how to practice hiv medicine as DO?

[zoner]

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I wasn't sure where to post this, but I didn't want to post in in Osteo forum and get spanked for it, but I guess I will try it here hoping that someone who is actually a resident or practicing can chime in...

I shadowed a HIV (infectious disease) specialist in the past, but I can't imagine how to go about practicing OMM/OPP as a HIV DO. It seems that the MD I shadowed only had like 10-15 minutes each per patient (this was inner city clinic that provided lots of free care) and I know it takes longer to do any kind of decent OMM/OPP on a patient. So if this is something I want to do (infectious disease) and incorporate OMM/OPP and do something unique as a DO, how would I go about doing that in my future practice?

 

[oms2]

like hvla on the patient + hvha on the docking glycoprotein, bid?

seriously, it depends on what you're trying to accomplish.

 

[Mosonik]

I'm stumped on your thought of applying OMM to the treatment of HIV. But there are people who know plenty more then me so perhaps they will chime in how how an osteopath can uniquely approach this disease.

 

[FrkyBgStok]

Agree with the above. There is a difference between treating HIV and treating the needs of a patient with HIV. If you want to do the second part, you can probably incorporate OMM. Not with the first part (though some OMM professors will tell you otherwise).

 

[oms2]

certain omm techniques can be valuable for symptomatic pain relief. that's about it.

 

[Druggernaut]

I shadowed a HIV (infectious disease) specialist in the past, but I can't imagine how to go about practicing OMM/OPP as a HIV DO. It seems that the MD I shadowed only had like 10-15 minutes each per patient (this was inner city clinic that provided lots of free care) and I know it takes longer to do any kind of decent OMM/OPP on a patient. So if this is something I want to do (infectious disease) and incorporate OMM/OPP and do something unique as a DO, how would I go about doing that in my future practice?

It doesn't take very long if you know what you're doing (which I certainly do not). But I think that you'd be doing your patients a disservice if they're coming to you for special management of their HIV beyond what their PCP can provide and you spend time doing OMM. I just can't see it being effective.

If it were a test question, I'd probably go with some technique to improve lymphatic drainage or "normalize sympathetic tone," both of which have a few techniques you could probably do in under two minutes, but I'd almost feel like it was insurance fraud to do it to a real patient. You could go after the musculoskeletal manifestations of the disease, but again, I'd probably let the PCP deal with that.

 

[zoner]

oh oh, no no no,, i didn't mean to use OMM/OPP to treat HIV ( i know only the antiretroviral drugs work), but lets say those same patients come in with issues that I am able to take care of using OMM/OPP since after all HIV specialists are also a PCP, how do you go about using that when it seems like you are mandated to spend only x amount of time on each patient. Also, lets say that you did have more time, how do you bill the insurance company or the company that are providing free care? Do you first ask the patient do you want me to use OMM/OPP for that? I have no clue

 

[Badgers326]

oh oh, no no no,, i didn't mean to use OMM/OPP to treat HIV ( i know only the antiretroviral drugs work), but lets say those same patients come in with issues that I am able to take care of using OMM/OPP since after all HIV specialists are also a PCP, how do you go about using that when it seems like you are mandated to spend only x amount of time on each patient. Also, lets say that you did have more time, how do you bill the insurance company or the company that are providing free care? Do you first ask the patient do you want me to use OMM/OPP for that? I have no clue

So let's say your patient is HIV+ patient is diagnosed with Pneumocystis jirovecii and therefore is having respiratory problems. You could first give them the appropriate meds, but you could also treat their ribs using a rib raising technique which could help aid respiration and circulation of the patient with congestion.

There is other stuff I'm sure you could do, but this is an example.

And of course you get your patient's consent before performing OMM on them.

 

[zoner]

So let's say your patient is HIV+ patient is diagnosed with Pneumocystis jirovecii and therefore is having respiratory problems. You could first give them the appropriate meds, but you could also treat their ribs using a rib raising technique which could help aid respiration and circulation of the patient with congestion.

There is other stuff I'm sure you could do, but this is an example.

And of course you get your patient's consent before performing OMM on them.

and is that something I do as a bonus? or do I write it out on some report and charge the insurance company?

 

[oms2]

medicare/insurance cos. will reimburse for omm at different rates depending on body region. the billing/procedure codes are well established and claims are handled like other medical procedures.

 

[Badgers326]

and is that something I do as a bonus? or do I write it out on some report and charge the insurance company?

No you get paid for OMM. It is a procedure. You document your findings and you are paid based on how many regions you treat. These are the regions: head, cervical, thoracic, lumbar, sacral, pelvic, lower extremity, upper extremity, rib cage, and abdomen.

 

[zoner]

No you get paid for OMM. It is a procedure. You document your findings and you are paid based on how many regions you treat. These are the regions: head, cervical, thoracic, lumbar, sacral, pelvic, lower extremity, upper extremity, rib cage, and abdomen.

but do all companies and/or insurance honor that? for example, AHF which is where I shadowed, would they reimburse the docs for doing that? Seriously though, all the docs there were so stressed because they had see see sooooo many patients per day

 

[BabyDoc86]

but do all companies and/or insurance honor that? for example, AHF which is where I shadowed, would they reimburse the docs for doing that? Seriously though, all the docs there were so stressed because they had see see sooooo many patients per day

The DO I shadowed saw 4 pts in 4 hrs. She specialized in OMM and told me that for her, this was common. So for some it may not be as slammed a schedule as it is for others.

 

[ModernAlchemist]

I've spent a lot of time shadowing in infectious disease and I've never seen the doctor take that short of a time. Most of the time it's at least 20-30 mins per patient. Though, that is inpatient.

 

[zoner]

I guess it might have to do with the fact that where I shadowed was a semi free clinic

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[lobo.solo]

I knew a DO that was doing a 1-2 year fellowship in HIV care. Family docs can do this type of fellowship.

 

[MedPR]

but do all companies and/or insurance honor that? for example, AHF which is where I shadowed, would they reimburse the docs for doing that? Seriously though, all the docs there were so stressed because they had see see sooooo many patients per day

You'll choose what insurance plans you accept. If a patient's insurance does not reimburse for OMM you likely won't take them on as a patient and if you do will likely not use OMM on them. Unless you want to work and not get paid for it.