OMM used to shield sexual abuse

[deleted407021]

Question: are you taught "vaginal manipualation"? How are you taught to do this, and what do you use it for?

It’s not in our curriculum afaik. The chair of our PT department has mentioned it being used in PT, however.

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[Anti-PD1]

Given the lack of evidence and invasiveness, why doesn't the AOA throw intra-pelvic OMM out of the playbook?

 

[Stagg737]

Question: are you taught "vaginal manipualation"? How are you taught to do this, and what do you use it for?

I don't remember it being taught to us, at least not demonstrated. From what I understand it's more of an OB technique, but idk. I also wouldn't ever perform it even if I had been taught it and there's only a handful of techniques I'd ever really consider actually doing in even rarer situations.

The AOA needs to stop existing, and the LCME needs to take over accreditation of DO schools.

I've talked to a few higher ups in certain administrative positions in the past, and some of them had made statements hinting that they wouldn't be surprised if this happened in the next 10-15 years especially given that the merger will soon be complete. I'd personally welcome it, as I don't think there is a significant enough (or really any) difference between MDs and DOs anymore and the existence of two separate degrees only confuses the general public as well many people in the medical field.

Wth. Distilled,

1) Sexual assault is bad

2) Larry Nassar sexually assaulted girls under the guise of OMM, also covered by MSU

3) Whether or not OMM is proven, the vast majority is not intra-pelvic

4) Intra-pelvic OMM doesn't have robust evidence for use. If it were performed, as with any sensitive procedure, open communication, sterile technique, and a chaperone would be employed

5) Intent matters

6) The AOA has not denounced Nassar yet

7) MD = DO

-An MD student

Thank you for being a reasonable and normal human being. Literally no one here has supported that scumbag, and I don't know where some people are getting that impression. Nassar was a POS who doesn't represent DOs, and it's disgusting that the AOA didn't denounce him long ago.

 

[el_duderino]

Thanks for the responses.

 

[Psai]

Man this thread kills me

 

[Lucca]

The two threads on this topic have been merged. Moving to Topics in Healthcare.

 

[Stagg737]

Given the lack of evidence and invasiveness, why doesn't the AOA throw intra-pelvic OMM out of the playbook?

Lack of evidence doesn't matter to a lot of the higher ups, it's a ridiculous tradition that's been embedded into the curriculum and which the old guard clings onto as their last piece evidence that the "DO identity" is unique. If lack of evidence were an issue there's be several other techniques that would have been thrown out long before this one (Chapman's points, cranial, etc). The invasiveness is less of an issue, as there's plenty of MD techniques that are also invasive, the only issue there is the increased risk of abuse of the technique as happened here (and could with other procedures like pelvic exams). I agree it should be thrown out or at least have significant research put into it like almost all OMM techniques (though after the Nassar thing I think the odds of that are somewhere south of 0%), but until the old guard retires/dies off or the merge of the degrees themselves, I don't foresee it happening.

 

[Lawpy]

Lack of evidence doesn't matter to a lot of the higher ups, it's a ridiculous tradition that's been embedded into the curriculum and which the old guard clings onto as their last piece evidence that the "DO identity" is unique. If lack of evidence were an issue there's be several other techniques that would have been thrown out long before this one (Chapman's points, cranial, etc). The invasiveness is less of an issue, as there's plenty of MD techniques that are also invasive, the only issue there is the increased risk of abuse of the technique as happened here (and could with other procedures like pelvic exams). I agree it should be thrown out or at least have significant research put into it like almost all OMM techniques (though after the Nassar thing I think the odds of that are somewhere south of 0%), but until the old guard retires/dies off or the merge of the degrees themselves, I don't foresee it happening.

Man, I seriously dislike the AOA/COCA and the old DO establishment.

 

[W19]

Lack of evidence doesn't matter to a lot of the higher ups, it's a ridiculous tradition that's been embedded into the curriculum and which the old guard clings onto as their last piece evidence that the "DO identity" is unique. If lack of evidence were an issue there's be several other techniques that would have been thrown out long before this one (Chapman's points, cranial, etc). The invasiveness is less of an issue, as there's plenty of MD techniques that are also invasive, the only issue there is the increased risk of abuse of the technique as happened here (and could with other procedures like pelvic exams). I agree it should be thrown out or at least have significant research put into it like almost all OMM techniques (though after the Nassar thing I think the odds of that are somewhere south of 0%), but until the old guard retires/dies off or the merge of the degrees themselves, I don't foresee it happening.

Medicine in general is a very conservative profession...

 

[Anti-PD1]

Man, I seriously dislike the AOA/COCA and the old DO establishment.

It seems like a vast majority of the young D.O. population feels this way. The old establishment can't fight time, they'll eventually pass. Do you see D.O. classmates with the same zeal for the osteopathic identity? They'd be the natural stakeholders to carry on the torch.

 

[Lawpy]

It seems like a vast majority of the young D.O. population feels this way. The old establishment can't fight time, they'll eventually pass. Do you see D.O. classmates with the same zeal for the osteopathic identity? They'd be the natural stakeholders to carry on the torch.

Right, but the question then becomes: what is the osteopathy identity? Does it exist or is it outdated?

 

[AlMedNY23]

Right, but the question then becomes: what is the osteopathy identity? Does it exist or is it outdated?

I see it becoming a specialty residency/fellowship pathway down the line for those who want to incorporate OMM into their practice

Sent from my SM-G950U using SDN mobile

 

[Lawpy]

I see it becoming a specialty residency/fellowship pathway down the line for those who want to incorporate OMM into their practice

Sent from my SM-G950U using SDN mobile

So this means there will be only one medical degree, and all schools and residencies will be accredited by LCME/ACGME?

I recently learned that OMM is used as CME credits at many MD programs. Making OMM as a residency/fellowship makes sense. But hopefully the outdated and invasive practices are abolished to prevent future scandals from arising.

 

[Anti-PD1]

So this means there will be only one medical degree, and all schools and residencies will be accredited by LCME/ACGME?

I recently learned that OMM is used as CME credits at many MD programs. Making OMM as a residency/fellowship makes sense. But hopefully the outdated and invasive practices are abolished to prevent future scandals from arising.

I know we're deviating here, but I just wanted to add, I don't think it'll be that easy for the LCME to accredit DO schools and convert them. LCME has specific funding and research requirements. Unless they create a qualifier, i.e. designating former DO schools as 'Community-based MD' or something.

Also, the ACGME merger was House of Cards. Leverage. ACGME rewrote it's fellowship requirements, demanding graduation from MD or Canadian schools. AOA was left playing catch up, and was strong armed into accepting the merger. I don't see how the LCME will ever have leverage over COCA.

 

[DNC127]

So this means there will be only one medical degree, and all schools and residencies will be accredited by LCME/ACGME?

I recently learned that OMM is used as CME credits at many MD programs. Making OMM as a residency/fellowship makes sense. But hopefully the outdated and invasive practices are abolished to prevent future scandals from arising.

I dont think it should be a fellowship... more like a summer CME thing where you go 4 hours a weeks for like 12 weeks and get a certificate certifying you in "osteopathy"... That would be taking it more serious than 95% of the students at my school so I feel like its fair for those who are genuinely curious.

 

[DNC127]

I know we're deviating here, but I just wanted to add, I don't think it'll be that easy for the LCME to accredit DO schools and convert them. LCME has specific funding and research requirements. Unless they create a qualifier, i.e. designating former DO schools as 'Community-based MD' or something.

Also, the ACGME merger was House of Cards. Leverage. ACGME rewrote it's fellowship requirements, demanding graduation from MD or Canadian schools. AOA was left playing catch up, and was strong armed into accepting the merger. I don't see how the LCME will ever have leverage over COCA.

By saying students from non LCME schools can't attend ACGME residencies once they have complete control over them lol.

 

[Lawpy]

I know we're deviating here, but I just wanted to add, I don't think it'll be that easy for the LCME to accredit DO schools and convert them. LCME has specific funding and research requirements. Unless they create a qualifier, i.e. designating former DO schools as 'Community-based MD' or something.

Also, the ACGME merger was House of Cards. Leverage. ACGME rewrote it's fellowship requirements, demanding graduation from MD or Canadian schools. AOA was left playing catch up, and was strong armed into accepting the merger. I don't see how the LCME will ever have leverage over COCA.

The top DO schools like KCUMB and MSUCOM can readily become MD schools because they likely already met most of the LCME requirements. The newer and weaker DO schools will sadly have to be eliminated and closed.

UC Irvine was formerly a DO school that converted to MD. So it's definitely possible for established and respected DO schools to do the same.

 

[AlMedNY23]

So this means there will be only one medical degree, and all schools and residencies will be accredited by LCME/ACGME?

I recently learned that OMM is used as CME credits at many MD programs. Making OMM as a residency/fellowship makes sense. But hopefully the outdated and invasive practices are abolished to prevent future scandals from arising.

I would assume so. I only say this based on a couple of factors/trends I've noticed (not based on any insider intel):

1. Overwhelming majority of upcoming and young DO physicians do not utilize OMM. Many of them are also in specialties where OMM is not an appropriate treatment model (whether it is EM and its pace, more sub-specialized fields which require more serious intervention, etc.)
2. ACGME has already taken over post-graduate training. Now if everyone is going into the same programs, what is the point of having two board exams? The consolidation of board exams with a USMLE with an osteopathic subsection (e.g. USMLE-O) may be a logical next step.
3. AACOMAS has eliminated grade replacement for the current cycle and going forward. Thus, the entrance standards have been raised, and the grade policy is the same as that for AMCAS.
4. With these changes, it is only a matter of time before the LCME takes over osteopathic medical education.
5. With the majority of DOs practicing indistinguishably from MDs, and OMM really only being appropriate for a subset of specialties, the differences between DO and MD training are not significantly different enough to warrant a totally different educational pathway/degree.
6. At that point, OMM becomes a specialty/fellowship pathway because as I mentioned before, it does have its merits in musculoskeletal medicine and pain management.

Again this is all speculation...

 

[Anti-PD1]

The consolidation of board exams with a USMLE with an osteopathic subsection (e.g. USMLE-O) maybe a logical next step.

I'm registering "First Aid-O"... come at me Tao Le

 

[W19]

DO--the new DNP

 

[AlMedNY23]

DO--the new DNP

Nice try

 

[Trogghunter]

I could only hope that this case would turn into a Nationwide MD vs DO thread on mainstream media. Real question...could msucom be closed down for this?

 

[Stagg737]

Man, I seriously dislike the AOA/COCA and the old DO establishment.

As do most of the younger generation of DOs. Idk who people like NontradCa hang out with, but most of the DOs I've talked to are far from brainwashed about OMM and hate the AOA/COCA as much as physicians in general hate hospital admins.

It seems like a vast majority of the young D.O. population feels this way. The old establishment can't fight time, they'll eventually pass. Do you see D.O. classmates with the same zeal for the osteopathic identity? They'd be the natural stakeholders to carry on the torch.

Very few. Like few enough that I can count them on one hand (and my class size is 250+).

Right, but the question then becomes: what is the osteopathy identity? Does it exist or is it outdated?

It's outdated. Most of us just identify as physicians. I personally don't care if the letters behind my name are MD or DO, I just want to get trained well and treat my patients like every other physician. The problem with the whole "DO identity" thing, like with any other group or organization in society, is that those at the extremes of the spectrum yell the loudest and get the most attention.

I know we're deviating here, but I just wanted to add, I don't think it'll be that easy for the LCME to accredit DO schools and convert them. LCME has specific funding and research requirements. Unless they create a qualifier, i.e. designating former DO schools as 'Community-based MD' or something.

Also, the ACGME merger was House of Cards. Leverage. ACGME rewrote it's fellowship requirements, demanding graduation from MD or Canadian schools. AOA was left playing catch up, and was strong armed into accepting the merger. I don't see how the LCME will ever have leverage over COCA.

It won't happen overnight, but it's a gradual change that is happening. First step will be that residencies require Step scores instead of COMLEX. Once a Step score is required, there won't be a need to continue taking the COMLEX exam other than to make medical schools and COCA happy. After that, there won't be a need to complete OMM courses to take boards or gain residency positions, only to appease standards set by the DO schools. Or the ACGME can just say they're not going to accept DOs into ACGME residencies and that DO schools will have to convert to MD by X date. Either way, I think that movement is happening already and as long as the ACGME doesn't totally shaft the whole system I don't have a problem with it. It will be a battle if it happens though, as COCA and the AOA make a ton of money off of DOs, and that's a huge motivation for keeping the degrees separate.

The top DO schools like KCUMB and MSUCOM can readily become MD schools because they likely already met most of the LCME requirements. The newer and weaker DO schools will sadly have to be eliminated and closed.

UC Irvine was formerly a DO school that converted to MD. So it's definitely possible for established and respected DO schools to do the same.

Actually most wouldn't meet LCME requirements at the moment from what I understand. I've had this discussion with one of the mods here that attends my school (who is much more knowledgeable about the standards and research than I am), and there are more problems than just research. For example, my school's "chair of surgery" is just adjunct faculty and is actually a professor at another medical school. From what I understand, LCME requires full-time faculty to head certain departments, and not all DO school have them as most aren't directly affiliated with teaching hospitals. I think some would have problems with clinical education as well, but idk the standards well enough to comment. I don't think the better schools would have a problem with these issues if they were given 5-7 years to fulfill those obligations like they were with the merger, or if some standards (like availability of research) was slightly lowered to accomodate, but I think some schools would have significant problems (though there are a few schools, both MD and DO which I don't think should exist and I wouldn't have a problem with them being shut down).

 

[BornSinner]

Oh, I hope we don’t have to do this in lab this semester.

Also, how do you pull or hurt those muscles? Horseback riding or an enthusiastic game of leap frog.

We had to learn this in lab. Awkward for everyone involved except for the instructors drinking the Kool-Aid.

"Ischiorectal release" stuff like that.

 

[BornSinner]

Don't really understand why the doc has to palpate the labia in order to move the leg as if it affects the positioning lmfao

Am a DO student, and ask a similar question sitting in lab every week.


Apparently has to do with the body's fascia being all interconnected and stuff called tensegrity which applies to building stuff and physics yet has been co-opted in DO teachings to sound more "smart/scientific."

 

[Can'tdecide111]

What he did was disgusting. And I hope a review of boundaries will occur in all of the realms of medicine. No population, especially Olympic athletes, deserve this grotesque treatment.

 

[Reveler]

COCA and the AOA would stand to lose A LOT of money if the professions merge. I understand folding everything under LCME is the logical conclusion of this thread’s thought experiment, but a lot of wealthy people/organizations would have to fold their egos for this to happen and I don’t see that happening anytime soon. The AOA can’t find a way to give up techniques like cranial, Chapman’s points, etc. after all these years and still deifies a man that claimed to cure scarlet fever by shaking babies. The idea that they would hand over the profession is a bit short-sighted. Despite the fact that 90% of DOs will never employ manipulation, the 10% that do will ascend the AOA ranks to establish themselves as the new Old Guard that all future young DOs wil fantasize about supplanting.

 

[nlax30]

Just saw this email from the AOA President

Like many of you, I have watched in horror as more than a hundred women and girls bravely shared their stories of abuse at the hands of Larry Nassar. As a proud DO, I’m furious that a convicted pedophile hid behind his medical license to justify his crimes and chose to use one of the tools that osteopathic physicians are trained to provide, OMT, as a defense.

Today, this false narrative has been repeated in a vile op/ed in the Los Angeles Times. The AOA has reached out to the editor to demand changes to this cheap, defamatory article. We are responding to this situation as we have to every attack on the integrity of our profession.

I know that some members are frustrated that the AOA has not publically condemned Nassar. It’s important to understand that the organization cannot comment on any criminal case or lawsuit.

Instead, the AOA worked behind the scenes to educate journalists that the allegations against Nassar are by no means acceptable medical practice by any physician, DO or MD. Since this news broke in September 2016, AOA has responded to hundreds of media inquiries in an effort to prevent this case from becoming a referendum on osteopathic medicine, as Nassar’s attorney originally implied. We made it clear that the AOA would not in any way legitimize his actions.

The concept of medically accepted treatment is likely to come into play again during the multiple civil suits targeting Nassar and others alleged to have overlooked his crimes. The AOA will continue to help media understand, when necessary, the principles and practices of osteopathic medicine but will not inappropriately insert itself into the news or make DOs the focus of any coverage.

Make no mistake: Larry Nassar is a convicted molester who used his medical license to justify his crimes. We are all angry and looking to prevent future molesters from exploiting patients, the practice of medicine and our profession.

Mark A. Baker, DO

AOA President

 

[but_wait]

On a related note, very few of the articles I read mentioned that he was a DO rather than an MD, and if it did it was just in passing with no elaboration on the point. But maybe it's just the ones I've been reading.

"Dr. Larry Nassar was not a doctor" by VIRGINIA HEFFERNAN.
posted before, but learned more about osteopathic medicine in one editorial than i knew after 6 months of MD school... :|

 

[but_wait]

I could only hope that this case would turn into a Nationwide MD vs DO thread on mainstream media. Real question...could msucom be closed down for this?

“He has cancer and a serious heart condition – now what do you think we should do about that?” - MSU Board of Trustee Vice Chair Joel Ferguson, on Dr. William Strampel DO (former Dean of the MSU College of Osteopathic Medicine), who stepped down in December citing health concerns [...but is still on staff and receiving full salary].

surely they've tried OMM?

ashamed Michigan tax dollars go to this place...

 

[but_wait]

What the former Dean wrote in an email after he supposedly believed the initial Title IX investigation cleared Nassar does not equate to MSU-COM defending sexual predators FFS. Everyone here is disgusted at what unfolded, deeply saddened by what the Nassar survivors had to endure (though that's an inkling to what they had to experience), and ready to stand in solidarity and ensure this never occurs again.

perhaps then as a student you might call for the dismissal of the 3 remaining of 4 whom internally reviewed his case in 2014:

Jeffery Kovan, team doctor for the university's basketball, soccer, track and softball programs.
Lisa DeStefano, chairwoman of MSU's Osteopathic Manipulative Medicine Department.
Jennifer Gilmore, physician in the Department of Osteopathic Manipulative Medicine.

 

[raiderette]

My uncle, with chronic back pain has been opiate free since receiving OMM treatment from a DO. That said, I can't see a doctor justifying inserting a bare finger into a young girl, especially for something other than a gynecological exam. From this thread, I have heard too many examples of this treatment being taught and excused.

 

[Crayola227]

Didn't read the thread.

I'm an MD. I've had a lot of adjustments, some musculosketetal counseling, strain/counterstrain, from DO colleagues and chiropractors over the years. I'm not sure eating chocolate has a placebo doubleblind controlled study saying it's awesome and feels good to eat it, but it does. A lot of the stuff I mentioned, feels good and has made me feel subjectively better. So IDGAF about its evidence base. I think there is value to it.

There are even reasonable theories why it doesn't result in an actual "adjustment" of joints, yet might have an effect on pain that is more difficult to measure. Some of this relates to pain gate theory in the spine. We are notoriously unable to do an awesome job of measuring the sort of things that happen on the neuronal level. There will never be a placebo controlled double blind study about jumping from airplanes without parachutes. We have to use common sense.

Often in medicine we have to go with "proof in the pudding" meaning what seems to be the subjective improvement that seems to result from an intervention. There's plenty of times placebo effect is at work. Provided that we account for risk of harm and costs, there you have it. Sometimes we have to do what *seems* like a good idea.

There are quite literally historical and politicolegal reasons/benefits to having a system of medicine that is evidence based yet separate from allopathic, which all other evidence or practices aside, is one reason to maintain the osteopathic tradition. Which isn't to say that both systems of medicine need improvement in various ways.

As far as intravaginal OMM, I don't know enough about it, but like all things genital related, it's a sensitive subject. Obviously any actual malpractice is bad. If a patient consents to intravaginal OMM for what is accepted reasons within the scope of practice for recommending the procedure, I see no reason for a qualified DO not to provide it if all parties are consenting for ethical reasons pertaining to beneficience towards the patient, and absent personal gain or feelings that make the provider less than objective or benficient.

I have no idea if that happened here, but touching patients without consent or good cause is assault.

I'm tired of ragging on DOs. I see no reason to abolish that system or most OMM. I have worked with DOs and have found them to be competent equals to the MD.
NP and PAs OTOH... less than charitable views.

 

[nlax30]

"Dr. Larry Nassar was not a doctor" by VIRGINIA HEFFERNAN.
posted before, but learned more about osteopathic medicine in one editorial than i knew after 6 months of MD school... :|

If all you know about osteopathic medicine is from that op-ed then please go read actual legitimate sources. I have no idea why that piece even started talking about osteopathic medicine as that is not what this case is about.

This is about a sick and distributing individual who exhibited this pattern of abuse even before med school. Has nothing to do with osteopathy.

OTL: Michigan State among those that enabled serial sex abuser

Here’s an ESPN article that actually does a decent job highlighting the depth and years of abuse that went on despite many many opportunities for various people to step up and say something such as parents, MSU admin, gymnastic coaches, etc....

 

[nlax30]

I’m a DO and never learned about these sort of OMT techniques during school but then again I never pursued further training to treat pelvic floor issues for which these techniques are sometimes used by physical therapists. Even so, like any sensitive procedure, they should be done with chaperones and with consent.

Again, this is about a sick and twisted individual who was going to abuse little girls no matter what initials he had behind his name.

 

[but_wait]

If all you know about osteopathic medicine is from that op-ed then please go read actual legitimate sources. I have no idea why that piece even started talking about osteopathic medicine as that is not what this case is about.

i've actually shadowed 2 DOs prior to medical school (ICU, ER), they never really elaborated on it outside of a single joke (something about the brain being related to the shoulder?). that ICU doc was perhaps the 2nd best doctor i shadowed amongst a dozen plus imo, and did his residency at cleveland clinic, for what that's worth. not saying osteopathic doctors are anything less than real doctors, just that to teach OMM to all DO students seems an unjustifiable waste of time [again imo], seeing as a lot if not the great majority don't even seem to practice let alone believe in it...

 

[nlax30]

i've actually shadowed 2 DOs prior to medical school (ICU, ER), they never really elaborated on it outside of a single joke (something about the brain being related to the shoulder?). that ICU doc was perhaps the 2nd best doctor i shadowed amongst a dozen plus imo, and did his residency at cleveland clinic, for what that's worth. not saying osteopathic doctors are anything less than real doctors, just that to teach OMM to all DO students seems an unjustifiable waste of time [again imo], seeing as a lot if not the great majority don't even seem to practice let alone believe in it...

I agree that the majority don’t end up using it in practice but different schools I think tend to place varying emphasis on it. At least at my med school our OMM was pretty practical and very little time was spent on the controversial/fringe cranial techniques which even then were presented more so that we were at least familiar with the concept.

I could say the same about a number of subjects I spent quite a bit of time on in med school, like histology/path, that I don’t use based on the chosen specialty.

 

[saban81]

Please point me to a case where a school/hospital dismissed sexual assault accusations because the victim didn’t “understand” the nuance Breast/pelvic exam.

If you are in medical school you should really learn what exactly an OBGYN does......... and wait you think there actually isn’t MDs that have committed sexual assault using their profession?

 

[Microshaft]

Just saw this email from the AOA President

nice signature
especially the DO lol

 

[saban81]

Thats the thing, we find something that doesnt work, we stop using it. Our societies issue guidance. We acknowledge doubt of efficacy. And eventually the practice does changes just like PSA. Do DO's do that with OMM? Is there any critical review of your own literature? or does it get taught and practiced like it is completely efficacious. They make cult members out of you.



Think of it like the PSA, first there was disbelief, then backlash, then acknolwedgement and then acceptance. We are atleast capable of apraising something and then saying . Nope, not doing it. Eventually it does trickle into practice. I dont think OMM recieves the same treatment from most DOs.

Lol you are being an idiot. Do you know how many pharmaceuticals are proven to have little efficacy yet remain in use for decades. It is one of the major factors driving the cost of medicine. Need more examples look no further then proton therapy. Plenty of techniques in omm have plenty of literature backing them up most of them are just a varioation of physical therapy, but I guess you don’t think that is useful too. Is omm slow to adapt? yes. But to act like this is different from any other part of medicine is laughable. Learn a thing or two before trying to be an incessant troll. I don’t even like omm, but your assertions are remarkably stupid. Especially the idea that all other parts of medicine are evidence based lol.

 

[saban81]

But seriously, this could end up putting elements of OMM under public scrutiny for the first time.

Lol dude it’s an LA times op ed. Are you serious? And doctors are general are under scrutiny right now mainly for the cost of medicine.

 

[Lawpy]

There are quite literally historical and politicolegal reasons/benefits to having a system of medicine that is evidence based yet separate from allopathic, which all other evidence or practices aside, is one reason to maintain the osteopathic tradition. Which isn't to say that both systems of medicine need improvement in various ways.

What are the benefits in keeping the DO degree separate from MD?​

COCA and the AOA would stand to lose A LOT of money if the professions merge. I understand folding everything under LCME is the logical conclusion of this thread’s thought experiment, but a lot of wealthy people/organizations would have to fold their egos for this to happen and I don’t see that happening anytime soon. The AOA can’t find a way to give up techniques like cranial, Chapman’s points, etc. after all these years and still deifies a man that claimed to cure scarlet fever by shaking babies. The idea that they would hand over the profession is a bit short-sighted. Despite the fact that 90% of DOs will never employ manipulation, the 10% that do will ascend the AOA ranks to establish themselves as the new Old Guard that all future young DOs wil fantasize about supplanting.

So politics and AOA/COCA wealth interests are what's responsible for keeping the DO degree separate from MD. I can't disagree, but it's pretty depressing honestly.

 

[saban81]

OMM is not evidence based (by any robust standard), the AOA defends sex abusers and vile practices like vaginal manipulation of children, and osteopathic schools deify child abusers like AT Still and (previously) Larry Nassar.

Jesus Christ do any of you actually study medicine? You do realize tons of treatments aren’t evidenced based. Some of the biggest progressions in medicine were made by just giving someone a drug and hoping it works. We don’t even understand the mechanism of action for several drugs we use. You think proton therapy is evidence based ? Lol

 

[jw3600]

DO--the new DNP

Ugh. See this annoys me. I’m literally 1000x better than you. Yes I’m a DO (unfortunately and technically) but if you’re gonna try and call me a nurse I’m gonna be forced to remind you that you literally are garbage compared to me as a medical student/residency applicant.

 

[Lucca]

Please keep it civil. Let’s not stoop to personally attacking each other. Keep discussion to the Larry Nassar case, the various responses to it, and specific procedures and practices — I.e let’s not turn this into an MD /DO battle royale anymore than it already is.

 

[W19]

Ugh. See this annoys me. I’m literally 1000x better than you. Yes I’m a DO (unfortunately and technically) but if you’re gonna try and call me a nurse I’m gonna be forced to remind you that you literally are garbage compared to me as a medical student/residency applicant.

Lol...

 

[bigindian4891]

Funny, this is the only place where we see a discussion of DO=abuse.

OMM is fake medicine and always is harassment

 

[Moose A Moose]

Ugh. See this annoys me. I’m literally 1000x better than you. Yes I’m a DO (unfortunately and technically) but if you’re gonna try and call me a nurse I’m gonna be forced to remind you that you literally are garbage compared to me as a medical student/residency applicant.

 

[Matthew9Thirtyfive]

"DO -- the new DNP"

Refer to my previous comment about arrogant MD's. Don't insult a profession especially when you are in no position to be doing so. Must hurt your feelings seeing all these so called "DNP" outscoring you on board exams.

Cheers.

 

[Peach Newport]

In terms of genital OMM:

In school we learn 2 things that are similar to this:

Like in the video mentioned, we palpate just above the pubic tubercle, often for counter strain. In most people the pubic tubercle is at least about 2-3” from any actual genitals, so it’s a little awkward, but we learned techniques for being less invasive and more professional about it. It requires clear communication but you should NOT actually be touching, or even “brushing” the genitals.

The most “questionable” and awkward thing is ischiorectal release/pelvic diaphragm reset. The patient lies on their back, and flexes their hip to about 90*. The operator than palpates the ischial spine (butt bone), and puts their finger JUST on the medial aspect of it. (There’s more to it, this is just the awkward aspect of the technique) This is usually more like 1-2” from the anus or genitals... and trust me, NO ONE had a good time doing this. That being said, like the pubic tubercle stuff, there were mandatory techniques for being extremely careful, communicative, and being very obvious with your careful avoidance of anus/genitals.

Now here’s the thing: OMM is more about the underlying theory than techniques. In any OMM class, you’re not graded necessarily on doing the “correct” technique, but on how well you actually apply the principles. Are you correctly locking out the muscles? Are you using the correct isometric/eccentric/concentric muscle motions? Do you understand the anatomy? Are you actually doing what you’re setting out to do?

... so as a result, there are *some* people who apply these principles to muscles in the pelvic area (mostly pelvic floor/diaphragm) which is technically internally consistent with osteopathic philosophy and principles. The area is still made of muscle and fascia, after all. There’s at least one book about it.

This is pretty rare, and very fringe - it’s definitely an “advanced” or “upper level” kind of OMM. There are relatively few DOs who consistently practice OMM, and even fewer who regularly practice pelvic floor OMM... and even fewer who actually use the intrarectal/intravaginal versions. The few that do are *aggressively* professional about it, vigorously educating patients, using gloves, and using a chaperone - because they absolutely have to.