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Camaxtli said:
Why hasn't this occurred yet?

I'm curious on your thoughts about the billing? What I'm gathering is that the effectiveness of the treatment has to be proven in order for insurance to cover it? Does this happen with other treatments as well?
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Why do you think it hasn't? Every PT school is now required to instruct its students in HVLA, and some choose to do so from a very osteopathic perspective.
 
jesspt said:
Why do you think it hasn't? Every PT school is now required to instruct its students in HVLA, and some choose to do so from a very osteopathic perspective.
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Interesting. Thank you for the insight.
 
Are you kidding? This is what we need. OMM is a waste of time and resources. It's a relic of old times and it needs to go away ASAP. We need to stop compensating for our perceived inadequacies vs. MDs.
 
OMT, take what you need and throw the rest out. If you are an osteopath and you see nothing good from it then you are either doing it wrong/getting it done wrong on you or you are simply b*tching because it is cool to do so. I hate the class as much as most people do but I am not completely ignorant to say that we need to completely get rid of OMT. I do techniques on my friends and family and have gotten some nice results.
 
Drrrrrr. Celty said:
I'm more curious on what this all means. Like explain it to me like I'm 5. Do they intend to entirely do away with funding for OMT based therapies? What happens if OMT is no longer funded? What does it mean for osteopathic medical training?
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You can't bill for OMT and another visit at the same time anymore, as it is now considered duplication of services if this goes through. So if you wanted to do OMT, you'd have to schedule a separate visit. So either you do OMT for free or you waste everyone's time with a second visit that doesn't pay all that much for the paperwork involved.
 
Drrrrrr. Celty said:
The problem is that, that's where the decent research actually ends. Even then there's never been an outcomes driven study that compares OMM to other cheaper modalities, i.e meds, therapy, life style changes, etc.




Have you actually looked at some of the OS papers?

And sure, I love getting HVLA and Myofacial release done to me. My back is a hypertrophied giant hard end feel. That does not however tell me about statistical outcomes nor does it tell me whether it should be a prefered tx for lower back pain.
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It's really tough to do a good study on techniques that have a very physical diagnosis model, against which sham treatments can't really be successfully devised since the person performing them would either lack the physiological knowledge (if they were an actor) or belief (if they were a physician applying sham treatments in place of real ones). I'm not saying it works or it doesn't, but hell, it at least works well in the short term for friends, family, and loved ones while costing me nothing to perform.
 
Mad Jack said:
You can't bill for OMT and another visit at the same time anymore, as it is now considered duplication of services if this goes through. So if you wanted to do OMT, you'd have to schedule a separate visit. So either you do OMT for free or you waste everyone's time with a second visit that doesn't pay all that much for the paperwork involved.
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Good explanation! Did you sign the petition? It only hurts us if we don't?
 
Camaxtli said:
Good explanation! Did you sign the petition? It only hurts us if we don't?
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Do you know that over 95% of DOs do not use OMT? The ones use them daily in their practice tend to go with cash model. It won't hurt anyone, really.
 
kenjixshadow said:
Do you know that over 95% of DOs do not use OMT? The ones use them daily in their practice tend to go with cash model. It won't hurt anyone, really.
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That stat is a bit misleading. 95% of DOs don't use it on 50% or more of their patients. Something like 13-15% actually use it on their patients, 8% just don't use it on the majority of their patients.

In any case, that's not really accurate. The ones making bank and are the ones taking cash. Plenty of DOs out there are billing for OMT and aren't looking to make a cash-only killing.
 
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Mad Jack said:
It's really tough to do a good study on techniques that have a very physical diagnosis model, against which sham treatments can't really be successfully devised since the person performing them would either lack the physiological knowledge (if they were an actor) or belief (if they were a physician applying sham treatments in place of real ones). I'm not saying it works or it doesn't, but hell, it at least works well in the short term for friends, family, and loved ones while costing me nothing to perform.
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People throw this around a bit too often. You can very easily do a single blind or a quasi-experiment correlation study using Physical therapists, meds, OMM, etc and then very simply give them a survey or scale to rank their satisfaction or outcomes on a timed basis. No one is saying we need a double blind causal testing study to prove OMM.
 
Drrrrrr. Celty said:
People throw this around a bit too often. You can very easily do a single blind or a quasi-experiment correlation study using Physical therapists, meds, OMM, etc and then very simply give them a survey or scale to rank their satisfaction or outcomes on a timed basis. No one is saying we need a double blind causal testing study to prove OMM.
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Except every time they do a study that isn't double blind, such as the numerous LBP studies, everyone says they aren't good enough.
 
Mad Jack said:
Except every time they do a study that isn't double blind, such as the numerous LBP studies, everyone says they aren't good enough.
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I think OMT is pretty well proven to provide relief for back pain.
 
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Mad Jack said:
You can't bill for OMT and another visit at the same time anymore, as it is now considered duplication of services if this goes through. So if you wanted to do OMT, you'd have to schedule a separate visit. So either you do OMT for free or you waste everyone's time with a second visit that doesn't pay all that much for the paperwork involved.
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Could you bill for two visits one after another on the same day?
 
GUH said:
Could you bill for two visits one after another on the same day?
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You'd probably have to expect them to need OMT afterward. Likewise as he pointed out, it'd be tons of paperwork for limited gain?
 
kenjixshadow said:
Do you know that over 95% of DOs do not use OMT? The ones use them daily in their practice tend to go with cash model. It won't hurt anyone, really.
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kenjixshadow said:
Do you know that over 95% of DOs do not use OMT? The ones use them daily in their practice tend to go with cash model. It won't hurt anyone, really.
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Mad Jack said:
Won't affect me either way, as I don't think I'll ever professionally do OMM.
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Even if you don't plan on using it wouldn't you like to have the option to bill for it? What is the downside in signing? Is anyone not signing for any reason?
 
I'm not signing. I don't really want my tax money spent on woo.

I've had OMM faculty that I think are fantastic, but that's more because I think they're great doctors, and would be great no matter what they did. They're clearly filling a demand in their private practices, and if they have patients that benefit from it, I think that's terrific. But as much as I don't want to deny them or any one who wants to base their career on OMM the opportunity to do so, I don't think we should be spending limited public money on unproven treatments.
 
starri said:
I'm not signing. I don't really want my tax money spent on woo.

I've had OMM faculty that I think are fantastic, but that's more because I think they're great doctors, and would be great no matter what they did. They're clearly filling a demand in their private practices, and if they have patients that benefit from it, I think that's terrific. But as much as I don't want to deny them or any one who wants to base their career on OMM the opportunity to do so, I don't think we should be spending limited public money on unproven treatments.
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If you've been out on rotations and still believe that OMM is a significant cause of medicare waste, then I'd love to know which hospitals and clinic's you've rotated through.
 
GUH said:
If you've been out on rotations and still believe that OMM is a significant cause of medicare waste, then I'd love to know which hospitals and clinic's you've rotated through.
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So because it's not the biggest, it doesn't count?

I'm not a fan of any Medicare waste, but my grandmother always said if you watch your pennies, the dollars watch themselves.
 
starri said:
So because it's not the biggest, it doesn't count?

I'm not a fan of any Medicare waste, but my grandmother always said if you watch your pennies, the dollars watch themselves.
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Nobody said it was the biggest. If they're investing resources into investigating ways to cut down on Medicare spending, putting OMT on the chopping block is a waste of those resources.

And watching pennies doesn't do much good if you're losing dollars elsewhere.
 
GUH said:
If you've been out on rotations and still believe that OMM is a significant cause of medicare waste, then I'd love to know which hospitals and clinic's you've rotated through.
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I doubt OMM is a significant waste in hospitals or clinics purely on the basis that it almost is never used in those settings. What major hospital has their medicine staff on rounds doing OMM?
 
Drrrrrr. Celty said:
I doubt OMM is a significant waste in hospitals or clinics purely on the basis that it almost is never used in those settings. What major hospital has their medicine staff on rounds doing OMM?
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None that I've seen!
 
FWIW the DO I shadowed only said she used it on her husband...I'm sure it was some weird foreplay thing she was probably into.
 
You know the state of osteopathic medical education is poor when we are relying on the government to force us to modernize our curricula by dropping this archaic and questionable modality.
 
jojo58 said:
You know the state of osteopathic medical education is poor when we are relying on the government to force us to modernize our curricula by dropping this archaic and questionable modality.
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You know you've read a post that has nothing to do with the thread when.....

And also Osteopathic medicine as a whole historically innovated itself towards the status of full physician.
 
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Im not saying OMT is totally bad and in the same league as homeopathy. I love the social aspect of it; there's never a dull moment in the OMT lab. However, it would serve us better as DOs if we removed or GREATLY de-emphasized OMM. That would leave more time in our curricula to work on other subjects. Heck, we might be able to study as much as MDs and get board scores high enough to match in ortho, derm, plastics, etc.
 
jojo58 said:
Im not saying OMT is totally bad and in the same league as homeopathy. I love the social aspect of it; there's never a dull moment in the OMT lab. However, it would serve us better as DOs if we removed or GREATLY de-emphasized OMM. That would leave more time in our curricula to work on other subjects. Heck, we might be able to study as much as MDs and get board scores high enough to match in ortho, derm, plastics, etc.
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I think ppl like to down play it, but OS is a time sink and it does negative affect people's board scores. Also Cranial negative affects my IQ.
 
jojo58 said:
Im not saying OMT is totally bad and in the same league as homeopathy. I love the social aspect of it; there's never a dull moment in the OMT lab. However, it would serve us better as DOs if we removed or GREATLY de-emphasized OMM. That would leave more time in our curricula to work on other subjects. Heck, we might be able to study as much as MDs and get board scores high enough to match in ortho, derm, plastics, etc.
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I seriously doubt any difference in scores between DOs and MDs is due to the 2-3 hrs a week we spend on OMM.

And honestly, I think a lot of the musculoskeletal techniques are at least as useful as a lot of surgical procedures.

But yeah, Chapman's points, cranial and viscerosomatics need to go away.
 
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NurWollen said:
I seriously doubt any difference in scores between DOs and MDs is due to the 2-3 hrs a week we spend on OMM.
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I always dislike this argument b/c it's not the whole picture. You should also take in accounts of 10-20 hrs of outside lab practicing OMM for the practicals and 4-5 hrs cramming for the written exams, for 2 years. Not to mention most ppl add in extra 2-3 days to study the OMM portion on the COMLEX. I did a quick math and the hrs we normally spend on OMM-related are ranging from 300-400 hrs. MD students have literally that much time advantage over us to either study or work on a research project. There are other factors, but this is one of the contributions to why MD students tend to do better on the USMLE.
 
Exactly. People really like to pretend that it's nothing, but the time commitment is there. I'm not saying that there's anyway to get around it, but chances are the schools that end up doing the most OS tend to also do worse on boards.

It does kinda make me salty, not going to lie.
 
Drrrrrr. Celty said:
Exactly. People really like to pretend that it's nothing, but the time commitment is there. I'm not saying that there's anyway to get around it, but chances are the schools that end up doing the most OS tend to also do worse on boards.

It does kinda make me salty, not going to lie.
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All that OMT learned last year and I didn't even use it for my SP today haha


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AlteredScale said:
All that OMT learned last year and I didn't even use it for my SP today haha


Sent from my iPhone using SDN mobile
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Honestly the only reason I know what OMT to use is because someone brought up the technique and how they used it on their family. I was going to legitimately just do the wrong thing and or ME.

Idk, I hope they kinda give us a good refresh of COMLEX PE friendly OMT tbh. Like I'm clearly not getting anything I'm going to be using on PE next year right now for sure.
 
kenjixshadow said:
I always dislike this argument b/c it's not the whole picture. You should also take in accounts of 10-20 hrs of outside lab practicing OMM for the practicals and 4-5 hrs cramming for the written exams, for 2 years. Not to mention most ppl add in extra 2-3 days to study the OMM portion on the COMLEX. I did a quick math and the hrs we normally spend on OMM-related are ranging from 300-400 hrs. MD students have literally that much time advantage over us to either study or work on a research project. There are other factors, but this is one of the contributions to why MD students tend to do better on the USMLE.
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Most students absolutely DO NOT spend 10-20 hours outside of assigned lab time studying for each practical. Come on.
 
jojo58 said:
Im not saying OMT is totally bad and in the same league as homeopathy. I love the social aspect of it; there's never a dull moment in the OMT lab. However, it would serve us better as DOs if we removed or GREATLY de-emphasized OMM. That would leave more time in our curricula to work on other subjects. Heck, we might be able to study as much as MDs and get board scores high enough to match in ortho, derm, plastics, etc.
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Differences in board scores are not the reason DOs don't often match into competitive ACGME specialties. Most programs in those specialties don't even look at a DO's board scores.
 
GUH said:
Most students absolutely DO NOT spend 10-20 hours outside of assigned lab time studying for each practical. Come on.
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20 is definitely a stretch, but 10 is the norm. Not to mention, the practicals always fall into the worst time when there are pertinent exams needed to be studied for.
GUH said:
Differences in board scores are not the reason DOs don't often match into competitive ACGME specialties. Most programs in those specialties don't even look at a DO's board scores.
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The gentlemen was definitely talking about USMLE scores. Sure, there are other things come into play for competitive specialties, but any application with less than 240 on Step 1 will go to the trash regardless. How many DO students have 240+? Not that many, so his point still stands.
 
kenjixshadow said:
20 is definitely a stretch, but 10 is the norm. Not to mention, the practicals always fall into the worst time when there are pertinent exams needed to be studied for.

The gentlemen was definitely talking about USMLE scores. Sure, there are other things come into play for competitive specialties, but any application with less than 240 on Step 1 will go to the trash regardless. How many DO students have 240+? Not that many, so his point still stands.
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Even DOs with 240+ scores are not considered at most programs in certain specialties. http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf is the link in case you're interested. For example, only 28% of ENT programs and 27% of Plastic Surgery programs even consider osteopathic applicants. Board scores don't matter if your application goes straight to the circular file.
 
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