Osteopathic medicine is in its sesquicentennial year in the U.S., but the practice wasn’t recognized in North Carolina until the mid-90s, paving the way for Campbell’s med school
Dr. Barbara Walker is a retired Army colonel who has served in the U.S. and overseas during wartime. She was there in Operation Desert Storm. In Operation Desert Shield.
Professional, efficient, committed to the mission. A visionary and, said one colleague, an unwavering pioneer.
To some, however, Walker DO, FACOFP, is an indefatigable firebrand.
“Stubborn and crotchety.”
Her words.
Traits shared, probably, by Dr. Andrew Taylor Still, the founder in 1874 of osteopathic medicine, which celebrates its 150th anniversary this year. That’s especially significant for Campbell University’s Jerry M. Wallace School of Osteopathic Medicine, the first and (still) the only osteopathic medical school in North Carolina.
Walker played no small role in helping to establish and shape Campbell’s medical school, which celebrated an anniversary of its own — 10 years — in 2023.
Walker came to North Carolina in the late 1980s when she was assigned to Fort Bragg — now Fort Liberty — where she completed her residency. She was a licensed DO in California and assumed — wrongly, as it turned out — that she could simply apply to the state Medical Board and receive her license in North Carolina by reciprocity.
It didn’t work out that way.
“I figured I would get a North Carolina license and found out that I wasn’t eligible because the boards weren’t accepted,” Walker said.
“I was told I could either take FLEX, which was the Federal licensing exam that was required for foreign medical graduates at the time, or I could take the MD boards, because the osteopathic boards weren’t accepted.
“And I said, ‘That’s not acceptable.’”
Medical licensure in North Carolina has a complicated history — convoluted and oftentimes nonsensical, not much unlike the arcane rules surrounding the way the state governs distilled spirits.
The history of osteopathic medicine in North Carolina dates to 1904, when a handful of DOs from around the state met in Greensboro. The population of North Carolina at the time was 1.9 million, according to the N.C. Osteopathic Medical Association, and just 17 DOs were licensed in the state.
Ten colleges nationwide taught osteopathic medicine. Now, the U.S. has 41 accredited colleges of osteopathic medicine, accredited to deliver instruction at 66 teaching locations in 35 states, according to the American Association of Colleges of Osteopathic Medicine.
“In the current academic year, these colleges are educating more than 35,000 future physicians— 25 percent of all U.S. medical students,” the AACOM states. “Seven of the colleges are public, while 34 are private institutions,” including Campbell University.
But, most probably because of a lack of knowledge and understanding, North Carolina didn’t license its first DO until 1971. Before that, DOs practicing in the state fell under the auspices of the N.C. Osteopathic Society and were limited in how they could practice medicine.
They couldn’t prescribe medications, for example.
Walker got her DO license in 1992, but not until she completed a deployment to the Saudi desert and, upon her return, an exhausting journey through a phalanx of appeals and proverbial hoops.
An editorial correction to the state’s Medical Practice Act, in 1995, cleared a path for DOs licensed in other states to practice in North Carolina. The ACT, as defined by the NCOMA, describes the rights and responsibilities of a physician.
“My license was basically setting a precedent at that time,” said Walker, who retired from the Army in 2006. “Within about six months, they said if you were board certified or recertified within the last five years by an (American Board of Medical Specialties) that you could get a license by reciprocity.
“We now have … close to 4,000 DOs licensed in the state, and Campbell has made a huge difference in that.”
Still and the history of osteopathic medicine
Still learned about medicine — as it was then — from his father, a physician and Methodist preacher who moved his family to Kansas in 1853, when Andrew was 25. The younger Still, who was married with two young children, joined the 9th Kansas Cavalry and would become a captain and major in the Kansas Militia during the Civil War.
As a medic, he saw war’s awful brutality. The leeches and the bloodletting. The amputations and the morphine.
His return home was no less traumatic.
Spinal meningitis killed three of his children. His first wife had died during childbirth, and a daughter from his second wife died of pneumonia.
Heartbroken and distraught, Still felt abandoned by many of the medical techniques he grew up learning, remembering and practicing.
The string of tragedies, suffering and loss left him searching for another path. Another way to treat people, to care for them and, at best, cure them.
In 1870, Still completed a short course in medicine at the new College of Physicians and Surgeons in Kansas City, and he would begin investigating treatments such as hydropathy — using water in therapeutic treatments — improved diet, bone setting and magnetic healing. He imagined a day when rational therapy would include manipulation of the musculoskeletal system, surgery and less use of drugs.
He named the approach “osteopathic medicine,” because of his focus on the musculoskeletal system.
At 64 years old in 1892, Still founded the first school of osteopathic medicine — the American School of Osteopathy (now A.T. Still University) — in Kirksville, Missouri.
Still later said, “An osteopath is only a human engineer, who should understand all the laws governing his engine and thereby master disease.”
Body, mind and spirit. Structure and function.
Still, says Dr. Robin King-Thiele — the associate dean of postgraduate affairs for Campbell’s School of Osteopathic Medicine, was a sort of pioneer, too. Yes, she says, Still would probably tell people a medical education is paramount. Medication, too, is important and even critical to the health of a patient.
“In addition to that,” King-Thiele says, “you shouldn’t be afraid to examine your patient, touch your patient. You shouldn’t have a hand on the doorknob as you’re trying to exit the room.”
The tenets of osteopathic medicine, as defined by the American Osteopathic Association, say: The body is a unit; the person is a unit of body, mind, and spirit; the body is capable of self-regulation, self-healing and health maintenance; structure and function are reciprocally interrelated; and rational treatment is based upon an understanding of the basic principles of body unity, self-regulation and the interrelationship of structure and function.
Body, mind, spirit
The phrase, “If it doesn’t kill you, It’ll cure you,” came from Still’s era of medicine, said Dr. Eric Gish, associate dean of Osteopathic Manipulative Medicine Integration at Campbell.
“A lot of people recognized it,” Gish says. “Still was trained as an MD first, so he had the medical training at the time and recognized that this [type of treatment] wasn’t as helpful as people had hoped it would be.”
Still, Gish says, believed the body was created to maintain health, though melding that viewpoint with the practice of medicine was a novel concept at the time, and not always well-received.
“So, he started looking at structure,” Gish says. “He started looking at function, and he recognized that the body structure helps to govern its function, and vice versa. The body has a natural desire to work toward healing, or health, and the human being is comprised of a tribunal of body, mind and spirit that’s intertwined and cannot be separated.
“That was considered a very novel concept back in the 1800s, when people were still bleeding people to kind of balance out the ill humors, and they were prescribing mercury and arsenic and cyanide and opiates. Addiction was widespread, because people were just prescribing whatever they had at their disposal, thinking it might help.”
Gish, who is also a pharmacist, says pharmacology is still a vital tool in the medical arsenal.
“It has to be, needs to be, and it has advanced far beyond whatever could have been envisioned back in the day,” he says.
What then, Gish asks, makes osteopathic training unique?
“That’s where I think we offer something a bit different, in that we still provide hands-on manipulation training. So, we do something different, or we have the potential to do something different, and I think we have the potential to be the most comprehensive form of medical care out there because of that.”
DOs have the same training as allopathic doctors — a conventional MD, for instance — and comprise 11 percent of physicians in the U.S. who are practicing in all medical specialities, including primary care, pediatrics, OBGYN, emergency medicine, psychiatry and surgery, the American Osteopathic Association says.
Even though some are still learning about osteopathic medicine. Even despite its long and colorful history.
A pioneer’s journey
Walker knew she wanted to be a doctor, and she began applying to medical schools in California. First, she needed from her undergraduate school a letter from a pre-medical advisory committee.
“When I finished speaking with the committee,” Walker says, “I had a woman come up to me, and she said, You have a very osteopathic philosophy. Have you applied to the new osteopathic school?’”
That school is now the College of Osteopathic Medicine of the Pacific at Western University in Pomona.
“I looked at her and touched her arm. I looked her in the eye and I said, ‘Yes, but I really want to be a doctor.’
“She looked at me, touched my arm and said, ‘But you would be.’ At which point I thought, well, I guess I’d better find out what this It was all about.”
An Army recruiter was partially responsible for persuading Walker to become a DO. She called military doctors, both DOs and MDs, who were working side by side.
“Without exception, I was told if I wanted to do anything at all in primary care that I should not go MD, but that I should go DO, because I would be able to do more for my patients,” Walker says.
Jerry M. Wallace School of Osteopathic Medicine
The roots of Campbell’s medical school date to 2009, when Dr. Jerry Wallace, the school’s fourth president, visited William Carey University — a small Baptist school half the size of Campbell in Hattiesburg, Mississippi.
Wallace was part of a team tasked by the Southern Association of College and Schools to review William Carey’s application for a school of osteopathic medicine, a way to treat patients Wallace was still learning about.
Wallace thought there was no way the little the Mississippi school could afford to launch a medical school. Especially in 2009, when the country was still trying to crawl out of the Great Recession.
Yet it did. After their visit, Wallace and his team were impressed enough with the possibility to push forward.
As talk of a medical school got louder, Wallace laid the groundwork for feasibility study and, as part of that, asked for meeting with a number of DOs, including Walker, who decades before established herself as a leader in osteopathic medicine in the state.
Walker had been involved with the N.C. Osteopathic Association since 1989 and would later became a member of Campbell’s Board of Trustees, as well as president of the N.C. Medical Board.
She brought words of encouragement.
“[Dr. Wallace] said he was impressed with the profession, but he said his was a faith-based institution, and that was very important. I said that osteopathic medicine was a faith-based profession, and I thought that they would do very well together, and they certainly have,” says Walker, who would become Campbell’s first osteopathic CAMEL — Community Advocate and Medical Education Liaison.
The inaugural class, in 2013, at Campbell was interviewed and accepted before the building was completed. The residency placement rate, after graduation, was 100 percent when the first cohort of doctors graduated.
“For me, joining the Campbell team and being a part of that inaugural faculty was more of a Don Quixote story,” King-Thiele says. “We weren’t even allowed to have an unrestricted license in ‘95 and here we are in 2013 starting in our first 162-person class.
“Are you kidding me? That’s like charging windmills kind of stuff, and who wouldn’t want to be a part of that?”