Unlike most other medical models, osteopathic medicine is uniquely based upon a foundational set of philosophical principles that form the basis of rational, evidence-based care. Originally expounded by the founder of osteopathic medicine, Andrew Taylor Still, they have been variously formulated over the last century and a half since their initial exposition. The classical understanding of Still’s fundamental concepts of osteopathy can be organized in terms of health, disease, and patient care.
Health
1. Health is a natural state of harmony.
2. The human body is a perfect machine created for health and activity.
3. A healthy state exists as long as there is normal flow of bodily fluids and nerve activity.
Disease
4. Health is a natural state of harmony.
5. The human body is a perfect machine created for health and activity.
6. A healthy state exists as long as there is normal flow of bodily fluids and nerve activity.
Patient Care
7. The human body provides all the chemicals necessary for the needs of its tissues and organs.
8. Removal of mechanical impediments allows optimal body fluid flow, nerve function, and restoration of health.
9. Environmental, cultural, social, mental, and behavioral factors need to be addressed as part of any management plan.
10. Any management plan should realistically meet the needs of the individual patient.
Over time these became condensed, and are currently expressed as the following Tenets of Osteopathic Medicine. These express the underlying philosophy of osteopathic medicine as approved by the American Osteopathic Association’s House of Delegates, and are considered official, binding, and guiding policy of the institution:
The body is a unit; the person is a unit of body, mind, and spirit.
The body is capable of self-regulation, self-healing, and health maintenance.
Structure and function are reciprocally interrelated.
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function
I tend to formulate these principles somewhat more holistically:
The person is a functionally integrated unit of body, mind, and spirit or connection to the infinite.
Persons are constantly engaging performative acts of self-regulation, self-healing, and health maintenance.
Structure and function are reciprocally interrelated at all levels.
Rational treatment is based upon an understanding of personal holistic unity, self-regulation, and the integrity of the structure-function relationship.
There has also been a movement to separate the Tenets of Osteopathic Medicine from a series of interrelated Principles of Patient Care derived specifically therefrom. These are organized as follows:
Proposed Tenets of Osteopathic Medicine:
- A person is the product of dynamic interaction between body, mind, and spirit.
- An inherent property of this interaction is the capacity o f the individual for maintenance of health and recovery from disease.
- Many forces, both intrinsic and extrinsic to the person, can challenge this inherent capacity and contribute to the onset of illness.
- The musculoskeletal system significantly influences the individual’s ability to restore this inherent capacity and therefore to resist disease processes.
Proposed Principles of Patient Care:
- The patient is the focus for healthcare.
- The patient has the primary responsibility for their health.
- An effective treatment program for patient care is founded on these tenets.
What each of these formulations share, and what is at the core of the ongoing discussion of how best to formulate and honor our founding principles, is the dynamic and holistic nature of the patient, the physician, and their interaction. As osteopathic physicians we are constantly striving to find better ways to serve the health of our patients, our selves, and the surrounding community by remaining cognizant of our intersectional and interconnected capacity to maintain and heal our own selves and others. It is this shared humanity that binds the osteopath and her oath to her practice of care. It is both what sets us apart and what makes us an integral part of the larger community of healers, and it is our duty both to guard and to spread these ideals to all who will listen, patient and physician alike.
