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The Patient-Centric Approach Turns 125 Years Old this Year, Here’s Why it’s Trending Today

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Over a century ago, a philosophical medical doctor by the name of A.T. Still decided to test a breakthrough theory. At the time, a lot of medications that were being used to treat patients were doing more harm than good. He believed that looking at a patient from a holistic perspective, that by considering that person’s well-being outside of their chief complaint, could change the way the western world approached medicine.

He was right, but he was also way ahead of his time. More recently, many medical doctors are co-opting the patient-centric approach practiced by osteopathic doctors, or DOs, for over a century. Patients are understanding that one trip to the doctor, or one filled prescription, isn’t really the key to long-term health.

“The patient-centric approach focuses on the patient’s total needs, their home and socio-economic situation, their health literacy, and how all the factors that make up their lives truly affects their health,” says Dr. Jay Feldstein, President and CEO of Philadelphia College of Osteopathic Medicine (PCOM), about the osteopathic approach developed by A.T. Still. “Taking the extra time to focus on what the individual’s health care needs really are is the key to getting a good health outcome.”

Below, we speak with Dr. Feldstein about the main factors of the patient-centric osteopathic approach and how the practice, founded 125 years ago, continues to shape the future of western medicine — maybe now more than ever.

Can you give us an overview of the history of osteopathic medicine?
So, the first osteopathic hospital opened in 1892. PCOM was founded in 1899 as the first osteopathic school in the state of Pennsylvania, and the first on the east coast. From day one we’ve paid special attention to the function of the neuromusculoskeletal system and its interaction with other body systems, and how all of that affects a patient’s health. We’ve always looked at the patient as a whole — who they are as a person, their family situation, and worked on prevention, diet and nutrition. Imagine that in 1899. Now it’s kind of in vogue, but then, not so much.

How has that patient-centric philosophy evolved?
It’s evolved to where we’re starting to build real teams around patient care. 10 to 15 years ago, you went to your primary care doctor and they may have had a few medical assistants and a receptionist. Now, you have a health care team that includes a nurse practitioner, physician’s assistant, nutritionist, dietitian, a pharmacist, a clinical social worker or a psychologist. You’re seeing more of a team approach at the time of the visit, which helps educate patients so they can be more self-aware of their own condition and play a bigger role in the decision-making process.

What kind of momentum are you seeing from an education perspective?
You’re seeing a drive in the marketplace in terms of students. Now, close to 25 percent of all medical students in the United States are osteopathic medical students. The field has grown from when I graduated in 1981, when there were only six practicing schools, to 34 accredited schools in 2017. It really is being seen as a growth opportunity as more and more people want a holistic approach to their health care.

What are a few things patients should consider when choosing a holistic healthcare professional?
First, you want to make sure that they graduated from an accredited medical school, whether it be osteopathic or allopathic (where students graduate with an MD), and that they’re residency-trained and board-certified. Then, you need to ask yourself what your personal goals are: Are you looking for a smaller practice with individualized attention? Is a strong patient-doctor relationship more important to you, or—with the advent of telemedicine—is convenience? You need someone you can communicate with and trust, and who meets your individual needs.

You mentioned that the patient-first philosophy is trending right now. Why do you think it took others so long to catch on?
I think it’s about people realizing that there’s only so much you can do with medication and surgery and that if you don’t treat the behavior — which is kind of the root issue in all chronic diseases —you tend to spend more in the medical system without necessarily having a better health outcome.

How does that make you feel, as someone who’s known this all along?
Well, I think it’s validation of what we’ve been saying and doing for over a hundred years.

For more information about Philadelphia College of Osteopathic Medicine and their approach to holistic medicine, visit pcom.edu.