So...Would You do D.O.?

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Would you ever choose DO?

  • Yes

    Votes: 283 66.6%
  • No

    Votes: 142 33.4%

  • Total voters
    425
Ugh, you're proving my point ... what's wrong with the study I just linked that was conducted at University of Texas Health Sciences and published in the American Journal of Obstetrics and Gynecology ????

Nothing. Like I said; "results are modest at best".

It would be nice to find the original paper.

*Edit*

This is the best I can do without paying for the whole article:

Results

Intention-to-treat analyses included 144 subjects. The Roland-Morris Disability Questionnaire scores worsened during pregnancy; however, back-specific functioning deteriorated significantly less in the usual obstetric care and osteopathic manipulative treatment group (effect size, 0.72; 95% confidence interval, 0.31–1.14; P = .001 vs usual obstetric care only; and effect size, 0.35; 95% confidence interval, –0.06 to 0.76; P = .09 vs usual obstetric care and sham ultrasound treatment). During pregnancy, back pain decreased in the usual obstetric care and osteopathic manipulative treatment group, remained unchanged in the usual obstetric care and sham ultrasound treatment group, and increased in the usual obstetric care only group, although no between-group difference achieved statistical significance.

Conclusion

Osteopathic manipulative treatment slows or halts the deterioration of back-specific functioning during the third trimester of pregnancy.


http://www.ajog.org/article/S0002-9378(09)00843-6/pdf

I am not the greatest at biostats, but I do note that the confidence intervals overlap between the OMM and conventional group.
 
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Ugh, you're proving my point ... what's wrong with the study I just linked that was conducted at University of Texas Health Sciences and published in the American Journal of Obstetrics and Gynecology ????

For a commonly used method (worthy of being taught at the medical school level) thought to provide a positive treatment outcome, there should be dozens if not hundreds of papers in support with (a few major studies and a constellation of smaller ones). The issue with OMM is that there are only a few papers, and that those papers mostly have mixed results.
 
Nothing. Like I said; "results are modest at best".

It would be nice to find the original paper.

Oh whoops, I thought it was in there ...

(ugh sorry, AJOG is giving me crap and I can't get to the article ... it was on their homepage a few days ago, and I thought there was links in the news stories that covered it. Haha, it exists ... I promise).

See, but this is my point ... OMM isn't a fix all, it's an adjunct therapy, and people who claim otherwise should not do so in the face of more effective medical treatment. Can OMM help with lower back pain? Sure, the NEJM article says this. If you need surgery, should you keep going back for more and more OMM, even if it helps a little bit (ie slaps a bandaid on a huge gash)? No. However, in my book (and sorry if I'm being insulting or whatever ... it wasn't my intent and for some reason, before this discussion, I thought you were a DO student), there is a difference between studies that say 'yeah, it's helpful and good for what it does' and saying there is no evidence whatsoever. The evidence is there ... it just shows OMM for what it is - a helpful, adjunct therapy which works when employed correctly with appropriate patients. Few things are a fix all, especially manual techniques like OMM. Also, it doesn't shock me these findings aren't posted in the big journals people usually associate with 'good science.' Articles concerning findings/confirmation on things of this nature isn't big, breaking scientific news. Is it important and advantageous to patients ... sure. But it isn't like finding a genetic links for Autism. That story gets published on the cover of Science, not the one about OMM reducing pain levels in OB patients.
 
For a commonly used method (worthy of being taught at the medical school level) thought to provide a positive treatment outcome, there should be dozens if not hundreds of papers in support with (a few major studies and a constellation of smaller ones). The issue with OMM is that there are only a few papers, and that those papers mostly have mixed results.

That's kind of my point. It's hard to find legit studies on the matter. I appreciate the OB paper. That's the first one I am aware of that has been adapted by a conventional medical publication since the Andersson one in the NEJM.
 
For a commonly used method (worthy of being taught at the medical school level) thought to provide a positive treatment outcome, there should be dozens if not hundreds of papers in support with (a few major studies and a constellation of smaller ones). The issue with OMM is that there are only a few papers, and that those papers mostly have mixed results.

It's under researched ... I'm not debating this. However, research is out there and (from what I hear) more and more studies are being conducted. A big issue is that DO schools don't bring in the NIH money like MD schools do. Research on OMM is ongoing (I've seen it firsthand), and will continue, and I hope it will reach the level to satisfy all at some point. Until then, dismiss it or not, there are studies.

Also, another interesting thing is that in the UK there are schools that train people to be straight up 'Osteopaths,' meaning they aren't physicians, and only receive training in OMM, and I've seen some interesting research out of there. Hopefully, if these schools remain popular, good research will continue coming out.
 
That's kind of my point. It's hard to find legit studies on the matter. I appreciate the OB paper. That's the first one I am aware of that has been adapted by a conventional medical publication since the Andersson one in the NEJM.

I hope this trend continues, and I'll definitely follow it and post stuff on SDN when it does.

I do understand some of the fallacies with research published in things like JAOA, and I hope publication in bigger journals continues.
 
Oh whoops, I thought it was in there ...

(ugh sorry, AJOG is giving me crap and I can't get to the article ... it was on their homepage a few days ago, and I thought there was links in the news stories that covered it. Haha, it exists ... I promise).

See, but this is my point ... OMM isn't a fix all, it's an adjunct therapy, and people who claim otherwise should not do so in the face of more effective medical treatment. Can OMM help with lower back pain? Sure, the NEJM article says this. If you need surgery, should you keep going back for more and more OMM, even if it helps a little bit (ie slaps a bandaid on a huge gash)? No. However, in my book (and sorry if I'm being insulting or whatever ... it wasn't my intent and for some reason, before this discussion, I thought you were a DO student), there is a difference between studies that say 'yeah, it's helpful and good for what it does' and saying there is no evidence whatsoever. The evidence is there ... it just shows OMM for what it is - a helpful, adjunct therapy which works when employed correctly with appropriate patients. Few things are a fix all, especially manual techniques like OMM. Also, it doesn't shock me these findings aren't posted in the big journals people usually associate with 'good science.' Articles concerning findings/confirmation on things of this nature isn't big, breaking scientific news. Is it important and advantageous to patients ... sure. But it isn't like finding a genetic links for Autism. That story gets published on the cover of Science, not the one about OMM reducing pain levels in OB patients.

I actually think we are saying a lot of the same things. I think OMM can be useful, but it is too variable from patient to patient to be regularly adapted and used. For instance, acupuncture shows a benefit for people that are open to it. However, it's not going to do much for a skeptic. Some people swear by it, and some people think it's a sham. In the end, the efficacy probably has more to do with the patient's mindset going in than anything else. It's hard to nail down the hard science of the matter.

However, as I said, I am not anti-OMM. I just don't see it as being hugely advantageous. If I had a patient with chronic low back pain that didn't resolve after a month (as 80% of them do) and wasn't helped by the traditional anti-inflammatory, analgesic, and muscle relaxer (+PT) combo, that or chiropractic would be my next recommendation.

I certainly would try that as opposed to keeping someone on narcs for a long term period, which I think happens all too often.

I am at an MD school, but it's no Stanford so I don't look down my nose at anyone in medical school regardless of the letters. Plus, I am in a DO heavy area and, save for the letters on the coat, can't tell a difference anyways.
 
I regret to inform everyone that I believe AwakenedApollo's posts have been removed completely from SDN. My biggest fan, erased ...

RIP

February 20, 2010 - February 21, 2010

fly away to Stanford Med majestic bird, fly away ... 🙁
 
I actually think we are saying a lot of the same things. I think OMM can be useful, but it is too variable from patient to patient to be regularly adapted and used. For instance, acupuncture shows a benefit for people that are open to it. However, it's not going to do much for a skeptic. Some people swear by it, and some people think it's a sham. In the end, the efficacy probably has more to do with the patient's mindset going in than anything else. It's hard to nail down the hard science of the matter.

However, as I said, I am not anti-OMM. I just don't see it as being hugely advantageous. If I had a patient with chronic low back pain that didn't resolve after a month (as 80% of them do) and wasn't helped by the traditional anti-inflammatory, analgesic, and muscle relaxer (+PT) combo, that or chiropractic would be my next recommendation.

I certainly would try that as opposed to keeping someone on narcs for a long term period, which I think happens all too often.

I am at an MD school, but it's no Stanford so I don't look down my nose at anyone in medical school regardless of the letters. Plus, I am in a DO heavy area and, save for the letters on the coat, can't tell a difference anyways.

Yeah I do too.
 
I hope this trend continues, and I'll definitely follow it and post stuff on SDN when it does.

I do understand some of the fallacies with research published in things like JAOA, and I hope publication in bigger journals continues.

The issue will have to be picked up by bigger journals for the profession as a whole to give it credence. I don't think that a bias by the NEJM is the problem, I think it's the lack of solid research with appropriate methodology and statistics.

Like I said, I am more than willing to be open to it. I'll even train up on it if the evidence shows it to be worth the time and effort.
 
I regret to inform everyone that I believe AwakenedApollo's posts have been removed completely from SDN. My biggest fan, erased ...

RIP

February 20, 2010 - February 21, 2010

fly away to Stanford Med majestic bird, fly away ... 🙁

Maybe you can derive comfort from knowing that all five of his posts were to you.
 
It's under researched ... I'm not debating this. However, research is out there and (from what I hear) more and more studies are being conducted. A big issue is that DO schools don't bring in the NIH money like MD schools do. Research on OMM is ongoing (I've seen it firsthand), and will continue, and I hope it will reach the level to satisfy all at some point. Until then, dismiss it or not, there are studies.

It is not a matter of dismissing it. Rather, in the absence of positive evidence, OMM should not be assumed to be true. The corollary is that in the absence of overwhelming positive evidence, it should not be taught at the medical school level.

The NIH is not the only source of money, and considering the potential benefit to DO schools if several large studies were published supporting OMM's efficacy, I am surprised to find that little research has been done so far. It does make me wonder if the lack of publications is a case of negative result purgatory.
 
The results would be much different if it displayed who voted for what. This is just an example of premed's insecurity.
 
Oh, MY GOD.

There will always be snobs. There will always be people who care more about appearances and names than actual substance.

And there will always be people who care more about meaningful material -- who have the brains to make judgements and decisions about quality for themselves. I put myself in this category. I have a near-genius IQ but I've never gotten over a 3.5 ANY semester in undergrad or grad school. Why? I just didn't care to make the extra effort while I was working almost full time. I preferred to have a life outside school. Now, I prefer to pay less so I'm going to LECOM, the cheapest school I got into (instead of CCOM - the "approved" DO school according to someone here). What's right for one is not right for all.

People who allow prejudice (yes, it's pre-judging), rumor and ignorance to influence their impressions of medical schools and the doctors they produce are beyond hope, as far as I'm concerned. Snobs. You're just snobs, and no one likes you. If you'd rather NOT be a physician than have to be a DO, I pray to God I never have to work with you. I just think you must be horribly self-absorbed, superficial elitists who clearly want prestige and don't give a *hit about bettering health and prolonging lives. I predict you will regret your decision when you're wrist-deep in someone's colon someday.


Neither of us two groups are going to change our minds. Just call it a day?
 
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It is not a matter of dismissing it. Rather, in the absence of positive evidence, OMM should not be assumed to be true. The corollary is that in the absence of overwhelming positive evidence, it should not be taught at the medical school level.

The NIH is not the only source of money, and considering the potential benefit to DO schools if several large studies were published supporting OMM's efficacy, I am surprised to find that little research has been done so far. It does make me wonder if the lack of publications is a case of negative result purgatory.

There is evidence that it works. Whether it is the placebo effect or not, it works.
 
I want all of you to analyze something for me. I do not know where the terminology "allopathic" originates, but it is definitely an interesting choice of words. In Greek, "allo" means "other", so in effect, allopathic medicine tells you what it is not, rather than telling you what it is. Would someone kindly tell me what allopathic medicine is?
 
There is evidence that it works. Whether it is the placebo effect or not, it works.

If it doesn't beat placebo, then you have to question if it really works. This isn't limited to OMM. Check out the latest issue of Newsweek about SSRIs for an interesting discussion on this.
 
I want all of you to analyze something for me. I do not know where the terminology "allopathic" originates, but it is definitely an interesting choice of words. In Greek, "allo" means "other", so in effect, allopathic medicine tells you what it is not, rather than telling you what it is. Would someone kindly tell me what allopathic medicine is?

It was a term created by MD medical students to show that they were as legit as osteopathic medical students.

I keed.... I keed.........
 
The issue will have to be picked up by bigger journals for the profession as a whole to give it credence. I don't think that a bias by the NEJM is the problem, I think it's the lack of solid research with appropriate methodology and statistics.

Like I said, I am more than willing to be open to it. I'll even train up on it if the evidence shows it to be worth the time and effort.

The methodology concerns me, and I don't know if it is simply out of the hands of researchers, or if they are going to have to come up with some very creative ways of making the testing better. For example in the recent OB study:

- It wasn't double blind with respect to both the patient and the doctor performing OMM. However, how could it be? Unlike a doctor who is handing out either a placebo or real medication and can't tell the difference, a doctor who is either administering a sham or real OMM treatment knows what's up.

- Differing abilities across practitioners. It's a hands on technique, and unlike a drug manufactured by machines, not all hands are created equal. This is always going to cause problems.

- A ton of different techniques with lots of varying degrees of acceptance. Again, it isn't just like a pill where it's effective or it isn't ... HVLA and muscle energy could be great, but cranial could be bogus. Well, does that make all OMM legit, or all bogus, or do we have to break it down, etc.

Now, I don't want to use this as a cop out, but it is an issue, even in the more accepted studies (ie the OB one or the back pain in NEJM).

As far as the statistics go ... I'll have to look at them in greater detail I suppose.
 
I do spend lots of time under bridges...

Anyway, you'll have to be more clear as to what "evidence" is.

If you think any positive evidence is sufficient (whether or not it is better than placebo), then you are suggesting that any treatment with a placebo effect should be considered valuable and taught at the medical school level.

Since that is clearly a ridiculous statement, the phrase "positive evidence" is self-explanatory.
 
I want all of you to analyze something for me. I do not know where the terminology "allopathic" originates, but it is definitely an interesting choice of words. In Greek, "allo" means "other", so in effect, allopathic medicine tells you what it is not, rather than telling you what it is. Would someone kindly tell me what allopathic medicine is?

I heard it popped up as a result of osteopathic medicine. I read a funny article time by an MD who asked 'when did I become an allopath?' He essentially concluded it came about during the earlier days of DO/MD distinction.
 
People who allow prejudice (yes, it's pre-judging), rumor and ignorance to influence their impressions of medical schools and the doctors they produce are beyond hope, as far as I'm concerned. Snobs. You're just snobs, and no one likes you. If you'd rather NOT be a physician than have to be a DO, I pray to God I never have to work with you. I just think you must be horribly self-absorbed, superficial elitists who clearly want prestige and don't give a *hit about bettering health and prolonging lives. I predict you will regret your decision when you're wrist-deep in someone's colon someday.

So.. you're hatin' on the pre-judgers.. Then you judged them based on a stereotype you conceived in your mind.

Why yall haters gotta hate?
 
So.. you're hatin' on the pre-judgers.. Then you judged them based on a stereotype you conceived in your mind.

Why yall haters gotta hate?

Why don't you look up the definition of stereotype, k?
 
Hey man, you've forgotten about those Caribbean schools.😉
 
Why don't you look up the definition of stereotype, k?

Maybe people like them voted no just to watch people like you go nuts...

At any rate, you don't need their opinions to validate your decisions in life.
 
The methodology concerns me, and I don't know if it is simply out of the hands of researchers, or if they are going to have to come up with some very creative ways of making the testing better. For example in the recent OB study:

- It wasn't double blind with respect to both the patient and the doctor performing OMM. However, how could it be? Unlike a doctor who is handing out either a placebo or real medication and can't tell the difference, a doctor who is either administering a sham or real OMM treatment knows what's up.

- Differing abilities across practitioners. It's a hands on technique, and unlike a drug manufactured by machines, not all hands are created equal. This is always going to cause problems.

- A ton of different techniques with lots of varying degrees of acceptance. Again, it isn't just like a pill where it's effective or it isn't ... HVLA and muscle energy could be great, but cranial could be bogus. Well, does that make all OMM legit, or all bogus, or do we have to break it down, etc.

Now, I don't want to use this as a cop out, but it is an issue, even in the more accepted studies (ie the OB one or the back pain in NEJM).

As far as the statistics go ... I'll have to look at them in greater detail I suppose.

In fairness, "pain" is a subjective entity and it's hard to quantify it in a study.

I am not denying that it will be hard issue to research. Still, the burden of proof is on those who advocate for OMM in this instance.
 
Maybe people like them voted no just to watch people like you go nuts...

At any rate, you don't need their opinions to validate your decisions in life.


MY concern with their opinions goes only so far as to make me wish I could tell who they are in real life so I could avoid having any member of my family see them as a patient.
 
Why don't you look up the definition of stereotype, k?

Merriam-Webster's Medical Dictionary:
Main Entry: stereotype
Function: noun
an often oversimplified or biasedmental picture held to characterize the typical individual of a group

illegallysmooth said:
I just think you must be horribly self-absorbed, superficial elitists who clearly want prestige and don't give a *hit about bettering health and prolonging lives.

You should stick to telling us about your near-genius IQ and how that landed you in a school you are apparently defensive about.
 
MY concern with their opinions goes only so far as to make me wish I could tell who they are in real life so I could avoid having any member of my family see them as a patient.


Hence the whole "near-genius IQ" tirade.
 
Merriam-Webster's Medical Dictionary:
Main Entry: stereotype
Function: noun
an often oversimplified or biasedmental picture held to characterize the typical individual of a group



You should stick to telling us about your near-genius IQ and how that landed you in a school you are apparently defensive about.

You don't see how that word doesn't apply here? Let me explain. What I described was not an often oversimplified picture of any typical group (i.e. races, genders, lawyers, etc.) "People who claim they want to be doctors but wouldn't become doctors if they had to go to DO schools and only want to have the MD degree" is not a "typical group" that is "often oversimplified" or as any stereotype attached.

Secondly, I was responding to the person addressing Jagger and saying he's not intelligent enough to go to an MD school and further mentioned several DO schools that he deemed to be sufficient. Perhaps I should better explain the direction of my posts instead of expecting people to follow along.
 
MY concern with their opinions goes only so far as to make me wish I could tell who they are in real life so I could avoid having any member of my family see them as a patient.

You want to know so that, in the chance that they enroll this year, you can have your family members avoid them in seven years when they are able to practice independently?

Okay...............................
 
Hence the whole "near-genius IQ" tirade.

You're confusing two statements with entirely different objectives. Don't play if you can't follow along, boys and girls.

I wouldn't want any member of my family to see someone of the aforementioned group because I'd rather my family's physician be more concerned with helping people, curing disease - ya know, those sorts of issues.
 
You want to know so that, in the chance that they enroll this year, you can have your family members avoid them in seven years when they are able to practice independently?

Okay...............................


Did you seriously think I was making a request for information to be able to track them down in 7 years? Or are you just talking with no real point, responding seriously to a sarcastic comment and trying to come across as the more reasonable one here?
 
You don't see how that word doesn't apply here? Let me explain. What I described was not an often oversimplified picture of any typical group (i.e. races, genders, lawyers, etc.) "People who claim they want to be doctors but wouldn't become doctors if they had to go to DO schools and only want to have the MD degree" is not a "typical group" that is "often oversimplified" or as any stereotype attached.

Secondly, I was responding to the person addressing Jagger and saying he's not intelligent enough to go to an MD school and further mentioned several DO schools that he deemed to be sufficient. Perhaps I should better explain the direction of my posts instead of expecting people to follow along.

I can see why we were informed ahead of time about your near-genius IQ. We would never have guessed it otherwise.

The "typical individual of a group" does not mean the "individual of a typical group." Try taking a breath and re-reading that.

There is no book of pre-registered typical groups ready to be stereotyped. I can create a stereotype right now if I so choose. In fact, I am.
 
I can see why we were informed ahead of time about your near-genius IQ. We would never have guessed it otherwise.

The "typical individual of a group" does not mean the "individual of a typical group." Try taking a breath and re-reading that.

There is no book of pre-registered typical groups ready to be stereotyped. I can create a stereotype right now if I so choose. In fact, I am.

SERIOUSLY. Someone has the gall to come on here and tell another human being he isn't intelligent enough to go to an MD school, and I'm the bad guy for stating my IQ range along with the DO school I have chosen to attend? Do you see no flaw in reasoning here?
 
Game 1:

JaggerPlate v. AwakenedApollo
Winner: JaggerPlate

Game 2:

JaggerPlate v. Old Grunt
Game ended in a tie.

Game 3:

Old Grunt v. illegallysmooth
In progress. Please stay tuned.

Post game re-cap: It would be nice if we could get this thread back on topic.
 
You're confusing two statements with entirely different objectives. Don't play if you can't follow along, boys and girls.

I wouldn't want any member of my family to see someone of the aforementioned group because I'd rather my family's physician be more concerned with helping people, curing disease - ya know, those sorts of issues.

Post A: You going nuts.
Post B: Someone telling you that you are nuts.
Post C: You claiming you actually don't care all that much.
Post D: Everybody pointing out you being nuts.

This is the last post responding to you, I should know better than to argue with defensive crazies with illusions of grandeur.
 
You're just so ridiculously angry and being cruel to others who don't agree with you because you are relentlessly trying to justify your own decisions in your own mind.

It's like calling other people "snobs" and "prejudice" makes you feel like you're better, when all you want to hear is "I'm good enough, I'm good enough, I'm good enough." That's why you claimed that your GPA was a result of outward circumstances rather than admitting your own deficiencies.

Stop trying to justify your own life by criticizing others. For one, you do not have any reason to judge someone based on their own, personal decision making process. There are multiple reasons one is entitled to consider for not wanting to take a certain path.

In short, it is very obvious that your anger comes from your own deep insecurity.

You're going to be a D.O. OWN IT.

Oh, MY GOD.

There will always be snobs. There will always be people who care more about appearances and names than actual substance.

And there will always be people who care more about meaningful material -- who have the brains to make judgements and decisions about quality for themselves. I put myself in this category. I have a near-genius IQ but I've never gotten over a 3.5 ANY semester in undergrad or grad school. Why? I just didn't care to make the extra effort while I was working almost full time. I preferred to have a life outside school. Now, I prefer to pay less so I'm going to LECOM, the cheapest school I got into (instead of CCOM - the "approved" DO school according to someone here). What's right for one is not right for all.

People who allow prejudice (yes, it's pre-judging), rumor and ignorance to influence their impressions of medical schools and the doctors they produce are beyond hope, as far as I'm concerned. Snobs. You're just snobs, and no one likes you. If you'd rather NOT be a physician than have to be a DO, I pray to God I never have to work with you. I just think you must be horribly self-absorbed, superficial elitists who clearly want prestige and don't give a *hit about bettering health and prolonging lives. I predict you will regret your decision when you're wrist-deep in someone's colon someday.


Neither of us two groups are going to change our minds. Just call it a day?
 
Post A: You going nuts.
Post B: Someone telling you that you are nuts.
Post C: You claiming you actually don't care all that much.
Post D: Everybody pointing out you being nuts.

This is the last post responding to you, I should know better than to argue with defensive crazies with illusions of grandeur.

That's what I thought. Quit now.

My opinion is that anyone who would rather be a NON-PHYSICIAN than a DO is 1) A snob 2) has the wrong motivation to enter the field of medicine and 3) is not someone I'd want to take my family to.

And yes, it makes me angry to see someone make the outlandish statement that one person is more intelligent than another simply because of where he or she went to medical school. In my opinion, THAT is nuts.

If anyone is having illusions of grandeur, it's anyone who thinks that being an MD means you're more intelligent than any DO.
 
SERIOUSLY. Someone has the gall to come on here and tell another human being he isn't intelligent enough to go to an MD school, and I'm the bad guy for stating my IQ range along with the DO school I have chosen to attend? Do you see no flaw in reasoning here?

I'll go out on a limb here and say you won't have to worry about me treating you or your family. I have no desire to go into psych.
 
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