"Unity" Campaign

[Doc2002]

Hi everyone.

I'm first year D.O. student, and I just read some of the points presented in the so-called "unity campaign" being promoted by the AOA.

In their public relations initiative, the AOA is going to be placing newspaper ads, and other promotional advertisments on osteopathic medicine. These advertisements will promote the osteopathic "philosophy", and boost claims of holism and manual manipulation. Now lets talk about reality. The percentage of DO's who actively practice OMM, and who do it well, is so insignificant, that the AOA is doing nothing more than FALSE ADVERTISMENT. With regard to holism, it is quite an ignorant position to say the the "holistic" approach to medicine is unique to those who carry the DO degree. The fact of the matter is that any competent physician (DO, MD, DPM, DDS), will look at the "whole" person.

The truth is that the majority of osteopathic physicians practice mainstream medicine. This fact is reflected in the numbers. Over 60% of DO's enter into allopathic residency programs, and this number is expected to INCREASE. Even in the osteopathic residency programs, the ill-defined "osteopathic principles" are swept under the carpet. When I asked an internal medicine resident in an OSTEOPATHIC PROGRAM about OMM, she said: "You know more than I do. We just don't do that here." Here's another interesting factoid: The AOA has more neurosugery residencies than OMM residencies.

The bottom line is that the AOA is making false claims about the osteopathic profession. OMM should be regarded as a chosen SUBSPECIALTY of medicine, and NOT as a defining characteristic of an entire profession. If the AOA wants to boost the publics' awareness of osteopathic physicians, they should work on modernizing and expanding osteopathic hospitals and facilities, and affiliated these hospitals with major medical centers. Placing an ad in the LA Times that reflects less than 10 percent of the profession is nothing more than a foolish act and a waste of money.

We, as the future of the profession, should make our voices heard, and not let the minority speak for the majority.

Thank you for your time.

Doc2002

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Members don't see this ad.

 

[Henry]

As a matter of fact, today in the SOMA convention at PCOM, we have a speaker from AOA discuss about the unity campaign. There will be promotion to the US general public about osteopathic medicine.

Also, I believe that UAAO has a program that provide fundings to local chapter. The program is aimed to allow DO schools to invite a DO, who practice OMM, to the campus and demonstrates OMM techniques.

Does anyone have more information regrading this?

[This message has been edited by Henry (edited April 10, 1999).]

 

[mevannorden]

If the osteopathic profession has no distinguishing characteristics that set it apart from the allopathic profession, then there is no need two separate professions. Although it is true, and sad I might add, that most DO's do not practice manipulation, it still has more place in practice than as a subspecialty. The techniques are not that hard, they work, and it isn't that hard to bone up on techniques you've forgotten. It all boils down to what the individual wants to do. I personally think DO's who don't utilize manipulation are selling their patients short. How else can you deal with lower back pain, besides surgery or muscle relaxers?

I would also disagree with the statement that all competent physicians are "holistic". Many physicians, in fact most, I would guess, do not take into account mental, emotional and spiritual matters when they evaluate a patient. The truth is that the soulish and spiritual realms have a great influence on the body, something that is taught at osteopathic schools, at least mine. Osteopathy strove so long and so hard to be equal to MD's that we lost our distinctiveness. The osteopathic philosophy IS unique, and, although all DO's don't follow it strictly, the public still needs to be informed of that uniqueness.

 

[Deb]

Of course DOs practice mainstream medicine. That's what they're trained
to do. However, those who don't also use OMM are doing their patients a
great disservice. I don't know why more DOs don't use OMM...perhaps they
weren't well trained. Or maybe they just haven't actually seen the results
themselves (seeing is believing). I've used it on family and friends, for
simple things like infections, congestion, musculoskeletal pain and was amazed
at how well it worked. Also, I see no need to make OMM a subspecialty. If a
second yr like myself can properly utilize different techniques, then any
physician certainly could. It's not rocket science!

Also, doing an ACGME residency is really beside the point and has nothing
to do with staying true to the profession. Students choose ACGME residencies
because the training is often better: full time, paid, teaching faculty
(better learning experience), larger hospitals (more varied pathology),
name recognition (prestige and future employment opportunities), geographic
location, etc. I plan to do an ACGME residency AND utilize OMM (once I'm in
practice). There's NO reason one can't do both.

I think your assertion that the AOA is engaged in "false advertisement" is
a little extreme. It may be an exaggeration, but certainly not a falsehood.
If they want to expand the public's awareness they should work at increasing
the number of physicians that actually practice OMM. Finally, when it comes
to the "osteopathic philosophy" we've had this discussion before. Some of us
believe it's unique to the profession and others disagree. However, the fact is
there are many "competent" physicians (MD and DO) who DON'T practice holistic
care, ie. go beyond the primary pathology. Also, I have to ask...if you aren't
interested in OMM and don't believe our philosophy is unique, why are you in DO
school?

 

[2003]

I believe they (the AOA) will choose their words carefully. For example, they might say that "DO students take everything in school MD students do, as well as osteopathic manipulative techniques. Both MD's and DO's are licensed to practise medicine in all 50 states."

 

[Kansai]

There may be a more practical reason why some D.O.s don't use OMM: managed care. The 2 D.O.s I shadowed prior to applying to med school don't use OMM because they are not reimbursed by insurance companies. These are both family practice docs in large group practices in the Washington, D.C. area. Both of them told me they would like to use OMM, but with 40 patients a day and no payment for manipulation, it comes down to economics. This is pretty sad. Perhaps the AOA should also target managed care companies.

Stef

 

[justwannabadoc]

I think we should all target MCO's. We should practice cost-effective medicine but we should also be able to spend time with our patients.

 

[Deb]

Kansai,

I'd be interested to know which insurance companies refuse to pay for OMM.
Do you know? The physicians I've worked with had no problems. Also, I know
for a fact that medicare pays for OMM (I had to check on it for a relative).

 

[StudentDoctorJJ]

Dear friends,

I have noticed that there has been considerable activity concerning the "Unity Campaign". Unfortunately, it seems that the AOA hasn't been very specific to us (DOs, students, friends of osteopathy) about its proposed means to carry out the resolutions which were passed by the AOA House of Delegates in 1998. Beginning in July '99, I will be a member of the AOA Task Force on Osteopathic Unity as a representative of SOMA. I have tried very hard to educate myself on the past operation of the task force, and I will be more than happy to answer any questions that you have to the best of my ability. My e-mail address is [email protected]. Good luck!!

Jason James
MS-II, PCSOM

 

[Doc2002]

Deb:

I respect your opinions. In regard to your question: "why did I chose osteopathic medicine if I didn't believe in its philosophy," well, you probably know the answer. It is because I didn't gain admission to my first choice school (an allopathic medical college). This is the situation for most D.O. students (a fact, not an opinion). The reason why OMM isn't practiced is directly related to this fact, and has nothing to do with insurance or any of other claims made above. Although these may be contributory, they are not the underlying cause. The main reason why OMM is used by such an insignificant number of physicians is because students either don't believe in it, or don't want to learn it, and never had any intention to in the first place.

Like most D.O. students, I wanted a career in medicine, and the letters made no difference to me. What does make a difference to me; however, is when my licensing body (the AOA) makes false claims about the degree that I am working so hard to earn. Just becuase I'm in a D.O. program, doesn't mean I have to agree with all the polital rhetoric of the AOA, or have a picture Andrew Still on my wall. I have a right to my opinion, and a right to pave the way for the future of my profession. I plan to be very vocal about it. Those who carry the D.O. degree are fully competent PHYSICIANS, and should be labled as such.

One more thing. Someone PLEASE define "osteopathic unity" to me.

I respect all of your opinions and comments.

Sincerely

Doc2002

 

[Jack DOe]

Doc2002,

In my opinion, if you choose to come to an osteopathic medical school (whatever the reasons) you have made a conscious choice to place your name along with the osteopathic principles herald throughout its colorful history. Willingly accepting the DO degree is a testament to that fact. You do have every right to have your voice heard, but more than likely it will fall upon deaf ears. I believe the campaign for osteopathic unity means unity around our tenets and our people. Our tenets are not each unique by themselves but are unique in placing them all together. Also, many physicians may practice this same medicine irregardless of the degree but this does not take from us but only add that others outside our profession agrees with these tenets. This has not always been true throughout osteopathic history. Therefore the AOA are not the ones making false claims, but you sir by not living up to your commitment made at osteopathic medical school acceptance are the one who has made false claims.

Jack DOe

 

[mevannorden]

DO2002

I still must disagree that the AOA is making false claims. The purpose of the Unity Campaign, as far as I can tell, is to inform the public about Osteopathy. It is true that Osteopathy is, by most people, misunderstood at best, unknown at worst. It would be nice if osteopathic physicians and students didn't have to explain what an osteopath is to everyone they talk to. I think that is at least part of the purpose.

Also, I think it's important that people understand that their is an alternative treatment to musculoskeletal disorders besides surgery or chiropractic. Granted, many if not most DO's do not practice OMM, and for this reason I think the AOA needs to develop a publicly accessable data base with locations of DO's who do practice OMM. I have a friend who has severe pain that shoots down his leg that I suspect is coming from the sciatic nerve. He's been to chiropractors and doctors, but never to a doctor who uses OMM. It's possible that his pain is from something as simple as a hypertonic Piriformis m., in which case it would be a shame if he had to live in pain from it. If people like him understood there is an alternative, and could find out where to find it, they could very possibly have their pain fixed instead of living with it day in and day out.

Out of curiosity, DO2002, do you believe in OMM?

Mark

 

[drusso]

Doc2002 et al,

I'm a little confused. Exactly what is there to *believe* about OMM? Either it is an effective adjunctive treatment for musculoskeletal conditions or it is not. Either it contributes to the nonspecific well-being and health status patients or it doesn't. Where does *belief* enter the equation? Either you find the neurophysiology of how manipulation affects the nervous system logical or you don't. If you don't find it logical, then explain what you think doesn't make sense. To dismiss something based upon belief and not science is irrational. Do you want to be irrational?

Recent surveys indicate that there is indeed a GROWING interest in OMM among entering DO students. This is probably due to a number of factors including an interest in "alternative medicine" (which OMM is not), a growing appreciation of the role of psychosocial factors in health promotion and disease prevention, and decreased stigma that manipulation enjoys today compared to the past. In fact, when our school offers continuing medical education in OMM, I'm amazed that about 15-30% of the enrollees are MD's! Among the reasons that a lot of DO's don't practice manipulation is simply because most are not very good at it! Or, they may have been discouraged from practicing it in residency. Or, they trained during an era when manipulation was branded as quackery. Consequently, their skills deteriorated. If they are not practicing OMM based upon a belief that it "doesn't work", then they are not practicing it for all the wrong reasons.

Overall, don't you think that it is a good thing that DO's who don't feel confident in their manipulation skills don't do it? Would you want someone mucking around with you who didn't know what they were doing? Do you expect every FP to be able to do hernia repairs even if they haven't done one since residency? Poorly performed manipulation can seriously hurt someone. Why would you insist that patients put themselves at risk so that a doctor may feel "osteopathic" about his approach to patient care?

Manipulation is not synomymous with osteopathic medicine. It is a tool, an important tool, but no more important than any of the other tools that physicians use to diagnose and treat disease. It just so happens that DO's recieve specialized training in how to use this tool early in their education and MD's don't. I'm disappointed that as a first year medical student at a DO school you've missed this point. If this is still your opinion, then someone is not doing their job and short-changing you of the medical education you deserve. I suggest that you contact your Dean immediately and demand that you get the information you need.

For good or for ill, OMM is indeed becoming more of a specialty unto itself. Still, there should be some basic OMM skills and techniques that every DO should know and be competent at performing. You expect most physicians to be able to perform simple suturing, read routine x-rays, interpret laboratory data, recognize heart sounds, and do a thorough neurological examination. In addition to the above, if you're a DO, you are doing your patients a disservice if you don't know one or two techniques for the most common musculoskeletal conditions that present to a primary care setting. If don't intend to be working in primary care or in a field where musculoskeletal complaints are common, then blow off OMM! But, hopefully you will still appreciate osteopathic philosophy or the osteopathic approach to patient care.

Finally, the fact the DO's are pursuing ACGME residencies in higher proportions has nothing to do with "believing" in osteopathic principles and everything to do with students seeking the best training they can obtain given their career objectives. Again, this notion of "belief" makes no sense to me. The most osteopathically minded DO's I know completed ACGME approved residencies, some even do manipulation. How do you explain this?

You either find osteopathic principles and philosophy having merit or you don't. If you don't, then why not? Where is the merit lacking?

ACGME residencies tend to be located in large academic medical centers whereas AOA approved residencies are more community based. Why would you insist that a student seeking an experience in a large academic medical center be forced to do an AOA residency, and if he doesn't do so, turn around and brand him "un-osteopathic!" Give me a break. Choose what you like.

Again, someone explain to me why "belief" has anything to do with medicine in general and osteopathic medicine in particular. Medicine is either evidence-based or it is not. There are proven therapies, unproven therapies, and investigational therapies for any given disease or condition. There indications for which OMM fits all of those categories.

Frustratedly,
--dave

[This message has been edited by drusso (edited April 14, 1999).]

[This message has been edited by drusso (edited April 14, 1999).]