MD doing OMM

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I don't know where to put this so I'm putting it here and I trust a mod will move it to a more appropriate location if needed.

I'm a 4th year MD student interested in OMM and wanting to learn more about it. Is it possible for me to learn these techniques and practice them/bill for them? I know very little about it currently but it seems interesting. Thanks

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I don't know where to put this so I'm putting it here and I trust a mod will move it to a more appropriate location if needed.

I'm a 4th year MD student interested in OMM and wanting to learn more about it. Is it possible for me to learn these techniques and practice them/bill for them? I know very little about it currently but it seems interesting. Thanks
Yes. My former school has developed curriculum for MD residents. There are also NMM Felowships available should you decide to enhance your skills.
 
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I don't understand this world anymore.
 
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OP let me know if you're interested in trading degrees with me...
 
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If you want to learn OMM as an MD, you need to get your cranial bones examined.
 
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I'm judging from some of the comments here that learning this skill may not be worth my time.
 
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I'm judging from some of the comments here that learning this skill may not be worth my time.
the general consensus around here is that OMM is the price you have to pay for getting into DO school. Some of it may be genuinely interesting, depending on the person. Others just take one OMM class and just deal with the pain as it goes on and then rejoice knowing that they never have to worry about it again after graduation. Personally I don't know too many DOs who even practice OMM anymore in the real world, but that doesn't mean that there aren't people like that out there. If you're interested, then there's probably some resources on youtube that you could look into.
 
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the general consensus around here is that OMM is the price you have to pay for getting into DO school. Some of it may be genuinely interesting, depending on the person. Others just take one OMM class and just deal with the pain as it goes on and then rejoice knowing that they never have to worry about it again after graduation. Personally I don't know too many DOs who even practice OMM anymore in the real world, but that doesn't mean that there aren't people like that out there. If you're interested, then there's probably some resources on youtube that you could look into.

I see. I watched some online med ed videos actually. I found the terminology confusing. I also question the efficacy of some of these treatments. I would be interested in learning more though and possibly practicing it in the future, and billing for it.
 
I see. I watched some online med ed videos actually. I found the terminology confusing. I also question the efficacy of some of these treatments. I would be interested in learning more though and possibly practicing it in the future, and billing for it.
OME would be a great start. If you are resident and still interested I believe it is UNECOM that provides the course. ATSU in Kirksville also provides one from my search.

Just like chiropractic medicine and naturopathic medicine, the hands on manipulation of OMT does not have the best evidence. That is because of the methods of obtaining outcomes (patient satisfaction) are difficult to interpret and the assumptions are made at a very detailed MSK/Neuro level that just cannot be proven in a lab.
 
I see. I watched some online med ed videos actually. I found the terminology confusing. I also question the efficacy of some of these treatments. I would be interested in learning more though and possibly practicing it in the future, and billing for it.
In all seriousness, the majorly of OMM is complete BS with zero scientific evidence. With that said there are some parts that are useful, mainly just muscle energy, some HVLA and some counterstrain. f you are really interested just watch the OME videos on it and you could also find a lot on YouTube. Dirty medicine has some videos covering the basics of OMM so that would help with the terminology. If you wanna see the BS I’m talking about look up chapman points and cranial OMM
 
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Yes. My former school has developed curriculum for MD residents. There are also NMM Felowships available should you decide to enhance your skills.
Would you mind posting the curriculum you referenced? From the standpoint of being able to be reimbursed by insurance companies, is it as simple as completing that program? Does the MD need to demonstrate competency in OMT via state licensing? If so, who offers those state or national-level competency exams? Does the referenced NMM fellowship require a certain specialization for entry to the program? Diddo for how the MD is deemed competent in OMT after completing the NMM fellowship.

I believe DO’s can bill and be reimbursed as long as they are licensed in their state as a physician. I’ve been wondering specifically what a MD needs to do in order to have those same capabilities.
 
Would you mind posting the curriculum you referenced? From the standpoint of being able to be reimbursed by insurance companies, is it as simple as completing that program? Does the MD need to demonstrate competency in OMT via state licensing? If so, who offers those state or national-level competency exams? Does the referenced NMM fellowship require a certain specialization for entry to the program? Diddo for how the MD is deemed competent in OMT after completing the NMM fellowship.

I believe DO’s can bill and be reimbursed as long as they are licensed in their state as a physician. I’ve been wondering specifically what a MD needs to do in order to have those same capabilities.
Lots of questions. I can't post the curriculum as I'm not there anymore and it is not my property. Secondly, it is incorporated into their residency, so you would have to do your residency there. I believe you would be given a certificate for completing the program. As a physician, you technically could bill for brain surgery if you could find someone to let you do it. I believe the program would have to fulfill Coca requirements. States offer an unrestricted license so I don't thing billing for omt would be an issue if you have the training certificate. Contact COM's that have there own residencies for more info.
 
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States offer an unrestricted license
I didn’t realize this but it’s good to know. The more important question then becomes insurance company reimbursement. Is the certificate mentioned something that would suffice for reimbursement under most circumstances? Because if an unrestricted license is all that’s required then you could simply be a self-taught OMT MD and would have no issue in being reimbursed.
 
Would you mind posting the curriculum you referenced? From the standpoint of being able to be reimbursed by insurance companies, is it as simple as completing that program? Does the MD need to demonstrate competency in OMT via state licensing? If so, who offers those state or national-level competency exams? Does the referenced NMM fellowship require a certain specialization for entry to the program? Diddo for how the MD is deemed competent in OMT after completing the NMM fellowship.

I believe DO’s can bill and be reimbursed as long as they are licensed in their state as a physician. I’ve been wondering specifically what a MD needs to do in order to have those same capabilities.
Questions like this bring my heart at ease, knowing that there may actually be a day when MDs can also do OMM and nobody will care about the difference between MDs and DOs in the match. We're doing more work at bridging the gap here on SDN than COCA will ever try to do in their lifetime
 
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I'm judging from some of the comments here that learning this skill may not be worth my time.
It is 100% worth your time and a lot of it is backed up by literature. I would recommend looking into some residency programs that offer osteopathic medicine tracks, and if you like it you can always do the ONMM +1 year after residency.
 
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It is 100% worth your time and a lot of it is backed up by literature. I would recommend looking into some residency programs that offer osteopathic medicine tracks, and if you like it you can always do the ONMM +1 year after residency.

This thread will probably get locked cause you revived a thread that was 7 months old, but where is this literature that everyone keeps talking about in DO school
 
This thread will probably get locked cause you revived a thread that was 7 months old, but where is this literature that everyone keeps talking about in DO school
Here's a good one
 
Here's a good one

This article has been cited at least 6 times in the OMM lectures at my school lol

"The OMT techniques were delivered after a standard diagnostic evaluation17 at each treatment session. The lumbosacral, iliac, and pubic regions were targeted using high-velocity, low-amplitude thrusts; moderate-velocity, moderate-amplitude thrusts; soft tissue stretching, kneading, and pressure; myofascial stretching and release; positional treatment of myofascial tender points; and patient’s isometric muscle activation against the physician’s unyielding and equal counter-force. Time permitting, optional techniques18 could be used if the physician judged 1 or more of the 6 designated techniques to be contraindicated or ineffective."

So which techniques did they use?? MET and HVLA are both soundly backed by literature and used by other professions. Myofascial 'tenderpoints' and stretching though are straight up pseudoscience
 
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This article has been cited at least 6 times in the OMM lectures at my school lol

"The OMT techniques were delivered after a standard diagnostic evaluation17 at each treatment session. The lumbosacral, iliac, and pubic regions were targeted using high-velocity, low-amplitude thrusts; moderate-velocity, moderate-amplitude thrusts; soft tissue stretching, kneading, and pressure; myofascial stretching and release; positional treatment of myofascial tender points; and patient’s isometric muscle activation against the physician’s unyielding and equal counter-force. Time permitting, optional techniques18 could be used if the physician judged 1 or more of the 6 designated techniques to be contraindicated or ineffective."

So which techniques did they use?? MET and HVLA are both soundly backed by literature and used by other professions. Myofascial 'tenderpoints' and stretching though are straight up pseudoscience
You think that stretching muscles/myofascial release to reduce dysfunction is pseudoscience? Also I'm not sure what your "and used by other professions" has to do with the initial thread of if it works or not. May I ask why you're in DO school if you aren't interested in OMM?
 
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You think that stretching muscles/myofascial release to reduce dysfunction is pseudoscience? Also I'm not sure what your "and used by other professions" has to do with the initial thread of if it works or not. May I ask why you're in DO school if you aren't interested in OMM?

'Myofascial' stretching is not the same as muscle stretching, it's stretching of the fascia superficial to the muscle away from it. MET like I said is backed by literature which is why DPT's also use a version of it.

Like most DO students, I'm in DO school because I couldn't get into a good MD program.
 
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There is one thing you can do to fulfill your wish. Transfer to a DO school if you can or it is allowed. Other than that I do not know how but am more curious to know WHY.
 
You think that stretching muscles/myofascial release to reduce dysfunction is pseudoscience? Also I'm not sure what your "and used by other professions" has to do with the initial thread of if it works or not. May I ask why you're in DO school if you aren't interested in OMM?
I disagree with your last sentence. I started out having an open mind to OMM when I started, but got turned off to it when my school started stating certain concepts were true without evidence. You're allowed to dislike omm and be a do student, I do think you should give it a chance though.
 
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I had a pretty open mind when we started with Muscle Energy.

When we started getting into cranial vault movements, Chapman’s Points, and ischiorectal fossa releases with the main literature coming from methods performed on dogs and not humans, the wool over my eyes spontaneously combusted.

You take the bad with the good and like Andy Dufrenese, crawl through the river of **** and come out clean on the other side.
 
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To follow up on Proudfather's post, suspend your disbelief and try to learn something useful.

How do we know it’s useful if there is no sound scientific literature to back it up?
 
How do we know it’s useful if there is no sound scientific literature to back it up?
Some of it's useful, like palpatory skills and knowing surface anatomy.

Listen to your patients. Even if it triggers a placebo effect, that's useful.

Otherwise, it's the tax you have to pay for not getting into an MD school.
 
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Some of it's useful, like palpatory skills and knowing surface anatomy.

Listen to your patients. Even if it triggers a placebo effect, that's useful.

Otherwise, it's the tax you have to pay for not getting into an MD school.

No doubt that a good portion of OMM is useful. I have a problem though with billing people for a placebo effect.
 
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No doubt that a good portion of OMM is useful. I have a problem though with billing people for a placebo effect.
I would be okay with it if they said "we've done studies where we have done this on X many people, it seemed to be effective on the majority of those it was done on. We theorize that it works by this concept, but we don't know for sure." Then I would be okay with people paying for the service. People would have informed consent and would know that while there is a general idea, it's not completely certain why it works.
 
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I interviewed at a DO school a few weeks ago and one of my interviewers is a graduate from a prestigious MD school who sought out training in OMM. I was flabbergasted to say the least, but it made sense. Looking at their LinkedIn page, I saw that they had a holistic practice that included yoga and what not.
 
I seem to have to repost this again and again so her goes.......... From SDN July 2022.

To counter the notion that peer reviewed journals dont publish data regarding OMM or that it lacks efficacy, I am reposting this again. I reposted this in july 2022. Its worth reposting in this thread. These articles below are from mainstream peer reviewed journals, some of the top in their specialty. I'm sure more exist now if anyone has the intellectual curiosity to look. Many currently exist in the JAOA file. Noll, et al, has studies on pneumonia patients with N's in the 200's.

I have been listening to medical students trash OMM for a couple years now without any feedback. Remember pre meds read SDN and might actually think you know what you are talking about. It is not all pseudoscience. Mainstream journals aren't in the habit of publishing pseudoscience.
Annals of Internal Medicine: 2004, 141; 432-439
Manipulative Therapy in Addition to Usual Medical Care for Patients with Shoulder Dysfunction and Pain;
Gert J.D. Bergman, et al.
American Journal of Obstetrics and Gynecology, (ACOG Green Journal), Am J Obstet Gynecol 2010; 202:43.e1-08
Osteopathic Manipulative Treatment of Back Pain and Related Symptoms during pregnancy: a Randomized Controlled Trial
John C. Licciardone, D.O. et al.
Annals of Internal Medicine; 21 December 2004; Vol 141: Number 12; pp. 920-928.
A Clinical Prediction Rule to Identify Patients with Low Back Pain Most Likely to Benefit from Spinal Manipulation: A validation Study
Maj John D. Childs, PhD, et. al.
Annals of Thoracic Surgery: 2017 Jul;104(1): `45-152. doi: 10.1016/j.athoracsur.2016.09.110. Epub 2017 Jan18
Osteopathic Manipulative Treatment Improves Heart Surgery Outcomes: A Randomized Controlled Trial.
Racca V, et. al.
These are some articles published in peer reviewed mainstream journals showing positive correlations with OMT. These articles don't represent a cure for cancer or for the common cold, but suggest OMT was beneficial in their study and like anything, more work is needed. Students having trouble wrapping their arms around cranial and Chapmans points is understandable. Too many students have very firm opinions about OMT and should reserve them until they have actually treated patients, not classmates, with OMT. Once again, these mainstream journals are not in the habit of publishing pseudoscience. Whew, got that off my chest.....


In addition,for the enthusiasts of Evidence Based Medicine, in all reality, it is actually "Best" Evidence Based Medicine. In medicine, before one changes the parameters of their practice, data should be reproduced at other centers. It can be risky to change ones practice on a single peer reviewed article. Why do I say this? The Lancet, probably the most prestigious medical journal on the planet, published a paper suggesting that childhood vaccines appeared to have a role in Autism. We today, are still suffering from the fallout of that error with the ubiquitous anti vaxer movement. Perdue Pharma published data in in the New England Journal of Med if my memory is accurate, during the 90's that suggested one could not become addicted to opiates if they were taken while one was experiencing pain. We have seen the horrific results of that in the opioid epidemic. In 2021, 250 to 300 drugs were taken off the market by the FDA. Good work, right? Except for the fact that the FDA, using Evidence Based Medicine, APPROVED them initially. Medical students, for all of the decades I was in med ed, have attempted to tell their trainers what they need to know, having never practiced medicine. I take it all with a grain of salt.
 
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I seem to have to repost this again and again so her goes.......... From SDN July 2022.

Why are things like Chapman points and cranial OMT still taught though? It's always 'students should have an open mind when it comes to OMM', but no legitimate criticism amongst DO's is actually allowed of techniques which common sense can demonstrate are absolute pseudoscience.
 
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Why are things like Chapman points and cranial OMT still taught though? It's always 'students should have an open mind when it comes to OMM', but no legitimate criticism amongst DO's is actually allowed of techniques which common sense can demonstrate are absolute pseudoscience.
Couple things here. Tender points are fascinating. They come in different types and don't follow normal spinal pathways. Tenderpoints are a thing. Lots of literature on their management and treatment. Myofascial, counterstrain, and acupuncture are examples of tenderpoints. Now, a Chapman's point is a tender point with loose association with say appendicitis, just like McBurny's point. Mcburny's sign may not be positive in appendicitis as the appendix may be behind the cecum and pointing cephalad.. Yet, no one is suggesting not to check for Mcburny's point in suspected appendicitis. Parts of OMM are historical, like chest percussion for consolidation of fluid, but still used today when examining patients. Cranial still mystified many, yet I see dentists and Chiro's advertising that they offer it. In the end, if the patient feels better,and believes it helps, what's the problem? I hope I added some texture for you.
 
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In the end, if the patient feels better,and believes it helps, what's the problem? I hope I added some texture for you.

I won't dispute the details of OMM with you because it's obvious you know way more about OMM than I do. But like I said in an earlier reply to this thread, with using techniques that are more scientifically ambiguous, I think there's an ethical issue with having patients falsely believe their medical conditions are being effectively treated, and worse, being charged lots of money for.
 
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I'm not sure how someone who has a headache, gets treated with OMT, and then feels better will " Falsely believe their medical conditions are being effectively treated".? Especially when they leave the office feeling better. If someone has a migraine, takes medicine, feels better, but it comes back as they always do, were they not effectively treated?. No different if they were treated with OMM. Would psychologist sessions, where the patients just talks, are they being effectively treated? They get charged plenty. Listen. I get it, many students aren't interested in OMM and believe they waste their time studying it. Wait till you use what you know on family and friends and surprise yourself. Keep an open mind and your opinions may change when you actually treat patients with musculoskeletal issues.
 
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If someone has a migraine, takes medicine, feels better, but it comes back as they always do, were they not effectively treated?. No different if they were treated with OMM.

Could you explain how an OMT would treat a migraine, and cite literature demonstrating how it works?
 



A 6 second Google Scholar search. You can answer a lot of your questions with a little intellectual curiosity. Are you a 1st year student? You should be also asking your instructors these questions. That is why you pay tuition.
 
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A 6 second Google Scholar search. You can answer a lot of your questions with a little intellectual curiosity. Are you a 1st year student? You should be also asking your instructors these questions. That is why you pay tuition.

Did you read it yourself? It didn’t answer either of my questions. It didn't even say what technique(s) they used.
 
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Did you read it yourself? It didn’t answer either of my questions. It didn't even say what technique(s) they used.
Sill not sure if you are a med student or not. I have answered your questions and provided multiple references. Whether you like my answers or not isn't important to me. Its clear, you have done few, if any inquiries into the OMM literature. Your lack of intellectual curiosity is problematic as being a physician requires lifelong learning. If you really are a med student, you probably are not far enough along in training to realize that you don't need to perform a double blinded randomized clinical trial to suggest that it's raining outside. Chiropractor's parking lots are full for a reason, or people wouldn't go to them and they would disappear from the landscape. Like it or not, as a DO, you are trained differently than MDs, and have been given additional tools to help your patients. You can view this as a positive, or not.I highly suggest you look inward and resolve your conflict with the fact you will be a DO. Otherwise, you will regret your decision to attend DO school and always wonder why you didn't take that gap year.
 
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Sill not sure if you are a med student or not. I have answered your questions and provided multiple references. Whether you like my answers or not isn't important to me. Its clear, you have done few, if any inquiries into the OMM literature. Your lack of intellectual curiosity is problematic as being a physician requires lifelong learning. If you really are a med student, you probably are not far enough along in training to realize that you don't need to perform a double blinded randomized clinical trial to suggest that it's raining outside. Chiropractor's parking lots are full for a reason, or people wouldn't go to them and they would disappear from the landscape. Like it or not, as a DO, you are trained differently than MDs, and have been given additional tools to help your patients. You can view this as a positive, or not.I highly suggest you look inward and resolve your conflict with the fact you will be a DO. Otherwise, you will regret your decision to attend DO school and always wonder why you didn't take that gap year.

None of the articles you linked answered my question about how OMT would actually treat the migraine. If you can't explain how it works, how could you tell it's not just a placebo effect? It's been decades or more than a century since some of these techniques have been practiced, and we are still looking for evidence that they work 100 years after the fact.

Also, there's no need for personal attacks or psychoanalyses. If I wasn't curious about the subject why would I care at all? I already said that I do believe a good portion of OMT is useful and makes scientific sense. Even if I didn't, isn't it just as unintellectual to go through four years of DO school, learn all the ins and outs of every technique, spend hundreds of hours studying for in-house/board exams/practicals, and not question any of it? It's okay to acknowledge that many of the techniques and principles DO schools still teach exist so that DO's can be unique. I don't have an inferiority complex for saying that, and I think that line of thinking is more beneficial to the DO profession than blindly believing everything we've been taught.
 
The problem is what is a “control” for OMT? Most RCTs use oral or IV medications which are trivially easy for researchers to create a double blinded study with a placebo. It’s literally impossible to create a double blind RCTs for OMT, since, well you kind of have to be able to see where you put your hands.

The same goes for the overwhelming majority of surgical procedures, when viewed in this way. Perhaps you could drape OMT patients so only their relevant anatomy is present, however several OMT procedures are “active” i.e. they require the patient to respond to commands, so maybe you could create some kind of standardized synthetic voice command, but patients often need adjusting commands to maximize the effectiveness and safety of the specific OMT. So the lack of research is not because it’s less likely to have clinical relevance, but because a lot of the modern research culture focuses on double blind RCTs which by its very nature precludes anything that requires some sort of two way interaction. Not only that, but there’s not as much profit motive unlike demonstrating a new “product” such as a novel drug or medical device which can make millions to billions of dollars for the manufacturer as there is for demonstrating a technique that only requires what everyone has - their own hands and the capacity to learn the technique.

It’s slowly becoming more acceptable to include the active participation patient in their healthcare, transitioning slowly away from the historical paternalistic approach to medicine to a more patient centered approach.

It’s not a matter of if, but when, there will be more high quality evidence to support the use of alternative treatments that don’t involve the blind acceptance of drugs and/or procedures.

Also, while there is the idea of a placebo OMT, or “sham” treatment, it’s far from ideal as a control in a RCT, and not really a true placebo.
 
Parents cooked mackerel for dinner routinely because it was one of several distintive dish in our culture. Me and my siblings hated it and bitched/moaned eating it, but we ate it becasuse we did not have a choice. I guess we could have chosen to go to bed hungry. Now as an adult, I will not eat mackerel ever again. I gag when I think about eating mackarel. I am not a DO student but if my mackarel can serve as an anology to OMM, than I understand your plight as a DO students not wanting to eat mackeral weekly.
Not all DO students are self hating DOs
 
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The problem is what is a “control” for OMT? Most RCTs use oral or IV medications which are trivially easy for researchers to create a double blinded study with a placebo. It’s literally impossible to create a double blind RCTs for OMT, since, well you kind of have to be able to see where you put your hands.

The same goes for the overwhelming majority of surgical procedures, when viewed in this way. Perhaps you could drape OMT patients so only their relevant anatomy is present, however several OMT procedures are “active” i.e. they require the patient to respond to commands, so maybe you could create some kind of standardized synthetic voice command, but patients often need adjusting commands to maximize the effectiveness and safety of the specific OMT. So the lack of research is not because it’s less likely to have clinical relevance, but because a lot of the modern research culture focuses on double blind RCTs which by its very nature precludes anything that requires some sort of two way interaction. Not only that, but there’s not as much profit motive unlike demonstrating a new “product” such as a novel drug or medical device which can make millions to billions of dollars for the manufacturer as there is for demonstrating a technique that only requires what everyone has - their own hands and the capacity to learn the technique.

It’s slowly becoming more acceptable to include the active participation patient in their healthcare, transitioning slowly away from the historical paternalistic approach to medicine to a more patient centered approach.

It’s not a matter of if, but when, there will be more high quality evidence to support the use of alternative treatments that don’t involve the blind acceptance of drugs and/or procedures.

Also, while there is the idea of a placebo OMT, or “sham” treatment, it’s far from ideal as a control in a RCT, and not really a true placebo.
Controls? Either do nothing, or tickle people on their toes or fingers.
 
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I have a problem though with billing people for a placebo effect.
Cool, are you lobbying to get the licenses stripped from all chiropractors, naturopaths, and psychoanalysts? People and even insurance voluntarily pay for BS all the time. I would personally not feel good focusing on a service I know doesn't work, but running a non evidence based practice is plenty legal in America. I don't see any reason to single out and ban DOs from doing it.
 
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Cool, are you lobbying to get the licenses stripped from all chiropractors, naturopaths, and psychoanalysts? People and even insurance voluntarily pay for BS all the time. I would personally not feel good focusing on a service I know doesn't work, but running a non evidence based practice is plenty legal in America. I don't see any reason to single out and ban DOs from doing it.

Who's singling out DO's? The OP is about OMM.
 
Who's singling out DO's? The OP is about OMM.
The OP is about whether an MD can practice OMM.

You brought up that you have a problem with people billing for placebo. Its not in any way a distinctive or defining characteristic of OMM practitioners. Arguably it's almost completely irrelevant to an OMM focused discussion. You're framing it like a DO exclusive practice when its rampant everywhere outside of the most conventional EBM practice. Hell even MDs do it sometimes to line their pockets (ever heard of PRP injections?).
 
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