Volume 105, Issue 5

“Flexner's damning report insisted on thorough-going reform of the nation's medical education system—including the osteopathic medical education system as practiced in all 8 colleges of osteopathic medicine, noting that “not one `of the eight osteopathic schools is in a position to give such training as osteopathy demands.' “Though changes within the osteopathic medical profession were slow in coming, Dr Gevitz's description of the profession's response to this nationwide challenge was clear and enlightening. It was in the midst of this challenge that the profession found opportunity, stimulation, and a strong impetus to begin the necessary improvements to our educational system.”

As Felix J. Rogers, DO, notes in the current issue, an editorialist writing in The New England Journal of Medicine once labeled the lack of a clear definition of osteopathic medicine and a unifying identity for osteopathic physicians “the paradox of osteopathy.” The author analyzes how each article in this special focus issue of JAOA—The Journal of the American Osteopathic Association describes various modern aspects of the profession as viewed through the lens of the tradition and philosophy of osteopathic medicine. Each commentator in this issue of JAOA discusses what makes osteopathic medicine distinct from allopathic practice, identifies common themes within the practice of osteopathic medicine, and suggests solutions to the challenge of the profession to define its reputed “distinctiveness.”

Canadian physician Sir William Osler (July 12, 1849, to December 29, 1919) has been considered by many to be the father of modern medicine. His contributions to medicine were formidable, though they have been eclipsed by more recent advances in medical science and technology. Dr Osler's contributions to the humanistic aspects of medicine continue to be of great interest and use to clinicians, however. The author discusses the life of Sir William Osler and the humanistic impact he had in three areas: medical education, patient care, and the concept of professionalism within the field of medicine. Furthermore, the author suggests that many aspects of Dr Osler's wisdom are of particular relevance within the tradition of osteopathic medicine. A discussion of the continued relevance of Oslerian thought to the evolving practice of osteopathic medicine is also provided.

Two visionary models of healthcare founded on similar principles and honoring the primacy of the patient emerged from late 19th-century American frontier medicine. Their approaches differed, however. While the Mayo Model of Care emphasized a team approach to solving “a problem,” Dr Still's model of osteopathy took an integrative approach attuned to the specific needs of the body's various systems. The author suggests that it is time to innovatively renew Dr Still's original model of patient care by incorporating some of the time-tested and popular features of the Mayo Model of Care. The author further discusses the advantage osteopathic physicians have over their allopathic counterparts as medical care moves from an organ-specific model to a cellular, molecular, and genetic model—adding that there is a potential for even greater possibilities for osteopathic medicine when osteopathic principles are applied to larger societal problems.

The author asserts that the distinctiveness of osteopathic medicine has been long established in the profession's tradition of clinical practice—a tradition that has been consistently reinforced in the literature with official statements of osteopathic medicine's philosophy and tenets. Indeed, the original impetus for the establishment of osteopathic medicine in the late 19th century was an ambitious one—a wholesale reformation of the practice of medicine in the United States so as to address what was then a major public health issue: musculoskeletal disorder in a mainly agrarian nation. The author argues that the profession will once again reach the level of its own ambition to become a reforming influence within the practice of medicine only when we can demonstrate treatment outcomes that are relevant to today's public health issues.