Of 'the holistic aproach', MDO, and other stuff.

[jimjones]

I think the person who posted about the MDO title took more abuse than they deserved. I wouldn't want it changed.. don't get me wrong.. I agree that it would make people even more confused...but the poster is right about something. The DO education is not really that much different than the MD. OMT I think is under rated, I think that is really what sets DO education apart, not the philosophy that is so overstated. I have not seen in the curriculum anything about 'holistic approach' or 'body functions as a whole'. When someone walks into a DO;s office and says I've got a sore throat, a DO doesn't say 'how are you feeling mentally' or 'how is your back.' And when someone walks into an MD's office and says 'I've got a sore throat' the doctor is not going to look in the throat, mutter something to themselves, and hand a prescription to the throat. "Here throat, your prescription."

I think the feild needs revamping its call-sign. It lacks credibility touting philosophies which aren't really distinct.

And I also agree that it doesn't make much sense to have seperated residencies for psyc, surg, derm, etc.

Anyone care to agree with me or am I going to get dragged throught the streets with this post?

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[TCOM-2005]

Little Jimmy you are a good egg. However, you are wrong on a few accounts. First, if you had really done your homework you would know that D.O.'s are trained to ask just the question you said they don't (when it is appropriate). Secondly, manip. has come a long way, but has a longer road to travel still. You are correct on your residency comment.

 

[DO/MBA]

We aren't trained to ask about there back when they have a sore throat.?! We only cover that in our review of systems, just like MDs. What we are trained to do is touch our patients, however I believe the MDs that I know are just as adept at that as we are. To say that our philosophy is different than an MDs is archaic thinking. As medical practices get better, the two will be very, very similar. Remember, it was "popularized" because the medicines in the late 1800's because medicine just plain sucked then. If OMT is backed by strong research MDs will probably adopt it to use. Where will the difference be then? Please don't go to the " The body is a whole thing" Any MD will agree that the patient needs to be treated not just the symptoms. I'm not trying to start an arguement here, but when I started I believed there was a difference, but the more MDs I work with the more I see that they have the same "philosophy". However, when I go home my family lines up for treatments, so I'm glad I'm a D.O.

 

[jimjones]

Isn't that my point?

If OMT is backed by strong research MDs will probably adopt it to use. Where will the difference be then? Please don't go to the " The body is a whole thing" Any MD will agree that the patient needs to be treated not just the symptoms. I'm not trying to start an arguement here, but when I started I believed there was a difference, but the more MDs I work with the more I see that they have the same "philosophy".

Hey: Isn't that my point??

 

[Maximus]

Hi...Just thought I would put my two cents in.

One of the great needs in osteopathic medicine is the scientific substantiation of OMM, by means of well-designed research. This is also a need in the chiropractic and physical therapy professions, as a lot of the benefits to musculoskeletal manipulation are anecdotal. Anecdotal is all one needs to form a question and study the method by means of proper scientific method. As DO's substantiate the effectiveness of OMM, no doubt the MD community will feel less reluctant to acknowledge it as a legitimate treatment form. Most MD's who have honestly observed the effects of OMM already do this I might add.

Talk to most MD's who actually work side by side with a DO and they will tell you that the approach to medicine is no different. We train in the same hospitals, from the same residencies…how can our overall philosophies be that different? In my opinion, Osteopaths had to realize that medicine is more than just manipulation, but a combination of sensible pharmacological treatment and hands on treatment guided by a holistic approach. MD's have had to realize that possibilities exist in treatments that are not necessarily documented by science, and that the science that proves treatments often comes after the anecdotal.

It is good to have multiple means of looking at things, which is why this endless premed debate often frustrates me. MD's stomp on DO's for being different, DO's stomp on MD's for being close-minded, when that is the real problem is that both professions suffer from pride. People hate finding out that their way is NOT THE ONLY way! By the way…have you ever met two MD's or two DO's that believed the same thing on every subject? NO! Individuality, personal ethics, and experience play a big role in their professional opinions. No two MD's are the same. No two DO's are the same. So no MD and DO should be expected to be the same.

Conclusion: Respect each other for what you are…Doctors! All educated and licensed to treat the ailments of your fellow man. Stop judging each other and go to work. Let's learn from each other regardless of degree and do what we do best.

Maximus

 

[Freeeedom!]

It is good you guys are talking about this...but DO/MBA, I would be careful regarding constantly manipulating family. Manipulation for the sake of practice can be dangerous, hypermobile joints can be just as damaging as hypomobile joints. Stabilization is a key, and is notably missing in most DO curricula. When I left school, I had never seen SOOOOO many people in back pain in my life! I went through school and gotten a cervical manipulation twice, neither time did I want it or need it (I was a poor guinea pig).

 

[DO/MBA]

Jim, I am just backing you up. Reinforcing your thoughts. I also agree with freeeedom, they don't teach stabilization as the key. Some of them even admit to "shot-gunning"

 

[jimjones]

Thanks for your input people. I have been quite keen on osteopathic schools for a while, but recently the anti-allopathic sentiment has been bothering me and making me question the institution a little bit. I do have tremendous respect for allopathic medicine. It was not osteopathic med that brought us anitbiotics, anesthesia, organ transplantation, etc. etc. Those that try to distance osteopathic 'approach' or philosophy to health care make me wince a bit.
What draws me to osteopathic med is the combined medical training and OMT. I think the extra training would be huge to a family practitioner. But there is an inconsistency in the osteopathic institutions identity which makes me hesitent to jump into it. It seems to embrace allopathic medicine and crap all over it at the same time.

 

[John DO]

Jim, it wasn't allopathic medicine that brought most of these advances, either. It was science (PhDs): biochemists, etc. Since the allopathic medicine establishment has been bolstered by the Rockefeller money for so many years (research the establishment and find the turning point--it came from a grant to revamp the schools--one that was not offered to osteopathic schools since they were not accepted at the time).

The only thing DOs refer to when they discuss the "whole body" approach is not necessarily asking about mental status, etc. A good case in point is my wife, who has been treated by several MDs in the past for recurrent headaches by being offered 800mg ibuprofen, which doesn't seem to work. In school, I learned about myofascial release, a technique supported by MDs (the current predominant book concerning referred pain was written by an MD, Travell), but is not taught in MD schools and is not practiced by MDs. Travell claims that a unilateral HA concentrated around the right temple can be referred pain from a trigger point on the anteromedial border of trapezius. I checked my wife's trapezius and, sure enough, I got a positive sign. I treated the trigger point and, voila, HA gone (without drugs). This was diagnosed and treated by a first-year DO student (me) more succssfully than by several very experienced MDs, because they resorted to more conventional medicinal treatments, treating the SYMPTOMS, not the CAUSE.

The point is not to feign an unrelated organization of systems so that we can tout a false philosophy; the systems ARE related and this relationship MUST be considered, which, sadly, is not done in the majority of MD's (and quite a few DO's) offices. Unfortunately, I don't think the issue is MD/DO; I think it is more HMO, but that is another thread altogether!

 

[jimjones]

John DO: Thanks for the great response. Makes sense what you said about treating your wifes headache. Thanks for contributing intellectually and not kicking me all over the forum. Anyone else care to contribute?

 

[mompremed]

Originally posted by jimjones:
•....What draws me to osteopathic med is the combined medical training and OMT. I think the extra training would be huge to a family practitioner. But there is an inconsistency in the osteopathic institutions identity which makes me hesitent to jump into it. It seems to embrace allopathic medicine and crap all over it at the same time.•

My DO mentor who is also adjunct faculty at a DO school says that 20 years or so ago there was a lot of difference between MD's and DO's in philosophy, but over time, the MDs have moved closer to where the DOs are, and vice versa, (OMM notwithstanding). He insists that the MDs he is in practice with practice just as holistically as he does....and I know they do because I know who he's in practice with!

I don't know about other areas of the country, but having worked in hospitals here in the midwest for many years (some of them teaching hospitals), I have not ever been able to detect the slightest disrespect of either profession for the other. In fact it is the rare practice indeed that does not have both MD and DO physicians on staff. Also, I have 2 MD mentors that have encouraged me to "go DO" because they support my desire to be a physician and they feel that DO schools are more accepting of older students, and they feel very confident that I will receive every bit as good a training at a DO school as MD schools - in some cases, better training!

Whatever premed/med school debates might continue to "rage" regarding MD vs DO - I think it is no longer even a question of semantics in the real world of medicine. Now, in the general population - you know, the masses who are not really educated about these things (like my mother! ) - it may take awhile longer to accept that DOs are real doctors just like MDs. Maybe it's those pre-conceived misconceptions that the debate really stems from..... but I have never seen a hint of it in the medical community itself. (But then they say there ARE no atheists in the foxhole....eh? And believe me, the "front lines" of medicine ARE very much like a war zone!!)

And in defense of what you have observed concerning the DO profession as a whole being somewhat...well...defensive - don't forget, the MDs - well, actually the AMA - did try to wipe them out. Of course they tried to wipe ALL the other practitioners out as well, midwives, homeopaths, naturopaths, etc. over the past century and a half, so it wasn't really personal on the part of the AMA. They just didn't want any competition from anyone. (There is documentation to prove that, BTW, at least as far as the midwives go.)

Fortunately, the "times they are a changin'" and I sincerely believe that DOs are in a unique position to become agents of change for the improvement and expansion of healthcare treatment modalities in the coming years.

Cheers,
mompremed

 

[Freeeedom!]

I think it is great that you used the "Myofascial Trigger Points" techniques supported by Travell, but it is also important to realize that P.T's have practiced these techniques for YEARS and they are there for the referral...far more seasoned in manual medicine and prevention of musculoskeletal woes than DO's...primarily because that is all they do (one LONG sentance).
Our jobs as Physicians is to not only treat, but to refer on to P.T. for limited visits.

It is MORE than just a trapezius trigger point, it is most likely overaction of upper trapezius from poor mechanics or even a chair for a desk that is the WRONG height!!

Things just don't GO AWAY when you treat them...you must prevent them. We as DO's must be acutely aware that prevention is the key...and PT's have time for much of this preventative teaching.

PS, Travell has MANY MANY referred pain patterns to the periorbital region (occiput, TMJ, scalenes etc).

 

[John DO]

Most obviously, freeeeedom. I was not instructing on the technique; I was merely citing an example. Thank you for expounding for me . . .

 

[Freeeedom!]

Wow. A bit on the touchy side I guess.

 

[John DO]

sorry if i appeared so; it is easy to be edgy at the end of a quarter. i am only on SDN right now because i am sick of studying (i haven't seen my family more than a few hours the past week) . . .

 

[jimjones]

Posted on another topic by Realruby2000:

Hey everyone,
sometimes people are plain dumb...or mabey they're being stupid...but sometimes when i try to explain the differences between and MD and a DO (which are almost none), some slow ******s start thinking im a chiropractor/homeopathic herb man. and some dont understand that osteopathic medical schools are medical schools just like allopathic! anyone have a quick and simple way of getting such an easy concept accross? would it be ok to sy DO = MD + chiroprct

This is the type of thing I'm talking about. What is the image osteopathic medicine wants for itself. Is it "MD + Chiropractic" (OMT stuff)or is it an alternative to allopathic medicine. I think the osteopathic institution is inconsistant with this and I can't get over it, it bugs me. My idea is that it has essentially merged with the allopathic but has retained its identity with the OMT and musculoskel diagnostics, this is inconsistant with having seperate DO residencies and the different approach to the patient philosophy.

 

[Teufelhunden]

DO = MD + DC ??

Heck no! Most chiropractors can manipulate circles around DO's. Our OMM training doesn't come close to comparing to the traning chiro's receive. It's not our fault - I mean - we have to learn medicine, while chiro's spend 4-years focused on manipulation - so of course they're much better at it. Of course, I'm speaking in general terms as their are many DOs who have dedicated themselves to OMM and are truly experts in their field.

Please, any chiro's out there, don't flame me for my comment. I can hear you all now with the "We do learn medicine." Please, just don't. I'm not slamming DC's - they provide a valuable service to many patients - I just get a little rattled when they start rambling about how they learn "medicine," because they don't.

Now it's I who am rambling....