There has long been an air of mystery surrounding the practice of osteopathic medicine. What do these physicians study? What is manipulative medicine? John C. Prestosh, DO, president of the American College of Osteopathic Emergency Physicians (ACOEP) sheds some light on what DOs do.
There has always been a mystery in the House of Medicine. Questions asked; credentials questioned. While much of the mystery has been answered over the years, some questions still remains: What is osteopathic medicine? How are DOs different from MDs? What is this group that represents them, this ACOEP? I hope this article will shed light on the osteopathic profession, its physicians, and the organization.
Andrew Taylor Still, the founder of Osteopathic medicine (pictured above), was a licensed MD and served in the Civil War as a surgeon in the Union Army. He was disillusioned with the practice of medicine at that time and was determined to find a better way to combat disease processes. With much time and study, Dr. Still came to the conclusion that the musculoskeletal system played an integral role in many illnesses. He instituted the correction of body alignment by using manual techniques. Today, these techniques are known as Osteopathic Manipulative Medicine or OMM. Doctors of Osteopathic Medicine or DOs believe OMM is a pertinent component of the care they deliver to their patients. Dr. Still also endorsed a different philosophy of practicing medicine. He promoted the belief that physicians should focus on treating the whole patient, including the patient’s physical, mental, spiritual, and emotional components. He believed that just treating the manifestation of a disease process did not always lead to the root cause of the disorder disabling the patient.
Doctors of Osteopathic Medicine (DO) complete four years of medical training. Osteopathic graduate medical education typically involves an internship year plus residency training. For some specialties, including emergency medicine, medical school graduates directly enter the residency of their choice. They will then obtain full licensure and have the capability to practice in all the United States. Work is in progress to ensure that DOs will soon be accepted globally and osteopathic physicians will not have any restrictions in the worldwide practice of osteopathic medicine.
The scenery of graduate medical education is changing due to the Single Accreditation System (SAS) agreed upon by the AOA, AACOM, and ACGME. However, this action does not detract from the current osteopathic training model. Presently, there are more than 25,000 osteopathic medical students receiving training in thirty-one colleges of osteopathic medicine at forty-five different locations. Research has shown that Osteopathic medical school enrollment has grown close to seven percent since 2007. Females account for forty-six percent of all students and approximately eight percent of students are represented by minorities.
Historically, the majority of osteopathic physicians have chosen primary care as their career choice. While still true, times are beginning to reflect a change in this mindset. Currently, approximately fifty-six percent of Osteopathic physicians serve in primary care and forty-four percent practice in other specialties. Emergency medicine is the largest specialty currently practiced by DOs with approximately ten percent of those in specialty practice. This then leads to the question, “What is the American College of Osteopathic Emergency Physicians (ACOEP)?”
The ACOEP was founded in 1975 in Toledo, Ohio. Four osteopathic physicians had a vision that emergency medicine had the ability to become a specialty of its own. Through their diligence and hard work, the AOA recognized emergency medicine as an osteopathic specialty in 1978, and recognized ACOEP as a specialty college. In 1979, the AOA approved four emergency medicine residencies, two in Michigan, one in Illinois, and one in Pennsylvania. The length of training has changed over the years, and now all AOA accredited programs require four years of training. Presently, there are 62 osteopathic emergency medicine residencies located throughout the United States teaching greater than 1,200 residents.
The American College of Osteopathic Emergency Physicians has also grown in membership throughout the years and currently represents more than 5,500 members. Currently, membership in ACOEP is only open to DO physicians as active members. With the Single Accreditation System progressing, we anticipate MD students becoming part of osteopathic residencies and then becoming members of the College. The ACOEP Board of Directors has amended its Bylaws, and when approved will include non-osteopathic physicians as active members with full voting privileges in our College. I believe this will further enhance the membership and strength of the organization.
Early in 2016, the ACOEP Board of Directors concluded a Strategic Planning Session redefining its mission and goals. The ACOEP mission statement now promotes patient-centric, holistic emergency care consistent with osteopathic philosophy practiced by all emergency medicine professionals. It is our belief that many non-osteopathic physicians practice the art of medicine in a holistic manner. The ACOEP can and would like to be a “home” for these practitioners. We are endorsing five goals within our new strategic plan: Member Engagement and Value, Advocacy and Involvement, Education and Knowledge, Improving Awareness, and College Strength and Sustainability.
While all these goals are extremely important and ACOEP has designated dedicated individuals from the Board of Directors and staff to address each point, I would like to single out Education and Knowledge as an example of what ACOEP is doing. Among other educational activities offered throughout the calendar year, ACOEP hosts two major conferences, a Scientific Assembly and a Spring Seminar. This past spring, we had record attendance at the Spring Seminar in Scottsdale, Arizona. The ACOEP was excited to have two founders of emergency medicine as Keynote Speakers and share our stage. Judith Tintinalli, MD, and Peter Rosen, MD, presented pertinent, thoughtful, and at times, even humorous words of wisdom that were appreciated by the conference attendees.
ACOEP is having its next Scientific Assembly in San Francisco, California, and I believe it will be our best program yet. We will be presenting multiple, 30-minute lectures as well as workshops for ultrasound, advance EKG, airway management, and a new workshop and important active shooter workshop. We have a “Resident’s Day” designed specifically to their interests as well as a dedicated student track that is always well-received. We have planned social events to include not only the conference registrants but their family and friends.
The American College of Osteopathic Emergency Physicians is by no means one of the largest members in the “House of Emergency Medicine.” Its Board of Directors believes we may be the best kept secret in emergency medicine. I believe that if you attend either the Spring Seminar, Scientific Assembly, or both, you will not be disappointed.