Do we really need a separate osteopathic subforum?

[Drrrrrr. Celty]

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Sure thing, deflect. Give me a study that shows efficacy.

Source: A person that doesnt believe in pseudoscience

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704351/

https://www.ncbi.nlm.nih.gov/pubmed/25723574

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1208896/

 

[Drrrrrr. Celty]

i'll never understand why OMM, if it's even supported by science, is unique to DO schools. if OMM really is scientific and backed with strong studies, what stops MD schools from using it as an elective?

They do. Many MD residents are taught it in cities with big DO populations. Osteopathic recognition by the ACGME also has opened the door to training in it in the graduate level.

But honestly, a big part of it is due to the fact that most doctors probably won't ever need it unless they are in Primary care or in PM&R. You're not going to be doing this in a hospital or on sick patients.

 

[Lawpy]

They do. Many MD residents are taught it in cities with big DO populations. Osteopathic recognition by the ACGME also has opened the door to training in it in the graduate level.

then what makes DO unique

 

[67552931811]

i'll never understand why OMM, if it's even supported by science, is unique to DO schools. if OMM really is scientific and backed with strong studies, what stops MD schools from using it as an elective?

When people say OMM, MD students think of the same **** that us DO students hate, i.e. the neck/ back cracking (please correct me if I'm wrong). A very small part of omm is cracking backs and all that pointless ****. The vast majority is muscle techniques used by physical therapists and PM&R physicians. Again, I will never use it because I have no interest, but it's annoying when people who are so clueless on the subject matter attempt to tear it down.

Chapman points? Lol. Cranial? LOL. Yah, that stuff is ridiculous and you'll be hard pressed to find any of us who back that. But, that's literally less than 10% of the class.

 

[67552931811]

then what makes DO unique

Nothing. It's marketing rhetoric.

 

[Drrrrrr. Celty]

then what makes DO unique

As can be noted by the merger and the future mergers, not a significant amount anymore. Everyone is trying to make their patient feel better these days.

 

[Lawpy]

When people say OMM, MD students think of the same **** that us DO students hate (please correct me if I'm wrong). A very small part of omm is cracking backs and all that pointless ****. The vast majority is muscle techniques used by physical therapists and PM&R physicians. Again, I will never use it because I have no interest, but it's annoying when people who are so clueless on the subject matter attempt to tear it down.

Chapman points? Lol. Cranial? LOL. Yah, that stuff is ridiculous and you'll be hard pressed to find any of us who back that. But, that's literally less than 10% of the class.

Nothing. It's marketing rhetoric.

As can be noted by the merger and the future mergers, not a significant amount anymore. Everyone is trying to make their patient feel better these days.

yeah i think OMM could serve as a useful elective for interested medical students that want to employ physical therapy techniques in practice. i don't see the point of having OMM skills lab in preclinical years and spending a lot of time on it.

there's a lot of extra redundancies involved in the DO education pathway that i think a standardization of sorts would be helpful. like both MD and DO schools focusing only on USMLE and same shelf exams rather than unique DO versions of the exam.

 

[Stagg737]

Studies show that 90% of patients will choose a DO over an x-ray machine to be their PCP.

That's a better tagline than most of the pro-DO ads I've seen...

Here's another one:

Stahp, please.

Ischial tuberosity spread 😉

Doming that pelvic diaphragm.

My wife loves those techniques.

What indications do you believe it is more efficacious compared to the standard of care?

Several modalities have been shown to be more efficacious for low back pain than traditional medical standards of care of opioids, injections, or surgery. Those modalities include OMM, chiropractic manipulation, massage, and acupuncture (true and sham acupunctures). Like B-hawk said, 99.99% of the time OMM is an adjunct treatment, typically for musculoskeletal pain, but there are indications for certain techniques like myofascial release and muscle energy (which PTs regularly use but have different names for).

i'll never understand why OMM, if it's even supported by science, is unique to DO schools. if OMM really is scientific and backed with strong studies, what stops MD schools from using it as an elective?

Someone posted a while ago that they took an OMM elective at their USMD school and I've heard of some residencies offering it as an elective/didactic. Physicians just don't use it because they either don't know how to bill for it or it falls into treatment that other healthcare professionals like PTs would give. I did unknowingly have a sports med MD perform OMM on me before though, so it does happen it's just not common.

 

[Drrrrrr. Celty]

yeah i think OMM could serve as a useful elective for interested medical students that want to employ physical therapy techniques in practice. i don't see the point of having OMM skills lab in preclinical years and spending a lot of time on it.

there's a lot of extra redundancies involved in the DO education pathway that i think a standardization of sorts would be helpful. like both MD and DO schools focusing only on USMLE and same shelf exams rather than unique DO versions of the exam.

I think OMM lab probably like PCM lab can be a 1 year thing and I'd be happy with that. And yah, honestly 80%+ of my class takes USMLE so only having a single test would be ideal.

 

[AlbinoHawk DO]

When people say OMM, MD students think of the same **** that us DO students hate, i.e. the neck/ back cracking (please correct me if I'm wrong). A very small part of omm is cracking backs and all that pointless ****. The vast majority is muscle techniques used by physical therapists and PM&R physicians. Again, I will never use it because I have no interest, but it's annoying when people who are so clueless on the subject matter attempt to tear it down.

Chapman points? Lol. Cranial? LOL. Yah, that stuff is ridiculous and you'll be hard pressed to find any of us who back that. But, that's literally less than 10% of the class.

I always thought the HVLA cracking was the fun part of the curriculum regardless of any actual effectiveness. Chapman's, cranial and even counterstrain points are all ridiculous ****. Hell, even a lot of lymphatic stuff (e.g. pedal pump) is very clear mumbo jumbo.

 

[libertyyne]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704351/

https://www.ncbi.nlm.nih.gov/pubmed/25723574

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1208896/

:"The quality of research related to testing the effectiveness of MET is poor. Studies are generally small and at high risk of bias due to methodological deficiencies. Studies conducted to date generally provide low-quality evidence that MET is not effective for patients with LBP. There is not sufficient evidence to reliably determine whether MET is likely to be effective in practice. Large, methodologically-sound studies are necessary to investigate this question."

That is from link 2.

 

[libertyyne]

You don't believe in physical therapy??? Hahahahahahah. K bud. Again, you literally have no idea what you are talking about. You are focused on the **** literally all of us hate (which is a small part of omm and to put in writing, I find the course to be a complete waste of time). This small part I am not defending and you can't even argue because you are so clueless on the topic that you don't even know the terminology.

Enjoy your evening, pre-med. Perhaps educate yourself on a topic you are so against before arguing against it. You seem like the perfect liberal 🙂

Perhaps you should answer the question instead of name calling. Show me some studies that prove efficacy.

 

[Drrrrrr. Celty]

:"The quality of research related to testing the effectiveness of MET is poor. Studies are generally small and at high risk of bias due to methodological deficiencies. Studies conducted to date generally provide low-quality evidence that MET is not effective for patients with LBP. There is not sufficient evidence to reliably determine whether MET is likely to be effective in practice. Large, methodologically-sound studies are necessary to investigate this question."

That is from link 2.

Generally your ability to create a quality research study for a physical manipulatory technique or techniques is difficult. It's not as easy as comparing the outcomes of patients sorted into groups and treated with things that inherently are more standardizable.

Being entirely fair though, I literally just pulled 3 random pubmed articles out of the dirt.

 

[Drrrrrr. Celty]

I always thought the HVLA cracking was the fun part of the curriculum regardless of any actual effectiveness. Chapman's, cranial and even counterstrain points are all ridiculous ****. Hell, even a lot of lymphatic stuff (e.g. pedal pump) is very clear mumbo jumbo.

I think in terms of lymphatic techniques a good amount are common place in general medicine. The non common place ones like sinus or things like gallbrath are pretty useful.

 

[67552931811]

Perhaps you should answer the question instead of name calling. Show me some studies that prove efficacy.

And that occurred where? You are a pre-med soooo

I do apologize if "bud" hurt your feelings. Sincerely 🙁🙁🙁. How low of me.

 

[Drrrrrr. Celty]

:"The quality of research related to testing the effectiveness of MET is poor. Studies are generally small and at high risk of bias due to methodological deficiencies. Studies conducted to date generally provide low-quality evidence that MET is not effective for patients with LBP. There is not sufficient evidence to reliably determine whether MET is likely to be effective in practice. Large, methodologically-sound studies are necessary to investigate this question."

That is from link 2.

On the topic, I would actually love to see more research on certain topics and treatments however. But there's generally a lack of interest in researching among DOs who generally are not known for being 'academics'.

 

[67552931811]

Perhaps you should answer the question instead of name calling. Show me some studies that prove efficacy.

You want me to show you that physical therapy works and that physical medicine and rehabilitation is an actual field which produces results? LOL. I'm good. You can google that **** on your own, "bud" 😉

 

[Drrrrrr. Celty]

And that occurred where? You are a pre-med soooo

I do apologize if "bud" hurt your feelings. Sincerely 🙁🙁🙁. How low of me.

Can you chill? Jesus, go study and stop being so petulant.

 

[libertyyne]

On the topic, I would actually love to see more research on certain topics and treatments however. But there's generally a lack of interest in researching among DOs who generally are not known for being 'academics'.

I would be curious to see the results as well. I am always fascinated by how much of medicine has no evidence to support its use. Considering that OMM has been such a large part of the "identity" of DO schools It is surprising that they did not place more resources on larger studies.

 

[Drrrrrr. Celty]

I would be curious to see the results as well. I am always fascinated by how much of medicine has no evidence to support its use. Considering this OMM has been such a large part of the "identity" of DO schools It is surprising that they did not place more resources on larger studies.

Medicine is a technical skill, not a science.

Also the identity comes before the scientific method was all that popular tbh. Also something about MDs being about as crazy as the average SDN user except in the late 19th century.

 

[libertyyne]

Medicine is a technical skill, not a science.

Also the identity comes before the scientific method was all that popular tbh. Also something about MDs being about as crazy as the average SDN user except in the late 19th century.

Thats why I was curious enough to ask what techniques people use. If they are efficacious as adjuvant therapies shouldnt it become standard of care and MDs should also adopt it? But a pre-requisite of that is efficacy data which seems to be in short supply .

 

[Stagg737]

I always thought the HVLA cracking was the fun part of the curriculum regardless of any actual effectiveness. Chapman's, cranial and even counterstrain points are all ridiculous ****. Hell, even a lot of lymphatic stuff (e.g. pedal pump) is very clear mumbo jumbo.

Agree with Chapman's and Cranial, I think counterstrain can be useful if the person really knows what they're doing. I had a guy that had been practicing OMM for around 60 years actually fix a msk problem I had for years with 2 or 3 sessions of modified counterstrain (along with appropriate home-care). No placebo effect, there were measurable differences before and after treatment as well as gradual changes. I also thought counterstrain and tender points were BS when we first learned about them, but after that experience I do think that it's something worth actually researching. I won't say more here for anonymity reasons, but I'd be happy to get more specific via PM if you want.

There are also some of those random techniques that can be extremely useful that people just don't seem to use. My personal favorite is mesenteric release for those days when I don't get enough fiber...

 

[IslandStyle808]

I would be curious to see the results as well. I am always fascinated by how much of medicine has no evidence to support its use. Considering that OMM has been such a large part of the "identity" of DO schools It is surprising that they did not place more resources on larger studies.

Its the unfortunate part of medicine. There are techniques that are practiced today based on very weak evidence, or even non-existant evidence (not referencing OMM on this point).

 

[libertyyne]

Perhaps you should answer the question instead of name calling. Show me some studies that prove efficacy.

You want me to show you that physical therapy works and that physical medicine and rehabilitation is an actual field which produces results? LOL. I'm good. You can google that **** on your own, "bud" 😉

 

[Drrrrrr. Celty]

Thats why I was curious enough to ask what techniques people use. If they are efficacious as adjuvant therapies shouldnt it become standard of care and MDs should also adopt it? But a pre-requisite of that is efficacy data which seems to be in short supply .

I think time will show what the future curriculums of medicine will be. I think that chances are OMM will be relegated to being a graduate medical education training as opposed to one in medical school. In terms of data, who knows. In either case I would love someone to do some sacral and lumbar techniques because my ass hurts from studying repro for 16 hours yesterday....

 

[libertyyne]

I think time will show what the future curriculums of medicine will show. I think that chances are OMM will be relegated to being a graduate medical education training as opposed to one in medical school. In terms of data, who knows. In either case I would love someone to do some sacral and lumbar techniques because my ass hurts from studying repro for 16 hours yesterday....

I am doubtful that it will be taken up in MD schools extensively without the evidence burden being met. And Osteopathic schools seem hard pressed to let it go. It might be the status quo continues as is.

 

[Drrrrrr. Celty]

I am doubtful that it will be taken up in MD schools extensively without the evidence burden being met. And Osteopathic schools seem hard pressed to let it go. It might be the status quo continues as is.

You're going to run into a lot of non-EBM first year tbh. Doesn't stop it from being used. And they're opening up.

 

[hallowmann]

I always thought the HVLA cracking was the fun part of the curriculum regardless of any actual effectiveness. Chapman's, cranial and even counterstrain points are all ridiculous ****. Hell, even a lot of lymphatic stuff (e.g. pedal pump) is very clear mumbo jumbo.

I've had a lot of success with CS. That said, I don't really follow the designated points. I find tender points. People are different, and there are slight differences in what they'll present with depending on what they did to cause it. The points might be a guide, but the idea that everyone that comes to you with some type of hypertonicity will be limited to specific points that are relieved only by specific movements doesn't seem realistic to me.

With knowledge of muscular origins and insertions, and even just communication with the patient, you can find the appropriate CS positions for any tender point that you find.

 

[NurWollen]

Whoa whoa whoa can we change back to the Osteo forum being separate from the Allo forum? I really enjoyed being able to discuss Osteo-specific issues like school expansion, COCA, etc. Every thread I've participated in is lost in the volume of the Allo forum.

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[NurWollen]

Don't you get notifications when people comment on threads you commented on?

Sure I do. But the point is you comment on a thread and the volume in Allo is so high it just disappears in A) page 6 obscurity or B) a jumbled mess of trolling and counter-trolling.

 

[Drrrrrr. Celty]

I won't lie, the forum merger kind of eliminated or pushed back into page two many DO specific threads and topics. Not many MDs are really interested in DO specific topics so those end up being significantly less bumped as random posts or general topics.

But honestly we had a pretty good community on the DO forum. I rarely even see their posts anymore outside of this thread lol.

 

[NurWollen]

I won't lie, the forum merger kind of eliminated or pushed back into page two many DO specific threads and topics. Not many MDs are really interested in DO specific topics so those end up being significantly less bumped as random posts or general topics.

But honestly we had a pretty good community on the DO forum. I rarely even see their posts anymore outside of this thread lol.

This, exactly. DO specific topics get much less traffic and I don't see posts from anyone I 'know' anymore. Turns out the DO subforums' "unique distinctiveness" was more real than any actual DO unique distinctiveness.

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[Drrrrrr. Celty]

This, exactly. DO specific topics get much less traffic and I don't see posts from anyone I 'know' anymore. Turns out the DO subforums' "unique distinctiveness" was more real than any actual DO unique distinctiveness.

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I think we had a pretty good group on there haha.

It's not to say that plenty of people on Allo aren't also great. I just think they occasionally have so many voices at once that it's rare to actually know what a single person thinks. DO was more cozy and chill, maybe it was the having lots of future FM ppl haha

 

[NurWollen]

I think we had a pretty good group on there haha.

It's not to say that plenty of people on Allo aren't also great. I just think they occasionally have so many voices at once that it's rare to actually know what a single person thinks. DO was more cozy and chill, maybe it was the having lots of future FM ppl haha

100% agree.

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[Drrrrrr. Celty]

100% agree.

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In either case what I'm worried about is the enormous beat down any potential negative DO topic is going to get, see Jk's XCOM WOOT WOOT. Like we're pissed, but don't use this as a spring board for why DOs are inferior or something stupid.


Also while I'm happy to explain some OMM. I'm afraid OMM topic may just become arguments between OMT oriented people and skeptical MDs who think it's all just voodoo.

 

[67552931811]

Can you chill? Jesus, go study and stop being so petulant.

LOL! True irony coming from you, my man.

 

[JoeUSA]

This is so dumb -_-
Who even asked for this? I'm a DO student and I preferred a separate page. It made searching for stuff easier.
If I wanted a combined forum I would've gone to Reddit.

I agree with you. DO and MD students also have different interests. Now, it is much harder to find a DO topic in the medical student forum. DO topics are likely to get minimized in a combined forum.

 

[Winged Scapula]

I agree with you. DO and MD students also have different interests. Now, it is much harder to find a DO topic in the medical student forum. DO topics are likely to get minimized in a combined forum.

When creating or looking for a thread, use the "DO" tag. That will make it much easier to find what you need.

 

[Drrrrrr. Celty]

LOL! True irony coming from you, my man.

Remind me to throw shade next time I see you lol.

 

[NurWollen]

LOL! True irony coming from you, my man.

Remind me to throw shade next time I see you lol.

Hey now let's all just tune in to the CRI and get along as refugees from the Osteo forums.

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[cbrons]

Off topic question: Do you use kayexalate for hyperkalemia?

I knew at one of my sub-Is this year that EBM wasnt a high priority for the teaching service when they discussed using this on a pt with hyperK.

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[hallowmann]

Thats why I was curious enough to ask what techniques people use. If they are efficacious as adjuvant therapies shouldnt it become standard of care and MDs should also adopt it? But a pre-requisite of that is efficacy data which seems to be in short supply .

To be fair, some MDs do adopt/use a good amount of it. I know plenty of PM&R and Sports Med docs that use at least some OMT. Even know a Neurologist or two. The truth is that OMT as a skill is only really useful (in terms of being used regularly on patients) to a handful of specialties. There's little point in teaching it in medical school. DOs are learning it primarily for historical reasons.

I actually think opening the NMM residencies up to MDs with an ACGME ONMM RRC and an ACGME Osteopathic focus RRC are a good start to training MDs that are more likely to use it. We'll have to see where it actually leads in the future.

 

[Redpancreas]

What indications do you believe it is more efficacious compared to the standard of care?

There doesn't have to be any superiority in efficacy. I rotated a few days in a Family in a small community hospital with half DOs and MDs. They work up and prescribe everything an MD would for standard back pain. In addition, they do a better job recognizing things like scoliosis and muscle asymmetry. Sometimes during the physical exam itself they would take 2 minutes tops rotating/cracking or doing something with the back and it apparently helps. Most my friends say it helps for like a week or so with pain and even DOs admit it's not a fix but it's something. You'll see in your third year that especially in suburban center with low maintenance population, half the battle with making the patient feel better is psychological. Therefore doing anything that includes touching the patient, does no harm and only takes a few minutes is better than the a physician that doesn't even examine the patient.

On top of that, OMM seems to work according to circumstantial evidence. We could do an experiment and see how patients feel with it relative to psychiatry but it's not really something worth policing.


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[ortnakas]

I won't lie, the forum merger kind of eliminated or pushed back into page two many DO specific threads and topics. Not many MDs are really interested in DO specific topics so those end up being significantly less bumped as random posts or general topics.

But honestly we had a pretty good community on the DO forum. I rarely even see their posts anymore outside of this thread lol.

This, exactly. DO specific topics get much less traffic and I don't see posts from anyone I 'know' anymore. Turns out the DO subforums' "unique distinctiveness" was more real than any actual DO unique distinctiveness.

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Haha, this. I've rotated with MD students and I don't feel like my education has been very osteopathically distinctly different, but I have to admit I kinda miss having the DO board with people I "know."

 

[Lee]

Well, based on feedback and some technical issues, the osteopathic medical student forum has been restored.

We can definitely relook a merger of forums. For now, rolling back the change will ensure there is adequate time and input given before making a change in the future.

 

[235009]

Well, based on feedback and some technical issues, the osteopathic medical student forum has been restored.

We can definitely relook a merger of forums. For now, rolling back the change will ensure there is adequate time and input given before making a change in the future.

Weak. Some people are always going to hate any change and have a strong immediate reaction because they take a little longer to adjust to change.


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[Stagg737]

There doesn't have to be any superiority in efficacy. I rotated a few days in a Family in a small community hospital with half DOs and MDs. They work up and prescribe everything an MD would for standard back pain. In addition, they do a better job recognizing things like scoliosis and muscle asymmetry. Sometimes during the physical exam itself they would take 2 minutes tops rotating/cracking or doing something with the back and it apparently helps. Most my friends say it helps for like a week or so with pain and even DOs admit it's not a fix but it's something. You'll see in your third year that especially in suburban center with low maintenance population, half the battle with making the patient feel better is psychological. Therefore doing anything that includes touching the patient, does no harm and only takes a few minutes is better than the a physician that doesn't even examine the patient.

The bolded is a point that everyone seems to ignore. Heck, when I worked/volunteered in the ED we'd give fluids to a lot of patients that didn't need any kind of treatment. The doc's justification was usually that most people run on the slightly dehydrated side and patients are a lot less likely to complain when you actually do something than if you don't do anything, even when they don't need anything. Plus most OMM just feels good, and patients tend to like you and listen to your medical advice more when they can walk out of your office/clinic feeling better than when they came in.

 

[Winged Scapula]

Weak. Some people are always going to hate any change and have a strong immediate reaction because they take a little longer to adjust to change.


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Eh, there were actually technical issues which we didn't think through/realize before making the change and was causing some trouble so it seemed best to revert until we could get it all figured out. It wasn't just the whining.