Greetings from Down Under

[Ozteo_Ben]

Hey there Everyone!

Just thought i would say hi! It's exciting how big osteopathy is in the states in comparision to Australia. I am amazed!

Just a little about myself.. I am a 2nd year osteopathic student at the University of Western sydney in Australia.

There are so much I would like to learn about the American Osteopathy. Love to hear from anyone!

yours in good health! (oh boy isn't that lame )

Ozteo_Ben

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[DO DUDE]

Hi,

What practice rights do 'osteopaths' have in Australia? I heard they were similar to chiropractors in the U.S.

 

[Henry]

Hi Ozteo Ben,

In US, we don't use the word "Osteopathy" very much. Instead, "Osteopathic medicine" is the term we use to describe our profession. This is because, in the US, being a DO requires to attend 4 years of medical school training plus several years of post-doc. residency training in the hospital.

DO in the US are allow to practice medicine and OMT.

 

[Ozteo_Ben]

G'day guys,

Do dude,

'Osteopaths' in Australia, as you have guessed.. basically have rights similar to that of chiropractors. We are regarded as an alternative form of therapy.

Henry, I am very aware of the utilisation of the term "osteopathic medicine" instead of osteopathy in the states. Since that all of our textbooks or the majority of them are American. Such as Greenman, Digiovanna and Ward (AOA bible). Where do OMT and osteopathic diagnosis fit into your curriculum? Osteopathic medicine is a very much hands on profession, don't you agree? How do DO schools differ form that of MDs? We have osteopathic practicals since day 1, do you also have such training??

 

[UHS2002]

Hi Ozteo Ben

the major difference between MD and DO med schools in the US has traditionally been the concentration on primary care/ clinical medicine at the DO schools vs. more emphasis on research at MD institutions. This is changing though, to a small degree, as more and more DO institutions are developing research programs. It will never get to the same degree as the MD institutions, because the osteopathic profession is much smaller (read "less funded" too)and there are some philosophical differences between the professions (I know nobody wants to hear it).

The only day to day difference I see in my education, from the education my friends at MD schools are getting, is that we have osteopathic manipulation lectures and labs. On a more subtle level, I could say that there is a difference in the philosophy of practice we are slowly being "indoctrinated" into, but this is really opening a can of worms on this forum.

As you are well aware, osteopathic physicians in the US have full practice rights. I like that because we are being taught that manipulations is good for some conditions but we are also being taught to recognize when manipulation would not be at all helpfull and the place of pharmacological and surgical intervention in the management of a patient.By being skilled in diferent therapeutic modalities, we can diagnose a condition, perform manipulation as appropriate, and still send the patient out the door with a prescription if this is indicated too. For me, that is the great attraction of osteopathic medicine in the US.

I don't think, right now, that manipulation will have a proeminent part in my practice, although I do plan to use some of it, and I already do so on some of my friends and family (at their request). One of my professors said that being an osteopathic physician is not all about manipulation, that one can be an osteopathic physician and never use manipulation in his or her practice (he gave the example of a radiologist). It is more a matter of how one sees things.

 

[Henry]

I think USH2002 has given a good summary for the difference between MD and DO school.

Since I am not very familiar to other DO school program, I can only share about my own program.

We learn about OMT at the very begining of our medical school training. My school will introduce almost all the OMT in the first year, so we will have the background for the second year. Second year is mainly about how to apply OMT in different systems, diseases and disorder.

The hands on training in OMT is during the rotation years. Besides, I am planing to spend a rotation in OMT. Hopefully, I can learn enough to intergrate OMT in my future practice.

I also want to invite other DO students to share about their program and their experience in OMT here.

 

[OzOsteoStudnet]

G'day Ben,
I am at UWS as well.

Mate what i do not understand is why your first reply found it his duty to suggest the seppo osteo's are more qualified!

Here is the cat amongst the pigeons....

Why do the americans have to do med?
Isn't that going against the suggestions of Dr Gravett (Sec AMA 1919-21) who suggested that the difference between allopathic and osteopathic medicine are so great that no one can be both!

Lets Discuss this........

 

[NickCVM]

just like you said, that was in 1919-21 - Today, it's 1999.
things change .. for the better I hope.
--Nicolas--
WesternU'03

 

[Ozteo_Ben]

I hope you guys won't be offended by this msg but rather to be open minded and consider what I have to say objectively.
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I have now been conversing with American osteopaths and students for the past 3 or 4 days. It seems that the definition or the comprehension of the philosophies of Osteopathic medicine is quite obscured. Although there are many strength and weaknesses in having equal medical training for both Orthodox and osteopathic students, ppl I have been conversing with tend to shy away from the practices of manipulation and OMT. Perhaps, becoming a GP and having 15 mins consultations per patient is where the big bucks are. But quoting one physician, "We are in the people's business", aren't we suppose to make a difference? Instead of obscuring ourselves with allopathic practices? Money is important in our materialistic society but it isn't the be all, end all of everything. In my opinion, it is especially lethal in the health professions. What about ppl's passion? And love for what they do? I have too often see friends or ppl enrolled into med school, not because they were suitable, they want to be doctors, or want to help ppl. But because it is considered to be prestigious and a respectful profession, with its god-like status. In addition, money. For the love of god, some of them even cringe at the thoughts of some old lady coming thru the door with her never-ending list of complaints.

At first, I was intrigued and fascinated by the US osteopathic medicine. And was considering furthering my Osteopathic knowledge by studying in the US uponn the completion of my Australian degree. However, it is disappointing to note that many see osteopathy as a 2nd rated medical degree and a way of "getting the foot in the door". This attitude is the last thing we need in our profession.

I apologise for this bitter email but over the past few days, the conversations I have had made me think about where our profession is going. Sadly, this is truly how I perceive the Amercian osteopathic medicine..

PS I am also puzzled by the fact that many of you despise the term "Osteopaths"... I am sorry but I just find it hard to understand why.

 

[Ozteo_Ben]

OzsteoStudent,

I am sorry.. but I had trouble understanding what u were trying to say in your msg. Assuming that it was directed to me.. "Mate what i do not understand is why your first reply found it his duty to suggest the seppo osteo's are more qualified!"

Are u in first year? Who r u?

U'll be better off, posting your new topic on Premeds. Then, more ppl can see it and you can be notified if someone posts a reply.

Ben

 

[summerb]

Ozteo_Ben,

I understand your bitterness about the probable future of osteopathy, but I have a slightly different opinion of it. I completely agree that American Osteopathy has really lost a lot of the values that were emphasized in the past. But I see a definite benefit in having full practice rights, for although many MD's practice like DO's, and many DO's practice like MD's, an Osteopathic Medical school does give us the tools necessary to be the doctor that you describe (in terms of hands on treatments), plus being able to combine that with "allopathic" (whatever that term means) treatments. Many may not choose to do so, but at least the training is there. Every doctor is an individual and has to choose his own method of practice, whether I agree with his/her tactics or not. It is sad that we're losing a lot of the osteopathic philosophy and methods, and if I had it my way, all U.S. DO's would at least promise OMT, or knowledge thereof. That's not how it has progressed, but I certainly don't think that what we've become is a bad thing. It may not be the perfect depiction of the osteopaths of the 1920's, but DO's are still good doctors, just as MD's are. The issue of a doc-in-the-box having only 15 minutes per patient really isn't an osteopath vs. allopath dilemma. It's a general American health care problem, and many doctors nowadays, no matter how much money they care or don't care to make, have to do this in order to stay employed by an HMO, PPO, etc.

As for the DO degree being a 2nd rate degree, this is what I've gathered from this forum and from my interactions with some DO's. The prejudice is there with premeds and medical students, and with a few random, egotistical, success oriented, or uninformed doctors. Most of the medical profession doesn't look at it that way, however, for they judge doctors by their performance. As for the general public, they rarely know what initials follow their doctors name, so it's generally not a concern.

 

[Ozteo_Ben]

SummerB,

I cannot express how glad I was to get a response from someone who cares about our Profession. You are about one of the 3 out of 25 ppl I have spoken who cares.

I agree with you totally in having complete practice rigths for osteopaths. Fundamentally, this concept is ideal. However, from what I have gathered from here and the studentDOctor mailing list, the DO schools are the ones who have to get their acts together. It is not going to do our profession much good by accepting applicants who see osteopathic medicine as a backdoor/shortcut entrance into allopathic medicine. DO schools would need to weed/filter out these ppl to preserve the integrity of our profession. Futhermore, saving potential places for perspective students. Perhaps, in having students with high MCAT?? marks increases the school's profile and consequently, its reputation? Therefore, the dedication to the profession may not be as important? It's sad that applicants are selected even if they have the predetermined prejudice of not using OMT in their future practices prior to acceptance.

summerb, what is the average consultation time in the states? In australia, the average is about 45min and 90mins for the initial visit. By consultation, I mean time allocated for general consultation plus OMT.

Moreover, u have mentioned about DOs being employed by HMO and PPO, who are they? Medical insurance companies? Or corporate medical centres? Would u care to briefly explain the American Medical system. From what I have gathered, which could be wrong, is that there is no government funded Medical system but citizens are encouraged to take out medical insurances?

 

[drusso]

The practice patterns among DO's differ enormously in the USA. Among DO's who are Osteopathic Manipulative Medicine specialists, the consultations times are similar (though somewhat shorter) than the ones you describe. For DO's who do mostly GP (or as we say in the USA "primary care") it's more along the lines of 15-20 minutes. However, there are many DO's who do primary care 3-4 days a week and all OMM another day. This allows them to spend more time with patients and truly practice "osteopathically." There are also many DO's who do no OMM at all.

I appreciate your criticism of American osteopathic practice patterns, but I think you've got appreciate that most American MD's cannot think of musculoskeletal problems outside of a knee-jerk prescription for pain medication. On the other hand, any American DO worth his or her salt can *at least* treat acute problems with OMM before resorting to pain medication to just cover up symptoms.

For instance, I saw a patient yesterday who is a 42 year old woman presenting to the clinic for routine diabetes care. She's also noticed exacerbation of some chronic low back pain that she's been having. So much so that recently when she tried to bend over she almost "got stuck." Another student and I reviewed her diabetes situation, increased the dose of her glucophage (with our attending's oversight, review, and consultation of course), praised her for positive changes she's made in diet and exercise, and then did a "quickie" osteopathic structural exam. She was non-neutral at L4-L5 and also had some complex sacral mechanics going on too. Her paraspinal muscles were taut with substantial "ropiness" and tissue texture changes, not to mention several tender points in sacral and gluteal areas. Myself and the other student did soft tissue treatment, a "lumbar roll", some indirect sacrum treatments with respiratory force/cooperation, and Jones Strain/Counterstrain for her gluteal tenderpoints. We taught her some stretches she could do at home as well as how to properly lift heavy items at work.

She experienced immediate relief of most of her low back pain symptoms and was tremendously grateful for our efforts. We spent 15 minutes on diabetes and probably 25 minutes on her low back pain.

Bottom line: This is not the kind of care she could have gotten from a majority of MD's in the USA. The MD's would have likely addressed her diabetes issues only and prescribed NSAIDs for her pain--maybe hand her a patient handout on low back pain if she were lucky.