MD using holistic approach

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johnnydrama said:
Come on Half - you really need to learn about the scientific method.

There's a huge difference between the evidence for penicillin and any alternative therapies.
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No, your arguments are so regularly unfounded, I think you might need the refresher. I'm playing on your field.

You compare OMM to aliens and crystals...my analogy is appropriate.

If you'd like to have a real discussion, you need to regulate your own comments first...then you try to find fault in mine 😉

Edit:
Ps, all treatments are alternative until they are mainstream...by definition.

Compare the beginnings of many drugs and practices, like penicillin. How much scientific effort was directed in its creation and how well was it understood at first?
 
SpecterGT260 said:
Being of that opinion is not a result of my training but a part of who I am. It also doesn't mean that I won't do it. I just consider it a bandaid
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Bandages are great for bleeding...used well with antibacterial med's and some Neosporin, you've got a great chance for healing.

That's why it's a complementary treatment...not always sufficient for a cure, but sure helps
 
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HalfListic said:
Bandages are great for bleeding...used well with antibacterial med's and some Neosporin, you've got a great chance for healing.

That's why it's a complementary treatment...not always sufficient for a cure, but sure helps
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So does placebo. I maintain that if our benefit is placebo driven there is a better way we can do things
 
SpecterGT260 said:
So does placebo. I maintain that if our benefit is placebo driven there is a better way we can do things
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Well, sure...but thats a big if.

And, in the meantime...if something produces good result, and no harm...it warrants further investigation. OMT has shown great results.

We all know its tough to design a clinical trial for OMT study, but its really just a matter of time and interest. Im sure Ill help it along, and Ill keep an open mind the entire way.
 
HalfListic said:
Well, sure...but thats a big if.

And, in the meantime...if something produces good result, and no harm...it warrants further investigation. OMT has shown great results.

We all know its tough to design a clinical trial for OMT study, but its really just a matter of time and interest. Im sure Ill help it along, and Ill keep an open mind the entire way.
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Are you familiar with tranlsational medicine?
 
And keep in mind that according to the paper you gave, in the intention to treat analysis OMT not only did no benefit but did harm
They didn't comment on it much but in that analysis the only significance found was for serious adverse effects in the OMM group. This is why a mechanism is important. That paper suggests that starting OMM but not finishing will kill you 😉
 
SpecterGT260 said:
And keep in mind that according to the paper you gave, in the intention to treat analysis OMT not only did no benefit but did harm
They didn't comment on it much but in that analysis the only significance found was for serious adverse effects in the OMM group. This is why a mechanism is important. That paper suggests that starting OMM but not finishing will kill you 😉
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?

which one...Ive sited a few. But I can't say I remember any harm reported...

Edit: ok, you added to your comment. I'd have to respond by saying either you misunderstood something or are blowing it out of proportion.

OMM doesn't kill people...unless you are referring to that move at the end of kill bill, but it's rarely used 😉
 
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HalfListic said:
Well, sure...but thats a big if.

And, in the meantime...if something produces good result, and no harm...it warrants further investigation. OMT has shown great results.

We all know its tough to design a clinical trial for OMT study, but its really just a matter of time and interest. Im sure Ill help it along, and Ill keep an open mind the entire way.
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It's not that tough to do a good OMT study, it's just that the only people who would care enough to attempt it have a serious bias towards positive results.

I honestly don't think it's worth the research money (and definitely not worth the insurance money).
 
HalfListic said:
?

which one...Ive sited a few. But I can't say I remember any harm reported...
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Of course. That was Specter's point - the harm was there, but not reported.

If you knew enough about analyzing scientific literature, you might have spotted it too.

That kind of conclusion would have been harder to publish and probably earned the researchers criticism from the OMM community though... So it was glossed over.
 
I felt like this convo ended a long time ago.... but sure keep it going
 
HalfListic said:
?

which one...Ive sited a few. But I can't say I remember any harm reported...

Edit: ok, you added to your comment. I'd have to respond by saying either you misunderstood something or are blowing it out of proportion.

OMM doesn't kill people...unless you are referring to that move at the end of kill bill, but it's rarely used 😉
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i am not blowing it out of proportion any more than you are blowing their findings IN of proportion! wait.... waht? 😕

The point is, they altered the sample group to get what they wanted. In the ITT analysis there was no difference found except that there was significant adverse outcomes found in the OMT group. This was not mentioned in the discussion . But then when they did the per protocol analysis (which allows them to restrict the population and hand pick patients they deem "best fit") they dont find that significance but then DO find significance in a specific outcome. 👍 This should feel like fingernails on a chalkboard to you. Not because it is OMM... trust me this happens in wholly allopathic Allopathic all the time.
johnnydrama said:
It's not that tough to do a good OMT study, it's just that the only people who would care enough to attempt it have a serious bias towards positive results.

I honestly don't think it's worth the research money (and definitely not worth the insurance money).
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THIS. if the AMA did an OMT study (which they have no drive to divert funds towards) you would likely see very different results. The problem is that the AOA is the only entitiy publishing these things. this is a completely made up number, but I suspect (propose) that only 10% of the OMT studies that have been performed have been published. The rest showed no correlation and were not continued :shrug: prove me wrong 😉
johnnydrama said:
Of course. That was Specter's point - the harm was there, but not reported.

If you knew enough about analyzing scientific literature, you might have spotted it too.

That kind of conclusion would have been harder to publish and probably earned the researchers criticism from the OMM community though... So it was glossed over.
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I am honestly very impressed that they even included it. Per ITT (the clinical golden standard) OMT is harmful. Now, i do not believe that OMT is actually harmful. My point was only to demonstrate what happens if we draw conclusions without a real mechanism and accept it as "well ya but that is what happens, tra la la tra doo lee diddle" (I imagine everyone saying something foolish as doing a marry poppins style dance afterwards 🙂 )

Why is that finding overblown? That is "intention to treat", which assumes that the patients entered will behave as patients do an some of them will not comply and NOW (if you really think about ITT) you understand why I have a problem things like the "spiritual side" of medicine and why I said I do not think it is our responsibility to cater to the subjective side. It is nothing but a confounder and is something that needs to be removed until we can clearly see the biochemistry that is happening beneath all the bullsh** 🙂
 
johnnydrama said:
Of course. That was Specter's point - the harm was there, but not reported.

If you knew enough about analyzing scientific literature, you might have spotted it too.

That kind of conclusion would have been harder to publish and probably earned the researchers criticism from the OMM community though... So it was glossed over.
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Wrong...and horrible argument. Can you say anything other than, I wish everyone knew science like I do?

I've now been on here long enough to know that your grasp on science is little more than your opinion mixed with a few numbers and acronyms.

It's barely enjoyable to debate you anymore...you have no content.

And I still don't believe you are a resident...you honestly come across as an nerdy teenager.

Good luck
 
Schubie said:
I interviewed on Jan. 21, and I have not heard. I called them up, and the lady told me that I would know around or before March 1.
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Johnny is a d-bag (pot and kettle, I know....) but I have not found his science lacking
 
Didnt we have this argument around 2 weeks ago?
 
SpecterGT260 said:
Johnny is a d-bag (pot and kettle, I know....) but I have not found his science lacking
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His science is probably fine...it's just hard to find in his comments, which are mostly opinion and (faulty) extrapolations...
 
hopefulMD9 said:
Didnt we have this argument around 2 weeks ago?
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Yes! And it's a good discussion, but always gets way off track!!

Oh well, that's the Internet for ya. But, when there's no one explaining the DO side, I always feel compelled to do my best to create a balanced story for the people who read these forums...
 
HalfListic said:
His science is probably fine...it's just hard to find in his comments, which are mostly opinion and (faulty) extrapolations...
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Invalid =\= not agreeing with you. Jonathan and I do not always see eye to eye but it fair to equate shoddiness with disagreement. You should also know that I appreciate you keeping me sharp as well (reference to previous post) but if you think he is wrong prove it with something that is not emotion
 
HalfListic said:
Yes! And it's a good discussion, but always gets way off track!!

Oh well, that's the Internet for ya. But, when there's no one explaining the DO side, I always feel compelled to do my best to create a balanced story for the people who read these forums...
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Nah man i agree with you but it always comes back to a stalemate....people get offended or angry, then the conversation heads in a weird direction until the thread is locked or the people arguing lose their steam. :/
 
SpecterGT260 said:
Invalid =\= not agreeing with you. Jonathan and I do not always see eye to eye but it fair to equate shoddiness with disagreement. You should also know that I appreciate you keeping me sharp as well (reference to previous post) but if you think he is wrong prove it with something that is not emotion
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I feel like I respond to him on his level, and in kind. But, I'll check myself in case I'm giving a knee jerk response.
 
hopefulMD9 said:
Nah man i agree with you but it always comes back to a stalemate....people get offended or angry, then the conversation heads in a weird direction until the thread is locked or the people arguing lose their steam. :/
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True...that's what's always happened. But sometimes, I kind of hope more pre DOs would jump in and say what they think. Sometimes I wonder how must osteopathic philosophy anyone knows (and Im no expert either!)

I guess it's ok, though
 
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HalfListic said:
True...that's what's always happened. But sometimes, I kind of hope more pre DOs would jump in and say what they think. Sometimes I wonder how must osteopathic philosophy anyone knows (and Im no expert either!)

I guess it's ok, though
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I dont think a lot of pre DO's know ANY of the philosophy. They want to get in so they memorize a couple of facts and spit them out to adcoms. Its unfortunate but thats the way it is. :/
 
hopefulMD9 said:
I dont think a lot of pre DO's know ANY of the philosophy. They want to get in so they memorize a couple of facts and spit them out to adcoms. Its unfortunate but thats the way it is. :/
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yep
 
hopefulMD9 said:
I dont think a lot of pre DO's know ANY of the philosophy. They want to get in so they memorize a couple of facts and spit them out to adcoms. Its unfortunate but thats the way it is. :/
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I'm slightly guilty of this. But in my defense, I just got involved with SDN a few months ago and I'm trying to learn as much as possible by reading outside sources. I didn't know much about DO up until the beginning of this year. But I've shadowed 2 DO physicians and seen OMT in action. I do find it interesting and wish there were actually more DO's practicing it.
 
rzoo14 said:
I'm slightly guilty of this. But in my defense, I just got involved with SDN a few months ago and I'm trying to learn as much as possible by reading outside sources. I didn't know much about DO up until the beginning of this year. But I've shadowed 2 DO physicians and seen OMT in action. I do find it interesting and wish there were actually more DO's practicing it.
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Good though! As long as a person is headed in the right direction, you can't be at fault...

Do yourself a big favor and read a brief guide to osteopathic medicine...its very very short, but gives anyone who's just starting a great base of knowledge.

edit:

Heres the link, its only 32 pdf pages...free:

http://www.aacom.org/resources/bookstore/Pages/BriefGuide.aspx

or

http://www.aacom.org/resources/bookstore/Documents/Brief-Guide-to-OME_Final.pdf
 
HalfListic said:
Good though! As long as a person is headed in the right direction, you can't be at fault...

Do yourself a big favor and read a brief guide to osteopathic medicine...its very very short, but gives anyone who's just starting a great base of knowledge.

edit:

Heres the link, its only 32 pdf pages...free:

http://www.aacom.org/resources/bookstore/Pages/BriefGuide.aspx

or

http://www.aacom.org/resources/bookstore/Documents/Brief-Guide-to-OME_Final.pdf
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Yeah I've seen several references to it in the forums. Thanks for the link. I'll probably read it later on tonight.
 
HalfListic said:
Good though! As long as a person is headed in the right direction, you can't be at fault...

Do yourself a big favor and read a brief guide to osteopathic medicine...its very very short, but gives anyone who's just starting a great base of knowledge.

edit:

Heres the link, its only 32 pdf pages...free:

http://www.aacom.org/resources/bookstore/Pages/BriefGuide.aspx

or

http://www.aacom.org/resources/bookstore/Documents/Brief-Guide-to-OME_Final.pdf
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Ummm there's a picture of surgeons on the front cover, I thought DOs couldn't practice surgery...... :meanie:

Ok, for the poor, naive soul that might take this realistically even for a second. Yes, DOs are CT Surgeons, General Surgeons, Neurosurgeons (rare but yes), and other Surgical types all over the country. As to MDs using a more holistic approach, absolutely. It's been an encouraged trend in recent years to consider more about the patient than just prescribing medications.
 
COMedic2Doc said:
Ummm there's a picture of surgeons on the front cover, I thought DOs couldn't practice surgery...... :meanie:

Ok, for the poor, naive soul that might take this realistically even for a second. Yes, DOs are CT Surgeons, General Surgeons, Neurosurgeons (rare but yes), and other Surgical types all over the country. As to MDs using a more holistic approach, absolutely. It's been an encouraged trend in recent years to consider more about the patient than just prescribing medications.
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I actually found a couple of DO's in TMC doing some really remarkable stuff.

http://utsurg.uth.tmc.edu/pedisurgery/research/research-clinical.html#fletcher
Dr. Stephen Fletcher, DO. Chief of Division of Pediatric Neurosurgery.

http://www.methodisthealth.com/basic.cfm?id=35030
Dr. Drew Ludwig, DO. Part of the Neuro Intensive Care Unit at Methodist Hospital.

http://www.utsouthwestern.edu/fis/faculty/55716/robert-suter.html
Robert Suter, DO. Professor of Emergency Medicine at UTSW. Graduated from DMU.
 
Wow... I went off to enjoy my Friday night (Friyi... let it catch on) and I come back and sh** got real......
 
SpecterGT260 said:
I'm just scurred that I'll come back tomorrow night and I'll have no idea wtf is up
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LOL yeah that was my initial reaction after getting on a few hours ago. It's been a week or so since I was on last, LOL.
 
HalfListic said:
Wrong...and horrible argument. Can you say anything other than, I wish everyone knew science like I do?

I've now been on here long enough to know that your grasp on science is little more than your opinion mixed with a few numbers and acronyms.

It's barely enjoyable to debate you anymore...you have no content.

And I still don't believe you are a resident...you honestly come across as an nerdy teenager.

Good luck
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This is not something I've accused everyone of, but you in particular have often said things that reflect an unfamiliarity with scientific literature. I've said this before (to you), and if you keep missing the point I may say it again.

There are books and guides on analysis of scientific literature - you should read one before you start quoting papers to support your causes.

It's not my intention to be mean here, you really should learn these things.
 
wait... Jonathan... you're a resident? Since when? I was pretty sure you were a med student.....
 
HalfListic said:
sure...

its kind of a hot topic
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to follow up here: did you see my earlier post explaining the harm found in that other paper? The issue is about the bias in what was reported. They think their conclusion is valid in the PP analysis when it shows a benefit over normal medicine, but in the ITT analysis they completely ignore that there was statistical harm in that group. On what basis do they pick and choose which findings have meaning?

and as for transnational medicine: It is all about connecting the clinical observations to the lab bench. OMT makes no attempt to do this. They only attempt to validate clinical findings through associations but offer no real physiological mechanism for the treatment (excluding pain therapies and whatnot.... I am specifically focusing on infection and organ issues)
 
johnnydrama said:
This is not something I've accused everyone of, but you in particular have often said things that reflect an unfamiliarity with scientific literature. I've said this before (to you), and if you keep missing the point I may say it again.

There are books and guides on analysis of scientific literature - you should read one before you start quoting papers to support your causes.

It's not my intention to be mean here, you really should learn these things.
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You're not being mean...you're bing inaccurate. When you don't have a good argument, you fall back on "knowing science" better than everyone else. It's just not true. It's painfully obvious you know only little talking points about osteopathic medicine, but you still choose to try, so I can't fault your effort.

There are books on rhetoric that you should pick up. Really...you might be dismissed in these argument less often. Your ethos are pretty much bankrupted around here and I just lose interest in your comments.

Being something real to the conversations and I'll be more apt to take you seriously.
 
SpecterGT260 said:
to follow up here: did you see my earlier post explaining the harm found in that other paper? The issue is about the bias in what was reported. They think their conclusion is valid in the PP analysis when it shows a benefit over normal medicine, but in the ITT analysis they completely ignore that there was statistical harm in that group. On what basis do they pick and choose which findings have meaning?

and as for transnational medicine: It is all about connecting the clinical observations to the lab bench. OMT makes no attempt to do this. They only attempt to validate clinical findings through associations but offer no real physiological mechanism for the treatment (excluding pain therapies and whatnot.... I am specifically focusing on infection and organ issues)
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Yeah, you know I actually agree here.

Maybe our biggest difference in opinion lies in how we look forward. I'm more interested in what can and should be done. You seem more interested in picking apart what has and should have been done.

I just think that the mistakes of the past don't necessarily negate the value of OMM.

There's much that needs to be done, and in the right way. But I think it will be done and I plan to help it along.
 
I'd like to add that if it came to the point where OMT was given a good conclusive thrashing, and found to be harmful or ineffectual, I'd be first in like to get it cut out of medicine.

But, from what I've seen, it shows great potential and has helped a lot of people. I'm not willing to just ignore that.
 
Ps...we may need a new thread sometime with a title that doesn't mislead the conversation...

I'm going to be busy today so I won't start it yet
 
HalfListic said:
Yeah, you know I actually agree here.

Maybe our biggest difference in opinion lies in how we look forward. I'm more interested in what can and should be done. You seem more interested in picking apart what has and should have been done.

I just think that the mistakes of the past don't necessarily negate the value of OMM.

There's much that needs to be done, and in the right way. But I think it will be done and I plan to help it along.
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See I think this is our major misunderstanding here. I think the stubborn adherence to some practices dilute out the value of OMM where the value actually exists. My outlook is entirely looking forward. Time spent trying to validate something that is not real is time wasted that could have produced something else that was helpful. I think it is important for all practitioners to dissect their own practices and attempt to understand what is really going on. What if 100 years ago or so the first vaccine was given while simultaneously punching the kid in the face. The kid didnt get the disease. So we know that "shot+punchinface" prevents disease. We take on the mindset of "well we know that it works :shrug:" and continue on our merry way. This is how OMT strikes me. There is very likely a benefit in there somewhere, but it is very likely much more limited than the books would claim. Many of the practices (and I am not super up to speed on them...) like muscle energy or whatever seem to have very coherent mechanisms that drive them. They take the findings and go back to support them using what we actually know about the body. Where is this explanation for things like infections? it is noticeably absent. What if it were found that OMT can release cytokines associated with tissue damage without really injuring the patient and we get a rallying of the immune system? (I completely just made that up btw, but lets just assume) Do you think it would be better to blindly apply OMT in a shotgun-like approach, or to refine the treatment so we know if we aim our newly developed sniper-rifle OMT at the issue we will get a tangible and reproducible effect?

I would bet good money saying that if we stopped treating omt as a fix-all (and most practicing DOs do not in any way do this) and took time to apply it only to things that have basic science support or coherent mechanisms of function that the measured outcomes in patients would be much more significant.
 
HalfListic said:
I'd like to add that if it came to the point where OMT was given a good conclusive thrashing, and found to be harmful or ineffectual, I'd be first in like to get it cut out of medicine.

But, from what I've seen, it shows great potential and has helped a lot of people. I'm not willing to just ignore that.
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again I point to placebo. Not that all OMT is placebo, but the measured effects in the publications are extremely limited and inconsistent and I suspect there are numerous studies that didnt find anything and were never published. Since only DOs are interested in conducting such research we dont have a listing of the negative findings. However clinical research is not like bench research where you wouldnt want to publish a non-finding. Non-findings are incredibly important to clinical research.

It just strikes me as a double standard in that in all other treatment modalities we have to prove efficacy before we bring it to the clinic. Even if it isnt found to be harmful, it is still billed for. That is a "harm" by the patient and if it were to be shown to be ineffective or due to placebo effect in many of the instances in which it is performed you can bet this is a problem.
HalfListic said:
Ps...we may need a new thread sometime with a title that doesn't mislead the conversation...

I'm going to be busy today so I won't start it yet
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yeah we are off on a tangent..... 😳
 
johnnydrama said:
And once I was but a wee zygote, but my how times have changed.
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LIES!

I guess my confusion was more because I thought you were still a med student after the residents all started but I guess that was only a few weeks ago and not all programs start simultaneously 👍
You mated PM&R right? :meanie:
 
There are already lots of threads about the validity of OMT. This thread was about MDs using a holistic approach. Nobody even defined holistic, and nobody asked an MD about their training.

In my limited experience, very rarely could a person care less about your medical school, and it seems to me that 90% of what shapes a doctor is residency.

Would any attendings like to disagree? I will gladly yield to experience, but not if your experience is a free online 32 page PDF.
 
QualityProcess said:
There are already lots of threads about the validity of OMT. This thread was about MDs using a holistic approach. Nobody even defined holistic, and nobody asked an MD about their training.

In my limited experience, very rarely could a person care less about your medical school, and it seems to me that 90% of what shapes a doctor is residency.

Would any attendings like to disagree? I will gladly yield to experience, but not if your experience is a free online 32 page PDF.
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It was a tangent but the inevitable implications were MD vs DO on terms of holistic practice. What is this about a PDF now?
 
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