Core Principles in the Historical Development of Osteopathic MedicineA Draft

Michael M. Patterson, Ph.D.

Associate Editor of The Journal of the American Osteopathic Association

Member of the AOA Committee on Osteopathic History

Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL

AOA Committee on Osteopathic History-- 2001-02A committee of the Campaign for Osteopathic Unity

Chairman: Dennis J. Dowling, DO--AOAVice chairman: Gerald G. Osborn, DO--AACOMEthan R. Allen, DO--AOA Thomas Wesley Allen, DO--AACOMBenjamin A. Field, DO--AOANorman Gevitz, PhD--AACOMW. Ashley Hood-- student (now a DO)Eugene A. Oliver, DO--AOADouglas L. Wood, DO, PhD—AACOM

Staff advisers:

John B. Crosby, JD, AOA executive director Michael Fitzgerald, Secretary, AOA Assistant Director for PublicationsPhilip Saigh Jr, secretary to the AOA Unity Campaign Blue Ribbon CommitteeShelley Morrison, AOA Executive Communications SpecialistProject adviser: W. Douglas Ward, PhD,, Project Advisor

AOA-AACOM Subcommittee on Core Principles of Osteopathic History (existed for only 2001-02)

Chairman: Gerald G. Osborn, DO--AACOMVice chairman: Benjamin A. Field, DO--AOANorman Gevitz, PhD--AACOMMichael M. Patterson, PhD--AOAGina M. Piazza, DO--AACOMMartyn E. Richardson, DO--AOAKonrad Miskowicz-Retz, PhD--AOADouglas L. Wood, DO, PhD--AACOMSecretary: Michael Fitzgerald, AOA Assistant Director for Publications

AOA Committee on Osteopathic History--for 2002-03A committee of the Campaign for Osteopathic Unity

Dennis J. Dowling, DO, ChairGerald G. Osborn, DO, Vice ChairEthan R. Allen, DOBenjamin A. Field, DONorman Gevitz, PhDJaime L. Kibler--osteopathic medical studentMichael M. Patterson, PhD Joseph W. Stella, DODouglas L. Wood, DO, PhD

Staff Advisors John B. Crosby, JD, AOA executive director Michael Fitzgerald, Secretary, AOA Assistant Director for PublicationsPhilip Saigh Jr, Secretary to the AOA Unity Campaign Blue Ribbon Committee W. Douglas Ward, PhD, Project Advisor

What are the main thrusts of the Core Principles?

A. Founding Rationales, Philosophy and Early Development

1, 2, 3, 4, 7

1. The intellectual, medical, and social climate in which Andrew Taylor Still, MD, DO, first practiced the healing arts and which eventually led him to develop a reformed school of medicine that he would call osteopathy.

2. The fundamental principles and philosophies that underlay the early practice of osteopathy.

3. The political and cultural factors that shaped American medical licensure and jurisprudence to allow for the organizational and institutional growth of osteopathy in its formative period.

4. The relations between osteopathy and conventional medicine practiced in the early period of osteopathy’s growth.

7. The eventual transformation of osteopathy into osteopathic medicine.

B. Recognition and Licensure

9, 16, 17

9. The political efforts of DOs to obtain equal licensure provisions and equal treatment with MDs under the law.

16. The factors leading to and the consequences of DOs being admitted to the uniformed services as physicians and surgeons.

17. The increasing recognition of the osteopathic medical profession by state and national governmental agencies.

C. Education 8, 14, 15 8. The challenge of osteopathic medical schools to raise

educational standards. 14. The US Department of Education's and the Council

for Higher Education Accreditation's decisions to recognize AOA accreditation of medical colleges.

15. The causes of the tremendous growth of osteopathic predoctoral education from the late 1960s through today and both the positive and negative consequences of this expansion on the osteopathic medical profession.

D. Research

11 11. The development of basic scientific

osteopathic medical research.

E. Practice Patterns and Hospital Development

5, 6, 12, 18

5. The comparative early practices of DOs and MDs in treating various illnesses (with special reference to the influenza pandemic of 1918-19).

6. The struggle for defining osteopathy’s scope of practice and the respective intellectual positions of those who favored broad and narrow scopes of practice.

12. The reasons behind the development of the osteopathic hospital system and the importance of osteopathic hospitals in shaping osteopathic practice and identity.

18. The role of the "financing of healthcare" in changing the practice of osteopathic physicians, including its impact on both the number of osteopathic hospitals and the number of osteopathic graduate medical education programs

F. Current Trends

10, 13. 19. 20 10. The difficulty of DOs gaining the same social status and

visibility as MDs despite DOs coming ever closer to MDs in terms of training, as well as in terms of their diagnostic and therapeutic armamentaria.

13. The factors leading to and the consequences of the merger of DOs with MDs in the state of California and the unanticipated effects on the profession's solidarity elsewhere in the United States.

20. The historical development of osteopathic medical education, practice, and recognition outside the United States.

Questions Regarding the Competency Area of the Historical Development of Osteopathic Medicine

Is this a Competency Area we wish to include in the educational structure?

a. Is it important to require an historical competence?

b. Are we at a watershed time in the Osteopathic Profession that requires this competency?

How can these Core Principles be transmitted to our students (and non-DO Faculty)?

What are the best teaching methods?

How is the competency to be evaluated?

In the schools? In postgraduate education? On the Boards?

When should these competencies be taught and reinforced?

Early in first year Founding Rationales, Philosophy and Early

Development Education Current Trends

Later in preclinical training

Recognition and Licensure Practice Patterns and Hospital Development Research

Clinical Years

Reinforce Principles, especially Current Trends

Interest non-DO students and faculty in residency programs in the development of osteopathic medicine

Future Committee Activities

Provide a CD-ROM based compilation of educational materials

Provide reference literature and bibliographies Clarify and explicate the Core Principles Provide information on teaching the Core

Principles Work toward an edited volume addressing the

Core Principles

Leave you with the basic question:

Is this a Competency Area we wish to include in the educational structure of osteopathic medicine?

There will be a workshop at the AOA Convention in Las Vegas on Wednesday afternoon for those interested in teaching the Core Principles

DRAFT

Core principles for teaching

the history of osteopathic medicine

The AOA Committee on Osteopathic History will finalize the core principles at its meeting on Oct 8, 2002.

The history of osteopathic medicine should be taught objectively--examining the environment in which the profession began, its growth and development, looking at its relative strengths and weaknesses over time, and focusing on different challenges that the profession has faced and is facing today.

Students will come to appreciate the history of the osteopathic medical profession from understanding the social, economic, cultural, political, and medical forces and contexts that have shaped the profession's development. Learning specific dates may be useful to constructing a chronology of events, but this is not in itself history. And learning dates without a comprehension of the meaning of events has no especial value to understanding either the profession or the social movement students are about to enter. It is not dry facts that students should be learning. Rather, they need to understand dynamic historical processes and grasp the living, breathing, evolving phenomenon that is osteopathic medicine.

To this end the AOA Committee on Osteopathic History proposes that all students of osteopathic medicine become familiar with the following: