Miss me?
allright. I see a few unanswered criticisms and comments to field from since I was last on here.
so the point of my previous posts were to tell you the difference between DO's and MD's as per the topic of the thread- not to defend the validity of the DO profession or the efficacy of OMM. but lets take a detour.
To be fair, if "rational, modern" DO's ran the AOA (as in wanna-be MD's who don't use OMM), then our profession is as good as finished. It has no reason to exist. Just give us all MD degrees at that point. I am sorry if you slacked off or go to a doc-diploma-mill DO school and feel that your osteopathic skill is inadequate and cannot integrate it- again this is a failing of the education process, and not the art of osteopathy. Sadly, this is a very common story. your best option in such a place is to seek out specialists in private practice in your city who can be role models for you. make the best of the situation.
http://www.academyofosteopathy.org/findphys.cfm
look up neuromuscular medicine and osteopathic manipulative medicine specialists in your town for shadowing in the first 2 years, and get a rotation or two with them 3rd and 4th year. And USE it all 3rd and 4th year. If you don?t use your skills on a variety of patients under a variety of clinical situations you have lost the art and will probably not apply it effectively in your practice.
Try to follow as many different osteopaths as possible... as with any type of doc- there are awesome ones and crappy ones. I don?t doubt that some are so lousy that their benefit to patients is minimal. And then you see the ones that change lives left and right and you realize why we?re DO?s. if you can develop some of that skill and apply it to your specialty you will be unique in your profession, able to help those patients that nobody else can.
A big failing of the osteopathic profession is that our current AOA leaders (zealots, as you say- and rather stupid ones) let these new random DO schools surface all over with severely inadequate OMM faculty, when we barely have enough skilled osteopathic faculty at our core schools. Thus, the common story of the inadequate DO becomes even more common... and not only does nobody integrate functional anatomy into their practice, but probably the majority of DO's today don't even know anything about osteopathy. Its like having a bunch of MD's who have had a few chiropractic lessons (shudder). or they are zealots who are essentially chiropractors that couldnt save a life in the ER if it was their mothers... no offense you chiros, but most of you are taught to crack backs and charge a bill- without understanding key lesion mechanics and functional causes. fix the key lesion and it never comes back... but if you don't you'll be cracking the same vertebrae for years. If you also understand the visceral anatomy you can address all sorts of conditions, not just sloppy vertebrae.
a real osteopath integrates... learn anatomy and phys REALLY well, and then NOTHING is left to "belief". whats all this crap about "i want to believe". its like you're some freaking Jehovas witness bible nazi. osteopaths are scientists and artists, not religious fanatics (well... maybe a few are, but they need to keep it quiet). the reason it is a science is that its all built on a rock-solid foundation of knowns- anatomy, physiology, and pathophyisiology.
and to that "show me the functional anatomy studies" parrot... wake up. read your textbooks. read doctor Willards work from NECOM. now read it again. functional anatomy isn't clinical- its basic science. perhaps more complicated anatomy than you were taught, but critical to understanding OMM.
Now as far as the clinical efficacy of individual techniques, yes
I agree that our profession needs a TON of research. we are under-researched for a number of reasons:
1)osteopathy treats the whole patient... thus, no two patients with the same condition are treated in the same way. just try setting up a good pneumonia study when every single patient needs a different treatment from the ground up based on their structural strains and systemic stresses.
2) OMT is NOT a double-blind tool. how can a skilled practicioner do a practicioner-blind sham treatment? at BEST you can do single blind... and even then you are pushing it (massage the right place and you'll get benefit, sham it too hard and its obvious to the patient).
Now imagine proving to me that surgery works. hmm??? there are virtually NO double blind or placebo-controlled studies for the surgeries we use every day. Should we stop performing all of these surgeries due to insufficient evidence? The results are "self evident"... right? well no... I would actually love to see a double blind study for surgery on pancreatic cancers, cholecystectomies, and appendectomies, but it just aint gonna happen, now is it?
At best you can do outcome studies... but guess what? there are some good outcome studies for OMM out there. I would love EBM double blind OMM research too, but it just ain't happening.
3) DO's dont know how to do research. a failing of the education. we have virtually no research education or publication requirements in DO schools. Thus, once we graduate we write some truly pitiful papers... and some of these make it into JAOA since there is such a small pool of papers to choose from.
4) resources. Most DO schools dont even have PhD programs. very little funding for research facilities. it shows the emphasis of those ever-wise AOA leaders.
so after all this, you see only a few good OMM papers. surprised? i'm not at all. BUT there ARE a few good ones out there. you just have to look.
http://ostmed.hsc.unt.edu/ostmed/index.html
so there isn't much data (though more than for most common surgeries), and unless you do the research yourself there wont be more anytime soon. the only way to understand the value of OMM is to understand functional anatomy and the clinical pathophysiology of disease way better than most of your colleagues... or to see outcomes from skilled specialists. its not enough to read case studies since they can be exaggerated or distorted. That said I have dozens of my own cases that i could share with anyone who is interested, and im still just a student. Believe nobody's case study though. see it for yourself. Understand it for yourself. yes that answer sucks, but deal with it, since thats the best you'll get.
And if you think OMM is a joke but went DO anyway... its your own damn fault for going DO. quit your bitching... some of us are proud osteopaths with very happy and now very well patients!
cheers,
bones