After three of Andrew Taylor Still’s children died of spinal meningitis in 1864, the midwestern healer turned against mainstream medicine. Eschewing drugs and surgery, Still gravitated toward the wellness offerings of his era, dabbling in magnetic healing and hydrotherapy, before outlining a philosophy of his own. Drawing from the teachings of his Methodist-preacher father and his own experiences farming on the frontier, Still argued that the body was a self-healing machine. When physical, psychological, and spiritual afflictions interfered, a doctor’s job was to gently return a patient to homeostasis, usually through hands-on manipulation of the spine. Still called this new discipline osteopathy.
While allopathic, or medical, doctors can trace their lineage back to Hippocrates and ancient Greece, osteopathy is a uniquely American tradition, comparable to jazz, says Wolfgang Gilliar, the dean of osteopathic medicine at Touro University, in Nevada. One in five Americans has never heard of osteopathic doctors, according to the American Osteopathic Association, but they are a substantive presence in health care. As of 2017, they quietly account for more than 8.5 percent of all physicians in the United States and 26 percent of first-year medical students. While M.D.s may specialize in ever more complicated fields, many D.O.s are proud generalists, and they’re more likely to serve patients’ most basic health needs as primary-care doctors. They are especially prevalent in rural settings, but one is also in the White House: In 2018, President Donald Trump selected the osteopathic doctor Sean Conley as his physician.
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Today, osteopathic manipulative medicine consists of dozens of manual techniques—many of them also employed by masseuses, chiropractors, and physical therapists. There’s high velocity, low amplitude, or HVLA, a pretzel of trust in which a doctor wraps their arm around a curled-up patient to deliver a quick, popping thrust. Strain/counterstrain, which involves holding a patient’s aching joint in a pain-free position, is so gentle that it can feel like nothing at all. D.O.s also do soft-tissue work, including kneading and stretching; lymphatic techniques, such as pumping a patient like a Shake Weight at 100 beats per second to encourage drainage; and myofascial release, a subtle but sustained pressure on irritated trigger points.
Many patients of osteopathic doctors, myself included, are exceedingly loyal. D.O.s believe that their holistic approach distinguishes their practice from that of allopathic doctors, and although they spend about the same amount of time with patients as other primary-care doctors, they are more likely than allopathic doctors to ask about a patient’s family life in relation to health. For those who respond to it, manipulative treatment can also provide a drug-free form of pain relief—something that the opioid crisis has shown patients desperately need, yet few doctors feel equipped to address. Whether they know the term or not, many Americans want what the osteopathic philosophy promises: a doctor who trusts their self-knowledge and sees them as a