Behind the Scenes: Dr. Bruce Wolf
Dr. Bruce Wolf President of Michigan Osteopathic Association
Dr. Bruce Wolf, DO, FAOCR, 50, is president of Michigan Osteopathic Association (MOA) and has been a member of the Michigan State University College of Osteopathic Medicine faculty since 2000. MOA has nearly 5,300 members and represents more than 70 percent of all licensed osteopathic physicians in Michigan.
Tell us about the practice of osteopathic medicine in Michigan.
Overall, we are doing well. As doctors of osteopathic medicine (D.O.’s), in the U.S, we are trained the same as MDs. We do it through medical school and curriculum, but the philosophy and approach is a little bit different. We tend to incorporate the overall, total health of a person. By incorporating the entire muscular and skeletal system, it allows opportunities to help maintain physical health as well as incorporate mental health. For example, if part of my neck might be having an issue I may need treatment of my upper back first, because it will loosen up that part of the neck. We treat one area first because it helps another area.
This holistic approach seems to reflect the way the health care system is moving.
People are looking more to themselves on what they can do to be healthy. It’s a hot issue across the country and affects all of us. The more that we can control our own well-being, the better off everyone is going to be. We tend to partner with our patients to promote their health. We want them to be an integrated part of their care, to help make decisions. If a person is actively engaged, they are more apt to follow the advice and direction that they need to get better.
To some degree, Michigan, with its strong osteopathic medicine culture, seems an outlier in the national medical scene. Is that good or bad?
Overall, we are doing extremely well. One in four medical students is now in an osteopathic college. The profession here in the United States is using D.O.’s or osteopathic physicians to identify us as a fully licensed physician. We can see patients, treat them, prescribe medicines, perform surgery and all of the other practice privileges that the state grants us. The reason we are using osteopathic physicians is because outside of the United States, the term osteopath has a different connotation and a different license perspective.
It’s sort of a branding issue, isn’t it?
The American Osteopathic Association has recognized some of that and it has taken some steps to increase the awareness of osteopathic physicians across the country. We have very good collaboration with our allopathic (MDs) counterparts and with our patients across the state.
A lot of the time, patients just go to the doctor and they are treated. They don’t necessarily know which degree they have. However, if they are getting some additional care with manipulation then that is coming from a D.O.
What are some ways osteopathic physicians might approach health and wellness issues differently from allopathic physicians?
Right now is a great example. In some areas we are in, like the flu season. It’s when you may develop a respiratory problem and you get congested, you’re coughing, your chest hurts, it’s hard to breathe. This time of year, all of that stuff kicks in.
One of the nice things about osteopathic medicine is that one of the approaches we can use is a technique to help further the movement of the rib cage. What it does is loosen those tight muscles and it helps move air better by letting the patient’s lungs expand. You are moving more air and hopefully getting rid of the germs, letting your body to get back the more neutral state.
Can we treat them with medicines when appropriate? Absolutely. But instead of fully relying on a medication, there are manipulative techniques that can help. Headaches, sinus trouble; same thing. There are techniques to help loosen up sinus drainage. There are manipulative techniques to help with headaches.
All of this would seem particularly appropriate for sports injuries.
Correct. There are a number of professional, college and high school teams that use osteopathic physicians as their medical staff. They help integrate the function of the muscular skeletal system in staying healthy. There are ways to help treat injuries without having to undergo surgery. They help maintain mobility and flexibility range of motion.
As the president of the Michigan Osteopathic Association, what are the important issues facing your members?
It’s not necessarily MD or DO issues. But, affecting all of us right now is the opioid public health crisis.
We are working hard with our allopathic partners, our judicial partners and our legislative partners to try and address this. The cost is huge both in manpower hours, dollars, lost productivity for employers and to society. So that is one issue.
Another, is maintaining access to care for patients. If we don’t have patients, it’s hard for us to practice. The changing insurance environment is imposing challenges for physicians across the state. If a patient has a high deductible insurance plan and they have to be hospitalized or go to a doctor for a procedure, they may have to make the decision of paying for medicine or buying food this week.
In some instances, the “olden times” were simpler. The person went to the doctor and paid him with some chickens. There can be an argument for that.
Many associations have trouble attracting younger members. What about MOA?
We have a large number who are members of our association. But like any other member-driven organizations in this environment, there is competition. We are trying to maintain our relevancy, so we are exploring a number of options to stay relevant and deliver tangible benefits to our members. We are not fully there yet; it’s a work in progress.
Does the requirement for continuing education give you leverage in recruiting members?
It is one of the member benefits. Absolutely. We can provide high quality programs that reach out to a lot of members and it is usually at a reasonable price for them to get the education that they need to for their practice. The state licensure, I believe, is 50 credits per year for a three year total of 150 hours. The state of Michigan has some of the strictest continuing education medical requirements. Each specialty mandates your participation. As a radiologist, I need 30 hours of lecture type training per three-year cycle. We are one of the few professions that continues continual medical education. The legal profession does not require it, nor does accounting. As physicians, I don’t think there are any of us who aren’t interested in furthering our education. The day that we stop learning, in my opinion, is the day that we stop practicing.
And finally, can you talk about the role of Michigan State University in osteopathic medicine?
Having the College of Osteopathic Medicine at Michigan State directly benefits the people of Michigan. For primary care, it’s in the top 10 in the U.S. News and World Reports ranking.
The entering class between all three campuses accepts over 300 students per year to train osteopathic physicians. Many end up staying in the state to practice after they complete their residency training and fellowships. In fact, within the last several years, Michigan State has expanded. It now has a branch campus in Detroit and a branch campus in Macomb County.
This conversation with Dr. Bruce Wolf has been edited for space and clarity.
Tags: Behind The Scenes