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Anybody see the cover of Newsweek this week?

Discussion in 'Medical Students - DO' started by The Sgt, Apr 23, 2004.

  1. The Sgt

    The Sgt Junior Member
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    This favorite scientific journal of medicine has this cover:
    [​IMG]
    titled "The Great Back Pain Debate; As millions of Americans seek relief from this ancient ailment, doctors are trying simpler, less invasive ways to end this agony."
    I quickly skimmed the article and saw no mention of osteopathic treatments or DOs in general.
     
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  3. sophiejane

    sophiejane Exhausted
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    If that's true, sounds like it is time for some letters to the editor of Newsweek.

    On the same note, I was in a coffee shop that is literally in the shadow of the TCOM campus, and I overheard a young woman talking to a man about how she had strained her forearm and was worried because she used her hands in her work and it really hurt. The guy (whom I think must have been a massage therapist) said, "You should definitely come in and let me work on you for a while. If you go to a doctor, all they are going to do is give you some pain meds and send you home." She could have walked across the street right then, paid $20 at the student/resident OMM clinic, and likely gotten some relief and possibly cured of her problem. It's funny/sad that even here with so many DOs in town, people are clueless.

    AOA, are you listening? I think it's time for me to call them up and find out.
     
  4. Billy33

    Billy33 Member
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    i didn't read the article but i'm very surprised it wasn't mentioned at all. it's actually kind of disturbing if you think about it. i'm sure all sorts of chiropractic treatments are mentioned though! i guess 110 years of a profession isn't long enough for people to start recognizing it's benefits. maybe you'll see some "letters to the editor" in the next edition.
     
  5. Doctor Peloncito

    Doctor Peloncito Family Physician
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    Here is the link. I haven't read it yet, but I will do so now.
     
  6. Anasazi23

    Anasazi23 Your Digital Ruler
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    Make no mistake...the AOA is NOT listening. This inept organization reeks of gross incompetence in promoting DOs and has done so since its inception.

    In much less time, chiropractors have become a scraingly-powerful lobbyist group, while people still have no idea what the hell DOs are. Taking out a couple of ads in Oprah magazine doesn't cut it. They (the AOA overseers) are out of touch with modern medicine, modern advertising, and modern wants/needs of young and new osteopathic physicians. The mantra of "just be a good doctor and the word will spread how great we are" has not worked for over 100 years. It's time for new blood....time for a real change. Unfortunately, the only DOs rabid enough to dedicate all their time to these organizations are in reality seeing patients, working in modern medicine, and can't be bothered with this stigmata. These people are so busy patting themselves on the back to the bagpipes playing at their esteemed FAAOAOA ceremony that they are wholly oblivious to the entire plight.

    Aside: I was at a drug dinner the other night and was speaking with a physician (MD) and his wife. He mentioned something about me being a DO, and his wife stated, "Oh, a DO is someone who hasn't passed their boards, right?" This type of ignorance is constant, and becomes demoralizing at times. Yet it will never stop.

    It will never, ever end until some groundbreaking changes are made at the highest levels.
     
  7. MacGyver

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    I read the article. Typical bunch of CAM nonsense about all kinds of untested treatments.

    whats even more disturbing is the question/answer thing done by the writer of this article. She has ZERO medical training, yet she somehow feels qualified to give people medical advice over her dumb column. She should be prosecuted for practicing medicine without a license:

    http://www.msnbc.msn.com/id/4767143/
     
  8. flighterdoc

    flighterdoc Rocket Scientist
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    If I may offer a suggestion to the DO Community (note, I might well apply and be accepted to osteopathic schools, and have no problem at all, in any way, with osteopathic medicine as I understand it):

    Please develop a coherent, objective, statement of how OM is better/different than allo. "the whole pt", and similar statements, sound (to me) as platitudes. What exactly is the difference? If there is no significant difference (which is my suspicion, since most DO's don't seem to practice OMM) than say so. Also, tell us how (in objective terms) how OMM is different than Chiropractic.

    I've seen that question asked many times, and the answers have always seemed lacking to me. I'd REALLY like to have a good understanding of the differences.

    Thanks!
     
  9. Doctor Peloncito

    Doctor Peloncito Family Physician
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    First of all, I just wrote a letter to the editor of Newsweek, so we'll see if it gets published. It probably won't, but if any of you are subscribers, you can let me know.

    As to flighterdoc's question, I don't think the "whole patient approach" is limited ot osteopathic medicine. I have been to many good M.D.s who practiced this same philosophy. It involves many things, including considering all sources of back pain before deeming it psychological in origin. It involves thinking about the consequences of your actions, treatments, and drug regimens (beyond the normal side effects). Patients are people, as such, they have many underlying issues and respond to many treatments. Often physicians are quick to prescribe medications or treat patients surgically when there are other things they can do first. OMM is one tool in an Osteopathic physician's proverbial toolbox that he or she can use when other methods fail.

    You will hopefully learn these things whether you go to an allopathic or an osteopathic school. I think that we as DO students and physicians often discount the training received by M.D.s as incomplete. I think that this patient centered philosophy is taught in many allopathic institutions. The physicians may put it into practice, or they may also throw it out. And D.O.s are often guilty of this as well.

    It's like they say, "don't judge a man until you have walked a mile in his shoes." Don't judge our profession until you have seen it in practice.

    wbdo
     
  10. flighterdoc

    flighterdoc Rocket Scientist
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    Sorry I didn't make myself clear. I'm not criticising any form of legitimate medicine at all, both allo and osteo certainly are that.

    I was trying to make the point that (IMHO) part of the problem with the publics (and my) understanding of osteopathic medicine is a lack of a clear definition of what it is, and how it is different/better/not better/whatever with allopathic.

    That is a question that I've never seen answered, in a way that makes sense to me. The "holistic" argument may certainly be valid, its just not especially satisfying as an explanation.

    I think that is the question that has to be answered, to get osteopathic medicine onto everyone's radar screen.
     
  11. H0mersimps0n

    H0mersimps0n HMO CRUSHER
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    yeah and you all shunned me when I suggested things like AOA paying for commercials during the super bowl and being more aggressive with advertising the profession.

    Screw that, we need recognition, respect can come with time and the success of our treatments.

    IMO the US is approaching it's second big coming of DO's. The first being late 19th early 20th century when people flocked to Kirksville and DO's to get treatments that didn't involve mercury or cupping...

    The public has all but shot a flare into the sky saying "HELP US WITH SOMETHING OTHER THAN A PILL" So we can sit on our hands and cross our fingers and hope that word of mouth will help our cause or we can be proactive and carpe diem...
     
  12. Doctor Peloncito

    Doctor Peloncito Family Physician
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    I suggest you read the D.O.s by Gevitz. It gives a very clear and unbiased history of Osteopathic Medicine (and medicine in general). The short answer is that we are an alternative route to the same goal (the goal of becoming a physician). The question as to why it is better is a difficult one to answer. In many ways (and I may get flamed for this) allopathic education is better in that there is much more money in most allopathic institutions. From a legal standpoint, we are the same. We are required to take the same courses and fulfill the same clinical requirements. We are required to pass equivalent board examinations. The differences between the two are largely historical. Most D.O. schools try to persuade their students to go into primary care. The huge, glaring difference, is that we are taught OMM. I am not going to go into explaining this to you. If you have questions about that, I'd check out the AACOM or the AAO for a much better and more concise description of OMM.

    hope this helps,

    wbdo
     
  13. H0mersimps0n

    H0mersimps0n HMO CRUSHER
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    Wannabe, I was actually thinking of Gevitz book (which I've read) when I posted (above) my historical viewpoint and opinion on osteopathic medicine. It's a shame many DO's haven't read that book, it should be a requirement for OMM class, then maybe students would actually appreciate where they came from because watching instructor after instructor, week after week, fumble and show total lack of organization it might change some minds within the profession.

    yeah I won't mention any schooL spEcifically, but some Changes definitely need tO be Made.
     
  14. Doctor Peloncito

    Doctor Peloncito Family Physician
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    Very subtle Homer ;)
     
  15. flighterdoc

    flighterdoc Rocket Scientist
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    I'll read the book, thanks. I've been to the AoA website, and corresponded with several DO's, and still don't have a clue.

    Can you provide a simple, one or two sentence explanation that doesn't include "holistic"?

    Thanks,
     
  16. H0mersimps0n

    H0mersimps0n HMO CRUSHER
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    DOH! :thumbup:
     
  17. Doctor Peloncito

    Doctor Peloncito Family Physician
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    One of our professors uses the following analogy:

    Medicine focuses on the interraction between the host and disease. The "allopathic" model focuses more on the disease, whereas the osteopathic model focuses on the patient.

    OMM is a system of modalities that is based on several basic tenets first described by Andrew Taylor Still, M.D. in 1874. These are:

    1. that the body is a unit
    2. structure and function are reciprocally interrelated
    3. the body possesses self-regulating mechanisms
    4. the body rationale therapy is based upon knowledge and use of the above three principles.

    Over the years, osteopathic medicine has evolved, but practitioners of OMM still hold true to these beliefs.
     
  18. sophiejane

    sophiejane Exhausted
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    I don't think it has anything to do with one being "better" than the other, they simply are. We are fortunate in this country to have two very cohesive training programs for physicians, each with a slightly different slant. DO schools tend to produce excellent primary care physicians and teach OMM (though it is not used by all DOs, it IS used in practice--I have personally observed a number of my family practice preceptors use OMM frequently on patients, so I'm not sure where you are getting your data about that.) MD schools have a history of producing some of the finest specialists and researchers. Not that there aren't both on both sides, but that's the way things stand at present.

    Patients make the decisions on who they prefer as their physician, and it has little or nothing to do with the letters behind their doctors' name. It has to do with the quality of care they receive and what they are looking for in a doctor.
     
  19. BklynWill

    BklynWill EM Attending
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    WannabeDO, how about posting your letter to the editor (in case it doesn't get published)?
     
  20. Doctor Peloncito

    Doctor Peloncito Family Physician
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    ok, here it is...


     
  21. BklynWill

    BklynWill EM Attending
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    Excellent letter. Make sure you let us know in the event we miss it in an upcoming issue. Our profession needs more people like you.
     
  22. LovelyRita

    LovelyRita Blade Slinger
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    WB,

    I'm so proud of you :D

    M.
     
  23. Doctor Peloncito

    Doctor Peloncito Family Physician
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    Well, since I don't subscribe, I'm counting on those who do to tell me :)
     
  24. DORoe

    DORoe BWAAA HAAA HAAA
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    I agree. Maybe you would like to take on the challenge that is the AOA? Very well written and clear representation of the profession.
     
  25. Docgeorge

    Docgeorge Bent Over and Violated
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    I think that osteopathic medicine in now in a state of flux with regards to its new crop of students. We are much more interested (at least at my school) in pursuing specialties and in research. More of us are interested in, and are presently participating in research. We are much more open minded when it comes to dealing with the allopathic world. We see that we are more similar then not when compared to our brethren. For the first time in my schools history we are going to have an AMA affiliated organization (the Iowa Medical Society) represented on campus. This is due solely to a student initiative. AOA is behind the times and is slow to adapt. One of my professors said it best when he said the AOA will only change through evolution not revolution. I believe that AOA will be a vastly different organization in 15 or 20 years when the old guard dies out and our generation take over the reins, until then all we can do live with what we have and try to make the best of it.
     
  26. Docgeorge

    Docgeorge Bent Over and Violated
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    I hate it when I see holistic written all over an applicants essay. Esp. when they say they want to be an osteopathic physician because they want to treat the patient "holistically". All that is fine, a little insulting to MDs (especially if they happen to be interviewing) but fine none the less.

    What really irks me is that they have no clue as to the definition of holistic means. I try to ask every single person I interview what the definition of holistic is if they have it plastered all over their essay. You should hear the stuff some of them come up with.

    Apparently holistic means everything from treating patients with ?herbs? and the "soothing touch" what ever that means instead of "you know... pumping them full of pills and stuff ".
     
  27. flighterdoc

    flighterdoc Rocket Scientist
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    Thank you! Thats my point.

    OK, call me a dumb-a** engineer, but WHAT EXACTLY do DO's do differently? How is the osteopathic practice in theory different? And, most especially, how is OMT different than Chiropractic?

    Specific examples of this will, I think, help explain to the masses what Osteopathy is. Using warm, fuzzy and vauge terms unfortunately lends credence to the FALSE ideas that some have, that osteopathy is some sort of voodoo. I don't believe it but when I try (for example) to explain an osteopathic school instead of an allopathic school, the soft terms used in virtually all explanations I've ever seen don't work.
     
  28. Docgeorge

    Docgeorge Bent Over and Violated
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    As much as some people would like to tell you DO's are different were really not. We're basically physicans who have incorporated manual medicne.

    I have 2 chrios in my class (husband and wife). I'll ask. But the big thing is that we are Physicians chrios are not. Secondly from what the OMM profs tell us, chrios use manipulations to fix subluxations and these are usually limited to the spine and OMM mainly increases range of movement and pain (via releasing muscle hypertonicity) and we deal in all areas of the body. Really what OMM is not some superstitious witch craft it's just manual medicine. The other big thing I happen to like about OMM is that it makes you really good at palpating the body.


    As a side note:
    the two major reasons for seeking medical help is a decrease in rage of motion and pain. (I'll dig out the citation later).
     
  29. Doctor Peloncito

    Doctor Peloncito Family Physician
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    I can't tell you the difference because I really don't have much experience with chiropracters. I will direct a classmate of mine to this thread who was in a chiropractic school for 2 years before coming to UHS, maybe he can supply a little insight.

    I already listed the basic tenets of osteopathic medicine in an earlier post, but I'll try to clarify a bit.

    In OMM we palpate for various somatic dysfunctions. This in a nutshell means that a joint or articulation has a restriction to its normal physiologic motion. Using various modalities we try to free that restriction and correct the somatic dysfunction. This allows for better blood and lymph flow and also can help if there were other somatic dysfunctions that were being caused by the first one. Often nerves can be pinched and OMM will relieve the tension.

    It is my understanding that chiropractic focuses on subluxations which are vertebral malalignments which are causing strain on the spinal cord. Again since I don't know much from chiropractic other than they make lots of money in the mall, I can't speak on the subject reliably. Anyway, my insomnia must end soon. I will pick this up later :sleep:
     
  30. Docgeorge

    Docgeorge Bent Over and Violated
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    Hey wannabe, you're gonna have to change your sig soon.
     
  31. polo8250

    polo8250 Senior Member
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    WannabeDO,

    Just wanted to applaud your letter. It was clear, concise, and represented osteopathic medicine quite accurately in my opinion. :thumbup:
     
  32. LovelyRita

    LovelyRita Blade Slinger
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    OK I'm just posting because I feel the need to defend those who take the holistic thing seriously. Holistic does mean to treat as a whole, not as the sum of its parts. It is part of the osteopathic philosophy, which everyone either takes it or leaves. Treating back pain with some ultram but also considering that maybe the patient needs to quit smoking to allow better blood flow to tissues and therefore prescribing zyban as well would constitute being holistic.

    Herbs and soothing touch are part of integrative medicine. Integrative medicine combines conventional medicine with things like herbal remedies, "soothing touch", diet modification, exercise, stress management, etc.

    All that said, I haven't read the article yet. I'm just so glad that Wannabe wrote the letter. The intentional or nonintentional exclusion of DO's from the national spotlight must end.

    This was all just my .02...i'm not trying to start any wars. :love:
    M.
     
  33. Doctor Peloncito

    Doctor Peloncito Family Physician
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    I agree with you completely Mary. By the way, nice avatar. Haven't seen any Beemers in the second year parking lot, so I'm guessing thats for after you finish your residency? :laugh:

    wbdo
     
  34. BackTalk

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    The difference between chiropractic and osteopathy at first glance may seem no more than the name. Osteopathy's benefits are said to be due to improved circulation of the blood, while in chiropractic, it is nervous function that is thought to be affected by treatment. Either way we both know manipulation is a valid form of treatment.

    Old school chiropractic deals with ?subluxations? which is an area of the spine that has ?nerve interference? and thus causes poor health. Removal of the subluxation will allow the body?s innate ability to heal itself. Anyway, that is the concept. Today its seems more schools are shying away from this theory in favor of looking at the subluxation as a biomechanical problem which causes a loss of function. This makes more sense. When it comes to chiropractic it all depends on whom you talk to. It seems that every chiropractor has their version on what chiropractic really is. The same holds true for osteopaths and their beliefs.

    I really do not know why osteopathy wasn?t mentioned in the article. I understand how you feel. It happens to us ALL THE TIME. I remember recently there was an article praising the use of osteopathy (OMT) for the treatment of ear infections and there was no mention of chiropractic. Chiropractors have been treating this condition for years yet there was no mention. It seems when chiropractic is mentioned it is usually negative such as the incidences of stroke and manipulation. Usually when something bad happens all the fingers point to us even though osteopaths and some physical therapists perform cervical manipulations as well.

    It is nice to see some positive PR on chiropractic from time to time. :D
     
  35. Doctor Peloncito

    Doctor Peloncito Family Physician
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    Thanks for your description of chiropractic. It was the most rational one I've heard in a long time. I hope this thread doesn't become a flame war, but inevitably it will. There are many trolls here that like to have fun with people who want to have serious discussions.

    I would add that OMM focuses on more than blood flow. The short description is that treatments are based on freeing up restrictions or "somatic dysfunctions." This allows for improved function by restoring motion and relieving pressure on any structure whether it be nerve, blood vessel, lymph vessel, or other musculoskeletal structures. It is our belief that in order for the machine that is our body to function properly, it's structure needs to be in tip top shape. It all goes back to the basic tenets. Even 130 years old, they still hold true.

    wbdo
     
  36. Dave81

    Dave81 Member
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  37. MacGyver

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    The only people who use the term "subluxation" are quack chiropractics. Run away from anybody who uses this term. It is NOT a medical term. Its a catch all phrase used by quack chiros to justify all kinds of nonsense treatments for everything from asthma to infertility.

    Next time you see the chiro, ask them exactly what a subluxation is. I guarantee you he wont be able to define it in precise terms. He'll ramble off some nonsense about the spine being "out of alignment."

    Give him an x-ray and ask him to show you the subluxation. Again, I bet you bottom dollar he wont be able to do it.

    Subluxations are for quacks. Chiros dont even agree on what they are.
     
  38. kristing

    kristing Senior Member
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    I've heard PTs and DOs use this term. I don't think it's jsut a quack term.

    And WE ALL need to stand up and explain the difference when the opportunity arises. For the person who overheard the conversation in the coffee shop, if you want osteopathy to be known, it is YOUR job to explain it. I know at times we are all tired of defending it, but it is OUR job as future DOs to educate when the opportunity arises.

    Here's another example of how a DO can be different. Patient comes into hospital with pneumonia. Patient develops some effusion and atelectasis. DO can do some manipultation (rib raising, lymphatic pump, etc), MD doesn't know of these modalities and calls respiratory therapy for some of the therapy they provide. We have some more tools.

    I agree that I don't know if I buy the whole "more holistic" argument, since I think new docs (MDs and DOs alike) are more holistic in their thought processes in general than the old guard. However, I do know that we have more tools to treat patients with.
     
  39. dodobird

    dodobird Junior Member
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    Way to go, Wannabe. That was an excellent letter.
     
  40. MacGyver

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    Then they are de facto quacks.

    Show me an x-ray with a "subluxation" in it

    Define "subluxation" for me.

    Show me an MRI or a CT scan with a "subluxation" in it

    Show me any lab tests taht reveal a "subluxation"
     
  41. VALSALVA

    VALSALVA sh*t or get off the pot
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    do you know what school the D.O. attended that used the word subluxation? i'm just curious because i've listened to a lot of D.O.'s from a lot of schools lecture on osteopathy and that word has never been used. in all the textbooks/review books, i've never seen that word printed. i'm just curious.
     
  42. box29

    box29 Keep on keepin' on Member
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    Podiatrists also use the term subluxation as a general term (I think) describing the position of a joint to be between normal alignment and complete dislocation. I have also heard this term used by my orthopaedic surgeon at the University of Chicago and my PCP who graduated from CCOM.

    Some perhaps choose to use this term and others don't...but whatever floats your boat!
     
  43. MacGyver

    MacGyver Membership Revoked
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    You ask 20 medical people what subluxation means, and they'll give you 20 different answers. Thats why I said the use of such a term is quackery.
     
  44. box29

    box29 Keep on keepin' on Member
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    Sorry to digress from the original post. Perhaps it's that you'll get 20 different descriptions of a similar meaning or concept. I mean not everyone can memorize multitudes of simple definitions. It can be difficult to explain the meaning of medical jargon to those who aren't familiar and hence the different definitions.

    According to Stedman's Medical Dictionary, 27th edition, page 1716,

    subluxation is defined as an incomplete luxation or dislocation; though a relationship is altered, contact between joint surfaces remains. SYN: semiluxation.

    I mean most medical professionals would know what subluxation means and perhaps they choose to use that versus "incomplete dislocation" versus "malalignment," etc. I guess it would be a matter of choice.

    But truly, you'll find that there are many different ways to describe a single thing in medicine.

    Just my $0.02
     
  45. Doctor Peloncito

    Doctor Peloncito Family Physician
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    Well, if anyone was interested, my letter seemed to be preempted by our fearless leader, Dr. Darryl Beehler, DO. While I think his letter was nice, did he have to end with the stupid propagandized tagline at the end? I'm personally sick and tired of DO's using this line. It does nothing but put down any good physician who doesn't happen to be a DO and makes us look smug in the process.

     
  46. LovelyRita

    LovelyRita Blade Slinger
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    mmmmm hmmmmm.....

    yep. Maybe you should send your letter again, Russell. Sometimes they still print letters regarding topics from the previous weeks.

    His letter could have used a little ooomph like, he should express his sincerity/disappointment at OMT being left out of the spotlight....or something like that.

    Newsweek should follow up and do their next health-oriented "cover story" on Osteopathic medicine as a way of acknowledging that they BLATANTLY left OMT out of the picture. This is unacceptable. I hope they got the message from Dr. B's letter....but something tells me they probably didn't.

    Wannabe for AOA prez!! :cool:
     
  47. H0mersimps0n

    H0mersimps0n HMO CRUSHER
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    Wannabe I could not agree more. I nearly walked out on him when he came to LECOM and started MD bashing. My girlfriend, entering MD school in the fall, goes to bat for me when she talks to her pre-MD counterparts and everyone responds really well. Crap, try to talk to a DO about MD medicine and they get all insecure, defensive and start MD bashing. If we have to MD bash to get ahead then I don't want to be any part of the "movement", I'll fall back on my knowledge, skills and medical philosophies to get my point across...

    pissed me off.. so insecure.
     
  48. Chrisobean

    Chrisobean The Killer Bean
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    did that letter actually get published? i thought the original was ALOT better, but hell, anything is better than nothing sometimes.
     
  49. Doctor Peloncito

    Doctor Peloncito Family Physician
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    That's because the original was written by me and this one was written by the president of the AOA. I was coming from a student/patient perspective and he is coming from the propaganda machine perspective of the AOA.
     
  50. Chrisobean

    Chrisobean The Killer Bean
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    yeah i got that part :D

    im glad someone is saying SOMETHING!
     
  51. dcratamt

    dcratamt Senior Member
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    Flighterdoc,
    Maybe this will help you with the, what is a D.O.?, thing. In general the big difference between D.O. and M.D. is the use of OMM, which many D.O.'s do not use and so adds to the confusion. OMM is comprised of different treatment modalities each using hands on skills. Some of these modalities are muscle energy technique, functional technique, strain-counterstrain, high velocity manipulation and fascial release. These techniques, and others, all work in different ways to rid the body of somatic dysfunctions or restrictions in the musculoskeletal system. These restrictions could be primarily in the joints or the fascia or involve the viscera. The basic premise is that these dysfunctions not only cause pain but block the flow of blood, lymph, nerve signals, possibly energy flow if you believe in such a thing. In general these dysfunctions also cause the body to use more energy than it needs to. If a person with back pain is forced to ambulate with an altered walking pattern then their body uses up more energy than it would if the dysfunction were not present. Now if this person with back pain and altered musculoskeletal functioning also has heart disease then their heart is going to have to work harder than normal to pump blood to the body to sustain the less than optimal gait pattern. So now the theory becomes, if you treat this person with their heart medications and relieve their somatic dysfunction is that person not better off than with meds alone? To summarize, the equation is this Patient(Host) + Disease = Illness. Allopathic medicine focuses solely on the disease process to eliminate illness whereas Osteopathy looks at the disease and also the condition of each unique Host in order to combat the illness. Far fetched? Don't knock it till you've tried it. :cool:
     

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