Kathleen Costanzo, D.O. Doctor of Osteopathic Medicine is a family and sports medicine physician in Erie, PA. She lives by these words from her father: “Did you do the best you possibly could? Did you do the most you could? Did you study hard? Practice hard? Did you make sure the people around you were taken care of? If you’ve done these things, I’ll never ask for more.”
This combination of drive and compassion has consistently motivated Dr. Costanzo’s choices. In 2018, it led to her accepting a new role with the Saint Vincent Hospital Residency Program director of the Osteopathic Focus Track.
“Saint Vincent is where I’m supposed to be,” she says. “Every step led me here.”
Before Dr. Costanzo was introduced to osteopathy, she practiced physical therapy (PT) in Washington, D.C. The choice was largely inspired by her time as an athlete in high school. She dealt with an injury, and when she went to PT, she liked the autonomy the therapist had the ability to evaluate, advise, and follow through with treatment.
During her career as a physical therapist, she began to think about broader treatment for her patients. A friend’s husband introduced her to osteopathy. Historically, the distinction between osteopathy and allopathy (traditional medicine) is that osteopathy focuses on the cause, not just the symptoms, whereas allopathy tends to focus on symptoms more than causes.
A doctor of osteopathic medicine (DO) is a physician licensed to prescribe medicine, perform surgery and diagnose medical conditions. DOs undergo similar training to medical doctors (MDs), including receiving a bachelor’s degree, usually in a scientific field, completing four years of medical school, and training through internships, residencies and fellowships that last approximately three to eight years.
DOs are able to specialize and also receive additional training in the musculoskeletal system and osteopathic manipulative treatment. In this training, they learn to use their hands both to diagnose disease and injury, and focus on the body’s natural tendency to heal itself.
“Osteopathy is both a philosophy and a branch of medicine,” says Dr. Costanzo. “It separates from allopathic medicine with the idea that mind, body, and spirit are related, and if you have an imbalance, it may lead to a disease-state.”
She illustrates the difference with the example of someone who comes to a doctor with a headache. “Traditional medicine might prescribe medication and tell them to come back if it doesn’t get better,” she explains. “Osteopaths, on the other hand, are capable of putting their hands on the patient to look for an asymmetry they can treat. The patient can potentially walk out of the office headache-free.”
This hands-on approach to medicine is based on an osteopath’s deep knowledge of the connections in the body. Sometimes, what seems like a typical or “obvious” diagnosis is incorrect. There may be another reason for pain, illness, or injury. Osteopaths dig deep, ask questions, and listen carefully in order to identify the root cause of an issue.
When Costanzo applied for medical school, she only applied to osteopathic programs, and ended up choosing to attend Lake Erie College of Osteopathic Medicine (LECOM) in Erie, Pa..
Dr. Costanzo was on clinical rotations during her residency at Saint Vincent Hospital when she was diagnosed with Hodgkin Lymphoma a form of cancer that attacks the lymphatic system. With LECOM’s support, she nonetheless completed five months of rotations while undergoing chemotherapy.
In part, she credits this feat to the support she received from family, as well as from faculty and classmates who knew at her request, the school made no announcement of her condition. “I was going to do it my way. If I can just do my best in every moment, that’s enough,” she recalls.
During this period, one of Dr. Costanzo’s oncologists asked if what she had been through might spur her to pursue oncology. Her response? “Absolutely not that’s not why I ended up with this disease.”
While she had intended to go into pediatrics, circumstances didn’t allow her to complete her rotations for that specialty. Instead, she chose family medicine, which would still allow her to work with children. Family medicine is “cradle to grave,” she points out. “I get the breadth of life.”
Then, six months into her residency for family medicine, she was diagnosed with a second cancer Renal Cell Carcinoma, or kidney cancer. She planned to take just one month off after major surgery a partial removal of her kidney.
The recovery took slightly longer than she would have liked she had to extend her residency by two months “but I didn’t have to repeat any rotations and I passed all my boards, and that means a lot to me,” she says.
Before the renal cancer, Dr. Costanzo had planned to complete a sports medicine fellowship. Now she was eager to finish her residency and start practicing, but her fellowship director convinced her to reconsider.
She chose a fellowship in Erie, ultimately because her oncologist was in Buffalo and she needed to continue going in for regular scans and blood work. While she may have made the decision out of necessity, she believes it was the right one. The fellowship allowed her more hands-on access to patients than some of her peers who went to larger university-based systems. The ability to be hands-on involved and invested is a significant part of who she is as a physician.
After her fellowship, she surprised herself by continuing on with sports medicine for six years. When her colleague Mark Lavallee, medical director for USA weightlifting, asked her to attend a local weightlifting meet, she found that her skills were uniquely suited for the sport.
“The biomechanics of the sport, the amount of weight they lift through space and how they lift it, leads to certain parts of the body being targeted for injury, and being an osteopath, I could treat them on the spot,” she explains.
Among other highlights, she was given the opportunity to travel to Poland with the junior national team. “I took care of all primary care needs in addition to injury, for athletes, coaches, and officials,” she says.
With a knack for connecting with her patients, Dr. Costanzo found that she was able to get athletes to “hear” her on some of the issues their coaches could not. For example, she describes one athlete who nearly passed out each time she went to lift. The coaches had been prescribing appropriate preventive measures eat, stay hydrated. But once the athlete heard it from Dr. Costanzo, a third party who knew the importance of listening as well as prescribing, the advice began to stick.
After her fellowship, years of practicing, and time with USA weightlifting, Dr. Costanzo believed she would remain in sports medicine. However, when she called her former director in Erie to inquire after a position as a sports medicine physician, she was presented with a new choice: come back to Saint Vincent to teach.
“Saint Vincent took me into their program off cycle when I had my first cancer, and they supported me through my second. So when they offered me the teaching position, I said yes,” she says.
Still, at first, Dr. Costanzo wasn’t sure how she would feel about teaching. “I thought I needed five more years of work before I could teach,” she admits. “But the first day I started working with those residents I look at them and I’m rewarded. Residency is grueling. But you want them to remember the reason they went into medicine in the first place.”
For Dr. Costanzo, that reason is to connect with patients: “We need to get back to listening to a patient tell you what’s wrong with them really listening and taking the time to get a good history.”
While she acknowledges the value of developments like telemedicine in helping to extend access to care, she also argues that the emphasis in health care needs to remain on communication, not just productivity.
“I’m afraid that we might lose the human part of medicine sitting with a patient when they’ve lost a loved one, and your whole schedule goes out the window because you let them cry in your office,” she says. “Those experiences are so important, and I don’t want to lose them.”
Another reason for Dr. Costanzo to come back to Saint Vincent was to be near her parents, both of whom were heading into their nineties. “They adopted me from a children’s home in Erie,” she says. “And coming back felt like coming full circle.”
That “full circle” got even fuller when a doctor associated with her residency, Dr. Richard Kuhn, passed away in 2017, and Dr. Costanzo discovered they had an incredible connection: He had been the doctor who performed her newborn evaluation and pre-adoption physical when she was a baby.
She went to the pediatrics floor at Saint Vincent to confirm this and met a nun who Dr. Costanzo describes as “a Sister who really makes the interns work for it.” When it became clear that the Sister had taken care of Dr. Costanzo and her older sister who was also adopted, “she came around the desk with tears in her eyes.” It was the start of a new friendship that continues to this day.
Although her path has taken some unexpected turns, this is just one more piece of evidence that Dr. Costanzo is indeed “where I’m supposed to be.”
Her father’s advice has led her from physical therapy, to medical school, through residency and cancer, into sports medicine, and back to Saint Vincent: “Did you do the best you possibly could? Did you do the most you could? Did you study hard? Practice hard? Did you make sure the people around you were taken care of? If you’ve done these things, I’ll never ask for more.”
Now, as a teacher, doctor, and PA Medical Society Everyday Hero Award winner, she passes along some advice of her own to the residents she works with: “Recognize that you didn’t get where you got on your own. Put your patients first. Be inquisitive. Don’t ever stop learning.”