Benefits of learning OMM?

[mke520]

I'll be attending an osteopathic school this Fall and was wondering if the average osteopathic medical student feels that OMM is beneficially to learn, or in other words a good tool to have, since I've heard most osteopathic physicians never use OMM in their practice?

I don't know much about OMM so any insight would be great...

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[SnowDoggy44]

Unfortunately, learning OMM in school is flawed because most of your healthy classmates have little dysfunction compared some of the patients you will see down the road. A lot of the somatic dysfunctions you find and treat during class aren't all that clinically symptomatic and you miss out on some of the benefit and excitement of OMM as it might relate to your actual clinical practice.

Some things you learn you will like and get you excited about being able to do something for others even though you are only in the first half of medical school. Other things will leave you asking "...What? No really, WTF?"

Either way, you get really comfortable touching patients which never hurts.

 

[Osteotastic]

In my OMM labs we were filled with healthy young students that the OMM never failed to diagnose with a "dysfunction" if they volunteered to go up front.

It was hilarious. So many people made the comments such as " I thought I was really healthy but all this time I guess my body was all F...ed up, and I never would have known!" lol . Good fun.

Joking aside. There are some good stretching and counterstain techniques and it feels good to crack my back now and then. I don't think our degree designation should be based solely in this old facet of our education as it is now however as DO.


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[Siggy]

First off, if for nothing else OMM is a great course in surface anatomy. You'll end up finding L4 so often you're head will spin, so when you're a 3rd year and the attending asks you how you're going to find L4 for a lumbar puncture, you'll have to stifle that, "Do I look stupid to you?" look.

Second, OMM has it's uses. I think, to an extent, lymphatics is generally under used. There are some studies out there that look at PNA with thoracic lymphatic pump techniques There's also a small study looking at reducing ventilator associated PNA with chest physiotherapy (which is, in part, similar to some OMT techniques). This is in addition to some of the other techniques (HVLA ("cracking"), muscle energy (focused isometric stretching... I've always hated the name "muscle energy" because it sounds more esoteric than it is), counterstrain (damn it, it does work).

The problem is the things that are much less useful or just plain... poop. Viscerosomatics (yes, I'll buy the concept and accept that it's there. It's more to the point that I don't care. No... really... knowing that the lungs map to T2-7, the hearts T1-5, changes nothing. I'm not not going to get the EKG or chest xray because of the findings) or ::shudder:: Chapman's points.

 

[mke520]

so it seems like there are a lot of really cool things that you learn from OMM but it doesn't seem like it will be something i'll be using a lot of as a physician. thanks for the responses i appreciate it

 

[babdoc]

but it doesn't seem like it will be something i'll be using a lot of as a physician.

Depends how you choose to practice.

 

[ChrisGriffen]

Depends how you choose to practice.

Most choose to practice medicine responsibly, by keeping up to date with the latest research and continuing to educate themselves on the efficacy of their treatment options...which is the exact opposite of OMT

 

[hallowmann]

Depends how you choose to practice.

It also really depends on what you do. I doubt you'd use a lot of (read: any) OMT as a pathologist, radiologist, etc. In PM&R its a completely different story. The rest are spectrum between those extremes.

 

[Pisiform]

One of the good things about omm is that I got to know human body up close and personal - male or female. I know exactly where to palpate, what and where are all the anatomical landmarks. So I have no hesitation what and how to make a patient feel comfortable and communicate with them when they are naked for PE etc.
We also get to learn really nice technique but I doubt I will be using them in practice

 

[Petypet]

So I have no hesitation what and how to make a patient feel comfortable and communicate with them when they are naked for PE etc.
We also get to learn really nice technique but I doubt I will be using them in practice

Learn this by having a wife

 

[Pisiform]

Learn this by having a wife

I consider wife/gf non-compliant in that regard. They just want us to do "other things" for which if I were to try it on patients would most certainly get me a lawsuit

 

[scummie]

Learn this by having a wife

I don't think the converse really applies for husbands, lol. OMM + candles isn't really what they need.

 

[Jwalker]

This is sad. Majority of the hate is self inflicted (comes from DOs). MDs are very receptive of OMM.

 

[mke520]

This be sad. Majority of t' hate be self inflicted (comes from DOs). MDs be very receptive of OMM.

so you think MDs in general are almost more receptive to OMM over than other DOs?

 

[GUH]

I'll be attending an osteopathic school this Fall and was wondering if the average osteopathic medical student feels that OMM is beneficially to learn, or in other words a good tool to have, since I've heard most osteopathic physicians never use OMM in their practice?

I don't know much about OMM so any insight would be great...

In addition to what others have said, you can also charge for OMM. That's a huge plus, especially in primary care where you will be competing against MD's and midlevels, but as a DO you have a skill set that will help you stand out.

You will also develop competency in palpation of musculoskeletal abnormalities and practice inspecting for the same. This holds true in spite of the controversy surrounding OMT techniques.

 

[Jwalker]

so you think MDs in general are almost more receptive to OMM over than other DOs?

Absolutely. Especially in fields like PM&R. Harvard PM&R has been doing basically OMT course for MDs for a while now.

 

[mke520]

Absolutely. Especially in fields like PM&R. Harvard PM&R has been doing basically OMT course for MDs for a while now.

wow that's pretty interesting! i'm possibly looking at going into peds, so does OMM work well with little kids at all or not really? i'm sure you don't get much practice if any on kids

 

[DocVapor]

wow that's pretty interesting! i'm possibly looking at going into peds, so does OMM work well with little kids at all or not really? i'm sure you don't get much practice if any on kids

There are lots of people that say that OMM works far better on kids than adults. Generally they don't have the decades of dysfunction that you have to fight against. Even cranial has great efficacy in newborns/neonates as well from what I understand.

 

[Pisiform]

There are lots of people that say that OMM works far better on kids than adults. Generally they don't have the decades of dysfunction that you have to fight against. Even cranial has great efficacy in newborns/neonates as well from what I understand.

I thought performing OMM on toddlers and pediatric patient is contraindicated most of the time and for a very good reason that they are non compliant or most of the times doesn't understand whats going on. Somebody who knows more about this can say but you cannot tell a child to assist you in an active technique that require isometric contraction or do HVLA. Cranium ... well sutures gets fused early on so it doesn't work .. our embryology professor keeps telling us it doesn't work whereas we learn otherwise in OPP ... guess who do I believe

 

[Dharma]

I thought performing OMM on toddlers and pediatric patient is contraindicated most of the time and for a very good reason that they are non compliant or most of the times doesn't understand whats going on. Somebody who knows more about this can say but you cannot tell a child to assist you in an active technique that require isometric contraction or do HVLA. Cranium ... well sutures gets fused early on so it doesn't work .. our embryology professor keeps telling us it doesn't work whereas we learn otherwise in OPP ... guess who do I believe

I've seen OMM done (quite well) on toddlers. I wouldnt say it's contraindicated. Avoided due to lack of comfort treating that patient population maybe. No, you can't perform ME or counterstrain (i.e. techniques that require participation), but HVLA, certain BLT techniques, and myofascial release is not out of the question. The set up may be a bit different than seen with adult population but it works and often with very light force (e.g. our one professor says "a pound of force!"). Sometime the key is distracting the patient to let them relax (toys work wonders).

Ever see condylar decompression done on a colicky infant? Pretty interesting stuff.

 

[hallowmann]

so you think MDs in general are almost more receptive to OMM over than other DOs?

I actually believe this is accurate. That said, most MDs don't know about some of the things we learn, like cranial rhythm and moving things with the power of our minds... which may be why some DOs are more averse to. Personally, I think some of it is great and it seems useful and helpful enough for some people for me to understand the importance of it being taught.

 

[mke520]

I actually believe this is accurate. That said, most MDs don't know about some of the things we learn, like cranial rhythm and moving things with the power of our minds... which may be why some DOs are more averse to. Personally, I think some of it is great and it seems useful and helpful enough for some people for me to understand the importance of it being taught.

Really? please tell me your joking...

 

[DocVapor]

Really? please tell me your joking...

My professors explained it to me this way:

When you need to use miniscule amounts of force/movement, just the thought alone of doing what you want to do is enough to cause your brain to automatically plan the movements. Even though you aren't physically trying to move your hands, the basal ganglia still lets some of that impulse pass through down to the hands, producing the very small movements needed.

I feel like it probably happens, but I'm not sold on whether it's enough to make a difference.

 

[SurgeDO]

OMT gets a bad reputation due to **** like chapman's points and cranial. it is also easy to write OMT off because they use words like "muscle energy"...which makes the uninformed a little standoffish.

there is no denying that stretching muscles (aka "muscle energy") can be beneficial. admittedly, i became a little too skeptical of OMT a little too quickly; i wish i hadn't.

OMT also helps me better understand the biomechanics of the body. being reminded of the origins and insertions of the muscles is also helpful.

overall, OMT is okay in my book. i just think it needs a little updating.

 

[Dyerseve30]

Regardless if you decide to use OMT in your practice or speciality, the palpation skills you gain from practicing OMT in lab is far and beyond other non-DO students. By the end of your first year in school you will be VERY comfortable touching and feeling people and actually understand what is going on.

I say this because while you may never use HVLA, muscle energy or counterstrain in the ER, you can still use palpation to aid in your diagnosis. Also, do not forget the psychological effects this has on patients. Many patients like that their doctor is actually touching them, and usually associate it with 'oh this doctor actually cares about me'.

 

[mke520]

so OMT seems like a very useful tool for the average primary care physician but can it useful for a physician who is not a primary care physician like a cardiologist or a surgeon?

 

[DocVapor]

so OMT seems like a very useful tool for the average primary care physician but can it useful for a physician who is not a primary care physician like a cardiologist or a surgeon?

Useful in specialties outside of PM&R, Sports med, etc? Maybe.

Economically worthwhile? Nope.

 

[Pisiform]

Useful in specialties outside of PM&R, Sports med, etc? Maybe.

Economically worthwhile? Nope.

Do you know how much is the compensation for billing one OMM treatment?

 

[Mad Jack]

My professors explained it to me this way:

When you need to use miniscule amounts of force/movement, just the thought alone of doing what you want to do is enough to cause your brain to automatically plan the movements. Even though you aren't physically trying to move your hands, the basal ganglia still lets some of that impulse pass through down to the hands, producing the very small movements needed.

I feel like it probably happens, but I'm not sold on whether it's enough to make a difference.

 

[Dharma]

My professors explained it to me this way:

When you need to use miniscule amounts of force/movement, just the thought alone of doing what you want to do is enough to cause your brain to automatically plan the movements. Even though you aren't physically trying to move your hands, the basal ganglia still lets some of that impulse pass through down to the hands, producing the very small movements needed.

I feel like it probably happens, but I'm not sold on whether it's enough to make a difference.

You can try this little trick to see how the mind affects subtle muscle movement in the hand (it's kind of fun too): Take a string with a paper clip at the end. Hold it vertically so the clip dangles. Now, without moving your arm, wrist, or hand just try making the paper clip spin in circles "with your mind." See how big you can get the circles, switch directions, and freak out a few people.

But yeah, I'm not sure how much of an effect that has on a human skull… sure fun on the paper clip though!

 

[Dharma]

Do you know how much is the compensation for billing one OMM treatment?

Not sure, but you code according to area treated, so you can knock out a few regions pretty quickly if you are efficient.

 

[babdoc]

Please see: http://wikipedia.org/wiki/Ideomotor_phenomenon

That said, there seems to be benefit with some modalities, as stated above.

 

[felix2929]

I really dislike that one of the arguments I constantly see supporting OMM is, "do you know how much extra money you can make billing for OMM?"

 

[mke520]

Useful in specialties outside of PM&R, Sports med, etc? Maybe.

Economically worthwhile? Nope.

i can definitely see omt being very useful in pm&r and sports med since i worked in a pt rehab clinic for several years

 

[DrSpine]

I really dislike that one of the arguments I constantly see supporting OMM is, "do you know how much extra money you can make billing for OMM?"

And what is wrong with that? I love how this forum abruptly looks negatively on anyone who gasp, chooses to make money and be successful in life. Yes it is unethical to bill just for the sake of billing, but OMT is a wonderful MEDICAL tool in your arsenal, patients love it, and you can bill for it which is a plus for you. Some also do cash based OMT. Nothing wrong with that so long as the patient is well informed on the benefits of OMT.

 

[Siggy]

so OMT seems like a very useful tool for the average primary care physician but can it useful for a physician who is not a primary care physician like a cardiologist or a surgeon?

Outside of my required OMM rotation 3rd year, I did the most OMT (paraspinal inhibition, rib raising, visceral techniques, and thoracic lymphatics) on my neuro sx rotation. Granted, the PD for the neuro sx residency is also the DME and the PD for the TRI at the hospital, but it was still a neuro sx rotation.

 

[Siggy]

And what is wrong with that? I love how this forum abruptly looks negatively on anyone who gasp, chooses to make money and be successful in life. Yes it is unethical to bill just for the sake of billing, but OMT is a wonderful MEDICAL tool in your arsenal, patients love it, and you can bill for it which is a plus for you. Some also do cash based OMT. Nothing wrong with that so long as the patient is well informed on the benefits of OMT.

When I retire, I'm going to start an OMT practice at a local resort spa or casino spa. Cash practice.

Alternatively, if you're in residency right now, it might be worth wild to try to get into an OMM fellowship. With the merger coming up and AOA residencies being able to keep their osteopathic identity, there's going to be a huge market for OMM training/certification so that the IMG/FMG crowd can try matching into formerly unfilled AOA residencies.

 

[HopefulReapp]

It also really depends on what you do. I doubt you'd use a lot of (read: any) OMT as a pathologist, radiologist, etc. In PM&R its a completely different story. The rest are spectrum between those extremes.

I shadowed a pm&r DO physician and he told me that he never used OMM. He did go to an acgme residency though so that might be why.


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[felix2929]

And what is wrong with that? I love how this forum abruptly looks negatively on anyone who gasp, chooses to make money and be successful in life. Yes it is unethical to bill just for the sake of billing, but OMT is a wonderful MEDICAL tool in your arsenal, patients love it, and you can bill for it which is a plus for you. Some also do cash based OMT. Nothing wrong with that so long as the patient is well informed on the benefits of OMT.

I'm not against running a practice to make money. I just don't like (maybe it wasnt this thread) that one of the main reasons people seem to suggest doing OMM is because you can bill for it. It would be as if cardiology fellows talked about learning to do caths because hey, did you know you can bill medicare for them? I don't know. It just sounds sleezy in my opinion.

 

[mke520]

I'm not against running a practice to make money. I just don't like (maybe it wasnt this thread) that one of the main reasons people seem to suggest doing OMM is because you can bill for it. It would be as if cardiology fellows talked about learning to do caths because hey, did you know you can bill medicare for them? I don't know. It just sounds sleezy in my opinion.

i agree with you that nobody should use omt just for the money, but if using omt can be used for the benefit of the patient then it's also a benefit for the DO since it's another procedure that they can bill for and make a little extra cash since physicians are being hammered by insurance companies on their reimbursements

 

[GUH]

I'm not against running a practice to make money. I just don't like (maybe it wasnt this thread) that one of the main reasons people seem to suggest doing OMM is because you can bill for it. It would be as if cardiology fellows talked about learning to do caths because hey, did you know you can bill medicare for them? I don't know. It just sounds sleezy in my opinion.

Tell me that it's sleazy to want to make a good salary when you have worked your butt off for 12+ years and taken six figures of debt while all your friends are making bank moving around numbers in a computer screen.
Physicians are not slaves.

 

[felix2929]

Tell me that it's sleazy to want to make a good salary when you have worked your butt off for 12+ years and taken six figures of debt while all your friends are making bank moving around numbers in a computer screen.
Physicians are not slaves.

I never said it was sleazy to want to make a good salary as a physician. I'm on quite the other side of that argument. I said that I think it sounds sleazy to say one of the main benefits of learning OMM is that you can bill it to medicare/insurance.

 

[Siggy]

What he's saying is:
Don't do a procedure simply because you can bill for it. Saying, "Hey, did you know you could bill some insurances an extra $30-40 for OMM to one-two regions. Easy revenue boost" is both sleazy and unethical.

Saying "Hey, OMT isn't just a waste of office time because it both helps the patient and will be reimbursed" is perfectly fine.

 

[Otto of the Silver-Hand]

I'm not against running a practice to make money. I just don't like (maybe it wasnt this thread) that one of the main reasons people seem to suggest doing OMM is because you can bill for it. It would be as if cardiology fellows talked about learning to do caths because hey, did you know you can bill medicare for them? I don't know. It just sounds sleezy in my opinion.

Cardiologists HAVE done that until CMS clamped down on them. (Sadly, though, some cards are still doing it... look at the card forum about the MT. Sinai scandal)

 

[cabinbuilder]

I'm hijacking this thread. I do OMM all the time and am currently working in a very large ER. The head of the ER who happens to be CHIEF of Staff sees me today and says, "I hear you have been doing quite a bit of manipulation here in the ER?" " The billers have been putting the charges through.". I say, "Yes, I do manipulation on the appropriate patient's and put the codes in for the billers". His reply? "Man, I wish I had learned how to do some of those techniques because I hear your patients love it".

OH, yea. Learn your OMM, folks. You will ONLY get kudos for it. That's what I"m talking about. Gotta love being a DO.

 

[mke520]

I'm hijacking this thread. I do OMM all the time and am currently working in a very large ER. The head of the ER who happens to be CHIEF of Staff sees me today and says, "I hear you have been doing quite a bit of manipulation here in the ER?" " The billers have been putting the charges through.". I say, "Yes, I do manipulation on the appropriate patient's and put the codes in for the billers". His reply? "Man, I wish I had learned how to do some of those techniques because I hear your patients love it".

OH, yea. Learn your OMM, folks. You will ONLY get kudos for it. That's what I"m talking about. Gotta love being a DO.

That's awesome!

 

[bones]

I'll be attending an osteopathic school this Fall and was wondering if the average osteopathic medical student feels that OMM is beneficially to learn, or in other words a good tool to have, since I've heard most osteopathic physicians never use OMM in their practice?

I don't know much about OMM so any insight would be great...

Congrats on your acceptance. I am a DO OMM specialist and I have been involved in teaching students for about a decade now, so I can give you some perspective. You are correct, most DOs do not use OMM in their practice. This occurs due to a few major factors-

1) they are turned off by unsubstantiated claims given to them in OMM class... they proceed to fake their way through practicals, and never look back. They typically don't encounter it through residency, and thats that.
2) they never developed their skills to the point where they were confident- and then went on to a residency where it wasn't used, and they become quite rusty. Even if they see applications for it later they often lack skill and confidence so it is used sparingly, even when patients ask for it and they want to use it.

A minority of students do go on to use it in their practice. Very few of them do it very well, just due to the structure of their residency training (which tends to be light on OMM except for some DO Family med programs and OMM specialty residencies) and the tendency of those attracted to OMM to believe weird things and not carefully validate the effectiveness (or lack thereof) of each thing they are taught.

A few things to consider:
While some people out there really are quacks and fool themselves and their patients, there really are also people out there changing lives with OMM every day. I have learned from many of these people, and I have become one myself with a lot of effort, and many of my former students are now doing this as well. You can too with the right training. I recommend you shadow whatever the best "guru" at your school is early in your first year- see real patients with them in clinic. Go in with a critical mind and ask lots of hard questions. See if the patients are significantly and beyond all doubt improved at the end of each visit- and whether the gains are maintained permanently more often than not. You may be disappointed, or you may be impressed- but either way it is probably a good idea to see the best your school has to offer.

There are legitimate applications in most fields of medicine if you learn from the right people. You may need to look hard for someone that can teach you the relevant connections.

You get paid for OMM, no matter your specialty. Its not charity work, and it counts as a procedure. In primary care it means you can see patients at your normal speed for twice the pay, or you could spend twice as long with them for the same pay (or something in between). If you are really good you have the option of working a cash practice in a big city for somewhere between $250-$600 per hour, and typically with quite low overhead- which would put a top grossing cash OMM doc among the top paid specialties in medicine. You will find physicians in practices like this representing a variety of residencies, despite OMM being their go-to treatment of choice (their residency may determine what patients they advertise to or conditions they treat with their hands). Patients pay that much out of pocket for one of two reasons- either its worth it, or they think its worth it. If you routinely prevent surgeries by making patients asymptomatic or routinely get patients healthily off their meds, you might be worth it. I do not believe a cash practice is sustainable without real results on a fairly consistent basis. People dont like to be ripped off. Most of the weird ineffective OMM people end up taking insurance and teaching at schools unfortunately... and now there are so many schools and so few OMM board certified physicians the schools take whatever they can get.

Also, good OMM research is hard to find. Partly because so few people are really good at it (so what they are really testing are poorly put together theories), partly because those doing the research are biased and want to see a result, partly because so few DOs know how to do research, and partly because OMM docs get paid much better to see patients than they get paid to do research. On top of all this it is extremely difficult to do a well blinded OMM study. Usually the best you can do is an outcomes study or blinding the patient and blinding whoever is reading objective tests the patient performs pre and post treatment.


So to summarize, most DOs don't use OMM, good research supporting OMM is sparse, but yet there may be very good reasons to spend the time to at least look more into it. If you go through the motions of the other students in class you will probably be disappointed. If you wish to have an open mind, seek out a sane and highly effective OMM mentor early in first year.

Good luck!

 

[NurWollen]

Congrats on your acceptance. I am a DO OMM specialist and I have been involved in teaching students for about a decade now, so I can give you some perspective. You are correct, most DOs do not use OMM in their practice. This occurs due to a few major factors-

1) they are turned off by unsubstantiated claims given to them in OMM class... they proceed to fake their way through practicals, and never look back. They typically don't encounter it through residency, and thats that.
2) they never developed their skills to the point where they were confident- and then went on to a residency where it wasn't used, and they become quite rusty. Even if they see applications for it later they often lack skill and confidence so it is used sparingly, even when patients ask for it and they want to use it.

A minority of students do go on to use it in their practice. Very few of them do it very well, just due to the structure of their residency training (which tends to be light on OMM except for some DO Family med programs and OMM specialty residencies) and the tendency of those attracted to OMM to believe weird things and not carefully validate the effectiveness (or lack thereof) of each thing they are taught.

A few things to consider:
While some people out there really are quacks and fool themselves and their patients, there really are also people out there changing lives with OMM every day. I have learned from many of these people, and I have become one myself with a lot of effort, and many of my former students are now doing this as well. You can too with the right training. I recommend you shadow whatever the best "guru" at your school is early in your first year- see real patients with them in clinic. Go in with a critical mind and ask lots of hard questions. See if the patients are significantly and beyond all doubt improved at the end of each visit- and whether the gains are maintained permanently more often than not. You may be disappointed, or you may be impressed- but either way it is probably a good idea to see the best your school has to offer.

There are legitimate applications in most fields of medicine if you learn from the right people. You may need to look hard for someone that can teach you the relevant connections.

You get paid for OMM, no matter your specialty. Its not charity work, and it counts as a procedure. In primary care it means you can see patients at your normal speed for twice the pay, or you could spend twice as long with them for the same pay (or something in between). If you are really good you have the option of working a cash practice in a big city for somewhere between $250-$600 per hour, and typically with quite low overhead- which would put a top grossing cash OMM doc among the top paid specialties in medicine. You will find physicians in practices like this representing a variety of residencies, despite OMM being their go-to treatment of choice (their residency may determine what patients they advertise to or conditions they treat with their hands). Patients pay that much out of pocket for one of two reasons- either its worth it, or they think its worth it. If you routinely prevent surgeries by making patients asymptomatic or routinely get patients healthily off their meds, you might be worth it. I do not believe a cash practice is sustainable without real results on a fairly consistent basis. People dont like to be ripped off. Most of the weird ineffective OMM people end up taking insurance and teaching at schools unfortunately... and now there are so many schools and so few OMM board certified physicians the schools take whatever they can get.

Also, good OMM research is hard to find. Partly because so few people are really good at it (so what they are really testing are poorly put together theories), partly because those doing the research are biased and want to see a result, partly because so few DOs know how to do research, and partly because OMM docs get paid much better to see patients than they get paid to do research. On top of all this it is extremely difficult to do a well blinded OMM study. Usually the best you can do is an outcomes study or blinding the patient and blinding whoever is reading objective tests the patient performs pre and post treatment.


So to summarize, most DOs don't use OMM, good research supporting OMM is sparse, but yet there may be very good reasons to spend the time to at least look more into it. If you go through the motions of the other students in class you will probably be disappointed. If you wish to have an open mind, seek out a sane and highly effective OMM mentor early in first year.

Good luck!

Thanks for offering that perspective. It's good to hear it from someone who a) knows what their talking about and b) isn't an OMM 100% the answer for everything quack.

I have an OMM practical later this week. I just might approach studying for it with a bit more of an open mind, thanks to this post. So, thank you.

 

[DocVapor]

So to summarize, most DOs don't use OMM, good research supporting OMM is sparse, but yet there may be very good reasons to spend the time to at least look more into it. If you go through the motions of the other students in class you will probably be disappointed. If you wish to have an open mind, seek out a sane and highly effective OMM mentor ea

I started rolling my eyes when I saw someone bumped this thread. But this is easily one of the most quality posts I have seen here about OMM. Well done.

 

[mke520]

not going to lie but i was thinking OMM was going to be more of a waste of time than something "useful" i could use in practice since i'm most likely not going into primary care, but like you said there are some applications of OMM that can be applied to most fields of medicine. i guess some people like myself get turned off by OMM because there are those quacks who say OMM is "the answer" for almost everything as well as the fact that there's not much research backing up OMM which made me a bit skeptical of how effective OMM really is. i appreciate your post, that was great, and i'll definitely go into OMM with a much more open mind now.

Congrats on your acceptance. I am a DO OMM specialist and I have been involved in teaching students for about a decade now, so I can give you some perspective. You are correct, most DOs do not use OMM in their practice. This occurs due to a few major factors-

1) they are turned off by unsubstantiated claims given to them in OMM class... they proceed to fake their way through practicals, and never look back. They typically don't encounter it through residency, and thats that.
2) they never developed their skills to the point where they were confident- and then went on to a residency where it wasn't used, and they become quite rusty. Even if they see applications for it later they often lack skill and confidence so it is used sparingly, even when patients ask for it and they want to use it.

A minority of students do go on to use it in their practice. Very few of them do it very well, just due to the structure of their residency training (which tends to be light on OMM except for some DO Family med programs and OMM specialty residencies) and the tendency of those attracted to OMM to believe weird things and not carefully validate the effectiveness (or lack thereof) of each thing they are taught.

A few things to consider:
While some people out there really are quacks and fool themselves and their patients, there really are also people out there changing lives with OMM every day. I have learned from many of these people, and I have become one myself with a lot of effort, and many of my former students are now doing this as well. You can too with the right training. I recommend you shadow whatever the best "guru" at your school is early in your first year- see real patients with them in clinic. Go in with a critical mind and ask lots of hard questions. See if the patients are significantly and beyond all doubt improved at the end of each visit- and whether the gains are maintained permanently more often than not. You may be disappointed, or you may be impressed- but either way it is probably a good idea to see the best your school has to offer.

There are legitimate applications in most fields of medicine if you learn from the right people. You may need to look hard for someone that can teach you the relevant connections.

You get paid for OMM, no matter your specialty. Its not charity work, and it counts as a procedure. In primary care it means you can see patients at your normal speed for twice the pay, or you could spend twice as long with them for the same pay (or something in between). If you are really good you have the option of working a cash practice in a big city for somewhere between $250-$600 per hour, and typically with quite low overhead- which would put a top grossing cash OMM doc among the top paid specialties in medicine. You will find physicians in practices like this representing a variety of residencies, despite OMM being their go-to treatment of choice (their residency may determine what patients they advertise to or conditions they treat with their hands). Patients pay that much out of pocket for one of two reasons- either its worth it, or they think its worth it. If you routinely prevent surgeries by making patients asymptomatic or routinely get patients healthily off their meds, you might be worth it. I do not believe a cash practice is sustainable without real results on a fairly consistent basis. People dont like to be ripped off. Most of the weird ineffective OMM people end up taking insurance and teaching at schools unfortunately... and now there are so many schools and so few OMM board certified physicians the schools take whatever they can get.

Also, good OMM research is hard to find. Partly because so few people are really good at it (so what they are really testing are poorly put together theories), partly because those doing the research are biased and want to see a result, partly because so few DOs know how to do research, and partly because OMM docs get paid much better to see patients than they get paid to do research. On top of all this it is extremely difficult to do a well blinded OMM study. Usually the best you can do is an outcomes study or blinding the patient and blinding whoever is reading objective tests the patient performs pre and post treatment.


So to summarize, most DOs don't use OMM, good research supporting OMM is sparse, but yet there may be very good reasons to spend the time to at least look more into it. If you go through the motions of the other students in class you will probably be disappointed. If you wish to have an open mind, seek out a sane and highly effective OMM mentor early in first year.

Good luck!