OMM/OMT elective for allopathic students

[Brachyury]

Are there any allopathic medical schools/hospitals or osteopathic schools/hospitals that offer allopathic medical students an elective in OMM? There have been several threads on this topic before, but the only institution that I could find in the threads was a CME course at Harvard. I've also searched on Google, but I can't find anything.
Thanks!

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[And I Was Like]

Are there any allopathic medical schools/hospitals or osteopathic schools/hospitals that offer allopathic medical students an elective in OMM? There have been several threads on this topic before, but the only institution that I could find in the threads was a CME course at Harvard. I've also searched on Google, but I can't find anything.
Thanks!

Not that I know of, when I interviewed at MSUCHM I asked if they allowed their students to take OMM electives (since MSUCOM is literally across the street) and they just looked looked super confused and then said no.

I'm more curious why you have an interest in such a pseudo-science.

 

[ArcGurren]

Not that I know of, when I interviewed at MSUCHM I asked if they allowed their students to take OMM electives (since MSUCOM is literally across the street) and they just looked looked super confused and then said no.

I'm more curious why you have an interest in such a pseudo-science.

I hope you're trolling, but if not... do you actually know what you're talking about?

I have seen OMM used in a family practice I rotated through. It doesn't cure everything, but that's not its purpose, it's a form of alleviating pain/diagnosing pain without loading up someone on painkillers. I saw two cases of low back strain... the principle was to relieve the muscle spasm using OMM by tiring the muscle out, and that would decrease the pain dramatically. It works very well.

So the next person to call it pseudoscience without actually knowing what the hell they're talking about, automatic troll-label.

 

[And I Was Like]

I hope you're trolling, but if not... do you actually know what you're talking about?

I have seen OMM used in a family practice I rotated through. It doesn't cure everything, but that's not its purpose, it's a form of alleviating pain/diagnosing pain without loading up someone on painkillers. I saw two cases of low back strain... the principle was to relieve the muscle spasm using OMM by tiring the muscle out, and that would decrease the pain dramatically. It works very well.

So the next person to call it pseudoscience without actually knowing what the hell they're talking about, automatic troll-label.

Anecdotal evidence is worthless, show me some studies please.

 

[ArcGurren]

Anecdotal evidence is worthless, show me some studies please.

I'm not aware of any studies offhand but I encourage you to look them up... I'm fairly certain others have seen or experienced similarly. At present I'm not really in the mood after having had to do academic searches for weeks while rounding.

 

[Bacchus]

I'm not aware of any studies offhand but I encourage you to look them up... I'm fairly certain others have seen or experienced similarly. At present I'm not really in the mood after having had to do academic searches for weeks while rounding.

There's a TCOM study on LBP and pregnant females. I don't find the need to justify my degree so Dr. Google can look it up and not I.

 

[And I Was Like]

I'm not aware of any studies offhand but I encourage you to look them up... I'm fairly certain others have seen or experienced similarly. At present I'm not really in the mood after having had to do academic searches for weeks while rounding.

Burden of proof is on you, not me. If OMM was so useful why wouldn't every MD use it, too?

 

[Shinken]

If OMM was so useful why wouldn't every MD use it, too?

Because MDs using OMM would constitute an implied approval of Osteopathic Manipulative Medicine, and MDs dont' want to do that due to ego and history (Read the numerous articles in JAMA and books that deal with the history of MD vs DO).

Besides, every single MD I know uses OMM, they just don't know it. They use it indirectly. Every time an MD sends a patient away with a prescription for physical therapy...you just wrote a prescription for OMM. Ask any physical therapist out there what techniques they use to treat the patient's musculoskeletal issues. Muscle energy, joint mobilization, soft tissue and myofascial techniques...Hmmm, sounds like the "pseudo-science" they teach in DO schools.

Also, people on SDN always like to throw out the "burden of proof" crap. The burden of proof would apply if there was no proof and we had to come up with the proof. The proof is already out there. "Burden of proof" is not the same as "google it for me or look it up on PubMed for me because I'm too lazy or ignorant to do so."

 

[isoquin]

I'm not going to get into the issue of osteopathic manipulation, but to speak to evidence based medicine, the burden of proof IS on the person making the claim. There is a ton of quackery out there (again, not saying OMT is or isn't, just making general statements), so claiming everyone else needs to look up whatever idea pops into your head flies in the face of evidence based medicine and every peer reviewed scientific journal in the world.

If you want to keep a discussion academic, support what you say with non-anecdotal evidence, or don't bother saying it in the first place.

 

[facetguy]

Because MDs using OMM would constitute an implied approval of Osteopathic Manipulative Medicine, and MDs dont' want to do that due to ego and history (Read the numerous articles in JAMA and books that deal with the history of MD vs DO).

Besides, every single MD I know uses OMM, they just don't know it. They use it indirectly. Every time an MD sends a patient away with a prescription for physical therapy...you just wrote a prescription for OMM. Ask any physical therapist out there what techniques they use to treat the patient's musculoskeletal issues. Muscle energy, joint mobilization, soft tissue and myofascial techniques...Hmmm, sounds like the "pseudo-science" they teach in DO schools.

It's only "pseudo-science" if a chiropractor performs these things, right? 🙄

 

[Brachyury]

Previous threads on this topic have degenerated into a posting war on the merits of OMM, and honestly, I'd appreciate it if we could keep the discussion related to the question I posted. Thanks!

 

[ArcGurren]

I'm not going to get into the issue of osteopathic manipulation, but to speak to evidence based medicine, the burden of proof IS on the person making the claim. There is a ton of quackery out there (again, not saying OMT is or isn't, just making general statements), so claiming everyone else needs to look up whatever idea pops into your head flies in the face of evidence based medicine and every peer reviewed scientific journal in the world.

If you want to keep a discussion academic, support what you say with non-anecdotal evidence, or don't bother saying it in the first place.

Jesus christ. This wasn't an academic discussion in the first place. All I did was give my experience... yes it's anecdotal, that's the point. I haven't the patience nor the time to look up OMM stuff in the midst of all my other clerkship work nor do I really have the brainpower to waste on it. What the attending above said however is more or less true re: OMM being similar to physical therapy. I agree with Brachyury though, this does not merit being the focus of this thread.

Now I remember why I try to stay away from other fellow med students when I want to have a real conversation.

Anyway... OP, I haven't heard of many Allo schools teaching it but they should, to be honest. There are electives at my school in alternative medicine (note to readers DO NOT even start on this discussion) so I don't see why they can't have these kinds of electives. Many faculty at universities are often DOs as well.

 

[DoctwoB]

Because i'm bored

No objective benefit to cranial osteopathy in CP:
http://www.ncbi.nlm.nih.gov/pubmed/21349889

Comparable results to conservative therapy (with reduced pain management) for temporomandibular disorders
http://www.ncbi.nlm.nih.gov/pubmed/20226365

OMT is not effective in preventing recurrence of recurrent otitis media
http://www.ncbi.nlm.nih.gov/pubmed/18831749

OMT does not improve outcomes following hip/knee arthoplasty and decreases rehab efficacy in subset of patients with osteoarthritis
http://www.ncbi.nlm.nih.gov/pubmed/15176518

OMT significantly reduces spinal pain at 2 months follow up, but not 6 months follow up (poor design, not controlled by sham treamtent)
http://www.ncbi.nlm.nih.gov/pubmed/14701889


Very few RCTs of OMT, and many of the study designs have significant procedural bias. Seems like OMT has some utility in a few disorders, but not in many. I also don't know where some of these ideas come from. Who expected OMT to help recurrent otitis media??

 

[Morphy]

Burden of proof is on you, not me. If OMM was so useful why wouldn't every MD use it, too?

Nice logic, kiddo.

http://www.nejm.org/doi/full/10.1056/NEJM199911043411903
Study's conclusion: use of medication (analgesics, antiinflammants, and muscle relaxants) was reduced in patients receiving OMT treatments.
There are other studies out there, but this one effectively highlights the intended purpose of OMT; that is, to be used as an adjuvant to standard medical care.

Also, the theory behind OMM is gaining ground. The concept of tensegrity is being explored and expounded upon at the macro and micro level (see Donald Ingber of Harvard).

To the OP, your best bet would be OMT CME's, in terms of quality and availability.

 

[DoctwoB]

Nice logic, kiddo.

http://www.nejm.org/doi/full/10.1056/NEJM199911043411903
Study's conclusion: use of medication (analgesics, antiinflammants, and muscle relaxants) was reduced in patients receiving OMT treatments.
There are other studies out there, but this one effectively highlights the intended purpose of OMT; that is, to be used as an adjuvant to standard medical care.

Also, the theory behind OMM is gaining ground. The concept of tensegrity is being explored and expounded upon at the macro and micro level (see Donald Ingber of Harvard).

To the OP, your best bet would be OMT CME's, in terms of quality and availability.

Based on my 15 minute lit review, I'd say that there are definitely cases where OMT is beneficial on top of standard therapy, usually by reducing need for pain medication. However, there are more studies demonstrating that OMT is not useful for condition X. I'm not in practice, so I have no idea of OMT is actually being used only for the beneficial things or for everything.

However, many these studies are often rife with procedural bias. A well designed study shouldn't compare medical therapy to medical therapy + OMT. It should compare medical therapy + sham OMT to medical therapy + OMT. There is plenty of evidence that adding a hands on treatment like OMT (or chiropractics, massage, etc.) has a significant placebo effect.

That being said, there are a few studies that accounted for this, and still demonstrated a modest benefit of OMT.

 

[Morphy]

Based on my 15 minute lit review, I'd say that there are definitely cases where OMT is beneficial on top of standard therapy, usually by reducing need for pain medication. However, there are more studies demonstrating that OMT is not useful for condition X. I'm not in practice, so I have no idea of OMT is actually being used only for the beneficial things or for everything.

However, many these studies are often rife with procedural bias. A well designed study shouldn't compare medical therapy to medical therapy + OMT. It should compare medical therapy + sham OMT to medical therapy + OMT. There is plenty of evidence that adding a hands on treatment like OMT (or chiropractics, massage, etc.) has a significant placebo effect.

That being said, there are a few studies that accounted for this, and still demonstrated a modest benefit of OMT.

Your method for testing OMT efficacy would be appropriate if it were a drug. Should it not be studied using the same methods that are used to evaluate medical procedures?

 

[DoctwoB]

Your method for testing OMT efficacy would be appropriate if it were a drug. Should it not be studied using the same methods that are used to evaluate medical procedures?

When practical, procedures should be and are compared to sham procedures. This may be unethical in certain cases of sham surgery due to the inherent risks of anesthesia, but in a minimal risk procedure such as OMT the comparison should be made.