What the heck even is osteopathic philosophy?

[adrummingdog]

Can someone please explain this to me? I've worked as a scribe since last summer and worked under many DOs as we had a lot of MD and DOs on the internal medicine team at my hospital. Honestly I saw zero difference in how they practiced medicine. None of the DOs I worked with ever used OMM. I keep hearing its important to know what the "DO philosophy" is when interviewing for DO schools but I honestly cannot find a concrete answer as to what it is besides being "holistic." It's not like MDs don't treat their patient holistically. Is OMM literally the only difference?

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[AnatomyGrey12]

A marketing scheme

 

[drducky.]

I’d avoid talking about holistics. The last thing you want is for a MD faculty to interview you and you say DOs are more holistics or treat the patient better.

Just say omm is another tool to treat patients if asked why DO?

 

[sloh]

Pseudoprofound bogus and OMM is hocus pocus riding on the coattails of placebo and contextual factors

 

[Dr Meow]

Holistic is just the leftover BS from days past much like Muslims not eating pork is a vestigeal philosophy based on pre-industrial unhealthy sanitation conditions.
DO = MD + OMM
OMM is not equal to holistic. DO's HATE it when people compare OMM to chiropractic BS, but that's basically what it is.

 

[adrummingdog]

@Goro thoughts?

 

[Goro]

@Goro thoughts?

I try to stay away from dumpster fire threads.

 

[IKARnAzA]

I'll take a stab at it. Here's a video from a former TUCOM OMM professor that really helped me understand and get excited about osteopathic philosophy:




Personal anecdote about holistic medicine (if you don't want to watch a 40 min video):
I regularly scribed for a DO at a free clinic that I volunteer at (and we actually became quite close). Naturally at a free clinic, the patient population tends to be individuals who are dealing with difficult extenuating life circumstances (living paycheck to paycheck, difficulties at work and home, etc). There were several that I met that were ongoing victims of domestic abuse, or did not have a real address so were living serially in a number of different motels or shelters. Not coincidentally, many of the same people who were dealing with these huge life stressors also suffered from things like chronic headaches, neck pain, general body aches that wouldn't go away. Sometimes, instead of prescribing medications, Dr. DO would tell them to "take a few minutes each day to do something that you love, something that makes you feel fulfilled and happy." I'm not going to sit here and say that every patient improved with this prescription, but the ones that did and came back during their follow-up visits on the verge of tears of joy made me realize that there MAYBE was some truth to this "holistic medicine" thing.

(Fun fact: during one of my interviews, a physician I was talking to actually told me that this phenomena was in-line with new research in an emerging field of neuroplasticity. Just some food for thought)

 

[deleted480308]

Can someone please explain this to me? I've worked as a scribe since last summer and worked under many DOs as we had a lot of MD and DOs on the internal medicine team at my hospital. Honestly I saw zero difference in how they practiced medicine. None of the DOs I worked with ever used OMM. I keep hearing its important to know what the "DO philosophy" is when interviewing for DO schools but I honestly cannot find a concrete answer as to what it is besides being "holistic." It's not like MDs don't treat their patient holistically. Is OMM literally the only difference?

It’s something you have to pretend being interested in from application season until graduation, then you just go be a doctor

 

[Deecee2DO]

Can someone please explain this to me? I've worked as a scribe since last summer and worked under many DOs as we had a lot of MD and DOs on the internal medicine team at my hospital. Honestly I saw zero difference in how they practiced medicine. None of the DOs I worked with ever used OMM. I keep hearing its important to know what the "DO philosophy" is when interviewing for DO schools but I honestly cannot find a concrete answer as to what it is besides being "holistic." It's not like MDs don't treat their patient holistically. Is OMM literally the only difference?

Its all BS. No one cares about osteopathic philosophy lol. Heck i dont even know what any of that crap means and Im a 3rd yr DO student. I hate OMM. Not to say DO school isnt hard to get accepted to (its still very competitive since its med school) but everyone knows if youre at a DO school youre there bc you didnt get into an MD school since either your MCAT wasnt as good or you had to reinvent your grades. Regardless im glad DO schools exist or I would have had to take the MCAT again. In retrospect though I probably shoukd have since residency application is such an uphill battle now for what I want to do. Just make some BS up in the interview about how OMM is another tool in your bag to tx patients (even though youll probably never use it but dont tell them that haha).

 

[Deecee2DO]

Holistic is just the leftover BS from days past much like Muslims not eating pork is a vestigeal philosophy based on pre-industrial unhealthy sanitation conditions.
DO = MD + OMM
OMM is not equal to holistic. DO's HATE it when people compare OMM to chiropractic BS, but that's basically what it is.

DO does not equal chiro (one is a medical doctor, one is not in the slightest). However, OMM=chiropractic. Whether these DOs get their panties in a wad or not its the honest truth. Chiro and OMM are the same thing

 

[Ho0v-man]

It’s what we tell ourselves to feel better while we hug our knees in the shower sobbing over our low mcat scores.

I worked with a lot of both prior to med school. Being completely fair, I really did notice that the older DOs took psychosocial factors into consideration more often. But that’s the most credit I can give this “holistic” stuff. It’s not a difference that exists today.

I think I got a couple rejections when interviewing because I straight up said that saying that DOs “treat the whole patient” is really insulting to MDs. If you want to say something along lines of DOs focus their training on rural/underserved areas or community-based care...ok sure I’ll let them have that I guess.

 

[hallowmann]

Lookup the 4 tenets of osteopathic medicine. It's essentially that. Back in the day those were revolutionary ideas. Now they're just a part of regular medicine. You'll actually still find a lot of older trained docs out in the community that are rigid in how they view disease and it actually makes you appreciate "osteopathic philosophy". The truth is though that for the last few decades at least MD training has focused on these things as well to a variable degree.

These ideas were not brand new with osteopathic medicine, but they were revived in a time when traditional medicine didn't value them. Galen focused a lot on nutrition, environment, and more holistic treatment as well, but it was also tied into a lot of concepts that didn't make sense, but were reasonable for what they knew at the time.

 

[deleted1066189]

I know two older DO's. One is an FM doc who just say it as a means to an end. He very rarely uses OMM on the lower back.
The other is an ENT. He avoids OMM completely but tries to use psychosocial factors when he can.

 

[DO2015CA]

Holistic is just the leftover BS from days past much like Muslims not eating pork is a vestigeal philosophy based on pre-industrial unhealthy sanitation conditions.
DO = MD + OMM
OMM is not equal to holistic. DO's HATE it when people compare OMM to chiropractic BS, but that's basically what it is.

It does not bother me when someone calls OMM Chiro cause that’s basically what it is. The vast majority of DOs think like me. The problem is the 5% that drink the kool aid are also the ones that inhabit the schools. The rest of us are too busy living in the real world.

I'll take a stab at it. Here's a video from a former TUCOM OMM professor that really helped me understand and get excited about osteopathic philosophy:




Personal anecdote about holistic medicine (if you don't want to watch a 40 min video):
I regularly scribed for a DO at a free clinic that I volunteer at (and we actually became quite close). Naturally at a free clinic, the patient population tends to be individuals who are dealing with difficult extenuating life circumstances (living paycheck to paycheck, difficulties at work and home, etc). There were several that I met that were ongoing victims of domestic abuse, or did not have a real address so were living serially in a number of different motels or shelters. Not coincidentally, many of the same people who were dealing with these huge life stressors also suffered from things like chronic headaches, neck pain, general body aches that wouldn't go away. Sometimes, instead of prescribing medications, Dr. DO would tell them to "take a few minutes each day to do something that you love, something that makes you feel fulfilled and happy." I'm not going to sit here and say that every patient improved with this prescription, but the ones that did and came back during their follow-up visits on the verge of tears of joy made me realize that there MAYBE was some truth to this "holistic medicine" thing.

(Fun fact: during one of my interviews, a physician I was talking to actually told me that this phenomena was in-line with new research in an emerging field of neuroplasticity. Just some food for thought)

Please stop. Telling your patients to do something good for their mental health is not osteopathic medicine. My MD colleagues also do this. I hate that the powers at be ride this propaganda like we are the only ones. If I were an MD I would be understandably upset about the way the DO heads talk.

Its all BS. No one cares about osteopathic philosophy lol. Heck i dont even know what any of that crap means and Im a 3rd yr DO student. I hate OMM. Not to say DO school isnt hard to get accepted to (its still very competitive since its med school) but everyone knows if youre at a DO school youre there bc you didnt get into an MD school since either your MCAT wasnt as good or you had to reinvent your grades. Regardless im glad DO schools exist or I would have had to take the MCAT again. In retrospect though I probably shoukd have since residency application is such an uphill battle now for what I want to do. Just make some BS up in the interview about how OMM is another tool in your bag to tx patients (even though youll probably never use it but dont tell them that haha).

haha I’m happy to have been able to witness how you’ve changed on sdn over the years it’s funny lol. The evolution of all DOs on sdn. From being happy just to be leaving chiro and accepted at any medical school. To now wishing you would’ve waited lol

 

[Ho0v-man]

The other day an attending asked me to explain what a DO is in a room full of other docs and some mid levels. I said:

“Well, we learn all the same stuff as MD students and can train in the same specialties. I guess the biggest difference is that in addition to all that stuff, I’ve also learned how to summon the ghost of A.T. Still into my body. This grants me the power to cast osteopathic magic on your spine which might make you poop better.”

 

[DO2015CA]

The other day an attending asked me to explain what a DO is in a room full of other docs and some mid levels. I said:

“Well, we learn all the same stuff as MD students and can train in the same specialties. I guess the biggest difference is that in addition to all that stuff, I’ve also learned how to summon the ghost of A.T. Still into my body. This grants me the power to cast osteopathic magic on your spine which might make you poop better.”

*shrug* sounds right

 

[sloh]

It was funny to watch classmates sip on that osteopathic kool-aid and waste an entire year doing an OMM fellowship. LOLOLOL

 

[Goro]

It was funny to watch classmates sip on that osteopathic kool-aid and waste an entire year doing an OMM fellowship. LOLOLOL

I have grads who did just that, opened an OMM practice in a wealthy town, and make as much as plastic surgeons, with less overhead!

 

[Deecee2DO]

I have grads who did just that, opened an OMM practice in a wealthy town, and make as much as plastic surgeons, with less overhead!

Dangg Goro lol really? how? genuinely curious

 

[Goro]

Dangg Goro lol really? how? genuinely curious

As one DO pointed out to me, "With an OMM table, I can perform OMM anywhere in the world"

Think about the logistics of such a practice. You just need an office, a table, and patient base. Just multiply that by beaucoup billable hours.

 

[sloh]

I have grads who did just that, opened an OMM practice in a wealthy town, and make as much as plastic surgeons, with less overhead!

I seriously need a lesson in griftonomics directed at the worried well

 

[Goro]

I seriously need a lesson in griftonomics directed at the worried well

Ask anyone who runs a concierge practice.

 

[deleted314957]

Can someone please explain this to me? I've worked as a scribe since last summer and worked under many DOs as we had a lot of MD and DOs on the internal medicine team at my hospital. Honestly I saw zero difference in how they practiced medicine. None of the DOs I worked with ever used OMM. I keep hearing its important to know what the "DO philosophy" is when interviewing for DO schools but I honestly cannot find a concrete answer as to what it is besides being "holistic." It's not like MDs don't treat their patient holistically. Is OMM literally the only difference?

Besides tending toward more of a primary care style, there is none. I loved the bit where they said he “specialized in osteopathic medicine”. These folks are just parading their ignorance. The guy has ER boards.

 

[deleted314957]

As one DO pointed out to me, "With an OMM table, I can perform OMM anywhere in the world"

Think about the logistics of such a practice. You just need an office, a table, and patient base. Just multiply that by beaucoup billable hours.

I have ZERO problem visualizing such a setup in, say, Scarsdale. And what I envision would be a real gold mine.
Far, far more cachet than going to a chiropractor!

 

[Goro]

I have ZERO problem visualizing such a setup in, say, Scarsdale. And what I envision would be a real gold mine.
Far, far more cachet than going to a chiropractor!

Or Great Neck!

 

[Real McCoy]

It was funny to watch classmates sip on that osteopathic kool-aid and waste an entire year doing an OMM fellowship. LOLOLOL

Won’t be wasted if they come back to teach OMM or become an OPP chair at a DO school. They are and will continue to be in high demand unless something changes within COCA or other accreditation bodies.

 

[VeggieMed]

I have grads who did just that, opened an OMM practice in a wealthy town, and make as much as plastic surgeons, with less overhead!

Do you have links to any of these clinics? What are they charging? Something absurd like $300/hr?

 

[DO2015CA]

Do you have links to any of these clinics? What are they charging? Something absurd like $300/hr?

The rich and famous do it all the time. That’s chump change to them

 

[drducky.]

I have grads who did just that, opened an OMM practice in a wealthy town, and make as much as plastic surgeons, with less overhead!

I can do some cranial for headaches.

“How do you feel now?”
“Same as before”
“I did it right then, that’ll be $300”

 

[Angus Avagadro]

Like other niche practices, an OMM practice works the same. My friend is a British DO. Used to have a Body Balancing practice in the UK. Most DOs who have an OMM practice are certified in acupuncture. Others have boards in nutrition. They market to a small group of patients who seek this kind of practice and pay cash for most services.Many sell supplements. These practices can be quite lucrative for the business minded DO. Face it, if chiropractors didnt make people feel better, then their parking lots wouldnt be full.
As far as the osteopathic philosophy, as others have pointed out, the MD world has gradually moved toward the idea of a more holistic approach and act more like DOs than say 50 yrs ago. This is why it is more difficult to note a significaI difference between MDs and DOs today. I guess we should declare victory and go home. As far as training, DOs get more emphasis on musculoskeletal exam, gait, PMR, etc.. So when we look at a patient, these are some of the sub conscious cues that come into play for us. I can say this with some confidence as my wife and I were meds students when we got married. I a 4th yr and she an MS1 at an east coast university. She received little training in the above areas I mentioned.
Some issues that respond well to OMM are pelvic rotations and shears, Psoas Syndrome, Thoracic outlet symptoms, and tension headaches. Like anything, if you dont look for things that respond to OMT, than you will never see any benefits from it
Rule #10. If you dont take a temperature, you can't find a fever.
House of God

 

[DO2015CA]

Like other niche practices, an OMM practice works the same. My friend is a British DO. Used to have a Body Balancing practice in the UK. Most DOs who have an OMM practice are certified in acupuncture. Others have boards in nutrition. They market to a small group of patients who seek this kind of practice and pay cash for most services.Many sell supplements. These practices can be quite lucrative for the business minded DO. Face it, if chiropractors didnt make people feel better, then their parking lots wouldnt be full.
As far as the osteopathic philosophy, as others have pointed out, the MD world has gradually moved toward the idea of a more holistic approach and act more like DOs than say 50 yrs ago. This is why it is more difficult to note a significaI difference between MDs and DOs today. I guess we should declare victory and go home. As far as training, DOs get more emphasis on musculoskeletal exam, gait, PMR, etc.. So when we look at a patient, these are some of the sub conscious cues that come into play for us. I can say this with some confidence as my wife and I were meds students when we got married. I a 4th yr and she an MS1 at an east coast university. She received little training in the above areas I mentioned.
Some issues that respond well to OMM are pelvic rotations and shears, Psoas Syndrome, Thoracic outlet symptoms, and tension headaches. Like anything, if you dont look for things that respond to OMT, than you will never see any benefits from it
Rule #10. If you dont take a temperature, you can't find a fever.
House of God

the farther I get along the medical training road the more I find myself quoting House of God.

man that was a good book

 

[Cornfed101]

I totally get why A.T. Still branched off from MDs... they were giving people mercury and stuff. MDs and DOs aren’t different now except you have to take extra exams and waste precious study time learning OMM. For an interview just look at the osteopathic tenets and you should be good

 

[thepoopologist]

Its a historical artifact that keeps the organizations in the money

If you actually like it, OMM itself is also a fallback specialty that allows people to continue to make a living without retraining. There was a resident a couple classes ahead of me who practiced psychiatry for a year after residency, said the hell with it and now does OMT. Still doesn't justify the tuition you have to pay for DO school.

 

[Mad Jack]

Its all BS. No one cares about osteopathic philosophy lol. Heck i dont even know what any of that crap means and Im a 3rd yr DO student. I hate OMM. Not to say DO school isnt hard to get accepted to (its still very competitive since its med school) but everyone knows if youre at a DO school youre there bc you didnt get into an MD school since either your MCAT wasnt as good or you had to reinvent your grades. Regardless im glad DO schools exist or I would have had to take the MCAT again. In retrospect though I probably shoukd have since residency application is such an uphill battle now for what I want to do. Just make some BS up in the interview about how OMM is another tool in your bag to tx patients (even though youll probably never use it but dont tell them that haha).

Not everyone went to DO school because they couldn't land an MD spot. We're more the exception than the rule, but I would still encourage anyone to go MD if you can. It's just an easier road with the merged residency system

 

[Angus Avagadro]

Not everyone went to DO school because they couldn't land an MD spot. We're more the exception than the rule, but I would still encourage anyone to go MD if you can. It's just an easier road with the merged residency system

Agree with this^^^^^. I didn't apy to any MD schools as I was interested in Family Med at the time. 3 of my friends from med school were scary smart. One a history major, with a minor in journalism, one a chem major who placed out of a senior level math course by only taking the final and got a masters in bio engineering, AFTER he was in solo family practice for a couple years. Another , number 1 in the class, was a family doc who would call oncologists and disagree with them on the chemo regime for his patients. I'd say the top third at our school would be in the top third at most MD schools. Sure, some in DO schools don't have the stats or apps for MD. But don't think there aren't a lot of very smart people in those DO classes

 

[VeggieMed]

Agree with this^^^^^. I didn't apy to any MD schools as I was interested in Family Med at the time. 3 of my friends from med school were scary smart. One a history major, with a minor in journalism, one a chem major who placed out of a senior level math course by only taking the final and got a masters in bio engineering, AFTER he was in solo family practice for a couple years. Another , number 1 in the class, was a family doc who would call oncologists and disagree with them on the chemo regime for his patients. I'd say the top third at our school would be in the top third at most MD schools. Sure, some in DO schools don't have the stats or apps for MD. But don't think there aren't a lot of very smart people in those DO classes

You didn’t apply MD because you wanted to learn OMM?

 

[Angus Avagadro]

When I applied to med school, the holistic family med approach was the most appealing for DO. Over 70 % of my class went into primary care. I hadn't planned on beoming a specialist or sub specialist. Also, they emphasized the rotating internship where they felt to be a good specialist you needed to be a good generalist. Since that time, the gap in primary care philosophy has closed considerably between MDs and DOs. I guess that says a lot for DOs.The students at my current school are very bright, as I said, would do well at any med school. As far as OMM, it wasn't a big deal to study or go to lab. I lived in a medical fraternity house where we had upperclassmen and omm tables available for practice. Mechanical back pain is a common complaint in primary care and having some tools to help in my office only made sense to me. Students complaining about med school hasn't changed, only what they complain about.

 

[Goro]

Agree with this^^^^^. I didn't apy to any MD schools as I was interested in Family Med at the time. 3 of my friends from med school were scary smart. One a history major, with a minor in journalism, one a chem major who placed out of a senior level math course by only taking the final and got a masters in bio engineering, AFTER he was in solo family practice for a couple years. Another , number 1 in the class, was a family doc who would call oncologists and disagree with them on the chemo regime for his patients. I'd say the top third at our school would be in the top third at most MD schools. Sure, some in DO schools don't have the stats or apps for MD. But don't think there aren't a lot of very smart people in those DO classes

Yup, same could be said for a bunch of my students.

 

[TragicalDrFaust]

Can someone please explain this to me? I've worked as a scribe since last summer and worked under many DOs as we had a lot of MD and DOs on the internal medicine team at my hospital. Honestly I saw zero difference in how they practiced medicine. None of the DOs I worked with ever used OMM. I keep hearing its important to know what the "DO philosophy" is when interviewing for DO schools but I honestly cannot find a concrete answer as to what it is besides being "holistic." It's not like MDs don't treat their patient holistically. Is OMM literally the only difference?

Magic words for me were “I’m interested in primary care”.

 

[DarkHorizon]

Only people who were into holistic stuff was the OMM faculty. They had to be though, in order to justify their existence. Even then, things like cranial osteopathy were just cringe overall. I was not once asked by anyone about osteopathic philosophy. I don’t know of any MD who treats the disease. They all treat the patient, just like DOs. In 2021, there’s no difference between a practicing MD and a DO, except for OMM practitioners. If they didn’t tell you their title, you wouldn’t be able to tell any difference. Holistic crap is for dem feels.

 

[VeggieMed]

Only people who were into holistic stuff was the OMM faculty. They had to be though, in order to justify their existence. Even then, things like cranial osteopathy were just cringe overall. I was not once asked by anyone about osteopathic philosophy. I don’t know of any MD who treats the disease. They all treat the patient, just like DOs. In 2021, there’s no difference between a practicing MD and a DO, except for OMM practitioners. If they didn’t tell you their title, you wouldn’t be able to tell any difference. Holistic crap is for dem feels.

Every physician treats the whole patient but OMM faculty are the only ones into “holisitic crap”? I’m confused

 

[culturekweenXx]

Every physician treats the whole patient but OMM faculty are the only ones into “holisitic crap”? I’m confused

These days "holistic" as a buzzword is more about unverified, questionable treatments like OMM than cognizance about social determinants of health, diet, exercise, mental health, etc

 

[DarkHorizon]

Every physician treats the whole patient but OMM faculty are the only ones into “holisitic crap”? I’m confused

Every physician treats the whole patient, MD or DO. Even as an orthopedic surgeon, I treat the whole patient, not just the bone. You have to take patient’s overall health into consideration before making any decision in regards to their specific condition. That’s just the philosophy of being a good, competent physician. The term “holistic” is used by alternative medicine practitioners largely, and the only physicians to still use it are OMM practitioners, in my experience.

 

[VeggieMed]

These days "holistic" as a buzzword is more about unverified, questionable treatments like OMM than cognizance about social determinants of health, diet, exercise, mental health, etc

Not even a med student yet but the majority of physicians that I have seen in practice hardly say anything about diet, exercise, stress etc. I think saying that EVERY physician practices that way is just false. I’m not even sure that the majority practice that way.

 

[Angus Avagadro]

Every physician treats the whole patient, MD or DO. Even as an orthopedic surgeon, I treat the whole patient, not just the bone. You have to take patient’s overall health into consideration before making any decision in regards to their specific condition. That’s just the philosophy of being a good, competent physician. The term “holistic” is used by alternative medicine practitioners largely, and the only physicians to still use it are OMM practitioners, in my experience.

I guess holistic means different things to different people. I never had an orthopaedic surgeon ask me about my family life, if their spouse really believed their knee hurt, diet, exercise, can I afford my meds, etc. I don't think every doctor compartmenalizes knee pain to just the knee, nor do I think every doctor who mentions holistic medicine is a Naturopath.

 

[Goro]

Every physician treats the whole patient, MD or DO. Even as an orthopedic surgeon, I treat the whole patient, not just the bone. You have to take patient’s overall health into consideration before making any decision in regards to their specific condition. That’s just the philosophy of being a good, competent physician. The term “holistic” is used by alternative medicine practitioners largely, and the only physicians to still use it are OMM practitioners, in my experience.

Things were different 50 to 100 years ago. Back then, DOs probably did have a monopoly on holistic care.

But the world has moved on.

 

[j4pac]

I love being a DO. I think it gives me a significant advantage in PM&R. OMT is an incredibly handy stillset. The ability to palpate has been pretty useful for both PM&R and primary care. I also think that the understanding of biomechanics and viscerosomatic pain is quite useful.

 

[VeggieMed]

I love being a DO. I think it gives me a significant advantage in PM&R. OMT is an incredibly handy stillset. The ability to palpate has been pretty useful for both PM&R and primary care. I also think that the understanding of biomechanics and viscerosomatic pain is quite useful.

Does using OMM in PM&R increase your salary?

 

[j4pac]

Does using OMM in PM&R increase your salary?

OMT can be very lucrative. A 7-region treatment, which isn’t hard to get, has a similar return as a 30 minute new patient appointment. The difference is that you typically can bill for a follow-up along with the OMT procedure...you can typically get both done in 20 minutes with minimal risk and get similar reimbursement as a 60 minute new consult. I know primary care docs who make $500,000 doing heavy OMT.

And speaking of placebo...we having nothing but crappy studied interventions for pain. OMT is probably the safest and most appreciated intervention that I do. Doesn’t involve meds, doesn’t involve needles. It’s quick and easy...reimburses relatively well. Patients really like it.