Manipulation is a psychomotor skill. It takes time to learn and requires practice to be good. It's not rocket science and it's not a panacea. It is simply a good modality for short-term (and some times long-lasting) relief of musculoskeletal pain syndromes. It also doesn't have to take very long to do if you are efficient---also it can pay quite well if you know how to bill and how to play the right games with insurance companies so that you get reimbursed for what you do.
A lot of older D.O.'s don't practice it because of the fear of being labelled a quack. Thirty years ago D.O.'s were just barely breaking into top allopathic medical centers. The quickest way to lose credibility among a bunch of M.D.'s when you're a D.O. in a heavily allopathic setting is to start talking about things like manipulation--which the vast majority of M.D.'s know nothing about and are probably not very interested in hearing about anyway.
Still, in my opinion, there is a resurgence of interest in manipulation these days. I am approached more and more frequently by M.D. attendings with questions about manipulation. I, myself, have even manipulated M.D. attendings! Let me tell you, there is nothing like a quick Kirkesville crunch on the OR table after spending 2 1/2 hours trying to pin a recalitrant hip...
I've met more than a few M.D.'s who have taken classes in OMM at Michigan State, NYCOM, etc. I routinely hear physical therapists talk about muscle energy and myofascial release treatments (both osteopathic manipulative techniques). Slowly, but surely, more quality research is appearing on the efficacy of manipulation too. NIH's center for complementary and alternative medicine is interested in all sorts of "body-work" therapies ranging from massage to rolfing, chiropractic, and osteopathy.
I think that learning OMM also teaches good physical exam/musculoskeletal medicine skills. I did a rehab medicine rotation and was amazed at some of the things that I learned as a second-year osteopathic medical student were only just barely being introduced to second and third-year PM&R residents.
Anyway, OMM is a good modality to learn and know. It has its place. Ultimately, you'll be a fine physician with or without it.
--Dave
[This message has been edited by drusso (edited April 26, 2001).]