Talk:History of the relationship of osteopathic and allopathic medicine in the United States

NPOV

Please explain NPOV tag. With specific references and citations. Or it will be deleted. Osteopathic!Freak ^talk 01:14, 7 July 2007 (UTC)

The entire article is POV, as there are no references, other than a passing reference in Cecil, that this discrimination actually exists. It appears to me that the point of the article is propaganda, contrary to WP:NOT. Leuko 01:32, 7 July 2007 (UTC)

Agreed. ThePackLeader 03:23, 7 July 2007 (UTC) The information in this article is sources. The article is still in development. I welcome your help in writing and editing the article. The fact that you both want this article deleted, only speaks to the need for this article existence. To explain why this topic is so controversial. Osteopathic!Freak ^talk 03:39, 7 July 2007 (UTC)

I have to agree with the POV tag here. The article doesn't make a case that this "discrimination" exists, or that it's been described in reliable third-party sources. Yes, there's been friction, as the Cecil quote alludes to, but to describe it as unilateral "discrimination" is inherently POV, especially in the absence of independent, reliable sources documenting such supposed discrimination. MastCell ^Talk 04:32, 7 July 2007 (UTC)

Thanks. The unilateral nature of "discrimination" is a problem. The word comes from the policy of the AMA and AMSA, who oppose the what this article is trying to describe. Other suggestions for the name? OsteopathicFreak ^{T ?} 04:41, 7 July 2007 (UTC)

Personally, I think the best solution is to merge any relevant content about friction between the two into Comparison of osteopathic and allopathic medicine, or a related article on the relationship between the two. The problem here is that the article provides absolutely no evidence that such discrimination exists. It cites the AMA as saying this type of discrimination is discouraged, but there's no background on whether it was a real problem to begin with. I think the best, most neutral approach is to take cited, sourced material and merge it into an article on the relationship between the two branches. MastCell ^Talk 04:45, 7 July 2007 (UTC)

Valid points. I agree that the article needs more sourced info. It may even be helpful to have a time line of events, which are numerous. I am not an expert on the topic, but I am familiar with the most commonly referred to historical events. I could use assistance, at least with creating a list of events. The page is really still a stub at this point. I am also not opposed to merging with Comparison of allopathic and osteopathic medicine. My concern is making that page too controversial. OsteopathicFreak ^{T ?} 05:14, 7 July 2007 (UTC)

Keep the information, change the name

Please make suggestions for a new name for this page. Or vote for which ones you prefer. Thanks. OsteopathicFreak ^{T ?} 19:06, 7 July 2007 (UTC)

• Separation in American medicine
• History of the separation in medicine in the United States
• History of the relationship of osteopathic and allopathic medicine in the United States
• History of allopathic and osteopathic medicine
• Discrimination in medicine in the United States
• Osteopathic struggle for equality in the United States
• Acceptance of osteopathic medicine in the United States
• American Medical Association and Osteopathic medicine
• Relationship of osteopathic and allopathic medicine in the United States
• Anti-competitive behavior in medicine

My preference would be for "Relationship of osteopathic and allopathic medicine in the United States", as the most neutral. In reference to the above thread, I'd actually favor folding this information into the "Comparison" article, or even into the parent article on Osteopathic medicine or History of osteopathic medicine. Guidelines (e.g. WP:POVFORK) encourage treating controversial aspects of a subject in the parent article where feasible, rather than splitting off a "controversy" or "criticism" article to segregate such material. MastCell ^Talk 19:36, 7 July 2007 (UTC)

I agree, this article should be folded into the "Comparison" article and deleted. I believe what ought to be compared are the professional advantages/disadvantages (e.g., name recognition) of each degree, etc. Thoughts? Tcamdg 00:35, 8 July 2007 (UTC)

Another name-change suggestion "Anti-competition in medicine"  ?? OsteopathicFreak ^{T ?} 23:26, 8 July 2007 (UTC)

If there's a clearly documented history of discrimination, then it would fine to mention that. I just don't think there's enough there to form its own article, and that it violates WP:POVFORK. MastCell ^Talk 02:23, 8 July 2007 (UTC)

There's a lot of information to be added, numerous court cases and rulings. Won't all this info bog down another page? WP:SPINOUT OsteopathicFreak ^{T ?} 22:37, 8 July 2007 (UTC)

I agree that "History of the relationship of osteopathic and allopathic medicine in the United States" is the most WP:NPOV. Also, it does seem that this article is a POV-fork - right now there is not all that much that it can't be included in the parent article. Leuko 00:03, 9 July 2007 (UTC)

The neutral portions of this article belong in a parent. If/when this material becomes such a large part of its actual parent page that we need to do a WP:SPINOUT, that would be the appropriate time to re-evaluate. Antelan ^talk 05:52, 11 July 2007 (UTC)

But what is the parent? Allopathic medicine? Osteopathic medicine? History of medicine? There's no consensus on where this material belongs. Most of the article, at this point, is about specifically allopathic organizations. OsteopathicFreak ^{T ?} 13:03, 11 July 2007 (UTC)

Then the neutral and well-sourced material should be placed in allopathic articles (some is education-specific, some is broadly applicable to allopathic medicine). I can do this, if you'd like. Antelan ^talk 15:32, 11 July 2007 (UTC)

No thanks. Let's leave it here while the article is still being written. 15:52, 11 July 2007 (UTC)

As far as I can tell, my proposal complies just fine with your requirements as stated above. Antelan ^talk 18:03, 11 July 2007 (UTC)

Every subtopic does not require its own article

Documented discrimination against osteopathic medicine belongs directly in the main osteopathic medicine article, not WP:contentforked into a side article like this. Antelan ^talk 03:45, 10 July 2007 (UTC)

• Should this article be merged into History of medicine or History of allopathic medicine or History of Osteopathic medicine? Or all three? The topic is too lengthy. Fix, edit and expand this article. Don't delete. OsteopathicFreak ^{T ?} 21:52, 10 July 2007 (UTC)

This article is 7k, not all of which are usable. There would be no problem with merging the appropriate pieces to their appropriate destinations. Antelan ^talk 03:05, 11 July 2007 (UTC)

the article is still a stub. OsteopathicFreak ^{T ?} 03:48, 11 July 2007 (UTC)

POV

I still have this lingering issue with POV. Whereas on this article, you point out that osteopathic grads are entering into specialties "previously dominated" by MD grads, you have claimed on other articles that one criticism of allopathic medicine is its lack of focus on primary care. So it's a Good Thing when osteopathic grads get into those non-primary care residencies, but it's a Bad Thing that allopathic grads aren't geared up for primary care. In essence, both osteo and allo are trending in the same direction, but you're slamming allo for doing the same things that causes you to praise osteo. Antelan ^talk 00:35, 12 July 2007 (UTC)

I'm not slamming them for anything. I'm just reporting what others have said. If I've indicated otherwise, I should change the wording, but keep the info. In other words, I'm just reporting that some people point to primary care focus (lack of specialty focus) as a weakness of osteo, others point to allo and say the lack of primary care is their weakness. Not my words, the words of critics. Common, well-sourced criticisms of both should be included. Gives the reader more information on what the discussion/controversy is about. OsteopathicFreak ^{T ?} 00:56, 12 July 2007 (UTC)

I guess I just don't see how either of those are really criticisms. Even though some might color them as such, we don't need to. For example, it is a fact that DOs are increasingly entering non-primary-care residencies. It is a fact that MDs have traditionally focused on non-primary care specialties and continue to do so. While I understand that these can be used to criticize both groups, the facts themselves are neutral and we really should try to stick to that. What do you think about that angle? Antelan ^talk 01:32, 12 July 2007 (UTC)

I do think its relevant that these facts are used in the context of criticism. There is quite a bit of discussion about the state of primary care medicine in the US. However, I think that's a whole other conversation, and as such deserves only a brief mention here, at most. I agree with you that the "facts", are far more important, while their placement within a rhetorical context is less so. OsteopathicFreak ^{T ?} 02:03, 12 July 2007 (UTC)

Dubious first sentence

The first sentence states, "The history of the relationship of osteopathic and allopathic medicine is described by the Cecil Textbook of Medicine, 22nd ed. as a history of "strong efforts" by allopathic organizations to discredit osteopathic medicine". Is that the best summary of the history of the relationship between osteo and orthodox medicine - that orthodox medicine simply tries to discredit osteopathic medicine? This article on Wikipedia is the first that I've seen claim this in such a broad way, and I cannot find the quotation in the Cecil textbook of medicine. If it's there, let's get a quote within the <ref> tag to back this statement. Antelan ^talk 07:05, 22 July 2007 (UTC)

I don't have a problem with getting you the exact quote. And I agree that this article needs to be expanded to include other aspects of the history of this relationship. But I have to say, its really disappointing that the tone of this has to get so accusatory so quickly. Why the offensive posture? I didn't make the quote up. I don't understand why this conversation has to be so acrimonious.

MANIPULATIVE AND BODY-BASED METHODS

Therapeutic massage, chiropractic, and osteopathic manipulation are the best known of the manual therapies. Massage is widely practiced and licensed in 25 states. Manipulation procedures are practiced largely within chiropractic and osteopathic systems that emerged in the American heartland in the late 19th century. Both fields originally proposed that vertebral misalignments contribute to many diseases, each of which could be treated by appropriate manipulations. There were strong efforts by allopathic organizations to discredit chiropractic and osteopathic medicine. In part as reactions to these challenges, chiropractic medicine evolved as a discrete discipline that primarily uses spinal manipulation, most often to address musculoskeletal problems. Four years of postgraduate education lead to a Doctor of Chiropractic (D.C.) degree, and chiropractic physicians are licensed to practice in all states.

Osteopathic medicine also may use manipulative techniques, but historical differences between osteopathic medicine and allopathic medicine otherwise have disappeared. Other than teaching manipulation, undergraduate medical training for an osteopathic degree (D.O.) is now virtually indistinguishable from that which leads to the M.D. degree. Osteopathic physicians complete conventional residencies in osteopathic or allopathic hospitals and training programs; are licensed in all states; and have rights and responsibilities, such as military service, that are identical to allopathic physicians and surgeons.

— Cecil Textbook of Medicine, 22nd ed. 2004. Chapter 34.

If you have access to "MD consult" through your schools library - you'll find the complete text of Cecil there. (Aside - marked amusement at irony of referring to website named "MD consult" for this information. :) ) ^Touro OsteopathicFreak ^T 11:59, 22 July 2007 (UTC)

Additional note: Where are you at with the POV tag? What needs to be changed before it can be removed? ^Touro OsteopathicFreak ^T 12:59, 22 July 2007 (UTC)

That quote is substantially misrepresented in the article. The Cecil source simply states, "There were strong efforts by allopathic organizations to discredit chiropractic and osteopathic medicine", most likely in reference to the Flexner era (circa 1910) efforts but certainly not extending throughout all of history since then. The lead of our article says, "The history of the relationship of osteopathic and allopathic medicine is described by the Cecil Textbook of Medicine, 22nd ed. as a history of "strong efforts" by allopathic organizations to discredit osteopathic medicine". That is a POV-pushing stance that twists a source's statement to achieve an end. You'd better believe that I will go on the offensive when sources are abused in this way. Antelan ^talk 20:13, 22 July 2007 (UTC)

OK. Wow. You seem really pissed about this. I do want to edit and make this article better. It is still in development. I will make a point of looking for more sources that discuss this topic. Such as discussions of the Wilk case, and California '62. I don't mean to be "abusing" any sources.

I gave you the full quote so that you could make better use of it. I'm actually really interested in this article being better. WP:AGF. This tone feel really threatening - "You'd better believe that I will go on the offensive." I like working with you on these article. But this kind of talk makes it really not fun. ^Touro OsteopathicFreak ^T 23:46, 22 July 2007 (UTC)?

You asked, "Why the offensive posture?" and I responded to an entirely different question altogether - sorry about that. My goal was to explain why I was taking the posture I took. I failed to thank you for providing the entire quote - so thank you. I'm sorry that my tone was so strident, but I stand by the content of my statements. After re-reading the intro sentence to this article, I still think it's out of step with this source, and I still maintain that it is lopsided towards one POV. I do consider it an abuse of sourcing when a sentence is attributed to a source that doesn't actually back it. Like you, I look forward to improving the medicine-related articles on Wikipedia. Antelan ^talk 00:55, 23 July 2007 (UTC)

I think your rewording of the Cecil sentence brought it into line with the source; thanks. Antelan ^talk 18:42, 6 August 2007 (UTC)

Intro paragraph

The new sentence seems perfectly neutral and true to the source to me, and I'd advocate that that might be a good starting point for the article. The intro paragraph could start with that new sentence to get things out on the table, then briefly identify major events in the history, and then mention the current status. What are your thoughts? Antelan ^talk 22:44, 25 July 2007 (UTC)

Sigh of relief. I glad you are okay with this quote. I'm glad that it is from AAMC pres. Getting it directly from an important allopathic source helps improve POV.

Your idea sounds prefect. Step on is getting the conflict out on the table, so people understand this was contentious. Then moving through quick list of most noteworthy events. Then closing intro with very clear statement about recent changes, improvements of the relationship - making it clear that the relationship has dramatically changed from 100, 50, 20 years ago. ^Touro OsteopathicFreak ^T 23:04, 25 July 2007 (UTC)

Regressed graphs

The graphs on this page with regression lines constitute original research. They could be a good graphical representation of the data you're presenting (which probably belongs on the osteopathic medicine page but I'll get back to that later) without the regression line. Antelan ^talk 21:23, 3 August 2007 (UTC)

OK - I actually appreciate what you are saying. But . . . seriously, do you really think this is original research? It's just a graph? Having a line makes them look nice. If you don't like the extrapolated data, I'm more understandable that this is more OR. I think we're we're being a little fine toothed though.

I agree that perhaps this info belongs better on the Osteopathic medicine page. Yet, I also hestitate, then that page becomes about allopathic residency programs. The osteopathic page should be about the osteopathic programs. This page is talking exclusively about allopathically accredited programs. So I'm unsure. Thoughts?

Also, perhaps three is excessive. They all sort of demonstrate the same trend in different ways.

What I would really like is a graph of US-MDs, US-DOs and IMGs. Perhaps this belongs on a page about "residency training in the US"? Thoughts?^Touro OsteopathicFreak ^T 22:29, 3 August 2007 (UTC)

Regression falls under inferential statistics, not descriptive statistics; you are interpreting the data, not describing them. Therefore, I don't see how you could construe this as anything but original research. It's not a big deal - cutting the lines out should do the trick, so long as the actual values are from the published sources. Like you mentioned, three may be excessive, so you could pick the best one or two. Maybe if we shrunk that big one at the end down, 3 wouldn't look so cluttered?

I don't think this content is germane to the "residency training in the US" article; it seems more relevant either to this article or to the osteopathic medicine article. These may be allopathic residencies you're talking about, but the info you're looking at is primarily of interest to DOs and those interested in osteopathic medicine. Antelan ^talk 23:14, 3 August 2007 (UTC)

Also, now that I see there are 4 graphs, together taking up more space than the text itself, I do think we need to select 1 or maybe 2 to keep. Any preferences? Antelan ^talk 00:01, 4 August 2007 (UTC)

FWIW, it would be my preference to include the graph with 'odds ratios' among those getting cut, since I can't find odds ratios in any of those sources. Antelan ^talk 00:22, 4 August 2007 (UTC)

Agreed odds ratio cut.^TU Hopping ^T 21:51, 18 August 2007 (UTC)

Rename to Osteopathic medicine

I think that there is now enough content between History of the relationship of osteopathic and allopathic medicine in the United States, International Practice Rights of U.S.-trained D.O.s, and Doctor of Osteopathic Medicine to create an article titled Osteopathic medicine. It is better to have one article on osteopathic medicine than lots of smaller articles with really long titles. The new "Osteopathic medicine" article would be a split from Doctor of Osteopathic Medicine and merged with History of the relationship of osteopathic and allopathic medicine in the United States and International Practice Rights of U.S.-trained D.O.s.

There are a couple of ways to do this, but here is my plan to keep some of the edit histories without actually creating a new article. First, I'd start with renaming this article to Osteopathic medicine, since the history of the relationship between allopathic and osteopathic medicine is really the history of U.S. practice rights of DOs. This topic really has not had much of an effect on allopathic medicine, so I think moving it solely under the osteopathic medicine article is appropriate. After renaming this article, some content from the Doctor of Osteopathic Medicine article could be moved here. Then, the DO article would be mostly about the degree, while Osteopathic medicine would be about the actual medicine. Finally, International Practice Rights of U.S.-trained D.O.s would be merged with Osteopathic medicine. The Comparison of allopathic and osteopathic medicine article should remain as-is, since it equally pertains to osteopathic and allopathic medicine. --Scott Alter 23:39, 17 November 2007 (UTC)

Agree 100%. User:Hopping ^T 03:38, 18 November 2007 (UTC)

Agree. The rationale seems good to me. If Hopping (i.e., someone with potential COIs different from my potential COIs on this issue) agrees, then I agree. Antelan ^talk 22:36, 18 November 2007 (UTC)

Moving towards specific plans, it would seem that most of the content in the current Doctor of Osteopathic medicine, would be moved into this article, which will be renamed "Osteopathic medicine". The Doctor of Osteopathic medicine would be rather short, and limited to a discussion of the degree itself. Is this correct? User:Hopping ^T 23:18, 18 November 2007 (UTC)

Yes, that is how I interpreted it as well. Antelan ^talk 23:21, 18 November 2007 (UTC)

Probably most would be moved (some text from the lead, all of "Osteopathic principles," some "History," "Status of OMM within Osteopathic medicine," "Criticism," and "Maintaining distinctiveness"). I proposed the rather complicated method to try and preserve some edit histories with the articles, but we could just as easily move Doctor of Osteopathic Medicine to Osteopathic medicine and create a new Doctor of Osteopathic Medicine. And after looking at History of the relationship of osteopathic and allopathic medicine in the United States again, this content would be split between the 2 articles (dates of practice rights should probably go with the degree article - since osteopathic medicine did not change, but the entitlement of those with the D.O. degree did). No matter which way this is done, it will involve a lot of cutting and pasting - and either way will require using {{db-move}} on Osteopathic medicine. --Scott Alter 00:05, 19 November 2007 (UTC)