OMM Blues

[bones]

Basically, we need a Flexner-like movement within our profession as it pertains to OMM curriculum. I wish we had more NMM/OMM specialists out there like you to teach and influence decisions at our schools as well as in the higher ranks of our profession.

I couldnt agree more.

---

Members don't see this ad.

 

[Seth Joo]

I couldnt agree more.

OMM is largely the reason why Osteopathic schools exist and are proliferating, that and most schools emphasize primary care and community medicine. Osteopathic schools are not there to create Cardiothoracic Surgeons, they are there to create primary care physicians for under-served communities.

There are quite a few DOs who run cash only practices that offer Osteopathic Manipulation, many of these are located in affluent suburbs of major cities, I feel these individuals do a disservice to those us who want the public to view us as bonafide practitioners of medicine.

 

[Mr Kenobi]

greetings,

Speaking as an NMM/OMM specialist in practice, you are right about a good many things. We need high quality research, which is sorely lacking. There are a lot of overblown claims. It is easy to pass off BS treatments as harmless therapy that "maybe" offers improvement- that stuff drives me crazy. The mysticism needs to be removed from the classroom and attendings should not expect students to believe any claims that cant be demonstrated live in front of the class with real patients. Anything short of immediate, massive and permanent results should be rejected as potentially (and probably) placebo, and all untested theories should be eliminated from med school testing and board testing until proper research and validation is done (cranial and chapmans points come to mind, but there are countless other examples). We need to place quality research training and the scientific method at the heart of all medical schools- including DO schools- and topics that are theory should be taught as theory and not passed off as "fact".

I am not prepared to say NMM/OMM should be eliminated from med school, for that would eliminate the reason to award a DO degree at all. Plus i get awesome results, I get paid well, and I'd like other DOs (at least those who are interested) to have the chance to do what I do. I havent done much to help the cause yet other than train a number of students- I haven't published research, mostly for selfish reasons (I love the clinical side/find research boring) plus i dont want to waste my time publishing in trash journals as many of my colleagues do. I'm working on building a team w some PhD's from the ivys, and perhaps start teaching NMM as an elective/CME through some of the top MD schools. I think thats where we need to go next if we want to be taken seriously in the scientific community- and believe it or not it seems MDs who seek this training out take it very seriously and are often very good at it... if we go this route there really will be no reason to get a DO degree. As the research comes out some aspects of manual medicine may start becoming mainstream- and will hopefully become a lot more effective in most practitioners hands as the BS is eliminated via good research. There will still be specialists in NMM i think, and hopefully far more effective ones.

thoughts?

Bones-

Thanks so much for adding to this thread. Sorry for my delay in responding. Between trying to catch up in school after attending the OMED convention and due to my school's weekly exam schedule, I've been waiting till I had a moment to breathe to reply!

I have spent a considerable amounts of time over the last couple years reading about the subject of OMM in osteopathic education in the archives on this forum and as I've come across your posts have always found your additions to the conversations to be insightful and well versed. You represent osteopathic physicians well. As a future DO, I thank you for that. As others have mentioned here, it is a real breath of fresh air to hear a practicing NMM/OMM physician bear the opinions that you do on this topic. I can't tell you how hard it has been for me to deal with the unproven, anecdotal medicine that is being presented as fact in my medical education. So again, thank you for speaking up and displaying to us that even in the field of OMM there are physicians that acknowledge the issues at hand within our current system.

As alluded to in my opening post; I completely agree that OMM should remain part of the curriculum at DO schools! It is a matter of reforming the way in which it is handled and the content that is being emphasized in our schools and on our licensing exams. We truly need to make the move towards evidence based medicine and I am hopeful that with the way things are going, we will eventually get there. Beyond more research taking place, what do you suggest needs to happen to get the ball rolling in the right direction to expedite these changes at the education and licensing level? During my time in Seattle for OMED, students seemed eager to file resolutions with SOMA seeking the reforms suggested in this thread (ie. a movement towards EBM in OMM education). Not sure how much (if any) weight this would hold even if it was sent to the AOA--but after all, if nothing is ever said, we can't really expect anything to happen here...right?

From what Ive been able to tell, within the current climate among young budding DOs there exists an unspoken yet universally understood situation where we must "suck it up" and learn pseudoscience in our schools without publicly questioning it's validity just to reach the point where we can dismiss it as soon as humanly possible... This shouldn't exist in our medical schools--yet the paradox remains and the cycle continues. Some true advancements to what is taught in our schools and the way it (OPP) is delivered could really cause us to see more and more osteopathic students/physicians slow their immediate dismissal of the practice as a whole and perhaps even increase its application. Now wouldn't that be nice

 

[GUH]

There are quite a few DOs who run cash only practices that offer Osteopathic Manipulation, many of these are located in affluent suburbs of major cities, I feel these individuals do a disservice to those us who want the public to view us as bonafide practitioners of medicine.

That's ridiculous. If you want to work directly with patients rather than through insurance companies, there is absolutely nothing morally wrong with doing so. We need more physicians in direct practice settings, not less. Once insurance companies and the government realize that doctors won't tolerate being treated poorly then maybe you will see more reasonable compensation.

 

[Seth Joo]

That's ridiculous. If you want to work directly with patients rather than through insurance companies, there is absolutely nothing morally wrong with doing so. We need more physicians in direct practice settings, not less. Once insurance companies and the government realize that doctors won't tolerate being treated poorly then maybe you will see more reasonable compensation.

I do not like DOs who run cash only manipulation practices, its sets our image back, some people think of us like Chiropractors. That is why I do not like it.
There are MDs who run cash practices as well, but they usually provide actual medical procedures, look at Dermatologists and Plastic Surgeons.

 

[GUH]

I do not like DOs who run cash only manipulation practices, its sets our image back, some people think of us like Chiropractors. That is why I do not like it.
There are MDs who run cash practices as well, but they usually provide actual medical procedures, look at Dermatologists and Plastic Surgeons.

That's like saying "some physicians run hair restoration centers so now some people think of us like barbers." Or "some psychiatrists run cash-only therapy practices so now some people think of us like psychologists".
You can argue about the evidence for certain procedures within the specialty, but OMM is a medical specialty and it is perfectly fair for a physician to make a living off of his training.

 

[NurWollen]

That's like saying "some physicians run hair restoration centers so now some people think of us like barbers."
OMM is a medical specialty. You can argue about the evidence for certain procedures within the specialty, but it is a medical specialty.

But no one has mistaken barbers for physicians since, oh, about 1897. Too many people still think that chiropractors are physicians or think that DOs aren't physicians, so I can see his point. I don't have a problem at all with cash-only practices, though. I guess it depends on the doctor's intent.

 

[GUH]

But no one has mistaken barbers for physicians since, oh, about 1897. Too many people still think that chiropractors are physicians or think that DOs aren't physicians, so I can see his point. I don't have a problem at all with cash-only practices, though. I guess it depends on the doctor's intent.

So because people are ignorant, OMM doctors should not run direct practices?

 

[NurWollen]

So because people are ignorant, OMM doctors should not run direct practices?

I suppose it depends on the physicians's intent. If you're honestly really in to OMM and think it will benefit people, I don't think there is anything wrong with cash only, especially if you're judicious in how you treat and what you treat them with. But if you're going to charge people hundreds of dollars for you to sit at the end of a table and put your fingers on the greater wings of their sphenoid....

 

[Seth Joo]

That's like saying "some physicians run hair restoration centers so now some people think of us like barbers." Or "some psychiatrists run cash-only therapy practices so now some people think of us like psychologists".
You can argue about the evidence for certain procedures within the specialty, but OMM is a medical specialty and it is perfectly fair for a physician to make a living off of his training.

Hair restoration physicians perform actual medical procedures and most of the good ones at least get some formal training.

I actually know a DO who performs manipulation only and has all his patients sign a disclaimer that results are not guaranteed. Many DOs use manipulation to treat conditions unrelated to musculo-skeletal pathologies. I heard of one claiming he can treat Irritable Bowel Syndrome with manipulation, sure whatever.

 

[Beargryllz]

results are not guaranteed.

This sums up all of medicine pretty much perfectly

 

[hallowmann]

Hair restoration physicians perform actual medical procedures and most of the good ones at least get some formal training.

I actually know a DO who performs manipulation only and has all his patients sign a disclaimer that results are not guaranteed. Many DOs use manipulation to treat conditions unrelated to musculo-skeletal pathologies. I heard of one claiming he can treat Irritable Bowel Syndrome with manipulation, sure whatever.

Lots of docs don't guarantee results. That's nothing new to medicine.

And at the risk of sounding like I drink the kool aide, I honestly wouldn't be surprised if some IBS could be helped with manipulation. Fear, anxiety, and stress are all potential triggers that exacerbate IBS symptoms in many patients. OMT can alleviate that (just as massage, breathing exercises, and other things can). I don't know if I would say it could cure it, but I could definitely see OMT helping with some people's symptoms.

 

[Seth Joo]

Lots of docs don't guarantee results. That's nothing new to medicine.

And at the risk of sounding like I drink the kool aide, I honestly wouldn't be surprised if some IBS could be helped with manipulation. Fear, anxiety, and stress are all potential triggers that exacerbate IBS symptoms in many patients. OMT can alleviate that (just as massage, breathing exercises, and other things can). I don't know if I would say it could cure it, but I could definitely see OMT helping with some people's symptoms.

I think diet and medication can help a lot with IBS, not sure about OMM.

 

[Seth Joo]

This sums up all of medicine pretty much perfectly

Obviously no one can guarantee nothing, but I called up a DO's office and the first thing she told me is that doctor cannot guarantee that his treatment will work.

 

[hallowmann]

I think diet and medication can help a lot with IBS, not sure about OMM.

I wouldn't be surprised if all 3 could. What helped a member of my family the most was stress lowering exercises. YMMV

 

[GUH]

Obviously no one can guarantee nothing, but I called up a DO's office and the first thing she told me is that doctor cannot guarantee that his treatment will work.

Would you feel better if the doctor did guarantee that OMM would cure whatever problem you had?
I sure wouldn't.

 

[cabinbuilder]

I think diet and medication can help a lot with IBS, not sure about OMM.

OH, I totally have to chime in on this one. I personally have LOTS of intestinal issues from multiple surgeries, adhesions etc. Food is the enemy and it hurts to eat every single day. Can't have more surgery to fix the adhesions because surgery just makes more. I also have an IBS component due to stress triggers and my gall bladder is gone. I take my PPI every day.

Twice a year, I fly to see my DO who specializes in adhesion manipulation because it is just about THE ONLY THING that works for me and I can totally feel the difference for months after I have it done. Not everyone has the GIFT of OMM but those who do are worth going to.

 

[Mr Kenobi]

Twice a year, I fly to see my DO who specializes in adhesion manipulation because it is just about THE ONLY THING that works for me and I can totally feel the difference for months after I have it done. Not everyone has the GIFT of OMM but those who do are worth going to.

I can't even

 

[Jwalker]

I can't even

Sounds like you've had a clumsy classmate do cervical HVLA to you. OMM is definitely not for everyone.

 

[Mr Kenobi]

Sounds like you've had a clumsy classmate do cervical HVLA to you. OMM is definitely not for everyone.

Naw bro. Everyone at my school has the "Gift of OMM", so our HVLA is on point.

 

[Seth Joo]

OH, I totally have to chime in on this one. I personally have LOTS of intestinal issues from multiple surgeries, adhesions etc. Food is the enemy and it hurts to eat every single day. Can't have more surgery to fix the adhesions because surgery just makes more. I also have an IBS component due to stress triggers and my gall bladder is gone. I take my PPI every day.

Twice a year, I fly to see my DO who specializes in adhesion manipulation because it is just about THE ONLY THING that works for me and I can totally feel the difference for months after I have it done. Not everyone has the GIFT of OMM but those who do are worth going to.

Would you feel better if the doctor did guarantee that OMM would cure whatever problem you had?
I sure wouldn't.

No doctor could guarantee anything, I believe there is a law against a doctor guaranteeing a result. I remember during my interview the professor asked me what I would do if I was in a position where I could not do anything for a patient. It turned into one of the most interesting conversations I ever had.

 

[wjs010]

Hair restoration physicians perform actual medical procedures and most of the good ones at least get some formal training.

I actually know a DO who performs manipulation only and has all his patients sign a disclaimer that results are not guaranteed. Many DOs use manipulation to treat conditions unrelated to musculo-skeletal pathologies. I heard of one claiming he can treat Irritable Bowel Syndrome with manipulation, sure whatever.

You mean you never heard of a somatovisceral reflex ,or maybe a hyperparasympathecatonia!!!? Completely legit

 

[bones]

I can't even

flying to see a good OMM specialist isn't out of the question. Even though I was so isolated where Ive been working the last few years I had a new patient fly to see me on the recommendation of a med student who knew him. It so happens in one visit his neuropathy of 20+ years was resolved, and it spared him a fairly major spinal surgery that he had been putting off. I dont know how he is doing today- but 6 months out from that one treatment he was still doing great. I have had a number of patients that drove more than 3 hours each way to see me- for a variety of conditions (I do 30 minute visits). While there are dozens if not hundreds of chiropractors between where they live and me- OMM is a very different service and patients know results when they see them.

 

[bones]

We truly need to make the move towards evidence based medicine and I am hopeful that with the way things are going, we will eventually get there. Beyond more research taking place, what do you suggest needs to happen to get the ball rolling in the right direction to expedite these changes at the education and licensing level? During my time in Seattle for OMED, students seemed eager to file resolutions with SOMA seeking the reforms suggested in this thread (ie. a movement towards EBM in OMM education). Not sure how much (if any) weight this would hold even if it was sent to the AOA--but after all, if nothing is ever said, we can't really expect anything to happen here...right?

Right.

I have a few very exciting projects I am working on for which I can't go into too much detail in a public forum like this because they are not finalized yet (PM me if interested). What I will say is we need to merge top of the line OMM/NMM results with some of the top research minds in the country- and build residencies around this. In the meantime, the UNT health group is doing some good stuff you can look at (http://www.hsc.unt.edu/orc/research_publications.aspx). I'm afraid the AOA is well aware of the terrible EBM in the OMM world and they dont seem to want to lift a finger.
When better quality studies start getting published regularly (regardless of outcomes) there will be a push to incorporate whatever is found into NMM curriculums and the material will probably make it to boards. I'm afraid they wont budge for anything less. Certainly not for reasonable concerns raised by a group of students (the old brass still control a lot there). ....unless of course those students had some clout on social media and could offer the AOA some power and fame in exchange for altering their stance on these matters.

 

[Back 5]

I can't even

I'm a walking Orthopedic case. Many many many surgeries from athletics, plus a few good old-fashioned ones thrown in, just for fun. I was told that OMM would help relieve any pain I had due to a build up of fascial trauma(?) from all the surgeries. After a 30-45 minute treatment, I didn't feel anything.

Now, I don't mean to sound like I'm belittling OMM, but I think our profession needs to perhaps consider the idea that OMM is great for MSK issues and things like a 'build up of fascial trauma' might stretch the realm of possibility.

 

[bones]

I'm a walking Orthopedic case. Many many many surgeries from athletics, plus a few good old-fashioned ones thrown in, just for fun. I was told that OMM would help relieve any pain I had due to a build up of fascial trauma(?) from all the surgeries. After a 30-45 minute treatment, I didn't feel anything.

Now, I don't mean to sound like I'm belittling OMM, but I think our profession needs to perhaps consider the idea that OMM is great for MSK issues and things like a 'build up of fascial trauma' might stretch the realm of possibility.

talk is indeed cheap. I have seen some real strange people in DO schools claiming all manner of things with OMM. Most of it is indeed BS, but some people I've tracked down do the real thing- and I've learned from them and copied their success. ...their claims can sound just as ridiculous as the people who don't get results though. My attitude was if you claim big things then prove it to me. See how many of their projections are accurate. The people full of hot air you can just ignore- but if you give each practitioner a chance to prove themselves, once in a while you will be shocked beyond belief. So- thats the state of OMM. Charlatans mixed with people who are humble but get minimal results... and then a few that get great results but have no evidence to prove it except whatever they can demonstrate (so they are usually clumped with the charlatans). This is why we need an overhaul. The stuff that seems to really work needs to be looked at carefully with large blinded studies- and the stuff that proves itself needs to be expanded upon and the mechanism better understood. the rest of the theories and junk techniques need to be thrown out.

If anyone reading this wants to find one of these osteopathic greats- look for an impressive reputation among their patients (or their students), and then- more importantly- ask their personal nurses if they would send their friends and family to them... hesitation should be enough to move on, but if they are enthusiastic give the doc a try. Shadow them for an afternoon- so you dont waste too much time if they've fooled their nurses. Good luck!

 

[Seth Joo]

You mean you never heard of a somatovisceral reflex ,or maybe a hyperparasympathecatonia!!!? Completely legit

Yes I have, I might have to look up the notes...I know I have them somewhere.

I was talking about that I had an issue with DOs who run cash only OMM practices. The DO I called has Mastercard/VISA/AMEX signs outside his office. I have an issue when a DO runs a practice like it was a Starbucks.

 

[wjs010]

Yes I have, I might have to look up the notes...I know I have them somewhere.

I was talking about that I had an issue with DOs who run cash only OMM practices. The DO I called has Mastercard/VISA/AMEX signs outside his office. I have an issue when a DO runs a practice like it was a Starbucks.

I know I was being sarcastic. Lol. Yea doing it like that sounds a bit chiropractery, which is never, ever a good thing

 

[Seth Joo]

I know I was being sarcastic. Lol. Yea doing it like that sounds a bit chiropractery, which is never, ever a good thing

There was a time when Osteopathic Medicine was seen as no different than Chiropractic medicine. The profession has made many steps forward. I do not like it when there are certain individuals eager to set us back for some quick cash.

 

[LeahWalker]

There's far too much of a "I don't understand it, and I can't do it, therefore it must be fake and I will deride and demonize it" attitude in here. I'm not sure what schools you go to, but thankfully people in my class are not so narrow-minded as to entirely block themselves from things they do not yet know about.

Truly unfortunate that patients will one day be subjected to such childish "doctors".

 

[Mr Kenobi]

There's far too much of a "I don't understand it, and I can't do it, therefore it must be fake and I will deride and demonize it" attitude in here. I'm not sure what schools you go to, but thankfully people in my class are not so narrow-minded as to entirely block themselves from things they do not yet know about.

Truly unfortunate that patients will one day be subjected to such childish "doctors".

Exquisite 1st post. I'm pretty sure almost everyone who posted in this thread that you resurrected from a year ago "knows about" cranial osteopathy. Getting your jimmies rustled from an internet thread and starting a troll account to let us know about it far exceeds any childish behavior exhibited in this thread. Might be time to look into skin thickening OMM techniques... you're gonna need em.

 

[Back 5]

We started Chapman's points today

 

[ortnakas]

We started Chapman's points today

You're not going to poke at the 12th rib instead of getting a CT with contrast for appendicitis?!

I kid (in case that wasn't obvious).

 

[NurWollen]

.

 

[alden014]

There are absolute contraindications as well for almost every treatment. Also, pretty much no one in this thread is "drinking the Koolaid" we are just pointing out that the entire basis of your argument is false. How about you get even some of your facts straight before going off on a rant specifically about said "facts."