The Osteopathic Future

As a physician “in the trenches”, I am not privy to the reasons behind the decision to allow the rapid growth of osteopathic training facilities that has occurred in recent years. But it would take only a short moment to realize that the result of this would be that there are now many osteopathic medical school graduates who will not be able to be trained in purely osteopathic residencies. Indeed, this has been a true statement for many decades.

But I am not as pessimistic about the implication that, as some have stated. the “merger of programs would be a catastrophic mistake in the history of osteopathic medicine.”[1] I was once the original osteopathic family medicine residency director at a combined allopathic (MD) /osteopathic (DO) program. I have been interested to see how that has fared over the last 10 years. What has, in fact, happened is that those osteopathic students who were interested in OMM (Osteopathic Manual Medicine)  have maintained and strengthened their interest by reaching out to mentors in their communities. As part of that process. there has indeed been a greater exposure of our principles to both allopathic residents and faculty. With this has come a better understanding and consequent acceptance of our training as having value, high standards, and effectiveness.

Medicine, in my experience, generally gradually embraces effective principles and therapies especially when the main driving reason for their existence is to improve patient outcomes. I have spoken with many of the osteopathic leaders who have been part of the discussions that have led to this ACGME (Accreditation Council for Graduate Medical Education) merger. Time will tell whether the prediction of catastrophe proves to be right or not. But I submit that the osteopathic principles which have guided my professional career are deep, strong, and are being enthusiastically endorsed by our osteopathic students and patients alike. As such I am not worried about the future of the DO profession.

The love of students for translating scientific principles into patient-specific treatments for the relief of their patient's suffering is an inestimable power. It is the purity of that commitment, to the extent that it is taught in our schools (I have students in the office regularly. My daughter is a first-year DO student.  I am satisfied that these principles ARE being taught) , nourished by mentors, and instilled as a guiding principle in the mature physician that separates the osteopathic profession from all others and makes it unique. It is the individual DO, therefore, that is the steward of our osteopathic legacy. It is the individual physician who is the purist manifestation of the ideal of our profession – an ideal that states that the honor of truly caring for another human being is more than enough compensation for the sacrifices necessary to fulfill that role. Despite the government and insurance regulations, long hours, and opportunity cost for pursuing and perfecting our craft, there is simply the opportunity to benefit of our fellow human beings and to simultaneously develop and use all of our talents in that quest. For us, this is enough. This is what matters.
The magic that is our profession takes place when a knowledgeable, caring osteopathic physician meets a patient in need. Unlike politics or sports, these encounters will usually take place behind closed doors. Technology will help physicians have the right information at the right time to do their job better. But the real, unsurpassed in all the world, wonder of our profession occurs when a physician looks into the eyes of his or her patient and simply knows enough about that patient without consulting an electronic record, to shut everything else out, look into the patient’s eyes, and ask, “What happened?”
These are the traits for which the osteopathic profession has come to be known. This is not by accident. This is the standard that has been created by the physicians who founded our profession, and continues to be passed down to our students and actively practicing physicians. This is the standard that will be passed on to future physicians. This standard is what motivates me, and I know it is what motivates many of my colleagues. Programs will come and go. Fear not. The roots of our profession are far too deep to allow the whirlwinds of initiatives to shake us.
This is a time of great change in the healthcare arena. Our current, and upcoming physicians, stand ready to make the adaptations necessary to continue our osteopathic heritage, strengthen it, adapt our methods, incorporate new tools, and explore new ways to help relieve and/or eliminate human suffering. What will not change is our commitment to use the best of our ability to take care of our patients. This is our overriding goal. Programs, methods, and technology will all change. Our ability to adapt our knowledge for the good of the patients we serve will not change except that it will be enhanced. 

Because what makes us unique is embedded in the core of many thousands of  individual osteopathic practitioners, our profession is in good hands. It always has been. May it always be so. 


Theodore W. Shively, DO
PrimeCare of Novi
Novi, MI