Do DO doctors use OMM frequently?

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mariposas905

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I believe the main difference between the DO and MD degree is the teaching of osteopathic manipulative medicine in DO schools. Do DO doctors use this a lot on their actual patients? Is it appreciated and useful for patients such that they would prefer going to a DO over MD docs just for the OMM?

I don't know much about OMM so I am trying to get an idea of what the training entails and the extent it is used for.
 
I believe the main difference between the DO and MD degree is the teaching of osteopathic manipulative medicine in DO schools. Do DO doctors use this a lot on their actual patients? Is it appreciated and useful for patients such that they would prefer going to a DO over MD docs just for the OMM?

I don't know much about OMM so I am trying to get an idea of what the training entails and the extent it is used for.
How do DO's incorporate OMM into their practice?
 
I believe the main difference between the DO and MD degree is the teaching of osteopathic manipulative medicine in DO schools. Do DO doctors use this a lot on their actual patients? Is it appreciated and useful for patients such that they would prefer going to a DO over MD docs just for the OMM?

I don't know much about OMM so I am trying to get an idea of what the training entails and the extent it is used for.
I worked as a scribe for a family medicine DO for about a year. About half of his appointments were strictly for OMM, which many patients seemed to benefit from greatly. In any case, it depends on the doctor, but if you want to incorporate it into your practice you can, if you don't then you don't ever have to use it.
 
Depends on school, at mine (do) we have 2 hrs/wk which doesn't take a noticeable amt of time away from other courses
 
I worked as a scribe for a family medicine DO for about a year. About half of his appointments were strictly for OMM, which many patients seemed to benefit from greatly. In any case, it depends on the doctor, but if you want to incorporate it into your practice you can, if you don't then you don't ever have to use it.

Yeah. My family docs from when I was 5 until I joined the Navy were DOs. They very rarely used it (not just on me, but in general). But you can if you want to.
 
My boyfriend goes to a DO specifically for the OMM. He loves it so much that he wants me to go DO.
 
I shadowed three DOs, two of whom used OMM all the time and one who never did. It depends largely on your specialty and the office you practice at.

The two DOs I saw doing OMM loved it and it was a really cool experience. But they were very upfront about how maybe only, in their estimation, 1 in 4 DOs really ever use it.

All three however stressed that having OMM classes gave them a mastery of physiology they wouldn't have had elsewhere, which is important IMO.
 
The family medicine docs typically do. In fact, if you are a DO doing family medicine clinic and don't do it, you're leaving potentially six figures worth of money on the table.

I haven't really seen physicians outside of primary care use it all too much.

There are also a few pure OMM/NMM fellowships, but it's a small number of people out of many DOs. I'm also not sure what will happen to them given the AOA/ACGME merger...

If you want, you can do it on family and friends, and even when you're doing inpatient hospital medicine. If you want to make a living out of it, it's best to do family medicine and then practice it extensively.
 
I wish US MD schools offer OMM as an elective. I'd probably take it for sure since I hear some people really love it.

There are plenty of ways to effectively use the placebo effect, I don't see how an entire elective on it would be necessary.
 
There are plenty of ways to effectively use the placebo effect, I don't see how an entire elective on it would be necessary.
Having been on the receiving end of OMT, I can attest to that it's NOT a placebo effect. I need to go see my colleague Dr NQ for a sore elbow now.
 
No to all of those, but great for musculoskeletal issues.

The last couple meta-analyses I saw showed no real difference between OMM and sham-touch. Is there something new out that I'm missing? Or is it just the general positive effect of touch/massage?
 
I've worked in an ER with MDs and DOs. The DOs would only use OMM when it came to misplaced joints and popped-sockets, so very rarely.
 
The last couple meta-analyses I saw showed no real difference between OMM and sham-touch. Is there something new out that I'm missing? Or is it just the general positive effect of touch/massage?
Haven't a clue. Jeeze, I hate saying this, but I'm an n=1, a case in point, if you will.

Can you have citations handy?
 
Haven't a clue. Jeeze, I hate saying this, but I'm an n=1, a case in point, if you will.

Can you have citations handy?

If I get some time, I'll do some lit searches again. But, even in your n=1 case, I imagine you might feel just as good with a targeted massage, or a session with a PT.
 
If I get some time, I'll do some lit searches again. But, even in your n=1 case, I imagine you might feel just as good with a targeted massage, or a session with a PT.
Again, an n=1, and I hate doing this, because I see other people doing this for other things, and it drives me up the wall, but my experience with PT vs OMT is that the PT is focused only on one thing....the "owie", if you will. My OMT colleagues hunt around for other things (the body is a unit business, I guess) and they can and do find something distal that's the real cause of the issue. Or, at least MY issue! I had another joint issue that massage did not help...but some muscle energy sure did!
 
Again, an n=1, and I hate doing this, because I see other people doing this for other things, and it drives me up the wall, but my experience with PT vs OMT is that the PT is focused only on one thing....the "owie", if you will. My OMT colleagues hunt around for other things (the body is a unit business, I guess) and they can and do find something distal that's the real cause of the issue. Or, at least MY issue! I had another joint issue that massage did not help...but some muscle energy sure did!

Quick perusal of the Cochrane databases shows inconclusive evidence of MET due to poor and/or biased data, spinal manipulative therapies in general are no better then other management techniques for low back pain. Speaking to the placebo issue, we already know that the perceived expertise/severity/invasiveness of the procedure has a strong positive influence on the placebo effect. Maybe there's something there, but I just haven't seen any good data to suggest it's anything unique above and beyond touch and placebo.
 
Quick perusal of the Cochrane databases shows inconclusive evidence of MET due to poor and/or biased data, spinal manipulative therapies in general are no better then other management techniques for low back pain. Speaking to the placebo issue, we already know that the perceived expertise/severity/invasiveness of the procedure has a strong positive influence on the placebo effect. Maybe there's something there, but I just haven't seen any good data to suggest it's anything unique above and beyond touch and placebo.
Many thanks for sharing. I have yet to deal with back pain, but I have a feeling my days are numbered on that score. But for my other muculoskeletal issues, I'm helped by OMT.

I'm quite the skeptic, so I tend to marvel at my OMT colleagues when they fix me.
 
Quick perusal of the Cochrane databases shows inconclusive evidence of MET due to poor and/or biased data, spinal manipulative therapies in general are no better then other management techniques for low back pain. Speaking to the placebo issue, we already know that the perceived expertise/severity/invasiveness of the procedure has a strong positive influence on the placebo effect. Maybe there's something there, but I just haven't seen any good data to suggest it's anything unique above and beyond touch and placebo.
Many thanks for sharing. I have yet to deal with back pain, but I have a feeling my days are numbered on that score. But for my other muculoskeletal issues, I'm helped by OMT.

I'm quite the skeptic, so I tend to marvel at my OMT colleagues when they fix me.

Wait I'm lost. What's the difference among OMT, physiatry (i.e. PM&R) and physical therapy? I mean apart from the educational differences?

Perhaps residents like @Planes2Doc can clarify
 
Wait I'm lost. What's the difference among OMT, physiatry (i.e. PM&R) and physical therapy? I mean apart from the educational differences?

Perhaps residents like @Planes2Doc can clarify

If you do PM&R, you lead the physical therapists, that lead the physical therapy assistants. Or at least that's what I'm familiar with. My friend is a PTA and has a PM&R doc round on the patients once a week in an inpatient rehab facility.

OMM is usually incorporated as an add-on with your typical primary care stuff, like medications to treat acute illnesses like an infection and chronic diseases such diabetes or hypertension.
 
Is it appreciated and useful for patients such that they would prefer going to a DO over MD docs just for the OMM?

Yes actually, the patients who receive OMM tend to love it and love their docs.

I believe the main difference between the DO and MD degree is the teaching of osteopathic manipulative medicine in DO schools. Do DO doctors use this a lot on their actual patients?

Very few. Like 5-10%

I wish US MD schools offer OMM as an elective. I'd probably take it for sure since I hear some people really love it.


I've actually been pleasantly surprised, I can see how what we have done so far is helpful. Now there are definitely parts of it that is complete magic, but some of it is actually fairly intuitive.
I imagine you might feel just as good with a targeted massage, or a session with a PT.

Honestly a decent amount of it is this.
 
There are plenty of ways to effectively use the placebo effect, I don't see how an entire elective on it would be necessary.

do you also think the results of carotid sinus massage is placebo effect?
 
Don't forget that placebo effect makes people feel better. It's like going to the ED with a virus, and leaving with a z-pak. Sometimes people want their trophy, or just have something done.
 
I've been on family medicine rotations for the last two months. One attending used OMT daily, on patients with a variety of issues but mostly musculoskeletal + headaches. The next uses it more rarely, but does have a few patients who specifically request it-- he uses it for MSK only, almost always back or neck pain.

It's not the magic cure-all button some OMT faculty will try to sell you on, but it's useful in certain situations.
 
Any anesthesiologists ever use it? Not operatively obviously, but pre or post op? Maybe for a pain followup in conjunction with other therapies?
 
I've been on family medicine rotations for the last two months. One attending used OMT daily, on patients with a variety of issues but mostly musculoskeletal + headaches. The next uses it more rarely, but does have a few patients who specifically request it-- he uses it for MSK only, almost always back or neck pain.

It's not the magic cure-all button some OMT faculty will try to sell you on, but it's useful in certain situations.

If you want to be entertained, spend some time reading the Journal of the American Osteopathic Association to see the full list of completely batshiat cures that the true believes attribute to OMT.

I fell down that rabbit hole a couple years ago when I was looking up the physician who had previously been writing 80 mg of methylphenidate a day to my floridly manic intake patient. He turned out to be a former dean at one of the older DO schools and had published multiple papers in it about OMT for various mental health conditions.
 
Diminished use of osteopathic manipulative treatment and its impact on the uniqueness of the osteopathic profession.
Johnson SM1, Kurtz ME.
Author information
1Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, 48824-1316, USA.
Abstract
PURPOSE:
To determine whether osteopathic manipulative treatment (OMT), a key identifiable feature of osteopathic medicine, is becoming a "lost art" in the profession, and whether the long-term evolution of osteopathic medicine into mainstream medicine and particularly specialization has had a similar impact on the use of OMT by family practitioners and specialists.
METHOD:
In April 1998, a two-page questionnaire was mailed to 3,000 randomly selected osteopathic physicians in the United States to assess factors affecting their use of OMT. Descriptive statistics, linear regression analyses, and analysis of variance techniques were used to test for differences.
RESULTS:
The response rate was 33.2%. Over 50% of the responding osteopathic physicians used OMT on less than 5% of their patients, and analysis of variance revealed OMT use was significantly affected by practice type, graduation date, and family physicians versus specialists. For specialists, 58% of the variance regression was attributed to barriers to use, practice protocol, attitudes, and training, whereas for family physicians, 43% of the variance regression was attributed to barriers to use, practice protocol, and attitudes. More important, the eventual level of OMT use was related to whether postgraduate training had been undertaken in osteopathic, allopathic, or mixed staff facilities, particularly for osteopathic specialists.

Above is from Pub Med. I think the JAOA looked into this a few years back and @Goro is pretty close.
 
2 cents. Even if it is difficult to incorporate OMM/OMT in the ED setting, the extra training can sometimes pay off. Say, you have to articulate a wrist with a lunate dislocation - someone who has been doing OMM/OMT in school may have an advantage over someone who didn't.
 
Some leave it behind completely. Some practice it exclusively. Some incorporate it into their daily practice. Some practice it, but separate from their otherwise daily work. You can choose to do with it what you please.
Lolz. Choose DO or don’t.
 
Some leave it behind completely. Some practice it exclusively. Some incorporate it into their daily practice. Some practice it, but separate from their otherwise daily work. You can choose to do with it what you please.
In other words...
"You got to know when to hold 'em, know when to fold 'em
Know when to walk away and know when to run.
You never count your money while they're layin' on your table.
There'll be time enough for countin' when... you balance their ligamentous tension."
 
I remember shadowing primary care DO and orthopedic DO - neither used OMM/OMT in office.
 
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