Dear DOs, All Doctors (Should) Care About The Whole Body
In February 2014, the ACGME, AOA, and AACOM outlined a single graduate medical education (GME) accreditation system. This meant that graduates from allopathic (“MD”) and osteopathic (“DO”) medical schools could apply to all residency and fellowship programs, regardless of whether they were allopathic or osteopathic in nature. I’m sure the intention was to blur the line between MDs and DOs, but many people remain highly divided about the differences.
In my opinion, the differences are insignificant in practice; however, I’ve spoken to some very passionate osteopathic students who are dead-set on trying to advertise their discipline as the one “focusing on the whole body” whereas allopathic doctors “only focus on symptoms.”
And this is where I’m dumbfounded… and annoyed.
Larger proportions of osteopathic medical school classes end up doing primary care and deal with chronic, systemic diseases (anyone heard of hypertension and diabetes?) which clearly affect the entire body. They also take extra classes like osteopathic manipulative medicine (OMM) to diagnose illness and injury with their hands and promote the body’s natural healing process.
Specialists (either allopathic or osteopathic), on the other hand, are just that. They usually focus on a single organ system in the context of the entire body. Take my own experiences in providing general anesthesia or taking care of critically ill patients in the ICU. Under general anesthesia, I can’t even talk to my patients! I have to assemble a myriad of other systemic, clinical markers to anticipate, diagnose, and treat acute changes. In the critically ill, I can’t focus on just the cardiopulmonary system, otherwise I’ll forego other organ systems.
My emphasis is and has always been on treating the whole body from an integrative standpoint. This is how all doctors should think, regardless of their training backgrounds. While I don’t have OMM at my disposal (apparently, many attending DOs I’ve spoken to have never used it after med school), I’m caring for the patient holistically while addressing the chief complaint.
No good doctor, regardless of his or her training background, should focus on just the symptoms. He or she must see the forest through the trees and consider the effects of a disease process, surgery, or medication on the whole person.