What the heck even is osteopathic philosophy?

[Angus Avagadro]

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.

As speaking of placebo...we having nothing but crappy studied interventions for pain. OMT is problem 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.

Agreed. I believe most studies looking at chronic pain find improvement in the activities of daily living in groups enrolled in stretching and reconditioning groups. Omm is mostly about dealing with tight muscles and their impact.

---

Members don't see this ad.

 

[j4pac]

Agreed. I believe most studies looking at chronic pain find improvement in the activities of daily living in groups enrolled in stretching and reconditioning groups. Omm is mostly about dealing with tight muscles and their impact.

I remember when I was a naive, sweet summer child in medical school. A part of me thought of OMT as a homeopathic remedy with little support in the medical literature. Again, I was naive. There is as much support in our medical literature as any other intervention for chronic pain (perhaps except a heating pad...which almost regularly wins out against anything). I thought the medicines would be my primary means of treatment...but I've used them long enough that they usually suck. If the patient doesn't get better from a quick stent from an NSAID...your other meds are going to be extremely limited. Read on medical literature regarding number to treat (NTT) for pain interventions, including meds and injections. There is scant evidence that the injections help for most of our pain complaints, and the number to treat for any of the pain meds is pretty much laughable. Takes about four patients to get one positive outcome from TCAs for neuropathic pain...it's our best class of meds, and yet again that's a 25% chance of a good outcome...and almost nobody can take it because of side effects. Gabapentin/Lyrica you say....you're looking at about 1 in 7. Cymbalta/Duloxetine? You’re looking at less than 1 in 10 with a good outcome. And that’s for neuropathic pain...evidence for axial pain is even worse.

I'm pretty confident that I can beat those numbers by a good margin with OMT...and OMT doesn't make my patients sick. None of my patients have vomited or had to go to the ER because of side effects from my OMT (knock on wood). I've never seen someone die from a GI bleed from my OMT. I've also never seen someone get a spinal headache or epidural hematoma from my OMT.

 

[sloh]

I think selling the DO title because it is “holistic” is a slap in the face towards MD’s. There is medicine that works and medicine that doesn’t work—this includes lifestyle interventions such as diet and exercise. To the extent that physicians don’t address diet and exercise as much as we’d like, it is largely due to poor patients adoption of these habits and many of them wanting quick fixes/passive interventions.

“Holistic, integrative, functional” are generally red flag terms to me—vague terms that give patients the warm fuzzies. It never fails that “clinicians” who promote themselves with these terms are peddling a bunch of garbage interventions that are placebos at best.

 

[Angus Avagadro]

I think selling the DO title because it is “holistic” is a slap in the face towards MD’s. There is medicine that works and medicine that doesn’t work—this includes lifestyle interventions such as diet and exercise. To the extent that physicians don’t address diet and exercise as much as we’d like, it is largely due to poor patients adoption of these habits and many of them wanting quick fixes/passive interventions.

“Holistic, integrative, functional” are generally red flag terms to me—vague terms that give patients the warm fuzzies. It never fails that “clinicians” who promote themselves with these terms are peddling a bunch of garbage interventions that are placebos at best.

I don't necessarily disagree. In my earlier post I was responding to why I chose to be a DO. I am older and can remember growing up in a town with a DO hospital and an MD hospital, and neither allowed the other to be on staff. My experience at the time was that DOs were using a more holistic approach in primary care. I believe the MD world actually became more holistic over time imo and today you see very little difference between the two. I have trained and taught in both the MD and DO world. When interviewing students, I ask them Why Our School? Then I forbid them to use the word holistic. That makes it interesting.

 

[Doc_Ock]

A lot of fluffy words that mean nothing plus some jazzed up chiropractic.

 

[Myfittycent]

I heard DO philosophy is analogous to Scientology on steroids.

 

[8YearsLate]

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?

In a hospital setting, it may be harder to note the differences. My attending's resident was a DO and a big inspiration to me. He admittedly never used OMM in ER care, however, when I had a significant spinal issue that was causing me pain, he was able to pull up his sleeves and alleviate it right away with a manipulative technique (which 2 weeks of NSAIDs could not accomplish). There are other MSK concepts that DO's incorporate regularly, like asking about shoe support or quality of your bed first when you complain of chronic pain. They might lean a little more heavily into nutritional or cognitive solutions before recommending medication (but this is case-by-case; I've met a pill-mill DO and a food-is-thy-medicine MD). In the hospital I think the biggest difference I noticed between the 2 DOs I had to compare against 2 MDs was that the DOs seemed to take more time explaining to the patient the physiological causes/implications of their condition, while the MDs seemed to be less timid about going straight to the treatment and put all the info in the discharge notes. However, this is very anecdotal and probably had a lot more to do with these individuals' styles. The letters after one's name do not determine their ability to practice holistic medicine.

 

[deleted1100659]

the osteopathic philosophy is set the annual tuition to the exact max amount of federal loans that can be borrowed. DO schools treat the whole person, including their wallet.

 

[Goro]

the osteopathic philosophy is set the annual tuition to the exact max amount of federal loans that can be borrowed. DO schools treat the whole person, including their wallet.

Especially CCOM