I actually have more problem with some of this stuff from a reimbursement angle - is the benefit derived from a treatment like OMM worth the money which must be paid to the physician for performing it? Or could a less trained practitioner whose time is worth much less than a physician's do essentially the same thing? Or even the same goal accomplished with a cheap med?
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I think this is an interesting point. I've thought about this. If a specific OMT treatment was proven to definitively reduce length of stay in a hospital, let's say rib raising for COPD exacerbations, then I'm quite certain hospitals would find a way to train less qualified (less expensive) individuals, such as RT's, to routinely carry out the procedure.
The classic paradox is that if OMT works, then we should train everyone to do it. Of course, patient care is more complicated than that. OMT needs to be utilized in individualized patients with specific ailments by adequately trained physicians. Just like any other medical procedure, like a joint injection or an epidural. Which is why, IMO, you shouldn't provide shotgun OMT to every patient for every condition under the sun. Nor should you disregard it for every patient, especially those with back pain.
I've rambled a bit, but the bottom line: less qualified healthcare workers shouldn't provide OMT, its a medical procedure, but that wouldn't necessarily preclude hospitals from trying to find a way to do it.
I think the value of OMM to a patient, relative to a medication, is very dependent on the skill of the practitioner and the preference of the patient. If a patient prefers to utilize OMM over a medication, as many do, then you should respect their autonomy, as long as the procedure is safe and appropriate.
As far as healthcare spending goes, OMT isn't even a drop in the bucket. If you think healthcare spending on OMT is a big problem, wait til you do a Hem/Onc rotation. Or even cardiology for that matter.
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