Particularly more holistic DO school??

[healingcasanova]

I have wanted to be a doctor all of my life.

After I entered college, I obtained a better understand of how our medical system works and decided what I really wanted was to be a healer. I graduated 2 years ago with the intention of attending a holistic school, like a naturopathic school for example. I have been practicing bodywork for 3years ( http://HealingCasanova.com ).

I have now begun the process of applying to med school as I have made some different choices. I believe that having a medical degree will provide me with move opportunity and influence in the long run to accomplish my goal of bringing healing, not merely a potential temporary fix, to those who desperately need it in our society.

However in searching for a mentor or the right school I have been met with great challenge. I understand medical curriculum is standardized I but I know there is a population of older physicians who have turned toward a more holistic practice. is there not a way the choose this from the beginning or must you go through med school then get further holistic type schooling?

Im looking for a practitioner mentor or schools with amore preventative practice reputation. I know DO schools tend to be more preventative, but is there one in particular?

Im interested in nutrition, bodywork, herbs, energetic medicine/ therapy and other holistic therapies in conjunction with western medicine.

Thank you for any guidance on my path.

---

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[VALSALVA]

I'll bite at this one...

I'm going to say that much of the "extras" you are seeking are going to be mostly extracurricular regardless of which osteo. school you attend. Medical school curricula are becoming more and more evidence/research based, and therefore, less compatible with homeo/naturopathic treatments. For instance, at KCOM, there is a course where various herbal therapies are reviewed, but the course is slanted in such way that the herbs are scrutinized as much (or more) as they are pharmacologically defined. Example: "Black Cohosh may ease the symptoms of PMS by doing x, y, and z, but there has never been a statistically significant study which indicated that this is really happening..." I don't recall anyone on the faculty who flatly discouraged us from exploring alternative therapies for ourselves.

Let me be clear that I'm not claiming that natural therapies don't work for some people, either legitimately or via placebo affect. I'm just pointing out that western/evidence based medicine isn't compatible with mostly anecdotal therapies OR therapies that have been shown to be no different than placebo despite anecdotal evidence. Of course, OMM falls under the same scrutiny in many ways, but I disgress...

Good luck with your studies and your search for a DO school that fits you well! Despite my personal reluctance when considering alternative treatment options, I believe folks like yourself have a real niche in our medical society as a whole.

 

[healingcasanova]

Thanks for your feedback! i really do appreciate it.

I definitely think there is that separation in medicine between people who go there ( holistically) and dont. Of course that fits in line with my belief that we cannot experience the good in something if we are not open to it in the first place. And certainly, people have different priorities. Those more geared toward Western med may have the priority of fastest fix. Those more geared toward natural therapies may be more in tune with their bodies negative reactions to things unnatural.

What kind of extracurriculars do you speak of? are there potential residencies that cater to this?

 

[Dr.Inviz]

I have wanted to be a doctor all of my life.

After I entered college, I obtained a better understand of how our medical system works and decided what I really wanted was to be a healer. I graduated 2 years ago with the intention of attending a holistic school, like a naturopathic school for example. I have been practicing bodywork for 3years ( http://HealingCasanova.com ).

I have now begun the process of applying to med school as I have made some different choices. I believe that having a medical degree will provide me with move opportunity and influence in the long run to accomplish my goal of bringing healing, not merely a potential temporary fix, to those who desperately need it in our society.

However in searching for a mentor or the right school I have been met with great challenge. I understand medical curriculum is standardized I but I know there is a population of older physicians who have turned toward a more holistic practice. is there not a way the choose this from the beginning or must you go through med school then get further holistic type schooling?

Im looking for a practitioner mentor or schools with amore preventative practice reputation. I know DO schools tend to be more preventative, but is there one in particular?

Im interested in nutrition, bodywork, herbs, energetic medicine/ therapy and other holistic therapies in conjunction with western medicine.

Thank you for any guidance on my path.

Repeat.

 

[Fermata]

Those more geared toward Western med may have the priority of fastest fix. Those more geared toward natural therapies may be more in tune with their bodies negative reactions to things unnatural.

Seriously?

 

[homeboy]

Thanks for your feedback! i really do appreciate it.

I definitely think there is that separation in medicine between people who go there ( holistically) and dont. Of course that fits in line with my belief that we cannot experience the good in something if we are not open to it in the first place. And certainly, people have different priorities. Those more geared toward Western med may have the priority of fastest fix. Those more geared toward natural therapies may be more in tune with their bodies negative reactions to things unnatural.

What kind of extracurriculars do you speak of? are there potential residencies that cater to this?

IMO, if you're planning a career of natural medicine, med school (4 yrs) plus residency (3+ years) is not going to automatically validate your usage of alternative / homeopathic remedies. It may, however, give you a more scientific background to the pathologic basis of disease and the logic behind modern treatment.
Also of note is that when you obtain a medical degree (MD or DO), you are held to a much higher level of scrutiny, and your misteps are legally (and monetarily) more significant.

I understand your desire to use non-Western medicine and treatments, but if you want to attend medical school simply to validate your current treatments, you're missing the boat. And often, regardless of what you truly want to do, to practice medicine in the US you do what the insurance companies tell you. Sad, but true.

 

[VALSALVA]

What kind of extracurriculars do you speak of? are there potential residencies that cater to this?

I don't think there are.

When I used the term "extracurricular" I meant it in the most literal sense. You're not going to get what you seek in the cirriculum. You're going to have to self-study that stuff or find other means of learning about it...outside of class. I really have no idea where you would begin, I just meant that it would be outside of the curriculum.

There may be student led homeo/naturopathic clubs at some schools, but I have no idea if they exist or what schools they are at. That might be something to look into because there are a bazillion student led clubs (at least my my school there were).

 

[spicedmanna]

Im looking for a practitioner mentor or schools with amore preventative practice reputation. I know DO schools tend to be more preventative, but is there one in particular?

Im interested in nutrition, bodywork, herbs, energetic medicine/ therapy and other holistic therapies in conjunction with western medicine.

If you are interested in integrative medicine, but also want to be a complete physician, then get your medical degree and get involved in clubs that cater to CAM. The structure of Western medicine is evidence-based, which as stated above, isn't all that compatible with CAM. However, there are schools that reportedly emphasize primary care, which, by nature, tends to integrate more preventive care and training. There are only 20-something osteopathic schools, so it isn't that hard to check each out individually. Look for their curricular emphases and their mission statement. When you interview, you can get a much better feel for the school and whether you will be happy attending there for a few years. In my opinion, the "happiness" criteria is a fairly important factor in choosing a school.

After you are done with the residency of your choice, you can pursue a 2-year fellowship in integrative medicine, a program that was intiated by Andrew Weil, at the University of Arizona. There, you are likely to find the training you are thinking about.

Make sure you know what you are getting yourself into. Western medicine is evidence-based. You need to have a sound appreciation for that kind of foundation and approach if you intend to go through medical school, in my opinion, as you are going to be submerged quite deeply in an evidence-based pool for a number of years.

 

[VALSALVA]

After you are done with the residency of your choice, you can pursue a 2-year fellowship in integrative medicine, a program that was intiated by Andrew Weil, at the University of Arizona. There, you are likely to find the training you are thinking about.

Is that the guy who used to go on Larry King all the time? Grey hair, big beard?

 

[spicedmanna]

Is that the guy who used to go on Larry King all the time? Grey hair, big beard?

 

[VALSALVA]

I'm completely busting out laughing! What a 'fro beard!!!

 

[spicedmanna]

I'm completely busting out laughing! What a 'fro beard!!!

 

[YogiDO]

What a sad state of affairs we are in. I assume that all of you reading this are DO students, so the next few lines should be redundant for you. Although you may know these facts, I doubt how many people truly understand them judging from the posts I read.

1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body’s capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Familiar??????

But how is it possible to practice this type of medicine in an environment that is dictated by insurance reimbursements. How many people graduating from osteopathic schools are actually practicing according to these tenets. Osteopathy IS a holistic branch of medicine. But in Fact, Osteopathy no longer exists in the United States. What the osteopathic schools are teaching is allopathic medicine, with some OMT technique, and since they need to differentiate themselves from MD schools they say they take care of the whole patient, it's talk. Where are the real osteopaths? The doctors in the tradition of Still, Sutherland, Becker, Jealous, osteopathy is just another piece of the business of medicine. And who can blame us, as the students and future doctors, we need to pay back $200,000 in loans plus interest, and we are constrained by insurance companies, with malpractice and liability on top of that, medicine no longer is treating the patient, but simply avoiding liability. It's a massive problem in our country, people are getting sicker, more obesity, more diabetes, more chronic fatigue, AND more Research.......getting us where?

I don't know what to say Healing Casanova. I am in your boat with you, and am very confused. You already have experience dealing with people in pain, and realize it is not an easy situation, the answers don't exist in textbooks on pharmacology and anatomy, although that knowledge may help in treating people. Healing is not taught in school, what we are taught is how to pass the COMLEX, an how to get into residency. Naturopathic school may be more what you are looking for, although insurance reimbursement is far worse for ND. I think this question you raise is an important dialogue that we should have on this forum, rather than the continual debate of MD v DO, and residency match, and the rest of it.

But what Homeboy says may be correct. If you are trying to get an MD or a DO to validate holistic therapies, you may be missing the boat, and that may be advice that I need to take to heart. Intelligent feedback would be appreciated.

Another thing that Homeboys said was poignant as well "regardless of what you truly want to do, to practice medicine in the US you do what the insurance companies tell you. Sad, but true." Is this true? Think about this. Think about the words pain management, diabetes management, the business of medicine does not want people to be cured or healed, these words or now TABOO in medicine, you can't even talk about curing or healing, or you're labeled a quack, make not of that. The reality of medicine in our country is pretty grim. I would love to hear a practicing DO who has a holistic slant explain how he practices in the light of all this, and if they were to do it all over again, would they go DO, or forget about the degree altogether.

Now, for all of you evidenced based research, surgery, radiology, oncology, orthopedic surgery people, please do not bash me all at once and allow this thread to exist for constructive dialogue. Thanks.....

 

[spicedmanna]

Anyone figure out what "holistic" means yet?

Excellent question. I have gathered the following, in context, as a suggestion to what the OP means:

"...goal of bringing healing, not merely a potential temporary fix, to those who desperately need it in our society."

"Im interested in nutrition, bodywork, herbs, energetic medicine/ therapy and other holistic therapies in conjunction with western medicine."

"...more preventative..."

 

[Dr.Inviz]

Excellent question. I have gathered the following, in context, as a suggestion to what the OP means:

"...goal of bringing healing, not merely a potential temporary fix, to those who desperately need it in our society."

"Im interested in nutrition, bodywork, herbs, energetic medicine/ therapy and other holistic therapies in conjunction with western medicine."

"...more preventative..."

Holistic -- an approach based on herbs and "open-mindedness", err, quackery.

 

[YogiDO]

Holistic:


1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body’s capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Remember?

 

[VALSALVA]

Holistic:


1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body's capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Remember?

I don't see how modern evidence based medicine contradicts any of these tenets.

1. The body is a unit...um...okay...lets move on
2. Of course they are interrelated. This is why we prescribe knee and neck braces or why we do hip replacements. By stabilizing the structure, we encourage better function.
3. Indeed, and most of the modern pharmacological agents help the body maintain those mechanisms. Example: ACEI's help to "cool down" an out of control Renin/Angiotensin/Aldosterone feedback loop. Another example: Bacteriostatic Antibiotics make it easier for macrophages to phagocytize bacteria.
4. See #3...modern medicine helps the body do this more efficiently and often times intercedes when the body cannot defend itself (i.e. pressors)
5. How about antidotes to modern day toxins such as herbicides, lead, etc. etc. Tell you what...you use OMM or something natural to treat acute herbicide toxicity...I'll use Atropine.
6. There are so many applications and effective treatments for water/fluid imbalances I don't know where to begin. Relief of increased ICP, for example. The new Vasopressin 2 receptor antagonists are being used to treat severe hyponatremia with great success. Hyponatremia can have terrible effects on mental status AND overall homeostasis. Until recently, we had no great treatments for this condition.
7. I simply object to this tenet.
8. I agree and this is where DO's have a real advantage over MD's. OMM to the spine can help lots of different conditions.

 

[spicedmanna]

Holistic:


1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body's capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Remember?

I understand what you are saying. These principles do form the core of osteopathic philosophy; there's no argument here. However, the concept of holism in medicine is much more longstanding, historically, than osteopathy. Keep in mind that in the American developmental timeline, homeopathy predates osteopathy in the use of the concept of holism. Indeed, from a global standpoint, holism in medicine can be dated some 2000 years BC in China.

 

[Krazykritter]

Holistic:


1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body’s capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Remember?

You can keep preaching the osteopathic tenets to all of us but here's a question for you; Other than in OMM, when was the last time in med school that anything you were taught that was "holistic" & applied these tenets? I honestly cannot remember the last time that we focused on these "prinicples of osteopathy" while learning the pathophysiology & medical treatment of diseases & guess what...I don't feel cheated at all.

Good luck defending in court the fact that you promoted the use of Black Cohosh for relief of menopausal symptoms & your patient developed endometrial cancer. Just b/c it's natural doesn't mean that it can't harm.

 

[Dr.Inviz]

Holistic:


1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body’s capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Remember?

I think I do remember now: You're a quack!

 

[scpod]

I honestly cannot remember the last time that we focused on these "prinicples of osteopathy" while learning the pathophysiology & medical treatment of diseases & guess what...I don't feel cheated at all...

No, but just because you don't g through it doesn't mean that's the way it's done everywhere. There is always an osteopathic element to each of our cases in PBL. How deeply you explore it depends on the individual facilitator, but we look at the osteopathic treatments that can be used in conjunction with western medicine for every pathology.

In addition, we will begin incorporating Integrative Medicine (ie. Complementary and Alternative Medicine) into PBL next semester. The first case is already written and approved. We have a fairly active CAM club here and some professors that are gung-ho about this.

So...you don't feel cheated...but what will it hurt to learn about this stuff. Your patients are already reading about it and learning about it over the internet. They see it every night on TV. The general public has lost a lot of faith in western medicine and you need to be prepared to confront your patients and discuss what's going on in their lives. If you make them think it's all a crock of &^%$, then you'll lose their trust and their care will suffer. Think about it.

 

[Krazykritter]

I don't believe I ever said it was a crock of &%*. In fact, most of those herbals have pharmacologic effects. The problem is that the formulations of the herbals they can buy OTC have a wide degree of variability unlike most medications whether generic or label. So trust me, I'm not going to go telling people they are idiots for wasting their money on herbals. Some might not do a whole lot, but there's a lot to be said for the placebo effect...Cranial comes to mine here (don't know why

Every school has its CAM people. If you are into the whole osteopathic "philosophy" then you certainly realize that considering how the lymph is moving isn't the only aspect to using the approach in practice. When I look at a case I always look at the patient's lifestyle & comorbid conditions to see if anything is interrelating; I would argue that this is as much the osteopathic philosophy as you consider what viscero-somatic reflex to treat w/ a placebo effect counterstrain or cranial treatment.

 

[mitawa]

You can keep preaching the osteopathic tenets to all of us but here's a question for you; Other than in OMM, when was the last time in med school that anything you were taught that was "holistic" & applied these tenets? I honestly cannot remember the last time that we focused on these "prinicples of osteopathy" while learning the pathophysiology & medical treatment of diseases & guess what...I don't feel cheated at all.

Good luck defending in court the fact that you promoted the use of Black Cohosh for relief of menopausal symptoms & your patient developed endometrial cancer. Just b/c it's natural doesn't mean that it can't harm.

As someone else said we have an intergrated curriculum. The clinical relevance and practical of OMT is included in our lessons on medical treatments and pathophysiology in addition to more commonly used treatments.

 

[menaniac]

5. How about antidotes to modern day toxins such as herbicides, lead, etc. etc. Tell you what...you use OMM or something natural to treat acute herbicide toxicity...I'll use Atropine.

Just FYI...Atropine *is* a "something natural" used to cure...it comes from the Deadly Nightshade plant (also known as Belladonna). Has been used for hundreds of years for various therapeutic uses. So has Digitalis (from Foxglove), and many other drug therapeutics. 70% of new drugs are derived from natural sources...hence the big pharma speciality of pharmacognacy (also natural products chemistry). Don't knock the natural stuff 'till you don't want to prescribe it anymore. That will leave your options for many things pretty slim...

Just because something is "natural", it doesn't mean it doesn't work, or doesn't have evidence to back it up (often in the form of clinical trials). The flip side is, just because something is "natural", it doesn't mean its good for you either....

From Wikipedia:

Atropine is a tropane alkaloid extracted from the deadly nightshade (Atropa belladonna) and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects. Being potentially deadly, it derives its name from Atropos, one of the three Fates who, according to Greek mythology, chose how a person was to die.

 

[VALSALVA]

Just FYI...Atropine *is* a "something natural" used to cure...it comes from the Deadly Nightshade plant (also known as Belladonna). Has been used for hundreds of years for various therapeutic uses. So has Digitalis (from Foxglove), and many other drug therapeutics. 70% of new drugs are derived from natural sources...hence the big pharma speciality of pharmacognacy (also natural products chemistry). Don't knock the natural stuff 'till you don't want to prescribe it anymore. That will leave your options for many things pretty slim...

Just because something is "natural", it doesn't mean it doesn't work, or doesn't have evidence to back it up (often in the form of clinical trials). The flip side is, just because something is "natural", it doesn't mean its good for you either....

From Wikipedia:

Atropine is a tropane alkaloid extracted from the deadly nightshade (Atropa belladonna) and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects. Being potentially deadly, it derives its name from Atropos, one of the three Fates who, according to Greek mythology, chose how a person was to die.

Not the point at all! Which would you rather give...Nightshade extract or Atropine? Here Mr. Smith...chew on some Foxglove.

I never stated that natural extracts/derivatives don't work...in fact I have a personal anecdote that says they do. About 2 years ago, I wandered into an independent health food/supplement store and got approached by the naturopath on staff. She stated she could give me some natural extracts (in pill form, of course) that would prevent me from getting any sort of common illness AND make me feel better overall. She even customized my regimen using a number of naturopathic texts (which she showed me). Seeing as that I was a curious medical student, the stuff she offered was cheap, and it was natural, I indulged - why not, right? Who wouldn't want to feel better and avoid illness? About 1 week after beginning my new regime, I began having suicidal ideations and was feeling so bad that I didn't know what to do with myself. A few days after my new and horrible symptoms began, I stopped the natural regime and everything corrected itself within 72 hours. That was crazy!

 

[spicedmanna]

Just because something is "natural", it doesn't mean it doesn't work, or doesn't have evidence to back it up (often in the form of clinical trials). The flip side is, just because something is "natural", it doesn't mean its good for you either....

Agreed. One of the issues is that when patients try to self-medicate, they don't have all of the relevant information. The stuff that they read is incomplete at best. Patients should consult with a knowledgeable source before taking stuff they don't know much about.

I agree that doctors should become exposed to CAM because, whether we like it or not, it is what plenty of patients are using these days. We need to know how to use it in conjunction with evidence-based care, or at least be able to talk intelligently about it, make good recommendations, and help them make sound choices in their healthcare. Physicians are the patient's healthcare advocate.

 

[It'sElectric]

Not the point at all! Which would you rather give...Nightshade extract or Atropine? Here Mr. Smith...chew on some Foxglove.

I never stated that natural extracts/derivatives don't work...in fact I have a personal anecdote that says they do. About 2 years ago, I wandered into an independent health food/supplement store and got approached by the naturopath on staff. She stated she could give me some natural extracts (in pill form, of course) that would prevent me from getting any sort of common illness AND make me feel better overall. She even customized my regimen using a number of naturopathic texts (which she showed me). Seeing as that I was a curious medical student, the stuff she offered was cheap, and it was natural, I indulged - why not, right? Who wouldn't want to feel better and avoid illness? About 1 week after beginning my new regime, I began having suicidal ideations and was feeling so bad that I didn't know what to do with myself. A few days after my new and horrible symptoms began, I stopped the natural regime and everything corrected itself within 72 hours. That was crazy!

Now that is some crazy ****.

 

[DragonWell]

I have wanted to be a doctor all of my life.

After I entered college, I obtained a better understand of how our medical system works and decided what I really wanted was to be a healer. I graduated 2 years ago with the intention of attending a holistic school, like a naturopathic school for example. I have been practicing bodywork for 3years ( http://HealingCasanova.com ).

I have now begun the process of applying to med school as I have made some different choices. I believe that having a medical degree will provide me with move opportunity and influence in the long run to accomplish my goal of bringing healing, not merely a potential temporary fix, to those who desperately need it in our society.

However in searching for a mentor or the right school I have been met with great challenge. I understand medical curriculum is standardized I but I know there is a population of older physicians who have turned toward a more holistic practice. is there not a way the choose this from the beginning or must you go through med school then get further holistic type schooling?

Im looking for a practitioner mentor or schools with amore preventative practice reputation. I know DO schools tend to be more preventative, but is there one in particular?

Im interested in nutrition, bodywork, herbs, energetic medicine/ therapy and other holistic therapies in conjunction with western medicine.

Thank you for any guidance on my path.

Honestly, I don't think you will get a whole lot of useful advice on this forum. Inevitably, conversations about integrative, alternative, holistic, what ever term you use, tend to not end productively in my opinion. CAM is a difficult subject to discuss because in addition to the scientific questions raised, CAM also represents a cultural shift. Teasing out these two issues in order to have a productive discussion about CAM almost never happens on SDN; it is far easier to fall back on cultural stereotypes and cite isolated studies which support your camp than to grapple with the shifting paradign which CAM represents. Of course, as the economic data shows, the public could care less if we are able to discuss CAM effectively; as they are already using and being used by CAM.

So, in a nutshell, I've got finals, and I'm not interested in playing the CAM game right now.

I'll just say that I've attended Bastyr University of Naturopathic Medicine, have been an LMT for five years, and am currently attending Osteopathic Medical School at LECOM-B, where I am president of the Integrative Medicine Club. There are many reasons why I am where I am, please feel free to pm if you have any specific questions.

My general advice for you is to seek out practitioners who do what you want to do and spend time with them. Find out how they got to where they are, and you will likely end up with a much better idea of where you should be going and what it will take to get there. I wouldn't spend your time worrying about the specifics of each school at this stage. Good luck!

 

[Yes_I_DO]

Just because something is "natural", it doesn't mean it doesn't work, or doesn't have evidence to back it up (often in the form of clinical trials). The flip side is, just because something is "natural", it doesn't mean its good for you either....

Agreed. One of the issues is that when patients try to self-medicate, they don't have all of the relevant information. The stuff that they read is incomplete at best. Patients should consult with a knowledgeable source before taking stuff they don't know much about.

I agree that doctors should become exposed to CAM because, whether we like it or not, it is what plenty of patients are using these days. We need to know how to use it in conjunction with evidence-based care, or at least be able to talk intelligently about it, make good recommendations, and help them make sound choices in their healthcare. Physicians are the patient's healthcare advocate.

I don't believe I ever said it was a crock of &%*. In fact, most of those herbals have pharmacologic effects. The problem is that the formulations of the herbals they can buy OTC have a wide degree of variability unlike most medications whether generic or label.

All very good points, and all the more reason to have these substances studied by research, standardized, and woven into your "evidenced-based medicine" bag-o-tricks.

 

[FS-Pro]

No, but just because you don't g through it doesn't mean that's the way it's done everywhere. There is always an osteopathic element to each of our cases in PBL. How deeply you explore it depends on the individual facilitator, but we look at the osteopathic treatments that can be used in conjunction with western medicine for every pathology.

In addition, we will begin incorporating Integrative Medicine (ie. Complementary and Alternative Medicine) into PBL next semester. The first case is already written and approved. We have a fairly active CAM club here and some professors that are gung-ho about this.

So...you don't feel cheated...but what will it hurt to learn about this stuff. Your patients are already reading about it and learning about it over the internet. They see it every night on TV. The general public has lost a lot of faith in western medicine and you need to be prepared to confront your patients and discuss what's going on in their lives. If you make them think it's all a crock of &^%$, then you'll lose their trust and their care will suffer. Think about it.

Man am I glad I don't go there.

 

[Dr.Inviz]

Man am I glad I don't go there.

 

[DragonWell]

The structure of Western medicine is evidence-based, which as stated above, isn't all that compatible with CAM.

I'm curious how you arrive at this conclusion. I think if you spent some time researching you would find that some treatments which fall under the CAM label actually have an abundant evidence base, some have very little. Rakel's Integrative Medicine text, which will be required at LECOM-B next year, while not perfect, is a good place to start. My focus, as well as the professors involved with the Integrative Medicine Club here, is on evidence based integrative medicine. We don't have drum circles, put crystals on our chakras, or discuss homeopathy , instead we discuss the published evidence and scientific basis for making specific recommendations, often nutritional, which may impact the disease process.

Just as someone can use OMT but not be a "cranialite" to coin JP's term, it is possible to use CAM without being a quack.

Throwing around generalities like "natural is not always better", CAM is a "bunch of quackery", and posting anecdotes about quack physicians satisfies the ego, but in reality is running around the same old circle over and over.

We need to know how to use it in conjunction with evidence-based care, or at least be able to talk intelligently about it, make good recommendations, and help them make sound choices in their healthcare.

I think this is very true. Our club did a medication screening for the community and, similar to the findings in JAOA, almost to a person, patients were taking at least one, and often several self prescribed supplements in addition to a host of physician prescribed pharmaceuticals. Most patients also admitted than they didn't talk to their physician about what they were taking.

This is a risk to a patient's well being and also a lost opportunity for patient education. I think most patients would like their doctor to advise them on what supplements or CAM treatments might be worth investigating, but they have heard the "it's all a bunch of quackery" speech too many times to broach the subject. Having a modicum of education about CAM in the medical curriculum is important if for no other reason than to help physicians talk to their patients about the subject.

 

[menaniac]

I'm curious how you arrive at this conclusion. I think if you spent some time researching you would find that some treatments which fall under the CAM label actually have an abundant evidence base, some have very little. Rakel's Integrative Medicine text, which will be required at LECOM-B next year, while not perfect, is a good place to start. My focus, as well as the professors involved with the Integrative Medicine Club here, is on evidence based integrative medicine. We don't have drum circles, put crystals on our chakras, or discuss homeopathy , instead we discuss the published evidence for making specific recommendations, often nutritional, which may impact the disease process.

Just as someone can use OMT but not be a "cranialite" to coin JP's term, it is possible to use CAM without being a quack.

Throwing around generalities like "natural is not always better", CAM is a "bunch of quackery", and posting anecdotes about quack physicians satisfies the ego, but in reality is running around the same old circle over and over.



I think this is very true. Our club did a medication screening for the community and, similar to the findings in JAOA, almost to a person, patients were taking at least one, and often several self prescribed supplements in addition to a host of physician prescribed pharmaceuticals. Most patients also admitted than they didn't talk to their physician about what they were taking.

This is a risk to a patient's well being and also a lost opportunity for patient education. I think most patients would like their doctor to advise them on what supplements or CAM treatments might be worth investigating, but they have heard the "it's all a bunch of quackery" speech too many times to broach the subject. Having a modicum of education about CAM in the medical curriculum is important if for no other reason than to help physicians talk to their patients about the subject.

Great post! You just said what I was *way*too lazy to type. Your integrative medicine club sounds great!

 

[spicedmanna]

Just as someone can use OMT but not be a "cranialite" to coin JP's term, it is possible to use CAM without being a quack.

I agree. I guess CAM is a nebulous label prone to prejudice. We shouldn't throw the baby out with the bath water as it applies to CAM. I believe it is you who said it best:

It's funny to me that when people think something doesn't work, they label it "CAM", but as soon as there is proof something works, it gets moved out of the CAM collumn and relabeled. Thus, herbal medicine becomes "pharmacognosy" and working with someone's diet becomes "clinical nutrition". Now that there is some evidence that stress reduction can speed wound healing and reduce hospital stays, "mind-body" medicine is being repackaged as "visualization and stress reduction therapy".

Poor CAM, they just can't win - if it doesn't work everybody says I told you so, and if it works, everybody says that's not part of CAM!

 

[ezal36]

There's a good oldtime d.o. practicing in mooresville,indiana. he attended WSVOM years ago and is looking for a holistic person to take over his practice.Great person . Go see him . He has a great practice and will give good holistic advice and philosophies.

 

[DragonWell]

Such as . . . what?

Yes, I've seen the in vitro studies showing antibiotic activity of various herbs, or decreased leukocyte migration, or whatever nebulous laboratory endpoints the authors could think of. What I haven't see is anything clinical. Anything.

Someone want to point out a study for me? Because I can pretty quickly toss out a half-dozen clinical studies where CAM treatments were shown to have no effect.

Hmmm...this is a really good question, unfortunately, one which I don't have time at the moment to do justice (uggh, finals).

In the mean time, here are a couple studies/endorsements which come to mind:

Omega 3's

Green Tea Consumption and Overall Mortality

Antioxidants and Macular Degeneration

Acupuncture and Post-Op Nausea and Vomiting

Glucosamine and Chondroitin in OA

Mediterranean diet and survival

Before the flaming begins : None of these studies are conclusive. More research is needed. I would again suggest checking out Rakel's Integrative Medicine text - evidence is evaluated using the "SORT" criteria, so it is very easy to see what level of evidence exists for a particular recommendation.

 

[scpod]

...Because I can pretty quickly toss out a half-dozen clinical studies where CAM treatments were shown to have no effect.

That pretty much proves......nothing. Why? Because anyone can pick a specific treatment, label it CAM, and call it a sham. Besides, it goes back to the old argument that just because a study doesn't exist that calls it effective doesn't mean it doesn't work. It may simply be that good studies haven't been done on it yet-- and possibly will never be done.

That's one of the limitations of evidence based medicine-- not enough studies done on it, so we can just discount it altogether. The problem is that everyone forgets that EBM is more than just studies. It involves critical thinking and using your best judgement based on things like clinical experience and personal observation as well. Yes, it involves using studies, but studies are far from the end-all-know-all answer to the world's problems.

In fact, I really love to hear people with the "show me the study to prove it" mentality, because it shows me that they have little confidence in their own decision making skills. Of course...that's only my opinion, since I don't have a study to back it up.

 

[DragonWell]

That pretty much proves......nothing. Why? Because anyone can pick a specific treatment, label it CAM, and call it a sham. Besides, it goes back to the old argument that just because a study doesn't exist that calls it effective doesn't mean it doesn't work. It may simply be that good studies haven't been done on it yet-- and possibly will never be done.

That's one of the limitations of evidence based medicine-- not enough studies done on it, so we can just discount it altogether. The problem is that everyone forgets that EBM is more than just studies. It involves critical thinking and using your best judgement based on things like clinical experience and personal observation as well. Yes, it involves using studies, but studies are far from the end-all-know-all answer to the world's problems.

In fact, I really love to hear people with the "show me the study to prove it" mentality, because it shows me that they have little confidence in their own decision making skills. Of course...that's only my opinion, since I don't have a study to back it up.

Very good points. The converse is also true - there are many in the CAM field, especially those with financial interests, who routinely use flawed studies with small sample sizes to "prove" what they are peddling is effective.

 

[homeboy]

What a sad state of affairs we are in. I assume that all of you reading this are DO students, so the next few lines should be redundant for you. Although you may know these facts, I doubt how many people truly understand them judging from the posts I read.

1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body’s capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Familiar??????

...

Now, for all of you evidenced based research, surgery, radiology, oncology, orthopedic surgery people, please do not bash me all at once and allow this thread to exist for constructive dialogue. Thanks.....

yet another fine example of the hard-line DOs elevating common sense and basic biologic understanding to a level of unique philosophy.
ridiculous.

 

[Taus]

yet another fine example of the hard-line DOs elevating common sense and basic biologic understanding to a level of unique philosophy.
ridiculous.

agreed 100%

 

[scpod]

yet another fine example of the hard-line DOs elevating common sense and basic biologic understanding to a level of unique philosophy.
ridiculous.

I'm amazed that people continue to NOT get the point of the osteopathic philosophy. It is not in any way intended to be "unique." It is simply the philosophy by which osteopathic medicine was created and exists. It makes no difference if other people believe the same principles or even if the principals are simply common sense because it is just spelling out the philosophy we agree to uphold in the osteopathic pledge.

Lots of organizations have a "philosophy." The Boy Scouts have one, most religions have one. It makes no difference that both the Catholics and Boy Scouts pledge to be reverent. Neither side claims a sole, unique hold on being reverent. They simply have spelled out (in writing) some of the principals they they hold dear and have pledged to live by.

It just doesn't make a difference whether MD's believe the same way because they haven't put the commitment down on paper to follow those principlals. That's what is is-- a commitment. That's all it is. It's not trying to be different or unique or the only people who can claim that the body is a unit. Yes, many DO's like to point out the philosophy, but it's not that they really are any different. They know that. They are highlighting the principals they agreed to live by. Sure, some of them might get a little "high and mighty" now and then, but what organization doesn't have it's radicals? What specialty doesn't think they are better than all the rest? What group of alumni doesn't think they went to the best school? If you want to turn it into something else...go ahead.

 

[medhacker]

I'm amazed that people continue to NOT get the point of the osteopathic philosophy. It is not in any way intended to be "unique." It is simply the philosophy by which osteopathic medicine was created and exists. It makes no difference if other people believe the same principles or even if the principals are simply common sense because it is just spelling out the philosophy we agree to uphold in the osteopathic pledge.

Lots of organizations have a "philosophy." The Boy Scouts have one, most religions have one. It makes no difference that both the Catholics and Boy Scouts pledge to be reverent. Neither side claims a sole, unique hold on being reverent. They simply have spelled out (in writing) some of the principals they they hold dear and have pledged to live by.

It just doesn't make a difference whether MD's believe the same way because they haven't put the commitment down on paper to follow those principlals. That's what is is-- a commitment. That's all it is. It's not trying to be different or unique or the only people who can claim that the body is a unit. Yes, many DO's like to point out the philosophy, but it's not that they really are any different. They know that. They are highlighting the principals they agreed to live by. Sure, some of them might get a little "high and mighty" now and then, but what organization doesn't have it's radicals? What specialty doesn't think they are better than all the rest? What group of alumni doesn't think they went to the best school? If you want to turn it into something else...go ahead.

I am nominating you for the Medhacker SDN Award!

 

[DragonWell]

I am nominating you for the Medhacker SDN Award!

Seconded!

 

[Taus]

I'm amazed that people continue to NOT get the point of the osteopathic philosophy. It is not in any way intended to be "unique." It is simply the philosophy by which osteopathic medicine was created and exists. It makes no difference if other people believe the same principles or even if the principals are simply common sense because it is just spelling out the philosophy we agree to uphold in the osteopathic pledge.

Lots of organizations have a "philosophy." The Boy Scouts have one, most religions have one. It makes no difference that both the Catholics and Boy Scouts pledge to be reverent. Neither side claims a sole, unique hold on being reverent. They simply have spelled out (in writing) some of the principals they they hold dear and have pledged to live by.

It just doesn't make a difference whether MD's believe the same way because they haven't put the commitment down on paper to follow those principlals. That's what is is-- a commitment. That's all it is. It's not trying to be different or unique or the only people who can claim that the body is a unit. Yes, many DO's like to point out the philosophy, but it's not that they really are any different. They know that. They are highlighting the principals they agreed to live by. Sure, some of them might get a little "high and mighty" now and then, but what organization doesn't have it's radicals? What specialty doesn't think they are better than all the rest? What group of alumni doesn't think they went to the best school? If you want to turn it into something else...go ahead.

again...fully agreed....but its unfortunate that the vocal minority who are usually speaking on behalf of the profession just make us look rediculous w/ the way they explain the philosophy as the "DO difference"...

 

[polynikesdb]

xxx

 

[StrengthDoc]

I'm amazed that people continue to NOT get the point of the osteopathic philosophy. It is not in any way intended to be "unique." It is simply the philosophy by which osteopathic medicine was created and exists. It makes no difference if other people believe the same principles or even if the principals are simply common sense because it is just spelling out the philosophy we agree to uphold in the osteopathic pledge.

Lots of organizations have a "philosophy." The Boy Scouts have one, most religions have one. It makes no difference that both the Catholics and Boy Scouts pledge to be reverent. Neither side claims a sole, unique hold on being reverent. They simply have spelled out (in writing) some of the principals they they hold dear and have pledged to live by.

It just doesn't make a difference whether MD's believe the same way because they haven't put the commitment down on paper to follow those principlals. That's what is is-- a commitment. That's all it is. It's not trying to be different or unique or the only people who can claim that the body is a unit. Yes, many DO's like to point out the philosophy, but it's not that they really are any different. They know that. They are highlighting the principals they agreed to live by. Sure, some of them might get a little "high and mighty" now and then, but what organization doesn't have it's radicals? What specialty doesn't think they are better than all the rest? What group of alumni doesn't think they went to the best school? If you want to turn it into something else...go ahead.

This is perhaps the best response I have seen to this issue. Well said.

 

[CommanderRiker]

What a sad state of affairs we are in. I assume that all of you reading this are DO students, so the next few lines should be redundant for you. Although you may know these facts, I doubt how many people truly understand them judging from the posts I read.

1. The body is a unit.
2. Structure and function are reciprocally inter-related.
3. The body possesses self-regulatory mechanisms.
4. The body has the inherent capacity to defend and repair itself.
5. When the normal adaptability is disrupted, or when environmental changes overcome the body's capacity for self maintenance, disease may ensue.
6. The movement of body fluids is essential to the maintenance of health.
7. The nerves play a crucial part in controlling the fluids of the body.
8. There are somatic components to disease that are not only manifestations of disease, but also are factors that contribute to maintenance of the disease state.

Familiar??????

But how is it possible to practice this type of medicine in an environment that is dictated by insurance reimbursements. How many people graduating from osteopathic schools are actually practicing according to these tenets. Osteopathy IS a holistic branch of medicine. But in Fact, Osteopathy no longer exists in the United States. What the osteopathic schools are teaching is allopathic medicine, with some OMT technique, and since they need to differentiate themselves from MD schools they say they take care of the whole patient, it's talk. Where are the real osteopaths? The doctors in the tradition of Still, Sutherland, Becker, Jealous, osteopathy is just another piece of the business of medicine. And who can blame us, as the students and future doctors, we need to pay back $200,000 in loans plus interest, and we are constrained by insurance companies, with malpractice and liability on top of that, medicine no longer is treating the patient, but simply avoiding liability. It's a massive problem in our country, people are getting sicker, more obesity, more diabetes, more chronic fatigue, AND more Research.......getting us where?

I don't know what to say Healing Casanova. I am in your boat with you, and am very confused. You already have experience dealing with people in pain, and realize it is not an easy situation, the answers don't exist in textbooks on pharmacology and anatomy, although that knowledge may help in treating people. Healing is not taught in school, what we are taught is how to pass the COMLEX, an how to get into residency. Naturopathic school may be more what you are looking for, although insurance reimbursement is far worse for ND. I think this question you raise is an important dialogue that we should have on this forum, rather than the continual debate of MD v DO, and residency match, and the rest of it.

But what Homeboy says may be correct. If you are trying to get an MD or a DO to validate holistic therapies, you may be missing the boat, and that may be advice that I need to take to heart. Intelligent feedback would be appreciated.

Another thing that Homeboys said was poignant as well "regardless of what you truly want to do, to practice medicine in the US you do what the insurance companies tell you. Sad, but true." Is this true? Think about this. Think about the words pain management, diabetes management, the business of medicine does not want people to be cured or healed, these words or now TABOO in medicine, you can't even talk about curing or healing, or you're labeled a quack, make not of that. The reality of medicine in our country is pretty grim. I would love to hear a practicing DO who has a holistic slant explain how he practices in the light of all this, and if they were to do it all over again, would they go DO, or forget about the degree altogether.

Now, for all of you evidenced based research, surgery, radiology, oncology, orthopedic surgery people, please do not bash me all at once and allow this thread to exist for constructive dialogue. Thanks.....

Great points. My good men, not only have D.O.s given up the practice of O.M.M. in real life, osteopathic medicine will continue to incorporate more and more allopathic philosophies in the near future. It's inevitable and all the more reason to change the D.O. initials as well. Why keep a title that's not commensurate with what that man does?

 

[homeboy]

I'm amazed that people continue to NOT get the point of the osteopathic philosophy. It is not in any way intended to be "unique." It is simply the philosophy by which osteopathic medicine was created and exists. It makes no difference if other people believe the same principles or even if the principals are simply common sense because it is just spelling out the philosophy we agree to uphold in the osteopathic pledge.

Lots of organizations have a "philosophy." The Boy Scouts have one, most religions have one. It makes no difference that both the Catholics and Boy Scouts pledge to be reverent. Neither side claims a sole, unique hold on being reverent. They simply have spelled out (in writing) some of the principals they they hold dear and have pledged to live by.

It just doesn't make a difference whether MD's believe the same way because they haven't put the commitment down on paper to follow those principlals. That's what is is-- a commitment. That's all it is. It's not trying to be different or unique or the only people who can claim that the body is a unit. Yes, many DO's like to point out the philosophy, but it's not that they really are any different. They know that. They are highlighting the principals they agreed to live by. Sure, some of them might get a little "high and mighty" now and then, but what organization doesn't have it's radicals? What specialty doesn't think they are better than all the rest? What group of alumni doesn't think they went to the best school? If you want to turn it into something else...go ahead.

"Yes, many DO's like to point out the philosophy, but it's not that they really are any different. They know that."
--But that's exactly the point--there IS no difference. So what the hell is the point in having a distinct profession based on an abstract idea that SOME DOs purportedly adhere to??

Comparing the DO philosophy to the Boy Scouts and religion is simply ridiculous. We're not talking about a club that gets together on the weekends and says some prayers or goes door to door selling popcorn. My point being, this is health care; this is the American health system we're talking about, not some random non-profit organization out to do good deeds or perform some menial task to earn a merit badge.
People have a choice of which religion they can attend based on whatever principles or religiosity they are inclined to. Health care should be health care, and your patients should seek you out because you're a good PHYSICIAN, not because you're a good DO.

I didn't "miss the boat"...there is no boat to miss. There is no "osteopathic philosophy"...it's a collection of basic biologic principles organized into a credo from the turn of the century, and at the time, was very applicable as the state of medicine was quite different. The rest of the medical world has caught on and since evolved, and the need for a separate profession bound to world-class patient care is NOT NECESSARY because all of medicine is bound to patient care. Arguing that DOs are different or better because their daily thought process frequents the notion that “the body is a unit, et al.” is a farce.

Let’s call a spade a spade: is our profession based on true distinction rooted in core differences of logic and approaches to patient care, or a nostalgic fantasy that superficial attributes equate to genuine professional distinction?

 

[scpod]

...There is no "osteopathic philosophy"...it's a collection of basic biologic principles organized into a credo from the turn of the century...

Right...and Bill Clinton really didn't have sex with that woman either, did he? All you're doing now is using semantics to (poorly) assert your argument. Of course it's not a different profession!!!! MD's and DO's are both physicians for God's sake!!!! They have different initials after them because they have slightly different roots-- doesn't make them different proffessions. In many states they are guided by the same medical boards.

The fact, though, is that there IS an osteopathic philosophy. It's written down on paper and many practitioners agree to follow by it. It guides therir thinking as well as their treatment of patients.

Here's the point where I just up and down and scream for a while. It's not different. You keep saying we are trying to be different and better. THAT'S NOT IT. We aren't trying to be DIFFERENT. We are just trying to be OSTEOPATHS! We took a slightly different path to get here, but we use the same current pricipals of medicine that everyone else in the world uses. Only, we are a little more accepting of things that aren't totally mainstream and we have made a COMMITMENT to a certain set of principles. We do the SAME things, but we have made a deeper commitment to certain principles. In that aspect alone...we are different, not better, because we have made a pledge that other physicians have not. We have a philosophy whether or not you choose to follow it or even believe in its existence. To deny its existence simply because it's a "collection of basic biological prinipals" is ludicrous.

 

[homeboy]

It guides therir thinking as well as their treatment of patients.

That's a joke. How does being a DO change your course of action when presented with a medical problem, other than being able to apply OMT, which MDs can learn via CMEs...

We aren't trying to be DIFFERENT. We are just trying to be OSTEOPATHS!

That's the most ridiculous thing I've heard all year. If you're not trying to be different, yet you still insist an osteopath is not equivalent to an allopath, I'm a little unsure how you're NOT contradicting yourself.

We do the SAME things, but we have made a deeper commitment to certain principles.

But those commitments are made on a personal level, and any physician--MD or DO--can make those commitments...you just want to wear that commitment on your shirt-collar, as if it's a token of your supposed commitment to certain superfluous ideas...

In that aspect alone...we are different, not better, because we have made a pledge that other physicians have not. We have a philosophy whether or not you choose to follow it or even believe in its existence. To deny its existence simply because it's a "collection of basic biological prinipals" is ludicrous.

I don't deny that people believe in those so-called "princples," I just deny that those principles have any inherent value that can lead to a so-called "philosphy" that is worthy of being deemed a seperate professional group: the DOs.


I mean what other profession legitimizes 2 completely equivalent professional groups with legally distinct names when they undergo the exact same schooling, boards, are legal equivalents, are compensated the same, and perform the EXACT same function?