Andrew Taylor Still, a frontier physician and Civil War surgeon, founded osteopathic medicine in 1874. Born on August 6, 1828, in a log cabin in Lee County, Virginia, Still developed his new approach to healing after growing disillusioned with the conventional medical practices of his era. What began as one doctor’s radical ideas in rural Missouri eventually grew into a medical profession now encompassing more than 207,000 physicians and students across the United States.
Still’s Path to Medicine
Still came to medicine the way many did in mid-1800s America. Around 1853, at age 25, he began training by reading medical texts and apprenticing with a practicing physician, his own father. He may have also attended a medical school in Kansas City, though no records survive to confirm that. This informal path was standard for the time, when medical education had few regulations and physicians learned largely through observation and practice.
Still served as a doctor during the Civil War, and in 1864 he returned home to face a devastating personal crisis: the deaths of family members he could not save. The combination of wartime horrors and personal loss pushed him to reject much of what he had been taught about medicine. The treatments available at the time were often harsh and ineffective, relying on practices like bloodletting, mercury-based drugs, and other interventions that frequently did more harm than good. Still became convinced there had to be a better way.
The Birth of Osteopathy in 1874
Still spent roughly a decade rethinking medicine from the ground up before settling on his new philosophy. He later identified June 22, 1874, as the date he formally conceived of osteopathy, describing it as a kind of vision. His ideas were not well received. The religious, social, and medical communities in his area rejected his unconventional approach, and he was effectively ostracized. He relocated to Kirksville, Missouri, where he spent years traveling the region as an itinerant bonesetter, treating patients with his hands rather than drugs.
His approach centered on the idea that the body’s structure, its bones, muscles, and connective tissues, directly influenced its ability to function and heal. Rather than prescribing the toxic medicines common in his day, Still used manual techniques to restore proper alignment and improve circulation, trusting the body’s own capacity for self-repair. This was a genuinely radical departure from mainstream medicine at the time.
The Four Core Principles
Still’s philosophy crystallized into four tenets that remain the official foundation of osteopathic medicine today, as recognized by the American Osteopathic Association:
- The body is a unit. A person is a unity of body, mind, and spirit, not a collection of separate parts to be treated in isolation.
- The body can heal itself. Given the right conditions, the body is capable of self-regulation, self-healing, and maintaining its own health.
- Structure and function are connected. The way the body is physically arranged affects how well it works, and vice versa.
- Treatment should follow these principles. Effective care requires understanding how body unity, self-regulation, and the relationship between structure and function all interact.
These ideas might sound intuitive now, but in the 1870s they were a direct challenge to the prevailing approach. Still was arguing for a holistic view of the patient at a time when medicine was fragmented and often dangerously aggressive in its treatments.
The First Osteopathic School
Still practiced and refined his methods for nearly two decades before formalizing osteopathic education. In 1892, he founded the American School of Osteopathy in Kirksville, Missouri, the first institution dedicated to training osteopathic physicians. This school, now known as A.T. Still University, remains in operation today and is considered the birthplace of the profession. The creation of a formal school was a turning point: it transformed osteopathy from one man’s philosophy into a teachable, reproducible system of medicine with its own educational standards.
What Osteopathic Medicine Looks Like Today
The profession Still launched from rural Missouri has grown dramatically. As of 2025, there are more than 207,000 osteopathic physicians (DOs) and osteopathic medical students in the United States. Nearly 40,000 students attend 44 colleges of osteopathic medicine across 71 campuses, and the number of people choosing the DO path continues to rise.
DOs are fully licensed physicians who can practice in every medical specialty, prescribe medications, and perform surgery, just like their MD counterparts. The key distinction in their training is an additional emphasis on the musculoskeletal system and a hands-on technique called osteopathic manipulative treatment, or OMT. During OMT, a physician uses pressure and gentle manipulation to stretch muscles, move joints into proper alignment, and address structural imbalances that may contribute to pain, congestion, or digestive problems. Techniques range from slow, sustained pressure to quicker adjustments, though the aggressive “popping” associated with chiropractic care is generally less common.
DO students take their own licensing exam series called COMLEX-USA, which all osteopathic medical students must pass before graduating. All U.S. licensing jurisdictions accept COMLEX-USA scores for DOs seeking a medical license. Some residency programs also ask DO applicants for scores on the USMLE, the exam taken by MD students, though this practice varies.
DOs in the U.S. vs. Osteopaths Abroad
One important distinction that often causes confusion: only DOs trained in the United States are fully licensed physicians with the same scope of practice as MDs. In more than 65 countries, U.S.-trained DOs have full practice rights. However, in many countries outside the U.S., “osteopath” training focuses specifically on manual therapy techniques, and practitioners are typically limited to manipulation rather than the full range of medical care. If you encounter the title “osteopath” internationally, it does not necessarily mean the person has the same medical training as an American DO.