A milestone for osteopathic physicians—and the NCMB

On November 18, 2009, an historic event took place at the offices of the North Carolina Medical Board in Raleigh. The first osteopathic physician to serve on the Board was sworn in as its president. His peers voted to give him the honor and privilege of serving the Boar--and the citizens of North Carolina--in its highest capacity.

It has been a long struggle for the osteopathic profession (the physicians with "DO" after their names, rather than the more prevalent "MD") to gain equality with the allopathic profession. In fact, it was just 14 years ago, in 1995, that the NCMB recognized the osteopathic board examinations as a gateway to licensure in North Carolina. Prior to that time, the DO had to be board certified by a specialty board approved by the American Board of Medical Specialties, or have taken the FLEX exam, to qualify for licensure in this state.

Osteopathic medicine was conceived in the late 1800s by an American frontier doctor, Andrew Taylor Still, MD. He recognized the limitations in the medical care of his day and approached patient care from an aspect of complete unity. He articulated a set of principles that have continued to guide the profession into its second century. In summary, those principles are:

1. The body is an integral unit, a whole. The structure of the body and its functions work together interdependently.


2. The body systems have built-in repair processes that are self-regulating and selfhealing in the face of disease.


3. The circulatory system, with its distributive channels throughout the body, along with the nervous system, provides the integrating functions for the rest of the body.


4. The contribution of the musculoskeletal system to a person's health is much more than providing a framework and support. The musculoskeletal system, and disorders of the musculoskeletal system, may affect the function of other body systems.


5. While disease may be manifested in specific parts of the body, other body parts may contribute to restoration or correction of the disease.

The first school of osteopathic medicine was founded by Dr. Still in 1892. Today there are 23 colleges of osteopathic medicine and three branch campuses throughout the country. There are currently more than 67,000 DOs in the country, according to the American Osteopathic Association, and about 740 in the state of North Carolina.

Although the profession had been present here in the US since the late 1800s it wasn't until 1966 that osteopathic physicians attained equivalent status with their allopathic counterparts. That was the year the U.S. Department of Defense authorized the acceptance of DOs into all the medical military services on the same basis as MDs. In 1996, Ronald Blanck, DO, was appointed Surgeon General of the Army. He was the first osteopathic physician to hold that post.

Osteopaths in North Carolina have struggled over the years to gain acceptance here. The profession owes a great debt to Barbara Walker, DO, who has been a tireless advocate for osteopaths in this state. She continues to practice in Wilmington.

Many of the MDs in our state work hand-in-hand with DOs across a wide range of specialties. Although the majority of osteopathic graduates select primary care as their specialty, DOs specialize in all areas of medicine.

There are two combined MD-DO family practice residencies here in the state. One is affiliated with the University of North Carolina and the Pikeville College of Osteopathic Medicine. The other is affiliated with Duke University and Nova-Southeastern University.

A distinctive aspect of the osteopathic medical curriculum is the instruction of osteopathic manipulative treatments (OMT). These maneuvers are used to correct not only musculoskeletal problems but also problems associated with the visceral organs. The procedures are taught from the first days of medical school and throughout the next four years. If the osteopathic graduate selects an osteopathic training program or a dually accredited program (MD-DO), the osteopathic manipulative skills are reinforced during postgraduate training.

Some osteopathic physicians sub specialize in OMT and basically provide these procedures as the main treatment regimen. Most osteopathic physicians blend both standard medical practices (evidence-based medicine) and proven osteopathic techniques to provide relief for a variety of medical conditions. In addition, there are many DOs who do no OMT in their practices.

Even today, osteopathic physicians have not yet attained complete equality with their allopathic counterparts. In North Carolina there is one hospital system that does not recognize the osteopathic board certification as equivalent to the allopathic board certification. At this time there is a dialogue between that system and the American Osteopathic Association. Hopefully a mutually agreeable resolution will be reached shortly.

I am the fortunate "first" osteopathic physician who will have the privilege of "Protecting the Public and Strengthening the Profession." I wish to thank the members of the NCMB who elected me president and my colleagues in the osteopathic profession for their support over the course of my career.

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