Category Archives: Health caring disciplines

Osteopaths, are they .O.D.’d MD’S?

Osteopaths (OD or DO0seem to be physicians with an excess of training. Who needs to be able to manipulate the spine if you are suffering from asthma?В How could the muscles and spine be connected to the lungs?

I have always been aware of Osteopathic medicine, but never understood why the fuss. Ever since medical school I came across Osteopaths who were treated just like MD’s. Yet In some states the two groups did not talk to each other and even had competing hospitals across the street from each other.

Why is Osteopathic medicine different from Medicine?

In the 1800’s Health care was not as organized or regulated. A young person would seek out an older and respected physician and learn from that practitioner. Where were schools as well, in fact at the University of Maryland we attended lectures in a building that had been used since colonial times.

Anyway, in 1874, Andrew Taylor MD started treating patient with spinal and muscular manipulation. In those days surgeons and medical doctors often trained and worked separately. The various medical sciences were in their infancy. If you were ill there were very few truly effective therapies, at least not by today’s standards. The principles of medical science were beginning to be set down. (Actually they are still evolving.) Much of the science consisted of trial, error and observation and conjecture. There are some well-known experiments that would be respected today, but most would not be accepted for publication.

The students of Dr. Taylor went two ways. Dr. Taylor insisted that his students also be MD’s, but others just taught the muscular skeletal approach. Their practice became much like Chiropractors. In most parts of the world and Osteopath practices just like a Chiropractor. In most parts of the US they are treated just like MD’s.

Osteopaths are not MD’s

Osteopaths differ from in MD’s not just in name. The thinking of Osteopathy is that they approach their patients with four principles in mind. First, the mind, body and spirit are one. Second, the body has self-regulatory mechanisms that seek to return the body to best function. Third, structure and function are related, a tight muscle indicates a dysfunction. And fourth, no one of the first three principles operates alone.

This sort of approach was not taught in my medical school. We attended many courses that thought the medical science. The idea of a mind – body connection was not talked about. Spiritual aspects of health were not mentioned. The idea of prayer healing was weird.

I remember a colleague mentioning a patient of his who had had cancer. He had little to offer her. She had taken herself to a prayer healer. When she returned the cancer was gone. We did not understand it, but if it worked for her, Great! However, it would have been malpractice to refer other patients her prayer healer.

In recent years studies on prayer and other forms of spiritual therapy often appear in the medical literature. Duke University has a Center dedicated to this. Other centers also exist.

As I retrained in Public Health, I became aware that for many the spirit was the source of illness not the other way around. I was apt to encounter people who believed as such. In fact Native Americans have always believed in such. The old westerns seemed to emphasize the herbs and potions as much as any ritual. The native American Beliefs were not mentioned in those westerns.

So to whom do you turn for healing?

That depends upon what ails you. Unfortunately, your symptoms don’t always tell the whole picture. We easily recognize common illnesses because they are common. Many times they will bet better on their own. Physicians have to restrain themselves when faced with a cold. Antibiotics can actually make matters worse. They kill the common bacteria and leave the body open to uncommon bacteria. If a virus caused your cold, the antibiotic had no role in your recovery, even if you feel they did.

Other illnesses like stomach upsets can have many causes. They usually get better on their own with only Tender Loving Care and Time. So enjoy your chicken soup.

Inflammatory conditions are not well understood. The interplay and mind, body and other factors remain elusive. Understanding the body as an integrated whole is essential.

If the tried and true does not work for you, then try what has worked for others. It will take time and much work to generate the evidence we have for the tried and true to become mainstream. New ways to study them will need to be designed.

Taking charge of your health and deciding to get better, may just do that. So, decide to be healthy.

PS. Joy can help a lot.

As Always, Seek joy,

Coach Dr. Dave



Trauma from Healthcare


 We all know some things in healthcare can be traumatic such a surgery. However to articles in the New York Times suggests healthcare is more traumatic than we expect.” Nightmares I.C.U.

“and the related letter “Diaries Aid Mental Recovery” suggests as much more common than I would’ve been expected. Have you experienced nightmares after healthcare?

In my years as a physician I was often called upon to manage delirious patients. Sometimes I could calm them down the path that of I by just talking to them. Often I had to physically restrain them, until medications could do the job. I thought little of how the patient might remember this. I probably should have known better.

As an infant I came to hate shots. Then age 3 a bout of whooping cough landed me in the ICU. The pain from a shot of penicillin got me to take a deep breath. I coughed out the mucus and breathe better. after I returned home I experienced night terrors for a wild. I can still recall some of the content of those nightmares. I still do not like getting poked with needles, but decided to not let it bother me when I started drawing blood and starting IV’s.

The New York Times articles suggest that some of the things we do are not as helpful as we think. As a geriatrician I tried to look for the cause of delirium as soon as possible. After the anesthesia from surgery we usually figure it’s the residual sedation from the anesthesia. Thus we would strive to avoid additional sedatives. In an ICU setting especially with the respirator the treatment can cause major panic. Patients have told me it’s next to impossible to breathe with the machine. As we try to get the patient off the respirator we set the machine to breathe with the patient. When this doesn’t work we use a variety of drugs some of which are supposed to cause amnesia.

These drugs do not cause a perfect amnesia. Often their use for such common procedures as colonoscopies. Many patients have told me they remember the whole thing. At least they don’t recall any pain. So I guess they’re effective when used this way.

Does healthcare cause other traumas?

When I was confronted with a new illness that might be cancer, I was never quite sure what to tell the patient. Even when I would’ve bet the lump was cancer, I hesitated to say so. This situation has been discussed much among physicians.

The idea of posttraumatic stress occurring from healthcare offers much room for study and improvement. This study can also be expanded to veterinary medicine. My cat in the associated photo was Seeking refuge on top of the kitchen cabinet. I was about to take her to the veterinarian. She had serious dental problems and would not eat or drink. She is about to get her teeth extracted. I have found she will eat cooked chicken  and drink chicken broth.

Healing from Healthcare Trauma

Most people get over the trauma of healthcare fairly quickly, but not all. There are several things you can do if you are wondering about what might be after effects of healthcare. First, talk to your provider. He or she can review the official report and explain what happened. This will allow you to compare your recollections with that history.

If your family of someone set up a Caring Bridge site for you there will be another record of your stay in the hospital. This can be helpful to family and friends as well.

If these leave you needing more a coach or councilor can help. Because they are attuned to your feelings and not the system that caused the trauma they may be better. SAs always You can consult me about your options thru my website.

As All Ways, Seek Joy,

coach Dr. Dave,

author of the forthcoming book, “recipes for lemonade (thriving through disability): Dr. Dave’s personal recipe”

Chiropractic, medicine or voodoo?

Years ago when I graduated from medical school it was unethical to have any professional contact with chiropractors. After seeing how ineffective we were at managing lower back pain I considered learning some chiropractic techniques. Does chiropractic therapy have anything to offer those with chronic illnesses?

Chiropractic therapy was founded in the United States in the late 1800s. It was one of several approaches to health care that emerged at this time. Unlike mainstream medicine otherwise known as allopathic medicine chiropractic medicine assumes all illnesses originate in a single source. Allopathic medicine assumes that therapy can come from many sources and their current model of disease can be referred to as a bio psychosocial model. Thus to me osteopathy  seems like a cardiologist claiming that all the ills one can suffer can be treated by treating the heart.

The other tenets of chiropractic medicine sound more familiar.. A conservative approach using the least harmful therapy we can all ascribe to. Unfortunately most professionals believe in what they’re doing and have only limited understanding of what others can offer their patients. If a patient came to me I was apt to prescribe medication because that was what I was trained to do. Over the years I learned others might have better options. We now expect a healthcare provider to attempt to explain the options and make referrals as the patient chooses. I have seen the good and the bad medications and surgery can do.

The third tenant of chiropractic medicine is the concept of homeostasis. This means that the body will try to heal itself. This was the point I was attempting to make in my blog, “your doctor won’t cure you”. If our bodies didn’t have an innate ability to heal itself life would not exist.

How do chiropractors approach illness?

Chiropractors initially believed that all illnesses could be traced to derangements of the spine. The spine contains the spinal cord through which the brain communicates with most parts of the body. thus if those communications are altered or interrupted the body would be out of alignment. We have all seen people with pinched nerves or major spinal cord injuries. Chiropractors however assume that subtle now alignment of the spine can cause illnesses that have little if anything to do with the spinal cord. In the United States it would be illegal for a chiropractor to claim he was treating diabetes. Studies have however, have shown that chiropractic medicine can be a helpful adjunct in treating lower back problems. There is more controversy about how effective they are treating other musculoskeletal problems.

Besides the spinal manipulation there is a therapeutic  benefit of interpersonal contact and of touch. There is a concept of therapeutic personality. I had several patients tell me they felt better just coming to see me. I was also convinced that many people suffering with the flu were at the point where they were going to get better when they decided to do something about their illness. Taking charge of your health can be therapeutic in and of itself.

Humans are also tactile animals we love to be held and touched. As we grow older we have experienced touching that was not so pleasant. But at times I felt a hug could be therapeutic. After dealing with the carnage of an horrendous accident, in which two kids were killed I had to hug my children.

Could chiropractors be therapeutic and other ways? Could they be therapeutic just because they’re not MDs? What have been your experience with chiropractors?

As All Ways, Seek Joy,

Coach Dr. Dave

author of the forthcoming book,, “Recipes for lemonade (thriving through disability ): Dr. Dave’s personal recipe”