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LETTER |
To the Editor:
I just returned from an extended vacation in India. Although I was in the areas that were hit by the tsunami, I was fortunate to have missed the tragedy by a couple of hours.
Upon my return, I read with great interest the November 2004 letter by Dr Clark ("Osteopathic Medical Training: Developing the Seasoned Osteopathic Physician." J Am Osteopath Assoc. 2004;104[11]:452–454) and the brilliant response by Dr Smith (J Am Osteopath Assoc. 2004;104[11]:454–455).
This argument has been ongoing in the profession for probably a hundred years. There are and always will be osteopathic "purists" who will adhere to osteopathic principles and practice (OPP) exactly as laid down by A. T. Still, MD, DO. And there are and always will be young osteopathic physicians with progressive thinking who want to enhance the depth of our knowledge and the depth of our caring. These young DOs will also argue that we must keep up with the advances in modern medicine as well as the use of complementary and alternative medicine and further develop the osteopathic approach.
As a result of the elaborate system insurance carriers now use to reimburse physicians for patient care, the days of the "ten-finger osteopath" are gone. There are no more 10- or 20-bed osteopathic hospitals. Hospitals are no longer owned and run by osteopathic families.
And because we no longer have our own Detroit Osteopathic Hospital (closed in 1992 and formerly located in Highland Park, Mich), the Osteopathic Medical Center of Texas (closed in 2004 and formerly located in Fort Worth), or similarly superb—and exclusively osteopathic—institutions at which our students and residents can continue their clinical education, we have to prepare our young professionals for this new world of healing and caring that does not fall under the osteopathic umbrella.
So, if we want to send our young osteopathic physicians to Yale University, Stanford University, Harvard University, Mayo Clinic, and the Cleveland Clinic, we have to adopt a broader view of our education and residency years in the osteopathic institutions of learning.
It is true that, in the past, some of us came to the osteopathic medical profession because we could not get accepted for admission at the "other" schools. Initially, we were all rebellious and extremely critical of our system of learning—and critical of our clinical trainers who were at times ill-prepared to be good teachers but were very intelligent, kind, compassionate, and helpful.
As we progressed, succeeded, and eventually won the respect of our patients and then the fellows on the other side of the fence, we were filled with a sense of gratitude for the osteopathic medical profession and those who taught us—regardless of the quality of our initial training. We came to recognize that the solid foundation we received in our residency years and at those osteopathic institutions of learning had indeed helped us pull through successfully at the Yales, Stanfords, and Harvards.
We must continue to provide our graduates with a solid medical background and instruction in OPP so that they can compete successfully with other physicians within the United States and abroad.
I believe that we should do as we have always done: if young DOs have new ideas, criticisms, and different outlooks, our profession should take a critical look at what they have to say—but then we should adopt it if it makes sense.
Kirksville College of Osteopathic Medicine (KCOM)
of A. T. Still
University of Health Sciences (then
Kirksville College of Osteopathic
Medicine)
Kirksville, Mo
Brigadier General (retired)
Iowa Air
National Guard
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