Is it possible to run an OMM specialty practice accepting only cash? I have heard of a few practitioners who do not take insurance and seem to be making ends meet ok. Does anyone know about how much money these practitioners make? Any info would be appreciated.
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NMM/OMM Specialty Practice
Started by dcratamt
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So you want to be a chiropractor? Really?
Ha ... not even close. OP, there were threads a few years ago about docs in NY and San Diego who ran strictly cash OMM practices and had to keep jacking up their prices to try and trim down on the patients, and still were very busy. I also know a while ago they reworked the billing codes for OMM, but I still think you could pull a cash only practice. It would be interesting to see how it works ... I'd do some investigating and try to contact some other docs doing it.
Oh, it's done! We've got a few OMM doctors in this region o' mine, (philly/delaware/nj) who charge cash only and do very well for themselves and their patients, from what I've gathered.
Do you have any of their practice websites (assuming they have them)? I was trying to google some last night to include in the thread, and all I found was some WHACK job in LA who mainly works with cranial.
Until you need any real medical advice, or a script, or any sort of other physical examination, or ... anything related to medicine.
Yeah it's possible. There aren't a lot of them but they're out there. I know a doc who does about 2/3 reimbursed and 1/3 cash at this time. He may eventually move to a strictly cash practice, but he would have to drop some of his loyal patients. His key piece of advice: when you graduate, don't waste time working for another doc because the business is so good you can just hang out a sign and be busy pretty quickly.
I know of a guy back east who does cash only and charges something like $175/half hour, $300/hour. He is very busy and has one employee to answer the phone. You can do the math. I have heard of other OMT specialists charging similar fees and filling their appointment books fairly quickly.
The guy who said it was like being a chiropractor obviously knows little about OMM (or about much else for that matter). D.C.'s tend to specialize in fixing subluxations and their scope of practice does not extend to referrals or any type of injection or prescription medicine at this time. Thus, they are much more limited in what they can charge and must rely on huge turnover and repeat visits. The very best chiros (especially the ones who have lots of chiros working for them) are making good money, but the rest are floundering because they've saturated the market.
OMM practitioners, on the other hand, have whole cities to themselves. In Boston you can count on one hand the number of OMM specialists, and similarly in Phoenix and other cities. And DO scope of practice is whatever you're licensed for, which at a minimum would allow injections, prescriptions, and referrals.
You can basically write your own ticket if you are an OMM specialist. I'm surprised more people don't do it. I guess they believe what they read on studentdoctor.net.
There's a doc in Michigan who's an OB/Gyn but strictly just does OMT for OB pts. She charges $500/hr and if you wanted to book something today you would have to wait a good amount of time until you saw her, possibly a few months.
If strictly OMT is your cup of tea you can make plenty of $$$. But remember even as primary care you can bill insurance and if you do it right you get pretty good reimbursement.
If strictly OMT is your cup of tea you can make plenty of $$$. But remember even as primary care you can bill insurance and if you do it right you get pretty good reimbursement.
Wow. That sounds a little excessive. Any idea what she does for that hour?
I've actually been researching and found a few online ... some of the people who have straight NMM/OMM practices seem a little odd, but almost every one I've seen has been straight up cash and multiple docs said they don't take any patients for their other specialty (usually FP) just manipulation. So it must be making some cash.
It doesn't happen often because it's bogus, and most physicians have ethical problems charging excessive money for crap that has no business being labeled a treatment modality.
It's a cop out...charge money for services that have no disproving evidence...if the patient likes it, they come back...if not, oh well, guess you won't see that patient again.
Not to turn this into another "OMM is useless" thread...I've been in too many of those over the years.
Such a waste.
OMM for OB patients with a multiple month wait... Wait long enough, and the problem will fix itself.
I'll stand corrected: You want to be a chiropractor that also does synvisc injections? Really?
I'll stand corrected: You want to be a chiropractor that also does synvisc injections? Really?
Don't worry; only some ignorant students here would compare you to a chiropractor. You should really seek advice about osteopathic practice from your professors and working professionals; the DO forums on sdn.net are full of ignorant premeds, trolls and MD wannabe's who take every opportunity to mock the profession.
Note the "resident" above who basically dismissed all touch therapy modalities. While he's welcome to his opinion, astoundingly ignorant though it may be, there are tens of millions of people in this country who would disagree. Just in OMM alone, there are many thousands of success stories, and studies are beginning to catch up with what practitioners have known for a long time: it works.
The medical field is moving toward a more humanistic, holistic model and that has to include touch therapy, which fills a very necessary and needed niche. Doctors like this "resident" are part of the problem; they view patients as test tubes to be filled with drugs. We who think more broadly are on the cutting edge of solving the healthcare problems with more creative and powerful modalities that address the patient as a person, not merely a collection of parts to be serviced.
Today OMM and osteopathic physicians are beginning to be well known and those DO's who accept and utilize OMM will find themselves very well positioned in the coming years.
Coming from a student, this reminds me of the South Park episode (Hippie Jam Fest) with all the college freshmen invading the town bragging how their professors have opened their eyes.
Hey chief, this "resident" is a resident, no need for quotations to snidely imply something.
Where do you get your numbers from? Tens of millions? Touch therapy? Are you serious? Yours is perhaps one of the most uninformed posts I've read in a while. You, my student-doctor friend, are the delusional one if you think Osteopathic Principles & Practice are at the forefront of medicine.
And I'm sorry, but what large osteopathic institution do you attend that treats these untold numbers of osteopathic-crazed patients?
In my city of several million, there is one osteopathic hospital amid the massive university-based health system, and with under 100 beds isn't exactly ‘cutting edge' because it might offer ‘touch therapy', hot towels and temple rubs. Sure, there are osteopathic strongholds (eg. MI and OH), but outside those enclaves, finding a DO that performs OMT and proclaims him/herself 'holistic' is next to impossible. Sure, there's a few in every major city, and a few scattered in between, but DOs comprise less than ~7% of physicians...good luck.
DCRATAMT, sure, you don't have to take my word for it, but I'd trust the overall trends vs what a koolaid-drinking med student says, and the trends are NOT touch therapy, OMT, chelation therapy, etc...
Positioning yourself by grasping OMM and our "osteopathic identity" is a step in the wrong direction.
I misused "touch therapy" terminology. I meant manual therapy which is an umbrella term that encompasses massage therapy, myofascial, trigger point, rolfing, OMM, chiro, PT, acupressure, acupuncture, tui na, etc. There are hundreds of types of manual therapy out there and it's ridiculous to lump them all together and call them koolaid. There are tens of millions of people who have benefited from these therapies, and mainstream medicine is starting to recognize their value.
If you are truly a resident physician, with osteopathic training no less, I would expect you to know the difference between "chelation therapy" and OMT. Casually conflating these modalities does not make your case; in fact it makes my case, that there is a kind of orthodoxy in mainstream medicine that rejects everything it doesn't understand. This was a more common attitude 50 years ago, and thankfully they have gotten more open minded today. What's sadly ironic is someone coming out of an osteopathic program and adopting the narrowest, out-of-date allopathic belief system possible. Fortunately, the allopathic profession itself has moved on and today recognizes the value of manual therapy modalities.
What???
How is attending a large allopathic, university-based institution "narrow" minded???
HOW has the allopathic world (eg. modern medicine) "adopted" manual therapy modalities? What, because Harvard offers CME on OMT, the allopathic world has "adopted" OMT?
Give me a break.
I honestly have no idea where you're getting this notion...please give me some source that defines the allopathic acceptance of craniosacral and BLT therapy.
Woah tiger, ease off the fellow SDN'r. It's getting a bit hot up in here.
Anyhow, university based institutions typically have rigid procedure and protocol by their very nature, EBM and all that, I don't know why you're arguing the point. There's something to be said for it. But I agree with the other cat, too, that there's so much medicine that's being worked on and researched, there is a propensity for those working on more of the mainstream matters pressing medicine and science today, to marginalize less well funded and recognized endevors. Why freak out about it, it's just the truth, and it's a departure point, not a dead end. Time will take care of the rest, and those with different proclivities than your own will thankfully pursue different courses of study and hopefully we'll all meet in the middle and serve society well. And if there's fringe elements on either side that are disproven along the way, then it's for the better good as well. Personally, I can't comment on "chelation" therapies. I'm sure there are those on both sides who could and wish to, but I suggest they start a new thread.
As "bizarre" as cranial is, we have primary care doctors prescribing anti depressants without therapy. We have astra zeneca claiming thanks to harvard that crestor should be used as a preventative measure for cardiovascular disease, even if one's cholesterol isn't high enough to warrent it's use. So keep your wits about you, not everything the "allopathic world" does works, and the bad guys don't wear black cowboy hats in real life.
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Not quite sure where you're coming from, or if your premedical career involved something in healthcare, but cranial is beyond "bizaare", and it's not a matter of "doing what works for you."
This is the mentality I have a problem with in medicine: people think that if no harm is done, there's no evidence to prove the contrary, and it makes people feel better, we should open our arms, or at least turn a blind eye.
Maybe in some careers that is acceptable, but medicine is more than doing no harm, it's about doing the right thing, and in today's medical arena, our standards should be exceedingly high in terms of what we give our blessing to as appropriate therapy.
Sure there are modalities that are benign that are often scoffed at simply because of their Eastern origin or non-modern appearance, and similarly, there are modalities (mainly drugs) that often DO end up harming some if not all patients. But the push to improve outcomes is exceedingly forceful and courses along a very fine line, and is often coupled with multi-million dollar consequences.
We take the good with the bad and combine oversight with internal standards to minimize bad outcomes, but the stakes are often MUCH higher with modern medicine. If a drug works, FANTASTIC, and it just might save your life in a dire situation; conversely, it might kill you. If accupuncture works, FANTASTIC, and it just might make your headache go away; conversely, it might not do anything at all. EG: no big deal.
And because medicine & treatment modalities do not just grow on trees, free to anyone for the picking, we have to be discriminitory with what we deem appropriate & acceptable care, and right now unproven, non-scientific, non-evidence-based modalities are not going to be given the same weight, given their non-repoducible, non-sustaining and often less consequential outcomes.
Drugs can always be proven unsafe & taken off the market, never to be used again. Things like cranial never will becuase there will always be patients who swear by it, similar to chiropractic, hot-rock therapy, magnet therapy, chelation, therapy, etc etc etc... because the stakes are much less, despite the fact there is always money involved.
As a medical profession we maintain higher standards than simply "it makes the patient feel (physically) better," less we offer temple rubs, foot massages and free candy for that very reason. Arguing that medicine is becoming more patient oriented doesn't simply mean we cave to their every whim.
You want to have an accupuncturist help your back pain? Fine, go ahead, but expecting Medicare to cover it requires reproducible results, which are universally absent in complimentary & alternative modalities.
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The DO that wrote my LOR for med school only does OMM, cash only, $130 per visit. He is really good at OMM.
Did this physician go to an integrated FP/NMM residency or NMM only residency? I am wondering about the St. Barnabas NMM program. Anyone heard anything about the program or the director Dr. Ettlinger?
Would you need to do a residency with NMM/OMM in it just to use it in practice?? I mean, if your goal is to have an NMM clinic, then it makes sense, but it seems like with the OMM training in med school, if one felt comfortable enough, they should be able to do it ... right?
Right. You can use OMT in your practice w/o having completed an NMM/OMM residency. I've worked with physicians, board certified in FP or IM only, who integrate it into their practice pretty successfully. When I did my early clinical experience last year, I even had a chance to do use it on a few patients. I was able to see how OMT could be used on a certain population of patients who have a great deal of chronic pain and trauma where other therapies haven't worked so well.
Before you all call me crazy, I have to say that while I find some of the elements of OMT questionable, I can also appreciate what it has to offer. I can see myself using ME, HVLA, MFR, lymphatics, and even strain/counterstrain as adjuvant therapy. The way I look at it is, why would throw out the baby with the bath water? It's an additional tool that we have, so I honestly think it's worth considering it's use where appropriate.
Boom. Honestly, I'm really glad to hear a med student say this, because I thought I was just being a stupid pre-med to assume that if one has to learn it ... why not apply it when appropriate/find a way to bill off of it. Here is where I draw the conclusion ... 'Medicine sucks, I can't get reimbursed for anything properly etc .... (next thread) I know an OB/GYN (not a NMM specialist) who offers it to her patients at $130 bucks a session, cash 😱.'
I'm not saying I'd want to turn it into some cash cow, or drop another specialty to run an OMM practice ... but it just seems like a viable, and bankable tool that you have to learn regardless, so why not try to use it???
I definitely get the people who don't enjoy it/don't want to bother keeping up with it in residency, etc ... I just was thinking from a different pov.
I can understand where you guys are coming from. If anything, that was the predominant attitude most med students had in my class.
But I can't underscore enough reality that just because something seems beneficial and probably isn't harmful, doesn't mean it IS beneficial.
You can replace 'ME, HVLA, strain/counterstrain' with any other non-osteopathic modality (chiropractic, accupuncture, etc..) and the statement would be no less valid.
Simply because we're taught the material doesn't mean it has any more worth than those aformentioned CAM modalities.
I don't mean to keep playing the devil's advocate, but all these projections from pre-meds and med sudents about what your practice is going to be like & what treatments you're going to employ is like a bunch of kids saying, "I want to be a fireman when I grow up!" or all the first yr med students saying, "I want to be a surgeon!"
I'm not saying I didn't do that as well--I'm just trying to give you guys a reality check: saying you can see a use for HVLA, BLT, S/CS, etc, in the context of your practice being 6-10 yrs out is a hard sell.
I can appreciate your optimism & open mindedness, but if you don't question things like OMT from the get-go, your reluctance to abandon it will increase over the years, unless it's for purely business reasons (ie. it's taking more time than it's worth to you). An open mind should not mean acceptance until someone disproves it.
There's a common saying that 1/2 of what you learn in medical school is false, you just don't know which half. For whatever reason, that notion can't be applied to OMT (and OPP in general).
Let's agree to perhaps disagree on the knee jerk level, but I think our perspectives may be more in agreement than it appears. You seem to be inferring that cranial would be used in place of a CAT scan, for example, and quality care wouldn't be offered at cranial's expense, and this isn't the case. I do agree that if a lay is going to a chiropractor for migraines and the "massage therapist" who's certified in "cranial sacral therapy" says cranial is all that this person needs, that could open up a can of worms. But to say that cranial therapy has been categorically and undeniably proven to be ineffectual from a research plane of view simply isn't accurate. Now before I misguide you into thinking I'm a) a cranial expert or b) proficient in cranial work, I'm speaking from second hand experience, and speaking to clinicians who perform it at a research level. Some of the clinical research results seem to point to ambiguous results, but with any manual therapy, it's exceedingly difficult to set up a proper research study. For some, this is a good enough reason for it's utter dismissal, and if you hold true to that, then I guess this conversation has reached its logical conclusion. May I mention that a well funded, $45,000,000 study has a better chance of accepted results than a $100,000 study. All I'm getting at is, personally, I am keeping an opened mind; I know you're further in your schooling and have had experiences that you draw off of, but if practitioners are having other experiences that contradict your own and come from a firm scientific and rational background, isn't there any room for growth on the subject in the future?
I don't condone any treatment that makes the patient feel better without making them better, but if there is a fascial or neural link that apparently facilitates a productive physiological change, even if its only parasympathetic or we can't yet understand the mechanism, then what? Its all good in the hood, from my view, but it doesn't just stop there. OMM has been grossly underresearched for decades (although excellent research is constantly overlooked, which is equally frustrating), and hopefully these current classes and future classes are changing that. RESEARCH IS IMPORTANT, I'm the first to agree with you. And I think that's what you're really advertising, homeboy.
By the way, do you really think magnetic fields have no future in clinical treatment? They're invaluable in diagnostic, but no to clinical, or just as it stands now? How do we get to point D if we cut the journey at A because of insufficient results? Another thread.
No, I'm saying cranial in general is a complete hoax, regardless of when and by whom it's used.
That's EXACTLY what I'm saying.
APPARENTLY according to who??? This is my entire contention: there is no proven apparent physiologic change, and even if there was, there is NO REPRODUCIBILITY.
No, what Im advertising is my annoyance with the blind acceptance of something as absolutely ridiculous as craniosacral therapy simply because its taught in conjunction with all the other LESS controversial modalities.
I've been posting on the innacuracies and fraudulent nature of cranial for some time now.
Here's 2 articles for example:
1.) [As was summed up in a 1999 systematic review by the University of British Columbia:]
The literature suggests that the adult cranium does not obliterate, fuse or ossify its sutures until well into late life. There is also some evidence (albeit of variable research quality) that there is potential movement at these suture sites in earlier life. Questions remain as to whether such movement is detectable by human palpation or whether mobility has any influence on health or disease. The authors of this review also note that, in accord with a basic tenet of craniosacral therapy, there is evidence for a craniosacral rhythm, impulse or primary respiration independent of other measurable body rhythms. However, [the] studies do not provide any valid evidence that such a craniosacral rhythm or pulse can be reliably perceived by an examiner. Our review does not suggest any reasonable data that would allow such a conclusion. The influence of this craniosacral rhythm on health or disease states is completely unknown. Clinicians require a reliable means of assessment for decision making. Craniosacral assessment has not been shown to be reliable. The literature on craniosacral therapy does not include any high grade evidence, such as random controlled trials, of its effects on health outcomes. The evidence that is available is of poor methodological quality, is highly variable, lacks consistency and does not allow any logical positive conclusions regarding craniosacral therapy.
2.) [Scientific Review of Alternative Medicine 6(1):23-34, 2002.)] Two professors at the University of New England College of Osteopathic Medicine concluded:
Our own and previously published findings suggest that the proposed mechanism for cranial osteopathy is invalid and that interexaminer (and, therefore, diagnostic) reliability is approximately zero. Since no properly randomized, blinded, and placebo-controlled outcome studies have been published, we conclude that cranial osteopathy should be removed from curricula of colleges of osteopathic medicine and from osteopathic licensing examinations.
Im saying that the advent of MRI technology does not simultaneously allow for the acceptance of magnetic bracelets & other crap simply on the generic thought that magnets are good.
Such modalities have been disproven time and time again, yet people are constantly being scammed because they think its actually doing something.
You want to believe that magnetic bracelets help RA and circulation? Fine, go to Walmart and pick some up, but DONT think that your local physician is going to write you a script for it and have insurance cover it.
If some massive, all-encompassing study proves some benefit to cranial and that it has reproducible results, fine, let's accept it and move on.
But until that happens, it should be removed from board exams and our education, and rejected as an official, AOA-approved treatment modality, which is an utter embarrassment to our profession.
But until that happens, it should be removed from board exams and our education, and rejected as an official, AOA-approved treatment modality, which is an utter embarrassment to our profession.
Until fairly recently it was thought that broken bones should be immobilized for weeks and the proximal joints and muscles should be rested as much as possible to avoid disturbing the healing process.
Now it is understood that the opposite holds true: exercise is the key to proper healing of such wounds.
This is merely one example of thousands of accepted medical practices which have not been proven. Yet, since they're in the textbooks, they continue to be taught to successive generations.
Aspirin has been shown to have over 100 effects on the human body, not just NSAID. Go to Science Daily News and do a search and you will find 8 or 9 new effects of aspirin on the body discovered in just the past decade. Yet, aspirin has been the most widely prescribed drug for the past century. Why do mainstream medical professionals not take a step back, commission a fifty million dollar study and establish exactly what this drug does, once and for all? Now think about the thousands of chemicals that have only been around for a few years or a few decades; are we sure they are all safe, too?
To assert that alternative modalities such as OMT and massage therapy are unproven is to take a dangerous stand because much of what we assume to be proven in mainstream medicine is also likely to change in years to come.
Massage therapy has been shown to be approximately as effective as psychotherapy in the treatment of depression (see this meta study). A NEJM study indicates that massage therapy was the most effective and long lasting treatment for common back pain in that study group, versus chiropractic, acupuncture, and several other modalities (OMT was not tested). A well known study written up in NEJM in 1999 demonstrated that OMT was about as effective as traditional surgery/drugs on lower back injuries.
Studies of manual therapy treatments are notoriously problematical because each practitioner is a little different, and it's difficult to separate the personal interaction from the treatment. When you get into the more esoteric practices such as cranial osteopathy, results are not really reproducible, although individual practitioners will tell you that they have observed improvement in their patients based on years of experience with thousands of treatments.
That cranial study at UNECOM that Homeboy cited did not go unchallenged; if you read the followup responses to that study you will find that practitioners vigorously disagree with the methodology and the conclusions. But read it and try it and decide for yourself.
Homeboy I have seen your postings in other topics and I think you are an intelligent person. But you are a little over the top with taking such an extreme stance on OMT. OMT is effective. Many of us have seen it with our own eyes. I've experienced it. Today, increasingly, allopathic doctors are referring for OMT because they have become convinced of its effectiveness and safety.
The best docs are people who stay open minded; otherwise we become mere technicians, doing everything "by the book". If we all are like that, how will medicine ever advance?
The JAOA had a cranial study last year measuring INTRAoperator reliability. It was pretty much 0, too.
My rejection of cranial is not extreme, nor do I reject every aspect of manual medicine. But as I've stated before, there are things that don't belong in our arsenal...OMT is one of them.
I'll repost this because it appears you didn't read it:
Sure there are modalities that are benign that are often scoffed at simply because of their Eastern origin or non-modern appearance, and similarly, there are modalities (mainly drugs) that often DO end up harming some if not all patients. But the push to improve outcomes is exceedingly forceful and courses along a very fine line, and is often coupled with multi-million dollar consequences.
We take the good with the bad and combine oversight with internal standards to minimize bad outcomes, but the stakes are often MUCH higher with modern medicine. If a drug works, FANTASTIC, and it just might save your life in a dire situation; conversely, it might kill you. If accupuncture works, FANTASTIC, and it just might make your headache go away; conversely, it might not do anything at all. EG: no big deal.
And because medicine & treatment modalities do not just grow on trees, free to anyone for the picking, we have to be discriminitory with what we deem appropriate & acceptable care as dispensed by physicians, and right now unproven, non-scientific, non-evidence-based modalities are not going to be given the same weight, given their non-repoducible, non-sustaining and often less consequential outcomes.
Drugs can always be proven unsafe & taken off the market, never to be used again. Things like cranial never will becuase there will always be patients who swear by it, similar to chiropractic, hot-rock therapy, magnet therapy, chelation, therapy, etc etc etc... because the stakes are much less, despite the fact there is always money involved.
As a medical profession we maintain higher standards than simply "it makes the patient feel (physically) better," less we offer temple rubs, foot massages and free candy for that very reason. Arguing that medicine is becoming more patient oriented doesn't simply mean we cave to their every whim.
You want to have an accupuncturist help your back pain? Fine, go ahead, but expecting Medicare to cover it requires reproducible results, which are universally absent in complimentary & alternative modalities.
"This is merely one example of thousands of accepted medical practices which have not been proven. Yet, since they're in the textbooks, they continue to be taught to successive generations."
---But that's NOT justification to accept cranial 'until proven otherwise'. You're accepting cranial by comparing it to other NEGATIVES, not by arguing any inherent POSITIVE that cranial offers.
---But that's NOT justification to accept cranial 'until proven otherwise'. You're accepting cranial by comparing it to other NEGATIVES, not by arguing any inherent POSITIVE that cranial offers.
But doesn't trigger point therapy offer reproducible results, and that's why medicare covers it? And isn't acupuncture covered by more and more insurance because it's been shown to have reproducible results?
The other post alluded to the contention surrounding the cranial study published out of UNE, and that's my understanding, too.
The same holds true for the new vitamin c study out of Brigham that was published the same day Astra-Z came out with their Crestor, the super-statin, as a preventative med.
The study showed that vitamin c doesn't help cardiovascular disease, nor does it help prevent it. But the dosage was 500 mg in tablet form, and the researcher, who I contacted, conceded in the study and in email that although higher doses may have indeed been effectual, that it was "Beyond the scope of the study". Studies demonstrate what they're intended to, in large part. If one thinks there isn't any bias in western medicine pharma studies... And to say that if a drug is proven ineffectual it's simply pulled from the market is another assertion thats puzzling to me.
Homeboy, are you taking the time to review the pharma evidence yourself as much as you're quick to review the effectiveness of OMT? Its fantastic to be dismissive in the name of EBM, and EBM is the revolution that's welcomed and needed, but in studies where EBM can't be applied as stringently as we'd like (ie double blind), we make due with the study dynamics that fit the bill, right?
To be clear, I think there's entirely more scandal on the pharma end of the spectrum than there is on OMT, and it's kind of silly to banter back and forth about a modality that you think has no supportive evidence for effectiveness but does no harm, while there are many treatments that cause harm that are given a free pass because the FDA in their infinite wisdom accepted 3 studies without requiring the other studies that failed or demonstrated potential problems.
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A similar tactic was employed for a recent large study on vitamin D and breast cancer. The authors used a wimpy 400 IU of vitamin D, found no effect, and proclaimed vitamin D supplements worthless. And of course all the 'science journalists' jumped on that headline and that is all anyone in the public got to hear.
Like I've stated multiple times now, the stakes are considerably higher with drug therapies than manual medicine, both in terms of risks (potential side effects, toxic/subtherapeutic doses) and outcomes (cardiovascular disease, cancer, etc).
Consequently there is infinitely more data on drug therapies...always has, always will...so it's not really surprising (and I don't really care) that you can constantly find data to contradict earlier data.
I'm not arguing the omnipotence of drug companies and the riskless, limitless potential for drugs. I've already admitted to that. But the inherent difficulty in studying OMT doesn't give carte blanche for its use until proven otherwise SIMPLY because there are other modalities (namely drugs) that are easier to study and prove/disprove.
No one ever said ALL evidence is GOOD evidence...there are PLENTY of ridiculous studies out there that have no worth.
But naming a few fraudulant studies is by no means 'evidence' of any sort...it merely points out the fault or misdirection of the study.
How does fraudulent research validate an unresearched/unproven modality?
In other words, you're defending the lack of evidence in OMT by saying there are fraudulent studies out there of supposedly accepted treatments. So what. The negatives in drug therapies don't equate to necessary acceptance of non-drug therapies, as if to assume research is flawed and we should just do what we were taught.
Are you needing justification for entering the DO school, or validation that you're not just going to "medical school", you're going to "OSTEOPATHIC medical school"? Just curious.
Consequently there is infinitely more data on drug therapies...always has, always will...so it's not really surprising (and I don't really care) that you can constantly find data to contradict earlier data.
I'm not arguing the omnipotence of drug companies and the riskless, limitless potential for drugs. I've already admitted to that. But the inherent difficulty in studying OMT doesn't give carte blanche for its use until proven otherwise SIMPLY because there are other modalities (namely drugs) that are easier to study and prove/disprove.
No one ever said ALL evidence is GOOD evidence...there are PLENTY of ridiculous studies out there that have no worth.
But naming a few fraudulant studies is by no means 'evidence' of any sort...it merely points out the fault or misdirection of the study.
How does fraudulent research validate an unresearched/unproven modality?
In other words, you're defending the lack of evidence in OMT by saying there are fraudulent studies out there of supposedly accepted treatments. So what. The negatives in drug therapies don't equate to necessary acceptance of non-drug therapies, as if to assume research is flawed and we should just do what we were taught.
Are you needing justification for entering the DO school, or validation that you're not just going to "medical school", you're going to "OSTEOPATHIC medical school"? Just curious.
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1. There's no argument from me that pharm has more to gain and lose in treatment, but even that's subjective dependent on who's wielding the pen and pad.
2. Don't mistake me, I'm not defending the lack of evidence for OMT, as you say, by demonstrating research bias in pharm studies. I brought that up because you took a position, and I was offering up the possability that said position isn't as bedrock as your confidence in the matter seems to indicate. The fact that you "don't really care anyway" doesn't help your claim to authority on the matter.
There are hundreds of studies that date back decades to present on OMT that show significance, and I'm just bringing to the table that they're small, largely uncirculated in the mainstream, etc. The DO profession isn't mainstream, so why would their research on OMM? Caveat: that's changing.
And would you like to suggest that OMT wasn't accepted by the mainstream medical community, in say Philadelphia, for example, in the 20th century because of evidence to the contrary of it's application?
3. You may not be arguing the omnipotence of pharm, but you like to argue the impotence of OMT, so that's why we're having the debate. In my view it's intellectually lazy to get up in the morning and basically proclaim the utter inferiority of OMT and the apex achievement of pharma, a quackwatch point of view, if you will. That being said, I'm very optimistic about the future of pharm, and who isn't??; the problem is we're still largely guessing on the mechanisms in their use, and everything that follows that. Besides, there have been dozens of compounds that began as complementary and ended as pharma, and that trend will continue. Although a disturbing trend has surfaced where complementary is such big business, things like the "detox foot pad" and stuff are being sold. I now recall you suggested I get a magnet bracelet, and I think you missed the point there speaking about magnetic therapy. Just because there's people out there preying on our consumer culture, doesn't and shouldn't invalidate the physics of medicine for serious researchers or clinicians, or dissuade patients from seeking out other means for treatment than the most invasive of procedures. I've seen promise in treating migranes with a fluctuating electromagnetic field generated by a helmet which seems to quiet the neuro-brain storm that's present in some migranes, and I don't see why it's necessary to mock "magnet therapy" at risk of turning people off to investigating for themselves, and the same goes for OMT.
4. I never claimed the studies I had mentioned briefly in the previous post were fraudulent -that would be erroneous - and I didn't mean to imply or infer such. The studies were NARROWLY DEFINED, and therefore easily misrepresented in the media, which reaches the lay population who don't use Ovid or Medline.
And to satiate your curiousity, homeboy, there's no unconscious attempt to find justification for my decision to enter a DO program, which would be odd in-and-of-itself since it was a consertive effort on my part to thoroughly research and gain favor/acceptance to the program for which I was. I'm keeping an open mind to the possability of deeper OMT studies in the future, and I have a bit of a background having spent some time in the fellowship clinic to be able to share my thoughts and feelings on the subject, that's all.
What??? Are you quite sure you know what you're talking about??
We work in the same hospitals, submit the same reimbursement forms, treat the same patients...
DOs are as mainstream as any other physician, contrast to OMM, and this is exactly where the disparity of your understanding comes into play.
The notion of "osteopathy" is not widely accepted (and no, this is not a "caveat"...it never will be...it is not "changing" regardless of your viewpoint working in the "fellowship clinic"), but NO ONE CARES.
I'm saying OMT never has and never will be accepted by "mainstream" medicine as a whole, but what little acceptance MDs have given (as evidence by CME offered to MDs in OMT, allowing them to perform & bill for it) essentially negates our profession...unless you can think of another defining quality supposedly inherent to osteopathic medicine that is unique...something absent in the rest of medicine.
No, the charlatins of the world don't invalidate things like magnet bracelets, but the lack of evidence SHOULD catapult it from the scope of treatment physicians offer. Health insurance IS not going to and SHOULD not cover something SIMPLY because it is purported to work by some faction of society.
I'm not dissuading patients from seeking what means they deem necessary to ease their pain or suffering (within reason), but we still have STANDARDS and can't simply adopt every single therapy modality because a patient wants it.
Let me give you a prime example.
My father is a PA that does psyche for the state. He sees parents of develeopmentally disabled patients ALL THE TIME that absolutely insist on colon cleansings, natural thyroid medicine for euthyroid states, every single herbal & non-regulated drug and treatment you can think of because they have some health professional recommending it or because they say it on TV or read it online.
These people are more than able to do what they want (though it's a sticky issue in terms of what's really in the best interest of the patient vs what the parent wants), but that doesn't mean the STATE, and consequently the TAX PAYER should pay for it.
--This is EXACTLY where your responsibility as a physician comes into play, becuase even though these people can do whatever they want and research whatever they want, they don't have the background & access to information to differentiate bunk from real, especially in historic context.
I'm NOT insulting the lay-persons' intelligence, but people often do bizarre things in desparation, or because they've exhausted all other options, and if you don't offer your professional advice / knowledge, you're doing them a disservice, regardless of how much they might disagree with you.
If your patient wants to wear magnetic bracelets (or have, say, chelation therapy, which is perhaps a better example in the clinical setting), you don't pat them on the back and say, "Good for you, I hope that works."
You give them the information you have at your disposal and give them your professional opinion. If they blow you off and want to get chelation therapy anyway, fine, good for them, but (along with other similar therapies) insurance isn't going to cover it & and I'm not going to condone it.
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I'm done with this conversation; by taking my statements out of their properly placed context, the discussion is devolving into something I don't recognize and can't lay claim to. Sorry.
