There is currently a debate within the osteopathic community over the feasibility of maintaining osteopathic medicine as a distinct entity within US health care. J. D. Howell, author of "The Paradox of Osteopathy," notes claims of a "fundamental yet ineffable difference" between MD and DO qualified physicians are based on practices such as "preventive medicine and seeing patients in a sociological context" that are "widely encountered not only in osteopathic medicine but also in allopathic medicine." Studies have confirmed the lack of any "philosophic concept or resultant practice behavior" that would distinguish a DO from an MD. Howell summarizes the questions framing the debate over the future of osteopathic distinctiveness thus: