to patient care through and beyond touch. Palpation is a form of listening, encouraging curiosity and fostering the ability to gather information from the patient through the body. Engaging with this approach from the earliest days of education creates a foundation of receptiveness that carries forth into all forms of interaction with patients. While palpation is not always available – due to timing of visit, personal comfort with proficiency in application of OMT or movement to telemedicine to prevent transmission of infectious disease – listening is ever-present.
Knowing that the musculoskeletal system has a role in disease and in health offers opportunity for osteopathic physicians to add a layer to listening. Hearing the reported concerns and making connections with and for the patient – how their back pain and indigestion are related, why the slip and fall was a precursor to their dysuria – remains accessible as a resource even without access to direct hands-on care in each encounter.
Living into the Tenets
Understanding that the health of the patient extends beyond the immediacy of their chief complaint and is influenced by many factors, is interwoven in the tapestry of the osteopathic approach. Consider the invitation extended by the temporary separation from direct in-person care to truly illustrate the significance of the unity of body, mind and spirit. As most complaints are of the body, the mind and spirit can be pushed aside or seen as diminutive components of both the concern of, and solution for, the patient.
This is not to discount the importance of a comprehensive physical exam or the many helpful, therapeutic, life-saving interventions that are applied through direct, in-person, hands-on care. It is to demonstrate the “and” of osteopathic medicine, along with the opportunity granted to give fair credence to the mind and spirit for the greater benefit of the patient.
It is common for the patient to attribute both feeling poorly and feeling better entirely to the experiences within and the interventions offered for their body. The time and space offered in a physically-distant encounter can create a stronger connection and illustrate the opportunity for sustainability of improvement by integrating the mind and spirit into the therapeutic measures.
One particularly helpful opportunity is to acknowledge the role of thoughts (mind) in generating feelings (spirit) leading to actions (body) and ultimately creating the results (health) for the patient. Noticing that this is not a means of assigning blame for current state of health but an opportunity to engage the patient with the therapeutic process. This develops a solid foundation of belief that they can be well and have the ability to be part of the solution, once again acknowledging the powerful relationship between structure and function, extending beyond the musculoskeletal system.
This naturally flows into the concept that the patient has the inherent capacity for self-healing, self-regulation and health maintenance. Illustrating all the ways in which they have an active role in their treatment plan encourages the patient to be an advocate for their own health. The osteopathic physician combines all of these through their expertise, experience and thoughtful engagement to create a rational and sustainable treatment plan that honors, embraces, acknowledges and empowers the patient.
Common Threads, Unique Tapestry
Modern medicine has evolved to embrace seeing the whole person. Ancient traditions are referenced as having similar sentiments that pre-date the launch of osteopathic medicine. This leads to concern that the philosophy, without the procedure, diminishes both the uniqueness and significance of the osteopathic approach. Consider that there are many common threads of health throughout the world, among varied professions, extending across many centuries. Independent components can be identified in a vast array of practices. The thoughtful combination and intentional integration into the foundational approach to patient care creates a tapestry unique to osteopathic medicine. Weaving these concepts into learning processes for osteopathic medical students, and into the practice of osteopathic physicians, offers an approach to medicine unlike any other available.
Continued Curiosity; Leading the Way
The profession began with an inquiry into discrepant outcomes, a challenge to the current system with a hope for something more. All of these continue into the present day. There are still vast discrepancies in outcomes that call us to investigate and reinforce the