Any DO psychiatrists in this forum?

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katiedid919

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Any osteopathic psychiatrists around? Particularly I'm looking for some information on entering allopathic residency programs as a DO student, but also interested in DO residencies as well. So if anyone has any experience with it, please let me know! Thanks!
 
I would like to know too... I am wondering if there are DO Psychiatrists that have found OMT to be a useful technique in their practice.
 
Sorry to but in on your thread but i was wondering if OMT affects the pathophysiology of psychiatric illness? I am a premed that is considering going to a DO school. It seems like the holistic approach fits in nicely with the practice of psychiatry.
 
Very good thought HyperSpace! I have been interested in these effects myself. OMT does affect pathophysiology, there are several techniques we have learned to specifically address depression. There are cranial techniques that I believe can be very powerful tools to psychiatrists.

Another interesting aspect of OMT is its ability to uncover "hidden" tenderpoints, sometimes which have a viscerosomatic reflex. I watched as an expert in OMT was treating a girl with neck pain. He uncoverd tissue texture changes that indicated an old injury. The tight tissue band seemed to point to a car accident (as the injury followed the path of a seatbelt). Upon questioning this girl she suddenly remembered this repressed memory of her childhood. She began to cry. It opened doors for her... and me as well.
 
I heard a rumor once that AT Still (the founder of Osteopathic medicine) worked with psychiatric patients in the 1800's when he ran one of the mental hospitals.

There are several DO's on the East Coast that I have talked with that are interested in using OMT to treat psychiatric patients.

There are only a small handful of Osteopathic Psychiatry Residencies. I do not know if they use OMT in their practices.

It would seem to me to be a perfect union, mind and body. To treat the whole person. If at the very least you decrease the number of antidepressants a person needs to take. You may indeed help to build report with your patients, allowing them to feel more comfortable thereby opening their mind to you.
 
I'm not so sure about cranio-sacral therapy. It really is on the fringes of what is considered to be the Standard of Care in Psychiatry.

If you're curious, please read this article from Stephen Barrett, MD. This link is from the award-winning website www.quackwatch.com, which has been recognized by JAMA, Forbes, and US News and World Report for its accuracy and reliability.

http://www.quackwatch.com/04ConsumerEducation/QA/osteo.html
 
The ironic thing is the overwhelming majority of DO's do not practice OMT. I do not have exact numbers but based on my conversations with my osteopathic colleagues,they mentioned something like 90% do not practice OMT. The ones that do practice it are almost entirely in family medicine or PM&R where they have an opportunity to do so. Many of the DO's I knew stated they were initially open to the idea of OMT but graduated disenchanted after learning more about it. They also stated that cranio-sacral is controversial among the OMT staff at their respective schools.

I think DO's are unfairly maligned by some on here. I just view DO schools as third or fourth tier medical schools. There are third and fourth tier law and business schools so why can't we have our version of that? They are essentially allopathic schools that are less competitive and less reputable. However, I don't question their training in the slightest. The reality is DO schools are a backdoor to getting a medical degree much like carribbean schools. I don't see anything wrong with that. Some people struggled in college and can't get into medical school regardless of what they do. These schools offer students a second chance and many of these students make the most of it by excelling in school and attaining great residencies. Don't judge DO's without getting to know them because I'm sure many of them feel the same way you do regarding OMT. I know some of us bare a grudge against DO's and FMG's because we worked hard to get accepted into our schools and they got into their schools with weaker stats. But you guys need to get over that and realize that you will be working alongside them whether you like it or not.
 
there are lots of DO psych residents nosing around in here ... do a search, there are already threads that exist on this very subject!
 
psychfriend said:
The ironic thing is the overwhelming majority of DO's do not practice OMT. I do not have exact numbers but based on my conversations with my osteopathic colleagues,they mentioned something like 90% do not practice OMT. The ones that do practice it are almost entirely in family medicine or PM&R where they have an opportunity to do so. Many of the DO's I knew stated they were initially open to the idea of OMT but graduated disenchanted after learning more about it. They also stated that cranio-sacral is controversial among the OMT staff at their respective schools.

I think DO's are unfairly maligned by some on here. I just view DO schools as third or fourth tier medical schools. There are third and fourth tier law and business schools so why can't we have our version of that? They are essentially allopathic schools that are less competitive and less reputable. However, I don't question their training in the slightest. The reality is DO schools are a backdoor to getting a medical degree much like carribbean schools. I don't see anything wrong with that. Some people struggled in college and can't get into medical school regardless of what they do. These schools offer students a second chance and many of these students make the most of it by excelling in school and attaining great residencies. Don't judge DO's without getting to know them because I'm sure many of them feel the same way you do regarding OMT. I know some of us bare a grudge against DO's and FMG's because we worked hard to get accepted into our schools and they got into their schools with weaker stats. But you guys need to get over that and realize that you will be working alongside them whether you like it or not.
Click to expand...

If you are seriously trying to defend the DO's by your second paragraph, you may actually have suceeded in offending some. Do you really think that all DO's are people who couldn't get into MD schools because of their weaker stats? I mean, they could live in a state where that may be the only option and they didn't want to leave home, they might like the whole OMT concept, they may have applied to both MD and DO and liked the DO one for some reason during interviews or many other reasons. Anyway, your argument for the DO's is weak and kind of insulting and I'm not even in DO school. And before you respond to this, re-read and re-analyze your paragraph again.
Choco
 
chocomorsel said:
Do you really think that all DO's are people who couldn't get into MD schools because of their weaker stats?
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Similarly, all people who go to lowered-tier medical schools don't do so because they couldn't get in to higher-tiered medical schools. But that is a pretty darn common reason why someone goes to a lower-tiered medical school.

We've had bloody DO vs MD fights on here recently, let's not start a new one.

chocomorsel said:
they might like the whole OMT concept
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Well, there's no accounting for taste. I like Jello Pudding Pops for depression, and have spent substantial effort concocting a dopaminergic mechanism to justify their use. But that doesn't make them standard of care.
 
chocomorsel said:
If you are seriously trying to defend the DO's by your second paragraph, you may actually have suceeded in offending some. Do you really think that all DO's are people who couldn't get into MD schools because of their weaker stats? I mean, they could live in a state where that may be the only option and they didn't want to leave home, they might like the whole OMT concept, they may have applied to both MD and DO and liked the DO one for some reason during interviews or many other reasons. Anyway, your argument for the DO's is weak and kind of insulting and I'm not even in DO school. And before you respond to this, re-read and re-analyze your paragraph again.
Choco
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There are no states that exclusively have a DO school without a pre-existing allopathic school. I apologize for generalizing about DO students. I don't think all DO's chose the osteopathic route because they were less competitive statistically but I do believe the majority of students chose the DO route for those reasons. The average Allopathic admission stats are significantly higher than that of their Osteopathic counterparts, which is an indisputable fact. Any conclusions based on those statistics is subject to interpretation. If you want to believe that osteopathic students chose to attend a DO school for reasons other than their lower statistics, that is your right. I personally believe the majority of osteopathic students chose to go DO based on a couple of reasons. They were less competitive statistically and the notion that the majority of DO's do not practice OMT. If students chose to attend an Osteopathic schools because he or she was passionate about OMT then why do so many of them not practice OMT?

I can see how my second paragraph could offend DO's. But you have to realize there are people who question their curriculum or their status as physicians which I don't agree with. Yes, I do think of osteopathic schools as lower ranked allopathic schools but I do respect their graduates as my equal colleagues. I will also acknowledge that many DO's are superior physicians to many allopathic physicians. I have a friend who attended Fordham law school. It's considered a lower tiered school in New York when compard to NYU, Columbia and Cornell. However, my friend finished in the top 10% of his class and beat out several grads from the other aforementioned schools. I think of DO's in the same manner.

I don't think DO's should be judged based on admission statistics. I personally think students should be evaluated how they perform in medical school regardless of where he or she attended school. I would not show any preference toward an MD or DO if I was a program director, but that would be my personal bias. I hate MD vs DO threads too so I won't respond. You may have the last response and I'll personally no longer contribute to this thread.
 
I appreciate the open discussion and honest opinions. It is usually due to lack of information that leads people to write articles like the above posted "quackwatch.com". MD versus DO is an old debate and not the subject of this thread.

Standard of care is the way in which a physician becomes "standard". Being a leader in the art of healing sometimes means working in the fringe... to think outside the box and outside ourselves. To consider the patient themselves, leaving the ego behind. I hope to be the type of physician that doesn't treat patients like a box of Toll House Cookies. That is why I only applied to DO schools. 🙂

All that being said, the question is still out there, are there any Osteopathic Psychiatry Residents that have had experiences using OMT with your patients?
 
billypilgrim37 said:
And leave Toll House Cookies out of this. Those work on dopamine receptors too, ya know...
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Haha! You are right, bringing a cookie into this was poor form. 🙂
 
True, being a leader sometimes means working on the fringe. However, for every 1 visionary working on the fringe, there's probably a hundred that stay there on the edges of accepted medical practice. Many of these 100 hypothetical practitioners cross the line into quackery.

I'm tired of hearing this undiscovered genius nonsense regarding cranio-sacral therapy.

As Stephen Barrett, MD writes, if a patient is to choose a DO, he or she should find a DO who has trained at an allopathic residency and who avoids things such as cranio-sacral therapy. Anything else and a DO is joining the ranks of naprapaths and homeopaths.
 
I urge you to reconsider your position psychMD. In many circles of the world, Psychiatry itself is a "fringe medicine". Pushing drugs we have little idea of how they work. We don't really undestand how Lithium or an SSRI works to stabilize mood, they just work. To many, the field of Psychiatry is "quackary"... and rightfully so.

This has been an interesting debate, yet an ironic one. If you choose to practice in the field of Psychiatry, it may be wise to be a little more open to techniques that, "just work."
 
PsychMD2100 said:
True, being a leader sometimes means working on the fringe. However, for every 1 visionary working on the fringe, there's probably a hundred that stay there on the edges of accepted medical practice. Many of these 100 hypothetical practitioners cross the line into quackery.

I'm tired of hearing this undiscovered genius nonsense regarding cranio-sacral therapy.

As Stephen Barrett, MD writes, if a patient is to choose a DO, he or she should find a DO who has trained at an allopathic residency and who avoids things such as cranio-sacral therapy. Anything else and a DO is joining the ranks of naprapaths and homeopaths.
Click to expand...

I disagree with Dr. Barrett's opinion regarding that. He is generalizing without really knowing how DO's are trained in osteopathic residencies. Many DO's have no choice but to do an osteopathic residency if they want to do a residency in an extremely competitive field like dermatology, ENT, neurosurgery, orthopedic surgery and urology. Allopathic residencies seldom take DO's in those fields. I know one DO who did IM at an osteopathic residency because that program was associated with many competitive fellowships like cardiology and GI. He has a much better chance securing a fellowship like than in an osteopathic residency versus an allopathic one. If anything, publishing generalized comments like that reflect poorly upon him and make him appear as if he is on a witch hunt. It's one thing to warn patients to approach certain OMT treatments with caution such as cranio-sacral. It's another thing entirely to tell patients not to see any DO who didn't train in an allopathic residency. I personally think cranio-sacral is quackery based on what I've read and I feel OMM is rather dubious. But I'm not going to label an entire osteopathic residency as being insignificant because I don't know how much OMT if any is integrated into those residencies. I'm making an assumption but I doubt a dermatology residency, even an osteopathic one, is going to emphasize OMM.

I will admit that I also make general comments on this forum that are unsubstantiated at times. I realize I'm being rather hypocritical in criticizing Dr. Barrett which I should take responsibility for. However, I would never publish my opinion on my own website with my name attached because I'm intelligent enough to recognize that my comments are of this nature. I feel these types of opinions are meant for anonymous forums.
 
psychfriend,

I don't completely disagree with you. I'm not at a DO school, but Maine only has 1 medical school, UNE, which is an Osteopathic Medical school.

I have friends from Maine that go/went to UNE because they wanted to stay in their home state.

And they're getting a great education. I have worked with MD and DO attendings and haven't seen a diffence.

Back when I was applying, I applied MD and DO schools because I simply wanted to go to medical school. THat's it. I'm at an MD program, but would have gone DO.
 
DrB said:
I urge you to reconsider your position psychMD. In many circles of the world, Psychiatry itself is a "fringe medicine". Pushing drugs we have little idea of how they work. We don't really undestand how Lithium or an SSRI works to stabilize mood, they just work. To many, the field of Psychiatry is "quackary"... and rightfully so.

This has been an interesting debate, yet an ironic one. If you choose to practice in the field of Psychiatry, it may be wise to be a little more open to techniques that, "just work."
Click to expand...

Your post actually argues against allowing things such as cranio-sacral therapy into psychiatric practice. If the world already views psychiatry as fringe medicine, why would we want to reinforce that impression by introducing such a nebulous form of treatment?

And no, cranio-sacral therapy doesn't "just work". I'd like to see a single study with sound methodology from a credible peer-reviewed journal showing its effectiveness against placebo. If we're going to accept cranio-sacral therapy, then we might as well bring back witchcraft and sorcery. Some DO schools are reminiscent of the pre-Flexner Diploma Mill schools of the early 20th century.

As an impressionable 3rd year medical student with exactly ZERO experience as a physician, I would "urge you to reconsider your position." Ask yourself, what kind of nonsense are they feeding you at that school that you attend?
 
You sound angry PsychMD, maybe your hostility towards new medical techniques stems from a troubled childhood... :meanie: Or maybe you are just mad that you didn't make it into a DO school yourself and subconsciously know that your education was lacking.

All poking fun aside I don't intend to change your mind PsychMD, but maybe you will think twice next time before being so rigid.

The interesting dilemma for cranio-sacral treatments is that they cannot undergo a double blind study. The practitioner would know that they were giving a sham technique thus resulting in a bias error. Imagine if new surgery techniques had to undergo such a study, I doubt anyone would want to volunteer for a double blind cardiac cath. :laugh:

I have watched as OMT has relieved headaches, backaches, and vertigo. I have even seen someone regain repressed memories and have an emotional breakthrough right on the OMM table. These things I have seen even in my impressionable third year, with "zero" experience. They are interesting to me and as such I intend to explore them further.

Good luck to the "Psychiatrist in Training" :luck:
 
DrB said:
The interesting dilemma for cranio-sacral treatments is that they cannot undergo a double blind study. The practitioner would know that they were giving a sham technique thus resulting in a bias error. Imagine if new surgery techniques had to undergo such a study, I doubt anyone would want to volunteer for a double blind cardiac cath.
Click to expand...

That's not an interesting dilemma. There are plenty of sound study designs that do not require double blinding when double blinding simply isn't possible. Pick up any surgery journal, and you'll see countless examples of the ways that researchers are able to get around these constraints.

I have no problem with DO vs MD, or DOs who train in osteopathic residencies instead of allopathic residencies, or even any practitioner who suggests an alternative therapy that doesn't get in the way of responsible standard of care. But the burden of proof falls upon the osteopathic community to demonstrate scientifically sound efficacy for their manipulation techniques. The osteopathic community has not risen to that challenge, and the excuses it offers don't hold water for anybody who's had any sort of reasonable epidemiology and research design training (and the paltry curricula in most medical schools simply doesn't count).

I'm not saying you shouldn't use these techniques in your practice if you strongly feel they have some benefit, as long as they do not get in the way of evidence-based best practices and sound professional conduct, and they pose no additional risk to your patient. But don't expect the rest of us to accept entirely unscientific endorsements without some sound evidence to back them up.
 
I agree very much, to use alternative techniques if they may help and only if they do no harm to the patient; however not to use such techniques as an alternative to the Standards of Care only in addition to. This is how we advance the field of medicine.

The JAOA has several published articles regarding the efficacy of OMT.

Here are a few examples:
Cranial Rhythmic Impulse

Osteopathy In the Cranial Field

OMT in Treatment of Depression
 
DrB said:
You sound angry PsychMD, maybe your hostility towards new medical techniques stems from a troubled childhood... :meanie: Or maybe you are just mad that you didn't make it into a DO school yourself and subconsciously know that your education was lacking.

All poking fun aside I don't intend to change your mind PsychMD, but maybe you will think twice next time before being so rigid.

The interesting dilemma for cranio-sacral treatments is that they cannot undergo a double blind study. The practitioner would know that they were giving a sham technique thus resulting in a bias error. Imagine if new surgery techniques had to undergo such a study, I doubt anyone would want to volunteer for a double blind cardiac cath. :laugh:

I have watched as OMT has relieved headaches, backaches, and vertigo. I have even seen someone regain repressed memories and have an emotional breakthrough right on the OMM table. These things I have seen even in my impressionable third year, with "zero" experience. They are interesting to me and as such I intend to explore them further.

Good luck to the "Psychiatrist in Training" :luck:
Click to expand...

Dear Not-Yet Dr B,

Let's talk about that anger. If anything, it seems to me that you're projecting your own anger onto me. I have nothing to be angry about. I've gotten what I've wanted out of life both personally and professionally. I also attend a Top 10 program in Psychiatry--something you'll probably never be able to do as a Diploma Mill graduate (even though you're 2 years from graduating).

Speaking of Diploma Mills, your "med school" (and I use that term very loosely) just opened in 2005. Touro University Nevada began planning its own existence during the summer of 2004, according to your school's own website. If I'm not mistaken, you are going to be in the first class of graduates. I'm sure you will be a fitting ambassador. How does it feel that both of my kids are older than your "med school"?

You probably just took your COMLEX 1 and you barely know how to write admit notes. Somehow, you feel qualified to hold up cranio-sacral therapy as the greatest thing since sliced bread. In addition to having no clinical experience, you still haven't produced a shred of evidence demonstrating the efficacy of cranio-sacral therapy. Those articles that you cited are pure rubbish.

billypilgrim37 already put together a nice response regarding surgical trials. Cranio-sacral therapy supporters hide behind that same specious argument that you presented in your earlier reply. Is it any surprise that you're the only person on this thread attempting to defend cranio-sacral therapy? I've encountered a couple of DOs regarding cranio-sacral therapy and they, themselves, agree that it's bogus. In fact, they say they are embarassed by cranio-sacral therapy since it gives DOs a bad name.

It's your life and your reputation (and your "med school's"). If you still think you're going to be a "leader", then you're more than welcome to howl at the moon. Cranio-sacral moon howling isn't going to get you anywhere.

Lastly, when I was a medical student, we were never allowed to identify ourselves as "Doctor", "Doc", or "Dr". For both ethical and legal reasons, we never represented ourselves as anything other than medical students. Does Touro University Nevada permit you to do such things? Does the Nevada Board of Medical Examiners condone such behavior?
 
Ok---

i haven't checked SDN in a few days and came back to an MD vs. DO rants from my original post....and that was so not what i was going for! I am not worried about the prestige of my med school, i'm just looking to be a great doc (which i will be, even though there will be a DO after my name).

Anyway back to my post....
I'm looking for info on psych DO's in MD or DO programs...who's got some?

Can we get back to that? 🙂
 
katiedid919 said:
Ok---

i haven't checked SDN in a few days and came back to an MD vs. DO rants from my original post....and that was so not what i was going for! I am not worried about the prestige of my med school, i'm just looking to be a great doc (which i will be, even though there will be a DO after my name).

Anyway back to my post....
I'm looking for info on psych DO's in MD or DO programs...who's got some?

Can we get back to that? 🙂
Click to expand...

Yeah, there is a psych intern, RaspberrySwirl-- I think that she matched into a NYC allopathic program. Do a search on her and send her a pm, she seemed really friendly on the threads last year, and acted as if she would be the kind of person willing to help someone else out.

If you're worried about matching into a good program due to the initials behind your name, I wouldn't be. In case you haven't been searching around these forums lately, psych has the lowest board scores of any specialty out there. Woohoo!!!!
 
PsychMD2100 said:
Dear Not-Yet Dr B,

Let's talk about that anger. If anything, it seems to me that you're projecting your own anger onto me. I have nothing to be angry about. I've gotten what I've wanted out of life both personally and professionally. I also attend a Top 10 program in Psychiatry--something you'll probably never be able to do as a Diploma Mill graduate (even though you're 2 years from graduating).

Speaking of Diploma Mills, your "med school" (and I use that term very loosely) just opened in 2005. Touro University Nevada began planning its own existence during the summer of 2004, according to your school's own website. If I'm not mistaken, you are going to be in the first class of graduates. I'm sure you will be a fitting ambassador. How does it feel that both of my kids are older than your "med school"?

You probably just took your COMLEX 1 and you barely know how to write admit notes. Somehow, you feel qualified to hold up cranio-sacral therapy as the greatest thing since sliced bread. In addition to having no clinical experience, you still haven't produced a shred of evidence demonstrating the efficacy of cranio-sacral therapy. Those articles that you cited are pure rubbish.

billypilgrim37 already put together a nice response regarding surgical trials. Cranio-sacral therapy supporters hide behind that same specious argument that you presented in your earlier reply. Is it any surprise that you're the only person on this thread attempting to defend cranio-sacral therapy? I've encountered a couple of DOs regarding cranio-sacral therapy and they, themselves, agree that it's bogus. In fact, they say they are embarassed by cranio-sacral therapy since it gives DOs a bad name.

It's your life and your reputation (and your "med school's"). If you still think you're going to be a "leader", then you're more than welcome to howl at the moon. Cranio-sacral moon howling isn't going to get you anywhere.

Lastly, when I was a medical student, we were never allowed to identify ourselves as "Doctor", "Doc", or "Dr". For both ethical and legal reasons, we never represented ourselves as anything other than medical students. Does Touro University Nevada permit you to do such things? Does the Nevada Board of Medical Examiners condone such behavior?
Click to expand...

Dude, that was harsh. Do you really think that you needed to slam him that badly?
 
silas2642 said:
Yeah, there is a psych intern, RaspberrySwirl-- I think that she matched into a NYC allopathic program. Do a search on her and send her a pm, she seemed really friendly on the threads last year, and acted as if she would be the kind of person willing to help someone else out.
Click to expand...

aww thats sweet. but RaspberrySwirl doesn't exist anymore. she's a doctor now 😉
 
katiedid919 said:
Ok---

i haven't checked SDN in a few days and came back to an MD vs. DO rants from my original post....and that was so not what i was going for! I am not worried about the prestige of my med school, i'm just looking to be a great doc (which i will be, even though there will be a DO after my name).

Anyway back to my post....
I'm looking for info on psych DO's in MD or DO programs...who's got some?

Can we get back to that? 🙂
Click to expand...

Sorry for the delay in responding.
As a resident in a well-regarded university based allopathic program I was trained by DOs and several of my colleagues were DOs. I am now an attending at a hospital with a well-regarded community-based residency program, and several of our (best) residents have the DO degree. Every DO I have known in a psych program has been an excellent psychiatrist, and fully equal to the MDs in these programs.
Come on aboard!
 
Looking at the stronger programs in the South and the Midwest, of those that list their residents on their websites, I think you'll find that almost all of these programs regularly have a DO or two included in many years.
 
OldPsychDoc said:
Sorry for the delay in responding.
As a resident in a well-regarded university based allopathic program I was trained by DOs and several of my colleagues were DOs. I am now an attending at a hospital with a well-regarded community-based residency program, and several of our (best) residents have the DO degree. Every DO I have known in a psych program has been an excellent psychiatrist, and fully equal to the MDs in these programs.
Come on aboard!
Click to expand...


Thanks OldPsychDoc... good to know! One of the Psychiatrists I am rotating with this month is a DO. From what I can tell she does an excellent job.
 
katiedid919 said:
Ok---

i haven't checked SDN in a few days and came back to an MD vs. DO rants from my original post....and that was so not what i was going for! I am not worried about the prestige of my med school, i'm just looking to be a great doc (which i will be, even though there will be a DO after my name).

Anyway back to my post....
I'm looking for info on psych DO's in MD or DO programs...who's got some?

Can we get back to that? 🙂
Click to expand...

My, my some people have touched a nerve. But to get back to katiedid's OP, I am a DO who went allopathic for residency (for a variety of reasons, but especially because there just aren't many options for osteopathic psychiatry residencies). If you have more questions or want details please feel free to PM me.

As to the other question re: OMT in psychiatry... well, that gets far more dicey. Crossing that physical space boundary to lay hands on one's patient is far more complicated in psych than in any other specialty. I 'knew' this would be the case, but I did not come to TRULY appreciate the extent to which this is true (and the huge emphasis and importance placed on boundaries, period, in this field above all other fields, I think) until I started residency. I think especially coming from a DO school where boundaries become more laxed and we are more comfortable "reaching out and touching" each other and our patients, it's hard to fathom how being in psych can change your perspective. It's not just about us maintaining the boundaries for our own good (i.e. malpractice attorneys would LOVE to hear that you had your hands on the head or, God forbid and what WERE you thinking! 😱, the sacrum of their poor vulnerable client with a trauma history while in a quiet dark corner of your office) but also for the good of the patient - physical touch can mean a lot of different things to different patients and that's got to be taken into consideration. Before I started residency I thought that maybe I should put more energy into learning an honing my CST skills because I thought I may be able to incorporate it into practice (I heard people talk about use of techniques which sometimes precipitated an emotional release... - not like that! get your mind out of the gutter!... 😛 ), but after starting training I could see that would have been a waste of time for me because it is not really very feasible in this line of work. For all of these reasons (and probably many others), we DO's are largely precluded from being able to incorporate OMT into a psychiatry practice. It certainly is not something that can just be assumed will be quick and easy and without much forethought. Is it impossible? I guess nothing is impossible. But is it improbable? Most likely.

Which isn't to say that our OMT skills go totally wasted... My colleagues and spouse still get to benefit once in a while from these albeit rusty skillz... 😀
 
katiedid919 said:
Any osteopathic psychiatrists around? Particularly I'm looking for some information on entering allopathic residency programs as a DO student, but also interested in DO residencies as well. So if anyone has any experience with it, please let me know! Thanks!
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Yut, yut....just thought I'd represent!

1/2 of psychiatry residents are IMG's,..thus, I think DO's play an important and significant role in representing the U.S. trained constituency.

Good luck my friends and colleagues!
 
I am a fan of OMT, however, I would recommend not touching your Psych patients. It is inappropriate. Leave the OMT to their other Docs. Your role is different.
 
Caveat: I am an M.D. I got nothing against D.O.s
Several of my best teachers are D.O.'s. I just had an incredible lecture from David Baron, D.O., one of the country's top psychiatrists and a specialist in sports psychiatry.

I also have nothing against anyone here. I don't intend to enter the somewhat angry sounding debate that's started on this thread.

I do though have to point these out.

I do not have OMT training (again I'm not a D.O.). However I do have to point out that as a psychiatrist, you are potentially crossing boundaries by touching your patient. As stated in several texts that are considered standard of care such as Kaplan & Sadock, psychiatrists should refrain from certain physical exams such as a full examination, a rectal exam or pelvic exam for these reasons.

Of course psychiatists need to do a PE for a new patient coming into a unit, (aside from the above). I don't know much about OMT so I'll stay away from that.

I have even seen someone regain repressed memories and have an emotional breakthrough right on the OMM table
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Repressed memories have several problems with them---the biggest is that several of them aren't true. Several therapists have been found actually to even manipulate 'repressed memories" to the point where they actually implanted false ones--making their patients believe something that never happened, to fit the therapists' theory of what happened.

A simple google search will yield several cases where repressed memories have been inappropriately used in court. I've seen cases where patients actually started to believe they were molested, based on a "repressed memory" that was only obtainable through the use of a "therapist". Given the lack of scientific validity with repressed memories, I sometimes wondered if the therapist was responsible for breaking the patient's family apart.

I strongly suggest that as doctors, we only advocate practice that fits the standard of care & utilizes a healthy respect for evidence based medicine.

To do otherwise hurts the validity of our profession & this forum. I would even suggest banning certain members if they were to suggest practice that goes against the standard of care & scientific validity.

Repressed memories are highly controversial at best. I wouldn't assume they're all not true, but I wouldn't assume they were true either.
 
dont worry whopper you arent insulting any DO's out there (at least not me, anyway). i cant imagine OMT being appropriate for use on psychiatric patients.
 
Thanks PeeWee.

I'm not saying you shouldn't use these techniques in your practice if you strongly feel they have some benefit, as long as they do not get in the way of evidence-based best practices and sound professional conduct, and they pose no additional risk to your patient..
Click to expand...

Agree. Again, I don't know OMT. I do think doctors should manipulate the placebo response when we can--in an appropriate manner. E.g. Don't give the patient a pill telling them it'll cure them when its just a placebo. However do allow the patient to feel in control of their therapy when appropriate, listen to their input, offer support, if the patient is doing something that's not harmful & makes them feel better-let them go with it.

There's a difference between being a doctor & a wannabe Jedi. (No offense to real Jedis, that'd be freakin cool to be one).
 
they do teach us that some cranial OMT can benefit depression. (my personal opinion is that the whole cranial concept is garbage, but i digress...)
the only place i could imagine it being useful is maybe treating physical symptoms of anxiety, and if i remember correctly there have been studies on using OMT for migraines. but again, i dont think its the psychiatrist's place to be doing this kind of stuff. leave it to their family doc.

wow i didnt know we had jedis in this forum. jedi psychiatrists rule! rock on 👍
 
I learned this as a psyschology major and I'm a bit surprised its not taught much in the medical curriculum.

The feeling of control, even if based on bogus factors is an important factor in the control of pain & anxiety.

This is based on several valid studies. Its one of the reasons why people feel scared to fly on planes instead of cars, even though planes are actually more safe (because behind the wheel, you feel in control).

In clinical practice, for this reason, it is important we allow our patients to feel a sense of control. One thing I do for example is for a patient with panic disorder, who suffers about 1 attack every 3 days, I'll tell them to hold 2 pills of ativan in their wallet. Often times they tell me that simply holding it in their wallet reduces the panic attacks they have because several of them were situational, and highly based on agoraphobia.

This in turn also allows me to limit my benzo prescriptions. If someone's having 3 attacks a week, I'll give them 12 pills for the month. That's it, and I expect that number to reduce with the CBT & SSRI they are also being given. If I see the patient demaning more--I'll confront them about it. Maybe I've been lucky, because all my patients I've done this with, I've gotten them to the point where their panic attacks only occur to the point where I don't have to prescribe them benzos anymore. They keep the 2 pills in the wallet from their old prescription as an emergency reserve. (I haven't done this approach with patients with known substance abuse.)

The placebo effect does work, in fact studies have to prove that in a double blinded study, the actual medication must be more effective than the placebo, which in pretty much every study I've seen has a benefit.

Given this, I wouldn't be surprised that OMT has a benefit (again I don't know OMT). The question is, does it benefit more than placebo? Again I don't know this area and its been somewhat debated above. I do suggest we manipulate the placebo response--but in an appropriate manner. No misleading or use of methods that are invalid.
 
whopper said:
I learned this as a psyschology major and I'm a bit surprised its not taught much in the medical curriculum.

The feeling of control, even if based on bogus factors is an important factor in the control of pain & anxiety.

This is based on several valid studies. Its one of the reasons why people feel scared to fly on planes instead of cars, even though planes are actually more safe (because behind the wheel, you feel in control).

In clinical practice, for this reason, it is important we allow our patients to feel a sense of control. One thing I do for example is for a patient with panic disorder, who suffers about 1 attack every 3 days, I'll tell them to hold 2 pills of ativan in their wallet. Often times they tell me that simply holding it in their wallet reduces the panic attacks they have because several of them were situational, and highly based on agoraphobia.

This in turn also allows me to limit my benzo prescriptions. If someone's having 3 attacks a week, I'll give them 12 pills for the month. That's it, and I expect that number to reduce with the CBT & SSRI they are also being given. If I see the patient demaning more--I'll confront them about it. Maybe I've been lucky, because all my patients I've done this with, I've gotten them to the point where their panic attacks only occur to the point where I don't have to prescribe them benzos anymore. They keep the 2 pills in the wallet from their old prescription as an emergency reserve. (I haven't done this approach with patients with known substance abuse.)

The placebo effect does work, in fact studies have to prove that in a double blinded study, the actual medication must be more effective than the placebo, which in pretty much every study I've seen has a benefit.

Given this, I wouldn't be surprised that OMT has a benefit (again I don't know OMT). The question is, does it benefit more than placebo? Again I don't know this area and its been somewhat debated above. I do suggest we manipulate the placebo response--but in an appropriate manner. No misleading or use of methods that are invalid.
Click to expand...

Great post, whopper! 👍 I'll remember the 2 ativan in the wallet....Great idea.
 
OldPsychDoc said:
I had a patient ask for a refill on their 10 xanax--since they'd been carrying around the same ones for 6 years and they were afraid the pills had expired.🙂
Click to expand...

lol...That is great. Maybe we should call this Linus Therapy? 😀

meet_linus_big.gif
 
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