Anybody else think OMM has some use?

[AnatomyGrey12]

I encourage you to seek out a practicing NMM physician and see what OMT is like in full length sessions. Its sad to see this self-loathing attitude ferment in this thread rather than giving a first year student some perspective on OMM as they originally requested.

I have. Every day for a whole month. It’s garbage. All of it. The evidence we have shows that best case scenario it’s placebo, and that is only for ME and soft tissue. Everything else: counterstrain, Chapmans, cranial, viscerosomatics, all of it is nothing but pseudoscience quackery.

And even for ME and the things that are close to PT, are not PT because they are performed and presented in a different manner to patients. And the fact that it is lumped under the same OMM umbrella as all the quackery listed above only serves to further invalidate any aspect that might actually have a real benefit.

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[deleted954943]

Hi everyone,

First year DO student here. Learning OMM in the pandemic setup has been challenging, but overall, I like OMM. I think it is useful for MSK pain ( for example, neck pain). The cranial stuff is BS, but some of it actually is useful for neck/back pain.

Am I the only one here? Like, yes , okay, I didn't get into an MD school, but I also don't hate OMM. It really does help my neck pain, for example.

Is this just me? I feel like we hate on OMM a little too much on here.

We D.O. students definitely hate on OMM too much. People project their rage at other life factors onto OMM. Don't get me wrong; it's annoying to spend the time learning considering most of us won't go into it. But it has its utility and is underserving of the hate directed toward it. People often dismiss it as being unscientific and having no empirical evidence to support it. While this may true in some respects, I'm willing to bet most of these people wouldn't recognize a well designed study or reliably criticize scientific literature if their life depended on it.

 

[AnatomyGrey12]

While this may true in some respects, I'm willing to bet most of these people wouldn't recognize a well designed study or reliably criticize scientific literature if their life depended on it.

My CV says you would lose that bet.

 

[Doc_Ock]

Just make OMM an MSK only elective (and get rid of True Believer/cranial crap) everywhere and merge the degree into MD

That's exactly what is in the works.

 

[MDMechEngr]

That's exactly what is in the works.

Source?

 

[woolsocks90]

Many do acknowledge that all aspects of OMM are not just pseudoscience. It's the amount of time that is spent on justifying the pseudoscience as if it is evidence based and spending a significant amount of time preaching it to students. I spent an extra year completing an OMM fellowship at my medical school and with it came a significant amount of time in an OMT clinic that provided full length sessions. My experience in the clinic was a significant influence on my frustration with having spent a significant amount of time in medical school learning it. That time could have been used elsewhere to provide better clinical or research experiences which would have actually helped with my future career in medicine.

Not to mention, very few students apply for NMM residencies or pursue future NMM fellowships (1-3 per class each year), so it doesn't make sense to accept that a significant amount of time be spent learning OMM in medical school. Why hinder the learning and career opportunities of the >99% of osteopathic physicians in the future merely to stroke the egos of a few?

And I too signed up for the 400+ hours of OMM, but that doesn't mean I forfeit the right to vocalize significant weaknesses in a broken system with hopes that it might be addressed for future students.

You sure like to spin things into your own words, which defeats any point in further responses to you. Like you, I'd also prefer less time spent on OMM during med school, maybe it could become a single course like micro? Who knows? I'm sure you truly know deep down that every aspect of OMM is not pseudoscience, at least if you understand the physiological mechanisms behind it. I encourage you to seek out a practicing NMM physician and see what OMT is like in full length sessions. Its sad to see this self-loathing attitude ferment in this thread rather than giving a first year student some perspective on OMM as they originally requested.

And to my previous comment about owning up to what you signed up for, you in fact signed up for your 3-400 hours of OMM and your argument cannot change that, I'm sorry.

 

[TwistedTea]

it provides stable employment for faculty who would otherwise be drinking water from the gutter

 

[pilloried]

Interesting addition to this thread. An Open Letter to the Self-Loathing D.O. Students

 

[AnatomyGrey12]

Interesting addition to this thread. An Open Letter to the Self-Loathing D.O. Students

“Because you chose to go DO you can’t ever bring up the dozens of things that are nonsensical and must ignore every negative part of the osteopathic training model”

Not really relevant at all. It’s a pretty intellectually dishonest argument.

 

[Doc_Ock]

Source?

A high-placed source. It won't happen overnight, I'd guesstimate around a decade or so. But yeah, it's happening.

 

[Ms Procrastinator]

Going off this thread, do any allopathic med schools offer OMM as an elective? I tried to find an answer on here but was brought to an old thread where everyone was more or less calling OP an idiot. I've wondered if things have changed since then. Before you all come after me asking why an allo school would offer it when osteo schools exist but I'm asking if they have a single elective, not a whole program based on it.

 

[Kardio]

Going off this thread, do any allopathic med schools offer OMM as an elective? I tried to find an answer on here but was brought to an old thread where everyone was more or less calling OP an idiot. I've wondered if things have changed since then. Before you all come after me asking why an allo school would offer it when osteo schools exist but I'm asking if they have a single elective, not a whole program based on it.

Not sure about a specific example - but I imagine if an MD school were to offer OMM it would be a component of a general class on Complementary & Alternative Medicine

 

[Osminog]

Interesting addition to this thread. An Open Letter to the Self-Loathing D.O. Students

I never liked the term "self-hating DO." To be "self-hating" is to hate yourself—to express distaste toward something that's a part of your identity. Saying that DO students/physicians who criticize OMM are "self-hating" carries the ridiculous implication that their pursuit of a DO degree somehow makes OMM an indelible part of their identities. You can be an OMM-hating (or AOA-hating or NBOME-hating or COCA-hating) DO without being a self-hating DO.

 

[TwistedTea]

Interesting addition to this thread. An Open Letter to the Self-Loathing D.O. Students

open letter is synonymous for unasked garbage opinions.

 

[deleted645092]

I might’ve responded to this thread previously but the importance of form/ function following structure or however they’ve advertised it since day 1 is gaining more and more traction in the scientific community. My school’s OMM curriculum is based around biotensegrity and “area of greatest restriction” from one of the OGs. I always just sort of learned and said sure whatever, but then a couple days ago I watched a documentary about how the current cutting edge of biology research is 3D modeling of cells and STUDYING HOW STRUCTURAL IRREGULARITIES CONTRIBUTE TO DISEASE.

So there’s science behind it, but it’s presented in kooky ways.

 

[TwistedTea]

I might’ve responded to this thread previously but the importance of form/ function following structure or however they’ve advertised it since day 1 is gaining more and more traction in the scientific community. My school’s OMM curriculum is based around biotensegrity and “area of greatest restriction” from one of the OGs. I always just sort of learned and said sure whatever, but then a couple days ago I watched a documentary about how the current cutting edge of biology research is 3D modeling of cells and STUDYING HOW STRUCTURAL IRREGULARITIES CONTRIBUTE TO DISEASE.

So there’s science behind it, but it’s presented in kooky ways.

yeah but doesn't mean it improves outcomes

 

[drstranger]

We had a lecture on Fascia from an anatomy PHD after learning about FDM and this made me laugh
"Fascial distortion model is Evidence-based medicine(even if anecdotal)"

 

[Osminog]

We had a lecture on Fascia from an anatomy PHD after learning about FDM and this made me laugh
"Fascial distortion model is Evidence-based medicine(even if anecdotal)"

For those who are interested, here's a pretty thorough takedown of FDM, one of the least evidence-based ideas in osteopathy.

 

[drstranger]

For those who are interested, here's a pretty thorough takedown of FDM, one of the least evidence-based ideas in osteopathy.

True believers read this study and only see one sentence "This does not mean that the clinical practice of FDM should be discontinued for the time being, since the lack of evidence does not imply the non-existence of an effect" but I agree with you. If you have to pull a plunger to use on a patient you should realize you are a joke....

 

[Doc_Ock]

Oh god, I could live to be 200 years old and my one wish would be to never hear the word "fascia" ever again.

 

[TwistedTea]

Oh god, I could live to be 200 years old and my one wish would be to never hear the word "fascia" ever again.

Tissue speed bro

 

[El-Rami]

I send everyone to PT lol
Limit that NSAID use

What about patients who don't have the means/have various obstacles that would make sending them to PT unrealistic? Transportation issues, work requirements, and insurance issues may not make this a realistic option for some patients.

Which begs the question, if you are able to provide some quick pain relief for a patient, then why not? You could use NSAIDs, sure, but NSAIDs might not be the best idea for patients who had a gastric bypass or elderly patients with renal issues, just to give two examples.

 

[TruthInMedEd]

Laymen can be randomly divided into two groups, with one group being taught how to correctly perform a particular OMM technique and the other being taught how to perform a sham technique. Without knowing if the technique they were taught was “real OMM” or not, they can perform the techniques on subjects.

It doesn't work that way. Medical students spend time weekly during their first two years of medical school learning how to diagnose and treat using these principles and practices, yet many still feel unsure of their abilities. You can not take someone off the street and simply "teach them a technique".

 

[hallowmann]

Which begs the question, if you are able to provide some quick pain relief for a patient, then why not? You could use NSAIDs, sure, but NSAIDs might not be the best idea for patients who had a gastric bypass or elderly patients with renal issues, just to give two examples.

The reason is time. You can only do so much in a primary care visit. It may only take a few minutes to perform some OMM, but the fact is that you have 15 min to see a patient and finish the note. I had a patient come in the other day. I knew exactly what the issue was within minutes, did a bit of OMM, but honestly literally a tiny bit, not enough to get good results, and then I sent her to Sports Med/PT so she could work at the specialized center longer term. I still took too much time with her, and I was 5 min late for the next patient.

To paint the picture a bit: In primary care, you're expected to see on the order of 20-25 pts in an 8 hr day. You may be slotted for 15-20 min per patient, but 5-10 of that is almost always taken up by the patient being late or rooming. The notes take a few minutes, possibly more depending on the patient, and the ones that take the longest are also the ones you're with the longest. You're left with 7-10 min if you're lucky with the patient, a few minutes of which are you asking them about what happened and a few minutes of which are an exam. The time's just not there to do OMM on most patients. That elderly patient with renal issues, probably also had 3 other potentially more important things that you needed to address today. Sometimes all you can do with that is pick your battles, treat what you can and refer what you can't.

Now if you had an OMM only practice or dedicated time, sure, spend those 30-60 min with one patient and hopefully make a difference without NSAIDs.

 

[Lawpy]

I think OMM has important uses but it shouldn’t be exclusive to DOs and a lot of the pseudoscience stuff should be removed to focus on MSK benefits

 

[Dr Meow]

I have specialized in classic osteopathic general practice for 30+ years. Previous to that I was an OMM Fellow at Kirksville. Osteopathic students who want to do an OMM rotation and see osteopathic practice in the real world are welcome to spend time in my office. After spending a day in my practice you will realize how wonderful osteopathy is and how little we all understand it. My patients come largely by word of mouth and recommendations of friends.
I see many posts here knocking OMM and osteopathy. How much time in a clinical setting have you actually seen it in action? BTW, osteopathy does not equal manipulation. It is so much more than that.

Blog - Harold Goodman, DO

Osteopathic physician and surgeon

drharoldgoodman.com

Harold Goodman, DO
Silver Spring, Maryland

I just moved away from Rockville for med school last semester. Didn't know you were so close by!