Perceptions of philosophic and practice differences between US osteopathic physicians and their allopathic counterparts.

Data were gathered through a random national mail survey of 3000 US osteopathic physicians. Nine hundred and fifty-five questionnaires were usable for analysis. Through open-ended questions, osteopathic physicians identified philosophic and practice differences that distinguished them from their allopathic counterparts, and whether they believed the use of osteopathic manipulative treatment (OMT), a key identifiable feature of the osteopathic profession, was appropriate in their specialty. Seventy-five percent of the respondents to the question regarding philosophic differences answered positively, and 41 percent of the follow-up responses indicated that holistic medicine was the most distinguishing characteristic of their profession. In response to the question on practice differences, 59 percent of the respondents believed they practiced differently from allopathic physicians, and 72 percent of the follow-up responses indicated that the osteopathic approach to treatment was a primary distinguishing feature, mainly incorporating the application of OMT, a caring doctor-patient relationship, and a hands-on style. More respondents who specialized in osteopathic manipulative medicine and family practice perceived differences between them and their allopathic counterparts than did other practitioners. Almost all respondents believed OMT was an efficacious treatment, but 19 percent of all respondents felt use of OMT was inappropriate in their specialty. Thirty-one percent of the pediatricians and 38 percent of the non-primary care specialists shared this view. Eighty-eight percent of the respondents had a self-identification as osteopathic physicians, but less than half felt their patients identified them as such. When responses are considered in the context of all survey respondents (versus only those who provided open-ended responses) not a single philosophic concept or resultant practice behavior had concurrence from more than a third of the respondents as distinguishing osteopathic from allopathic medicine. Rank and file osteopathic practitioners seem to be struggling for a legitimate professional identification. The outcome of this struggle is bound to have an impact on health care delivery in the US. Copyright 2002 Elsevier Science Ltd.