Osteopathy docs can play role in occupational health

Doctors of osteopathy (DO) are not well known by either the public or other health care providers, but recent research suggests that they can play an important role in occupational health care.

The study comes from Gunnar Andersson, MD, PhD, and others at Rush-Presbyterian-St. Luke’s Medical Center in Chicago. Andersson is chairman of the department of orthopedics. His research found that manual therapy by an osteopath is as effective at relieving chronic lower back pain as more conventional medical care, and the patients need fewer drugs and less therapy.1

"I wouldn’t say it’s an endorsement of osteopathy, but it supports the idea that it can be a valuable adjunct to other treatment methods," Andersson says.

The study was not able to put a dollar value on the different outcomes, but Andersson says osteopathy could be a useful option for patients who have difficulty taking medications, for instance. He suggests incorporating osteopathy as one option among many for patients with lower back pain.

"It’s not going to be right for everyone, but there seems to be reason to consider it," he says. "Some patients don’t like being manipulated, though. It can be a forceful manipulation and some patients just don’t like that."

As an orthopedic surgeon, Andersson says he was interested in exploring the benefits of osteopathy because he had heard so many patients say they got better from either osteopathic care or chiropractic manipulation, a somewhat similar modality that involves manipulation. (See article on p. 18 for more on how osteopathy works.)

Andersson says there is a role for osteopathic physicians in an occupational health program, but only as an additional option, not as a replacement for any currently offered treatment modality or staff.

The research was lauded by osteopathic physicians, who say they have long sought acceptance among more traditional medical care. Boyd Buser, DO, associate dean for clinical affairs at the University of New England College of Osteopathic Medicine in Bieddeford, ME, says the key point of the study is that osteopaths achieved equal results with less medication and fewer therapy sessions.

"The medication issue is very important because you have not only the cost of the medication, but also the potential for adverse effects, which are pretty prevalent with a lot of the medications," he says. "It’s also clear that DOs treat patients for a shorter period than physical therapists or chiropractors. We don’t say from the outset that you need a certain number of treatments and then we’ll assess your progress. With the osteopathy model, we treat and determine the need for further treatment on a visit-by-visit basis."

Doctors of osteopathy only make up about 6% of all physicians in the country, with a higher concentration in the Midwest and few on the West Coast, Buser says. The biggest challenge for osteopaths is the lack of understanding about who they are and what they do, he says.

"The general public is very poorly informed about osteopathic medicine, with some data showing that about 80% of Americans can’t tell you what a DO is or how they differ from an MD," he says. "Health care professionals have a little better idea, but there still is a real lack of understanding about manipulative medicine and how it can benefit patients."

[For more information, contact:

• Gunnar Andersson, MD, Chairman, Department of Orthopedics, Rush-Presbyterian-St. Luke’s Medical Center, 1653 West Congress Parkway, Suite 1471-J, Chicago, IL 60612. Telephone: (312) 942-4867.

• Boyd Buser, DO, Associate Dean for Clinical Affairs, University of New England College of Osteo-pathic Medicine, 11 Hills Beach Road, Bieddeford, ME 04005. Telephone: (207) 283-0171.]

Reference

1. Andersson GB, Lucente T, Davis AM, et al. A comparison of osteopathic spinal manipulation with standard care for patients with low back pain. N Engl J Med 1999; 341:1,426-1,431.