Osteopathic Hx

Question 1

A.T. Still

Answer 1

1. Father circuit rider and dr.
2. Frontier apprentice w/ father
3. Studied/practices in Kansas
4. Civil war = union military surgeon
5. Lost 1st wife and 4 kids

Question 2

Mid 19th century

Answer 2

1. No licensing boards
2. Scant state laws
3. Few med schools
4. Apprenticeships
5. “Heroic medicine” -desperate calls for desperate measures
6. Allopathy

Question 3

Allopathy

Answer 3

Diseases treated by producing condition antagonistic to condition being treated
1. Samuel Hahnemann: coined term to describe standard med

Question 4

Heroic medicine alternatives

Answer 4

1. Home remedies/Indian herbal preparations
2. Homeopathy
3. Eclecticism
4. Magnetic healing
5. Hydrotherapy
6. Bonesetters

Question 5

Osteopathic banner

Answer 5

1. 1874: flung banner
2. 1875: moved to Kirksville
   A. Practice: inc palpatory skills and anatomic knowledge
   B. 1887 quit traveling
   C. Attempted apprentices- didn’t know enough anatomy
3. 1889: officially embraces “osteopathy”

Question 6

Osteopathic schools

Answer 6

1. 1892: American School of Osteopathy (ASO)
2. 1894: revised charter of ASO
   A. Still insisted on DO school
   B. William Smith, MD, DO: received first diploma
   C. Course 2 yrs long
3. 1900: over 700 students and 18 faculty
4. 12 daughter schools

Question 7

Med schools at turn of century

Answer 7

1. Lack regulation
  A. Allopathic
  B. Eclectic
  C. Homeopathic
  D. Osteopathic 
2. No entrance requirements
3. AMA weak and needed reorganization
  A. 1904 revised constitution - reg med education
  B. DO schools not included in AMA survey
4. 1902: AOA adopted standards for DO schools
5. 1903: AOA begins inspecting DO schools
6. 1910: Flexner report 
  A. Harsh
  B. Marginal schools closed
  C. Converted -> non-profit
  D. 8 stayed open (6 still open today)
7. AOA curricula 3 yr to 4 yrs.

Question 8

Historical licensure

Answer 8

1. 1896: 1st legislative recog. DO practice
   A. ASO grads allowed to practice in Vermont
2. 1895: Missouri bill vetoed
3. 1897: Missouri bill passed
4. 1901: all states at least required registration
5. 1937: only 26 states gave DOs unlimited licenses
   A. 16 state: DO ed standard too low
   B. 8 states: 1 yr internship required
   C. Less DOs passed boards
   D. Curricula altered to Inc. pass rate
6. 3 approaches
   A. Separate DO boards
   B. Add DO part to existing boards
   C. Allow DOs to apply thru boards w/o DO part

Question 9

Current licensure

Answer 9

1. Grad accredited med school
2. Post grad training (1-3 yrs)
3. Pass boards
4. Other requirements
   A. Criminal background check
   B. Attestation of character
   C. Review of dr. Data base
   D. Letters of reference
   E. CME hours
   F. Practical exam
   G. Malpractice insurance

Question 10

California

Answer 10

1. 1960: CA osteopathic association negotiations w/ CA med. association
   A. AOA revoked charter of COA and approved new assoc.
   
   1. Osteopathic physicians and surgeons of CA (OPSC)
2. 1961: COA merged CMA
   A. COA lobbied OPSC to change to MD -> referendum
   D. No DO licenses in CA
3. COA-CMA merger
   A. COP and S Los Angeles-> CA college of med and university of CA college of med (1964)
   B. 1962: DOs given MD degree instead
   
   1. No extra training
4. 1968: OPSC backed military DOs
5. 1974: CA can license DOs

Question 11

Federal government recognition

Answer 11

1. WWI: tried to get commissions for DOs
   A. Exam - 25 passed but still denied
   B. DOs only reg soldiers, can’t use med training
2. WWII: regulatory, not legislative
   A. DOs not drafted - deferred
   B. DOs took over for MDs at war
3. 1956: less MDs -> DOs needed in military
4. 1963: DOs accepted as med officers
5. 1966: 1st commissioned officer
   A. Harry J. Walter, DO (Air Force)
6. 1967: AMA w/drew opposition and DOc included in draft

Question 12

Unified pathway for post-grad med. training

Answer 12

1. DO programs created as MD didn’t accept DOs
2. 1970: demographic switch
3. More pursued ACGME programs
4. 2009: ACGME reorganized
5. 2011: announced 2016 restrict access from non-ACGME to ACGME
6. 2012: AOA letter of intent for unified pathway
7. Preserves DO grad ability to go into ACGME programs
8. OPP
   A. Added osteopathic neuromusculoskeletal med under ACGME
   B. Osteopathic recog
   C. AOA database includes current DO program status
   D. ACGME: programs q/ and applying for ost. Program

Question 13

International osteopathy

Answer 13

1. Grads traveled
   A. UK
   B. Canada
   C. Australia
2. EST. Schools and professions limited to OMT
3. John Littlejohn, DO, PhD founded British school ost. (1917)