A signature difference

Brand identity: Highlighting the osteopathic physician’s distinctiveness

Brian Loveless, DO, argues that DOs and osteopathic medical students should be proud of what makes them unique and claim the titles of DO and DO student.

Brian Loveless, DO

Brian Loveless, DO, is the chief medical officer of WesternU Health.

Contact Dr. Loveless

What’s in a name? No, this isn’t going to be a column on Shakespeare (or Rodney Dangerfield, for that matter), but I want to talk about what we call ourselves in the osteopathic world. Our professional title has been a point of contention throughout our history. A.T. Still, DO, MD, trained as an MD and later took the degree of Diplomate of Osteopathy (later changed to Doctor of Osteopathy, and then to Doctor of Osteopathic Medicine). In his autobiography he wrote, “Let your light so shine before man that the world knows you are an osteopath pure and simple and that no prouder title can follow a human name.”

His students were proud to call themselves DOs, and yet today we still struggle with the terminology we use. When the current school year began, my Instagram was flooded with proud students at colleges of osteopathic medicine beginning their journey. Yet many of them called themselves “medical students” as opposed to “osteopathic medical students.” Deans at many schools posted statements congratulating the newly matriculated on “starting medical school” as opposed to “starting osteopathic medical school.”

Maybe you see this as a distinction without a difference. But is it? How can we hope to encourage our young physicians to practice the distinctive tenets of osteopathic medicine if we can’t even start them out with the right title?

Meanwhile, our leadership continues to struggle with clear messaging. The AOA has a brand campaign that highlights the mind-body aspects of our practice but does not strongly emphasize the other aspects of osteopathic medicine, such as structure-function, body self-healing and the manipulative aspects of our practice.

It hearkens back to the time in our history where we were struggling to gain equality with our MD colleagues. In order to do so, we minimized our distinctiveness. Now, however, is the time to emphasize our distinctiveness. We should be able, as a profession, to state clearly the type of medicine we practice, and we need to be able to proudly call ourselves osteopathic.

It has been said “(t)here is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.” The osteopathic profession has to be better about research and looking for evidence to support the foundational aspects of our profession.

While the current evidence base supports my contention that osteopathic medicine fulfills all of the components of the Triple Aim, we need to continue to strengthen the evidence.

I have said in earlier columns that I believe many of the practices broadly accepted in medicine today, including mind-body medicine, lifestyle medicine and many “integrative” practices, are really osteopathic medicine rebranded. We need to take back that brand, to call our approach to medicine by its proper name, and to call ourselves by our proper name. And we need to make sure that our students, patients and colleagues know that we are osteopathic physicians!

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8 comments

  1. Sam, OMS-I

    If DOs and DO students believe osteopathy IS medicine, can we not adopt language that clarifies that we are first and foremost physicians?

    The way I see it, some physicians do surgery, and some do not. Some practice OMM, some do not.

    Reply

    1. Steven Kamajian

      In 45 years of attending State and national conferences, I have not heard the term Osteopathy used without it reference to old literature. We are not an antiquarian society. What therefore is the difference if any between an Osteopathic physician who is a pathologist, radiologist, hospitalist, family physician or any other specialty and a now similarly residency trained MD. What is our brand….we need control of the narative. Our family treating your family could be a resturant chain, a hotel chain,a union representing the service industries, etc. This phrase defines absolutely nothing to the public that suggest a physician is involved in the topic. We have had almost 60 years since the merger of our profession in California and we still haven’t created a complete Brand statement with a simple brand promise

      Reply

  2. Steven Kamajian,D.O.

    This is a timely and accurate position. What IS our brand and what IS our brand promise? Those questions must be answered with simple precise and short phrases. Our patients FEEL the difference.
    Traditionally, we were clear that D.O.’s had a subtle different differential diagnosis and had options in treatment that were not easily available to M.D.’s. Somewhere along the line at social events D.O. began to answer the question “what is a D.O.” with
    “we are the same as M.D.’s” and stopped at that. When the merger in California occurred when D.O.’s were asked ‘why did you consent to change your degree’? There response was an overwhelming “I got tired of trying to explain what a D.O. is”
    If there is any failure that we all share professionally it is that we have not established our brand nor our brand promise precisely and clearly for everyone.

    Reply

  3. R Mitchell Hiserote, Do

    Thank you Brian for keeping the discussion going as it is an important distinction. As reminded by the late Dr Frymann DO, Osteopathy is a noun, a thing. Osteopathic is and adjective, a modifier to a noun. Semantics are important and they can change our intent when seeing patients. Intent changes the care we give.

    Reply

  4. Robert S. Juhasz, DO, MACOI, FACP

    Appreciate Brian Loveless, DO’s advocacy and wisdom. Our opportunity and responsibility, as osteopathic physicians, is to continue to work to improve care in all specialties through our unique approach to that care. Brian is right in saying that we must be able to study our approach to care and communicate our results through publishing our research. The AOA has focused research grants to help fund a number of research projects and continues to advocate for additional funding for osteopathic research. With DO’s and MD’s training together, our students, residents and fellows have the opportunity and responsibility to share their unique approach to care. If you have something special to offer the patients you are privileged to care for you need to share it with your colleagues and be proud of the skills and approach that you have learned through your osteopathic medical education. Be proud of those skills, use them and share them with others. Your patients (and theirs…) will appreciate it.

    Reply

  5. Daniel Clearfield, DO, MS

    I agree that osteopathic distinguishment and distinctiveness is essential for the preservation of our profession. If we truly want to maintain our profession, we need to have more osteopathic preceptors and mentors out there to teach our students, residents and fellows. While OMM and OPP are reinforced in the core curriculum within the first two years of osteopathic medical school, there is a huge disconnect once these students hit their clinical rotations, and often even further entering into post-graduate training. We need vocal clinical instructors and mentors outside of the OMM specialty who champion OPP. I am FP/OMM as well as Sports Medicine Boarded, and I incorporate OMT into roughly 50% of my patient encounters. That being said, I incorporate OPP into 100% of my patient encounters, and I am sure to instruct my rotating learners how this was accomplished.

    I know of amazing DO dermatologists, radiologists, and other specialists who do not do any OMT, but still use OPP to offer the best care for their patients. The profession needs to identify these individuals and CREATE INCENTIVE for them to continue teaching these osteopathic clinical values. Otherwise, our learners will have diluted experiences of OPP as they go through their training, and once they are out in practice there will be nothing distinctive between them and their MD colleagues. Once we lose our distinctiveness, we will see the amalgamation of our profession with the MDs.

    Reply

  7. Donald Grewell, DO, FAAFP

    The saying, “those that don’t look at history are much more apt to repeat the mistakes found in history” is certainly appropriate for this discussion. The Osteopathic profession in it’s history has faced the challenges we are facing now on more than one occasion. The 1962 California experience, where 20% of the DO’s kept their initial’s , 80% became MD’s (this from Dr. Ethan Allen who was one of the founders of COMP-Pomona) is a great example of how the profession is capable of rising to the challenge. Many of these 20% were involved in the founding of this new DO school, and it was established to retain this approach to patient care. Certainly looking at how far this school, and others, have come should help us realize the value of OPP; and any of us that interact with MD’s in medical education and share our thoughts about OPP, (which, in my experience, is universally accepted as good patient care) realize the chance our profession still has to influence the practice of medicine in a positive way. With all the AOA has done to promote this, I believe our best hope for success is thru AOA policy and educational efforts to promote OPP in all levels of education.

    Reply

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