OMM Clinics???

[drdrtoledo]

Where I come from most DO's don't use much of the OMT. I have heard from many students that the techniques they learn worked particularly well in the arthritic/elderly population. Has anyone ever heard of an office where the DO makes 1 hour appointments where he/she spends the time doing a complete OMM workup? With the general public tending to shy away from medicine and the constant problems with the elderly and medication I would think this could eventually be a very profitable business. People want their physician to take the pain away... they don't really care how.

And one more thing.. would DO's get compensated for visits if they are OMM oriented? I don't see why not since osteopathic medicine is a federally recognized field.

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[4th yr Fellow]

In response to OMM clinics..... I am only a 4h year med student but I will tell you what I know. In California, especially in affluent areas, there are many DOs that do only OMM, spend 45min-1.5hrs with each patient, but most charge cash. These docs do however tend to give superbills to their patients, who in turn can bill their insurance, and they say they can get about 80% of the visit covered.

Other DOs do bill insurance. There is an ICD-9 code for somatic dysfunction, however, I have no idea what the reimbursement is like. If you are a DO looking for more info on billing, or refering patients to OMM specialists, the AAO (american acadamy of osteopaths) is a good resource. They may be able to point you in the right direction.

 

[Hedwig]

DOs certainly do get compensated for OMM-only visits. Insurance companies like OMM because it's uninvasive and non-pharmacologic. However, I've yet to meet a DO who doesn't charge only cash--and a lot of it--in a non-academic practice. Don't get me wrong, it's not like cosmetic surgery. The doc gives the patient a receipt, and the patient bills the insurance company him/herself.

Manipulation is a skill that's very much in demand, and that's reflected in the amount charged for it. Please believe me when I tell you that I know some very, very wealthy men and women who ONLY practice OMM.

Personally, my dream is to be an ER doc or radiologist or inv. cardiologist or something like that, but have a very cush and profitable (i.e., cash only) OMM practice on the side.

By the way, did you know that DOs that only practice OMM have the LOWEST malpractice premiums of any specialists? Can't beat that.

 

[tBw]

Okay...this thread raises some questions for me. The following questions are asked out of ignorance but genuine interest...try not to take it the wrong way (ie I'm NOT doubting the value of OMM residency training, the effectiveness of OMM, or saying there is no difference between OMM and chiropractic techniques...)

1. If you can practice OMM regardless of the residency you do, and especially if you can practice it with a FP residency, why would someone limit themselves by doing a residency in OMM? Are there specific advantages beyond greater exposure to OMT?

2. Is what Hedwig proposes really feasible? I do not see why another DO would refer a patient to you if you were not OMM residency trained, I doubt an MD would, and I don't think you can 'refer' a patient to yourself (can you??). Practising OMM 'on the side' therefore requires people to specifically seek you out. They would surely have to have health insurance that allowed them to go direct to a specialist...but would this be covered if you weren't OMM residency trained? I've really never heard of this. Why would someone seek out a n osteopathic doctor as opposed to going to a chiropractor (I'm not asking what the difference is - I want to know why you think people would do this as I doubt most of the public could explain to you the difference....)

thanks for any insights!

onwis

 

[Hedwig]

I'm not a physician, so I can't address your first point.

As for the second, let me do my best to answer your questions. To have an OMM practice "on the side," as I proposed, is not really a difficult proposition. No, one can't refer to oneself. However, I don't see why one would need referrals for a side practice. How do you think every other business in the world gets started? You advertise. You make a reputation for yourself. And things take off from there.

I disagree with the notion that people would have to have health insurance that allows them to go straight to a specialist. Not in this case. I've met OMM docs who operate on a cash-only basis. And there are plenty--plenty!--of people willing to pay. Why? You've never been osteopathically manipulated, have you?

As for why people would seek out an OMM doc rather than a chiropractor. That's a toughie. Unlike people who are educated about osteopathic physicians, many laypeople do not know the difference between chiropractics, physical therapy, and osteopathic manipulative medicine, and probably even massage therapy. I've venture two guesses:

1. The public is becoming increasingly aware of DOs. The population of MDs in the United States is shrinking, whereas the DO population is really booming. This will be even more true in the coming decade when many more osteopathic medical schools open in the United States, beginning with the Virginia College of Osteopathic Medicine in 2003. As patients become more consumer savvy, they will know more and more about OMM, and how it's distinct from the other forms of manipulation. The fact that famous MDs like Andrew Weil, MD, are singing the praises of osteopathic manipulation (while being extremely critical of chiropractics) doesn't hurt either. Go to <a href="http://www.drweil.com" target="_blank">www.drweil.com</a> and search osteopathic or manipulation or something like that and see for yourself.

2. Why would someone go to a chiropractor when DOs, unlike DCs, are actual physicians with medical licenses; OMM's efficacy has been verified in the New England Journal of Medicine; there's a National Institutes of Health OMM research center in Texas; and OMM (along with physical therapy, which is virtually identical) has only the most irrelevant relationships to chiropractics, a shady profession of questionable value.

The obvious answer is, "Because patients don't know any of that." But don't sell people short. Especially in the Information Age.

 

[tBw]

Originally posted by Hedwig:
• You've never been osteopathically manipulated, have you?

•••

hum..well, yes actually I have, which is why I believe in OMM and am interested in becoming a D.O. ... but as I said, my question wasn't about my doubts of OMM, it was about my uncertainty of the general publics views of OMM

Thanks for the reply, Hedwig, it was really interesting. I guess I understand the idea that an OMM clinic could be run like any other business (just like chiropractors advertize...) - I was just unsure what the legal and insurance implications would be if you weren't residency trained in OMM but in ER or radiology or something. I mean I see no problem - but there have been circumstances before that people have asked about on here that surprised me (eg someone training as an RN wanting to refer patients to themselves as they were also a DC). I don't think such complications exist with what you suggest but I was just curious. Anyway, thanks for the input, I think it's a great idea.

onwis

 

[jdm]

Hedwig: no offense intended, but I hope you realize that OMM is like any other medical specialty - ie you need to really focus in it to be really good at it. Sure, if you're a cardiologist or ER doc you might remember a few things but if you plan to be a cardiologist and be good enough at OMM to have a lucrative cash practice "on the side" you are going to be doing an awful lot of studying over the next twelve years.