New England Journal of Medicine

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I'm curious to know how everyone feels about the research and editorial in the Nov. 4, 1999 issue of the NEJM.

Although the data shows that patients treated with OMM for low back pain use less meds and PT, the article manages to shed a bad light on our profession, and Dr. Howell seized the opportunity to write an ridiculously narrow-minded editorial which I'm sure he viewed as "the words which will really put those M.D.-wannabees in their inferior place."

Has he ever experienced a day in the life of an Osteopathic Medical student?

Has he ever been treated by a D.O. or received surgery from a D.O.?

Has he ever spoken to a patient of a D.O.?

Has he ever received OMM? Oh I forgot...the only D.O's who practice OMM are of "fundamentalist religious orientation."

Hey buddy, don't site poorly substantiated papers from 1987 to support your arguments?

I think it would be only fair for the NEJM to publish an Osteopathic rebuttle to Howell's tunnel-vision chef d'oevre.

Where are sitations of the hundreds of papers supporting the use of OMM?

It is as if this research is the first attempt anyone has ever made to study the effects of OMM. That seems pretty arrogant! It is as if the NEJM is the only publication in existence?!?!

Where do the patients fit in to Howell's picture? Aren't we all working for the common good of our patients?

The Osteopathic profession may not be perfect, but we are serving the needs of society.

I think the NEJM last week was very important.

We must realize that the NEJM article was the FIRST and ONLY non-pilot, blinded study published in a legitimately peer reviewed article that demonstrated efficacy of OM. This is a huge milestone. So what if it did not illustrate exactly what we THINK we know OM does. We must remember that if a study does not find a "desired" result it does not mean that our "desired" hypothesis is not true. It just means that the available data does not support it. this may be for many reasons, such as: the hypothesis is genuinely untrue (a certain possibility), our methods of data collection were not appropriate/sensitive enough, our methods of data interpretation were not appropriate, or countless other interpretive variations.

Let us look at it this way. The NEJM study serves as a fantastic stepping stone for the next step. In this light the NEJM article is a remarkable achievement.

As for the editorial, it was just that: an opinion. We all know that certain people have certain biases and we should not feel hurt or wounded by them. If you feel strongly enough about it, write a letter to the editor in reply-engage in an intelligent discourse about it.

What was so bad about the editorial? I think the article in NEJM was great. OMM is not the magic bullet. But, the journal conceded (by publishing the paper) that OMM provided a benefit which warented future consideration. The outcome was less meds, less PT and same result with less money spent overall. Seems like a pretty favorably commentary to me. As far as the editorial piece. What did Howeell say that was so bad? Many DO's do not use OMM in their practice. Is it so hard to believe that many who are hard core on OMM are religious fundamentalists? Some difficult truths came up in the article such as lower grades and MCAT scores for DO students. It is a fact that many have lower stats on matriculation. So he mentioned that so what. He also said that while some board scores may be lower (old study) DOs make good physicians. He ended the article by mentioning the paradox. I though he was right on. If we future DOs are just MDs with a different title then why not give us all MDs or DOs after our name? And, if OMM is a benefit why not teach all physicians OMM? Good question. But, until more "proof" is received via studies such as the one discussed OMM will continue to be controversial. I am all in favor of offering the benefits of OMM to scientific investigation.

Well said mt, although I do think that the fundementalist thing was a little half-baked and that the part about most of us DO students being MD flunkies was a little exaggerated (in the article of course), but, other than that, I'll have to agree with you.