Osteopathy in the USA after Still
In the early 20th century, osteopathy in the United States moved closer to mainstream medicine. The first state to pass laws giving those with a D.O. degree the same legal privilege to practice medicine as those with an M.D. degree was California in 1901, the last was Nebraska in 1989. In 1962, in California, the AMA tried to eliminate the practice of osteopathic medicine in the state. In 1974, the California Supreme Court ruled that licensing of DOs in that state must be resumed, and as of 2012, there were 6,368 D.O.s practicing in California. Osteopathic physicians are licensed to perform surgery and prescribe medications, and are taught to practice medicine with a patient-centered, holistic approach, emphasising the role of the primary care physician within the health care system plus osteopathic manipulative therapy (OMT) as an adjunctive measure to other biomedical interventions for a number of disorders and diseases. There are currently 29 osteopathic medical schools in the United States, offering education at 37 locations. As of 2011, there are approximately 78,000 osteopathic physicians in the U.S., but only about 2,000 of those practice OMT as their sole modality. (90% of manipulative therapy in the US is administered by chiropractors, of which there are 49,000). A 2001 survey of osteopathic physicians found that more than 50% of the respondents used OMT on less than 5% of their patients. The survey indicates that osteopathic physicians have become more like M.D. physicians in every respect —few perform OMT, and most prescribe drugs or suggest surgery as a first line of treatment. Osteopathic physicians are unevenly distributed in the United States. The states with the highest concentration are Oklahoma, Iowa, and Michigan where osteopathic physicians comprise 17-20% of physicians, and the lowest concentrations of DO’s are Louisiana, Massachusetts and Vermont where only 1–3% of physicians have an osteopathic medical degree. Public awareness of osteopathic medicine likewise varies widely in different regions. U.S. trained DOs are currently able to practice in 45 countries with full medical rights, including New Zealand and the United Kingdom, but not in Australia or the Republic of Ireland. The United States does not have any colleges training non-physician osteopaths, and osteopaths trained in other countries are not permitted to practice in the U.S.