M.D. and D.O. Clinical examples

[sean]

I hope this string will not get into the g.p.a. competency of pre-med M.D. v's D.O. and will instead concentrate on the actual differences ie philosophies, ethics, treatment, e.t.c... As a certified massage practitioner I am especially interested in the D.O. inclusion of muscular manipulation into its practice. How does Acupuncture, herbal medicine, homeopthy, meditation, pharmaceuticals, radiation therapies, A.I.D.S. research, and cancer treatment, fit into osteopathy. O.K. there is more than enough there to start the ball rolling. I look forward to reading your thoughts.

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[rhillstr]

Hey There,
Your best bet is to read back through the other posts-especially the last one and then ask again. The equation: DO=MD+OMM This doesn't include the issues of philosophy and focus as mentioned in many of the other strings/posts.
Take care,
Rob

 

[MOXIEJEN DO 2003]

My interpretation of Osteopathic medicine (which also happens to be the interpretation that I intend to carry into my clinical practice) is the idea of caring for the WHOLE patient. A.T. Still's basis began with the idea of the body being entirely interrelated, and that can be expanded to the entire environment of the patient. By environment I mean not only tending to how the patient's illness is affecting other parts of his or her body, but also how the illness is affected by the persons social, psychological, and spiritual well being.

An example that I can give, which is very concrete for me, is from when I spent time observing a DO in his office. He had a patient who had just completed knee surgery and this was her first time back in his office after all of her post-surgery care. After he had examined her and completed the necessary work-up, he took a moment to ask her how her country western dancing was coming along post surgery. After her appointment he related to me how disturbing it was to her that she had to give up her favorite pasttime because of her ailing knee. I felt that he showed great attention to her social needs by addressing that concern of hers. Simple, sure. But it made an impact upon me.

As far as integration of herbal and "non-traditional" therapies into Osteopathic medical practices, I believe it depends highly upon the individual practitioner. My cousin takes her children to a DO in San Diego, Viola Frymann and her partner Mary Ann Morelli, and they are open to non-traditional therapies in adjunct to 'traditional' ones. I believe in the case of radiation therapy and cancer treatment, DO's would use the most appropriate plan of treatment for their patients, again taking into consideration how that treatment will impact other parts of the patient's body and his or her psycholgical and spiritual well being.

Are you considering entering the field of Osteopathic Medicine, or are you trying to decide upon the right kind of practioner for yourself?

 

[ewagner]

As a first year student, we are all exposed to "Integrative or Complimentary" forms of medicine. Virtually all that are stated. But, in all basic science classes we are given a healthy dose of doubt. How can you not, when examples like chelation therapies for chronic heavy metal poisonings can not be proven. Or the use of accupuncture for stroke treatment...please? Sure, we are exposed to many elements of complementary medicine, but we spend most of our time on hard,well proven facts that can be used to disprove theories. Osteopathic Medical School is not a clearinghouse of alternative medicine, rather, it is a way to integrate thinking...structure has a direct correlation function. Whether that be in orthopedics, or when a physician reads a CT scan. You don't always have to "crack backs" to be an effective osteopathic physician. It is far deeper than that.

 

[OldManDave]

Sean,

I wish you the best of luck in your aspirations...but I warn you, it will not be easy. Even as diligent as I am, the personal slights and the GPA/MCAT monster always rears it's ugly head. My hope is that by open & honest discussion, the posters will reveal to themselves how ludicrous it is to bicker over things so subjective and inconsequential...good luck to you, I hope your approach exceeds my own!

Ewagner,

Excellent perspective...I think you make a cogent and valid point, "You don't always have to "crack backs" to be an effective osteopathic physician. It goes much deeper than that."

------------------
'Old Man Dave'
Senior, Neurosciences
Univ of Texas at Dallas
Class of 1999

 

[sean]

Thankyou for answering this string. I realize that it probably gets old explaining what "osteopathic" medicine but it an excellent way to spread the word. I have had a few years experience inthe Allopathic field and that coupled with a life time of experience of Allopathic medicine as my option of health care it is interesting to get into debates about other health care p[ractices. Let me first say that I spent two years working in an operating room as a circulatory support trchnician, anesteshia tech, an organ donor tech, ventricular device and intr aortic balloon tech. I have assisted in heart, liver and kidney transplants, and many many other surgeries. I say this not to impress, i doubt if it would, but more to say that I have had a fair amount of exposure to allopathic medicine. It is a very moving experience to have somebody under your watch. I will not forget. However I have also had alot of exposure to "alternative" methods of treatment and find them fascinating. As a licenced massage therapist I have practiced many styles, both western snd eastern and I find it to be a very effective therapy. While I agree that a healthy amount of doubt is good I do believe that this applies to all things. In fact I believe that it was A.T Stills "healthy doubt" that caused him to found the field of Osteopathy. Perhaps it comes from living on the west coast too long but I am more inclined to believe that if something works, use it. Acupuncture has been many peoples answer to an unresponsive pharmacutical driven health care industry. There are many scams and old wives tales out there but you know what, many of them are selling plastic surgery and eternal youth in the name of medicine. Acupuncture as a means of controlling blood flow has alot more scientific basis than does plastic surgery as a means of staying young. Irealize that I am picking on the weakest field in medicine, i.e. "unnecessary plastic surgery" however I do it to make a point; not all alternative practices are the same nor are "western" medical practices. Whilw Osteopathic medicine should not be a catch all for all the wierd stuff offered out there it can do itself a huge favor by staying open to other proven medical practices. Ewagne, I agree there is more to medicine than just cracking backs but there is more to medicine than just book diagnosis, a holistic approach requires just that, a whole approach. Does Osteopathic medicine as it is taught at school involve a lot of physical hands on or is it more observation? What say you all?
P.s. Thank you Moxiejen.DO for replying to me posting so directly. It is fun to read about something other than grades. And Dave thanks for you good wishes and good luck in your new life.

 

[ewagner]

Sean
I wish I had more time to respond but Neuroanatomy awaits! Yes, physical diagnosis in osteopathic medical school is very much "touch oriented". It certainly places student DO's at an advantage over their allopathic counterparts (that is...if we were competing, which we are not of course).
And thank you Old Man Dave for your nice comments. I don't know if I have been quoted before!

 

[DOPhD student]

I know some posters have stated that their DO schools expose them to complimentary medicine stuffs besides standard OMT. However, DO schools differ tremendously in what sort of exposure and how much of it they offer their students. For example, just as a hearsay, PCOM offers OMT only as electives which means DO students in PCOM can potentially go through the whole medical school experience without ever having to learn OMT. Now if I'm wrong, correct me. My school for example, require 4 semesters of OMT training and 1 month rotation during clerkship. However, nothing else complimentary is endorsed here. Some of the manip doctors do use magnet therapy and acupuncture on the side to complement their OMT practice, however students are not taught or exposed to these therapies. I suspect that most schools, like my school, fall somewhere between the extremes like PCOM and KCOM which I hear offers excellent OMT training.

 

[prefontaine]

DOPhD, from time to time the 'OMT is an elective at PCOM' rumor surfaces. My current roommate is a PCOM alumni and tells me that they had at least 200+ hours of OMT during the pre-clinical years. I believe this is the AOA minimum for accreditation. During the '60s or '70s, OMT may have been an elective there, but the same rumor also floats around about UHS. It would not surprise me if this was the case, at one time, for either school.

 

[prefontaine]

DOPhD, the above was simply FYI, but I almost forgot to ask this. Irwin Korr told me that the curriculum at your school was designed specifically to include the integration of OPP/OMM/OMT or whatever they call it down there. Is this something in the program that you are aware of or is this a concept that has possibly fallen by the wayside?

Steve

 

[DOPhD student]

Steve, unfortunately Korr is probably incorrect in his perception of my school. That may have been the original intention, but from what I see, the courses are pretty much detached from osteopathic principles, especially the basic sciences like neuro, pharm, micro, path, etc., but I suppose there is no easy way to integrate osteopathy or any kind of philosophy into these 'fact' courses. What I find more amazing is that even clinical courses like physical diagnosis and physical examination offer very little homage to osteopathic exam techniques and therapies, and if memory serves me correctly, I remember only one sentence in our class handout mentioning osteopathic manipulation might be effective in some cases of musculoskeletal disorders. I'd taken some pre-clinical courses like ped, radio, surg, ob/gyn, etc., and the same can be said for these. I don't think I got my money worth.

Btw, thanks for correcting my fact about PCOM. A PCOM student however said in a post that even if his/her school does make their students take OMM classes, it does so reluctantly and so a student interested in OMT might not fair well there.

 

[sean]

I am having difficulty following this thread. What I am hearing is that physical manipulation is not a big part of alot, if not most, DO programs. I find this confusing as I thought that this was one of the mainstays of the practice. I do not mean chiropracic work by the way, but touching and feeling the physical manifestations of the underlying problems.
Sean.

 

[Deb]

Just to add to the above remarks. From what I've seen on these posts
UHS has a stronger OMT curriculum than some schools. By the time we
finished the course, most of us were pretty proficient. The final
consisted of randomly drawing a specific area (ribs, thoracic, lumbar,
or cervical spine, upper or lower extremity, sacrum, pelvis), diagnosing
a dysfunction and treating it (in 5 min). If there was no dysfunction
you were given a diagnosis and had to set up the treatment. Each person
had to do this twice (two stations) and you couldn't use the same treatment
modality both times. If you first used HVLA, then at the 2nd station you
had to use ME or counterstrain. Also, during the 2nd yr, we had a number
of lectures devoted to integrating OMM into different areas of practice
(IM, peds, OB/GYN)...not as many as I would have liked but more it seems
than some schools. I'm also curious to know why (on this BB) there is a
general lack of interest in lymphatic treatments. Our faculty devoted a
lot of time to this modality and I'm surprised that no one here ever even
mentions it.

 

[BD]

To DOPhD, This is just to dispel the "myth" that PCOM offers OMT as an elective.First and second year students are required to attend weekly lectures as well as OMT lab sessions.