I got in a FaceBook discusion (an argument) about the effectiveness of Chiropractic the other day when I posted a video of Dr Stephen Novella where he takes it down and I called it “Chiro-quackery” and at best it might be considered physical therapy and/or overpriced massage and at it’s worst it’s pure bullshit and quackery (my article here and opinion on Chiropractic).
In that discussion one of my friends asked me:
…Do you differentiate between chiropractic and ‘manipulation’?
What do you think of the DO profession’s use of manipulation in the course of those care and the DO philosophy?
To which I replied:
By DO I assume you mean Doctors of Osteopathic which is something again altogether different from a Doctor of Chiropractic.
To be completely honest I can’t say I know enough about the Osteopathic profession to offer any kind of quailifed opinion I would be comfortable with stating but the premise seems dubious to me and (personal anecdote warning) some of the doctors I know personally don’t think too highly of it.
Skepticism is sometimes defined as healthy doubt when faced with a lack of credible evidence so in reality I had a pretty good opinion but I am not very well versed on exactly what Osteopathy is so thinking back to something I have read from Charlie Munger (who is Warren Buffett’s partner) about The Work Required To Have An Opinion.
“I never allow myself to have an opinion on anything that
I don’t know the other side’s argument better than they do.”
— Charlie Munger
“We all are learning, modifying, or destroying ideas all the time.
Rapid destruction of your ideas when the time is right is one
of the most valuable qualities you can acquire.
You must force yourself to consider arguments on the other side.”
— Charlie Munger
I don’t yet feel I know enough about the other side, the pro-Osteopathy position to comment confidently. I think the underlying premise behind osteopathy is nonsense. That being that “that diseases were caused by mechanical interference with nerve and blood supply and were curable by manipulation of “deranged, displaced bones, nerves, muscles—removing all obstructions—thereby setting the machinery of life moving.”” The idea that the body can be cured of a disease or ill by manipulation has never been shown to be true in any scientific journal and it appears that the consensus belief amongst the scientific and medical communities is that osteopathy is pseudoscience and woo.
While I feel I may not know enough about osteopathy to criticizes it confidently like I do chiropractic or homeopathy I will defer to those that know more scientifically than I do and say I too think osteopathy is pseudoscience and woo.
That said there is some more nuance to the field and practice of osteopathy in the U.S. According to Wikipedia (Osteopathy – Wikipedia):
…In the United States, osteopaths are legally restricted from using the title D.O. to avoid confusion with osteopathic physicians who are medical doctors trained and certified to practice medicine as well as osteopathic manipulation. Osteopaths, on the other hand, are trained only in manual osteopathic treatment, generally to relieve muscular and skeletal conditions.
So that means there are two main groups of people in the U.S. that can practice osteopathy, Osteopaths and Doctors of Osteopathy. But a Doctor of Osteopathy, a DO, receives the same education and training as a MD and has equivalent rights, privileges, and responsibilities as a physician who has earned the Doctor of Medicine (M.D.) degree. Except the DO also has this additional training in hands-on manipulation of the human musculoskeletal system and there is a difference in their philosophy of patient care. A noted DO has said ““The osteopathic philosophy involves treating the mind, the body, and the spirit. It’s a more holistic approach, For the patient, the osteopathic approach is less about prescribing medications and medical procedures and more on the body trying to heal itself.”
Okay, yeah, it’s “holistic”. There’s that “New Age” phrase that is so popular, I think it’s insulting and a disservice to MDs to imply that they don’t take a holistic approach to treatment but that’s an argument for another day.
Dr. Mark Crislip, a well-known skeptic and infectious disease doctor who is the current president of the Society for Science-Based Medicine wrote in an article, Pump it up: osteopathic manipulation and influenza – Science-Based Medicine:
…The literature would suggest that OM is left behind by most DOs upon graduation. DOs are not proud of their OM, and rarely invite them ‘round to dinner. It will be interesting to see if OM fades over time in DO school as the old time true believers die off and are supplanted by a generation of DOs trained with more traditional medical education…
Which I interpret to mean that a lot of DOs are moving away and or ignoring the pseudoscientific aspects of their DO medical school education.
So do I think the traditional osteopathy that was invented by Andrew Taylor Still works and would I consent to recieving or request osteopathic treatment?
Dr. Still believed that by correcting problems in the body’s structure, through the use of manual techniques now known as osteopathic manipulative medicine (OMM), the body’s ability to function and to heal itself could be greatly improved.
No, I would not consent to recieving or request osteopathic treatment. The keyword in that statement from from the American Association of Colleges of Osteopathic Medicine website is “believed”. Dr. Still “believed” something and never provided research evidence that it was true. I would never let an osteopath treat me and I would never let a DO treat me with osteopathy although I would consent to a DO treating me medically.
• Videos On Osteopathy
• Articles On Osteopathy
- Osteopathy – Wikipedia
- Osteopathy – RationalWiki
- Pump it up: osteopathic manipulation and influenza – Science-Based Medicine
- Osteopathy in the NICU: False Claims and False Dichotomies – Science-Based Medicine
- Massage Therapy rubs me the wrong way – Science-Based Medicine
- Using language to achieve the appearance of legitimacy for quacks – Respectful Insolence
- Yes, there really are people who don’t accept the germ theory of disease – Respectful Insolence
- Physical therapy+massage+woo=chiropractic – denialism blog
- Dubious Aspects of Osteopathy
- Osteopathy – The Skeptic’s Dictionary – Skepdic.com
- I fucking hate pseudoscience – Posts
— “Osteopathy is a tricky one. An overlap between genuine, evidence-based musculoskeletal treatment and overcooked, unverified claims harking back to its “cultish” roots make for prime bafflement. Andrew Taylor Still, who is credited as the founder of osteopathy, believed that disease was all musculoskeletal in origin, and that systemic diseases such as “scarlet fever, croup, diphtheria […] and whooping cough” could be cured through osteopathic manipulative treatment (OMT). Fewer and fewer osteopaths now rely on OMT, and a good rule of thumb is to avoid the ones who claim that OMT improves general, systemic health, or can cure things like asthma. The percentage of osteopathic physicians (DOs) who are involved in pseudoscientific practices like homeopathy seems to be higher than that of medical doctors, so if you’re looking for evidence-based treatment, be sure to check that your prospective DO doesn’t dabble in quackery. And don’t be fooled – there is nothing about osteopathy, per se, that sets it apart as embracing more of a “whole-person” approach than that employed by medical doctors. I would recommend this article, by Stephen Barrett of Quackwatch to anybody considering osteopathy: tinyurl.com/ypx7qrFrom Barrett’s article: “As medical science developed, osteopathy gradually incorporated all its theories and practices . Today, except for additional emphasis on musculoskeletal diagnosis and treatment, the scope of osteopathy is identical to that of medicine.”and”The American Osteopathic Association’s web site glorifies Andrew Still and asserts that osteopathic medicine has a unique philosophy of care because “DOs take a whole-person approach to care and don’t just focus on a diseased or injured part.” I consider it outrageous to imply that osteopathic physicians are the only ones who regard their patients as individuals or who provide comprehensive care or pay attention to disease prevention.”The Wiki article is also interesting, and discusses the American Osteopathic Association (AOA)’s response to Barrett’s article.