LETTERS
306 • JAOA • Vol 102 • No 6 • June 2002 Letters/Corrections
DO questions need for
proposed new tenets of
osteopathic medicine
To the Editor:
The article containing new tenets of osteo-pathic
medicine proposed by Felix Rogers,
DO, et al (J Am Osteopath Assoc 2002;102:63-
65), fails to address an obvious issue: What
is wrong with the existing four tenets or
osteopathic principles? The answer(s) to that
question should then direct us to specific
areas that require revision.
The authors state that “if tenets are accu-rate
and true, they will stand the test of time.”
Have the current four tenets not withstood
the test of time?
It seems that the cart is ahead of the horse.
Change for the sake of change is unwise;
however, change for just cause is wise. At
this point I have not been shown the just
cause. I await the ad hoc committee’s
showing the need and cause; otherwise, I
question why new tenets are proposed.
ROBERT C. CLARK, DO
Chair, Department of Osteopathic Manipulative Medicine
Touro University College of Osteopathic Medicine
Vallejo, California
Response
At the risk of sounding flippant, let me begin
by pointing out that tenets are like a favorite
sweater: you don’t realize it is worn out until
someone points it out to you.
Our group discovered that developing
tenets is complicated, because of multiple
requirements. While tenets need to repre-sent
an acceptable definition of the philos-ophy
and scientific basis of osteopathic
medicine, they should reflect best practices
and represent guidelines to shape osteo-pathic
care. Further, medicine has changed
since the tenets of osteopathic medicine were
proposed in Kirksville, Mo, in 1953.1 Not
only has our profession grown in numbers,
but it has become significantly more het-erogeneous.
Although it remains a profession
that is predominantly based on primary care
medicine, there is a wide variety of practice
styles, some of which emphasize osteopathic
manipulative medicine and others that are
group-based or part of multispecialty prac-tice.
Likewise, there have been major changes
in AOA-accredited hospitals, our relation-ship
to the allopathic medical profession,
patient involvement in healthcare, third-party
reimbursement, and guidelines for evi-dence-
based medicine.
As osteopathic medicine becomes a sig-nificant
part of the larger scientific commu-nity,
our language needs to change to reflect
that growth. A prior tenet stated that struc-ture
determines function, yet how do we
interpret that tenet today as we unravel the
secrets of the human genome? If others
pigeonhole the osteopathic medical profes-sion
as providing distinctive care only
through osteopathic manipulative treatment,
it becomes even more important that our
tenets need to change to acknowledge our
emphasis on the musculoskeletal system,
with an indication that our profession is part
of a much larger philosophy of health and
patient care.
The greatest change in the proposed
tenets and principles for care involve state-ments
related to the treatment of patients.
Corrections
JAOA—The Journal of the American Osteopathic Association regrets the following
typographical errors:
May BM, Hogan DE, Feighner KR. Impact of a tornado on a community hos-pital.
J Am Osteopath Assoc. 2002;102(4):225.
Lines 12 through 15 of the abstract should read as follows: “A total of 147 patients
met the study criteria, with an admission rate of 31 (21%) of 147 patients (6
[19.4%] of 31 to the operating room, 4 [12.9%] of 31 to the intensive care unit, and
21 [67.7%] of 31 to ward beds).”
These lines were printed in error as follows: “A total of 147 patients met the
study criteria, with an admission rate of 116 (21%) of 147 patients (6 [19.4%] of
31 to the operating room, 4 [12.9%] of 31 to the intensive care unit, and 31 [67.7%]
of 31 to ward beds).”
Protapapas MG, Cymet TC. Joint cracking and popping: Understanding noises
that accompany articular release. J Am Osteopath Assoc. 2002; 102(5): 245,283-
287.
The name of the first author of this article is misspelled. It should appear as: Marina
G. Protopapas, DO.
The current motto of the American Osteo-pathic
Association is: “DOs: Physicians
treating people, not just symptoms.” Prior
tenets fail to provide a foundation for that
statement. In contrast, the motto can be sup-ported
by the proposed tenets for patient
care which identify the patient as the focus
for healthcare and emphasize the need to
address the primary cause of disease, opti-mize
the patient’s natural healing capacity,
and underscore health maintenance and dis-ease
prevention, while incorporating evi-dence-
based guidelines.
FELIX J. ROGERS, DO
Ad-Hoc Committee on Tenets and Principles
Downriver Cardiology Consultants
Trenton, Michigan
Clinical Professor
Michigan State University College of Osteopathic Medicine
East Lansing, Michigan
Reference
1. The special committee on osteopathic principles and
osteopathic technic, Kirksville College of Osteopathy and
Surgery. An interpretation of the osteopathic concept.
Journal of Osteopathy. 1953;60:1-10.
