The authors have been professionally and personally associated with osteopathic medicine since 1972. During this period, they have observed, from several perspectives, the processes by which trainees and osteopathic physicians inculcate their unique professional identity. Yet, increasingly, the philosophic and practical components that have historically defined osteopathic medicine as a distinctive approach to medical practice are rapidly eroding. Powerful forces associated with such things as professional prestige, public acceptance, professional collaboration with allopathic physicians, as well as changing trainee expectations, are rapidly reshaping the osteopathic medical profession. The degree to which osteopathic medical practitioners embrace the philosophic and clinical components unique to their profession will determine whether the profession retains its identity as a separate medical entity. If the current de-emphasis of these identifying characteristics continues, little more than a name will distinguish osteopathic medicine from the allopathic medical profession.