the frequency of treatments.” 6

Doctors of Osteopathy will be leaders of the healthcare system in the 21st century as we look for ways to prevent illness and injury and take better care of our bodies. An excellent healthcare career choice for both men and women.

THE BEGINNINGS THE PRACTICE OF WESTERN MEDICINE BEGAN WITH THE GREEK CIVILIZATION IN

the 4th century BC, and from the first has been divided into two main schools of thought that continue to shape our thinking today. Hippocrates founded the first by emphasizing that the whole person is a unique being and must be studied and treated as a whole for good health. The second school was founded in the Greek town of Knidos by followers who looked at disease as an invader that had to be destroyed by any kind of intervention relieving the symptoms of disease. These two schools of thought have followed the history of medicine up to the 21st century. While the established medical profession has always pointed to Hippocrates as its origin in thought, it has actually practiced conventional medical treatment using the Knidian theory in treating illness and disease. Throughout the centuries there have been many medical reformers who reaffirmed the Hippocratic approach to medicine. In the 17th century, Dr Thomas Sydenham, English doctor and teacher and the father of modern, clinical methods, took his students to each patient’s bedside and showed them how to learn about disease through hands-on examinations. And Dutch physician, Hermann Boerhaave, emphasized the importance of studying the patient rather than the disease. The Hippocratic approach was to come into prominence in the 19th century with the birth of Andrew Taylor Still in 1828 to Methodist country preacher and doctor Abram Still and his wife Martha in Jonesburgh, Virginia. His early years were spent in Tennessee and then in Northern Missouri, where the frontier life formed the basis of his interest in nature and eventually anatomy. At the age of 16 with the help of his father, Andrew Still studied and observed medical practices. By this time the family had been living in Kansas for several years. He married at the age of 18, and in 1857 he was elected to the Kansas legislature and promoted the anti-slavery cause. 7

His wife died in 1857 leaving Dr Still with three young children and he remarried in 1860. His medical training continued with his father and other practicing doctors of medicine. He attended the College of Physicians and Surgeons in Kansas City, Missouri, but before completing his studies he enlisted in the army to fight in the Civil War where he served as a surgeon rising to the rank of major. After the war he went into medical practice but found the current theory and practice inadequate. In his autobiography Dr Still writes, “I was in the practice of medicine and had been for several years. I treated my patients as other doctors did. Some of them got well, and some of them died. Others, both young and old, got sick and well again without the assistance of the medical doctor.” In 1864, thousands died of a meningitis epidemic including his three children and his grief and helplessness drove him to seek other medical methods as he realized how ineffective treatment techniques and drugs were. Over the next decade he devoted himself to the study and analysis of all the available medical knowledge seeking a new kind of doctrine and experiment that would be based in science. By 1874, he announced the results of his decade-long studies and treatment of patients with the following three fundamental medical principles: The body is able to produce its own healing substances; a healthy body is dependent upon its structural integrity; and perverted structure is a fundamental cause of disease. “Besides these principles he also originated a system of manipulation. Basing his philosophy of practice upon these principles he proceeded to correlate manipulative therapy with other methods, used by doctors, such as drugs and surgery. In many instances he found that the use of manipulative methods made drugs and operations unnecessary. These concepts and theories were proved in his clinical experience. He developed the art of manipulative therapy based on his knowledge of human anatomy, physiology and chemistry and, above all, on his new found discovery of the vital inter-relationship between the structure of the body and its function.” (Osteopathy by Leon Chaitow) His fame spread quickly and people came from across America to be treated in his offices in Kirksville, Missouri. At the same time many of his fellow doctors were demanding to be trained in his theories and techniques. In 1892, Dr Still founded 8

the first College of Osteopathy in Kirksville, and three years later, 16 men and three women were its first graduates. That small beginning made a great impact and osteopathy grew against all odds and the opposition of the established medical profession. The clash with organized medicine continued and became confrontational in the 1960s in the state of California when the American Medical Association spent $8 million to put an end to the practice of osteopathy in that state. With AMA backing, the California legislature passed Proposition 22 that ended the practice of osteopathic medicine in California. DOs practicing in California were granted the MD degree in exchange for paying a $65 fee and by attending a short seminar. The College of Osteopathic Physicians and Surgeons became the University of California, Irvine, College of Medicine. But this decision proved so controversial and the protests were so strong that a group of influential DOs lobbied the California Supreme Court, and the decision was finally overturned. The California decision had a great impact on the future of osteopathic medicine in this country as these professionals struggled for parity with their MD counterparts. Following this decision, the United States Army decided to allow DOs to enter the military as physicians. DOs began enjoying wider professional recognition in other parts of the country. Andrew Taylor Still died in 1917 but he left a legacy of great importance to medicine and the healing therapies. Many physicians who carried on his work flourished and built further on his knowledge and expertise. In the more than 130 years since Andrew Taylor Still founded osteopathy, the profession has become an established world-wide discipline and has received global recognition as part of the healthcare system in the United States and countries around the world.

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WHAT OSTEOPATHIC PHYSICIANS DO “THE GREATEST INTEREST OF PRACTITIONERS OF OSTEOPATHY IS THE STUDY OF

human anatomy and physiology. Following in Dr Still’s footsteps, they know how important it is to have a thorough understanding of the correct position and function of each bone and other structures in the body. This is essential in order to find out about the normal and healthy workings of the human body. Those working in osteopathy look at the causes of disease and suffering originating in the abnormal working relationship that can exist within and between structures.” (From Discover Osteopathy, by Peta Sneddon and Paolo Coseschi) One of Dr Still’s early successful cases was of a small boy who had dysentery. He noted in his autobiography that when he placed his hands on the child’s back it was very warm, even hot, but the abdomen was cold. He began to work his hands at the base of the brain and by pressing and rubbing he found rigid and loose places in the boy’s spine and kept up the manipulations for many minutes. A day later the mother brought the boy back for a follow-up visit and all symptoms of dysentery were gone and the boy was fine. Dr Still proceeded to cure another 17 dysentery patients in the same manner. Osteopathic physicians use their eyes, ears and hands to help the body heal itself. They believe that disease mostly comes from within the patient and so they must concentrate on the person and the body and not the microorganisms that might be the cause. The body does have the capacity for self-repair and correction providing that good circulation is maintained along with a balanced diet, exercise and a positive attitude. There are times when some stages of a disease will have gone beyond a certain point, and then the osteopath will refer the patient to a specialist for further examination and treatment. The osteopath will take a full medical history on a new patient including all previous accidents, traumas, illnesses, operations, and all medications the patients is currently taking. This helps the osteopath to build a mental picture of the patient and what the patient may be experiencing, and then be able to treat the patient as a whole person. Then comes a thorough physical examination in standing, sitting and lying down positions. The patient will be asked to do some movements so the doctor can see where the patient is experiencing restrictions of movement, and then use fingers and hands to find out where the painful areas are. 10

Treatment and healing will follow, and it will be different for each patient. There is everything from a common cold that will not go away to a very serious illness that may require a total transformation and awakening. Healing does not always follow treatment and may come months or even years after clinical treatment. Functioning to the best of one’s potential is considered healthy. The osteopath must be able to relate to the patient and vice-versa, because mutual trust and understanding are part of the therapy. The doctor must adapt to the patient’s changing physical and emotional state, and the patient must give feedback to the doctor on how things are progressing.

WHERE OSTEOPATHIC PHYSICIANS WORK THERE ARE OVER 56,000 DOS PRACTICING IN THE UNITED STATES, AND ABOUT

35,000 are members of AOA. The majority of DOs practice in family medicine, including internal medicine, pediatrics, and obstetrics and gynecology. Osteopathic physicians and surgeons work in all 50 states in community hospitals, medical centers, teaching hospitals, colleges and universities, clinics, dental offices, rehabilitation centers, sports medicine facilities, research laboratories, and local, state and federal government agencies. Osteopathic physicians are in private and group practices, and are employed as consultants to business and industry. Men and women in osteopathic medicine enjoy their work and are always glad to share their experiences.

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OSTEOPATHIC DOCTORS TELL ABOUT THEIR CAREERS I Am a DO Specializing in Orthopedic Surgery “My high school years were filled with lots of sports and lots of injuries, and I spent a good deal of time going from one doctor to another to get better for the next game. In my senior year I injured my right shoulder in a football game and it was not getting better. My father suggested an osteopathic doctor he had visited some years earlier for a back problem with good results. I went to this doctor and I was hooked on osteopathy. It took about three months to get the kinks and pain out of my shoulder and then another three to four months before it felt like new again. I had been given therapy, injections, pain medication and nothing worked. This osteopath manipulated my shoulder and arm over and over again, and by the time I was ready for college I already had osteopathy on my career radar screen. My father is a hospital administrator and his brother is a neurologist, so medicine was not a new concept. I knew I had to get through my bachelor’s degree first before thinking about a medical degree, so I did research to find out what courses I should be taking to qualify for medical school. I also read up on the practice of osteopathy. The doctor I went to for my shoulder injury became sort of my mentor and opened many doors so I could get a feel for the profession before I started. I completed my bachelor’s degree and was accepted into the accredited osteopathic program at the school that I wanted and so began my path to becoming an osteopathic physician. During my internship at a well-known hospital I decided I wanted to go into orthopedic surgery and was able to find a residency program at the same hospital in this specialty. I became friends with another student, and by the time our residency was over we had decided to get some 12

experience and then start a group practice with several more osteopaths who specialized in orthopedic surgery. Our aim was to cover the orthopedic surgical field in an area that was not already saturated with doctors. I spent the first five years of my career on the staff of a large medical center in both family practice and orthopedic surgery. I learned from the medical doctors and they leaned from me in an atmosphere that is increasingly receptive to osteopathic treatment as it relates to primary care and preventative medicine. It was a great experience as I treated both children and adults, something that would help my practice for years to come. During this time, my friend who was at another medical facility and I found three more doctors specializing in orthopedic surgery who wanted to join our practice. After pooling our resources, deciding upon an area, office space, additional personnel and costs, the five of us became a group practice almost seven years ago. Our plan was to settle in an area with a number of community hospitals and close to a college of osteopathy where we could eventually teach, get our certifications and licenses to practice. We did just that and settled in a growing suburban area that has a number of community hospitals, a medical center and is within an hour’s ride from a college of osteopathy. We cover all the orthopedic specialties from shoulders to hips to knees. We also are into sports medicine and more recently, alternative treatments for arthritis. It has taken a long time to become established and have a growing practice. I am on the staff of three of the hospitals and work with one of the school districts on their sports medicine program. I am a lecturer at the college and am waiting for my appointment as an associate professor. The office is busy with patients and we are about to open an office in a second location. There have been problems along the way. Meshing five different personalities is not easy, and staying on the same page takes a lot of work, but we have made it and we are on our way to being very successful. I made the right choice for me and I am happy with my career.” 13

I Am a DO in Family Practice “I always wanted to help others. I never minded the extra effort of doing something for someone who could not do it for themselves or needed help in doing it. During my years in high school I volunteered at the local hospital and thought that I wanted to be a nurse. My mother had serious surgery when I was a high school senior and her recovery was slow and painful. From some healthcare people at the hospital, I heard about a doctor who practiced osteopathic medicine and that she was very good with patients who had a lot of pain. I convinced my mother to see her and went with her to the appointment. From the start, the osteopathic doctor did the right manipulations for my mother and within weeks she was feeling better. I was intrigued with what the doctor did and made an appointment to talk with her about osteopathy and if I would make a good candidate for this career. She explained the purpose and the feeling of helping people get better naturally. She suggested some books to read and then we could talk again. When I left her office I knew that someday I would also be a doctor of osteopathic medicine. I am the first in my family to become a doctor. It took almost a dozen years after graduating from high school to earn my DO and my certification. While I had some grant money, I had to take out loans that were paid back over many years of steady work. My first position was on the staff in the hospital where I had once volunteered. It had enlarged since my high school days and now there was a whole section devoted to osteopathic medicine, including pediatrics, surgery and family practice. After more than four years in practice at the hospital, I established my own office in a medical complex where I had an office and an examining room, but the reception area and the assistant medical and clerical personnel were shared. I started seeing patients there one morning and one afternoon a week and it has steadily grown. After another three years at the hospital, I joined the staff of a new community clinic where I knew I could make a greater impact on family health. I 14

now divide my time between the clinic and my office, which has grown into a solo practice with a nurse and a secretary. I am at the clinic all day on Mondays, Thursdays from 3 pm to 7 pm, and Saturdays from 8 am until 1 pm. I have office hours all day Tuesdays, Wednesdays and Fridays. On Thursday nights at the clinic, from 7 pm to 9 pm, I hold family wellness sessions where individuals and families can come and discuss medical concerns in an open forum. It is very popular and there is always standing room only. When I started thinking about osteopathy in high school almost 30 years ago, it was not considered main stream medicine and was scoffed at by the establishment. But that has changed. Today, osteopathic physicians are as recognized as MDs and are given due respect. There is a need for both. There have been times when I have had to refer a patient to an MD and vice versa. I have been approached by a medical publisher to write a book on osteopathic family practice and that may be a possibility. During this time I also married and managed to give birth to two girls who are now 10 and 12 years old and the lights of my life. My husband, who is a senior loan officer with a bank, and I manage our schedules with our children in mind. It is a busy life, but it is possible to mesh family and career. I am very happy with my life and my career. It is very rewarding.”

I Am a DO in Physical Medicine and Rehabilitation “I am a health nut and I come from a family of health nuts. My father is an osteopathic physician in a pediatric practice, and my two sisters and I were raised on eating healthy and exercising. Actually, my family were farmers from way back, and it was my father who broke tradition and went into osteopathic medicine instead of farming, for which we are all grateful. When I decided to follow my father into osteopathy I was not sure where I wanted to specialize. I spent a good deal of time reading and searching the Internet looking at various 15

specialties until I happened upon physical medicine and rehabilitation. I visited a large rehabilitation center and talked with several doctors on staff and found out that there is a great need for more professionals in this specialty. Osteopathy is a natural here as the body responds better in many instances with manipulative techniques than with machine therapy or drugs. It was surprising for me to learn that there are hundreds of thousands of injuries happening across the country each year, and medical and rehabilitation centers are swamped and short-handed in accommodating a growing patient population. I am a graduate of a university school of osteopathic medicine and then did my residency in a major teaching hospital. I am certified and in my second year of my first job at the rehabilitation facility connected to the teaching hospital where I did my residency. The experience is wonderful as I get to evaluate and treat patients in the light of their lifestyles and environment. The focus is always on the patient and not on the illness or injury. Patients come into rehabilitation for anywhere from 10 days to many months. Some rehab is ongoing depending upon the condition, such as arthritis where manipulative techniques are part of traditional medical treatment. Because there have been so many new technologies developed for rehab patients in the past few years, it is crucial that I stay on top of what’s going on professionally. I have started to attend meetings and conferences and connect with colleagues. There are always articles in publications and new books and papers to read. I want to be up on the latest technologies and techniques so that I can help my patients to the fullest. My career has just started so I am not sure where I will be in 10 or 20 years, except that I will do everything possible to advance my career and be the best doctor I can be. I may want to teach someday, or maybe write a book. I’m on the right track and I'm pleased with my career choice and my first work experience. I am looking forward and upward.”

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I Am a Student in Osteopathic Medicine “From my earliest years I wanted to be a doctor and take care of my family who have many and varied health problems. Both my parents used to smoke and both have battled weight problems. My father has high blood pressure and my mother is now a diabetic. I am the oldest of three children and we are trying to learn from their mistakes. I was in college searching for medical schools when I came across osteopathy and looked into it. I talked with my advisor and she wanted me to talk with osteopathic physicians, so I made appointments to do just that. After visiting and talking with three DOs in various work settings I was ready to look into osteopathic medical schools. I found the one I wanted and then proceeded to study for the MCAT exam to ensure that I would do well. I did and got into my college with no problems. In my third year of medical school I am already planning my internship and residency. I am undecided between family practice and pediatrics as a specialty and will make the choice during my internship. I am excited about osteopathy as a career because I like the concept of treating the body as a whole instead of in parts. Keeping people healthy through good nutrition and healthy lifestyles should be everyone’s goal. I would like to be able to make a difference in a life through what I am learning. Where my career will eventually take me is still unknown, but I am happy with my decision to study osteopathy and to eventually become a certified DO in a specialty. I know I have at least five more years of education ahead and I am studying hard to maintain my good grades. I want to be at the top of my class and continue that in internship and residency so that I will have a number of options open to me. So far my future is looking good.”

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PERSONAL QUALIFICATIONS ANY HEALTHCARE PRO FES SION REQUIRES EXTENSIVE KNOWLEDGE AND

keeping up with the advances in treatment, therapy and technology. For more than a century and a quarter, doctors in osteopathic medicine have practiced the whole person approach to medicine instead of just treating specific illnesses or symptoms. Medical school training emphasizes primary care with the focus on preventive healthcare. If you are interested in osteopathic medicine then you must be: Fully committed to this concept of treating the whole person Aware how the body is interconnected and how one part affects another Dedicated to primary care and prevention Willing to use your hands to diagnose and treat injury and illness Able to combine available medical procedures with osteopathic manipulative treatment (OMT) A good listener to hear what your patients are saying about their condition Attentive to detail as you collect, evaluate and analyze patient information A problem-solver as you take responsibility for treating others Able to make decisions based on professional standards and personal judgment while observing the code of medical ethics Most of all you must be a people person. Patients come to doctors when they are hurt or sick and need your logical thinking and calming manner. Good osteopathic medical care is all about connecting with people in order to help them make better choices about their healthcare.

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WHAT’S GOOD ABOUT THIS CAREER HEALTHCARE ISSUES ARE DEFINITELY ON THE FRONT BURNER IN THE 21ST

century, and osteopathic medicine will help lead the way. Smoking, drinking, drugs, obesity and inadequate exercise are increasing problems for all age groups across the country. In fact, recent studies on obesity in children are very disturbing and require immediate attention if we are going to save a generation from illness such as diabetes, high blood pressure, heart disease and more. Osteopathic medicine has some answers. Osteopathic physicians are trained in primary care with a focus on prevention. Their manipulation techniques combined with guidance on lifestyles, nutrition, exercise and more will be the wave of the future as the traditional medical profession is realizing the value of prevention and, how we live affects our health. Today, more than 50,000 active osteopathic physicians are respected members of the medical community as they contribute to every phase of healthcare in public and private institutions across the country.

WHAT’S NOT SO GOOD FOCUSING ON PRIMARY CARE AND PREVENTION IN HEALTHCARE IS A

wonderful idea if you can get patients to understand that their diets and lifestyles are part of the problem. Many patients come to osteopathic physicians from other doctors hoping to find that miracle cure to their health problems. They want to continue in their self-destructive ways, yet they want results. Patients have unrealistic expectations of their DOs and do not like to make changes in their lifestyles. There is competition with the established medical professionals, and great pressure on osteopathic physicians to get results quickly. The hours can be long and irregular in some settings such as hospitals and clinics, and the really big earnings usually come from group practices that are hard to either establish or break into. The technology keeps advancing and there is so much to read and stay current with. We are still a long way from full acceptance of alternative medicine, including osteopathic medicine. 19

EDUCATION AND TRAINING THE FORMAL EDUCATION AND TRAINING NEEDED TO BECOME EITHER A

Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) are essentially the same and among the most demanding of any professional career. The American Osteopathic Association has this to say about the education process: “To be considered for admission to any of the nation’s osteopathic medical schools, applicants typically have a bachelor’s degree, with undergraduate studies that include one year each of English, biological sciences, physics, general chemistry and organic chemistry. Other requirements may include genetics, mathematics, and psychology. Most prospective DO students major in the sciences with an emphasis in biology or chemistry; however, applicants may major in any discipline as long as they meet the minimum course and grade requirements. Applicants must also take the Medical College Admissions Test (MCAT).” The basic sciences cover much of the first two years of the osteopathic medical school curriculum, with the third and fourth years given over mainly to clinical work. The curriculum reflects the osteopathic philosophy of preventive medicine and whole patient care. Teaching is done in major medical centers, community hospitals and even doctors’ offices. Students are also involved in general medicine and research as they rotate through urban, suburban and rural settings giving them valuable exposure to various populations and areas of medicine. Students also study and learn the osteopathic manipulative treatment for the prevention, diagnosis and treatment of illness and injury. After they graduate, the new DOs must complete an approved 12-month internship in a hospital with rotations through departments including internal medicine, pediatrics, family practice, obstetrics/gynecology and surgery. The internship ensures that every DO has the opportunity to see and treat every patient as a whole individual. Upon completion of the internship, those interested in specializing will choose to go into a residency program that will require an additional two to six years of training depending upon the specialty. Doctors of Osteopathic Medicine must be licensed to practice medicine in all 50 states. Each state determines its own tests and procedures for licensure. Some states give DOs and MDs the same test, while other states give separate licensing tests. 20

Osteopathic physicians know that the study of medicine does not end with their formal education, and that is why DOs have a lifetime commitment to continuing medical education. The AOA requires its members to earn a specified number of CME credits every three years in order to keep their membership active. The American Osteopathic Association’s Commission on Osteopathic College Accreditation accredits each of the following schools of osteopathic medicine. This accreditation is recognized by the US Department of Education and the Council of Post-Secondary Education. Arizona Midwestern University, Arizona College of Osteopathic Medicine, Glendale www.midwestern.edu/azcom

A. T. Still University College of Osteopathic Medicine, Mesa www.atsu.edu California Touro University College of Osteopathic Medicine, Vallejo www.tucom.edu

Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona www.westernu.edu Florida Lake Erie College of Osteopathic Medicine, Bradenton www.lecom.edu

Nova Southeastern University, College of Osteopathic Medicine, Fort Lauderdale http://medicine.nova.edu Georgia Georgia Campus, Philadelphia College of Osteopathic Medicine, Suwanee www.pcom.edu Illinois Midwestern University, Chicago College of Osteopathic Medicine, Downers Grove www.midwestern.edu/ccom

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Iowa Des Moines University, College of Osteopathic Medicine, Des Moines www.dmu.edu Kentucky Pikeville College, School of Osteopathic Medicine, Pikeville http://pcsom.pc.edu Maine University of New England, College of Osteopathic Medicine, Biddeford www.une.edu/com Michigan Michigan State University, College of Osteopathic Medicine, East Lansing www.com.msu.edu Missouri A. T. Still University of Health Sciences, Kirksville College of Osteopathic Medicine, Kirksville www.atsu.edu

Kansas City University of Medicine and Bioscience, College of Osteopathic Medicine, Kansas City www.kcumb.edu/kcolleges/com/com.asp Nevada Touro University College of Osteopathic Medicine, Henderson www.tucom.edu New Jersey University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine, Stratford http://som.umdnj.edu/index.html New York New York College of Osteopathic Medicine of the New York Institute of Technology, Old Westbury http://iris.nyite.edy/nycom Ohio Ohio University College of Osteopathic Medicine, Athens www.oucom.ohiou.edu

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Oklahoma Oklahoma State University Center for Health Sciences, College of Osteopathic Medicine, Tulsa http://healthsciences.okstate.edu/index.cfm Pennsylvania Lake Erie College of Osteopathic Medicine, Erie www.lecom.edu

Philadelphia College of Osteopathic Medicine, Philadelphia www.pcom.edu Tennessee Lincoln Memorial University, DeBusk College of Osteopathic Medicine, Harrogate www.lmunet.edu Texas University of North Texas Health Sciences Center at Forth Worth, Texas College of Osteopathic Medicine, Fort Worth www.usc.unt.edu/education/tcom Virginia Edward Via Virginia College of Osteopathic Medicine, Blacksburg www.vcom-vt.edu West Virginia West Virginia School of Osteopathic Medicine, Lewisburg www.wvsom.edu Visit the school websites to learn about their programs, requirements, costs and more. Research will help you decide if the educational path to osteopathic medicine is right for you.

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EARNINGS POTENTIAL PHYSICIANS, INCLUDING OSTEOPATHIC PHYSICIANS AND SURGEONS, ARE

among the best paid professionals in the United States. Precise salaries are difficult to determine because many physicians and surgeons are self-employed in a private or group practice and their earnings are not made public, and medical centers and clinics, and others who employ these professionals do not make their salaries known. As in other professional careers, those in private practice or who own or partly own their practice, usually have higher median incomes than salaried physicians and surgeons. The following figures are from from a variety of association and state government sources: With less than two years of practice in the specialty of family medicine, DOs earn a median annual salary of $140,000, and with more than three years of practice the figure rises to $160,000. A DO in pediatrics with less than two years in the specialty earns about $135,000, and with more than three years the figure rises to about $165,000. A general surgeon with less than two years earns about $225,000, and with three years and more the figure rises to over $280,000. According to government statistics, the earnings of all physicians – MD and DO – range from $130,000 to $325,000. Salaries and benefits are different in every state and in every region of the country as they are based on area, type of employer, experience, responsibility and other factors such as hours worked, personality and professional reputation.

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OPPORTUNITIES STUDIES INDICATE THAT THE JOB GROWTH FOR DOCTORS WILL BE FASTER IN THE

next decade due to a growing and aging population. Some studies even predict a severe shortage of physicians by 2020 if the number of slots for medical students does not increase – medical schools have not increased their total number of students for many years. These estimates suggest that the country will need to train upwards of 3,000 more physicians each year to meet the growing demand. Osteopathic medicine is expanding at an unprecedented rate with new schools being planned and existing schools enlarging their enrollments to meet the need. Doctors of Osteopathic Medicine who are educated in the United States are fully licensed physicians and surgeons, and practice the full scope of medicine. They are licensed to practice osteopathic medicine by whatever state they live and work in. DOs are complete physicians and surgeons, fully-trained and licensed to prescribe medication and to perform surgery. Most are family practice, primary care physicians and practice in small towns and rural communities where they often care for entire families and even an entire community. Osteopathic physicians practice in the primary care branches of all medical specialties including family practice, pediatrics, internal medicine, and obstetrics/gynecology. They treat patients – individuals and families – in medical centers, teaching hospitals, community clinics and hospitals, rehabilitation centers, schools, sports facilities, Armed Services, various government agencies and more all across the country. According to the American Osteopathic Association, DOs represent more than six percent of the total US physicians and over eight percent of military physicians.

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GETTING STARTED IN YOUR CAREER SELECTING A CAREER PATH WILL BE ONE OF THE MOST IMPORTANT DECISIONS

of your life and should be made with great thought and considerable research. What do you want to be? Are you interested in doing the work required on a daily basis? Do you have the talent to do it? Can you meet all of the requirements? What will the education cost? How will you pay for it? Where do you see yourself in 10 years? Twenty years? Thirty years? This is a lot to ask of you at this stage of your life, probably while you are still in high school. But too many do not ask the tough questions and then find themselves stuck in careers that are unsatisfying and unrewarding. If you do the research up front and get as many answers to your questions as possible, you will have a much better chance of landing in a career that suits you and is fulfilling. Medicine is a noble and respected profession and a doctor can earn an excellent living. But the road to becoming a doctor is long and difficult and costly in terms of education. Many doctors spend years and a large percentage of their earnings paying back the loans. Most doctors will tell you that the lengthy education and financial struggle to become a doctor were worth it and they would do it again. If after reading this report you are really interested in pursuing it, or are at least interested in learning more about osteopathic medicine then here are some tips to help you get started. This overview can be the basis for your research into osteopathic medicine. Check out the websites and search further on the Internet. Communicating via email with the osteopathic medical schools you may be interested in is a good way to find out educational requirements, curriculum, costs and more. Visit your local library. Talk with osteopathic physicians in local hospitals and private practice about their work, the pros and cons, the good and the bad, and more. Come prepared with a list of written questions to ask and write down the answers. Most professionals are willing to share their experiences and give some insight and guidance on their career. 26

You should volunteer in a hospital, clinic or private practice that has osteopathic physicians to see first hand the connection between professional and patient, and to observe the demands made upon today’s doctors. Talk to as many people as you can including your school teachers and counselors, family members and friends to get their input. Be open to all opinions as you consider every aspect of this career. Keep notes on what you have learned and from whom, so that you can go back to that individual for follow-up or clarification. No career decisions are written in stone and many people do change their careers or go into other aspects of the career. A doctor may decide not to treat any more patients and go into the administrative end of medicine, or maybe teach, or write for medical publications. There are always options available. The important part is to do the research up front and find out all you can about the career and then you will be able to make an informed decision. Down the road you will be glad that you took the time. Good Luck!

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ASSOCIATIONS O American Association of Colleges of Osteopathic Medicine

www.aacom.org O American Osteopathic Association

www.osteopathic.org O The Cranial Academy

www.cranialacademy.org O Osteopathic International Alliance

www.oialiance.org

PERIODICALS O Chiropractic & Osteopath

www.chiroandosteo.com O International Journal of Osteopathic Medicine

www.intl.elsevierhealth.com/journals/ijos O Journal of the American Osteopathic Association

www.jaoa.org O US Osteopathic Medical Schools

American Association of Colleges of Osteopathic Medicine Application Service http://aacomas.aacom.org O Directory of Colleges of Osteopathic Medicine in the US

www.aacom.org/colleges

COPYRIGHT INSTITUTE FOR CAREER RESEARCH 2010 CAREERS INTERNET DATABASE www.careers-internet.org

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