Pioneering Physician

Hero Next Door: DO broke ground in education, South Africa

Karen Steele, DO, created a new OPP-focused admin position at WVSOM. She was also the first DO registered in South Africa.


Karen M. Steele, DO, fell in love with osteopathic manipulative medicine several years after finishing medical school.

“When I was in practice in family medicine and treating patients with OMM, I realized how powerful it was,” she says.

Dr. Steele was so impressed that she left practice to begin an OMM residency in 1986.

So began Dr. Steele’s lengthy, multifaceted career in OMM. The 63-year-old published influential research, strengthened OMM’s place in the curriculum at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, cowrote The Pocket Manual of OMT and became the first U.S.-trained DO permitted to practice in South Africa.

“Karen believes in osteopathic diagnosis and treatment,” says Thomas F. Steele, DO, Dr. Steele’s husband, who is also a family physician. “She is committed to providing osteopathic medicine to her patients, and she does a great job at it. During her career, she has also been an inspiration to many students, especially women, who saw her as a prominent role model.”

Early career

After finishing her OMM residency, Dr. Steele ran the OMM department at the Kirksville (Missouri) Osteopathic Medical Center, and she joined the faculty at her alma mater, the A.T. Still University—Kirksville College of Osteopathic Medicine (ATSU-KCOM). She also continued working with Richard H. Still, DO, the great-grandson of Andrew Taylor Still, MD, DO, which she had started doing during her residency.

“I contacted him and said, ‘Could I come and study with you one afternoon a week?’ ” she says. “So I went over there Wednesday afternoons. He did a unique form of manipulation where the patient is primarily seated and he is standing or seated behind the patient. I hadn’t seen it before, and I really liked it.”

Dr. Still told Dr. Steele that he learned the technique from a cousin who had been trained by the daughter of A.T. Still. Years later, when Dr. Steele was a professor at WVSOM, she had received countless requests from students who wanted to learn the technique, so she spent a few weekends with Dr. Still going over it, and the pair named it together. They called it seated facet release.

“I use seated facet release all the time because it is very gentle,” Dr. Steele says. “It requires a high level of diagnostic touch ability. You can localize the restriction by starting out within the spine and moving on to the body if necessary. You position the entire body around that tight spot for quite a bit of compression and then release. The technique usually takes care of that spot.”

Dr. Steele included seated facet release in the 2010 edition of The Pocket Manual of OMT: Osteopathic Manipulative Treatment for Physicians, a book she cowrote with other WVSOM faculty. The book is an outgrowth of the Mini-Manual of Muscle Energy and HVLA Techniques by Dr. Steele and her protégé Karen T. Snider, DO, herself a widely published researcher.

“Dr. Steele helped me through the whole process of writing that book,” Dr. Snider says. “She also helped me get involved with research.”

Several colleges of osteopathic medicine use A Pocket Manual of OMT as a textbook now, Dr. Steele says, and the book sells well internationally.

Research and education

While at WVSOM, Dr. Steele also cowrote several papers on osteopathic medical education and OMT for The Journal of the American Osteopathic Association and the AAO Journal, published by the American Academy of Osteopathy.

The papers addressed WVSOM’s Osteopathic Principles and Practice Integration Project, which Dr. Steele helped develop and lead. The project began in 1992 with the aim to more deeply incorporate OPP into WVSOM’s undergraduate and graduate curricula.

Faculty set up a free community OMT clinic where students could practice, required them to spend at least one clinical rotation with a preceptor who used OMT, and established lectures and OMT demonstrations for residents, among other initiatives. A 2009 JAOA study found that the project succeeded in infusing OPP into WVSOM’s curriculum and that it helped the project’s alums maintain use of OMT in clinical practice.

In 2003, WVSOM promoted Dr. Steele to associate dean for osteopathic medical education, a new position that she designed.

“In order to create an integrated curriculum, WVSOM needed a high administrative-level person who would be able to influence not only the OPP course and the osteopathic history course but also the anatomy course and the biochemistry course and the clinical rotations and the residency training,” she says. “I approached WVSOM’s president and dean with this idea and then over time, we developed the position.”

To Dr. Steele’s knowledge, the position was the first of its kind at an osteopathic medical school, and this month, Dr. Snider followed in her mentor’s footsteps by becoming the first assistant dean for OPP integration at ATSU-KCOM. The position, similar to Dr. Steele’s despite the tweaked title, is particularly relevant today, Dr. Snider notes.

“The osteopathic medical profession is increasing its student base faster than it is increasing its DO preceptor base,” she says. “We utilize MDs to train our osteopathic medical students. When they are being trained by MDs, they are not seeing the distinctly different components that make osteopathic medicine different. As educators, we have to provide our students with osteopathic training in the third and fourth year and in their GME, even when they are training with MDs.”

A few other osteopathic medical schools are now considering creating similar positions, Dr. Steele says.

Otitis media and South Africa

Another research interest of Dr. Steele’s has been the effect of OMT on fluid buildup in the middle ear following an infection. A pilot study she oversaw, published in June by the JAOA, found that patients who received OMT along with standard care for acute otitis media experienced faster resolution of fluid buildup than patients just receiving standard treatment.

Dr. Steele has been able to make use of this research in South Africa. Her journey there began in 2009, when she saw a presentation on volunteer opportunities in South Africa given by Adrienne Belafonte Biesemeyer, WVSOM’s international medicine and cultural coordinator. Dr. Steele was particularly intrigued by Baphumelele, an orphanage near Cape Town.

“I went up to Adrienne afterward and I said I would like to volunteer at that orphanage,” Dr. Steele says. “I told her that I believed the osteopathic care that we provide could help the children’s health outcomes and their future.”

Dr. Steele began studying South African health. She learned about the country’s HIV epidemic—nearly 18% of adults there have the virus, according to UNAIDS. She also learned that ear infections are one of the leading causes of deafness in the children there.

No U.S. DO had been granted permission to practice in South Africa at that point. In 2010, Dr. Steele traveled there with Biesemeyer, where they gave a series of presentations to physicians and health organizations. Dr. Steele navigated bureaucracy and dealt with confusion about the difference between U.S.-trained DOs and nonphysician osteopaths. Officials told her that obtaining registration—South Africa registers, rather than licenses, its physicians—would be tough.

But Dr. Steele persisted, and the Health Professions Council of South Africa approved her request to practice in October 2012.

This past February, Dr. Steele spent a month teaching the orphanage’s caregivers simple manual techniques to drain the middle ear and clear respiratory fluids. She also worked with staff at two Baphumelele hospitals.

“Most of the children have frequent otitis media,” Dr. Steele says. “And tuberculosis is the No. 1 killer in South Africa partly because many orphans have HIV and they get TB. So I was trying to drain the middle ear for the patients and then facilitate the respiratory system. And so I taught. By the time I left, I had taught all of the orphanage’s workforce.”

Dr. Steele hopes her work has paved the way for other DOs to get licensed to practice in South Africa. She plans to visit the orphanage again.

Back to private practice

Working with children has been a constant throughout Dr. Steele’s career—much of her research and clinical practice have involved OMT in children. After she left academia in 2012, she opened a private practice in Salem, Virginia, dedicated to treating children with osteopathic medicine. Dr. Steele says she was drawn to working with youngsters because so few clinicians focus on them exclusively, and she felt private practice would improve her work-life balance at this stage in her life.

“Being an associate dean was an all-encompassing task,” she says. “I decided I wanted to slow down some. I have seven grandchildren and another on the way. I wanted to spend more time with them.”

In her current role, Dr. Steele says she most enjoys seeing children’s function improve and witnessing their parents’ joy and relief.

“Sometimes teenagers come in saying ‘What are you gonna do for me?’ and then leave saying ‘Thank you, thank you’ ” she says. “And they have an improved gait and improved athletic performance. It’s a pleasure to see parents whose child no longer has colic—to see the child’s improved function and the effect it has on the family’s lives.”


  1. Dan Dobbins

    great work dr steele – I’m a US trained DO and ER doc in NZ working with some registrars who have worked in south africa / cape town – they rave about it. I’m interested in working in SA or even volunteering – what is the process like to get registered? Thanks for the info.

  2. Karen Steele

    Hello Dan:

    Thanks for the kudos. Their steps are outlined on the Health Professions Council of South Africa (HPCSA) website. Since one DO has already navigated the process, I imagine it might be easier for the second DO. The difficulty is their lack of understanding of US trained osteopathic physicians as differentiated from the osteopaths who are regulated through the Allied Health Professions Council of South Africa (AHPCSA). I was routed there many times and kept insisting that I be considered through the HPCSA.

    You will need to have your osteopathic medical training vetted through the ECFMG first, and complete the application and payment of the fee in Rand through the specific process outlined in their website. You will need a sponsoring organization where you will volunteer and sponsoring registered physician in South Africa to support your application. The volunteer physician status must be renewed annually.

    Good luck. Please let me know if you decide to give it a go.


  3. Kathryn Wanat

    Dr. Steele,

    I came across your story from my curiosity regarding the scope of practice for DOs here in South Africa. I am currently enjoying my summer break by traveling through SA. I have fallen in love with this beautiful country!

    I wanted to thank you for the recognition you have brought to the profession through your hard work. I plan to practice medicine internationally one day; in doing so, I know there are still many hurdles for D.O.s to overcome. Reading your story is extremely refreshing and inspirational – I appreciate your dedication!

    Warm Regards,

    Kathryn W, OMSII

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