Is anyone interested in OMM?

[Dr. Pickle]

I am just curious if anyone is interested in learning OMM...

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[Law2Doc]

I am just curious if anyone is interested in learning OMM...

I think only a couple of allo schools offer OMM. Unless you are already attending one of these schools I kind of doubt many are going to travel to another school to take a course in something a lot of osteos don't even seem to use once they graduate.

 

[Crixivan]

Will it allow me to charge extra?

 

[SomeDoc]

Any idea which schools those are? I didn't know that there were allo schools that did.

 

[Law2Doc]

Any idea which schools those are? I didn't know that there were allo schools that did.

I think Harvard has or had a course. See http://www.worldchiropracticalliance.org/tcj/2007/sep/b.htm

 

[-Goose-]

I thought that ETSU offered such a course, but I couldn't find anything about it on google.

 

[SomeDoc]

Oh ok... Harvard et al. offer those as CME (continuing medical education).

 

[NSAIDAllergy]

I am just curious if anyone is interested in learning OMM...

Actually, I'm hoping to learn some either during residency (if I match at a program that has some DOs there) or once I'm practicing. More treatment options never hurt.

 

[Colbert]

As a student at an osteopathic school, I thought I'd throw in my 2 cents.

I assume it's well understood at the curriculum at MD and DO schools is virtually identical, with the addition of OMM (osteopathic manipulative medicine) at the DO schools. Whether it fixes conditions, relieves pain, or allows osteopathic physicians to do things that MDs can't is always a point of debate and isn't something I plan on debating.

From my perspective, it's a useful tool to help in diagnosis and build patient relationships. There is something to be said for forming a trusting bond with a patient by using physical physician-patient interactions. Many patients need to feel that their physician cares about them individually, and spending enough time to preform an osteopathic treatment not only feels good, but makes them feel closer to the person they're supposed to tell things that might be embarrassing.

As for allopathic schools that offer OMM, I've never heard of it. Harvard doesn't offer a class through their medical school, they offer a weekend program that introduces MDs to osteopathic manipulation.
http://cme.med.harvard.edu/cmeups/pdf/00271286.pdf


If you're really interested in learning it, I'd recommend asking any DOs you rotate during your third or fourth year, or even any DOs who are your attendings or do residencies with. Some of them won't ever use it, but the majority would be more than willing to show a few things.

 

[SomeDoc]

As for allopathic schools that offer OMM, I've never heard of it. Harvard doesn't offer a class through their medical school, they offer a weekend program that introduces MDs to osteopathic manipulation.
http://cme.med.harvard.edu/cmeups/pdf/00271286.pdf


If you're really interested in learning it, I'd recommend asking any DOs you rotate during your third or fourth year, or even any DOs who are your attendings or do residencies with. Some of them won't ever use it, but the majority would be more than willing to show a few things.

That CME covers a lot in a few days. I'd be very open to teaching high-yield OMM to interested colleagues later down the road.

 

[Taurus]

There is something to be said for forming a trusting bond with a patient by using physical physician-patient interactions. Many patients need to feel that their physician cares about them individually, and spending enough time to preform an osteopathic treatment not only feels good, but makes them feel closer to the person they're supposed to tell things that might be embarrassing.

That sounds kinda creepy to me.

Maybe afterwards, you can give them DRE's to solidy that bond.

 

[PeepshowJohnny]

Not me.

Not because I don't think it works or anything like that, I just have no intention of going into primary care or any other arena where I'd be able to put it to good use.

 

[hermit]

I am just curious if anyone is interested in learning OMM...

Like...YEAH!. Cranial manipulation cures all.

 

[Monica Lewinsky]

As a student at an osteopathic school, I thought I'd throw in my 2 cents.

I assume it's well understood at the curriculum at MD and DO schools is virtually identical, with the addition of OMM (osteopathic manipulative medicine) at the DO schools. Whether it fixes conditions, relieves pain, or allows osteopathic physicians to do things that MDs can't is always a point of debate and isn't something I plan on debating.

From my perspective, it's a useful tool to help in diagnosis and build patient relationships. There is something to be said for forming a trusting bond with a patient by using physical physician-patient interactions. Many patients need to feel that their physician cares about them individually, and spending enough time to preform an osteopathic treatment not only feels good, but makes them feel closer to the person they're supposed to tell things that might be embarrassing.

As for allopathic schools that offer OMM, I've never heard of it. Harvard doesn't offer a class through their medical school, they offer a weekend program that introduces MDs to osteopathic manipulation.
http://cme.med.harvard.edu/cmeups/pdf/00271286.pdf


If you're really interested in learning it, I'd recommend asking any DOs you rotate during your third or fourth year, or even any DOs who are your attendings or do residencies with. Some of them won't ever use it, but the majority would be more than willing to show a few things.

As much as your perspective that OMM helps you "connect" with your patients, it does not take the place of evidence-based medicine. Where are the double-blinded trials? Where is the real research on this OMM? If it is so great, then why isn't there more than just the anecdotal evidence provided expressing its utility?

It would be truly baffling to meet an allopathic student interested in learning how to practice osteopathy (other than to perhaps learn it to understand it better). First, there are DO schools explicitly for that purpose. The DO schools are generally easier to get into (see GPA and MCAT averages, I understand the competitiveness is still there in terms of number of applicants). So why would someone interested in osteopathy goto an allopathic school, other than maybe a situation where location of the school was a prime concern? Furthermore, just from looking on SDNs USMLE and specialty residency boards, it appears that there is a large number of DO students who wish to pursue allopathic residencies and not just in the primary care specialties where OMM supposedly has the most value. If many DO students are willingly rejecting OMM through such career decisions, it makes you wonder what their perception of OMM truly is (e.g. DO student on the derm board wondering about how to get into an allopathic derm residency. I can't see how OMM would be of any utility in derm).

Once again, where's the research?

 

[ColinHay]

I thought that ETSU offered such a course, but I couldn't find anything about it on google.

not through the school they don't.
one of the familiy residencies has a bunch of DOs so they do some of that but its very informal.

 

[SomeDoc]

Where are the double-blinded trials? Where is the real research on this OMM? If it is so great, then why isn't there more than just the anecdotal evidence provided expressing its utility?

Double-blinded= A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving.

Look up Osteo/PM&R/PT journals for research statistics if you're interested. Some procedures are similar/identical but are given different names by the different profession(s)/specialties.

 

[Colbert]

Once again, where's the research?

Since you seemingly want to turn this into a MD vs DO thread, and feel the need to attack something you obviously know nothing about, I will take a minute to end this before it even begins. I'm not saying DO>MD or MD>DO, and at no point do I intend to. Like the vast majority of people, I believe MD=DO. I'll just show you that "research" you claim is missing.

In a two-minute Pubmed search of Osteopathic Manipulation, limited to free full texts (so you can read them for yourself), and intentionally leaving out any article published in the Journal of American Osteopathic Association in order to make sure there's no bias, I immediately came across these:

A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic
http://www.sciencedirect.com/scienc...serid=10&md5=fb171c6703128e3f32350f172ad00dc4

Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care
http://fampra.oxfordjournals.org/cgi/content/full/20/6/662

Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16080794

There are obviously many more articles about osteopathic treatment and manipulation that you can peruse if you like on Pubmed, these are just a few examples.

Again, I'm not preaching from my soap box that all the MDs are missing this vital part of medicine. I have nothing but respect for your education. But if you're going to try and attack mine and make claims like OMM is purely anecdotal, you better have credible sources to back you up.

 

[SomeDoc]

Since you seemingly want to turn this into a MD vs DO thread

I don't see anyone mentioning anything about this but you. Posts like this lead to perfectly valid threads being locked.

 

[gmard33]

Of course most research is throughly conducted but some "Evidence based research" has lead to bad medications being put on the market. Just because someone does a study doesn't always mean it isn't subject to error down the road.

Sometimes I don't think that pharmaceutical companies do enough research before they advertise their drugs on TV, jack up the prices and put their products on the shelf.

At least OMM won't give you a heart attack with continued use.

 

[MSKalltheway]

As much as your perspective that OMM helps you "connect" with your patients, it does not take the place of evidence-based medicine. Where are the double-blinded trials? Where is the real research on this OMM? If it is so great, then why isn't there more than just the anecdotal evidence provided expressing its utility?

It would be truly baffling to meet an allopathic student interested in learning how to practice osteopathy (other than to perhaps learn it to understand it better). First, there are DO schools explicitly for that purpose. The DO schools are generally easier to get into (see GPA and MCAT averages, I understand the competitiveness is still there in terms of number of applicants). So why would someone interested in osteopathy goto an allopathic school, other than maybe a situation where location of the school was a prime concern? Furthermore, just from looking on SDNs USMLE and specialty residency boards, it appears that there is a large number of DO students who wish to pursue allopathic residencies and not just in the primary care specialties where OMM supposedly has the most value. If many DO students are willingly rejecting OMM through such career decisions, it makes you wonder what their perception of OMM truly is (e.g. DO student on the derm board wondering about how to get into an allopathic derm residency. I can't see how OMM would be of any utility in derm).

Once again, where's the research?

I dont think thats it's fair to make the assertions that its "baffling" as to why MD students would want to learn OMM, and also why DO's go to pursue allopathic residencies. There are not only political reasons why DO's go to MD residencies, but certain fields would likely contraindicate certain OMM practices --> like being in rheum and dealing with someone who has severe OA of the spine, you probably dont want to go cracking away at someones back. Many dont end up using it because they know it just wont help. Also, there are not enough osteopathic residency spots for all DO students, so unless they want to roll like Dr. Jarvik, they must apply for allopathic spots.

The vast majority of pre-meds apply to DO schools because they like their chances of getting into those med schools at the time, not because they know anything about osteopathy. All of my pre-med friends at the time, myself included, didn't know what OMM was about or any of that, we only know when we get to school and learn about it. So no, I dont think it is at all shocking that allopaths would want to learn about some osteopathic techniques...very few learn about it until after matriculation, and by then its too late to make a switch even if you want to.

Where is the double-blinded, placebo controlled trials? I personally have no idea, thats something DOs will need to worry about. But if you must criticize their lack of research or their methods of blinding, you also cant fully blind surgeries or spinal injections in pain medicine. Its a little difficult when you have to do something to the patient.

 

[Dr. Pickle]

Thank you everyone for your good posts- i wanted to see OMM through an allopath's perspective-I was really happy to see the non-aggressive/logical posts although it almost did become one.

props to everyone being reasonable and peaceful in an anonymous thread-

especially props to Colbert

 

[RockShox]

A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic
http://www.sciencedirect.com/scienc...serid=10&md5=fb171c6703128e3f32350f172ad00dc4

Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care
http://fampra.oxfordjournals.org/cgi/content/full/20/6/662

Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16080794

Ok this is beside the point I know...but everyone knows I am a stickler for what is truly deemed as evidence, refer to all my rants about using wikipedia as a source. Pubmed and google searches for articles are great but just be cause the title implies that its "randomized" or has a sexy acronym it does not make it a good study. Study #2 is a case in point.

It seems legit until you read the methods section and realize that the OMM group received the standard medical treatment for back pain, that they were also told to exercise, and not rest excessively (also standard medical advice), and if the symptoms persisted despite OMM they were given cortisol/lidocaine injections. This is NOT the way to do a study. They should have done the control with standard medical treatment, and done ONLY OMM for the other group. Additionally cortisol injections?

More over the outcomes were based on patient completed questionnaires NOT through actual visits to the physician or with objective criteria recorded by trained sources.

Next.... when we look at the data there WAS a significant difference in the 3-month mark 4 only TWO of the criteria systems they used. This difference existed for only ONE of those systems by 6-month. On top of that the cost incurred by the OMM group was estimated to be 2x that of the control.

Finally...the OMM was performed by one and ONLY one practitioner...this makes it very hard to be truly randomized and adds to bias.

The point of this post is not to knock OMM or any other treatment...but to try to educate about reading articles and what they mean. This article may be on to something but you can't just stand by a tag line and not be rigorous about what the study actually did...where its flawed. In this case fatally.

I would not be such an article freak if i wasn't worried that someday through habit someone will read a title in JAMA, use it in practice without reading the article itself, and then harm someone or worse.

 

[RockShox]

A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic
http://www.sciencedirect.com/scienc...serid=10&md5=fb171c6703128e3f32350f172ad00dc4

Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care
http://fampra.oxfordjournals.org/cgi/content/full/20/6/662

Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16080794

Ok this is beside the point I know...but everyone knows I am a stickler for what is truly deemed as evidence, refer to all my rants about using wikipedia as a source. Pubmed and google searches for articles are great but just be cause the title implies that its "randomized" or has a sexy acronym it does not make it a good study. Study #2 is a case in point.

It seems legit until you read the methods section and realize that the OMM group received the standard medical treatment for back pain, that they were also told to exercise, and not rest excessively (also standard medical advice), and if the symptoms persisted despite OMM they were given cortisol/lidocaine injections. This is NOT the way to do a study. They should have done the control with standard medical treatment, and done ONLY OMM for the other group. Additionally cortisol injections?

More over the outcomes were based on patient completed questionnaires NOT through actual visits to the physician or with objective criteria recorded by trained sources.

Next.... when we look at the data there WAS a significant difference in the 3-month mark 4 only TWO of the criteria systems they used. This difference existed for only ONE of those systems by 6-month. On top of that the cost incurred by the OMM group was estimated to be 2x that of the control.

Finally...the OMM was performed by one and ONLY one practitioner...this makes it very hard to be truly randomized and adds to bias.

The point of this post is not to knock OMM or any other treatment...but to try to educate about reading articles and what they mean. This article may be on to something but you can't just stand by a tag line and not be rigorous about what the study actually did...where its flawed. In this case fatally.

I would not be such an article freak if i wasn't worried that someday through habit someone will read a title in JAMA, use it in practice without reading the article itself, and then harm someone or worse.

 

[Dr. Pickle]

good point rockshox- I have been told that there is an increased interest on researching the effects of OMM- further studies need to be done. But it is important to note that OMM usually be used in conjunction with conventional treatments, so only peforming OMM and not the standard treatment would violate what is taught to DO students (i believe so). Rather there should be two groups- one that receives standard treatment and one that receives standard treatment plus OMM only <--would that be reasonable?

 

[hermit]

But it is important to note that OMM usually be used in conjunction with conventional treatments...

The more I read about OMM the more ridiculous it sounds. This equates to diet pill commercials that tell you to take their product in conjunction with diet and exercise.

 

[SomeDoc]

Exercise is recommended in conjunction to diet in weight loss programs. There's no need for an additional program, but Pt.'s are recommended to implement an exercise program because the additional program of exercise (or another modality in the appropriate context) has been clinically proven to facilitate the achievement of desired patient health outcomes.

 

[Colbert]

The more I read about OMM the more ridiculous it sounds. This equates to diet pill commercials that tell you to take their product in conjunction with diet and exercise.

Or if you're prescribed antibiotics in conjunction with rest and a lot of fluids? I don't see how you think OMM being used along with other remedies makes it ridiculous. No one here is saying it is the cure for cancer or that it can heal broken bones, but it may help and assist other therapies.

 

[ufgrad00]

Or if you're prescribed antibiotics in conjunction with rest and a lot of fluids? I don't see how you think OMM being used along with other remedies makes it ridiculous. No one here is saying it is the cure for cancer or that it can heal broken bones, but it may help and assist other therapies.

Haha, I love how this subject starts flame wars.
Mostly the sparks always seem to come from the uptight premeds.

Just because something has loads of objective research behind it doesn't make it great either, for instance, the disasters with vioxx or all the uber addictive opiate derivatives. Come to think of it, OMM is an "addictive free" and "side effect free" therapy which can successfully be used to help with spinal and joint pain in conjuntion with medication and treatment. As long as the patient is getting better and feels better after having some joints manipulated and popped, then it is not an issue.

 

[Monica Lewinsky]

The amazing thing about SDN is that when you question the validity of OMM you get accused of starting an MD vs. DO thread and you get accused of being an arrogant premed.

In reality, I am medical student who applied to osteopathic schools along with allopathic schools. I wouldn't have applied to the DO schools if I felt they wouldn't have provided a good education for becoming a physician.

I have several friends attending DO schools, and they reiterate their choice was based mostly on the fact that they got in to the school and that they liked the philosophy of the school. They make a point that they don't necessarily want to be Osteopathic physicians but their life dream is to be Physicians. I believe that most DO students share this attitude.

As for the few studies that Colbert presented as "quality" OMM research, they really don't say much. Infant colic is rather mysterious in etiology in the first place, so its hard to even to pinpoint how OMM could be beneficial to these babies, other than maybe getting the babies more physical contact with adults (something which has been proven to be a real need in infants). I do not doubt that OMM might have some utility in lower back pain, however chiropractry (lest I associate DCs with DOs) literature also demonstrates similar utility.

As for the previous post that claims Vioxx, had loads of good objective research, the fact that enough clinical research and observation was done to eventually discover it was a bad drug demonstrates the power of evidence based medicine. We only use things we know that work, and we stop using things that we know are harmful. However, those in excruciating pain haven't exactly flocked to OMM and rely instead on opiates and other pain killers since OMM hasn't been proven effective at treating such extreme pain that those drugs were used for.

 

[SomeDoc]

However, those in excruciating pain haven't exactly flocked to OMM and rely instead on opiates and other pain killers since OMM hasn't been proven effective at treating such extreme pain that those drugs were used for.

Students are taught that OMM use is only indicated in certain somatic dysfunction pathologies. There are certain etiologies where OMM is not indicated- or may be indicated, but will not be as effective as a standalone modality (esp. in certain acute, time-sensitive pathologies). This is where some combination of drugs, surgery, and rehabilitation would be most effective. In situations characterized by the absence of such resources (ie. underfunded clinics, overseas health projects), the modality can be utilized as a method of treatment (and in some cases prevention) if the use of the treatment is not a contraindication.

 

[USCguy]

I'm an allopathic student, and I'm interested in receiving some OMM training post residency. Like an earlier poster said, nothing wrong with some extra tools in the bag. Maybe I don't ever use it on a patient, but if it only takes a couple of weekend sessions to learn about it, I think it would be worth it since it is something that I'm interested in learning. Obviously everyone else would have to make that choice for themselves.

 

[milan1320]

Hey everyone,

I just thought id chim in, I am currently a first year D.O student who is here becuase I can be close to my fiance. I really did not care about omm and was just using the school as a means to an end. However after taking some omm classes I can definitely see some of this stuff as being usefull. For instance during our recent history and physical class we were discusing differentials for a young female with abdominal pain when the doctor leading the discussion went off on a tangent He said he recently took his son and a friend sleding, the friend ended up landing pretty hard on his tailbone and developed a sever headache. After a couple of hours of aspirin and rest the headaches were not going away so the doctor looked at the kids back, saw the scapular spines were not at the same level. After a little omm to correct the scapulas the kids headaches went away within 10 minutes. I really think if people were just a little more open they would be surprised at the usefullness of SOME of this stuff ( btw I still think this cranial stuff is wack though)

 

[albaniandoc]

I am an MD student but, tend to agree, OMM has its place in medicine. A couple of years ago I was unloading heavy 16x16 patio blocks and stepped off the wrong way and I got this very nasty pain in my shoulder and down the arm. It felt like someone was twisting my arm constantly. It was tingling and doing all kinds of things. I called up my family doc who is a DO and as soon as I got a treatment everything went away. From what I remember ( I was an undegrad then so don't remember much about pathology) I think I had dislocated the first rib, maybe. Anyway, I am pretty sure that if I had gone to an MD I would get some NSAIDs and advice to rest the arm.
I am interested in OMM and I know my roomate did a couple of rotations during his fourth year with OMM clinics out in Cali.

 

[MSKalltheway]

I am interested in OMM and I know my roomate did a couple of rotations during his fourth year with OMM clinics out in Cali.

What programs were they and how did he set them up? I'm interested to know myself. I'm assuming your roommate goes to your school.