Osteopathic medicine is a branch of the medical profession in the United States that promotes the practice of science-based medicine along with a philosophy and set of principles set by its earlier form, osteopathy. Osteopathic physicians (DOs) are graduates of American osteopathic medical colleges. They 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., whose practitioners are generally considered neither part of the core medical staff nor of medicine itself; rather, they are considered alternative medicine practitioners. Osteopathic physicians sometimes refer to the other major branch of medicine as allopathic medicine.

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.

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). 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 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), the modern derivative of Andrew Taylor Still's techniques, during medical school, the majority of practicing physicians with a DO degree do not practice OMT in their daily work. There are ongoing debates about the utility of maintaining separate, distinct pathways for educating physicians in the United States.

Nomenclature

Physicians and surgeons who graduate from osteopathic medical schools are known as osteopathic physicians or osteopathic medical doctors.

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. It relies more on osteopathic manipulative medicine and alternative medical modalities. 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.

Demographics

thumb|left|Physicians entering US workforce by education, 2005

40 medical schools were offering DO degrees in 64 locations across the United States, while there were 155 accredited MD medical schools (2021–2022).

  • In 1960, 13,708 physicians were graduates of the 5 osteopathic medical schools.
  • Between 1980 and 2005, the number of osteopathic graduates per year increased by over 150 percent, from about 1,000 to 2,800. This number was expected to approach 5,000 by 2015.
  • In 2016, there were 33 colleges of osteopathic medicine in 48 locations, in 31 states. One in four medical students in the United States in 2016 was enrolled in an osteopathic medical school.
  • there were more than 145,000 osteopathic physicians and osteopathic medical students in the United States.

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Osteopathic physicians are not evenly distributed in the United States. States with the highest concentration of osteopathic physicians are Oklahoma, Iowa, and Michigan, where osteopathic physicians comprised 17–20% of the physician workforce in 2011. The state with the greatest number of osteopathic physicians is Pennsylvania, with 8,536 DOs in active practice in 2018. In the Northeastern United States, osteopathic physicians provided more than one-third of general and family medicine patient visits between 2003 and 2004. Others point out that there is nothing in the principles that would distinguish DO from MD training in any fundamental way. One study, published in The Journal of the American Osteopathic Association, found that a majority of MD medical school administrators and faculty saw nothing objectionable in the core principles listed above, and some endorsed them generally as broad medical principles. He founded osteopathic medicine in rural Missouri at a time when medications, surgery, and other traditional therapeutic regimens often caused more harm than good. Some of the medicines commonly given to patients during this time were arsenic, castor oil, whiskey, and opium. In addition, unsanitary surgical practices often resulted in more deaths than cures.

Still intended his new system of medicine to be a reformation of the existing 19th-century medical practices. He imagined that someday "rational medical therapy" would consist of the manipulation of the musculoskeletal system, surgery, and very sparingly used drugs. He invented the name "osteopathy" by blending two Greek roots osteon- for bone and -pathos for suffering, to communicate his theory that disease and physiologic dysfunction were etiologically grounded in a disordered musculoskeletal system. Thus, by diagnosing and treating the musculoskeletal system, he believed that physicians could treat a variety of diseases and spare patients the negative side effects of drugs.

thumb|upright|left|Mark Twain was a vocal supporter of the early osteopathic movement. The new profession faced stiff opposition from the medical establishment at the time. The relationship of the osteopathic and medical professions was often "bitterly contentious" Throughout the first half of the twentieth century, the policy of the American Medical Association labeled osteopathic medicine as a cult. The AMA Code of Ethics declared it unethical for a physician to associate with an osteopath voluntarily.

One notable advocate for the fledgling movement was Mark Twain. Manipulative treatments had purportedly alleviated the symptoms of his daughter Jean's epilepsy as well as Twain's own chronic bronchitis. In 1909, he spoke before the New York State Assembly at a hearing regarding the practice of osteopathy in the state. "I don't know as I cared much about these osteopaths until I heard you were going to drive them out of the state, but since I heard that, I haven't been able to sleep." Philosophically opposed to the American Medical Association's stance that its own type of medical practice was the only legitimate one, he spoke in favor of licensing for osteopaths. Physicians from the New York County Medical Society responded with a vigorous attack on Twain, who retorted with "[t]he physicians think they are moved by regard for the best interests of the public. Isn't there a little touch of self-interest back of it all?" "... The objection is, people are curing people without a license, and you are afraid it will bust up business."

Following an accreditation survey in 1903, the American Osteopathic Association began requiring 3-year curricula at osteopathic medical schools. The acceptance of osteopathic physicians was further solidified in 1996 when Ronald Blanck, DO was appointed to serve as Surgeon General of the Army, the only osteopathic physician to hold the post. However, the decision proved to be controversial. In 1974, after protests and lobbying by influential and prominent DOs, the California Supreme Court ruled in Osteopathic Physicians and Surgeons of California v. California Medical Association that licensing of DOs in that state must be resumed. Four years later, in 1978, the College of Osteopathic Medicine of the Pacific opened in Pomona, and in 1997, Touro University California opened in Vallejo. As of 2012, 6,368 DOs were practicing in California.

1969, AMA House of Delegates approval<span class="anchor" id="1969"></span><span class="anchor" id="AMA House of Delegates approval"></span>

thumb|290px|Total number of DOs in [[Residency (medicine)#United States|residency programs, by year:

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In 1969, the American Medical Association (AMA) approved a measure allowing qualified osteopathic physicians to be full and active members of the Association. The measure also allowed osteopathic physicians to participate in AMA-approved intern and residency programs. However, the American Osteopathic Association rejected this measure, claiming it was an attempt to eliminate the distinctiveness of osteopathic medicine. In 1970, AMA President Dwight L. Wilbur sponsored a measure in the AMA's House of Delegates permitting the AMA Board of Trustees' plan for the merger of the DO and MD professions. Today, a majority of osteopathic physicians are trained alongside MDs, in residency programs governed by the ACGME, an independent board of the AMA.

1993, first African-American woman to serve as dean of a US medical school

In 1993, Barbara Ross-Lee, DO, was appointed as the dean of the Ohio University College of Osteopathic Medicine; she was the first African-American woman to serve as the dean of a US medical school. Ross-Lee is the sister of singer Diana Ross.

2006, American Medical Student Association<span class="anchor" id="2006"></span><span class="anchor" id="American Medical Student Association"></span>

In 2006, during the presidency of an osteopathic medical student, the American Medical Student Association (AMSA) adopted a policy regarding the membership rights of osteopathic medical students in their main policy document, the "Preamble, Purposes and Principles."