Manipulation on Rotations

[Mixmaster]

I think most of us are in agreement that manipulation is the only aspect that differentiates MD's and DO's in terms of training. So how many of you have seen manipulation being used in the Hospital? (I have personally never seen anyone use it in the clinic or hospital.) Let's not count the OMM only rotation that some schools have. Somone want to start a poll? I have heard some numbers tossed around like only 5% of DO's actually use manipulation. Seems ridiculous to have a entire Medical organization around for the 5% or less that use manipulation.

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[MossPoh]

I have seen it....but it was more of a doctor doing it to a fellow doctor because of neck pain or something

 

[dcratamt]

I am a third year at PCSOM and have seen the other physicians here do OMM on hospital inpatients. I have also performed some OMM on these patients myself. It's pretty cool to get referrals for OMM from cardiologists, OB's, and pain management. The physicians themselves are showing up to get treated now. It's fun to watch the word spread!

 

[luckystar]

I've had one doc use and bill for OMM and he was an FP in a rural area. The patients would ask specifically for it. I'd say he did OMM in about 1/3 of his visits, on average.

 

[GregsAnatomy]

There's an OMM table in the student/resident lounge....I think I saw someone use it once....

 

[Smackey]

I think most of us are in agreement that manipulation is the only aspect that differentiates MD's and DO's in terms of training.

I disagree, however it may be just my school. I think another main aspect of differentiation is the way in which we are instructed to deal with patients. Every time a physician is explaining how to deal with/treat/interact with a patient they first tell us to act humble, meek and attentive. We are told to sit down with the patient, make contact, really listen, etc. I have friends at many allopathic schools who say that this aspect is never emphasized.

I don't know how many times the Docs have said "remember, every patient is superior to you in some way and maybe if things had been a little different they would be doctors too".

Too me this is a huge difference and something that makes me really glad of the school I chose. I hope it is universal throughout Osteopathic schools.

So how many of you have seen manipulation being used in the Hospital? (I have personally never seen anyone use it in the clinic or hospital.) Let's not count the OMM only rotation that some schools have. Somone want to start a poll? I have heard some numbers tossed around like only 5% of DO's actually use manipulation. Seems ridiculous to have a entire Medical organization around for the 5% or less that use manipulation.

And yes, we have a required OMM rotation that goes to the clinic and hospital.

 

[jawicobike]

I see a lot more OMT than I thought I would, although we're talking mostly about simple HVLA.

 

[DrMom]

I didn't do a med student OMM rotation, but I saw or performed OMM on cardiology (post-CABG), pediatrics (inpatient), OB (in and outpatient), EM, and family medicine (4 different clinics).

 

[Amy B]

I havent done any OMM on my family practice rotation. I am working with an MD. My classmate is on the other side of the office and he is with a DO and he has gotten to do OMM. My preceptor actually suggested a patient go to a chiropractor when the patient asked I cant hold it against him too long because he has been an AWESOME doctor to work with.

I have done OMM while at a nursing home. Paraspinal inhibition works wonders with elderly bowels whether they are hyperactive or hypoactive

 

[georgefred]

I disagree, however it may be just my school. I think another main aspect of differentiation is the way in which we are instructed to deal with patients. Every time a physician is explaining how to deal with/treat/interact with a patient they first tell us to act humble, meek and attentive. We are told to sit down with the patient, make contact, really listen, etc. I have friends at many allopathic schools who say that this aspect is never emphasized.

I don't know how many times the Docs have said "remember, every patient is superior to you in some way and maybe if things had been a little different they would be doctors too".

Too me this is a huge difference and something that makes me really glad of the school I chose. I hope it is universal throughout Osteopathic schools.


And yes, we have a required OMM rotation that goes to the clinic and hospital.

If you actually believe that allopathic schoos don't emphasize a patient first approach you are mistaken. I started medical school at an osteopathic school and transferred to an allopathic school after my second year. As far as I have seen my new allopathic school is as or more patient oriented than my old osteopathic school. Allopathic schools are no less interested in making sure that their students care about the "whole" patient. Individual students and physicians can choose to be pricks or caring empathetic physicians. I have met DOs and MDs who are pricks and it isn't due to where they went to school. The biggest difference I have seen so far between the two types of schools is that the time that osteopathic students spend learning OMM is spent in allopathic institutions learning patient care and physical diagnosis skills.

 

[Megalofyia]

I would think that a DO at a DO hospital or in an area with more DOs would be far more likely to do manipulations in the hospital setting. Where as in an allopathic hospital I could see it just not being used as much by DO just because.

Plus I suspect that DOs that are really into OMM are more likely to work in DO heavy hospitals and areas and/or to go into primary care where they are more likely to be in a clinic setting.

I know that with my classmates, those of us interested in OMM are planning on doing primary care and working in an office setting, whereas those of us who plan on specializing, for the most part, just go to OMM class do our stuff and dont practice enough to become proficient enough to try it on someone other than a classmate and thus will likely not be using it in a hospital setting.

 

[dcratamt]

I see a lot more OMT than I thought I would, although we're talking mostly about simple HVLA.

Luckily you are strong with the OMT force young osteopath.

 

[mcfreak]

I think most of us are in agreement that manipulation is the only aspect that differentiates MD's and DO's in terms of training. So how many of you have seen manipulation being used in the Hospital? (I have personally never seen anyone use it in the clinic or hospital.) Let's not count the OMM only rotation that some schools have. Somone want to start a poll? I have heard some numbers tossed around like only 5% of DO's actually use manipulation. Seems ridiculous to have a entire Medical organization around for the 5% or less that use manipulation.

I've seen it, I've done it

 

[Dr JPH]

I disagree, however it may be just my school. I think another main aspect of differentiation is the way in which we are instructed to deal with patients. Every time a physician is explaining how to deal with/treat/interact with a patient they first tell us to act humble, meek and attentive. We are told to sit down with the patient, make contact, really listen, etc. I have friends at many allopathic schools who say that this aspect is never emphasized.

I don't know how many times the Docs have said "remember, every patient is superior to you in some way and maybe if things had been a little different they would be doctors too".

Too me this is a huge difference and something that makes me really glad of the school I chose. I hope it is universal throughout Osteopathic schools.

I 100% disagree with everything you said above. In my opinion, humble as it is, that reasoning you describe above is the root of all discord between MDs and DOs...and also the cause of problems in the osteopathic community.

Now regarding the original question, I have seen and done OMM on several rotations. Mostly surgery, OB/GYN, EMED and outpatient primary care.

 

[dcratamt]

I 100% disagree with everything you said above. In my opinion, humble as it is, that reasoning you describe above is the root of all discord between MDs and DOs...and also the cause of problems in the osteopathic community.

Now regarding the original question, I have seen and done OMM on several rotations. Mostly surgery, OB/GYN, EMED and outpatient primary care.

I agree with JPHazelton

 

[jrf331]

 

[jrf331]

Let me first say that I am not the biggest believer in OMM, but I do think some techniques can make a difference in patient care. Having said this;
I have both seen and done OMM on rotations in the clinic and hospital.

 

[jrf331]

If you actually believe that allopathic schoos don't emphasize a patient first approach you are mistaken. I started medical school at an osteopathic school and transferred to an allopathic school after my second year. As far as I have seen my new allopathic school is as or more patient oriented than my old osteopathic school. Allopathic schools are no less interested in making sure that their students care about the "whole" patient. Individual students and physicians can choose to be pricks or caring empathetic physicians. I have met DOs and MDs who are pricks and it isn't due to where they went to school. The biggest difference I have seen so far between the two types of schools is that the time that osteopathic students spend learning OMM is spent in allopathic institutions learning patient care and physical diagnosis skills.

AMEN!!!

 

[toothless rufus]

Edit: Deleted for=not as funny as intended.

 

[Cuthbert]

4th year here. I would do 2-3 full body treatments a week during my FP rotation (which was 8 weeks long). Nothing in any other rotation - however, most others were under MD's.

 

[Smackey]

This will be my last post on the issue, since it is off topic and seems to be an area that might offend people.

No where did I state that the approach that I believe to be the Osteopathic approach is better, or was treating the "whole patient". I was simply stating my observations of the school I chose and the doctors I work with. I think their are several different techniques to approach patients, none of them being wrong... Just different. I would go as far as to say it is the difference between me choosing red and someone else choosing blue.

At some point people will have to realize that when someone points out what they feel is a difference, is not actually bashing anyone. Just stating a difference. Why must others turn this into a fight?

In my opinion, humble as it is, that reasoning you describe above is the root of all discord between MDs and DOs

That might be your opinion, but I believe that the history of Osteopathic medicine would show otherwise. This might be one issue now, however it is way down on the list of other issues that have seperated the professions in the past.

 

[Dr JPH]

That might be your opinion, but I believe that the history of Osteopathic medicine would show otherwise. This might be one issue now, however it is way down on the list of other issues that have seperated the professions in the past.

Its not the idea that separates the two but the attitude about that idea.

MDs dont scoff at us because we treat the whole patient but rather because we claim to be better and more "patient friendly" than they, which is simply not true.

Though you say opposite in your most recent post your initial statement falls right in line with this.

I know you are only a second year student so you are yet to have a totally clinical experience. When you do get there you will see that any differences you mentioned above are quickly wiped clean.

The one true and solid difference we have is OMT. That is what separates us. Having the ability to diagnose and treat using our hands.

Take it from someone who gets asked on a very regular basis my opinions on this from MDs (I am an OMM Fellow), our pre-clinical education differs very little from our MD counterparts. We dont learn a different way to speak to patients or a new way to look at a patients labwork. We dont ask different questions of our patients when taking a history nor do we focus on certain aspects of the patients well-being that would not be focused on by any competent physician.

The history of osteopathy is long and proud. The differences outlined by AT Still were necessary at the time...over 100 years ago. In this current era of medicine the one and only appreciable difference in manipulative medicine. It is that which must be developed, researched and passed on.

I am sure you will see what I am talking about when you get into your clinical years. Dont give up on the positive nature of your ideas...dealing with the patient and not a set of symptoms or a bundle of numbers is vitally important. But we do not do that because we are osteopaths...we do that because we are empathetic physicians.

Now...if the patient has a sacral torsion...

 

[Dr JPH]

BTW...


I am not trying to turn anything into a fight. But I feel compelled to openly talk about this issue whenever I get a chance because it is an area that seems to be pulling osteopathy apart at the seems.

The "whole patient" idea is great but it is far from unique and we need to stop acting like we invented it. We didnt even invent manual medicine but we sure have taken it from an imperfect science to at least a faily well understood physiologic mechanism.

I meet with premeds on a regular basis and I am astounded at the number of different views of what osteopathic medicine is. I constantly hear things like "I dont want to prescribe medicine." or "I want to offer something other than tests and surgery to treat cancer."



Where are they getting these ideas?

We need to focus our attention on our strong points and stop touting this abstract "holistic" idealogy. We are different because we can offer something additional to our patients that our MD friends cannot, at least not without additional training. But do we offer a "nicer" and "more complete" form of healthcare? Without OMT I do not believe that we do.

 

[homeboy]

If you actually believe that allopathic schoos don't emphasize a patient first approach you are mistaken. I started medical school at an osteopathic school and transferred to an allopathic school after my second year. As far as I have seen my new allopathic school is as or more patient oriented than my old osteopathic school. Allopathic schools are no less interested in making sure that their students care about the "whole" patient. Individual students and physicians can choose to be pricks or caring empathetic physicians. I have met DOs and MDs who are pricks and it isn't due to where they went to school. The biggest difference I have seen so far between the two types of schools is that the time that osteopathic students spend learning OMM is spent in allopathic institutions learning patient care and physical diagnosis skills.

I agree, and thought Smackey's post was pretty ridiculous.

It's rather pathetic that DO students are so full of themselves and their education that they would claim DOs have better patient interaction based merely on 2 yrs of didactic education and OMM labs...after which, we're all at the same hospitals.

Hazelton had it exactly: MDs dont scoff at us because we treat the whole patient but rather because we claim to be better and more "patient friendly" than they, which is simply not true.

 

[Old_Mil]

I meet with premeds on a regular basis and I am astounded at the number of different views of what osteopathic medicine is. I constantly hear things like "I dont want to prescribe medicine." or "I want to offer something other than tests and surgery to treat cancer."



Where are they getting these ideas?

(1) Find a mirror.
(2) Look in it.

 

[Dr JPH]

(1) Find a mirror.
(2) Look in it.

Apparently you neglected to read anything I have written on this website in the past 6 years including my comments above. I wouldnt expect anything different from you though given your history on SDN.

 

[jhug]

At some point people will have to realize that when someone points out what they feel is a difference, is not actually bashing anyone. Just stating a difference. Why must others turn this into a fight?

yea...i can never quite figure out why MD's hate the "you suck...I'm better" philosophy/difference the AOA spews...and why that starts fights is beyond me...
equally puzzling is the fact that my buddies at MD schools are actually taught that patients are just symptoms-not people...and that nothing in the human body is interrelated...they also reinforce the idea that MD's shouldn't listen/empathize/or be kind to patients...