The Revisions of the First Autobiography of AT Still, the Founder of Osteopathy, as a Step towards Integration in the American Healthcare System: A Comparative and Historiographic Review

Abstract

Introduction: Osteopathy was originally introduced in rural America in 1874 as a comprehensive therapeutic approach aimed at promoting health. This approach was distinct and often conflicting with conventional/allopathic therapeutic methods available at that time to fight disease. We argue that, in struggling to achieve recognition within the American healthcare system and within the educational academic field that was about to be structured, the American osteopathic profession tried to protect itself from the charges of sectarism by starting to embrace principles of the biomedical paradigm. Methods: A comparative and historiographic review of the second version of the autobiography of AT Still (1908), the founder of osteopathy, against the first (1897) was chosen as an example of the adaptation of the American osteopathic profession to its evolving academic environment. Results: Although there were only a few substantial variations, we argue that they aimed to dampen the non-biological components of osteopathy, namely, its philosophical, spiritual, religious, emotional, and Native American roots, in an effort to gain respect and recognition within the emerging gold standard of the Western medical system. The shift towards a distinct, fully integrated profession within regulated Western healthcare systems was perceived by many professionals as a threat to AT Still’s original ideas, and the trend started when he was alive. Conclusion: Our findings suggest that a crucial conversation regarding the future of the professional identity must take place within the osteopathic community.

Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy

“…European colonialism in America has established Western epistemology as the gold standard in medical education, reinforced by Cartesian dualism and the Flexner Report [ 5 ]. This report institutionalized the biomedical model, marginalizing Indigenous and non-Western medical traditions, and reflecting broader colonial legacies [ 36 ].…”

“…This Western lens tends to marginalize alternative healing traditions and Indigenous knowledge systems, perpetuating hierarchies of power and dominance that originate from colonial perspectives, which are also prevalent in healthcare [ 4 ]. The publication of the Flexner report in 1910 established the biomedical model as a new gold standard for medical education, which emphasized the study of science and technology [ 5 ] but resulted in the erasure of diverse cultural perspectives and the imposition of standardized approaches to healthcare [ 6 ].…”

“…As outlined by Tuscano et al [ 5 ], a faction of the osteopathic profession has historically sought to minimize the non-biological aspects of osteopathy—its philosophical, existential/spiritual, emotional, and Native American roots—in an attempt to align it with the needs of a changing healthcare sector that established the primacy of the biological component of health.…”