While manual medicine is an integral part of osteopathic medical education, the understanding of the importance of this medical practice has waxed and waned over the past 75 years, largely due to the increased emphasis on pharmaceutical interventions. Taking a longer view, we know that manual medicine has been a part of medical practice since the days of Hippocrates. In fact, in an era when pharmaceutical solutions were extremely rare, and surgical interventions were extremely risky, manual medicine was the primary mode of treatment. Manual medicine remained an integral part of medical practice until the Middle Ages when the black plague decimated Europe. Even in the absence of the germ theory, physicians recognized that contact with sick patients resulted in the spread of disease to the physicians. At this point, the popularity of manual medicine declined.

In the 1800s, Dr. Andrew Taylor Still "rediscovered" manual medicine and incorporated it as a tenet of osteopathic medicine. This reintroduced manual medicine into U.S. medical practice despite its absence in the philosophy of medical education that was imported from Europe.

The next great leap forward was the discovery of penicillin, which became generally available in the 1930s. Until that time, there was little medical science could do to proactively treat bacterial infections. Until the 1930s, hospitals were viewed as places to die rather than to recover. The advent of effective pharmaceutical interventions changed our view of hospitals from a hospice to a place of healing. This change of perception is evidenced by the fact that it was not until the 1940s that it was commonplace for women to deliver their children in a hospital.

As we enter the 21st century, we are a nation that is obsessed both with pharmaceutical remedies and the search for effective non-pharmaceutical remedies. The pharmaceutical industry has made spectacular strides, but their strides have driven up the product cost to the point that Americans are demanding government programs to pay for the cost of pharmaceuticals. At the same time, our society is intent on searching for remedies that do not come from the pharmaceutical manufacturers. The incidence of "home remedies" is so great that physicians are now advised to ask their patients about the use of home remedies before writing a prescription.

What does this mean for osteopathic medicine? It means that osteopathic physicians, who are trained to use both pharmaceutical and non-pharmaceutical treatment modalities, are superbly positioned to meet the demands of our society. It means that manual medicine, which is a time-honored treatment modality, can play a beneficial and vibrant role in today’s health care delivery system. It means that we at the Michigan Osteopathic Association must increase our efforts to educate third party payers of the benefits of manual medicine. Most of all, it means that the patients you serve as osteopathic physicians will benefit from your knowledge of manual medicine.