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MD/DO Merger, another great idea

Discussion in 'Medical Students - DO' started by jmor702, May 23, 2002.

  1. jmor702

    jmor702 Member
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    I am working on a proposal to the AOA, that would be a good for most MDs out there. It would allow MDs to become DOs, sharing all the rights, privileges, and prestige that comes with the title.

    Instead of the usual cold, unfeeling, unresponsiveness associated with an MD title, patients would be lulled into believing they were going to get a caring and concerned DO, who sees them not as a disease process, but as a human being with a problem.

    The only problem is that without a thorough grounding in Osteopathic philosophy, it wouldn't take long for the mDO to be seen through.

    Well it seemd like a plan at the time!
     
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  3. bones

    bones Osteopathic Physician
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    <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

    In a quest to unify medicine, I guess it doesn't REALLY matter whether all docs are MDs or DOs... just so long as there is one degree for everyone. I'm sure the AMA would be thrilled by the opportunity to have all their members become DO's, but would the AOA agree?
     
  4. GoForIt

    GoForIt Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">I'm sure the AMA would be thrilled by the opportunity to have all their members become DO's, but would the AOA agree?
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think AOA would be more agreeable if AMA would have all their members become DO-'s, meaning without OMM skills.
     
  5. Dr. Nick

    Dr. Nick Senior Member
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    I think somebody has been watching Patch Adams one too many times :rolleyes:
     
  6. Dr JPH

    Dr JPH Membership Revoked
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    Good movie.
     
  7. osteodoc13

    osteodoc13 Member
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    jmor:

    I would say just be patient, more and more physicians are understanding the utility of wholism. They are becoming more Osteopathic, without knowing, and soon we won't have to worry about MDs taking over us, because they will become us.
     
  8. Dr. Nick

    Dr. Nick Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by osteodoc13:
    <strong>jmor:

    I would say just be patient, more and more physicians are understanding the utility of wholism. They are becoming more Osteopathic, without knowing, and soon we won't have to worry about MDs taking over us, because they will become us.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">But, if they "become us" then what purpose will osteopaths serve? Since the AMA has much more power than the AOA it seems that DOs would become a dying breed, no?

    Of course, that doesn't matter since we aren't worried about protecting institutions. We are only concerned with quality patient care, right?

    OK, I don't really believe DOs or MDs are either going to become extinct in our lifetimes. There will always be people willing to follow fringe practices, like cranial, on faith. And I don't see MDs adopting anything so intangible. So.... live and let live.
     
  9. Dr. Nick

    Dr. Nick Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by JPHazelton:
    <strong>Good movie.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Snicker.

    "Patch Adams is the kind of film that will work for an audience that's just interested in having an emotional experience (with a happy ending) without caring how obviously or clumsily they are manipulated. I find this sort of sledgehammer film making to be offensive, but there are those who enjoy it. Somehow, though, I don't think there are enough viewers with such a low quality threshold to right Universal Pictures' floundering financial ship. Patch Adams is another miscalculation by a studio that hasn't done much right all year."

    I think that about sums it up. Well, as the old saying goes, "there's no accounting for taste."
    :p
     
  10. acurarte

    acurarte Member
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    The AOA will not even let D.O.'s who have graduated from their accredited schools be part of the AOA (referreing to internship requirements). The AOA is so backwards that it they don't even allow D.O.'s into their club. I can not foresee the actions mentioned above MD becoming DO even a remote possibility....
     
  11. dkwyler94

    dkwyler94 Senior Member
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    Finding out that the AOA doesn't allow all DOs to be members was rather disapointing to me. As I understand it, only 30% of DOs are eligible for membership in this organization. Therefore, I don't think we can consider it the organization that represents DOs. If they aren't, there really isn't a political institution currently who represents DOs as a whole.

    If I were political minded, I would consider trying to organize an Osteopathic association which would represent all Osteopaths. I think the other 40% who are affected by the actions of the AOA should have a say in their policies.

    Of course the AMA does allow all DOs membership, regardless of residency or internship. While I have never seen the numbers, I would guess that more DOs are members of the AMA than the AOA. This is just a guess on my part. Perhaps it would be best if all DOs were to join the AMA. The greater the numbers, the more they would have to listen to what we have to say.

    As they are the major political force representing doctors in the US today and a major force in shaping healthcare policies today, if DOs want a say, perhaps they should consider joining the AMA.

    (Just a plug for them. you can do so at <a href="http://www.ama-assn.org/" target="_blank">http://www.ama-assn.org/</a> It is only $18/year for students and you get a subscription to JAMA along with it. That is 52 issues a year for just $18. Sound like an advertisement yet?)
     
  12. osteodoc13

    osteodoc13 Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Dr. Nick:
    <strong> ...I don't see MDs adopting anything so intangible. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">WOW Dr. Nick...it isn't like you to say such a silly thing as this. Try reading a pharmacology book and tell me what is the mechanism of action for a SSRI. Now tell me how that treats depression.

    A great majority of the treatments given by MDs are based on nothing more than "We don't know why, but it works!"

    MDs, and most DOs, are pawns of the pharmaceutical companies, who continue to fund research on chemical "causes" of diseases simply to justify their own existence.

    How about paying more attention to the human body, and the "medications" it produces for itself.
     
  13. Takin' it to the barrier

    Takin' it to the barrier Junior Member
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    I don't think MD's should be able to become DO's. Being a DO is more than whole body medicine. There is a little thing called OMM that gives us an edge. I would agree to let any MD who wants to become a DO to do so only after taking OMM classes. I think the added 200hrs I will have of OMM class should do it!
     
  14. Neurogirl

    Neurogirl Resident Extraordinaire
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    Osteodoc13,

    I'm afraid it is YOUR statement that is "silly". Have you ever heard of the concept of "evidence based medicine" (EBM)? Of course there are many medications whose mechanisms of action are unknown, but that is hardly the point. The point is that they have been PROVEN to work and are safe to the patient.

    After matriculating into an osteopathic school, I was amazed and disappointed by the lack of GOOD research regarding OMM. Even more astonishing was the attitude of various professors. We'd leave pharm or clinical lectures (where the idea of EBM was pounded into us) and go to OMM lecture/labs where the idea was NEVER discussed and in fact was avoided.

    It is time for us to move forward. If we want OMM to be accepted by the entire medical community, then we must PROVE its' efficacy. If it is not efficacious, then it MUST be abandoned. If the old guard at the AOA can't/won't see the truth in this statement then perhaps it's time for them to go!

    Neurogirl DO, MPH
     
  15. Sweaty Paul

    Sweaty Paul Senior Member
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    Amen Neurogirl.

    In case you are interested at the last SOMA convention in Atlanta, the House of Delegates passed a resolution calling for Evidenced-Based Medicine to be the standard for all research for OTM/OMM/OPP. I think it speaks volumes that Osteopathic Students recognize the necessity of proving OTM's efficacy/inefficacy in a systematic, logical, and reproducible manner. I hope that the TCOM with the new research institute will generate quality research into a variety of topics regarding OTM.

    Sweaty Paul
     
  16. osteodoc13

    osteodoc13 Member
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    Neurogirl:

    I think it is YOU who is being silly. Osteopathic manipulation has proven itself for over 100 years. I agree that there need to be randomized, single-blind studies to show it's efficacy to the allopathic world who is completely devoted to studies, but what about the thousands of patients who have been treated effectively with OMM. Isn't that "evidence?" Spend time reading the writings of Still, Littlejohn, Sutherland, Frymann, and then spend time with your hands on patients, and see if you don't have your "evidence."

    We have allowed the allopathic world to tell us that we have to prove ourselves to them, and maybe we should. As the previous poster stated, the research center at TCOM and the research going on at KCOM should help in that arena. As students we need to be more proactive when we get out into "the real world" and take part in studies. BUT, we shouldn't have to prove the efficacy of OMM to ourselves. The students we accept should already be versed in Osteopathy, and if they spend the time with their hands on patients they don't need studies to prove it to themselves.

    Maybe we should spend less time in front of these computers and more time treating patients, family, and friends? :D
     
  17. Dr. Nick

    Dr. Nick Senior Member
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    Well said, Neurogirl.
     
  18. Neurogirl

    Neurogirl Resident Extraordinaire
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    Osteodoc13

    Oh my...where to begin. If you still don't understand the importance of evidence based medicine (EBM), then it is high time you learned. Surely you must realize (or maybe you don't) that even DOs are required to provide patients with the standard of care (SOC) for their illnesses. How do you think the experts determine SOC? By using EBM! Why would you think that OMM should be exempt from those same strict standards?

    BTW, I HAVE read Still and Frymann, as well as Sutherland. I have the utmost respect for all of them and their work. But in case you haven't noticed, WE NO LONGER LIVE IN THE 19th and 20th CENTURIES! We live in the 21st century. In this century, IT DOESN'T MATTER WHAT YOU THINK OR SEE! ALL THAT MATTERS IS WHAT CAN BE PROVEN!

    Also, I AM out in the "real world". I'm currently finishing my osteopathic internship and am about to begin my allopathic residency. Believe me when I tell you that MOST of your DO attendings and ALL of your MD attendings (and yes, no matter where you go, you WILL have to deal with MD attendings...even at osteopathic hospitals) will laugh in your face if you EVER try to pass off such a pathetic excuse as scientific evidence for the efficacy of OMM!

    Please don't misunderstand...I DO believe in OMM and am certain that some types of treatments will prove to be quite efficacious. However, until I have PROOF, I refuse to utilize any potentially harmful treatments. Also, the allopathic world did NOT force me to take such a stance. My OSTEOPATHIC training (non-OMM profs) taught me the importanc of EBM. I would hope that you had the same type of education, but perhaps you did not.

    Neurogirl DO, MPH
     
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  19. John DO

    John DO A.T. Still Endowed Chair
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    Potentially destructive, Neurogirl? Are we being a little melodramatic?

    Michael Kuchera, D.O., has a wonderful way of describing his stance on the subject. He states that, although EBM and studies are definitely important to this field, the Benefit:Risk ratio should be considered in all cases. If the patient stands to benefit, even only with a placebo effect, and the risk is minimal or nonexistent (except for the loss of precious time), then you would be doing a disservice to your patient to withhold these treatments.

    However, in the previously mentioned pharmacological instances, the risk factor is increased substantially, so the benefit is required to be much greater to maintain the ratio and to justify the increased risk; therefore, EBM is much more indicated than in a field, such as OMM, where the risk is not even worth considering in most cases.

    As we remember from basic math, if the numerator is 0, the result is nil, but if the denominator is 0, the result is infinite, which, in this ratio, translates to infinite benefit for your patient.
     
  20. Neurogirl

    Neurogirl Resident Extraordinaire
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    Your point is well taken. Perhaps I was being a bit melodramatic. I was referring specifically to HVLA and the very real potential for harm in the elderly and in those with varient spinal anatomy. Actually, I have been known to use Muscle Energy and Counterstrain, but only because they are such benign treatments with really no threat of harm. The main point I was trying to get across was that if we, as a profession, are to be taken seriously, we must adhere to the highest of professional standards. There is no room for ignorance and no substitute for good science. Am I...dare I say the word...a Science Nazi? <img border="0" title="" alt="[Eek!]" src="eek.gif" />
     
  21. Dr. Nick

    Dr. Nick Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by John DO:
    <strong>If the patient stands to benefit, even only with a placebo effect, and the risk is minimal or nonexistent (except for the loss of precious time), then you would be doing a disservice to your patient to withhold these treatments.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">But, wait a minute. Are we forgetting one factor here? What about cost to the patient.

    Think about this. I read that cranialsacral manipulation is generally billed at $35-$200 per hour. Is it really ethical to perform these "harmless" treatments in the absence of good evidence that they actually do anything?

    "As we remember from basic math, if the numerator is 0, the result is nil, but if the denominator is 0, the result is infinite, which, in this ratio, translates to infinite benefit for your patient."

    And potentially infinite profit to the practitioner - is that really "harmless?"

    Some would argue that billing your patients unneccesarily exorbitant fees would be a disservice to your patients.
     
  22. John DO

    John DO A.T. Still Endowed Chair
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    Dr. Nick,

    Ever wonder why pharmaceutical companies offer very limited monetary support (gifts, etc) to AAO (American Academy of Osteopathy--staunch proponents of OMM use) physicians? If we are to consider the concept of monetary benefit to the patient, in addition to intangibles, we need to consider ALL patients. I submit that those we save money on prescription medication costs will far outweigh those that may not benefit, if the practice was more widely used in a professional, responsible manner. However, the same algorithm applies: if the cost risk is high and the benefit minimal, the use of OMM would be contraindicated on the basis of economics, just as in the use of any other treatment modality.

    Neurogirl (ScienceNaziGirl), :)

    No one ever suggested using OMM irresponsibly. SOC still applies, even if the research hasn't been thorough. If you use OMM, you would know NOT to use it when contraindicated, as you mentioned. Again, refer to the Benefit:Risk analysis.
     
  23. Dr. Nick

    Dr. Nick Senior Member
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    Interesting post from qwackwatch.com. I think it addresses a lot of the points of discussion on this thread.

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    A former osteopathic medical school faculty member wrote:
    I spent 12 years teaching basic sciences and 7 years as an
    associate dean at the an osteopathic medical school. However,
    since the school's faculty came from institutions throughout
    the United States, I doubt that what I observed differed much
    from the situation at other osteopathic schools.
    Students carried a heavy curriculum in osteopathic manipulative
    therapy (OMT), beginning in their freshman year. The department
    of manipulative medicine was completely segregated from the other
    departments, both in principles and in practice. The osteopathic
    faculty members in the standard medical departments neither practiced nor taught OMT. Nor did the OMT faculty practice or teach the
    standard forms of medicine. It was as if OMT was a freestanding
    form of health care -- one that, unlike other departments, was
    not necessarily bound by scientific foundations. Being a basic science researcher, I have made attempts to set up an animal
    model to objectively test the claim that certain harmful forms
    of sympathetic nerve traffic could be altered by spinal OMT.
    However, I never received any support from the osteopathic faculty
    in seeing such a study completed. The general attitude of the
    osteopathic manipulation physicians was, "since we already
    know it works, why should we bother with proving it."
    Cranial therapy was a large component of the manipulative
    medicine department, both for patient care as well as for teaching
    the medical students. Interestingly, while the other faculty
    accepted most forms of OMT even though they did not use them,
    they did not endorse the use of cranial therapy. Indeed, I heard
    many criticisms of the practice by the non-OMT faculty. Their
    objections were the same as mentioned on Quackwatch -- that the
    cranial bones fuse early in infancy, after which no motion of these bones takes place. As you indicate, the alleged sensing
    of such motion forms the heart of cranial therapy.
    I have never heard any attempt by an OMT practitioner to offer
    a tenable defense to such criticism. To me it almost seemed as
    if the OMT practitioner felt that the practice could not be defended
    with ordinary logic since its basis lay somewhere in the metaphysical
    and that only their gifted hands were able to "sense"
    the cranial motion.
    But the seemingly metaphysical did not stop with the practice
    of cranial therapy. I know of one case in which a student with
    an undiagnosed illness consulted one of her OMT mentors who concluded
    that she had "a "hole in [her] aura."
    David E. Jones, Ph.D.
     
  24. Ice Man

    Ice Man Member
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    Wow, is it really like that? My friends say that their OMT dept. is part of the family med department. Also, they (along with 95% of the class) both say that Cranial is garbage and will never practice it. However, if your looking for the money angle talk to the neuro therapy people with Cranial-Sacral "degrees." Those are the people making a killing on this. I know one in a town of 50k. She charges $100/hour for that.
     
  25. osteodoc13

    osteodoc13 Member
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    Neurogirl:

    I'm not saying that the research doesn't need to be done. What I am saying is that those of us who use OMM know that it works. We have all seen the benefits of the work. We shouldn't have to prove it to ourselves. And I think it sucks that we have let the MD world say that, until we have "proven" that it works, they won't accept it.

    You say that you have done some ME and S/CS. Why did you do it? I know that you say they have little side effects (although I have gotten some powerful treatment effects from too much S/CS) but you must think that it would help the patient, or why would you waste 90 seconds treating a point? Why do you use it if there is no "EBM" to back it up? WE who use our hands know the power that lies in the body, and we understand how to use it to the patient's benefit.

    Maybe we should challenge the allopaths to prove that OMM doesn't work? We could get some of their MD/PhDs to work on creating good research projects, then use DOs as the hands. Anyone else think this is a good idea?
     
  26. osteodoc13

    osteodoc13 Member
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    Dr. Nick

    I too have read all of the info on Quackwatch regarding OCF. I notice that Dr. Barrett is not really up on his reading. It appears that most of his objection is based on reading some of Upledger's (whom we have already established is no longer considered part of the Osteopathic community) pamphlets and his web-site. He obviously has not read even a small majority of the research out there supporting OCF. He even goes so far as to say that the cranial bones fuse soon after infancy. The literature is overwhelming that this does not happen. If he was more well read in OCF I might give more credence to his arguments, but until then I consider him to be an underinformed town crier, nothing more.
     
  27. Dr. Nick

    Dr. Nick Senior Member
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    Hi Osteodoc,

    "Maybe we should challenge the allopaths to prove that OMM doesn't work? We could get some of their MD/ PhDs to work on creating good research projects, then use DOs as the hands. Anyone else think this is a good idea?"

    That statement simply stuns me. I'm pretty sure that you are just joking around though, right?

    Osteodoc, how do you propose to prove a negative? Why does the burden of evidence for the efficacy of therapy not lie on the practicing clinician?

    You're starting to scare me!
     
  28. Dr. Nick

    Dr. Nick Senior Member
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    Osteodoc,

    "It appears that most of his objection is based on reading some of Upledger's (whom we have already established is no longer considered part of the Osteopathic community) pamphlets and his web-site."

    I don't think it matters much that Upledger is no longer "considered part of the Osteopathic community." I've looked at that site and it seemed very much in synch with other stuff i've read about cranial. I looked at <a href="http://www.cranialacademy.org" target="_blank">www.cranialacademy.org</a> but it doesn't address many specifics at all.

    What is different from "mainstream" cranial theory?

    CranioSacral Therapy is a gentle, noninvasive manipulative
    technique. Seldom does the therapist apply pressure that exceeds
    five grams or the equivalent weight of a nickel. Examination
    is done by testing for movement in various parts of the system.
    Often, when movement testing is completed, the restriction has
    been removed and the system is able to self-correct [1].
    The rhythm of the craniosacral system can be detected in much
    the same way as the rhythms of the cardiovascular and respiratory
    systems. But unlike those body systems, both evaluation and correction
    of the craniosacral system can be accomplished through palpation.
    CranioSacral Therapy is used for a myriad of health problems,
    including headaches, neck and back pain, TMJ dysfunction, chronic
    fatigue, motor-coordination difficulties, eye problems, endogenous
    depression, hyperactivity, attention deficit disorder, central
    nervous system disorders, and many other conditions [2].
    Practitioners today rely on CranioSacral Therapy to improve
    the functioning of the central nervous system, eliminate the
    negative effects of stress, strengthen resistance to disease,
    and enhance overall health [3].
    Using a soft touch generally no greater than 5 grams, or about
    the weight of a nickel, practitioners release restrictions in
    the craniosacral system to improve the functioning of the central
    nervous system. By complementing the body's natural healing processes,
    CST is increasingly used as a preventive health measure for its
    ability to bolster resistance to disease, and is effective for
    a wide range of medical problems associated with pain and dysfunction, including: migraine headaches; chronic neck and back pain; motor-coordination
    impairments; colic; autism; central nervous system disorders; orthopedic problems; traumatic brain and spinal cord injuries;
    scoliosis; infantile disorders; learning disabilities; chronic
    fatigue; emotional difficulties; stress and tension-related problems;
    fibromyalgia and other connective-tissue disorders; temporomandibular
    joint syndrome (TMJ); neurovascular or immune disorders; post-traumatic
    stress disorder; post-surgical dysfunction [4].

    What here differs from "mainstream" cranial?
     
  29. Dr. Nick

    Dr. Nick Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by osteodoc13:
    <strong>He even goes so far as to say that the cranial bones fuse soon after infancy. The literature is overwhelming that this does not happen. If he was more well read in OCF I might give more credence to his arguments, but until then I consider him to be an underinformed town crier, nothing more.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">The literature, as Osteodoc puts it, is not "overwhelming." That is absurd.

    Try this:

    Goto: <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi" target="_blank">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi</a>

    and do a pubmed search for: "cranial suture fusion"

    Osteodoc, it is OK if you wish to defend your belief in cranial - I respect that. But please don't distort the substance of the current medical literature. That serves nobodys interests.
     
  30. osteodoc13

    osteodoc13 Member
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    Nick:

    I offered to send you the my bibliography of literature pertaining to OCF...you didn't take me up. I feel that, scanning through the list, the evidence is "overwhelming."

    Upledger teaches that diagnosis is not important, nor is knowledge of anatomy, physiology, or pathology. The only thing which matters is intent. This is pure Barbra Streisand. OCF is practiced by licensed physicians, with full scope of practice and a thorough knowledge of both osteopathy and medicine. No Osteopath would begin treating without making a diagnosis, just as an allopath would not write a script without seeing a patient. Anatomy is the basis of Osteopathic treatment. In Sutherland's first courses, he spent a week reviewing cranial anatomy, with a thorough study of the articulations of each bone. Physiology and pathology are interrelated with each other and with anatomy. Thus the CST that Upledger teaches bears very little resemblance to OCF practiced by osteopathic physicians.
     
  31. Dr. Nick

    Dr. Nick Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by osteodoc13:
    <strong>This is pure Barbra Streisand. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">LOL! I'm gonna have to borrow that expression if you don't mind <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

    I see your point, but these aspects don't seem to appear on the qwackwatch site, no?

    Cheers!
     
  32. osteodoc13

    osteodoc13 Member
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    As I've stated in other posts, this is one reason why I tend to dismiss Barrett's criticisms of OCF, and I also question the validity of his other information on his page. Don't get me wrong, I'm not into iridology or high colonics, but the lack of research into OCF makes me wonder how much research he puts into other links.

    Maybe if he had called the link "CranioSacral Therapy's dubious aspects" then I would have more respect for him.
     
  33. John DO

    John DO A.T. Still Endowed Chair
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    "Respect" and "Stephen Barrett" do not belong in the same sentence. In case you haven't noticed, all he does is offer editorial on his opinion that everything that is not Stephen Barrett is wrong.

    Dr. Nick, you encourage scholarly pursuit, but quackwatch.com is NOT a peer-reviewed venue that should be quoted as if it were science, any more than you would quote opinions posted on SDN as if they were research!
     
  34. Sweaty Paul

    Sweaty Paul Senior Member
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    As a future osteopathic physician I will quote an old Wendy's advertisement that was very popular when I was younger..."where's the beef?"

    I don't doubt that OCF is diff than Cranio-sacral as upledger teaches it. However, the fact remains that much of "science" on which the theory is based is flawed. Much of the research into cranial manip, therapy, treatments, diagnosis, and success of the above items is flawed or misinterepreted using sub-standard methods of data analysis.

    I would like someone to post access to legitimate studies showing any efficacy of OCF. I have admitted that the literature pointed that the cranial bones do move...I had to eat my words on that (despite the fact that the movement is very small). I am not unwilling to change my opinion, however, citing the Cranial Academy webpage as a source of information is a little like letting the fox into the henhouse.

    Perhaps we can, as a group (Osteodoc, stillfocused, Dr. Nick blondarb, John DO), pick one therapy that cranial is alleged to be effective. Then, we can each of us who have been involved with this thread do a little research looking for data concerning that particular therapy, and discuss the results of our own research and what the others find. This can mean a couple of things, that in the end we agree that OCF works/doesn't work, that more research needs to be done, or we will agree to disagree; but we will have investigated the topic with some degree of thouroughness and approached the topic with thoughtful and logical consideration.

    Let me know what you kids think.

    Sweaty
     
  35. osteodoc13

    osteodoc13 Member
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    Last night I threw together a web page so you all can look at the Cranial Bibliography. I am especially interested in what Dr. Nick thinks of the "non-existent" research on OCF. Here's the link:

    <a href="http://home.earthlink.net/~bloveless/biblio.html" target="_blank">http://home.earthlink.net/~bloveless/biblio.html</a>

    Good luck!
     
  36. jonty

    jonty Junior Member

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    <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" />

    Hi everyone

    I must say that coming from a place where there is no such thing as a DO or an MD, it is strange to hear health care workers arguing about whether they should be merged...

    In SA, we are trained to excel in clinical and surgical techniques (seems very MD) while never fogetting the fact that the patients psychological, emotional, spiritual and social wellbeing have serious effects on outcome of both medical and surgical cases (seems very DO).

    In short, a unification of the two disciplines is not so unthinkable because where I live, they are one and the same.

    What are your thoughts on this? :p
     
  37. med student

    med student Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by osteodoc13:
    <strong>Neurogirl:

    I think it is YOU who is being silly. Osteopathic manipulation has proven itself for over 100 years. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Well actually if you go to other countries they will say that witch doctors have proven themselves over hundreds of years. The problem is just because a patient thinks something works does not mean it actually works.
     
  38. med student

    med student Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by jmor702:
    <strong>

    Instead of the usual cold, unfeeling, unresponsiveness associated with an MD title, patients would be lulled into believing they were going to get a caring and concerned DO, who sees them not as a disease process, but as a human being with a problem.
    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">yeh those evil and cold MDs no one wants to go to them. When you make ridiculous generalizations like this you lose all credibility.
     
  39. bones

    bones Osteopathic Physician
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    <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

    don't get yourself up in a twist now med student... I think its safe to say this whole thread started as a bit of a joke in response to my previous thread on the idea of what it would be like to have an MD/DO merger to unify medicine. for some reason, several people took jmor702's post a little too seriously <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
    This has, however, evolved into an interesting discussion.

    Sweaty- good call on the research bit. I was about to do exactly what you suggested sometime this break- and I agree we need to change our focus from arguing a particular point to a focus of truthfinding. It is silly to quibble back and forth when the answers to our questions are out there (or at least could be if someone would write a good objective NIH proposal).

    lets get to the bottom of this and have our cranial quibbling ended for good.

    peace,
    bones
     
  40. Jersey Girl

    Jersey Girl Member
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    "Maybe we should challenge the allopaths to prove that OMM doesn't work? We could get some of their MD/PhDs to work on creating good research projects, then use DOs as the hands. Anyone else think this is a good idea?"

    Ostoedoc, this is a terrible idea! It would be like an admission to the osteopathic professions inability to prove the efficacy of OMT. It sends a message that we lack the scientific foundation and skills to prove OMT works ourselves. If DO's use OMT, and DO's are the ones preaching OMT, it is their responsability to prove how and why it works. The whole statement about letting MD/Ph.d's design the research, while letting the DO's be the hands is an insult. Let the MD's be the masterminds, while we behave like obedient lab technicians who follow orders?

    Dr. Nick
    I noticed that you don't have many posts in the allopathic forums, yet you are a student at an allopathic med. school. You always have a negative light to cast on the osteopathic world in every post you leave. I can't understand why an MD student spends more time posting in an osteopathic forum.
     
  41. bones

    bones Osteopathic Physician
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    thanks for posting that webpage brian- I converted it to a text file with a small font and its still 25 pages of just citations! admittedly, some are questionable and others are only very tangentially related to cranial... but it looks like we have a good place to start.

    Anyone up for co-authoring a review article?
    I didn't check the list yet, but I suspect if there are any already they are not from particularly objective sources- and an objective look at this stuff is long overdue.

    brian, if you know of any off-hand, could you point them out? (I don't feel like digging through the 25 pages today since I have a final tomorrow).

    just a thought,
    bones :cool:
     
  42. bones

    bones Osteopathic Physician
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by John DO:
    <strong>"Respect" and "Stephen Barrett" do not belong in the same sentence. In case you haven't noticed, all he does is offer editorial on his opinion that everything that is not Stephen Barrett is wrong.

    Dr. Nick, you encourage scholarly pursuit, but quackwatch.com is NOT a peer-reviewed venue that should be quoted as if it were science, any more than you would quote opinions posted on SDN as if they were research!</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">you said it JohnDO...
    Barrett states his goal is to:
    "combat health-related frauds, myths, fads, and fallacies" by "investigating questionable claims" and "improving the quality of health information on the Internet. " I sincerely wish he stuck to his plan.

    Instead, he attacks anything out of mainstream medicine, often without a shred of evidence to support his arguments. Of course, very few of the modalities he attacks have evidence to support their use, but as a scientific investigator he needs to seriously improve his standards of inquiry. He clearly has an agenda at the start of every "investigation."

    I'm looking for a more objective version of "quackwatch" on the internet (via a different author), but I have yet to find it.
    Let me know if any of you know of better sites with this theme!

    cheers,
    bones
     
  43. med student

    med student Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by bones:
    <strong> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />

    don't get yourself up in a twist now med student... I think its safe to say this whole thread started as a bit of a joke in response to my previous thread on the idea of what it would be like to have an MD/DO merger to unify medicine. for some reason, several people took jmor702's post a little too seriously <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" /> </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">opps my bad. :cool:
     
  44. Stillfocused

    Stillfocused Senior Member
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    For the record, "carnial suture fusion" does not mean either synostoses or obliteration by ossification.

    It just means that the space between the sutures have closed.

    These spaces are largely filled with collagen, a relatively compressible substance. And, they are innervated.
     
  45. osteodoc13

    osteodoc13 Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Jersey Girl:
    <strong>"Maybe we should challenge the allopaths to prove that OMM doesn't work? We could get some of their MD/PhDs to work on creating good research projects, then use DOs as the hands. Anyone else think this is a good idea?"

    Ostoedoc, this is a terrible idea! It would be like an admission to the osteopathic professions inability to prove the efficacy of OMT. It sends a message that we lack the scientific foundation and skills to prove OMT works ourselves. If DO's use OMT, and DO's are the ones preaching OMT, it is their responsability to prove how and why it works. The whole statement about letting MD/Ph.d's design the research, while letting the DO's be the hands is an insult. Let the MD's be the masterminds, while we behave like obedient lab technicians who follow orders?
    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">It's amazing how one comment can bring such an uproar around here! My point was that I don't feel that I have anything to prove, except to my patients. I understand the anatomy and physiology behind what I do, and my patients understand the efficacy. This, I feel, is a major problem in the Osteopathic community. Most of the people who do straight manipulation (or majority manipulation) are not the research-minded type. They go into medicine to treat patients, not run experiments, and so once they are out and working, there is no desire to do the research. My point about MD/PhDs is that apparently none of the research which has been done in the past 100 years is acceptable to the allopathic community. If they can design a better model to test OMM in a clinical setting, then let them do it. I don't mind letting a better researcher than I set up the trial, as long as I am allowed to use OMM and Osteopathy appropriately.

    My other point is that we are bending over backwards to prove a modality to the allopathic world which works at least as well as many of the modalities they use, with at least as much if not more scienctific basis. We as Osteopathic students should spend more time learning how to use our hands for more than typing on these keyboards. Let's start helping our patients.
     
  46. Stillfocused

    Stillfocused Senior Member
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    If they can design a better model to test OMM in a clinical setting, then let them do it. I don't mind letting a better researcher than I set up the trial, as long as I am allowed to use OMM and Osteopathy appropriately.

    Unfortunately, Allopathic medicine does not accept or even want to understand the philosophical basis of Osteopathy.

    Contemporary Allopathic medicine is entrenched in biological reductionism. To simplify things greatly, biological reductionists view the whole as merely a sum of its parts.

    However, traditional Osteopathy offers a quite different perspective. It see sees the whole as greater than the sum of its parts. It is an integrationist approach to science. To say that DOs treat the whole person is not just a slogan. In traditional Osteopathy it is the basis of treatment.

    We can design single blind outcome studies to demonstrate the "efficacy" of Osteopathic therapeutics. And, we should. Yet, these studies do not begin to do justice what is actually happening in a treatment.

    There is are fundamental epistemological differences between contemporary Allopathic medicine and traditional Osteopathy.

    Moreover, traditionally oriented DOs best understand the epistemology that undergirds their practice. As scientists it is incumbent upon them to develop the research methods that most deeply explain their practice whether it comes naturally or not.

    A biological reductionist researcher could not design a better Osteopathic study than could you.
     
  47. osteodoc13

    osteodoc13 Member
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    Stillfocused:

    Great point. I know that our best bet for true "proof" comes from traditional osteopaths. But my earlier point remains valid. Those who go into traditional osteopathy are in general not research minded. They tend to be very right-brained, and their focus is on treating patients. Also, as I said, most of them don't feel a particular urgency to prove to the general allopathic community the efficacy of their work. Their patients speak for themselves, and they don't really interact with insurance companies, IPA boards, or hospital boards who might question their work.

    What small outcome studies we have performed have been dismissed by the medical community. My point was that if they don't like the studies we have designed, maybe they could design a better one.
     
  48. oceandocDO

    oceandocDO Senior Member
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    Regarding Stephen Barrett, MD and his "website", just so you all know, Dr. Barrett is married to a D.O.!!!!!!!!

    He obviously has full faith in his wife's abilities as a physician and most of what he says is a mere attempt to get more hits to his site. There are countless other MDs who have much more impressive backgrounds than Barrett who have come out as advocates of OMT, such as Harvard-trained Dr. Andrew Weil. Most MDs dont give much respect to Barrett, at least the ones I've talked to. His opinions are best used by MD STUDENTS with little to no idea on what OMT actually is. They're the ones who lose credibility by actually referencing someone like that.

    It's funny how MDs send patients to physical therapy all of the time, but claim OMT is scientifically baseless, when 70% of OMT and PT are virtually identical.
     
  49. OldManDave

    OldManDave Fossil Bouncer Emeritus
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by jonty:
    <strong> <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" />

    Hi everyone

    I must say that coming from a place where there is no such thing as a DO or an MD, it is strange to hear health care workers arguing about whether they should be merged...

    In SA, we are trained to excel in clinical and surgical techniques (seems very MD) while never fogetting the fact that the patients psychological, emotional, spiritual and social wellbeing have serious effects on outcome of both medical and surgical cases (seems very DO).

    In short, a unification of the two disciplines is not so unthinkable because where I live, they are one and the same.

    What are your thoughts on this? :p </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">By George, I think you've hit upon the solution. Now, if we could simply convince all the crusty old farts in the AMA & AOA and all of the flag-waiving OMM zealots...we might have a deal!
     
  50. jimdo

    jimdo Senior Member
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    Hey everyone,
    Im new in these parts but Ive got to tell you all something Ive discovered that is absolutely revolutionary. Ive invented a brand new drug that treats condition X and it works!! I KNOW that it works and Im teaching everyone I know that it does so that they blindly accept its effect too . Granted, I have never actually tested it and run it through research trials, but that doesnt matter because Ive SEEN it work!!! Reproducible data?? Who needs it?? If people dont agree with me then the onus is on them to prove me otherwise because I KNOW it works. Also, Ive found that the drug works even better if you walk into the patients room backwards, hold a nickel in one hand and have the patient wash it down with a shot of Jack Daniels. REALLY IT WORKS!! TRUST ME!!
    Does anyone else here realize how absurd you sound when you say something works and that research is not necessary to prove it? Ever taken an antibiotic? Guess what, theres been research into it. Aspirin? And by the way, I am a DO student, 4th year who does see the potential benefit of some OMT. Ive even defended OMT in the past and will continue to do so if and when it is proven efficacious as it has been for low back pain (I think it was in JAMA). However, to suggest that we know it works therefore shouldnt have to be tested is absoultely unscientific, irrational and absurd.
    For the record, its not only the allopaths that feel this way, but the majority of osteopaths. Why else do you think decreasing numbers of DOs practice any OMT and a fringe minority uses cranial quackery. Dont get me wrong, I support some OMT and highly support research into the area. Until that research is in place, we CANNOT claim that it works. I WILL USE OMT when I have evidence it works from someone who doesnt have a vested interest in seeing that it works and seeing what they want to see.
     
  51. Ligament

    Ligament Interventional Pain Management
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    "The problem is just because a patient thinks something works does not mean it actually works."

    Well, I would take some issue to this. If the patient feels better, then it works, research or not. If I give a patient a placebo and the headache goes away, well, that patient is getting as much placebo as they want. Of course I would operate with this philosophy within reason.

    btw, I do not consider OMT placebo.
     

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