OMT and learning to feel normal/abnormal

[ChrisKnight]

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Just started OTM class, and have a hard time right now even knowing what normal is. With so many body types, anatomical variations, etc, it is very unclear right now what I should be feeling. Yeah, I can put my hand on the body and act like I know what I'm doing and pretend to know what's under my fingers, but it's just that...pretending. So my question is, how much hands on experience does it take just to understand the feeling of "normal" tissue?

 

[snurpy]

Just started OTM class, and have a hard time right now even knowing what normal is. With so many body types, anatomical variations, etc, it is very unclear right now what I should be feeling. Yeah, I can put my hand on the body and act like I know what I'm doing and pretend to know what's under my fingers, but it's just that...pretending. So my question is, how much hands on experience does it take just to understand the feeling of "normal" tissue?

I think the easiest for me is to feel bilaterally. It's easier to find differences between one side and the other and compare. Also, ask your partner if certain spots are more tender than others. Ask a professor if you're doing it right. I'm not sure how your school works, but in mine, we have a professor per ~8 students, and she goes around, puts her hands on your hands, or whatever else she has to, to make sure you're moving your hands the right way.

 

[rddoms]

Give it a few weeks, and you will get the hang of it. The more practice you have the easier it is (for most people).

 

[Slevin]

As long as they don't check make up your own Dx

 

[cyclohexanol]

Just started OTM class, and have a hard time right now even knowing what normal is. With so many body types, anatomical variations, etc, it is very unclear right now what I should be feeling. Yeah, I can put my hand on the body and act like I know what I'm doing and pretend to know what's under my fingers, but it's just that...pretending. So my question is, how much hands on experience does it take just to understand the feeling of "normal" tissue?

Awesome, you are already doing what the 'experts' do. You're set man.

 

[tideleonheart]

Awesome, you are already doing what the 'experts' do. You're set man.

To generalize like this and throw away all OMM into a pile of BS (as your signature implies) is just a little ignorant. There's plenty of double-blind, scientifically proven OMM techniques. Heck, lots of physical therapists do things identical and similar to OMM every day, but call it a different name.

By the way, let's not use cranial as a specific example and extrapolate it to cover all OMM. Cranial is a small fraction of OMM that is not even taught at all schools. It's an optional course on a weekend at my school, for example.

@OP: Practice. The more you do it, the better it gets. The less you do it, the harder it will be for you to feel anything. one thing that helps me is to not just blindly push on soft tissue. Instead, sink your fingers down past the soft tissue, maintain that pressure, then advance it further to try to feel what is underneath. (if that makes any sense)

 

[ChrisKnight]

Thanks for the responses.

 

[cyclohexanol]

To generalize like this and throw away all OMM into a pile of BS (as your signature implies) is just a little ignorant. There's plenty of double-blind, scientifically proven OMM techniques. Heck, lots of physical therapists do things identical and similar to OMM every day, but call it a different name.

By the way, let's not use cranial as a specific example and extrapolate it to cover all OMM. Cranial is a small fraction of OMM that is not even taught at all schools. It's an optional course on a weekend at my school, for example.

@OP: Practice. The more you do it, the better it gets. The less you do it, the harder it will be for you to feel anything. one thing that helps me is to not just blindly push on soft tissue. Instead, sink your fingers down past the soft tissue, maintain that pressure, then advance it further to try to feel what is underneath. (if that makes any sense)

If my beliefs regarding OMT are ignorant, then so are the beliefs of over 1/2 my classmates. I have no problem with this, as I could care less about the relevance of OMT. The only reason I'm addressing it is to make you aware of the not insignificant number of people who share my exact sentiments.

My signature is only meant to signify that my experience in that particular rotation was BS, not that all OMT is BS... I would concede that about 25% is not BS, which is very generous IMO.

I'm not sure where you are getting this data regarding OMT including "double-blinded scientifically proven techniques". Most of the "scientifically proven" data that I have seen includes studies on OMT involving cadaveric cat joints, tissue cultures and loads of n<10 studies. Clearly none of the prior are scientific in the least.

 

[snurpy]

If my beliefs regarding OMT are ignorant, then so are the beliefs of over 1/2 my classmates. I have no problem with this, as I could care less about the relevance of OMT. The only reason I'm addressing it is to make you aware of the not insignificant number of people who share my exact sentiments.

My signature is only meant to signify that my experience in that particular rotation was BS, not that all OMT is BS... I would concede that about 25% is not BS, which is very generous IMO.

I'm not sure where you are getting this data regarding OMT including "double-blinded scientifically proven techniques". Most of the "scientifically proven" data that I have seen includes studies on OMT involving cadaveric cat joints, tissue cultures and loads of n<10 studies. Clearly none of the prior are scientific in the least.

Your half of the class sounds like they chose DO as an alternative to MD schools then. What did they think OMM was about when they shadowed DOs?

 

[cyclohexanol]

Your half of the class sounds like they chose DO as an alternative to MD schools then. What did they think OMM was about when they shadowed DOs?

1) I know of very few who shadowed a DO prior to medical school.
2) Of the few DO preceptors I've had on rotations, with exception of the mandatory OMM rotation, not a single one has used OMT. So, even if someone had shadowed them prior to medical school, their experience would have been no different.

 

[bonesawz]

Your half of the class sounds like they chose DO as an alternative to MD schools then. What did they think OMM was about when they shadowed DOs?

I never shadowed a DO. Only a small percentage use it anyway, so shadowing a DO doesn't mean you would see it. You make a good point about the PTs doing OMM. My philosophy is let them handle the muscle aches and pains while I handle MIs, chest tubes and intubations. Anyone else tired of the standard OMM defense... if you don't love omm and have a picture of AT still on the wall, then you must be a bitter MD reject. Why is that the automatic go to response to any criticism of omm? Surely you can come up with something better than that.

 

[Slevin]

The funny thing is that at my school we have some DO's that have a cash only practice who are doing well that only practice OMT. We also had a lecture on how much you can charge and get reimbursed for doing OMT depending on the number to areas you treat.

From my 1st semester we've been hearing allot about reimbursement and the business side of medicine, it's actually opened my eyes because while yes we want to treat the patient but we also want to get paid for our hard work. My school recognizes that getting paid and treating patients go hand in hand and that by adding OMT you can easily take in an extra 30-40% than you would otherwise.

 

[cyclohexanol]

The funny thing is that at my school we have some DO's that have a cash only practice who are doing well that only practice OMT. We also had a lecture on how much you can charge and get reimbursed for doing OMT depending on the number to areas you treat.

From my 1st semester we've been hearing allot about reimbursement and the business side of medicine, it's actually opened my eyes because while yes we want to treat the patient but we also want to get paid for our hard work. My school recognizes that getting paid and treating patients go hand in hand and that by adding OMT you can easily take in an extra 30-40% than you would otherwise.

Yes, OMT is excellent at transferring money from the wallets of patients into yours. For a month last year I watched people come in, lay on a table, have fingertips placed on various parts of their body, then leave an hour later $425 lighter. If you want to have this kind of practice, it is entirely within the realm of possibility. Personally, I would rather help my patients as opposed to just taking their money.

 

[snurpy]

Yes, OMT is excellent at transferring money from the wallets of patients into yours. For a month last year I watched people come in, lay on a table, have fingertips placed on various parts of their body, then leave an hour later $425 lighter. If you want to have this kind of practice, it is entirely within the realm of possibility. Personally, I would rather help my patients as opposed to just taking their money.

Eye of the beholder. I'd like to think that understanding the patient's body on a deeper level and using OMM techniques would speed up the healing process (as a few papers have shown). No, I don't have a picture of AT Still on my wall, but I think a lot of what it preaches makes sense. Incidentally, I think you can bill insurance for OMM treatments if you put it under the vague "treated for musculoskeletal pain" category. I don't imagine that it's as rewarding as $425 though.

As far as shadowing DOs, I thought most schools required shadowing to apply. The two I shadowed in my area both used OMM heavily. It's a shame that more aren't using it, but I can't imagine its usefulness outside of primary care or the ICU. But, it's weird if people are applying to DO schools without a clue as to what OMM really was about. I'm more curious as to what their opinions were before matriculating. Did they think it was a massage class? Another hoop to jump through to become a doctor? Something even potentially useful in the future? If it's the latter, I'm sorry if they didn't think OMM was as amazing as they hoped, or if they were disappointed.

 

[tideleonheart]

If my beliefs regarding OMT are ignorant, then so are the beliefs of over 1/2 my classmates. I have no problem with this, as I could care less about the relevance of OMT. The only reason I'm addressing it is to make you aware of the not insignificant number of people who share my exact sentiments.

My signature is only meant to signify that my experience in that particular rotation was BS, not that all OMT is BS... I would concede that about 25% is not BS, which is very generous IMO.

I'm not sure where you are getting this data regarding OMT including "double-blinded scientifically proven techniques". Most of the "scientifically proven" data that I have seen includes studies on OMT involving cadaveric cat joints, tissue cultures and loads of n<10 studies. Clearly none of the prior are scientific in the least.

Just FYI, I actually don't plan on using OMM in my practice because I'm probably going to do a surgical field. I think one of the big problems with OMM is that pre-meds or med students get the idea that OMM is this wonderful, magical, mystical treatment that you can use on nearly every person who walks in the door. If this is how someone was taught or what they think, then I think they will be disappointed.

The way I view OMM is just like every single other treatment modality in medicine: only useful when indicated and with patient variation. For example, one patient with foot pain for a month and a suspected navicular dysfunction may be treated with OMM and experience instantaneous relief. Others it may not help at all. To contrast, a person with high BP may experience very little reduction using a certain high BP modality. So, you use a different treatment, use a combination treatment, or just say screw treatment, let's get you exercising (heaven forbid!).

Another person mentioned earlier about the similarities between OMM and PT, so why not leave it to a PT? That's a pretty valid argument! What if you had a PT on your team that sort of acted like a PA, but did more physical medicine. I'd love to hear what others think about this.

 

[Bacchus]

The funny thing is that at my school we have some DO's that have a cash only practice who are doing well that only practice OMT. We also had a lecture on how much you can charge and get reimbursed for doing OMT depending on the number to areas you treat.

From my 1st semester we've been hearing allot about reimbursement and the business side of medicine, it's actually opened my eyes because while yes we want to treat the patient but we also want to get paid for our hard work. My school recognizes that getting paid and treating patients go hand in hand and that by adding OMT you can easily take in an extra 30-40% than you would otherwise.

$65 for 2-3 areas... my thoracolumbar region and c-spine. When I got the insurance statement I was in disbelief, haha. Of course, the DO didn't see the full $65.

 

[passthekoolaid]

.

 

[Buckeye(OH)]

I did a month of solely OMT (not by choice, and I wanted to kill myself since I had already matched into something that would never require OMT), but it wasn't till then that I got good at OMT.