I discovered osteopathy when my husband started his medical training at an osteopathic medical school in the United States. At that time, he explained to me the differences between allopathic medical doctors and osteopathic medical doctors, but it wasn’t until I experienced care under an osteopathic physician that I truly understood the benefits of osteopathic medicine.
Osteopathic medicine began at the end of the 1800s with Dr. Andrew Taylor Still as a rejection of the standard care at the time. He noticed that patients were often not getting better and in some cases were even being harmed with the traditional allopathic medical practices being used during that period.
Dr. Still believed that the body had an innate ability to heal on its own and he called the system he developed osteopathy. He incorporated the use of manual manipulation of bones and joints as one of his methods for treating patients.
By the middle of the 20th century, osteopathic medicine was more widely recognized in the mainstream and doctors gradually gained full practicing rights in all 50 states. The training is very similar to allopathic doctors – 4 years of medical school and a residency afterwards. And, osteopathic medicine is rapidly growing as 1 out of every 5 doctors graduating from medical school in the United States is an osteopathic physician. You may have even gone to an osteopath during a trip to the Dr’s office and not even realized it.
Dr. Jeffery Groesbeck, D.O. is a practicing osteopathic physician in Saco, Maine, USA, and he was kind enough to sit down with me for an interview. Here’s what we discussed.
1. What made you want to become a doctor?
I took a really roundabout way of getting there. I started college thinking I would make a career out of something in music or art, but finished that year feeling unfulfilled. The following summer I took a 2-3 hour basic massage course at a community center and really liked it. I later enrolled in a Medical Massage Therapy program and became a Certified Massage Therapist. There was something about healing with my hands that resonated in me, but I felt like there was more for me to do. Physical therapy and chiropractic were my first thoughts. However, my father had seen an osteopath a few years before who had helped him with his asthma (and has not needed medications for it since). He suggested osteopathy to me and the more I read about it the more I felt that was the path for me.
2. How do osteopathic treatments augment traditional allopathic treatments?
Osteopathic manipulative treatment (OMT) helps restore function to the body. Beyond decreasing muscle strain and pain treatment, it can be geared toward improving lymphatic and blood flow. This is important because with proper blood and lymphatic support the body can more easily support the role of the immune system in fighting infection. On top of this, medicines given will reach the infection more easily.
For instance, I’m often asked to see patients in the hospital for pneumonia who are being treated with antibiotics. If I can improve lymphatic and blood flow the cells of the immune system have greater access to and from the infection so the body is able to take care of the infection more easily. The antibiotic, which is circulating through the bloodstream, will be delivered to the infection more readily. All of this means recovery time is shorter.
3. For those who don’t know what the difference is between an MD (allopathic physician) or DO (osteopathic physician), can you please explain? Why did you choose osteopathy?
MDs and DOs both go to medical school for four years, then complete post-graduate training in residency programs and fellowships. However, beyond covering all the traditional basic sciences during medical school, osteopathic student learn Osteopathic Manipulative Treatment as well.
The difference, to me, really comes from the theory behind WHY I do what I do. There are some basic osteopathic principles that describe this. These are: 1) each person is an integrated unit of body, mind and spirit. 2) The body possesses self-regulatory function to defend, repair and remodel itself. 3) Structure and function are integrally related. 4) Rational treatment is based on the above principles.
Treating people in this way means taking a very holistic view of each patient’s needs and treating them accordingly. So the difference will usually come from the holistic view of the patient. Treatment may or may not include medicines or manipulative treatment… it really depends on the individual.
I chose osteopathy because I like the idea of the holistic approach, focusing on individuals and not a disease. Given my background with massage, the hands-on component was vital as well. There is definitely a different type of relationship when you are diagnosing and treating patients with your hands, and I like that.
4. What are some of the best preventive elements of osteopathic manipulation?
Going back to those four basic principles, we know that structure and function are integrally related. So if there are structures of the body that aren’t working optimally, they can’t function properly. Our bodies can only handle so much dysfunction before they succumb to illness or we experience pain due to that dysfunction. For instance, if there are muscles that are tight when they shouldn’t be, I can help restore proper tone in the muscle and therefore help restore the body to its proper structure. The problem with a tight muscle goes way beyond the muscle itself. It causes strain on the nerves, blood vessels, and lymphatics in that area which in terms causes changes up- and downstream from there which then cause their own problems. So to prevent illness or discomfort we restore the body to its proper structure so it can take care of itself.
As an example, I have patients with respiratory illnesses who see me regularly. Part of my focus is on keeping their ribs and the muscles around them moving the way they should. This maximizes the efficacy of their breathing effort. When that happens they have more energy to spend on doing things besides breathing. It also decreases time on heavier medications (or hospitalization) for their disease and they live happier, healthier lives.
Outside of manipulation, a part of my time with most patients is spent on prevention. If there are postural exercises, stretches, or lifestyle modifications to make we discuss them. Keeping in mind that each person is a unit of body, mind, and spirit, I enjoy the challenge of looking at each patient’s life and discussing what can be adjusted to prevent illness or increase their health. This means really getting to know my patients and I like that.
5. What is a visit to an osteopathic practitioner like?
Each physician’s approach will be a little different but my approach is similar to many osteopaths. During the first visit we spend a good chunk of time talking. I’m getting to know the person – we review their medical history, any medications they take, past illnesses and surgeries, family history. I spend a lot of time talking talking about their work or schooling, hobbies, home life, etc. Those things are all really important. The things I’ll look for in someone who spends their work day in front of a computer will be different than the farmer I see after him or her.
Next I’ll do a physical exam. Part of this will be like the exam you would expect your Primary Care Physician to do. The other part of the exam will be things like watching the way a patient walks, their posture and a thorough structural exam. That entails a thorough hands-on exam of muscles, bones and ligaments throughout the body. While I’m doing that I’m assessing how well things move, if anything is out of place, tight, or painful. Once I’m done with that I’ll have a basic understanding of the patient and we’ll talk about how to treat them most effectively.
I’ll then use various techniques to treat the patient. Often, people think of back and neck “cracking” or “popping” when we talk about treatment. While I do use those techniques on occasion, and they are safe, there are a number of other techniques that may be used as well. It really depends on the needs of the individual at that time.
Follow up appointments are similar but will involve a more specific, shorter discussion on how things have been going before I do an exam to reassess the patient and offer more treatment if needed.
6. So you became board certified in family medicine prior to your fellowship in neuromusculoskeletal medicine (osteopathic manipulation), how do these two interrelate?
The two work together so well! I feel like having the extra fellowship training in osteopathic manipulation gives me an extra tool to help my patients be well. Low back pain, joint pain, headaches, and respiratory illness (including coughs, colds, and asthma) are all among the top reasons why people go to their doctor. Each of these lend themselves so well to osteopathic treatment. Not only can I prescribe my patient medications if needed, but I can offer them a hands-on diagnosis and treatment to help them change as well. Patients often leave my office feeling better than they did when they walked in, and I love that.
7. Are there ever any contraindications for osteopathic treatment?
There are contraindications for particular treatment techniques for various conditions or illnesses. However, there are almost always other techniques that can be used.
8. What kind of patients do you see?
Being a family doctor I see everyone and everything and this extends to those who see me specifically for osteopathic treatment as well. I see infants in the NICU born at 26 weeks and infants at home who are having troubles with latching and breastfeeding. Other common childhood complaints include ear infections, asthma, scoliosis, and young athletes with musculoskeletal complaints. In adults there are patients with chronic disease whose ability to function I help to maintain, such as Multiple Sclerosis or arthritic complaints. There are also plenty of athletes and weekend warriors, and hard working moms and dads. I see many patients on the older end of the spectrum, as well. It really is everyone and everything.
9. What sorts of illnesses do you see most often?
In terms of OMT, what I see the most is back pain, neck and shoulder pain and headaches. In children I see a lot of kids with recurrent ear infections, torticollis and plagiocephaly. I also see a lot of newborns with breastfeeding problems.
10. What can an osteopathic practitioner offer patients that they might not find elsewhere?
What I offer is a very complete mode of healthcare for the entire family. I understand prescription medicines and how they work and I prescribe them when needed. I use X-rays, MRI’s and CT’s when needed and can interpret them. But those are all things you would expect your primary care doctor to do easily. On top of that I offer a skilled hands-on diagnostic approach that examines the entire body. I can then use any number of techniques to treat what I find. I see it as the best of both worlds.
11. What are your feelings about natural treatments (I understand this is quite a broad term) which could include homeopathy, naturopathy, herbal medicine, Ayurvedic medicine, Chinese medicine, etc?
I get asked about these treatments from time to time and in general I’m all for them. I don’t have a great deal of training within the realms of “natural treatments” (yet) but believe they are often very beneficial. As long as something has been shown to be safe and the theory behind why it works is sound, then I’m all for it. As with any treatment I think its use should be supervised by a physician when needed, and if there is a recognizable lack of efficacy after a trial period, then let’s try something else. In general I’m really excited that more of these treatments are reaching a greater number of people.
12. I’ve talked about this in a previous post, lymphatic pumping is something we do regularly in our family if one of us comes down with a cold or other illness. Can you please explain what it is and how it works?
Lymphatic pumping is just what it sounds like – getting the lymph fluid pumped, or moving. The lymphatic system doesn’t have a pump like the heart to get fluid moving so it is dependent on muscle contraction and motion throughout the body. When the lymphatic movement is optimized the immune system can deliver and remove necessary components to fight illness. Lymphatic pumping usually involves a pumping or rocking motion from the feet, the legs, hips, abdomen, ribs or shoulders.
A couple of months ago I posted about how to stay healthy during the changing seasons and I mentioned lymphatic pumping because it’s something we use regularly in our family if we come down with a bug or something. Normally, you would have a physician or partner help with the pumping motion to assist the lymph fluid. However, you can also do it on your own and here’s how.
1. Lay on your bed or couch with your feet touching the headboard/wall or edge of the couch.
2. Release any tension in your belly.
3. Start gently pushing your feet against the headboard or edge of the couch until you are rocking back and forth.
4. Rock gently back and forth for about 5 minutes.
Many thanks to Dr. Groesbeck for his thoughtful and informative interview. I’m certain Dr. Groesbeck’s patients are happy to be under his care. My hubby is seeing an osteopath next week!