Wednesday, July 10, 2019

A new medical school—shall we rejoice?

I am a child of osteopathic medicine. My father was president of an osteopathic college and administrator of the associated hospital. When my brother and I were young, we could count eighteen D.O.s in the family. My ex-husband was a D.O. Today, my brother (retired) and one nephew and one niece represent the family in the profession. I went to work in an osteopathic hospital at the age of fourteen and worked in D.O. institutions off and on until the early 1980s, doing secretarial and then marketing work. To say I am thoroughly steeped in the osteopathic philosophy is probably an understatement.

To me, ever a lay person, it boils down to one simple contrast. Osteopathic medicine teaches that health is the body’s natural way of life and that dis-ease of any one part of the body affects the entire body. Allopathic medicine—traditional or mainstream western medicine—focuses on the dis-ease and curing it. (Allopathic is a term mostly used by proponents of alternative forms of medicine—like me).

My own health history provides an example. Before my hip surgery, a bone that had gone amuck was protruding through the cap of the hip joint and into the abdominal cavity. In addition to pain, I had wild gastrointestinal and urinary symptoms. I asked my M.D. surgeon (who I pretty much think walks on water) about it, and he said no relation because the offending femur was to the left of the abdomen. Well, sorry, I don’t believe that. I think it caused an imbalance and uproar in the entire system. Now that I am well past surgery, those side effects are gone.

D.O. physicians also believe in minimal use of medication, and as a survivor of an unneeded prescription of digitalis, I can testify to that. It made me so nauseous I could barely function, and to my astonishment, the doctor’s office said, “Just quit taking it.” If it wasn’t crucial why was I taking it in the first place?

But I am not writing to discuss my health history. Since 1966, Fort Worth has been home to the Texas College of Osteopathic Medicine, a school that has grown from very humble beginnings and an entering class of twenty to a multiple-building campus that now graduates at least a hundred physicians annually (sorry I don’t have accurate statistics). It sends over half its graduates to rural areas where physicians are so badly needed.

For years I heard rumors of applying to grant an M.D. degree, but I discounted them. Now it has come to pass. TCU and the UNT Health Sciences Center (umbrella institution for TCOM) have joined forces to enter their first class of M.D. students this month. Shall we rejoice?

I think not, but that’s just my uneducated perspective. Most new M.D.s, after the residencies required today, specialize; they don’t become the family physicians that osteopathic institutions send to underserved communities. I have heard the justification that the M.D. program was needed to secure research grant money—far as I know, way back even in the days when I worked at TCOM there was an active and respected research program. And the college had become an important community participant; for example, it hosts the coroner’s office and labs.

My neighbor, a new young family practice M.D., tells me now that residency is required of all graduates—only internship was required in my day—there are not enough residency slots for new graduates. The new school will only increase that problem. Perhaps the overall health care problem is to create more post-graduate slots rather than more graduates. Maybe those so anxious for a new medical program didn’t think of that. There were already eight M.D. schools in Texas.

But the big loser to me is that the osteopathic program. I fear it will be diminished and disappear. Increasingly there is less difference between the two philosophies. Younger D.O.s rarely use manipulation, once a hall mark of the profession. Now that is left to chiropractic medicine, which is incidentally an offshoot of osteopathic technique.

I don’t know what to say about why an osteopathic institution would not defend its integrity, and I may be proven wrong. Perhaps the D.O. program will flourish, but I am not wildly hopeful. I would like not to believe that the Health Sciences Center saw this as an opportunity to become one of the “big” or “regular” guys (over half the students are female, by the by) and I would like not to believe that TCU saw it as an opportunity to add the prestige of a medical school. Now that a donor has underwritten the tuition for the entering class for the first year, TCU can use that figure to boost its fund-raising stats.

No, I’m not rejoicing, and I’m looking a bit askance at those who hail this as a great advance. May I be proven totally wrong—it would make me happy—as long as the osteopathic component is preserved. And if it flourishes, I’ll really rejoice.

No comments: