Five years ago, then-16-year-old Daniel Gallegos was rushed to LA County USC Medical Center after a terrible car crash. The teen was put on life support solely to maintain the viability of his organs for harvesting.
“His lung was sheared from its wall cavity, his spleen severed, liver lacerated, pelvis shattered and his left arm was broken,” said Gallegos’ mother, Connie Schultz. “I wouldn’t wish this on even my worst enemy.”
After four days in a coma, 10 days in intensive care and more than a month in Children’s Hospital, Gallegos was sent home just barely alive.
“He was completely bedridden,” Schultz recalled. “They sent him home with an open wound in his abdomen and had left his arm to heal on its own. Surgery wasn’t an option in his condition.”
It was only after the boy’s arm worsened that Gallegos’ pediatrician suggested that Schultz try a different approach.
“When my son’s doctor recommended an osteopathic physician, I figured that I had nothing left to lose. I would have tried anything,” she said.
Doctor of osteopathy Sean Tsai came that same day and performed the first in a series of weekly osteopathic manipulative treatments (OMTs) on Gallegos.
After the first treatment, Gallegos slept through the night. Four months later — without any additional medication or physical therapy — Gallegos was walking. And now, at age 22, he is the owner of a thriving T-shirt business.
“I thank the doctors at county for giving back my son’s life and I thank [Tsai] for giving him his quality of life back,” Schultz said.
Success stories like this are unusual. Perhaps Gallegos was lucky — but it is also possible that more people could reap the benefits of osteopathic medicine if insurance companies made them more readily available.
Although in practice most DOs are indistinguishable from MDs, their philosophy will always be inherently different from that of a typical MD, an allopathic physician.
“MDs and DOs have exactly the same credentials,” said Dr. Michael Seffinger, DO and interim chair of the department of osteopathic medicine at Western University of Health Sciences, the only osteopathic medical degree program in Southern California. “Both degrees allow the graduate to become fully licensed physicians. The only difference is that DOs spend additional hours in medical school learning how to touch patients and learning how to evaluate them as whole people.”
The philosophical foundation of osteopathy is to look at a patient as an entire person — not just an individual symptom. DOs often find that the root cause of knee pain may stem from the feet or that lower back pain may signify that a patient has one leg longer than the other.
Tsai, who has a private practice in Pasadena, is one of the few doctors of osteopathy in Southern California who chooses manipulation as his primary method of rehabilitation. OMT refers to a hands-on system of treatment in which the physician uses gentle pressure and resistance to realign bones, muscles and joints.
Seffinger believes that although most DOs do not use their skills in manipulation as a regular course of treatment, the hours spent learning to view patients through a holistic lens makes them approach medicine differently from MDs throughout their careers.
“Research shows that even DOs who don’t perform manipulation still spend more time with patients than the average MDs,” Seffinger said, adding “of course, there will always be some MDs and DOs who are exceptions.”
Despite their positive values and incontestable medical credentials — Dr. Ronald Blank, DO, was formerly the Surgeon General of the US Army — DOs have historically faced severe discrimination, especially in California. Perhaps because osteopaths (as opposed to doctors of osteopathy) worldwide are not necessarily trained medical practitioners, neither the American public nor the medical field has ever fully accepted DOs as mainstream.
“Some people still think of me as a voodoo witch doctor,” said Dr. Brian Loveless, who has a private practice in Chino, “which is pretty frustrating since I spent seven years in medical school.”
Traditional allopathic physicians are generally not opposed to osteopathic manipulation as a course of treatment, but they see its shortcomings as well.
“I recommend that patients always try a non-surgical approach, but sometimes it becomes clear that surgery is the only option for a patient,” said Dr. Arya Nick Shaime, a spine surgeon at the UCLA Medical Center.
“When a patient continues with osteopathy or physical therapy because they are afraid of surgery, I see that as a huge problem,” Shaime added.
In 1962, the California Medical Association (CMA) de-accredited DOs — requiring that all practicing osteopaths in the state pay $65 to have their licenses switched to allopathic degrees (MDs). Eighty percent complied with the law. But California DOs waged a more than decade-long battle against the CMA that resulted in their re-accreditation in 1974.
Dr. Ethan Allen, DO, still a practicing physician in Norwalk, paid the $65 in 1962 and then shoved his MD license into a drawer, refusing to abandon his osteopathic philosophy and approach.
“During that time I still believed in the validity of my manipulation skills that MDs don’t have,” Allen said. “Sixty-five percent of my patients come to me for OMT and I believe that it is successful. I wasn’t about to give that up.”
Now the most formidable combatants in the war against osteopathic medicine are insurance companies.
Loveless is presently engaged in a dispute with a small insurance company, but DOs are frequently denied reimbursement for their services by large companies as well.
“Insurance companies aren’t legally allowed to discriminate against DOs,” Loveless said. “But they find ways to do it anyway. Often insurance companies will classify OMT as physical therapy and only partially cover treatments or limit the number of sessions that they allow. That means that I have patients who can’t afford to see their treatments through to the end.”
Because of rising discontent with the medical field, Loveless expects that more people will begin seeking alternatives — but find that they are financially barred from the luxury of a second opinion.
“Most of my patients are people who have been suffering with chronic pain for a long time, many of whom are considering surgery,” Loveless said. “Sometimes surgery is necessary but sometimes it is avoidable. It’s sad that the alternative isn’t accessible to everybody.”
Not only a DO but also an historian of osteopathic medicine, Seffinger added that “Big insurance companies are always looking for ways to justify keeping their money.”
Since a few DOs who practice manipulation have opened practices in Santa Monica and Hollywood, osteopathic medicine has infiltrated the celebrity healing circuit.
“I can’t help but think that if one of those stars got on TV and talked about OMT, my phone would be ringing off the hook,” Loveless said.
But increased publicity would not solve the problem of making osteopathic medicine available to the elderly, people whom Loveless believes need it most. “But they are also the ones who struggle the most to pay for it,” Loveless said.
The majority of OMT recipients now fall into one of two categories: people who can pay for treatments up-front without having to think about the cost and people willing to make financial sacrifices for their health.
Now that Daniel Gallegos has fully recovered, he and his mother still see Tsai as their regular physician. “I pay Dr. Tsai out of pocket,” Shultz said. “It’s a big sacrifice, but one I will always be willing to make. I see healthcare as something that should be a given, not something extra or conditional. And that’s not the way it is in this country.”