OMM in practice

[hotlikebutter]

of you DO graduates out their in your residencies, how often do you use or encounter peers who use OMM? in my reading, im pre DO, it seems that the younger DO's dont practice OMM all that much compared to the older DO's. Is this a sign that the DO and MD are really not that different in practice? Also, why do you think the AOA continues to emphasize equal but different between the DO and MD if OMM is the key that separates them, and it's not often used anymore? im sure both types of degrees can build compotent doctors, but why the need to foster a them versus us mentality? any insight will be appreciated. thanks.

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[JunkintheTrunk]

because of OMM class, DO's are more comfortable with touching their patients....compared to new MD's who seem a little awkward and feel like they're invading. we know how to use our hands having taken an OMM class, we have an extra tool to use if the opportunity arises, and we get very good at diagnosing with our hands....not just cracking backs. i've heard tons of stories of MD students getting treated with OMM by one of their DO friends/colleagues, and they all wish they could have had that included in their training.

 

[DeLaughterDO]

HLB,

I think it really all depends on the specialty - a lot of specialties are not very conducive to the use of OMT. Primary care practitioners (FP, Peds, etc) are probably more inclined to use OMT. Unfortunately, many osteo students either didn't want to go to DO school (i.e. they are allo-wannabes) or they do not go into primary care. This can help explain the fact that many DOs do not use OMT. In the past, osteo students actually wanted to be DOs BECAUSE of the fact that we have the option of OMT. Today, osteo schools are used as a contingency plan. Sad but true.

Other variables include time and reimbursement. When you are in private family practice, for instance, patients are frequently scheduled every 15 minutes. This is barely enough time to determine what a problem is, much less spend 5-10 minutes treating the patient with OMT. Furthermore, OMT is not well reimbursed (if at all) by most insurance companies.

That said, I'm on my family practice rotation right now and I've used OMT at least 3 times a week since I've been here. That doesn't count the work I've done on the staff in the office.

Of course, my preceptor is really big into osteopathic diagnosis and treatment.

jd

 

[Robz]

Is this a sign that the DO and MD are really not that different in practice?

This is a serious understatement.

There are few people that promote OMM and make a living at it but in reality the practice standards and malpractice lawyers cause physicians to pretty much adhere to a standard level of care...which in turn causes nondifferentation in practice.

Now some specialities such as indivdual practices for FP or IM have more time to do OMM on their patients and thus do so. Remember its whats best for the patient. With that being said....the fact not much reinbursement from medicare/medicaid patients cause many PCP physicians to run a practice of 15 minute consultations then then on to the next patient...not a lot of time to do OMT which requires time and energy to do correctly.

 

[Howard Roark]

because of OMM class, DO's are more comfortable with touching their patients....compared to new MD's who seem a little awkward and feel like they're invading. we know how to use our hands having taken an OMM class, we have an extra tool to use if the opportunity arises, and we get very good at diagnosing with our hands....not just cracking backs. i've heard tons of stories of MD students getting treated with OMM by one of their DO friends/colleagues, and they all wish they could have had that included in their training.

I do not think that MD students feel awkward when touching patients. In addition to 3rd and 4th year clerkships, my MD school had us spend 1/2 of each day of second year in the clinic/hospital seeing (and touching) patients. This is more clinical exposure than most MD schools (and I assume more than most DO schools). Good luck


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[Robz]

I do not think that MD students feel awkward when touching patients. In addition to 3rd and 4th year clerkships, my MD school had us spend 1/2 of each day of second year in the clinic/hospital seeing (and touching) patients. This is more clinical exposure than most MD schools (and I assume more than most DO schools). Good luck

I think this is a good point but I wanted to add that I believe it is up to the indivdual. I know they pretty much force you to touch other people in OMM classes but there are A LOT of classmates of mine that are shy or reluctant to touch others but are warming up. This is where I would see a difference in the 3rd/4th years. By the end though most would be comfortable touching the patient but the DO may as a generality have better palpatory skills....

I still the main point leads to the indivdual and their background...

I know here at NSU I have already spent time in the clincial setting by shadowing/rounding with a physician every other friday at his office and I have shadowed OMM clinics as well. Even in the first couple months of school I have had a lot of patient exposure which makes one more comfortable with the whole process. Is this a MD/DO thing? No....its more of a curriculum issue with the indivdual medical school.

 

[hotlikebutter]

thanks to everyone who replied. i just wanted a feeling of what real practice is like. i have two interviews in a few weeks and didnt want to walk into them without at least some understanding of the profession besides what i read in a book. but i guess the take home message is that your practice is whatever, scientific based of course, you want it to include and some specialties use OMM more. thanks again.