Opinion: Relieving the burden on health systems through holistic solutions for self-care
Written by Dr. Boyd Buser, Chair, Osteopathic International Alliance (OIA).
Amidst a rise of chronic conditions, aging populations, and the recent pandemic it is hardly surprising that healthcare systems are increasingly overstretched.
We need the entire healthcare landscape to come together in a concerted effort to ease this pressure and strengthen the resilience of health systems globally. To this end, it is crucial that we embed holistic solutions throughout our industry.
The oldest forms of healthcare look to hold the greatest potential to improve the health of individuals and their quality of life all while strengthening health systems themselves. It has long been said that an ounce of prevention is worth a pound of cure.
Practicing self-care was the earliest means by which individuals, families and communities were able to maintain, monitor and promote their own health in order to cope with illness and disability.[1] Like self-care, osteopathy takes a rounded and preventive approach to improve overall patient well-being. This means that both osteopathy and self-care go beyond a person’s biological needs, encompassing sociological, psychological, and spiritual elements to maintain their wellbeing in the fullest sense.
Taking a holistic approach to care
Many current healthcare systems were founded around a disease-centered approach to healthcare. In the US, it wasn’t until 1874 that we moved back towards a person-centered perspective. [2] During the American Civil War, physician, Andrew Taylor Still had the idea that much like a machine, the human body could be sustained if all of its parts were returned to their proper functional relationship. [3] This concept led him to the founding of the osteopathic profession and the creating of the first school of osteopathic medicine in Kirksville, Missouri.
From this concept the field I’ve dedicated my life to arose, put simply - "osteopathic healthcare is based on a perception of the body as an integrated whole.” [4] Osteopathic professionals use a range of approaches including ‘hands-on’ manual techniques for assessment and diagnosis to identify and treat various health conditions, such as musculoskeletal structural problems that influence the body’s physiology, especially the nervous system, breathing, and circulation." [5] Osteopathic medicine recognizes the body’s inherent capacity to regulate and repair itself, the interrelatedness of body systems and the relationship between structure and function. Rational treatment should be based on these principles.
Ensuring health maintenance and prevention
I believe it is critical for osteopathy to be integrated into national health systems so that people can access it and have treatment covered under their health insurance. Osteopathy should be a primary contact profession, where you don’t need a referral from another professional. However, for this to happen, osteopathy must be a regulated profession.
A 2020 study conducted by the Osteopathic International Alliance (OIA) found that osteopaths practiced in at least 35 countries, with statutory regulation in 13 countries, and 22 countries with voluntary regulation for osteopaths.[6] Since this study was published, statutory regulation of the profession has been achieved in several additional countries.
As a result, the role of an osteopath varies widely internationally. Globally, there are two different streams of professionals providing osteopathic healthcare: osteopathic physicians who provide osteopathic medicine and osteopaths who provide osteopathy. In the United States, a Doctor of Osteopathic Medicine, also known as a D.O, is a fully trained and licensed doctor, practicing in all medical and surgical specialties. However, the physician stream does not exist in many other countries.
The OIA works closely with WHO to ensure patient care and promote osteopathy’s potential for health systems, encouraging the regulation of the profession and assuring that its distinction is maintained at the global level. We also work to promote robust, consistent educational standards through our academic partner members.
Advancing healthcare
Much like the health of an individual depends on all their body systems functioning in harmony, so too the wellbeing of health systems worldwide relies on every sector functioning seamlessly together. Over the last 10 years we have seen a significant growth in the osteopathic profession, with countries increasingly regulating the practice and recognizing osteopathy as a distinct healthcare profession. We have also seen a shift in the public perception of healthcare services, which has encouraged holistic solutions for self-care, such as osteopathy, to be included as key offerings within health systems.
In my opinion, the potential benefits of further incorporating self-care and holistic care solutions into health systems are immense, but to unlock them we first need to provide people with not just knowledge but also access to these methods of care. In this way, they will understand the benefits of the practice as an approach to health maintenance and prevention. As we strive to advance healthcare and improve health systems, it is critical that we include holistic methods of care as part of our efforts to advance universal health coverage.
About the author
Boyd R. Buser, D.O. served as the 120th President of the American Osteopathic Association (AOA) in 2016-2017. From 2007 until 2018, Dr. Buser served as Vice President for Health Affairs and Dean of the University of Pikeville’s Kentucky College of Osteopathic Medicine, where he held the rank of Professor of Osteopathic Principles and Practice and Professor of Family Medicine. He is a graduate of Des Moines University College of Osteopathic Medicine, is dually board certified in Osteopathic Manipulative Medicine and Family Medicine, and is a Distinguished Fellow of the American College of Osteopathic Family Physicians. He has taught extensively both nationally and internationally in the field of Osteopathic Manipulative Medicine. He has a long history of advocacy in the physician payment policy arena, having been elected by the AMA’s Board of Trustees to serve on the Current Procedural Terminology (CPT) Editorial Panel in 2007, the first DO to be so elected. Dr. Buser is a past Chairman of the Board of the National Board of Osteopathic Medical Examiners (NBOME) and is the current Chair of the Board of Directors of the Osteopathic International Alliance. He served as a member of the Kentucky Board of Medical Licensure from 2007-2018. From 2011-2013, he served as the Co-Chair of the AOA/AACOM Blue Ribbon Commission on the Advancement of Osteopathic Medical Education. He chaired the AOA’s Bureau of OGME Development and was an instrumental figure in the development of the single accreditation system for graduate medical education in the US. In 2020 he was elected to the Board of Directors of the Accreditation Council for Graduate Medical Education (ACGME). In 1995, Dr. Buser served as President of the American Academy of Osteopathy and was named Educator of the Year by the AOA and American Osteopathic Foundation in 1994. Dr. Buser currently resides in Kennebunkport, Maine with his wife Pam, serving as Clinical Professor at the University of New England College of Osteopathic Medicine.
[1] Factsheet Self-Care Interventions for Health. World Health Organization 2022. https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventions
[2] Osteopathic Philosophy. Western University 2023: https://www.westernu.edu/osteopathic/about/osteopathic-philosophy/
[3] Osteopathic Philosophy. Western University 2023: https://www.westernu.edu/osteopathic/about/osteopathic-philosophy/
[4] Global review of osteopathic medicine and osteopathy 2020. Osteopathic International Alliance 2020: https://oialliance.org/wp-content/uploads/2021/02/OIA_Report_2020_FINAL.pdf
[5] Global review of osteopathic medicine and osteopathy 2020. Osteopathic International Alliance 2020: https://oialliance.org/wp-content/uploads/2021/02/OIA_Report_2020_FINAL.pdf
[6] Global review of osteopathic medicine and osteopathy 2020. Osteopathic International Alliance 2020: https://oialliance.org/wp-content/uploads/2021/02/OIA_Report_2020_FINAL.pdf
