Osteopathic Medicine, Born In Missouri, Now Seeks To Fill Rural Health Care Gaps

Jun 28, 2017

Twenty-four-year-old Kalee Woody says that when she was growing up in Bronaugh, Missouri, she saw the small town slowly fading, as businesses closed, growth stagnated and residents had to drive to other places to see a doctor.

It’s a town that, like much of rural Missouri, is recognized by the federal government as having a shortage of healthcare providers.

Now Woody wants to help.

She enrolled in medical school and in July starts classes at the just-opened Kansas City University of Medicine and Biosciences campus in Joplin, the first new medical school in Missouri in nearly half a century . Woody wants to serve someday in a rural community much like the one she grew up in – where, as a doctor, she’ll also be seen as a community leader.

“They have so much contact with different people. They just get to know everyone. Everyone knows them and, by association, they become a leader,” Woody says.

Osteopathic medical schools, whose numbers have doubled in the last 10 years, are in the middle of a huge push into smaller communities.

“We’re going to have an opportunity to teach those students in a rural environment and show them how cool it really is to work there,” says Darrin D’Agostino, executive dean of the Kansas City University of Medicine and Biosciences.

Darrin D’Agostino, executive dean of the Kansas City University of Medicine and Biosciences, wants to encourage graduates of the school to practice in rural areas.
Credit Courtesy Kansas City University of Medicine and Biosciences

D’Agostino says osteopathic schools take a more holistic approach than M.D. programs, which accounts for the high numbers of doctors of osteopathic medicine, or D.O.s, going into primary care instead of specialties.

These days, the care provided by D.O.s and M.D.s is typically so similar that most patients wouldn’t know the difference. But that hasn’t always been the case.

At the root of osteopathic medicine is osteopathic manipulative treatment, a hands-on technique that looks like a cross between chiropractic manipulation and massage. There’s evidence this can help treat some kinds of pain.

It sounds New-Age-y, but the idea dates back to the days of the Old West.

In the late 1800s, a former Kansas state legislator and civil war surgeon, Andrew Taylor Still, decided to reconsider basic assumptions about medicine after he watched three of his children die from spinal meningitis.

“The therapeutic options were very different than we have available to us right now, and he thought that the available system of medicine simply didn’t work,” says Joel Howell, an M.D. and professor of the history of medicine at the University of Michigan, who has written about Still and the practice he invented.

KCUMB CEO Dr. Marc Hahn cuts the ribbon for the school's new medical school in Joplin, Missouri.
Credit Alex Smith / KCUR 89.3

Still eventually founded the first osteopathic school in Kirksville, Missouri, in order to teach his kind of medicine, which was based on a very different understanding of the body and human health.

“He set out to devise an alternative healing practice based on this notion that manipulation of the spine could improve blood flow and thus improve health by allowing the body to heal itself,” Howell says.

Osteopathic manipulation is now just one of the techniques that D.O.s are taught to use along with mainstream treatments.

The burst of new osteopathic medical schools is part of  a decades-long effort to move osteopathic physicians into practice throughout the country. Many are in states like Alaska, Mississippi and New Mexico that have very small numbers of working D.O.s.

Howell says these newly minted physicians can probably help out a lot in medically underserved parts of those states, but they may have to do some public relations work first. 

“I think they should be prepared to explain what being a D.O. means,” Howell says.

The bigger challenge may be acceptance from M.D.s. They still dominate medicine, making up the preponderance of doctors, and almost all of the most prestigious medical schools such as Harvard, Stanford and Johns Hopkins churn out M.D.s.  

“The general reception is that we ignore it,” Howell says. “We don’t know much about it; we don’t do it. I think if pushed, most people would figure that for some kinds of illnesses, it doesn’t do any harm, and it might well help.”

Earlier this month, hundreds of curious Joplin residents turned out for the opening of the new Kansas City University of Medicine and Biosciences medical school. School and community leaders in this city of 51,000 in the southwestern corner of Missouri are confident that in surrounding rural areas with a shortage of health care providers, patients won’t care much about whether someone’s a D.O. or an M.D. – just as long as they’re a doctor.

Alex Smith is a health reporter for KCUR. You can reach him on Twitter @AlexSmithKCUR