How is a DO more than MD + OMT?

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newyorkcougar

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I have spent quite a bit of time trying to explain to my friends and family what a DO is. In the process I have tried to adumbrate the elusive "osteopathic philosophy." I have tried to explain that while the two degrees are essentially equal, DO's come from a different, more holistic philosophy. Yet I have been a little frustrated when it comes to describing what that translates into in the clinic. With most DO's reporting that they rarely use OMT in their practices, how are we actually different?
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newyorkcougar said:
I have spent quite a bit of time trying to explain to my friends and family what a DO is. In the process I have tried to adumbrate the elusive "osteopathic philosophy." I have tried to explain that while the two degrees are essentially equal, DO's come from a different, more holistic philosophy. Yet I have been a little frustrated when it comes to describing what that translates into in the clinic. With most DO's reporting that they rarely use OMT in their practices, how are we actually different?
Click to expand...

Have you shadowed a DO that does OMT yet?

If not, you should. The doctor I see uses OMT quite often. He had a fellowship in sports medicine but many patients come to him because of pains in their back and legs, etc. You will see how different and how AWESOME OMT is! Its used not only for therapeutic purposes but as a diagnostic tool. The DO can do many range of motion tests or manipulations to pinpoint the troubled muscle. Its really a site to see. Plus, the DO I shadow is really wacky: he tells jokes, does magic tricks and does these weird voices. He's awesome!
 
I had a 2 hour long discussion with an osteopath about this last night. He put it into words quite nicely, and his words carried the experience of 20 years of practice. He basically said that osteopathic medicine and allopathic medicine have become almost the same in the manner in which problems are treated. The distinctiveness lies not in the treatment, but in the approach to the treatment. You've heard it before, and it's almost an intangible quality that is hard to put into words. But patients see the difference. They may not realize that you're a DO, but they notice some is different in the way in which you approach them as a person. Granted, an allopath can do the same thing. But I wanted that quality engrained in me and nurtured throughout my education. The DO schools seem to go out of their way to make physicians who have this sort of sensitivity. But I agree, it's hard to relate this to someone in a short time span.

http://www.acponline.org/journals/news/nov03/communication.htm
 
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I have the same difficulty explaining to my parents what exactly a DO is and the differences between them and MDs. I have found my parents to be exceptionally difficult because they have absolutely no medical background!!

Thanks for putting up this thread...new ideas are helpful! :idea:
 
JohnDO said:
I had a 2 hour long discussion with an osteopath about this last night. He put it into words quite nicely, and his words carried the experience of 20 years of practice. He basically said that osteopathic medicine and allopathic medicine have become almost the same in the manner in which problems are treated. The distinctiveness lies not in the treatment, but in the approach to the treatment. You've heard it before, and it's almost an intangible quality that is hard to put into words. But patients see the difference. They may not realize that you're a DO, but they notice some is different in the way in which you approach them as a person. Granted, an allopath can do the same thing. But I wanted that quality engrained in me and nurtured throughout my education. The DO schools seem to go out of their way to make physicians who have this sort of sensitivity. But I agree, it's hard to relate this to someone in a short time span.

http://www.acponline.org/journals/news/nov03/communication.htm
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:rolleyes:
 
BamaAlum said:
:rolleyes:
Click to expand...

:laugh: I'm sorry. I opened up that link and started laughing....and I can see why bama is rolling his eyes. :D
 
It's a good article, but from my experience, it depends on the person. I had varying experiences with DO's & MD's. Social skills are important.
 
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Saying that DO's are more holistic and that MD's are stiff, robot-like machines who can't approach a patient on a personal level is the equivalent of saying that all Eskimos where seal skin coats and that everyone from Alabama is inbred (we're not, by the way). I'm not sure where the misconception from DO students that MD's and MD students somehow have the humanity trained out of them came from but it is ridiculous. If you have the personality of a brick wall as a pre-med it doesn't matter where you go to medical school, you will surface from your training with the personality of a brick wall. Sorry, but I don't buy the AOA's PR platform that states that we are somehow more "holistic." We are capable of performing OMT. Outside of that there is little difference in our training.
 
BamaAlum said:
Saying that DO's are more holistic and that MD's are stiff, robot-like machines who can't approach a patient on a personal level is the equivalent of saying that all Eskimos where seal skin coats and that everyone from Alabama is inbred (we're not, by the way). I'm not sure where the misconception from DO students that MD's and MD students somehow have the humanity trained out of them came from but it is ridiculous. If you have the personality of a brick wall as a pre-med it doesn't matter where you go to medical school, you will surface from your training with the personality of a brick wall. Sorry, but I don't buy the AOA's PR platform that states that we are somehow more "holistic." We are capable of performing OMT. Outside of that there is little difference in our training.
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:thumbup:
 
BamaAlum said:
... everyone from Alabama is inbred ...
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:D

dont-cha love faulty quotes. this is actually not quite as bad as some of the perpetuating ones in the media right now surrounding the election..... :rolleyes:
 
BamaAlum said:
....If you have the personality of a brick wall as a pre-med it doesn't matter where you go to medical school, you will surface from your training with the personality of a brick wall. ......
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I totally agree, but It would seem... that Osteopathic schools would be less likely to admit a troll than say an Allopathic school. Many more Strong Type A's supposedly go to MD schools, whereas the holistic approach is more attempted at a DO school...

Congrats to each of you on being priviledged enough to be med students....

DrDad

**Disclaimer**
this is purely and totally experience based thoughts, do not assume that there is or is not corroborating evidence. thanks (LOL - :D )
 
cooldreams said:
:D

dont-cha love faulty quotes. this is actually not quite as bad as some of the perpetuating ones in the media right now surrounding the election..... :rolleyes:
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So true. lol
 
What is wrong with being an MD + OMT? We get so beat down about being less than MD's, might as well take pride in someone who considers us more than MD's. ;)
 
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Saying that DO's are more holistic and that MD's are stiff, robot-like machines who can't approach a patient on a personal level is the equivalent of saying that all Eskimos where seal skin coats and that everyone from Alabama is inbred (we're not, by the way).
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"It's a good article, but from my experience, it depends on the person."
 
JohnDO said:
"It's a good article, but from my experience, it depends on the person."
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I agree... take out the rhetoric about osteopathic physicians being the only kind of doctors that do this and it is a good article. I remember reading that study, though and don't remember seeing any faults (other than being in the JAOA;)). If you can afford to spend a little more time with your patients, you will be much more respected by your patients.
 
JohnDO said:
I had a 2 hour long discussion with an osteopath about this last night. He put it into words quite nicely, and his words carried the experience of 20 years of practice. He basically said that osteopathic medicine and allopathic medicine have become almost the same in the manner in which problems are treated. The distinctiveness lies not in the treatment, but in the approach to the treatment. You've heard it before, and it's almost an intangible quality that is hard to put into words. But patients see the difference. They may not realize that you're a DO, but they notice some is different in the way in which you approach them as a person. Granted, an allopath can do the same thing. But I wanted that quality engrained in me and nurtured throughout my education. The DO schools seem to go out of their way to make physicians who have this sort of sensitivity. But I agree, it's hard to relate this to someone in a short time span.

http://www.acponline.org/journals/news/nov03/communication.htm
Click to expand...

Excellent post, well stated, JonDO :thumbup:
 
please dont quote aoa propoganda when trying to figure out what DO's are all about. Go read philosophy and mechanical principles of Osteopathy by AT Still if you can find a copy.


okay, so here it is:

Functional Anatomy.

Osteopaths (at least the good ones) draw from a tremendous base of knowledge of functional anatomy, which is critical in both diagnosis and treatment. We use this, along with- as Dr Still put it... "intelligence" to figure out treatments for serious disease.

Unfortunately there are probably quite a few DO's who never learned this stuff- and thus they ARE just MD's + OMT... but not osteopaths. AT said so himself.


Bones MSIV
OMM Fellow
KCOM
 
bones said:
please dont quote aoa propoganda when trying to figure out what DO's are all about. Go read philosophy and mechanical principles of Osteopathy by AT Still if you can find a copy.


okay, so here it is:

Functional Anatomy.

Osteopaths (at least the good ones) draw from a tremendous base of knowledge of functional anatomy, which is critical in both diagnosis and treatment. We use this, along with- as Dr Still put it... "intelligence" to figure out treatments for serious disease.

Unfortunately there are probably quite a few DO's who never learned this stuff- and thus they ARE just MD's + OMT... but not osteopaths. AT said so himself.


Bones MSIV
OMM Fellow
KCOM
Click to expand...

Please enlighten us with your superior "intelligence" about how to treat "serious" disease. Also, please let us know how we can become one of the "good" osteopaths. :rolleyes:
 
adumbrate the elusive "osteopathic philosophy."

you actually used the word "adumbrate". wow.
 
To the OP-I just finished my Family Practice rotation. I had two MD students working with me. Our assigned preceptor was a DO. I was surprised that the MD schools in the area sent their students to a DO for FP. But it just reinforced what I witnessed on my rotation. There was essentially no difference between me and the MD students in the manner in which we were encouraged to treat patients. In fact, the MD students didn't even know our preceptor was a DO until I pointed it out to them. What was even more strange was that the two MD students didn't even think the few HVLA techniques that he performed were part of his medical school training; they simply thought they were something he picked up in his forty plus years of practicing medicine. Then when they saw me do a Lumbar Roll on a patient with Lumbago they asked me surprisingly where I had learned that. They seemed intrigued and then asked me to show them how to do it. My point is that is seems readily apparent that what is going on in medicine is what another poster already stated: convergence. Yes there still are some MDs out there who harbor prejudice. But they generally are more of the old school of thinking. To further prove my point, one of my four attendings on my OMM rotation is an MD who went back to school to complete his OMM training after starting out in PM&R. He refers to himself as a "recovering allopath." I actually feel that is going a bit too far, but you catch my drift. Hopefully this trend will continue to a point where one day we won't even have to answer such questions as to what is the difference between a DO and an MD.
 
Plinko said:
To the OP-I just finished my Family Practice rotation. I had two MD students working with me. Our assigned preceptor was a DO. I was surprised that the MD schools in the area sent their students to a DO for FP. But it just reinforced what I witnessed on my rotation. There was essentially no difference between me and the MD students in the manner in which we actually feel that is going a bit too far, but you catch my drift. Hopefully this trend will continue to a point where one day we won't even have to answer such questions as to what is the difference between a DO and an MD.
Click to expand...

Interesting! A lot of things are becoming more and more the same. Prevention and wholistic etc... )

So with out stimulating WWIII, I ask..

The term Osteopathy is slightly misleading. I am sure every gets something like... are you a bone doctor.. etc... historicaly yes.. DO did follow bone setters.. and A Still decided to merge Osteo with Pathology.

If the MD degree stands for medical doctor (which include both Allos and Osteos) shouldn't allos be called DA.

Or should all physicians have MD+(accr.)

Here are some idea: MD(osteopathy) MD(allopahy), MD/DO, MD/DA, or simply MD(O), MD(A)

or DOs get an MD with Fellowship in Osteopathy. MD (FCOMT)

Just morning ideas.. don't get too worked up.
 
Yes, the DO is a historical term. And I think that most MDs don't term themselves as allopaths, since this is also a dated term (we just needed a way to differentiate). The name thing is already a big debate and has been argued before--i.e. OMS (osteopathic Medical student) instead of MS, etc. (Docbill, Might want to search this topic on SDN)

I also agree that the two professions are starting to merge recently, especially with the advent of evidence based medicine and learning that medicine (i.e. conventional drugs and subsequent treatment modalities) and surgery isn't the only way to get results (i.e. alternative therapies, of which we have been categorized into). Especially since the general public wants and craves all forms of CAM and will pay out of pocket for it. Many of us have fallen into an identity crisis because of this.

However, we still are different in our approaches, as the KCOM OMM fellow stated on the previous page. However, these have become muddled as the profession strives to maintain itself while struggling to decide whether to remain separate or combined. The confusion the OP is having is a reflection of what many of us have to deal with: our identity and what it means, and do we fully believe and will carry out what we are taught.
 
I for one have no identity crisis. I will be a DO, I want to keep my DO degree, and I am proud of it.
 
First, I don't care about the DO MD difference.

First, I try to avoid the discussion as much as possible. I am a doctor, I use medicine to treat people. Even if I don't have an MD degree, I am a medical doctor. We all are. (Unless you are perhaps specializing in bone disease).

I usually just say that it is a historical difference stemming from the 1800s when medicine in this country was in its infancy and was based on philosophical ideas more than on science. As science became the base of medicine, the two fields have merged back together in practice, but they use seperate degree names for historical reasons.
 
babyruth said:
Yes, the DO is a historical term. And I think that most MDs don't term themselves as allopaths, since this is also a dated term (we just needed a way to differentiate). The name thing is already a big debate and has been argued before--i.e. OMS (osteopathic Medical student) instead of MS, etc. (Docbill, Might want to search this topic on SDN)

I also agree that the two professions are starting to merge recently, especially with the advent of evidence based medicine and learning that medicine (i.e. conventional drugs and subsequent treatment modalities) and surgery isn't the only way to get results (i.e. alternative therapies, of which we have been categorized into). Especially since the general public wants and craves all forms of CAM and will pay out of pocket for it. Many of us have fallen into an identity crisis because of this.

However, we still are different in our approaches, as the KCOM OMM fellow stated on the previous page. However, these have become muddled as the profession strives to maintain itself while struggling to decide whether to remain separate or combined. The confusion the OP is having is a reflection of what many of us have to deal with: our identity and what it means, and do we fully believe and will carry out what we are taught.
Click to expand...

Thanks for the info.. I am aware of OMS and MS story... I don't think it makes a difference in the public eye. Since the public don't get to see much of this.

Under the AOA suggestion of using OMS, that means one may use OMD!

For some it may be an identity crisis... I personally don't conceal the fact... I try to educate others about this. Having only 8 practicing DOs among 30 million in Canada makes things even more interesting. That is one DO per 3,750,000.
 
dkwyler94 said:
First, I don't care about the DO MD difference.

First, I try to avoid the discussion as much as possible. I am a doctor, I use medicine to treat people. Even if I don't have an MD degree, I am a medical doctor. We all are. (Unless you are perhaps specializing in bone disease).

I usually just say that it is a historical difference stemming from the 1800s when medicine in this country was in its infancy and was based on philosophical ideas more than on science. As science became the base of medicine, the two fields have merged back together in practice, but they use seperate degree names for historical reasons.
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Perhaps the most rational and well thought out post on this thread.
 
BamaAlum said:
Perhaps the most rational and well thought out post on this thread.
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Maybe the most rational and well thought out post on this whole forum. Having a DO degree does not make one any more holistic than someone with an MD. Those are personality traits that can only be exaggerated by a good (or poor) education.
 
WannabeDO said:
Maybe the most rational and well thought out post on this whole forum. Having a DO degree does not make one any more holistic than someone with an MD. Those are personality traits that can only be exaggerated by a good (or poor) education.
Click to expand...

absolutely.

Osteopathic medicine is dying. we have more DO's now than ever- with new DO schools opening every year... yet very few students really understand what osteopathy is. Many are just MD's + a little HVLA and a friendly demeanor. And yes, MD's can be friendly too... So there IS no difference between your average DO today and an MD.

osteopathy is the art of seeking distal causes using functional anatomy as your base. When someone presents with pneumonia, the first thing you ask is why... why has their immune system failed, restrictions in rib cage movement? resultant loss of lymphatic flow? check thoracic inlet for restrictions to the lymph system. Have they been taking antacids? (which have now been shown to increase risk of pneumonia- less stomach acid= less defense). what about lung irritation due to tonic sympathetic irregularity?- check thoracic segments 1-6, and then seek the cause of this dysfunction if present (postural decompensation? smoking?). What about psych factors such as stress or depression (both lower immune function). diet? lack of phyiscal exercise?

Treatment will obviously be entirely dependent on the above factors, with a secondary thought being which antibiotics you need to give.

MRSA? VRSA? no problem. give what meds you can, but there is little reason to worry since the majority of patients will recover by correcting the predisposing factors above, of which many can be addressed with OMT. If you havent shadowed a skilled osteopath in a hospital setting you should- you will understand what i mean by this.

I cant tell you how many DO's and MD's i've worked with that just give antibiotics let the patient sit around in the hospital, and discharge the patient without further thought- even with the evidence that OMT reduces hospital stays by several days in pneumonia patients... and not to mention that the underlying causes of the pneumonia has not been addressed.

Many of these treated but non-cured patients end up as frequent fliers. This is only one example of the failure of the training for your average DO internist.

the point? as Osteopaths we are functional anatomy specialists- and how this effects the mind and spirit of patients (and vice versa). mix this with general knowledge of medicine, a healthy dose of deductive reasoning, skill with our hands and specialized knowledge from our residency- and you have a DO. what we risk losing is that first part... and without it we really might as well be MD's.

hope this helps,
:D

bones MSIV
OMM fellow
 
It is interesting that we are discussing the death of osteopathy in a time when the public is starting to look more and more for other modalitites of treatment than drugs. For example, accupuncture, homeopathy, and traditional chinese medicine are both becoming huge, while naturpathy has become more clearly organized and regulated with major university programs. This is an exceptional opportunity for DO's to use their special training and yet more and more DO's report using OMT less and less frequently.

A DO I shadowed said that he didn't use OMT because he just didn't have time for it. Another DO I talked to condescendingly balked when I asked him how much he uses OMM.

It seems to me that this is foolish. This is a prime time for us to meet the demand for other modalities, rather than to abandon them.
 
bones said:
MRSA? VRSA? no problem. give what meds you can, but there is little reason to worry since the majority of patients will recover by correcting the predisposing factors above, of which many can be addressed with OMT. If you havent shadowed a skilled osteopath in a hospital setting you should- you will understand what i mean by this.
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Are you seriously suggesting that VRSA can be treated with OMT? Sounds like another Viola Frymann case...
 
BamaAlum said:
Are you seriously suggesting that VRSA can be treated with OMT? Sounds like another Viola Frymann case...
Click to expand...

Of course it can.

and of course you give antibiotics too- (duh)

Viola Frymann is very skilled at what she does, so no discredit to her- but I think her case was extreme. It is critical to understand the full pathogenesis of the diseases you treat- and you can simultaneously address acute symptoms and underlying causes with all tools at your disposal. OMT is only one of these- we CANNOT be good physicians if we reject the modern tools at our disposal such as antibiotics- but to rely on these alone without understanding or addressing underlying causes is providing sub-par care for your patients as well- and some mayl die as a result, just as some may die if you neglect antibiotics.

With VRSA, your antibiotic choices are very limited, so without knowledge of functional anatomy and skill with OMT your patient's chance of death is quite a bit higher than with other pneumonias. This is one disease for which modern medicine fails, but your osteopathic skills work as well as ever. This stuff saves lives.

i know this is hard to believe for those of you who have never worked on a sick patient for your entire first two years of medical school. This is a failure of our DO education system, not of osteopathy itself.

bones
 
First of all, let me preface this by saying that I am proud of my medical school. I have no regrets on choosing UHS for my medical training. Although I will never use OMT in my specialty of choice (pathology) I do believe that it has its place as an adjunct therapy. That being said I do have a serious problem with those in the osteopathic profession who profess that certain therapies work based on anecdotal evidence alone. Like any therapy I want to see evidence based trials reviewed by peers. There have been recent studies involving OMT that have been excellent. An paper in one of the peds journals about otitis media and OMT comes to mind. Please show me evidence that functional anatomical discrepancies are the cause of most pneumonias. In a hospital setting I would say that aspiration is the major cause of pneumonia. My point is this: The osteopathic community has to get to the point where our claims are backed up by research not just because 'Old Dr. So and So does this and you should see the results.'

20 years from now we will probably look back and laugh at the way we treat certain diseases. As we elucidate more of the molecular etiologies of cancer we will look back and think of our current methods as barbaric. That is the nature of the science of medicine. It is constantly evolving based on new data. It is imperative that the osteopathic profession also move in the direction of an evidence based approach to OMT. There will always be a place for OMT, but it is important that we can defend it with more than, 'it works, trust me.'
 
docbill said:
Interesting! A lot of things are becoming more and more the same. Prevention and wholistic etc... )

So with out stimulating WWIII, I ask..

The term Osteopathy is slightly misleading. I am sure every gets something like... are you a bone doctor.. etc... historicaly yes.. DO did follow bone setters.. and A Still decided to merge Osteo with Pathology.

If the MD degree stands for medical doctor (which include both Allos and Osteos) shouldn't allos be called DA.

Or should all physicians have MD+(accr.)

Here are some idea: MD(osteopathy) MD(allopahy), MD/DO, MD/DA, or simply MD(O), MD(A)

or DOs get an MD with Fellowship in Osteopathy. MD (FCOMT)

Just morning ideas.. don't get too worked up.
Click to expand...

It's real nutty how history convolutes titles and what they truly represent. In reality though, there are MDs that are practicing doctors that don't practice "medicine" (e.g. pathologists), using the strict definition of the word medicine, so you can use the same logic to question the validity of their title. In England, all MDs go to the same medical schools but the surgeons are not called Dr. They are called Mr., Mrs., etc. The whole thing is not worth trying to make sense of. Nor is it worth it in my opinion attempting to change. The important thing is that the people who need to know what a DO does, or an MD does, do know. And for those that don't (e.g. the public) I have rarely heard of a case where it changed their perception of the level of treatment, or the type of treatment, they were receiving.

If and when you are questioned as to what a DO is, I suggest you use dkwyler94's explanation. It is as good of an answer I have heard.
 
Surgeons are called Mr. or Ms. in england because of the origin of surgery. Sureons were originally barber surgeons who were mere technicions(sp????). They were not educated in traditional medical subjects and were not elelgable to stand before the Royal College of Physicans they could only stand before the Guild of Barber Surgeons. It was'nt untill the 18th centuary that Surgeons in england started going to medical school and actually becomeing physicians before heading off to learn the art. Thus is the reason that surgeons are called Mr. in England.
 
Docgeorge said:
Surgeons are called Mr. or Ms. in england because of the origin of surgery. Sureons were originally barber surgeons who were mere technicions(sp????). They were not educated in traditional medical subjects and were not elelgable to stand before the Royal College of Physicans they could only stand before the Guild of Barber Surgeons. It was'nt untill the 18th centuary that Surgeons in england started going to medical school and actually becomeing physicians before heading off to learn the art. Thus is the reason that surgeons are called Mr. in England.
Click to expand...

and physicians do not use the title Dr. That is reserved for MD/PhD or its equivalent.
 
My point is this: The osteopathic community has to get to the point where our claims are backed up by research not just because 'Old Dr. So and So does this and you should see the results.'

BAMA,

you took the words right out of my mouth. on another thread ("revolution") i made the point that in 100+ years of existence, the osteopathic profession has been absolutely pitiful in contributing to the scientific basis of medicine. i will add that that applies to the scientific basis of osteopathy as well.

a case in point... (incidentally bones, none of the following is directed personally at you. your post was very rational, well thought out and a pleasure to read.) bones gave the example of the hospitalized pneumonia patient and some possible anatomical causes of the patient's illness. it seems to follow then that the "cure" for this patient involves correcting the dysfunctional anatomy by the use of OMT. and of course bones acknowledges we need to kill the bug(s) using antibiotics. bones also refers to articles that have shown a reduction in hospital stay when OMT is used adjunctively in the hospitalized pneumonia patient.

at this point, i should say that i desperately, desperately want to believe all of this. i like osteopathy. i think applied appropriately osteopathy helps people. i just don't know how and that scares me.

so, unfortunately, i cannot believe...in most cases, i painfully choose instead to accept the null hypothesis: that nothing happens or at best, the improvements are not uniformly measureable across the population at large. why do i do this? well, in the case above, i do it because i have yet to see well done (large, valid, reproducible, etc.) studies that show WHAT the anatomical dysfunctions are and WHICH manual techniques can correct them. thus, i have no real basis for choosing whether or not to use OMT, which techniques to use, how i should monitor therapy, etc. take this in contrast with the antibiotic. i can start empirically because i know which antibiotics have been shown to work against pneumonia caused by suspected bugs X, Y, or Z. i know this because thousands of studies have been done across the world to demonstrate it. i can do a culture and sensitivity and hone my choices down. i believe the lab because thousands of studies show me that their techniques for isolating and culturing bugs are valid (mostly). if i ask, they can show me in the lab which drug killed which bug at what concentration.

now i'm out of scary empirical land, provided i believe my lab. so, i will start the best abx available. they may or may not work...but at least i have some pretty good reasons to believe they will. either way, i will monitor the patient clinically looking for changes after starting the abx. in addition, i will seek evidence of change radiographically, i might do another culture, i might get other imaging, change the abx, and so on.

you see the point.

sadly, in 100+ years, OMT has yet to really leave the empirical stage of development. even the pneumonia studies were empirical (not to mention small) - sure, they show a reduction in hospital stay. but WHY? WHAT anatomical dysfunctions were corrected? show me. and then study it again, again and again and show me again. otherwise, for the sake of my patients, i have to remain a skeptic. what scares me most about OMT is that there are hundreds of techniques claimed to be applicable in probably thousands of situations, nearly none of which have been tested with any rigor whatsoever. if osteopathic techniques were drugs, most of them wouldn't be on the market right now. would you throw drug X at the above pneumonia just because dr. so and so said it worked well 30 years ago on 2 patients in arkansas? no. but we do this with OMT all the time. incidentally, i think all good physicians should adopt this attitude, whether its OMT we're talking about OR a new drug, surgical procedure, etc.

and so, while I do OMT occasionally, i usually do so only if i am relatively certain it won't hurt things and with no expectation that it will help.

but i still want to believe...

before i fall off my soapbox, let me offer at least one possible cure for this malaise. that is to get the AOA, ACOFP, ABCDE, XYZPDEQ and whoever else is running this show to STOP FRETTING ABOUT WHERE WE ARE IN RELATION TO THE MDs. WE WON THAT BATTLE...ENOUGH ALREADY! WE'RE DOCTORS! rather, we should be working day and night to develop REAL research programs in our schools, hospitals (all 6 of 'em), non-profits, etc. REAL PROGRAMS that do BASIC SCIENCE research AS WELL AS clinical (OMT) research. real programs as in the kind that produce scientists (PhDs) who can seriously study OMT and every thing else. give me some real reasons to have as much faith in OMT as i do in abx.

our profession contributes almost NOTHING to advance medicine OR osteopathy and our reputation suffers for it. and i believe that if we continue on this course, our profession will die for sure.

and now i will fall off my soapbox and straight into bed.

healthydawg
 
healthydawg said:
My point is this: The osteopathic community has to get to the point where our claims are backed up by research not just because 'Old Dr. So and So does this and you should see the results.'

BAMA,

you took the words right out of my mouth. on another thread ("revolution") i made the point that in 100+ years of existence, the osteopathic profession has been absolutely pitiful in contributing to the scientific basis of medicine. i will add that that applies to the scientific basis of osteopathy as well.

a case in point... (incidentally bones, none of the following is directed personally at you. your post was very rational, well thought out and a pleasure to read.) bones gave the example of the hospitalized pneumonia patient and some possible anatomical causes of the patient's illness. it seems to follow then that the "cure" for this patient involves correcting the dysfunctional anatomy by the use of OMT. and of course bones acknowledges we need to kill the bug(s) using antibiotics. bones also refers to articles that have shown a reduction in hospital stay when OMT is used adjunctively in the hospitalized pneumonia patient.

at this point, i should say that i desperately, desperately want to believe all of this. i like osteopathy. i think applied appropriately osteopathy helps people. i just don't know how and that scares me.

so, unfortunately, i cannot believe...in most cases, i painfully choose instead to accept the null hypothesis: that nothing happens or at best, the improvements are not uniformly measureable across the population at large. why do i do this? well, in the case above, i do it because i have yet to see well done (large, valid, reproducible, etc.) studies that show WHAT the anatomical dysfunctions are and WHICH manual techniques can correct them. thus, i have no real basis for choosing whether or not to use OMT, which techniques to use, how i should monitor therapy, etc. take this in contrast with the antibiotic. i can start empirically because i know which antibiotics have been shown to work against pneumonia caused by suspected bugs X, Y, or Z. i know this because thousands of studies have been done across the world to demonstrate it. i can do a culture and sensitivity and hone my choices down. i believe the lab because thousands of studies show me that their techniques for isolating and culturing bugs are valid (mostly). if i ask, they can show me in the lab which drug killed which bug at what concentration.

now i'm out of scary empirical land, provided i believe my lab. so, i will start the best abx available. they may or may not work...but at least i have some pretty good reasons to believe they will. either way, i will monitor the patient clinically looking for changes after starting the abx. in addition, i will seek evidence of change radiographically, i might do another culture, i might get other imaging, change the abx, and so on.

you see the point.

sadly, in 100+ years, OMT has yet to really leave the empirical stage of development. even the pneumonia studies were empirical (not to mention small) - sure, they show a reduction in hospital stay. but WHY? WHAT anatomical dysfunctions were corrected? show me. and then study it again, again and again and show me again. otherwise, for the sake of my patients, i have to remain a skeptic. what scares me most about OMT is that there are hundreds of techniques claimed to be applicable in probably thousands of situations, nearly none of which have been tested with any rigor whatsoever. if osteopathic techniques were drugs, most of them wouldn't be on the market right now. would you throw drug X at the above pneumonia just because dr. so and so said it worked well 30 years ago on 2 patients in arkansas? no. but we do this with OMT all the time. incidentally, i think all good physicians should adopt this attitude, whether its OMT we're talking about OR a new drug, surgical procedure, etc.

and so, while I do OMT occasionally, i usually do so only if i am relatively certain it won't hurt things and with no expectation that it will help.

but i still want to believe...

before i fall off my soapbox, let me offer at least one possible cure for this malaise. that is to get the AOA, ACOFP, ABCDE, XYZPDEQ and whoever else is running this show to STOP FRETTING ABOUT WHERE WE ARE IN RELATION TO THE MDs. WE WON THAT BATTLE...ENOUGH ALREADY! WE'RE DOCTORS! rather, we should be working day and night to develop REAL research programs in our schools, hospitals (all 6 of 'em), non-profits, etc. REAL PROGRAMS that do BASIC SCIENCE research AS WELL AS clinical (OMT) research. real programs as in the kind that produce scientists (PhDs) who can seriously study OMT and every thing else. give me some real reasons to have as much faith in OMT as i do in abx.

our profession contributes almost NOTHING to advance medicine OR osteopathy and our reputation suffers for it. and i believe that if we continue on this course, our profession will die for sure.

and now i will fall off my soapbox and straight into bed.

healthydawg
Click to expand...

Well put, and very true. Also, it is worth noting that, any study of the efficacy of an OMT modality does not have to explain the way in which an effect is generated. All that is needed is an experimental design that shows a significant effect, and that it can be repeated consisitently be other groups. An MOA is nice, but not necesary to show efficacy.
 
Amen brother, Amen!
 
healthydawg said:
before i fall off my soapbox, let me offer at least one possible cure for this malaise. that is to get the AOA, ACOFP, ABCDE, XYZPDEQ and whoever else is running this show to STOP FRETTING ABOUT WHERE WE ARE IN RELATION TO THE MDs. WE WON THAT BATTLE...ENOUGH ALREADY! WE'RE DOCTORS! rather, we should be working day and night to develop REAL research programs in our schools, hospitals (all 6 of 'em), non-profits, etc. REAL PROGRAMS that do BASIC SCIENCE research AS WELL AS clinical (OMT) research. real programs as in the kind that produce scientists (PhDs) who can seriously study OMT and every thing else. give me some real reasons to have as much faith in OMT as i do in abx.

our profession contributes almost NOTHING to advance medicine OR osteopathy and our reputation suffers for it. and i believe that if we continue on this course, our profession will die for sure.
Click to expand...

This is the root of the problem and demonstrates that all too often politics in medicine are as important as the science. Until we get physicians in leadership positions in the AOA that are willing to face the scrutiny of evidenced based medicine and remove the MD chip from their shoulders the problem will perpetuate. Hopefully, our generation of DO's will be the one that finally lets go of the DO vs. MD axe and focuses on reforming the AOA and developing a more academic atmosphere among our schools. In the end we will be better physicians for it and our patients will receive better care as a result of it.
 
Unfoutuantely there are enough zelots in our ranks as to make the reforming of the AOA difficult unless enough of us who are unhappy with the AOA swallow some bull **** and become active with in it, otherwise the zelots will still rule. How do you think the realistic and progressive DO's of today are'nt in positions of power within the AOA?
 
I once explained the difference between Do and MD this way. If you apply to an MD school, and that school's admission requirements is say:

min QPA 3.8
MCAT >27
X credits of this or Y credits of that

If that MD school gets your application and you do not meet this criteria, your application goes directly into the trash without a second look! You could have done research, you could have a degree in a very difficult discipline, you could have awesome letters of recommendation, you may have been president of every club in college, you may have went to the african bush for a semester and taught kids how to read and write. None of it matters, if you don't meet application criteria, your application is trashed and you propmtly get a reject letter.

DO schools on the other hand have more extensive applications, they require more letters of recommendation, they want to know about you and your qualitites as a person, did you volunteer for an organization, were you active in clubs in college, did you do research, were you employed before applying to med school, the whole list? What does your personal statement say, they actually do take the time to read these! Whatever it is about you that makes you such a wonderful person, they want to know about it! To DO schools, this info is more important than your grades and MCAT scores. But at the same time, DO schools do filter out trolls who say, "alright, I only need a 2.5 QPA to apply to this place" Believe me, they have their way of weeding these people out during the application/interviewing process. I do tell people, don't think that you can do terrible on the MCATs, get poor grades and get accepted into a DO school. Yes, you may meet admission criteria, but if you have nothing else to show for yourself, they are not interested.

That is the best way I can distinguish the two, I only base this on my experiences from applying to medical school.
 
daveyboy said:
Well put, and very true. Also, it is worth noting that, any study of the efficacy of an OMT modality does not have to explain the way in which an effect is generated. All that is needed is an experimental design that shows a significant effect, and that it can be repeated consisitently be other groups. An MOA is nice, but not necesary to show efficacy.
Click to expand...

Great point. If you look at the research of most drugs, the exact modality is unknown, but the effects in treatment are consistent and scientifically relevant.
 
healthydawg said:
My point is this: The osteopathic community has to get to the point where our claims are backed up by research not just because 'Old Dr. So and So does this and you should see the results.'

BAMA,

you took the words right out of my mouth. on another thread ("revolution") i made the point that in 100+ years of existence, the osteopathic profession has been absolutely pitiful in contributing to the scientific basis of medicine. i will add that that applies to the scientific basis of osteopathy as well.

a case in point... (incidentally bones, none of the following is directed personally at you. your post was very rational, well thought out and a pleasure to read.) bones gave the example of the hospitalized pneumonia patient and some possible anatomical causes of the patient's illness. it seems to follow then that the "cure" for this patient involves correcting the dysfunctional anatomy by the use of OMT. and of course bones acknowledges we need to kill the bug(s) using antibiotics. bones also refers to articles that have shown a reduction in hospital stay when OMT is used adjunctively in the hospitalized pneumonia patient.

at this point, i should say that i desperately, desperately want to believe all of this. i like osteopathy. i think applied appropriately osteopathy helps people. i just don't know how and that scares me.

so, unfortunately, i cannot believe...in most cases, i painfully choose instead to accept the null hypothesis: that nothing happens or at best, the improvements are not uniformly measureable across the population at large. why do i do this? well, in the case above, i do it because i have yet to see well done (large, valid, reproducible, etc.) studies that show WHAT the anatomical dysfunctions are and WHICH manual techniques can correct them. thus, i have no real basis for choosing whether or not to use OMT, which techniques to use, how i should monitor therapy, etc. take this in contrast with the antibiotic. i can start empirically because i know which antibiotics have been shown to work against pneumonia caused by suspected bugs X, Y, or Z. i know this because thousands of studies have been done across the world to demonstrate it. i can do a culture and sensitivity and hone my choices down. i believe the lab because thousands of studies show me that their techniques for isolating and culturing bugs are valid (mostly). if i ask, they can show me in the lab which drug killed which bug at what concentration.

now i'm out of scary empirical land, provided i believe my lab. so, i will start the best abx available. they may or may not work...but at least i have some pretty good reasons to believe they will. either way, i will monitor the patient clinically looking for changes after starting the abx. in addition, i will seek evidence of change radiographically, i might do another culture, i might get other imaging, change the abx, and so on.

you see the point.

sadly, in 100+ years, OMT has yet to really leave the empirical stage of development. even the pneumonia studies were empirical (not to mention small) - sure, they show a reduction in hospital stay. but WHY? WHAT anatomical dysfunctions were corrected? show me. and then study it again, again and again and show me again. otherwise, for the sake of my patients, i have to remain a skeptic. what scares me most about OMT is that there are hundreds of techniques claimed to be applicable in probably thousands of situations, nearly none of which have been tested with any rigor whatsoever. if osteopathic techniques were drugs, most of them wouldn't be on the market right now. would you throw drug X at the above pneumonia just because dr. so and so said it worked well 30 years ago on 2 patients in arkansas? no. but we do this with OMT all the time. incidentally, i think all good physicians should adopt this attitude, whether its OMT we're talking about OR a new drug, surgical procedure, etc.

and so, while I do OMT occasionally, i usually do so only if i am relatively certain it won't hurt things and with no expectation that it will help.

but i still want to believe...

before i fall off my soapbox, let me offer at least one possible cure for this malaise. that is to get the AOA, ACOFP, ABCDE, XYZPDEQ and whoever else is running this show to STOP FRETTING ABOUT WHERE WE ARE IN RELATION TO THE MDs. WE WON THAT BATTLE...ENOUGH ALREADY! WE'RE DOCTORS! rather, we should be working day and night to develop REAL research programs in our schools, hospitals (all 6 of 'em), non-profits, etc. REAL PROGRAMS that do BASIC SCIENCE research AS WELL AS clinical (OMT) research. real programs as in the kind that produce scientists (PhDs) who can seriously study OMT and every thing else. give me some real reasons to have as much faith in OMT as i do in abx.

our profession contributes almost NOTHING to advance medicine OR osteopathy and our reputation suffers for it. and i believe that if we continue on this course, our profession will die for sure.

and now i will fall off my soapbox and straight into bed.

healthydawg
Click to expand...

Schools like KCUMB, UNECOM, and of course the university affiliated schools are beginning to enter the academic side of medicine, a step in the right direction. I hope others follow suit. This is one reason why I chose to go to a university based school for my osteopathic education.
 
I know that our school is trying as well, but because we don't have a large institution affiliation or other forms of funding (although that is changing) we are having a hard to time supporting the research---although I know that we are doing research on OMT and asthma.
 
healthydawg said:
My point is this: The osteopathic community has to get to the point where our claims are backed up by research not just because 'Old Dr. So and So does this and you should see the results.'
Click to expand...

This is something that I want. Sometimes I feel like there isn't enough research to back what i am learning. I take it bit by bit and some of it is great and some is kinda eh.... No matter what a controlled blind type of trial (how ever you could do that) would be great.
 
Miss me? :D

allright. I see a few unanswered criticisms and comments to field from since I was last on here.

so the point of my previous posts were to tell you the difference between DO's and MD's as per the topic of the thread- not to defend the validity of the DO profession or the efficacy of OMM. but lets take a detour.


To be fair, if "rational, modern" DO's ran the AOA (as in wanna-be MD's who don't use OMM), then our profession is as good as finished. It has no reason to exist. Just give us all MD degrees at that point. I am sorry if you slacked off or go to a doc-diploma-mill DO school and feel that your osteopathic skill is inadequate and cannot integrate it- again this is a failing of the education process, and not the art of osteopathy. Sadly, this is a very common story. your best option in such a place is to seek out specialists in private practice in your city who can be role models for you. make the best of the situation.

http://www.academyofosteopathy.org/findphys.cfm
look up neuromuscular medicine and osteopathic manipulative medicine specialists in your town for shadowing in the first 2 years, and get a rotation or two with them 3rd and 4th year. And USE it all 3rd and 4th year. If you don?t use your skills on a variety of patients under a variety of clinical situations you have lost the art and will probably not apply it effectively in your practice.

Try to follow as many different osteopaths as possible... as with any type of doc- there are awesome ones and crappy ones. I don?t doubt that some are so lousy that their benefit to patients is minimal. And then you see the ones that change lives left and right and you realize why we?re DO?s. if you can develop some of that skill and apply it to your specialty you will be unique in your profession, able to help those patients that nobody else can.


A big failing of the osteopathic profession is that our current AOA leaders (zealots, as you say- and rather stupid ones) let these new random DO schools surface all over with severely inadequate OMM faculty, when we barely have enough skilled osteopathic faculty at our core schools. Thus, the common story of the inadequate DO becomes even more common... and not only does nobody integrate functional anatomy into their practice, but probably the majority of DO's today don't even know anything about osteopathy. Its like having a bunch of MD's who have had a few chiropractic lessons (shudder). or they are zealots who are essentially chiropractors that couldnt save a life in the ER if it was their mothers... no offense you chiros, but most of you are taught to crack backs and charge a bill- without understanding key lesion mechanics and functional causes. fix the key lesion and it never comes back... but if you don't you'll be cracking the same vertebrae for years. If you also understand the visceral anatomy you can address all sorts of conditions, not just sloppy vertebrae.


a real osteopath integrates... learn anatomy and phys REALLY well, and then NOTHING is left to "belief". whats all this crap about "i want to believe". its like you're some freaking Jehovas witness bible nazi. osteopaths are scientists and artists, not religious fanatics (well... maybe a few are, but they need to keep it quiet). the reason it is a science is that its all built on a rock-solid foundation of knowns- anatomy, physiology, and pathophyisiology.

and to that "show me the functional anatomy studies" parrot... wake up. read your textbooks. read doctor Willards work from NECOM. now read it again. functional anatomy isn't clinical- its basic science. perhaps more complicated anatomy than you were taught, but critical to understanding OMM.


Now as far as the clinical efficacy of individual techniques, yes
I agree that our profession needs a TON of research. we are under-researched for a number of reasons:

1)osteopathy treats the whole patient... thus, no two patients with the same condition are treated in the same way. just try setting up a good pneumonia study when every single patient needs a different treatment from the ground up based on their structural strains and systemic stresses.

2) OMT is NOT a double-blind tool. how can a skilled practicioner do a practicioner-blind sham treatment? at BEST you can do single blind... and even then you are pushing it (massage the right place and you'll get benefit, sham it too hard and its obvious to the patient).

Now imagine proving to me that surgery works. hmm??? there are virtually NO double blind or placebo-controlled studies for the surgeries we use every day. Should we stop performing all of these surgeries due to insufficient evidence? The results are "self evident"... right? well no... I would actually love to see a double blind study for surgery on pancreatic cancers, cholecystectomies, and appendectomies, but it just aint gonna happen, now is it?

At best you can do outcome studies... but guess what? there are some good outcome studies for OMM out there. I would love EBM double blind OMM research too, but it just ain't happening.

3) DO's dont know how to do research. a failing of the education. we have virtually no research education or publication requirements in DO schools. Thus, once we graduate we write some truly pitiful papers... and some of these make it into JAOA since there is such a small pool of papers to choose from.

4) resources. Most DO schools dont even have PhD programs. very little funding for research facilities. it shows the emphasis of those ever-wise AOA leaders.


so after all this, you see only a few good OMM papers. surprised? i'm not at all. BUT there ARE a few good ones out there. you just have to look.
http://ostmed.hsc.unt.edu/ostmed/index.html

so there isn't much data (though more than for most common surgeries), and unless you do the research yourself there wont be more anytime soon. the only way to understand the value of OMM is to understand functional anatomy and the clinical pathophysiology of disease way better than most of your colleagues... or to see outcomes from skilled specialists. its not enough to read case studies since they can be exaggerated or distorted. That said I have dozens of my own cases that i could share with anyone who is interested, and im still just a student. Believe nobody's case study though. see it for yourself. Understand it for yourself. yes that answer sucks, but deal with it, since thats the best you'll get.

And if you think OMM is a joke but went DO anyway... its your own damn fault for going DO. quit your bitching... some of us are proud osteopaths with very happy and now very well patients!
:D

cheers,
bones
 
bones said:
Miss me? :D

allright. I see a few unanswered criticisms and comments to field from since I was last on here.

so the point of my previous posts were to tell you the difference between DO's and MD's as per the topic of the thread- not to defend the validity of the DO profession or the efficacy of OMM. but lets take a detour.


To be fair, if "rational, modern" DO's ran the AOA (as in wanna-be MD's who don't use OMM), then our profession is as good as finished. It has no reason to exist. Just give us all MD degrees at that point. I am sorry if you slacked off or go to a doc-diploma-mill DO school and feel that your osteopathic skill is inadequate and cannot integrate it- again this is a failing of the education process, and not the art of osteopathy. Sadly, this is a very common story. your best option in such a place is to seek out specialists in private practice in your city who can be role models for you. make the best of the situation.

http://www.academyofosteopathy.org/findphys.cfm
look up neuromuscular medicine and osteopathic manipulative medicine specialists in your town for shadowing in the first 2 years, and get a rotation or two with them 3rd and 4th year. And USE it all 3rd and 4th year. If you don?t use your skills on a variety of patients under a variety of clinical situations you have lost the art and will probably not apply it effectively in your practice.

Try to follow as many different osteopaths as possible... as with any type of doc- there are awesome ones and crappy ones. I don?t doubt that some are so lousy that their benefit to patients is minimal. And then you see the ones that change lives left and right and you realize why we?re DO?s. if you can develop some of that skill and apply it to your specialty you will be unique in your profession, able to help those patients that nobody else can.


A big failing of the osteopathic profession is that our current AOA leaders (zealots, as you say- and rather stupid ones) let these new random DO schools surface all over with severely inadequate OMM faculty, when we barely have enough skilled osteopathic faculty at our core schools. Thus, the common story of the inadequate DO becomes even more common... and not only does nobody integrate functional anatomy into their practice, but probably the majority of DO's today don't even know anything about osteopathy. Its like having a bunch of MD's who have had a few chiropractic lessons (shudder). or they are zealots who are essentially chiropractors that couldnt save a life in the ER if it was their mothers... no offense you chiros, but most of you are taught to crack backs and charge a bill- without understanding key lesion mechanics and functional causes. fix the key lesion and it never comes back... but if you don't you'll be cracking the same vertebrae for years. If you also understand the visceral anatomy you can address all sorts of conditions, not just sloppy vertebrae.


a real osteopath integrates... learn anatomy and phys REALLY well, and then NOTHING is left to "belief". whats all this crap about "i want to believe". its like you're some freaking Jehovas witness bible nazi. osteopaths are scientists and artists, not religious fanatics (well... maybe a few are, but they need to keep it quiet). the reason it is a science is that its all built on a rock-solid foundation of knowns- anatomy, physiology, and pathophyisiology.

and to that "show me the functional anatomy studies" parrot... wake up. read your textbooks. read doctor Willards work from NECOM. now read it again. functional anatomy isn't clinical- its basic science. perhaps more complicated anatomy than you were taught, but critical to understanding OMM.


Now as far as the clinical efficacy of individual techniques, yes
I agree that our profession needs a TON of research. we are under-researched for a number of reasons:

1)osteopathy treats the whole patient... thus, no two patients with the same condition are treated in the same way. just try setting up a good pneumonia study when every single patient needs a different treatment from the ground up based on their structural strains and systemic stresses.

2) OMT is NOT a double-blind tool. how can a skilled practicioner do a practicioner-blind sham treatment? at BEST you can do single blind... and even then you are pushing it (massage the right place and you'll get benefit, sham it too hard and its obvious to the patient).

Now imagine proving to me that surgery works. hmm??? there are virtually NO double blind or placebo-controlled studies for the surgeries we use every day. Should we stop performing all of these surgeries due to insufficient evidence? The results are "self evident"... right? well no... I would actually love to see a double blind study for surgery on pancreatic cancers, cholecystectomies, and appendectomies, but it just aint gonna happen, now is it?

At best you can do outcome studies... but guess what? there are some good outcome studies for OMM out there. I would love EBM double blind OMM research too, but it just ain't happening.

3) DO's dont know how to do research. a failing of the education. we have virtually no research education or publication requirements in DO schools. Thus, once we graduate we write some truly pitiful papers... and some of these make it into JAOA since there is such a small pool of papers to choose from.

4) resources. Most DO schools dont even have PhD programs. very little funding for research facilities. it shows the emphasis of those ever-wise AOA leaders.


so after all this, you see only a few good OMM papers. surprised? i'm not at all. BUT there ARE a few good ones out there. you just have to look.
http://ostmed.hsc.unt.edu/ostmed/index.html

so there isn't much data (though more than for most common surgeries), and unless you do the research yourself there wont be more anytime soon. the only way to understand the value of OMM is to understand functional anatomy and the clinical pathophysiology of disease way better than most of your colleagues... or to see outcomes from skilled specialists. its not enough to read case studies since they can be exaggerated or distorted. That said I have dozens of my own cases that i could share with anyone who is interested, and im still just a student. Believe nobody's case study though. see it for yourself. Understand it for yourself. yes that answer sucks, but deal with it, since thats the best you'll get.

And if you think OMM is a joke but went DO anyway... its your own damn fault for going DO. quit your bitching... some of us are proud osteopaths with very happy and now very well patients!
:D

cheers,
bones
Click to expand...


wow... thats a really good post! :thumbup: :thumbup:
 
Bones, you are awesome. I don't want to inflate your ego too much, but from what I know of you on SDN, you are a true role model for what oteopathic students should aspire to be. I know I do. I truly believe OMM is a lot more important than a lot of DO's I know give it credit for, and while I don't believe it is the absolute center of our profession, I do believe it is very important, should be used more, and it is a large part of what truly makes us an alternative choice from allopathy. Thanks for taking the time, if you help nobody else, you do help me as an impressionable new osteopathic medical student! :cool:

BTW, I am going to remember your surgery reference as a comparison to researching OMM and its so called "anecdotal only" research proof, it was an excellent way of legitimizing how OMM research is done and for evaluating outcomes as a central tenet of proving it works.
 
bones said:
Miss me? :D

And if you think OMM is a joke but went DO anyway... its your own damn fault for going DO. quit your bitching... some of us are proud osteopaths with very happy and now very well patients!
:D

cheers,
bones
Click to expand...

1. your dancing skeleton is neat; is it break dancing?

2. I like OMM b/c it has worked for my chronic back spasms. Are there any good rural FP programs that allow the use of OMM? just asking
 
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