Posted on 08 Jul 2015 23:04
Some people are saying that Joseph Mercola is an osteopath, so he's not even a real doctor. Is this true? What is an osteopath? Is an osteopathic physician very different from a medical doctor?
I should start with a bit of transparency: I abhor Joseph Mercola. And, while I'd love to be able to point and say, see, "he doesn't even have a real medical degree!" unfortunately, although doctors of osteopathy are a minority, they are real doctors.
Your family physician, whom you think of as a real doctor, M.D., or medical doctor, is sometimes referred to as an allopathic physician. While allopaths are called M.D.s, osteopaths are called D.O.'s. You may well have been treated by a D.O. without even knowing it, say, during a visit to the hospital.
There are some differences in philosophy of care, and some other notable differences. However, osteopaths receive an education similar to allopathic medical students. The prerequisite courses required are similar, and they must take the MCAT prior to being admitted to an osteopathic medical school. They complete four years of medical school, an internship and residency as allopathic medical students. In other words, their residency is the same as or very similar to their allopathic counterparts. Since osteopathic medical schools do not partner with teaching hospitals, they divide their clinical work in medical facilities and doctor's offices. They must take the state licensure to practice medicine in their state, and they must stay current in their medical education. In other words, a D.O. is a fully qualified medical professional. They can prescribe medication just like your regular doctor. Unless you were specifically aware of it, you would probably notice little difference.
Osteopaths can specialize in different medical fields just as allopaths do and they generally can have the same types of practices. After medical school, they can choose to practice in one of the 18 American Osteopathic Association specialty areas, which will require two to six years more training. Most osteopaths work as family doctors, in pediatrics, obstetrics, gynecology, or internal medicine.
D.O.'s also receive training in some additional osteopathic practices, such as osteopathic manipulative medicine, and they do tend to focus on primary care and preventative medicine.
As you are probably aware, Dr. Joseph Mercolas "focus" is on preventative medicine, and he has developed it into his own quack brand pulling in millions of dollars. Is osteopathy quackery?
A Short History of Osteopathy
Osteopathy did indeed begin as a form of quackery. The difference between osteopathy and other quack medical systems, such as homeopathy or naturopathy, however, is in how it evolved. From the beginning, osteopathic medicine sought to be a legally recognized and licensed form of medicine in the United States. This made all the difference.
Osteopathy was started by Andrew Taylor Still. In the early 1850's in eastern Kansas, Still's father, a Methodist minister, also practiced medicine. Young Andrew learned about medicine from his father, and by reading medical books.
Still was a hospital steward during the Civil War, during which he gained a lot of experience working with patients, and with diseases. Still also claimed to have been a field surgeon and to have attended medical school in Kansas city, but there is no evidence that these claims are true.
Regardless, he began practicing medicine on his own. Three of his children contracted meningitis in 1864. Although Still and three other doctors cared for them, they died. This sullied Still's opinion of orthodox medicine (although apparently not his opinion of his own ability) and he began to consider other means of curing disease. He became interested in mesmerism and its concept of magnetic fluid within the body and the idea that an imbalance of these fluids caused disease. With a "laying of hands," however, a mesmerist could affect these fluids, and thus the body, including the internal organs.
In 1874, Still began billing himself as "A.T. Still, Magnetic Healer." Practicing in Kirksville, Missouri, he used his "laying of hands" to treat patients. He later incorporated bonesetting, or the reduction of fractures and dislocations, and the manipulation of painful joints. If this sounds like Chiropractic, that is because chiropractic is an offshoot of osteopathy. Still's practice of treating ailments by manipulating the joints or bones focused much on the spinal column, just as modern chiropractic care does.
While imbalanced magnetic fluids and manipulation of joints might seem like two different things, Sill was able to combine them into his own "theory." He claimed that disease was indeed the result of the obstruction and imbalance of the fluids but that this resulted in the misplacement of bones, especially the spinal column. Basically, his way of healing was the get the fluids flowing again and balance them. It wasn't really a novel idea. It was also not novel that he got his patients to believe he was helping them.
Still called his new medical system Osteopathy. The Latin word os means "bone" and the Greek pathos means "disease." After successfully practicing his brand of medicine in Kirksville, Missouri for a number of years, in 1892, he opened his American School of Osteopathy. The curriculum was four months long.
When Still and his students tried to get licensed in Missouri, they were rejected. Although a bill was passed by the legislature allowing licensure, the governor vetoed the bill, saying that the curriculum was insufficient. After all, it was four months long, consisting only of a few months of anatomy and osteopathy. Traditional medical schools had three to four year curriculums.
In response, Still added four terms to his curriculum, of five months each. They included anatomy, physiology, surgery, and midwifery. Then, he added histology, chemistry, toxicology, pathology, etc. until his medical school was covering every subject taught in standard medical schools. Drugs were not a part of osteopathy, though, since manipulations filled their role, so pharmacology was not added.
It was enough. Missouri granted licensure. Then, other osteopathic schools began to open in other states. They too, had trouble getting the states to license them. The same story happened again and again, and meanwhile, medicine was advancing. The medical establishment considered osteopaths quacks and, perhaps uniquely, the field did not respond by fighting for its own place, but on adapting to the growing demands of the field of medicine. Pharmacology was eventually added, especially given the huge advancements in drug therapies, and osteopathy began to look more and more like orthodox medicine. It began to be accepted, and by 1937, twenty-six states had granted D.O. the same practicing privileges as M.D.s. By 1960, thirty-eight states granted licenses to D.O.s. And, by 1973, osteopaths could officially practice in all 50 states.
By this time, osteopathic medicine had well distanced itself from Andrew Still's original ideas, and was incorporating the "materia medica" of mainstream medicine ideas more and more. Still was far from happy with this development, and tried to block these developments, but was overruled the American Osteopathic Association Board of Trustees.
In the end, osteopathy became largely indistinguishable from mainstream medicine. As above, some difference are maintained, although how much this is an effort to keep some type of distinction between osteopathy and allopathy is hard to say. Manipulation is still part of the medical courses, but ideas about "magnetic fluids" or vital forces have long since vanished. It should be noted that it is the blending of osteopathy with allopathy that makes it so similar, not the fact that D.O.'s are licensed. After all, chiropractic eventually won licensure as well.
Osteopathy and Quackery
The personalities and scientific rigor of osteopathic physicians are no doubt as varied as among M.D's. There is no shortage of quacks emerging from either. When powerful charlatans like Mercola arise, it is natural for us to want to find a simple explanation. A cause. If we can say, "he's a quack because he's an osteopath," it brings a little more order to our universe. We can rest more secure in our belief that "real doctors" are not osteopaths. This belief is unfounded, and there are no such easy explanations. Mercola is a quack of his own making.