Goro

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Great question! There are two ways to go about it:

Get some studies to demonstrate efficacy or lack thereof.
Get data to demonstrate that those bones do NOT move.

Explain to devotees the concept of confirmation and observer bias.

If the technique is efficacious, find the actual explanation, rather than the tactile delusion the practitioners belabor under.

Then maybe we can eliminate Chapman's points, while we're at it.

All the while, we have to do this as gently as if talking to a beloved but slightly dotty old aunt.

Start by reading this:
http://rationalwiki.org/wiki/Pseudoscience

http://www.skepticalraptor.com/skepticalraptorblog.php/pseudoscience-fool/
 

starri

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As long as OMM-believers are in positions of authority at the AOA, cranial will still be a thing.

Plus, it's testable on COMLEX. I'm 90% sure that's why Chapman points are taught, because it's easy to write questions about them.
 

ChiTownBHawks

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As long as OMM-believers are in positions of authority at the AOA, cranial will still be a thing.

Plus, it's testable on COMLEX. I'm 90% sure that's why Chapman points are taught, because it's easy to write questions about them.
I remember talking with a family member (who is a MD) about Chapman points. Their face was priceless.
 

MLT2MT2DO

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Great question! There are two ways to go about it:

Get some studies to demonstrate efficacy or lack thereof.
Get data to demonstrate that those bones do NOT move.

Explain to devotees the concept of confirmation and observer bias.

If the technique is efficacious, find the actual explanation, rather than the tactile delusion the practitioners belabor under.

Then maybe we can eliminate Chapman's points, while we're at it.

All the while, we have to do this as gently as if talking to a beloved but slightly dotty old aunt.

Start by reading this:
http://rationalwiki.org/wiki/Pseudoscience

http://www.skepticalraptor.com/skepticalraptorblog.php/pseudoscience-fool/
Only in OMM are we asked to prove and do studies that something does NOT work. Any actual field of medicine would cease to exist if they just said "believe this, it works, trust us, we're doctors".

How about Osteopathic schools catch up to the 21st century and teach evidenced based medicine instead?

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Goro

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The difficult we do today...the impossible takes a little longer.
;)

We do need to be more rigorous with our OMM colleagues and simply say "prove it" when they make an assertion about unproved claims.

Only in OMM are we asked to prove and do studies that something does NOT work. Any actual field of medicine would cease to exist if they just said "believe this, it works, trust us, we're doctors".

How about Osteopathic schools catch up to the 21st century and teach evidenced based medicine instead?

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starri

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I remember talking with a family member (who is a MD) about Chapman points. Their face was priceless.
My base hospital has DO, MD, and Caribbean students rotating at it. There is a sizable proportion of DO residents and a fair number of DO attendings, but it's still majority MD. When I was on my psych rotation, I was sitting around with a DO student from another school and a couple of the MD residents, and we started talking about Cranial, and it was like I'd grown another head.

I am a total believer in the ability of OMM for treating back pain. My own personal anecdotes don't rise to the level of evidence, but I've personally found it helpful. A friend of mine and I even treated a bed-bound patient who was having some muscle spasms from the way she was holding herself because her central line was painful. She was on telemetry, and from what the nurses told us, her heart functions actually calmed down as we were working. I didn't believe it either.

But Cranial, there's no defending that one.
 

Goro

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The only positive thing I can say about cranial is that IF it does work, it's doesn't have to do with bone movement.

Back into the attic now, Auntie Lou.


My base hospital has DO, MD, and Caribbean students rotating at it. There is a sizable proportion of DO residents and a fair number of DO attendings, but it's still majority MD. When I was on my psych rotation, I was sitting around with a DO student from another school and a couple of the MD residents, and we started talking about Cranial, and it was like I'd grown another head.

I am a total believer in the ability of OMM for treating back pain. My own personal anecdotes don't rise to the level of evidence, but I've personally found it helpful. A friend of mine and I even treated a bed-bound patient who was having some muscle spasms from the way she was holding herself because her central line was painful. She was on telemetry, and from what the nurses told us, her heart functions actually calmed down as we were working. I didn't believe it either.

But Cranial, there's no defending that one.
 

starri

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The only positive thing I can say about cranial is that IF it does work, it's doesn't have to do with bone movement.
My bigger problem with Cranial is not that it's taught at all. If it was presented as just something that was an expression of osteopathic philosophy, I think I would still think it was silly, but not be wounded by it. But the authoritative way that it's taught just gets my dander up.

In fairness, I will say I believe that I had some terrific OMM faculty. But I think it's more because they were great doctors first.
 
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Drrrrrr. Celty

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As I've stated before, I like OMM. I benefit from it and it works for many of my pains. But it is in that recognition that we need to legitimately focus on actually making sure we're good and knowledgable in actually applicable topics that we may actually use one day. Don't poison the whole field by keeping the worst of it.
 

starri

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Do you think teaching OMM actually detracts from the basic sciences, though? Because at least the way we do it, it's kind of cordoned off into its own thing, and the two sets of faculty very rarely cross paths.
 

JustPlainBill

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Great question! There are two ways to go about it:

Get some studies to demonstrate efficacy or lack thereof.
Get data to demonstrate that those bones do NOT move.

Explain to devotees the concept of confirmation and observer bias.

If the technique is efficacious, find the actual explanation, rather than the tactile delusion the practitioners belabor under.

Then maybe we can eliminate Chapman's points, while we're at it.

All the while, we have to do this as gently as if talking to a beloved but slightly dotty old aunt.

Start by reading this:
http://rationalwiki.org/wiki/Pseudoscience

http://www.skepticalraptor.com/skepticalraptorblog.php/pseudoscience-fool/

Spoken like an unbelieving infidel! You must now genuflect and go rub the unshaven pate of the closet A.T. Still statue (we had a bronze bust in the library at TCOM) in penance ----

I'm sorry, Goro -- the suspension of disbelief that occurred during cranial was mind boggling -- from the D.O./Ph.D who took us from a pulsating neuron in a petri dish to being able to palpate the mitochondrial respiratory pathyway to the D.O. who trained under Sutherland who stated, and was completely serious, that the reason human serum approximated seawater was because we evolved from fish during a cranial lecture -- it was just too much....to coin a phrase, "JPB got off the boat -- he split from the whole effin program"......
 

Goro

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tWait a minute....somebody said they could palpate mitochondrial function? Really?

I would have called a psych consult at that point.

I'm sorry, Goro -- the suspension of disbelief that occurred during cranial was mind boggling -- from the D.O./Ph.D who took us from a pulsating neuron in a petri dish to being able to palpate the mitochondrial respiratory pathyway to the D.O. who trained under Sutherland who stated, and was completely serious, that the reason human serum approximated seawater was because we evolved from fish during a cranial lecture -- it was just too much....to coin a phrase, "JPB got off the boat -- he split from the whole effin program"......

No, my students generally like Osteopathy and take pride in their profession, but they tend to view OMM/OMT as this necessary hurdle they have to deal with, sort of like COMLEX, and get over. The vast majority of the students have done lab research, respect the scientific principle, and so just hold their noses when the true believers start lecturing.

The cult of Still mindset is fading...give it another generation to dissipate.

Oh, without trying to give out too much info, we basic science Faculty do try to get the OMM/OMT faculty o integrate some of their material with ours. So, just making something up, if we have a series of lectures on, say, pregnancy, my physiology colleague can share the stage with my OMM/OMT colleague when discussing childbirth. The latter talks more about what you can do to make the patient feel better during contractions.



Do you think teaching OMM actually detracts from the basic sciences, though? Because at least the way we do it, it's kind of cordoned off into its own thing, and the two sets of faculty very rarely cross paths.
 
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JustPlainBill

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Wait a minute....somebody said they could palpate mitochondrial function? Really?

I would have called a psych consult at that point.
yep --- I defecate you zero ounces, compadre --- He went from a palpating neuron in a petri dish to palpating pulsations in brain parenchyma and then went off into a discussion of the respiratory rhythm and came back and associated the respiratory rhythm with the pulsating neuron and tied it into the oxidative phosphorylation that occurs in the mitochondria and claimed that was part of the respiratory rhythm -- and told us cranial bones moved as a result and that's what we were palpating --- my BS meter was pegged....

But remember, these are the supposed anatomy studs who reversed the action of the deltoid vs supra/infraspinatus when it comes to which one is responsible for the first 15 degrees of abduction and the ones who repeatedly misidentified the spine of the scapula vs the inferior angle of the scapula (I made it a point to ask that question and point out the anatomical landmark on another student 3 times and a double board certified attending (OMM and FM) got it wrong all 3 times -- to be sure, I checked with the anatomy department -- just in case I couldn't figure it out from Netter's) -- it was at that point that I realized it was pretty much a game, drink the Kool Aid, cooperate and graduate --- I lost a lot of respect for physicians at that point ----
 

Goro

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Get some formalin-fixed cells or tissue samples, let him palpate those, and interpret them.

That will shut him up fast.

Another test would be to get a cadaver head, put it in a hole so only the scalp is showing. Have some live volunteers in other holes. Let them try to interpret each skull. Watch hijinks ensue.

In essence, use something like this:

http://jama.jamanetwork.com/article.aspx?articleid=187390
https://www.psychologytoday.com/blog/homo-consumericus/201109/eleven-year-old-debunks-therapeutic-touch-the-case-emily-rosa

yep --- I defecate you zero ounces, compadre --- He went from a palpating neuron in a petri dish to palpating pulsations in brain parenchyma and then went off into a discussion of the respiratory rhythm and came back and associated the respiratory rhythm with the pulsating neuron and tied it into the oxidative phosphorylation that occurs in the mitochondria and claimed that was part of the respiratory rhythm -- and told us cranial bones moved as a result and that's what we were palpating --- my BS meter was pegged....

But remember, these are the supposed anatomy studs who reversed the action of the deltoid vs supra/infraspinatus when it comes to which one is responsible for the first 15 degrees of abduction and the ones who repeatedly misidentified the spine of the scapula vs the inferior angle of the scapula (I made it a point to ask that question and point out the anatomical landmark on another student 3 times and a double board certified attending (OMM and FM) got it wrong all 3 times -- to be sure, I checked with the anatomy department -- just in case I couldn't figure it out from Netter's) -- it was at that point that I realized it was pretty much a game, drink the Kool Aid, cooperate and graduate --- I lost a lot of respect for physicians at that point ----
 

JustPlainBill

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Get some formalin-fixed cells or tissue samples, let him palpate those, and interpret them.

That will shut him up fast.

Another test would be to get a cadaver head, put it in a hole so only the scalp is showing. Have some live volunteers in other holes. Let them try to interpret each skull. Watch hijinks ensue.

In essence, use something like this:

http://jama.jamanetwork.com/article.aspx?articleid=187390
https://www.psychologytoday.com/blog/homo-consumericus/201109/eleven-year-old-debunks-therapeutic-touch-the-case-emily-rosa
I thought about using lasers to detect any 'cranial bone movement' with live volunteers -- not that hard to set up and accurate to the nth degree in terms of detecting movement --- ah, well.
 

starri

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yep --- I defecate you zero ounces, compadre --- He went from a palpating neuron in a petri dish to palpating pulsations in brain parenchyma and then went off into a discussion of the respiratory rhythm and came back and associated the respiratory rhythm with the pulsating neuron and tied it into the oxidative phosphorylation that occurs in the mitochondria and claimed that was part of the respiratory rhythm -- and told us cranial bones moved as a result and that's what we were palpating --- my BS meter was pegged....
And he was a DO/PhD? What was the PhD in?

It's like a vague assortment of concepts that have nothing to do with one another free associated from one to the next.
 
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MLT2MT2DO

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tWait a minute....somebody said they could palpate mitochondrial function? Really?

I would have called a psych consult at that point.




No, my students generally like Osteopathy and take pride in their profession, but they tend to view OMM/OMT as this necessary hurdle they have to deal with, sort of like COMLEX, and get over. The vast majority of the students have done lab research, respect the scientific principle, and so just hold their noses when the true believers start lecturing.

The cult of Still mindset is fading...give it another generation to dissipate.

Oh, without trying to give out too much info, we basic science Faculty do try to get the OMM/OMT faculty o integrate some of their material with ours. So, just making something up, if we have a series of lectures on, say, pregnancy, my physiology colleague can share the stage with my OMM/OMT colleague when discussing childbirth. The latter talks more about what you can do to make the patient feel better during contractions.



Do you think teaching OMM actually detracts from the basic sciences, though? Because at least the way we do it, it's kind of cordoned off into its own thing, and the two sets of faculty very rarely cross paths.
I gotcha.

Axis 1: Delusional disorder NOS
Axis 2: Narcissistic Personality disorder
Axis 3: Dementia NOS
Axis 4: Moderate; dealing with loss of purpose relating to career
Axis 5: GAF 50

Recs: Suggest very geriatric male retire from teaching future physicians and move to Florida Keys.

Thank you for allowing us to partake in your patient's care

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racerwad

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Do you think teaching OMM actually detracts from the basic sciences, though? Because at least the way we do it, it's kind of cordoned off into its own thing, and the two sets of faculty very rarely cross paths.
OMM itself doesn't detract from the basic sciences; arguably, it is the other way around. The basic sciences removes any face validity OMM has.

We also had a bust of Still in our OMM lab and during our weeklong cranial indoctrination session, we also heard many similar tales to what @JustPlainBill is recounting. The mechanism of cranial, Chapman's, et al, could not be more out of line with what we know about human anatomy and physiology. Even the palpation of "somatic dysfunction" of the spinal column seems far fetched to me - I don't think that anyone's Merkel cell's have the fine touch discrimination to feel when one transverse process is more or less posterior. The interoperator reliability of far more objective findings have shown that we just aren't that good at sensing this small differences. Look at the cross-sectional anatomy on the next CT spine you see. There is a lot of tissue between the transverse processes; to think that those differences can: 1) be palpated and 2) "correcting" those differences would have some sort of net effect is magical thinking.

OMM, without an understanding of the basic sciences, seems like a plausible theory. Once you have an understanding of the basic sciences (ironically taught in parallel), OMM loses all plausibility.
 

Drrrrrr. Celty

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I thought about using lasers to detect any 'cranial bone movement' with live volunteers -- not that hard to set up and accurate to the nth degree in terms of detecting movement --- ah, well.
I think they showed that it does happen..... 70 microns of movement...
 
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TheFutureFatMan

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Ya...the cranial stuff seems a little insane. I've seen OMM work, I've experienced it, but when people preach about "cranial" it makes it harder for me to justify the component of OMM that are actually effective. Physicians that use OMM, like everyone else on the planet, can be their own worst enemy.
 
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ortnakas

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Ya...the cranial stuff seems a little insane. I've seen OMM work, I've experienced it, but when people preach about "cranial" it makes it harder for me to justify the component of OMM that are actually effective. Physicians that use OMM, like everyone else on the planet, can be their own worst enemy.
Agreed. I'm not the biggest fan of OMM in general, but I don't mind learning about most of the musculoskeletal stuff, and some of the visceral/lymphatic techniques are all right. Cranial is past my capacity to suspend disbelief. (Weirdly, a lot of us got headaches after the cranial labs, so maybe it does SOMETHING, but it certainly doesn't move fused bones.)
 
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AlteredScale

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The nap I took during our first Cranial lab was easily my favorite thing that ever happened in OMM lab.
The best feels to be had since the start of med school.


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OMM itself doesn't detract from the basic sciences; arguably, it is the other way around. The basic sciences removes any face validity OMM has.

We also had a bust of Still in our OMM lab and during our weeklong cranial indoctrination session, we also heard many similar tales to what @JustPlainBill is recounting. The mechanism of cranial, Chapman's, et al, could not be more out of line with what we know about human anatomy and physiology. Even the palpation of "somatic dysfunction" of the spinal column seems far fetched to me - I don't think that anyone's Merkel cell's have the fine touch discrimination to feel when one transverse process is more or less posterior. The interoperator reliability of far more objective findings have shown that we just aren't that good at sensing this small differences. Look at the cross-sectional anatomy on the next CT spine you see. There is a lot of tissue between the transverse processes; to think that those differences can: 1) be palpated and 2) "correcting" those differences would have some sort of net effect is magical thinking.

OMM, without an understanding of the basic sciences, seems like a plausible theory. Once you have an understanding of the basic sciences (ironically taught in parallel), OMM loses all plausibility.[/QU

I can't say I agree that bone restriction isn't palpable. I mean it's not like microns of movements, some folks are obviously restricted from one side to the other by an obvious difference, when that's the case it's not super hard to feel. Most of the OMM seems fairly practical, even from the standpoint of simple body mechanics... Stretching, massage, etc. But chapman points... The respiratory mechanism of the cranial bones... They loose me there.
 
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Zero_Your_Hero
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OMM itself doesn't detract from the basic sciences; arguably, it is the other way around. The basic sciences removes any face validity OMM has.

We also had a bust of Still in our OMM lab and during our weeklong cranial indoctrination session, we also heard many similar tales to what @JustPlainBill is recounting. The mechanism of cranial, Chapman's, et al, could not be more out of line with what we know about human anatomy and physiology. Even the palpation of "somatic dysfunction" of the spinal column seems far fetched to me - I don't think that anyone's Merkel cell's have the fine touch discrimination to feel when one transverse process is more or less posterior. The interoperator reliability of far more objective findings have shown that we just aren't that good at sensing this small differences. Look at the cross-sectional anatomy on the next CT spine you see. There is a lot of tissue between the transverse processes; to think that those differences can: 1) be palpated and 2) "correcting" those differences would have some sort of net effect is magical thinking.

OMM, without an understanding of the basic sciences, seems like a plausible theory. Once you have an understanding of the basic sciences (ironically taught in parallel), OMM loses all plausibility.
I can't say I agree that bone restriction isn't palpable. I mean it's not like microns of movements, some folks are obviously restricted from one side to the other by an obvious difference, when that's the case it's not super hard to feel. Most of the OMM seems fairly practical, even from the standpoint of simple body mechanics... Stretching, massage, etc. But chapman points... The respiratory mechanism of the cranial bones... They loose me there.