Forbes Osteopathic Medicine Article

[DrfluffyMD]

Although i dont believe the same as you here regarding DOs being inferior physicians in MSK Im with you on the topic of @Mad Jack 's poor argument

I don’t believe DOs are inferior physician. I am using an example along the line of mad jack’s argument and apply it to DO vs MD so you can all see how ridiculous it is.

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[Mad Jack]

So along your line of reasoning, what do most DO learn and what most DOs do are different also? Does your post mean it’s ok for me to simply view DOs as inferior physicians with lesser test scores who couldn’t get into med school versus fully train physicians with a unique knowledge and training in MSK conditions (which is what I currently believe)?

DOs learn everything MDs learn, plus OMM. The ones that practice OMM do fellowships in OMM, generally after a full residency (every one I worked with except one was full FM board certified with an additional fellowship in OMM). That's completely different than chiros on every level.

 

[Sephirakra]

Chiropractic spinal manipulation is virtually identical to OMM, yet chiropractic gets trashed-on and OMM is seen as "effective". They are both HVLA. You would have seen the same results with a chiro doing spinal manipulation as you did in the OMM clinic. But, for some reason, because it is OMM and is in reference to DOs people may be more willing to open their eyes as seeing it as providing some sort of function in comparison to chiro. However, other than yourself, who has actually SEEN results from manipulation in the clinic and can give first-hand empirical knowledge on the subject, many of our medical student peers/colleagues/fellow SDNers repeatedly trash talk chiropractic manipulation despite having ANY experience with it at all. The purpose behind OMM and chiropractic manipulation as a safer and more cost effective alternative treatment for low back pain compared to surgery/opioid analgesics is to restore function/mobility within the joint complex, reduce capsular adhesion formation/inflammation and induce articular mechanotransduction via HVLA (essentially a different form of passive mobilization). This CAN be great for some patients as you have seen in the OMM clinic. However, like you also stated it is a lot more difficult to study manipulation from a research perspective because there are so many variables and it would be tough to perform studies in this arena (we do have some but it is not as comprehensively studied as much of the other medical research currently out there). If you take out the supplements and scam artist chiros trying to tell you they can cure your reflux and cancer and tell you that you have to be treated for life, you have chiropractic spinal manipulation (HVLA) which serves virtually the same exact purpose/function as OMM (HVLA). Source: I am a DO student who was previously a licensed chiro, so I have a great deal of background knowledge in manipulation and non-surgical MSK.

P.S. Thank you for your insight into the OMM clinic

Weren't you just accepted to a DO school? Have you even started classes yet? If not, it's fairly disingenuous to portray yourself as one.

 

[cryhavoc]

all chiros licensed in all 50 states can run labs, perform a comprehensive physical exam and order imaging just fyi. It is literally insane how misinformed some people are lol what do people think chiros do pop and pray? lmao they perform a comprehensive phys exam and take a hx just like your medical doctor would they order blood work and imaging (MRI CT Radiographs) when necessary and are trained as such. Ive had a few younger male patients with chronic low back pain present to the clinic as a DC myslef before med school and following taking a comprehensive Hx performing a physical exam and interpreting my own radiographs suspected AS (Ankylosing Spondylitis) I ordered HLA-B27 labs with ESR and CRP and MRI for increased sensitivity for sacroliliitis and based on hx, physical exam, labs and imaging dx them with AS only to refer them to rheumatologists for treatment. This was not common I would see this in practice as AS is not nearly as common as chronic mechanical low back pain but just to make a point here

So their training is equivalent to the 4-8 years a physician has on interpreting the results?

 

[Mad Jack]

Although i dont believe the same as you here regarding DOs being inferior physicians in MSK Im with you on the topic of @Mad Jack 's poor argument

Chiropractors and Immunization

Answers to Questions about Chiropractic

 

[Deecee2DO]

Chiropractors and Immunization

Answers to Questions about Chiropractic

What the heck does Vax have to do with what we are talking about

 

[Mad Jack]

I don’t believe DOs are inferior physician. I am using an example along the line of mad jack’s argument and apply it to DO vs MD so you can all see how ridiculous it is.

I never said anything about test scores or anything else you mentioned. Chiropractors do not practice medicine in any capacity, they practice chiropractic, which you should read about on their very own sites and sources to understand why it is not actually medicine, why they are the core of the antivax movement, and why their practices are often more supplement-shilling businesses that attempt to generate revenue than they are legitimate clinics (what clinic would offer multitreatment discounts? oh right, one that doesn't seem to actually fix problems). Check out chirobase and quackwatch, they do a far better job of explaining what, exactly, is wrong with chiropractic than I can do in a few forum posts.

 

[Deecee2DO]

So their training is equivalent to the 4-8 years a physician has on interpreting the results?

I never said that gosh people are amazing. I said that DCs can run labs and order imaging in response to the poster who said we cant. Its not difficult to interpret lab results for AS as apart of a clinical hx physical exam and order an MRI to r/o sacroiliitis and refer the patient to the proper specialist. Thats called competence. A chiro doesnt need 8 years of post grad training to make these decisions. I wasnt treating the AS patient. This isnt brain surgery here.

 

[Deecee2DO]

I never said anything about test scores or anything else you mentioned. Chiropractors do not practice medicine in any capacity, they practice chiropractic, which you should read about on their very own sites and sources to understand why it is not actually medicine, why they are the core of the antivax movement, and why their practices are often more supplement-shilling businesses that attempt to generate revenue than they are legitimate clinics (what clinic would offer multitreatment discounts? oh right, one that doesn't seem to actually fix problems). Check out chirobase and quackwatch, they do a far better job of explaining what, exactly, is wrong with chiropractic than I can do in a few forum posts.

You are exceptionally ignorant and stubborn for a physician/med student

 

[Deecee2DO]

Weren't you just accepted to a DO school? Have you even started classes yet? If not, it's fairly disingenuous to portray yourself as one.

Sent from my LGUS997 using SDN mobile

An OMS-0 and previous chiro who has a ton of clinical experience practicing with DOs in practice and have a lot of MSK knowledge so as a source on the topic of OMM and HVLA and MSK I know what im talking about. Are any of these people making accusations about what chiro is about previously DCs or having gone through chiro school and DO school? nope

 

[sab3156]

So along your line of reasoning, what do most DO learn and what most DOs do are different also? Does your post mean it’s ok for me to simply view DOs as inferior physicians with lesser test scores who couldn’t get into med school versus fully train physicians with a unique knowledge and training in MSK conditions (which is what I currently believe)?

If I'm going to be real with you, @DrfluffyMD ... 99.99% of DO students are those who did not make it into MD school. There is a theory that OMM is actually God's punishment for those who slacked in college (some other atheist scholars hold the view that OMM is a weed-out tactic developed by the AAMC in conjunction with LCME and ACGME to see if people who couldn't get into MD school actually have the determination to get through a fake science).

 

[Deecee2DO]

So their training is equivalent to the 4-8 years a physician has on interpreting the results?

it doesnt take 8 years to dx AS and refer to a rheum. As a DC i am adequately trained to Dx AS and refer to a rheum.

 

[Mad Jack]

What the heck does Vax have to do with what we are talking about

Because chiropractors have literally cost the lives of children by claiming to be primary care providers and insisting that vaccines aren't necessary. There's also their general love of selling homeopathic and other useless supplements. I might have an axe to grind because one literally nearly killed my friend by insisting he didn't need his gallbladder out, be could just take thousands of dollars worth of supplements and the stones would be gone, encouraging my friend to go against the medical advice of three of his physicians. Fast forward a few months, emergency operation for gangrenous cholecystitis. The chiro board naturally did nothing and claimed the care was adequate. Chiropractic "care" is a joke. I'm sure there are a few ethical chiros out there that believe in mainstream medicine and take their place as adjunct providers for a small subset of musculoskeletal complaints, but they all bill themselves as primary care providers around here that shill alternative medicine and frequently encourage their patients to act against mainstream medical advice, which is very dangerous.

 

[Mad Jack]

An OMS-0 and previous chiro who has a ton of clinical experience practicing with DOs in practice and have a lot of MSK knowledge so as a source on the topic of OMM and HVLA and MSK I know what im talking about. Are any of these people making accusations about what chiro is about previously DCs or having gone through chiro school and DO school? nope

You haven't gone through DO school, you're a premed. OMS-0 is not a thing, it literally is showing off that you're nothing. Once you'e got some actual time under your belt from which you can gauge the inadequacy of your prior education, feel free to compare, but until then you're a chiro premed.

 

[Sephirakra]

An OMS-0 and previous chiro who has a ton of clinical experience practicing with DOs in practice and have a lot of MSK knowledge so as a source on the topic of OMM and HVLA and MSK I know what im talking about. Are any of these people making accusations about what chiro is about previously DCs or having gone through chiro school and DO school? nope

I didn't say jack about the rest of the commenters on here, nor am I questioning your DC credentials. It's just that I'm also an OMS-0, which is to say, not yet a med student. I'm excited for both of us going forward! Don't put the cart before the horse, buddy.

 

[Deecee2DO]

You haven't gone through DO school, you're a premed. OMS-0 is not a thing, it literally is showing off that you're nothing. Once you'e got some actual time under your belt from which you can gauge the inadequacy of your prior education, feel free to compare, but until then you're a chiro premed.

You have no place to give info about chiro. Zero. You have no experience in that category

 

[Deecee2DO]

You haven't gone through DO school, you're a premed. OMS-0 is not a thing, it literally is showing off that you're nothing. Once you'e got some actual time under your belt from which you can gauge the inadequacy of your prior education, feel free to compare, but until then you're a chiro premed.

Hahaha in MSK yes my education in this category is on par with current DO students and my clinical competency in this arena far surpasses OMS-1s and 2s, as a DC. in other aspects of medicine (path pharm immuno cards GI etc)? absolutely not, not even close: a DO student would far surpass me in these categorys.

 

[Mad Jack]

You have no place to give info about chiro. Zero. You have no experience in that category

I have a medical education. I have enough of a base in the science of medicine to judge any treatment modality. Doctors set the bar for what is medicine, everyone else is a second-class citizen or worse. I have researched chiropractic and found it wanting at best and dangerous at worst. I also like how you have failed to address the dangerous and useless profit-motivated aspects of chiropractic practice (miseducation about vaccines, homeopathy, useless supplement hawking, etc).

Hahaha in MSK yes my education in this category is on par with current DO students and my clinical competency in this arena far surpasses OMS-1s and 2s, as a DC. in other aspects of medicine (path pharm immuno cards GI etc)? absolutely not, not even close: a DO student would far surpass me in these categorys.

You might be surprised at just how in-depth our MSK education is. The school I attended had an anatomy department that was the focus of the first year and three months of school, with a neuroanatomy department that was second to none. Just because MSK is the majority of what chiros do doesn't mean that they necessarily are better at it than anyone else, it just means they spend a lot of time on something (and have the potential to be less efficient with that time due to the lesser degree of other material they have to learn).

 

[AnatomyGrey12]

I can count on one hand how many ethical chiropractors I’ve met who simply stick to MSK issues and don’t have any sort of agenda. The majority around where I’m from put on these quack hypothyroid treatment commercials encouraging people to come see their “chiropractic physicians.”

Lol one even told my father in law they could “cure” his Menieres.... uh yeah ok....

Not to mention the other one who was doing cervical HVLA on my post MVA family member.. now I might be a lowly DO student and not have the all powerful MSK knowledge of a DC but I’m 100% confident that recent trauma is a massive contraindication for that treatment

Or the other one who did adjustments on a friend’s baby because “vaccines are bad” and “routine adjustments will prevent him from getting these diseases vaccines supposedly protect against” and “you can’t get autism from adjustments.”

 

[Mad Jack]

I can count on one hand how many ethical chiropractors I’ve met who simply stick to MSK issues and don’t have any sort of agenda. The majority around where I’m from put on these quack hypothyroid treatment commercials encouraging people to come see their “chiropractic physicians.”

Lol one even told my father in law they could “cure” his Menieres.... uh yeah ok....

Not to mention the other one who was doing cervical HVLA on my post MVA family member.. now I might be a lowly DO student and not have the all powerful MSK knowledge of a DC but I’m 100% confident that recent trauma is a massive contraindication for that treatment

Or the other one who did adjustments on a friend’s baby because “vaccines are bad” and “routine adjustments will prevent him from getting these diseases vaccines supposedly protect against” and “you can’t get autism from adjustments.”

Our DC friend hasn't spoken out about any of the unethical or dangerous practices engaged in by a great number of chiros, which I find pretty revealing. If you aren't willing to call out the unethical/unsafe practices of your field, you're basically an accomplice.

 

[libertyyne]

1. Subluxations do not exist.
2. A majority of students surveyed in 2015 indicated "A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes." Chiropractic identity, role and future: a survey of North American chiropractic students This is not even including old chiropractors that have spent a lifetime treating subluxations and are unlikely to move away from that.
3. A large portion of State laws state that Chiropractors are licensed to treat "subluxations" . Such a thing doesnt exist, might as well be licensed to hunt unicorns, or perform dinosaur organ transplants.
4. Chiropractors more so than other health professionals tend to be anti-vaccine Are Chiropractors Backing The Anti-Vaccine Movement?
5. Chiropractic treatment is not better than standard of care for back pain and neck pain. (The only two areas where there is evidence to indicate it is useful at all)
6. The plural of anecdote is not Data. I am sure there is a similar amount of "data" to support homeopathy which is completely bunk.
7. Chiropracty is not without risk, strokes are a known complication for cervical work they do, but they tend to gloss over that.
8. Chiropractic benefits are overstated and the large studies indicate no benefit over standard of care.

• A 2011 Cochrane Systematic Review of spinal manipulative therapy for chronic low-back pain reported that “High-quality evidence suggests that there is no clinically relevant difference between SMT [spinal manipulative therapy] and other interventions for reducing pain and improving function in patients with chronic back pain”.
• A 2013 Cochrane review of spinal manipulative therapy for acute low-back pain concluded that “SMT is no more effective for acute low back pain than inert interventions, sham SMT or as an adjunct therapy. SMT also seems to be no better than other recommended therapies. Our evaluation is limited by the few numbers of studies; therefore, future research is likely to have an important impact on these estimates.”

You read that right, no better than SHAM!

• A 2012 National Center for Complementary and Alternative Medicine review of back-pain studies reported that “Overall, studies have shown that spinal manipulation is one of several options─including exercise, massage, and physical therapy─that can provide mild-to-moderate relief from low-back pain. Spinal manipulation also appears to work as well as conventional treatments such as applying heat, using a firm mattress, and taking pain-relieving medications.”
• https://sciencebasedmedicine.org/ch...manipulation-red-flags-a-comprehensive-review

In a world where chiropracters as a bunch cant stop teaching and practicing subluxation based medicine, and the paucity of evidence supporting its use over standard of care, Coupled with other crazy quackery and anti vax attitudes there is no reason to ever send a patient to chiropractic care. I would rather send my patients to a physical therapist.

Show me an honest chiropracter who practices according to their scope of practice and I will show you 2 dozen ones making outrageous claims.

 

[freak7]

1. Subluxations do not exist.
2. A majority of students surveyed in 2015 indicated "A majority agreed (35.6%) or strongly agreed (25.8%) the emphasis of chiropractic intervention is to eliminate vertebral subluxations/vertebral subluxation complexes." Chiropractic identity, role and future: a survey of North American chiropractic students This is not even including old chiropractors that have spent a lifetime treating subluxations and are unlikely to move away from that.
3. A large portion of State laws state that Chiropractors are licensed to treat "subluxations" . Such a thing doesnt exist, might as well be licensed to hunt unicorns, or perform dinosaur organ transplants.
4. Chiropractors more so than other health professionals tend to be anti-vaccine Are Chiropractors Backing The Anti-Vaccine Movement?
5. Chiropractic treatment is not better than standard of care for back pain and neck pain. (The only two areas where there is evidence to indicate it is useful at all)
6. The plural of anecdote is not Data. I am sure there is a similar amount of "data" to support homeopathy which is completely bunk.
7. Chiropracty is not without risk, strokes are a known complication for cervical work they do, but they tend to gloss over that.
8. Chiropractic benefits are overstated and the large studies indicate no benefit over standard of care.

• A 2011 Cochrane Systematic Review of spinal manipulative therapy for chronic low-back pain reported that “High-quality evidence suggests that there is no clinically relevant difference between SMT [spinal manipulative therapy] and other interventions for reducing pain and improving function in patients with chronic back pain”.
• A 2013 Cochrane review of spinal manipulative therapy for acute low-back pain concluded that “SMT is no more effective for acute low back pain than inert interventions, sham SMT or as an adjunct therapy. SMT also seems to be no better than other recommended therapies. Our evaluation is limited by the few numbers of studies; therefore, future research is likely to have an important impact on these estimates.”

You read that right, no better than SHAM!

• A 2012 National Center for Complementary and Alternative Medicine review of back-pain studies reported that “Overall, studies have shown that spinal manipulation is one of several options─including exercise, massage, and physical therapy─that can provide mild-to-moderate relief from low-back pain. Spinal manipulation also appears to work as well as conventional treatments such as applying heat, using a firm mattress, and taking pain-relieving medications.”
• https://sciencebasedmedicine.org/ch...manipulation-red-flags-a-comprehensive-review

In a world where chiropracters as a bunch cant stop teaching and practicing subluxation based medicine, and the paucity of evidence supporting its use over standard of care, Coupled with other crazy quackery and anti vax attitudes there is no reason to ever send a patient to chiropractic care. I would rather send my patients to a physical therapist.

Show me an honest chiropracter who practices according to their scope of practice and I will show you 2 dozen ones making outrageous claims.

Sir, did you drop this?

 

[sab3156]

Can we all just unite under a pact that in the future when we are practicing physicians, we will lobby for an end to the teaching of OMM in a medical school setting? Thanks.

 

[libertyyne]

Can we all just unite under a pact that in the future when we are practicing physicians, we will lobby for an end to the teaching of OMM in a medical school setting? Thanks.

Most of omm should be in a museum.

 

[BorntobeDO?]

I remember when I was interviewing at NSU and they had the little museum at the front. It straight up had a 'book of quackery' right there from 1895 I believe. It was pretty hard not to laugh. I mean how can you take it seriously when its roots are clear? But then again not all OMM is quackery tho.

 

[W19]

Chiro are out of control in FL... They are sending their own people out on the street to provoke car accidents. I know there are bad apples in every profession, but the bad apples in this profession are more than the good ones in FL. I certainly hope that things are different in other US states. My car insurance premium has increased dramatically in the last 5+ years because of these people and some other people who are driving without insurance...

 

[libertyyne]

Remove some of the bizarre stuff from OMM, agreed. But I don't see why it couldn't still be taught as elective for those interested.

Could you please list an indication and technique that is evidence based? I would like to see the data myself to see if there is a baby in this bathwater.

 

[Chibucks15]

Could you please list an indication and technique that is evidence based? I would like to see the data myself to see if there is a baby in this bathwater.

Eh a lot of it is voodoo but having been a patient before I even knew what OMM was it definitely works for the MSK stuff. And anything that works for at least some pain as an alternative to opioids is worth pursuing in my book. Even if you rarely use it it could be helpful to stem the tide of the epidemic currently. I'm talking more muscle energy/low velocity stuff not the crazy subluxation treatments from chiros

 

[libertyyne]

Eh a lot of it is voodoo but having been a patient before I even knew what OMM was it definitely works for the MSK stuff. And anything that works for at least some pain as an alternative to opioids is worth pursuing in my book. Even if you rarely use it it could be helpful to stem the tide of the epidemic currently. I'm talking more muscle energy/low velocity stuff not the crazy subluxation treatments from chiros

Osteopathy for musculoskeletal pain patients: a systematic review of randomized controlled trials

That's the best I could find for musculoskeletal stuff for omt. It says the randomized control trials showed no efficacy.

I mean it's only a viable option if it works.

 

[Chibucks15]

Osteopathy for musculoskeletal pain patients: a systematic review of randomized controlled trials

That's the best I could find for musculoskeletal stuff for omt. It says the randomized control trials showed no efficacy.

I mean it's only a viable option if it works.

I don't disagree...and anecdotal evidence doesn't support it enough I'm aware. I'm just saying I was helped by it. Who knows why. But like I said, anything to stem the opioid crisis is worth trying. I do wish there would be actual studies but that's the problem is pain is so subjective and a lot of OMM isn't really measurable (at least not to my knowledge). Cranial and lymphatic pumping and that is questionable to say the least I'm simply talking basic MSK manipulations aren't that far out of the realm of possibility of helping

 

[sab3156]

Osteopathy for musculoskeletal pain patients: a systematic review of randomized controlled trials

That's the best I could find for musculoskeletal stuff for omt. It says the randomized control trials showed no efficacy.

I mean it's only a viable option if it works.

Thanks for posting that review. I agree with you - it's all without any evidence, and for insurance companies to pay for any of it is ridiculous. Sure, stretching and massaging makes people feel better for a little bit. That doesn't make it viable medical treatment.

I'm simply talking basic MSK manipulations aren't that far out of the realm of possibility of helping

That is not a reason to keep teaching that stuff in medical school. Should we teach Kama Sutra in medical school, as well?

 

[Chibucks15]

Thanks for posting that review. I agree with you - it's all without any evidence, and for insurance companies to pay for any of it is ridiculous. Sure, stretching and massaging makes people feel better for a little bit. That doesn't make it viable medical treatment.




That is not a reason to keep teaching that stuff in medical school. Should we teach Kama Sutra in medical school, as well?

Whatever man I'm just saying if it can help people not overdose on opioids I'm in on it (for some things). There really isn't a need to act all high and mighty about it. Thank god everyone on here has you to show us the way oh wise one

 

[libertyyne]

the msk stuff is without evidence? so you think pt is without evidence? i guess you'll be the only physician ever who doesn't refer a pt to physical therapy.

Maybe read the study. It is only about omt techniques.

 

[Chibucks15]

Maybe read the study. It is only about omt techniques.

It's behind a pay wall. I get that it isn't 100% proven. I'm with you in saying a good chunk of it needs to go. But if there is any chance at MSK stuff (the only things I deem plausible) working even slightly to decrease the public's dependence on highly addictive medication that's an epidemic in this country I see no reason why to not move forward with it. Especially when there really isn't any adverse effects. I'm no OMM apologist but I see value in that. We can agree to disagree

 

[libertyyne]

omt msk is pt msk. i went to pt school homeslice. same damn stuff, different names.

and, he said "Its all without evidence." meaning, in the context he quoted and given the fact that the msk in omt is the same damn **** as pt, that he wont be referring to pt.

or perhpas you both should understand the non-difference before you speak without knowing.

Maybe post some evidence to back it up. I have posted a peer reviewed journal article that says omt is equal to placebo for msk. This was a systematic review that looked at randomized control trials.

 

[libertyyne]

post some evidence that pt has has evidence?....

some battles aren't worth battling. you sound intelligent enough to figure that **** out on your own there buddy.

Lol. Maybe stop making claims that omt is efficacious for msk issues then . Simple. I am sorry you have to learn psuedoscience in DO school, but it doesn't become efficacious if you keep on saying it.

 

[sab3156]

It's behind a pay wall. I get that it isn't 100% proven. I'm with you in saying a good chunk of it needs to go. But if there is any chance at MSK stuff (the only things I deem plausible) working even slightly to decrease the public's dependence on highly addictive medication that's an epidemic in this country I see no reason why to not move forward with it. Especially when there really isn't any adverse effects. I'm no OMM apologist but I see value in that. We can agree to disagree

Simply "thinking" that the MSK stuff works isn't a valid reason to believe in its efficacy or to continue teaching it in a medical school setting. I'm not interested in your feelings and what your gut is telling you. I'm interested in the scientific research.

There really isn't a need to act all high and mighty about it. Thank god everyone on here has you to show us the way oh wise one

Ad hominem attacks do nothing to increase the validity of your argument.

 

[Chibucks15]

Simply "thinking" that the MSK stuff works isn't a valid reason to believe in its efficacy or to continue teaching it in a medical school setting. I'm not interested in your feelings and what your gut is telling you. I'm interested in the scientific research.



Ad hominem attacks do nothing to increase the validity of your argument.

I'm just stating my opinion on why I am interested in learning it in my medical school setting. If you both hate it so much then I suggest attending an MD school. It was your choice to attend a DO school and now you have to learn in the setting you signed up for. I see no benefits for you or anyone else trying to rail against a system that you made the choice to get into. I am in no way arguing I am simply stating my opinion on the possibility certain treatments can lessen reliance on opioids. Never presented it as scientific fact, acknowledged my evidence as purely anecdotal, have said I wished there were studies on it, and as I said in my last post, we can agree to disagree.

 

[cryhavoc]

Lol. Maybe stop making claims that omt is efficacious for msk issues then . Simple. I am sorry you have to learn psuedoscience in DO school, but it doesn't become efficacious if you keep on saying it.

So all the patients I regularly interact with who rave about how OMT changed their lives and how miserable they were with their chronic pain are paid actors? I’m not even going into an OMT-focused speciality so I’m not defending it for my own use. And I was the biggest skeptic.

I don’t argue with results. I regularly learn about hundreds of drugs that barely correct an issue and are straddled with dozens of nasty side effects I have to memorize. It is like trading one disease for a pharmaceutical disease.

Just because it was slightly more effective than a placebo doesn’t impress me.

OMT doesn’t have big pharmaceutical companies funding intensive research. Because it is cheap, easy, and quick. No money to be made. And the designing of research studies for a subject like OMT is a minefield. Because every patient is different and responds to different things.

We know certain medications are better for certain people. The best medicine in the future will tailor drugs via genetics. Is it really so crazy to think people respond differently to different types of physical therapy?

Now try to design a research paper with that in mind. It is a nightmare AND there is no money to be made.

 

[libertyyne]

So all the patients I regularly interact with who rave about how OMT changed their lives and how miserable they were with their chronic pain are paid actors? I’m not even going into an OMT-focused speciality so I’m not defending it for my own use. And I was the biggest skeptic.

I don’t argue with results. I regularly learn about hundreds of drugs that barely correct an issue and are straddled with dozens of nasty side effects I have to memorize. It is like trading one disease for a pharmaceutical disease.

Just because it was slightly more effective than a placebo doesn’t impress me.

OMT doesn’t have big pharmaceutical companies funding intensive research. Because it is cheap, easy, and quick. No money to be made. And the designing of research studies for a subject like OMT is a minefield. Because every patient is different and responds to different things.

We know certain medications are better for certain people. The best medicine in the future will tailor drugs via genetics. Is it really so crazy to think people respond differently to different types of physical therapy?

Now try to design a research paper with that in mind. It is a nightmare AND there is no money to be made.

Testimony is literally what homeopaths , chiropractors, magnet healers, faith healers hang their hats on.
The plural of anecdote is not data.

Blaming big pharma is also another common trait of people who have no evidence.

Lack of standardization and lack of agreement among experts is also a hallmark of pseudoscience.

OMM has had over 100 years , still cant show clear superiority to standard of care or sham in good quality studies.

 

[cryhavoc]

Testimony is literally what homeopaths , chiropractors, magnet healers, faith healers hang their hats on.
The plural of anecdote is not data.

Blaming big pharma is also another common trait of people who have no evidence.

Lack of standardization and lack of agreement among experts is also a hallmark of pseudoscience.

OMM has had over 100 years , still cant show clear superiority to standard of care or sham in good quality studies.

But neither can surgery or medication for many of these same complaints, like back pain. So what do you tell them? Too bad?

Doctors are healers first and scientists second. It is your number one priority as a physician to alleviate your patient’s suffering if you can, not publish a research paper. If I thought their religion could also help a particular patient, I’d be sure to suggest it to them too. It isn’t my job to prove why things such as physical therapy and a people’s faith help people with their chronic pain, it is my job to help my patient.

Of course, if there are treatments I think the patient could benefit from with proven success, they would also be a part of the plan. Which is what separates us from the snake oil salesmen, we have a lot more tools. And a willingness to coordinate.

I thought holistic medicine was commonly practiced by all physicians these days? Would you really not recommend alternative medicine that the patient feels is working when conventional medicine fails, provided the alternative did not damage the patient’s health?

Seems like a no-brainer to me with no downsides. At least until a better solution is invented, if that ever happens.

 

[Osminog]

Doctors are healers first and scientists second.

Doctors are healers and scientists first. If a doctor's healing practices aren't informed by science at their core, then he cannot be a competent physician.

If you approach an average surgeon and ask him about a certain procedure, he will be able to explain the physiological/biochemical mechanisms underlying the effectiveness of the procedure -- and these explanations will be well-grounded in the scientific literature. (Perhaps there will be elements of the procedure that are based solely on his experience or "gut," but the core of it will still be scientific.)

If you approach a homeopath and ask him about his "healing" practices, he will share some pseudo-scientific concepts (e.g., "water memory"), relay a few feel-good anecdotes, and then tell you that the science simply hasn't advanced enough to fully appreciate his approach.

At this stage in the game, OMM practitioners seem to more closely resemble the homeopath than the surgeon in a lot of respects.

 

[cryhavoc]

Doctors are healers and scientists first. If a doctor's healing practices aren't informed by science at their core, then he cannot be a competent physician.

If you approach an average surgeon and ask him about a certain procedure, he will be able to explain the physiological/biochemical mechanisms underlying the effectiveness of the procedure -- and these explanations will be well-grounded in the scientific literature. (Perhaps there will be elements of the procedure that are based solely on his experience or "gut," but the core of it will still be scientific.)

If you approach a homeopath and ask him about his "healing" practices, he will share some pseudo-scientific concepts (e.g., "water memory"), relay a few feel-good anecdotes, and then tell you that the science simply hasn't advanced enough to fully appreciate his approach.

At this stage in the game, OMM practitioners seem to more closely resemble the homeopath than the surgeon in a lot of respects.

I refute that.

I want you to refer to all the medications with an unknown mechanism with several theories on how they “might work” that are commonly used in Western medicine and get back to me. These are not herbals but for many serious illnesses like autoimmune problems and cancer.

Almost all of psychology and psychiatry is unproven and mysterious. Because the science is new and hard to quantify, do we assume there is no hope and don’t help people with mental illness? No.

You can fill a thimble with the amount of psychology you can prove with a legitimate scientific study. All theories.

Humans are incredibly complicated and unique individuals and the scientific method studies the average. It is incapable of encapsulating humans perfectly.

I hold my position that a doctor is a healer first and a scientist second. There is a vast ocean of debate on the topic but many hold that a doctor is a clinician, and not a scientist. Science is a tool they use, not the root of their profession.

There are many situations when statistics and evidence-based medicine pays off and that is when it should be used. Like the procedure for strokes and heart attacks. And just as many situations that cannot be cookie-cut and require less rigid methods. Because human are individuals and can vary greatly between each other.

 

[libertyyne]

But neither can surgery or medication for many of these same complaints, like back pain. So what do you tell them? Too bad?

Doctors are healers first and scientists second. It is your number one priority as a physician to alleviate your patient’s suffering if you can, not publish a research paper. If I thought their religion could also help a particular patient, I’d be sure to suggest it to them too. It isn’t my job to prove why things such as physical therapy and a people’s faith help people with their chronic pain, it is my job to help my patient.

Of course, if there are treatments I think the patient could benefit from with proven success, they would also be a part of the plan. Which is what separates us from the snake oil salesmen, we have a lot more tools. And a willingness to coordinate.

I thought holistic medicine was commonly practiced by all physicians these days? Would you really not recommend alternative medicine that the patient feels is working when conventional medicine fails, provided the alternative did not damage the patient’s health?

Seems like a no-brainer to me with no downsides. At least until a better solution is invented, if that ever happens.

If the evidence shows that it is no more efficacious than placebo, it is IMO unethical to knowingly send a patient to get a placebo treatment.

 

[cryhavoc]

If the evidence shows that it is no more efficacious than placebo, it is IMO unethical to knowingly send a patient to get a placebo treatment.

I don’t view it as a placebo, I disagree with the design of the study. It tries to standardize something that is organic. Which is not how OMT is practiced. Thus the false version implemented for the sake of the study is placebo, actual OMT may or may not be. Because it is impossible to design a study that objectively studies a treatment that varies on an individual level with individual situations and injuries.

Could you imagine? This particular treatment only works on 47 year old waitress who worked on a farm as a kid and have these genetics markers and this particular psychology? You could never find studies of that nature.

You may want a “cure all” but cure alls just don’t exist.

Not every injury is the same. Not every patient is the same age or been through the same physical events in life. Every body is different. Thus you could never gather a sample size that allows you to definitely perform the same technique on the same type of person.

I view it like psychology. Does not mean it is illegitimate, it means that you cannot study it in such a manner.

And as it helps alleviate the problem, I view it as a legitimate course of action.

 

[AnatomyGrey12]

If you approach an average surgeon and ask him about a certain procedure, he will be able to explain the physiological/biochemical mechanisms underlying the effectiveness of the procedure -- and these explanations will be well-grounded in the scientific literature

Wrong. Just wait until you see how much “research” there is behind a lot of what is done in modern medicine. There are numerous surgical procedures that are done on a daily basis across the country that studies have shown to be essentially worthless.

If the evidence shows that it is no more efficacious than placebo, it is IMO unethical to knowingly send a patient to get a placebo treatment.

Lol really? Even if there is a chance it actually helps them feel better? We’re not talking placebo herbal supplements for cancer here, we are talking 5 minutes of manual therapy that could potentially keep a patient off opioids or from having major surgery.

 

[libertyyne]

I don’t view it as a placebo, I disagree with the design of the study. It tries to standardize something that is organic. Which is not how OMT is practiced. Thus the false version implemented for the sake of the study is placebo, actual OMT may or may not be. Because it is impossible to design a study that objectively studies a treatment that varies on an individual level with individual situations and injuries.

Not every injury is the same. Not every patient is the same age or been through the same physical events in life. Every body is different. Thus you could never gather a sample size that allows you to definitely perform the same technique on the same type of person.

I view it like psychology. Does not mean it is illegitimate, it means that you cannot study it in such a manner.

This is kind of the hallmark of psuedoscience. Two practioners do not agree on treatment, have differing modalities that they use, Cant agree upon standardized protocols to check for efficacy.

 

[libertyyne]

Wrong. Just wait until you see how much “research” there is behind a lot of what is done in modern medicine. There are numerous surgical procedures that are done on a daily basis across the country that studies have shown to be essentially worthless.



Lol really? Even if there is a chance it actually helps them feel better? We’re not talking placebo herbal supplements for cancer here, we are talking 5 minutes of manual therapy that could potentially keep a patient off opioids or from having major surgery.

If there studies indicating it doesnt work better than placebo, How is doing it to your patients not a performance of placebo?

 

[Osminog]

I don’t view it as a placebo, I disagree with the design of the study. It tries to standardize something that is organic. Which is not how OMT is practiced. Thus the false version implemented for the sake of the study is placebo, actual OMT may or may not be. Because it is impossible to design a study that objectively studies a treatment that varies on an individual level with individual situations and injuries.

Could you imagine? This particular treatment only works on 47 year old waitress who worked on a farm as a kid and have these genetics markers and this particular psychology? You could never find studies of that nature.

You may want a “cure all” but cure alls just don’t exist.

Not every injury is the same. Not every patient is the same age or been through the same physical events in life. Every body is different. Thus you could never gather a sample size that allows you to definitely perform the same technique on the same type of person.

I view it like psychology. Does not mean it is illegitimate, it means that you cannot study it in such a manner.

And as it helps alleviate the problem, I view it as a legitimate course of action.

How do you feel about homeopathy?

 

[cryhavoc]

This is kind of the hallmark of psuedoscience. Two practioners do not agree on treatment, have differing modalities that they use, Cant agree upon standardized protocols to check for efficacy.

Pseudoscience claims to use the scientific method. I do not think the scientific method could encapsulate something so organic and individualized. You sound like people discussing psychology in the 18th century. Mental illness exists. Pain exists. Sorry people aren’t so easy to study.