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Thoughts on Osteopathy?

Discussion in 'Medical Students - MD' started by Dr. Nick, May 28, 2002.

  1. Dr. Nick

    Dr. Nick Senior Member
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    You guys should come over to the Osteopathic board and read about some of the stuff that is being taught in Osteopathic schools! As an MD student I found it very surprising.

    Check out the threads about craniosacral teachings - wow, that is some iffy stuff.

    I'm curious what other allopaths think?
     
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  3. Stillfocused

    Stillfocused Senior Member
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  4. Ice Man

    Ice Man Member
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    Stop being inflammatory and wait until the research is done before we set our opinions. We don't have a CLUE about OMM. Unless you or I can produce some research refuting this "iffy" stuff, or they can give some research backing it, then accept that they have the right to practice manual medicine. I know that anecdotal evidence means nothing, but if it is just placebo effect the patients seem to like it. The research is being done, now. Just wait for the results.
     
  5. Stillfocused

    Stillfocused Senior Member
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    <a href="http://www.healthsciences.okstate.edu/college/fammed/mills-omt/overview.htm" target="_blank">http://www.healthsciences.okstate.edu/college/fammed/mills-omt/overview.htm</a>
     
  6. ckent

    ckent Membership Revoked
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    I see that you have been busy making a lot of "friends" in the osteopathic forum Dr. Nick. I am an MD student and I happen to be a frequent reader of the osteopathic forum too, and I have also been reading your posts in the osteopathic forum for a while now with some amusement. I don't know why these guys are so upset at you, I didn't read anything that you wrote that sounded too antagonistic, but then again maybe I didn't read it all.

    I actually wasn't too clear on what a DO was either until I started frequenting this internet forum a couple of years ago. I do wonder about those that claim that DO's have a more "holistic" approach then MD's; I've never heard any of my professors tell us to "just treat the symptoms and ignore the cause", but I'm only a second year so maybe we will get more of that when I start my rotations soon :rolleyes: . Some of their OMM techniques do sound a bit sketchy too, and I also wonder about the "science" behind some of their philosophies. I understand that research is not as heavily emphasized at some DO schools, which is a shame because I think that even if you are going to be a family practioner in rural USA, you will still need to be able to understand and evaluate the research that is constantly being spun out of medicine. I definitely don't think that it is good just to train students to use anecdotal evidence to "prove" something, and to accept things because that's just the way that they are. Those are just my thoughts on their philosophies though.

    As a career, I do recommend people to try to pursue the DO route since I have learned more about it and if they were having trouble getting into an MD school. It seems like after medical school, the differences in what you do on a daily basis all go away. I wouldn't recommend it to anyone as a first choice though, as many in the DO forum frequently say that it was for them. The main reasons for this are because barriers to get into some specialties still do seem to exist, and I think that a lot of them are wasting their time learning OMM and having to take the COMLEX too.
     
  7. Ice Man

    Ice Man Member
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    ckent, I think you are right about what you say. I am also an MD student MS-3. However, I have a few friends that are in DO school now and have a friend who is a DO now. They don't even believe in a lot of the stuff they do, but there has to be some clinical trials done. They are in the process of doing them now. We are people of science, MD's and DO's. Bashing what they do, or mostly don't do, does nothing but get our equals mad at us. We may have to work with or for a DO some day. Since they are competent doctors I think we should let it lay. They will produce the research that will either be for or against OMT and I think they will adjust (or MD schools will adjust) accordingly.
    Also, I am glad that Dr. Nick is challenging the idea's of Osteopathic Medicine. They need to get going on their research. Who knows if their is no EBM in a couple of years 3rd party payers may not pay for OMM treatments. What would that make them? Us
    BTW if a DO really wants MD behind his name, I'm sure there is some Foreign school that would love to take 50k to do it. Just kidding.
     
  8. Castro Viejo

    Castro Viejo Papa Clot Buster
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    I'm sure some of the seasoned osteopathic medical students who have researched OMM and related therapies can shed better light on this, but from what I've read, research into the efficacy of OMM has been going on since as early as the 1940s. The problem then, as is the problem today, remains the same: it is difficult to standardize OMM practices. Whereas we in the allopathic world can speak of giving a patient X mg of a certain drug, and that is surely reproducible across all MDs/DOs, the osteopathic researchers have trouble doing just that. You can't have a practitioner deliver, say, an exact amount of "force" in an OMM maneuver. There are other issues involved, I'm sure, but standardization has always been among the most prominent.
     
  9. psyche

    psyche Member
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    Just a note on the use of the term allopaths to describe conventionally trained physicians, a usage which now seems to be accepted uncritically everywhere. The term is largely an invention of homeopaths who wanted to distinguish themselves from mainstream physicians in the 19th century. "Homeo" means same; and homeopaths
    believed in administering small doses of a remedy that would in normal persons produce the same symptoms of the disease. To contrast themselves with orthodox physicians, homeopaths came up with the term allopath. "Allo" means different and, at least according to homeopaths, conventional physicians believed in giving remedies that would in normal persons produce symptoms different from that of the disease. Of course conventional physicians believed no such thing. The term then encompasses a criticism of mainstream medicine which happens to be off-base. Osteopaths resuscitated the term to contrast their philosophy with that of conventional medicine some time ago. No dictionary I've consulted includes the term. Using it gives it a validity it has never earned.
     
  10. MOZ

    MOZ Member
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    osteopathic research has been going on since the 1940s as the previous poster suggested. kim korr and sted denslow were the primary researchers in that era. their work focused primarily on emg's and muscle physiology if i'm not mistaken. a more recent paper published in jama suggested that omm worked just as effectively as conventional treatment of low back pain, except that omm cost less. more research will come when the osteopathic research center gets going. as an osteopathic student and one that has undergone omm treatment many times, i have no doubts about its effectiveness.
     
  11. jrich15

    jrich15 Member
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    Webster's II New Riverside University Dictionary Copyright 1984, 1988: Allopathy-Therapy or treatment of disease with remedies that produce effects differing from those of the disease treated.-allopathic adj.
     
  12. double elle

    double elle Senior Member
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    Hi all! I am a first year at KCOM and thought I'd respond.

    I love OTM. If you've ever had a vertebrae our rib 'out' and had it treated in about 20 seconds, you'd love it! It's almost instant relief. There are some other techniques we learn for soft tissue, muscle, fascia, etc that are really good at simply making a person more comfortable until the underlying problem can be figured out. I my opinion, that's what it's all about.

    NOW, there are some 'do-do-do-do' (twilight zone) techniques that I am NOT fond of. However, I simply will choose not to use those techniques. It is supposed to be thought of as the 'foundation' of osteopathic medicine. The skill upon which the profession was founded. I find that is only true to an extent. I mean, if we could treat everything with palpaption, why the hell did I have to take biochem??

    I think of OTM (OMM, whatever) as an additional service I can offer to my patients. Nothing more, nothing less. If it relieves pain, muscle tension, etc...then it's worth it. If I can help with lower back pain and wean someone off the painkillers, that's great.

    There are some OTM gurus who think OTM can cure anything. They could be right, but we don't know that for certain yet. You are absolutely right about the research aspect with regards to OTM techniques. Not enough has been done, especially with the cranial techniques. However, I will give it all a chance. You never know when it will come in handy.

    I agree with your thoughts that alot of people choose DO schools as a last resort. And it shows in their attitudes towards OTM. I think that's sad. There are some really cool OTM techniques that would amaze you. Actually, you can be taught really easily.

    Anyway, I just thought I'd say that a lot of the DO students out here realize that OTM has its limitations. It's just nice to know that sometimes there are MD's out there who realize the flip side...that OTM has its advantages, too.

    Lastly, when I clicked on the topic to read this, I thought I was going to read a bunch of DO bashing and such. I was happy that wasn't the case.

    You all have a great summer! We, here at KCOM, only get a week off and then we have summer quarter!
     
  13. psyche

    psyche Member
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    jrich15:

    O.K., you got me. Your particular dictionary has the definition. Mine doesn't, though. But more importantly, look at that definition. I'm willing to bet if you told any M.D. that they provide "treatment of disease with remedies that produce effects differing from those of the disease treated," you'd get some pretty funny looks. Allopathy as a concept is complete bunk, made up by those with an axe to grind.
     
  14. jrich15

    jrich15 Member
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    Psyche,
    I agree with you that it doesn't mean anything anymore. At the time it was "coined" medicine in general was not scientific. Today there is really very little difference b/w the two (osteopathic and allopathic). The difference is greatest between individual practicioners not whether they are DO or MD.
     
  15. psyche

    psyche Member
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    I agree...the two are converging. That seems to be the dilemma facing osteopathy. How does it carve out a niche in the medical profession if its evolution moves it closer and closer to conventional medicine? And saying that osteopathy is distinctive because it provides more holistic and patient-centered care is intellectually dishonest because conventional medicine has been moving in that direction for some time. I actually think D.O's are every bit as competent as M.D's; it just seems that the growing prominence of osteopathy is due more to how inordinately difficult it is to get into med school and not so much the appeal of its philosophy.
     
  16. jrich15

    jrich15 Member
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    Once again I agree. I applied to both DO and MD. I looked at the quality of ed provided,if the school was a fit, and residency match list. I don't feel going to a DO school will make me a more patient oriented doctor or attending a MD school will make me less. My personality determines that. As far as the increase in DO numbers go, I feel this is related to three things: One is the difficulty in gaining acceptance into MD programs, Second is the increase in awareness of premeds about the DO route, and third is the increase in difficulty for FMG getting residencies in the US. This is just my opinion.
     
  17. dkwyler94

    dkwyler94 Senior Member
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    As a student at KCOM, I found this thread rather interesting. It seems that many of the same comments you hear around the halls of KCOM is what has come to light in this thread concerning the research.
    There was research done into OMM as early as the 1940s that I am aware of; however, as far as I could find little has been done since this time. DOs felt that it worked, research had been done, and they didn't need to do any more research. This is where Osteopathy finds itself now. Trying to hold on to its last bit of distinctivness, OMM, with 60 year old research.
    To their credit, they have recognized this, and at least at my school there are several different studies currently being worked on and each school magazine lists more grant proposals for more research. I am very interested to see what these studies will proove.
    I knew nothing about OMM before I came to school here. After working in a hospital for several years, and noticing no differences between the DOs and MDs, I just assumed that it was a historical footnote. I'd heard the did OMM, but none of the docs I knew did.
    My observations in coming here is there seems to be two parts of OMM. The part treating the musculoskeletal system, and the part treating visceral problems through reflex arcs triggered by treatment of the musculoskeletal system. I was surprised of how similair the first part was to what I had seen PTs doing.(I was trained as a PT tech so have some experience with them). I think very few people would have a problem accepting this. These are the areas LL discussed above.
    The second part seems a further stretch for me and one of a fair amount of debate even at KCOM. All I can say is what many of you said. Wait for the research. If it indicates its beneficial, I'll use it. If not, I won't. Until then, I might use it if nothing else works and just not charge them.
    Cranial is another area all together. One I am very skeptic of and one I think few DOs accept or utilize from what I am hearing.
    But if I don't get back to studying for my final, I won't be using it or anything else to do with medicine.
    Oh, and to Dr. Nick who started this thread, it seems a little inflammatory to me. Fortunatly, it seems like most everyone who read it recognizes in the end, we are eventual colleagues.
     
  18. oceandocDO

    oceandocDO Senior Member
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    I'll throw my $0.02 to this topic which was an obvious attempt to stir up this stale debate and beat a dead horse a few more times. I'm a first year at NYCOM. I too was skeptical of OMM when I got here, but my confidence has increased, and I'm a hard sell. Most of it is first hand experience seeing patients with Parkinson's, disc problems, emphysema, etc show dramatic improvement with these treatments. However, much of it's efficacy is in the hands of the provider. It's not a drug you push or a strict protocol you follow. It's an art, an acquired trait, like a cardiologist's ausculatory skill or a surgeon's suturing. Cranial techniques may be garbage, but there are countless "cures" in medicine which have not been proven in the scientific sphere. Many argue how a lot of anti-psychotic drugs actually work, but they do. Many even argue how the birth control pill actually works, but it does. Evidence based medicine can be debated, but patients LINE UP for these treatments by the thousands. And actually, there is proven science behind a vast majority of OMM. The field of physical therapy would not exist today as we know it without the foundations of OMM! MDs will send their patients to a PT in a hearbeat, but will they ever refer their patient to a DO for the same relative treatment?

    Besides the arguement on it's efficacy, I have found the extra anatomy, physiology, and biomechanics training that OMM has afforded me has helped tremendously in all areas of my medical training. IMO, DOs have much more instinctive abilities to visualize joint articulations, muscle attachments, pulmonary action, and overall musculoskeletal function. I'm definitely not saying MDs lack this ability, but who can argue that this training doesnt add something to the curriculum? DOs are used to touching people, and patients love this. We don't get to third year and freak when we have to palpate someone. On paper, a DO education really is the finest collection of all mainstream and "alternative", yet proven, medical curricula. How many MD students would like an additional 200 hours of class their first two years? Hmmmmm.... <img border="0" title="" alt="[Wink]" src="wink.gif" />

    The fact is, the number of DOs have doubled in 10 years. Two new schools are accepting their first classes in the coming year or two, one at Virginia Tech and another in Utah. DOs will never be the majority. That's not the goal or the ideology, but the profession will be a force to be reckoned with. All it takes is time and public awareness, which is slowly increasing. This summer the Smithsonian is supposed to have an exhibit dedicated to osteopathic medicine and PBS is due to run a special on it's history and it's future. While the field may be more mainstream today than 50 years ago, medicine as a whole is going through a bit of a metamorphosis and while a complete merge is not warranted, there will have to be an equal melting of ideas and techniques, for patients are starting to demand it.
     
  19. Bradleyp

    Bradleyp Senior Member
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    Like my post in a previous thread, medicine (ie medical education) is what you make of it. DO and MD schools use mostly the same textbooks and learn in much the same manner and it is up to you how much you get out of it. Although I think many OMTs are really benefical most DOs don't use them in private practice, a shame. I do however think idea of DOs providing more holistic care, compassionate care or patient oriented care is also ridiculous (although it looks good on paper). I probably will end up going to a DO school, but an MD I work for is about the most caring doc I have ever known. The amount of true care or compassion provided by a doctor cannot be taught by a PhD in a classroom, nor can it be learned. We are going to encounter good and bad MD and DO physcians in our medical education and practices. I agree with previous posts that DO schools need to focus more on research, but most MDs and DOs in private practice have nothing to do with research, they simply dont have the time.
     
  20. jabroni108

    jabroni108 Member
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    i am going to DO school in the fall. one reason is that i hate research. i work in cancer research now and i cant wait to leave. you stare at test tubes all day and you work for 10 months hard and you just might get a positive result. however, there are some DO's starting to do research at the facility; which, proves (to me) that the DO-MD realms are fusing. You will have some jackasses that say DO's are stupid. fine. All i know is that one day i wont have to do research and I can be a doctor. bye.
     
  21. OsteoMed02

    OsteoMed02 Senior Member
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    OceanDocDO,

    I just wanted to thank you for the incredibly informative and positive post. I'm going to be a first-year D.O. student in the fall and I couldn't be happier with my choice. I'm excited that I'll be learning traditional medicine in addition to the OMM. I shadowed a physician who practiced this specialty and the way he worked his hands on his patients was amazing. What was even more amazing was the increase in mobility and positivity in each patient as well. For more info on osteopathy, I'd recommend that people read "The D.O.'s" by Norman Gevitz. I don't think osteopathy gets enough recognition and with the shifting medical paradigms of today, it may very well be the refreshing approach that many are searching for. <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />
     
  22. droliver

    Moderator Emeritus 10+ Year Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by oceandocDO:
    <strong>. Most of it is first hand experience seeing patients with Parkinson's, disc problems, emphysema, etc show dramatic improvement with these treatments. However, much of it's efficacy is in the hands of the provider. It's not a drug you push or a strict protocol you follow. It's an art..</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">It's definately not science. And explain to me exactly how emphysema & Parkinson's are treated by this?

    <strong>. Many even argue how the birth control pill actually works, but it does...</strong>[/QUOTE]

    The OCP mechanism of action is pretty straight forward. No debate I've ever heard

    <strong>. Evidence based medicine can be debated, but patients LINE UP for these treatments by the thousands. And actually, there is proven science behind a vast majority of OMM. ...</strong>[/QUOTE]

    Thousands of people also call psychics on 1-800 numbers. Evidence-based medicine is the standard we strive for in western medicine. I'm not sure that OMM has many foundations for some of its claims in credible peer-reviewed publications

    <strong>.The field of physical therapy would not exist today as we know it without the foundations of OMM! ...</strong>[/QUOTE]

    This is a pretty broad statement as PT has evolved from a synthesis of ,nursing,anatomy, physiology, orthopedic surgery, plastic surgery, gerentology, and a number of other fields

    <strong>. IMO, DOs have much more instinctive abilities to visualize joint articulations, muscle attachments, pulmonary action, and overall musculoskeletal function.</strong>[/QUOTE]

    IMO lack of anatomic knowledge and understanding of resultant pathophysiology is endemic to both DO & MD practictioners that do not get to visualize & palpate these structures directly. This would pretty much include all non-surgeons.

    <strong>. On paper, a DO education really is the finest collection of all mainstream and "alternative", yet proven, medical curricula. </strong>[/QUOTE]

    In reality, many osteopathic schools struggle to provide adequate preclinical & clinical exposure for their students as compared to their allopathic peers.This is not to say that you can't go this route & end up an excellent doctor, but I can't see how you can look @ the oppurtunities offered to the two groups and equate them
     
  23. oceandocDO

    oceandocDO Senior Member
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    Alas! We have our first anti-DO "I'm better than you" member of the club. Welcome. You're knowledge is lacking.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> It's definately not science. And explain to me exactly how emphysema & Parkinson's are treated by this?
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I wont go into depth, but the science to most of the muscular aspects of OMM revolves around well documented muscle spindle (flower spray, nuclear chain) and golgi tendon receptors and their relaxation or stimulation. It's basic muscle/nerve physiology. Read up on it. Parkinson's is treated with various muscle energy, counterstrain, FPR, etc techniques to release hypertonic muscles and hence provide relief from involuntary, sometimes spastic movements. It's not a cure, but an improved quality of life. NYCOM has one of the larger Parkinson's research centers in the country. Dr. E. Fazzini, a neurology professor at NYCOM, and head of Parkinsons research at NYCOM, and at NYU, is a DO. He sees more Parkinson's patients than any other doctor in the world, including Michael J Fox supposedly. Dont know how much he uses OMM himself, but I know many of the docs under him use it.

    Emphysema can be aided with the help of techniques to decrease the A/P size of the chest. Again, muscle energy can be used to relax hypertonic inhalation muscles. Once the ribs are brought out of their exhalation restrictions, the person has an easier time getting rid of air. Again, not a cure, but patients do see greater expiratory volumes and hence better blood gases.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> The OCP mechanism of action is pretty straight forward. No debate I've ever heard
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">No, actually, there is some debate out there as to the actual mechanism by which the pill avoids pregnancy. A recent examples of debate: DeCook JL, McIlhaney J, et al. Hormonal Contraceptives: Are they Abortifacients? (Sparta, MI: Frontlines Publ., 1998). You explain to me your theory on it's efficacy and I'll give you another.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> This is a pretty broad statement as PT has evolved from a synthesis of ,nursing,anatomy, physiology, orthopedic surgery, plastic surgery, gerentology, and a number of other fields
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Yes, it may be broad, but your statement is even broader! My point was that PTs use many of the same techniques that DOs use, which DOs created, but PT is accepted by the medical community as "mainstream" and OMM is not.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> IMO lack of anatomic knowledge and understanding of resultant pathophysiology is endemic to both DO & MD practictioners that do not get to visualize & palpate these structures directly. This would pretty much include all non-surgeons. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Wrong again. I guarantee you, the extra 200-300 hours of class time a DO student receives in those very concepts will enable him or her to avoid this epidemic. I guarantee you, walk up to a second year MD student and ask him/her how many articulations are on a rib, or what direction does the spinous process of T10 face? Not too many would know. I'd put money that 3 out of 4 DO students would.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> In reality, many osteopathic schools struggle to provide adequate preclinical & clinical exposure for their students as compared to their allopathic peers.This is not to say that you can't go this route & end up an excellent doctor, but I can't see how you can look @ the oppurtunities offered to the two groups and equate them </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Are you kidding me?? This is the most absurd of your ill-informed statements. I will be doing rotations in third and fourth year right next to MD students from various NY schools. As far as preclinical education, how many ways can you teach biochemistry, anatomy, and physiology? We all stare at Netters and sleep on Robbins. We're both taught by some MDs, PhDs, DOs or the like. We take your boards and do just as well on them. Opportunities may not be equal for a Harvard grad and a DO grad (although, NYCOM did send 3 grads to Harvard this year), but in most areas a DO can do anything and go anywhere. Research may be more pronounced at MD schools, but most DOs go into medicine for the love of patient contact, not to sit in a lab. Different strokes for different folks. If you don't understand this, I wouldnt want you as my doctor.

    The defense rests. In all honesty, I assume you are a great physician, but one who hasnt yet opened your eyes or ears. Please go back to staring at the letters after your name, just like some schlep from some school in the Bahamas does.
     
  24. migraineboy

    migraineboy Member
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    Droliver - I must also disagree with your broad statement that osteopathic programs struggle to provide adequate pre-clinical and clinical education to their students. We utilize the same educational resources as our allopathic counterparts. There are not special color-by-number, pop-up editions of Harrison's, Schwartz's Surg, or Tintinalli. And the NEJM and Mayo's Clinic Proceedings that are delivered to my door are the same that are delivered to everyone else. As far as clinical exposure, I spent my third year in smaller osteopathic community hospitals while my fourth year was spent at larger allopathic hospitals. While the scope of pathology is reduced at these smaller AOA hospitals, the amount of hands-on experience and responsibility offered is tremendous. With few, if any, interns and residents present, we were expected to function in an "intern-like" fashion early on. Coupling that with constant 1-on-1 interaction with the attendings made for a fantastic educational experience. My rotations at larger allopathic institutions did not provide near as much teaching or responsibility. I feel your comment is as unfair as it is untrue. Just my thoughts....
     
  25. Bradleyp

    Bradleyp Senior Member
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    This is an argument that goes on and on, it has been dicussed in much more scholarly circles than the the SDN website, lets give it a rest already. DOs and MDs are both practicing physicians in all, yes all, specialties. Many prestgious physicians are MDs and many are DOs. DrOliver's comments are a joke and an insult to our intelligence, it is easy to criticize a field you are not a part of and really don't know much about. Only those who are osteopathic physicians are qualified to judge osteopathic medicine, the same for allopathic medicine. Both are instrumental in our health care system as it exist today and will be far into the future.

    It's hard to make an intelligent comment with this avatar.
     
  26. Jersey Girl

    Jersey Girl Member
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    I would just like to add that I strongly agree with the statement made about Physical therapy and OMM. I have read Norman Gevitz's "The DO's" as well as other books on Osteopathy. It seems to be generally accepted knowledge that OMM and the techniques used by physical therapists are very much alike. Norman Gevitz explains that when OMM was in its early stages, it was used to help set broken bones and restore use of broken limbs. These are some of the same reasons a patient sees a physical therapist today.
    Also, it is very untrue that osteopathic medical schools have difficulty providing their students with clinical exposure. NYCOM for example, has over 18 hospital affiliations throughout out the Bronx, Brooklyn, Manhattan, and North Jersey. Many which are very prestigous hospitals such as Newark Beth Isreal, and Long Island Jewish Medical Center. I just wanted reiterate how ignorant that post was.
     
  27. Stillfocused

    Stillfocused Senior Member
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    Not go to far a field here, but dkwyler94 said:

    My observations in coming here is there seems to be two parts of OMM. The part treating the musculoskeletal system, and the part treating visceral problems through reflex arcs triggered by treatment of the musculoskeletal system.

    Do PTs treat Systemic Dysfunction with manual therapy? Not that I have seen. Yikes! Since they legally cannot diagnose.

    Someone please correct me if I am wrong here but I understand that PTs do practice some manual techniques that are based on Muscle Energy (basically stretching) and they call it PNF (proprioceptive neuromuscular facilitation) or "contract relax" techniques.

    They may also use something a bit like Strain/Counter Strain. I know that some PTs may also learn some basic HVLA.

    However, I understand that the scope of manual medicine as taught in COMs (FPR, BLT, Myofascial Release, OCF, Chapman?s Reflexes, etc.) is far broader than what is taught in PT school and is intended to address more than musculoskeletal rehabilitation.

    I think that it is inaccurate to say that ?OMT basically the same thing as PT.?
     
  28. oceandocDO

    oceandocDO Senior Member
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    No, OMT is definitely not the same thing as PT, but both rely on similar musculoskeletal principles. PTs dont diagnose but their goal in treatment modalities is to increase healthy function of dysfunctional musculoskeletal injury. My point, and I imagine the point of other posters as well, was to merely point out that most MDs wholeheartedly believe in PT, but many are very skeptical of OMT. Is this logical? Most disbelieve OMT because they are told to do so or dont know anything about it, hence they discredit it in some overly defense mechanism (ala droliver above), not for scientifically based reasoning.

    Jersey girl, to avoid confusion, OMT is definitely not used any longer to set broken bones. There may have been some element 100 years ago where this was used by DOs, but not any longer. Much has changed. (An aside, remember, 100 years ago MDs used to use leeches to "cure"). OMT can be very useful in obtaining full range of motion back, however, after the bone heals.
     
  29. Dr. Nick

    Dr. Nick Senior Member
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    Stillfocused,

    "Troll," huh?

    Don't you think you owe it to your patients to expose ALL of your practices to the widest possible scrutiny?

    Dr. Nick
     
  30. jimdo

    jimdo Senior Member
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    Im a 4th year DO student and am happy to provide a perspective as such. Most of the posts by my field here come from 1st and 2nd DO students. They make some valid points but their perspective may be limited to the small clinical exposure that they have had. I would be thrilled to answer any questions here about the DO realm, the practice (or should I say the overwhelming nonpractice) of OMT, the fact that only a small number of DOs feel that OMT is what makes one a DO and how MDs have responded to me at teaching institutions. There is much more to a DO than OMT. To assume that being a DO must mean you support OMT is flat wrong. Also, if one doesnt support OMT, he is not any less of a DO. These are common misperceptions that my colleagues at earlier levels may or may not believe.
     
  31. brandonite

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    I have always been very skeptical about OMM... It sounds dangerously like chiropractics to me, which I have little respect for.

    Can one of you DO's or pre-DO's send me a reference to a peer reviewed article in some sort of reputable journal? I do have an open mind about this sort of thing, but I can't just believe on blind faith.

    In terms of osteopathy in general... Well, I like ckent and a few others have mentioned, I am a little unsure as to what exactly it was in the MD cirriculum that means that we no longer look after patients, and instead focus on the disease... :rolleyes: I mean, it is fine to talk about the need to treat the patient as a whole, but how exactly do MD's not do that? And what is it specifically about the DO profession that makes it so special in this regard, other than the usual catch phrases about treating the patient, not the disease, etc...?

    Again, this post is not meant to be inflammatory, but I am just trying to understand...
     
  32. The thing is, there really isn't that much of a difference between an MD and a DO today, like there was over 100 years ago. That is part of the current identity crisis. Today, here DO's are with different letters behind thier name, when in reality, DO's and MD's have become very alike over time. So should the difference in lettering exist? I am not saying it shouldn't, I am just bringing out the question. I know a while back, DO's were very different from MD's. 100 years ago, treating the whole person was a novel approach to medicine. Many MD's have actually become osteopathic over time, because they have adopted the whole person approach as well. Yes, MD's do treat the whole person now. 100 years ago, medicine was very different, the whole person approach was novel. So now we have DO's in practice who don't use OMT to a very large extent, and a large number MD's in practice who are being very wholisitic in treating their patients. They have become like one another. So when MD's and MD students sit here and bash DO's, they need to be careful. Because a DO isn't all that different from themselves.
     
  33. jimdo

    jimdo Senior Member
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    brandonite,
    I have only one more year until graduation from a DO school. I currently train at Henry Ford Hospital in Detroit which is a large and respected tertiary MD institution. I myself wondered before coming here how much of an actual difference there was between the MD and DO and to my surprise I have found very little. Granted, there is a small and decreasing fraction of DOs and trainees that wish to emphasize the differences, but the vast majority finds it tiresome and unproductive. OMT may be one of the standards that is used to differentiate us from the MD, but there is little substantive data to support or refute its effects. Consequently, fewer and fewer of us are willing to use it regularly for anything more than physical therapy or symptomatic relief until proven otherwise. Research is ongoing though so stay tuned.
    As for the comments often used such as MDs becoming more "osteopathic", I am troubled by them as I would be if one said DOs were becoming more allopathic. I understand the tendency to use these descriptions and what is intended by them, but it may be better to say that the MDs and DOs have met somewhere in the middle. It would seem to be kinda insulting to tell someone of a profession that they were becoming more like those of another. Rather, in order to get the same point across, why dont we leave it at we are in fact meeting in the middle in both philosophy and practice. I say this as a proud DO who has immense respect for both my DO and MD colleagues.
    I agree with the previous post in that the past tells the story. Years ago moreso than today, there was a tendency for MD training to focus on localizing the disease process, attacking it and trying to cure it. DOs took a different angle and looked to health as the answer. Rather than using stuff like meds to accomplish their effect, they felt that enabling the body to fight its own battles was the best approach and shyed away from direct intervention. Over time both MDs and DOs saw the flaws in their limited perspectives and began to drift toward one another. MDs began to recognize that the body itself is better at fighting off an invader or healing itself of a condition under optimal circumstances than any medicine could be. DOs realized that it was absurd to think that the body could cure itself entirely of any problem without the aid of medication and/or surgery. Therefore, over time, the two fields have drifted together to the point that very little is distinguishable between them other than historical origin and philosophy of training.
    I cant speak to how MDs are trained because I have never been trained as an MD. I can speak as to DO training. The first two years are probably identical to your training with Biochem, Anatomy etc except that we receive little training in research protocol and statistics. Instead we are trained in this thing called OMT which for many of us the jury is still out. I applaud your openmindedness about it and wish I could be more helpful to you on that area. The third and fourth years are identical to yours as they are our clinic years. We can enter any specialty area from FP to Neurosurgery and often train in your residency programs due to lack of space in our own. The best I can say is that perhaps our philosophy of training is emphasized more on the maintenance of health and the freeing up of barriers that may slow the body from healing itself. After all, there is no physician in the world that can heal a patient. It is the patient himself that heals, our job is to give them the tools and enable them to heal most effectively. But again, MD training may now support this philosophy too, I dunno. But Im told in the past it had not emphasized it.
    I hope that in some way this has helped. I have meant no disrespect to anyone here and am happy to answer any questions. I plan to enter neurology so I can entertain any question in that area as well.
     
  34. Dr. Nick

    Dr. Nick Senior Member
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    Great post, Jimdo. I like your perspective.
     
  35. drusso

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    OMT research is evolving. Today there is little hardcore evidence-based medicine to support a majority of OMT practices, but there are a few randomized controlled trials, many case reports, and wealth of anecdotal evidence. All science begins with observation.

    Osteopathic manipulation intellectually and historically predates chiropractic. The founder of chiropracty, visited the first osteopathic school in Missouri in the 1800's, took classes, dropped out, and founded his own school across the border in Iowa. Hence, chiropractic has always been viewed as "incomplete" from an osteopathic perspecitve.

    For Brandonite: The crux of osteopathic theory goes that by manipulating the musculoskeletal system (not just the spine, but the whole body) one *may* be able to exert certain physiological effects that help patients heal. For DO's, manipulation is just another modality combined with drugs and surgery, not a substitute.

    For example, I did my ICU rotation at an osteopathic hospital with a DO critical care specialist who used OMT from time to time in the ICU and in his clinic. A patient admitted to his service with respiratory failure would get all the standard ICU medical care (mechanical ventilation, pressors, invasive hemodynamic monitoring, etc) as well as OMT aimed to improve respiratory biomechanics. I'm not talking about the "crunching/cracking" OMT, but more gentle massage-like modalities to help relax respiratory muscles and increase thoracic cage compliance, etc. His patients did just as well as anyone else's. I do know that after an OMT treatment, patients looked more comfortable on the vent...tidal volumes seemed to increase a little bit too. There's no RCTs available to address this question, but that is an example of how DO's use manipulation AND medicine together to try to improve patient outcomes.
     
  36. Posted by JimDO

    "why dont we leave it at we are in fact meeting in the middle in both philosophy and practice"

    This is exactly what I was trying to say. Thankyou for clarifying my post, and making it more clear.
     
  37. jimdo

    jimdo Senior Member
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    Good posts here today. Glad I could contribute.
     
  38. tplacke

    tplacke Junior Member
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    Brandonite, if you're looking for a peer reviewed article just pick up any issue of the Journal of the American Osteopathic Association. Yes, they may be a little biased, but no more than an article in JAMA.

    There was an excellet study several months back that examined OMT + Medications, OMT alone, and Medications alone as therapies for back pain. The greatest benefits (patient's self reports of pain relief) were achieved with the combined therapies of OMT and perscription medications.
     
  39. pharmer

    pharmer Senior Member
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    I am applying to medical schools this year and my preference is to attend an allopathic school, but I am curious to find out as much about osteopathic medicine as possible. After reading this thread I was a bit suprised the statement made by brandonite did not come up earlier. What is the difference between OMT (OMM) and the "adjustments" that chiropractors make? Are some of the same techniques used by both or are they completely different? It seems to me that they are both based on the same line of thinking.
     
  40. Darth Vader

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by pharmer:
    <strong>I am applying to medical schools this year and my preference is to attend an allopathic school, but I am curious to find out as much about osteopathic medicine as possible. After reading this thread I was a bit suprised the statement made by brandonite did not come up earlier. What is the difference between OMT (OMM) and the "adjustments" that chiropractors make? Are some of the same techniques used by both or are they completely different? It seems to me that they are both based on the same line of thinking.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">This topic is being discussed ad nauseum here:

    <a href="http://forums.studentdoctor.net/cgi-bin/ultimatebb.cgi?ubb=get_topic;f=4;t=002957" target="_blank">http://forums.studentdoctor.net/cgi-bin/ultimatebb.cgi?ubb=get_topic;f=4;t=002957</a>
     
  41. Don't refer him to that board. I don't think he will get a true and accurate answer at that forum. Many in that forum are chiropractors trying to put a weird twist on Osteopathic medicine. Maybe JimDO, or another DO can better address the question in this forum. I don't think very much has come out of that forum despite it's incredible length.

    JimDO, I have a question for you. Have you noticed discrimination as a DO now that you are further along in the process? I sense alot of tension between the first and second year MD and DO students on this network. Is it is bad as it can seem on these forums? Or is discrimination not really a big factor once you get out?
     
  42. Zeffer

    Zeffer "My dog ate em. I swear thats the truth!"
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    Last night I had the opportunity to work with a D.O. doing a Peds residency. The D.O. seemed to function exactly as all M.D.'s. So my question is this:
    Why have so many D.O.'s if they practice the same way M.D.'s practice?
    Earlier on this board someone mentioned that we could do with fewer D.O. schools if they were to serve only those interested in practicing D.O. teachings fully.
    So my only conclusion to my question is that since the D.O. schools have lower MCAT and gpa on average many students who don't feel they would be successful in the Allopathic application process apply D.O. Not because they believe in the D.O. philosiphy, but rather so they can become a doctor.
     
  43. drusso

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Zeffer:
    <strong>Last night I had the opportunity to work with a D.O. doing a Peds residency. The D.O. seemed to function exactly as all M.D.'s. So my question is this:
    Why have so many D.O.'s if they practice the same way M.D.'s practice?
    Earlier on this board someone mentioned that we could do with fewer D.O. schools if they were to serve only those interested in practicing D.O. teachings fully.
    So my only conclusion to my question is that since the D.O. schools have lower MCAT and gpa on average many students who don't feel they would be successful in the Allopathic application process apply D.O. Not because they believe in the D.O. philosiphy, but rather so they can become a doctor.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Why wouldn't a DO function exactly like a MD? What did you expect to see different? Many students apply to both DO and MD schools because they are both routes to the same end. This doesn't mean that these students don't believe in the osteopathic approach to patient care. Why don't you ask your peds resident why he or she accepted admission to a DO school?
     
  44. dkwyler94

    dkwyler94 Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Why wouldn't a DO function exactly like a MD? What did you expect to see different? Many students apply to both DO and MD schools because they are both routes to the same end. This doesn't mean that these students don't believe in the osteopathic approach to patient care. Why don't you ask your peds resident why he or she accepted admission to a DO school?
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think this is true to myself and many others at my school. I just wanted to be a doctor. MD or DO. It doesn't really matter. In my 3rd and 4th year I will be trained by both MDs and DOs at the same institutions that train MDs. During my residency I will most likely be in programs with both MDs and DOs.

    I could have gone MD, but I decided to go to the best school I got into and that I thought I would like going to. My school has much of a feeling of comaraderie. Students are always helping each other out. I feel like I am friends with the majority of my class. I feel I am getting as good as an education as I would anywhere, and those who choose to take the USMLE from my school average above 80%-tile.

    Do I think going to a DO school is going to change how I practice. No, but I think the school fits me better than the MD schools I could have gone to.
     
  45. jackjinju

    jackjinju Senior Member
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    Hi Jersey Girl...how is Newark BI? I was thinking of applying there for residency. Anyway, I am not trying to upset anyone...I am a 4th year allopathic student and I have rotated with PCOM and LECOM students, and I feel that their 3rd year experience is adequate but not as demanding. PCOM students only do 4 week rotations in surgery and medicine (we do 12), as well as all for all other 3rd year rotations (which we do 6 weekers). Also, they only take exams for some of their 3rd year rotations, and they're school administered exams. I've taken a school administered exam and shelf exam for my surgery rotation, and I'll tell you that the school administered exams are JOKES compared to the shelf exams which are subject-specific board exams that we have to take for all courses.

    LECOM only takes around 2-3 exams for their entire 3rd year....I couldn't believe it! What cake! Plus to practice in many states you have to take an extra osteopathic internship year. That seems excessive, and almost makes one wonder if the 3rd and 4th year education is truly adequate. The students themselves were fine, I thought. I think DO students just get shafted, that's all. I think the DO schools should have more demanding 3rd years, and throw out the internship IMHO.
     
  46. Ice Man

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    Wow, you should be president of the AOA. The students would love you. It seems every DO student I have spoken with said that exact same thing about the internship year.
     
  47. As far as Newark BI, I can't tell you from experience because you are much further along than I am. I will be an MSI this august at NYCOM. However, I can tell you from living in NJ that Newark BI has a great deal of prestige and is known for being a very good hospital. It's one of NYCOM's major clinical campuses, I am hoping to eventually be there myself. Sorry I couldn't help more. Good luck.
     
  48. Noeljan

    Noeljan Senior Member
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    JimDO
    That was an amazing post:)
     
  49. docmanphilly

    docmanphilly Junior Member

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    Hey jackjinju ---

    GET YOUR INFO STRAIGHT!!!

    As a PCOM 3rd year I did 12 weeks of medicine, and 12 weeks of surgery over years 3 and 4. (Not to mention OB/gyn, ER, Medicine Sub-i, Family Medicine, Peds, etc.) These were not electives, they were required parts of the curriculum. As for exams, we do take an exam in our fourth year for our medicine sub-I. The number of exams and the number of weeks we spend on various services seemed equivalent (+ or -) to what my friends were doing in their various MD programs. <img border="0" alt="[Pissy]" title="" src="graemlins/pissy.gif" />
     
  50. jimdo

    jimdo Senior Member
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    Jerseygirl,
    Sorry it has taken so long to reply to your post. Ill do my best to answer your question. Since I have been training, I have noticed no difference between the treatment given to my MD friends and we DOs. Once you begin the third year of training, all of this "I'm better than you stuff" that both sides are guilty of in the first two years gradually fades away. That takes me to another point where the practice standard of DOs and MDs are virtually identical in the vast majority of cases. Why don't DOs distinguish themselves more? Simply put, there is no need to do so. Some of my colleagues will disagree, but it is evidenced by the VAST majority of DOs not using OMT regularly. Is that a good thing? I dunno, it's not really for me to tell others how to practice medicine. But I am aware of and do know that once you begin clinical work, very little distinction exists other than the isolated cases that are way overblown. I think we DOs are more to blame for trying to distinguish ourselves and then we get upset if someone treats us "differently" than some of our other colleagues. I have found the only discrimination of sorts has been when I do suggest OMT to an MD attending and then only because they are not familiar with the specifics. Once I RESPECTFULLY explain the process and thought behind it, I literally have NEVER been turned down from doing it under any clinical situation in which I have suggested it.
    So if the two are so similar, why have DOs in the first place and so many DO medical schools? I thuink this was posted in another comment above. I'll do me best to elucidate a few points in that regard. I'm not going to sit here and blow air up your a** and give the same old song and dance of how DOs are more holistic and treat the patients as a whole. That song and dance is old news and that ship has sailed. Whereas I do believe that we as DOs do in fact treat patients based on that philosophy, I find it would be rather insulting to the MDs and not necessarily the best way to address the subject. I rather prefer to look at it from the perspective of two different paths of medical practice that were once significantly divergent (to the fault of each) but have converged to the point where no real distinction can be made as an overall group. Nevertheless, because there once was a significant difference, it brings with it different ways of being trained along with a different EMPHASIS. I think that emphasis is the key word here. In my training, the emphasis lay squrely on health restoration and prevention. I am told by some MD buddies that their emphasis has been on picking up the pieces once the damage has been done (i.e. the infamous term curing the disease and not the patient) By the way, for the record, I find that term appalling and insulting on average because I don't believe that most people would treat the disease at the expense of the patient. Anyway, Im certain that both MDs and DOs are competently trained in medical treatment, but I simply believe that there is a slightly different emphasis and focus for each while continuing to address the other areas as well. This is why I find the ad nauseum discussion of differences quite tiring. However, due to the difference in focus, there are subtle differences in training and hence the "need" for different programs in which to train.
    Please forgive this rambling post. It's kinda late, I'm beat and my head keeps hitting the keyboard. Ill try to address any more questions later on. I hope that I have added something to the questions posed in my absence.
     
  51. TweetyPie

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