Starting to regret going to an osteopathic school

[FrustratedDO]

First off, let me make it abundantly clear that I am NOT trying to start a flame war. I know how touchy these subjects can be. I really want a chance to vent and see if there are others out there who share my opinions.

I'm a first year DO student. While I was in undergrad, I was very, very enthusiastic about going to a DO school. I looked at it as a place where the alleged 'gunner-ism' and competitive atmosphere of the allopathic schools would be absent. My main reasons for wanting to be a DO was a more patient-centered thinking that the schools encouraged. My GPA and MCAT were competitive for MD and DO schools, so its not like I was forced into choosing a DO school because I couldn?t get in anywhere else. I genuinely wanted to be a DO.

But since the beginning of the year, I am getting more and more disgusted and dismayed at the attitudes of some of my classmates and of the faculty. Actually, not all of the faculty, just the OMM department.

I've never been a big fan of alternative medicine, so when my classmates started to talk about acupuncture and herbs and junk, I remained silent. So many of them were so excited about it. I'm skeptical, but I wanted to give OMM a chance. I began the year with an open mind, but at this point, I'm disgusted.

OMM is the sacred cow of the DO world. And the OMM faculty are the ones who enforce the religion. And they treat it like a religion - as if you have to 'believe' in order for it to work. I'm so sick and tired of being forced to 'drink the kool-aid' of a OMM. The fact that cranial osteopathy is even taught nowadays is enough to make me gag. Its embarrassing and frankly, it makes us look like fools as a profession.

The other thing that bugs me is the superiority complex that I see very often. As if in allopathic schools, they tell the student to focus on the symptoms and ignore the patient.

And the constant prattling about "treating the patient, not the symptoms" got very old, very quickly. I got really tired of explaining to friends and family what a DO is. I'm got very sick of pretentious people telling me that I'm an 'O'MS1, rather than a MS1. As I looked the AOA, I got even more discouraged. Here is an organization that seems bound and determined to keep us marginalized. Look at the nonsense they waste OUR money on: Postcards to TV shows, begging them to insert a DO character. Need I say more.

New DO schools open every year. Yet, the number of osteopathic residencies dwindles, and the ones that stay open are regarded as of questionable quality at best. I'm really starting to feel like I made a mistake in coming to a DO school. I can see people thriving here if they have a personality that leans towards alternative medicine, but I find it oppressive.

The DO world has some major issues that it needs to deal with. Here are my suggestions for change.

1)Eliminate the COMLEX. Why in the world should we have 2 distinct medical licensing exams? If the DO education is equivalent to an MD, then we should take the same test. Make OMM an add-on module just for us.

2)All medical schools, DO & MD should be accredited by the LCME, with oversight on the opening of new schools. It's not fair that we share the same profession as MDs, yet we can open schools left & right without any input from them. Its their future also.

3)Get rid of the osteopathic residencies. Either close them, or bring them up to par with allopathic programs, and open them to everyone.

4)Change the freakin name. There should be ONE set of damn initials for medical professionals, and it ought to be the one that 99% of the lay population recognizes. This is solely a pride issue of the old school DOs who run the AOA.

5)RESEARCH - Osteopathic medicine had leeched off of allopathic medicine since we accepted the use of drugs to treat illness. It's about time we started to contribute something back to the development of medicine.

6)OMM should either by backed up by peer-reviewed research or dropped. Let's shine some light on this - if it works, and can be proven, great. But why am I learning to manipulate the skull bones in one class, but in anatomy class, I'm told they are permanently fused?

I know the odds of any of these reforms happening is almost zero. And for me, I'm stuck and I'll have to make the best of my schooling. I can't transfer out or begin again, for personal reasons. But I sure wish someone had posted something like this when I was applying. I may have thought twice.

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[Eiko]

First off, let me make it abundantly clear that I am NOT trying to start a flame war. I know how touchy these subjects can be. I really want a chance to vent and see if there are others out there who share my opinions.

I'm a first year DO student. While I was in undergrad, I was very, very enthusiastic about going to a DO school. I looked at it as a place where the alleged 'gunner-ism' and competitive atmosphere of the allopathic schools would be absent. My main reasons for wanting to be a DO was a more patient-centered thinking that the schools encouraged My GPA and MCAT were competitive for MD and DO schools, so its not like I was forced into choosing a DO school because I couldn?t get in anywhere else. I genuinely wanted to be a DO.

But since the beginning of the year, I am getting more and more disgusted and dismayed at the attitudes of some of my classmates and of the faculty. Actually, not all of the faculty, just the OMM department.

I've never been a big fan of alternative medicine, so when my classmates started to talk about acupuncture and herbs and junk, I remained silent. So many of them were so excited about it. I'm skeptical, but I wanted to give OMM a chance. I began the year with an open mind, but at this point, I'm disgusted.

OMM is the sacred cow of the DO world. And the OMM faculty are the ones who enforce the religion. And they treat it like a religion - as if you have to 'believe' in order for it to work. I'm so sick and tired of being forced to 'drink the kool-aid' of a OMM. The fact that cranial osteopathy is even taught nowadays is enough to make me gag. Its embarrassing and frankly, it makes us look like fools as a profession.

The other thing that bugs me is the superiority complex that I see very often. As if in allopathic schools, they tell the student to focus on the symptoms and ignore the patient.

And the constant prattling about "treating the patient, not the symptoms" got very old, very quickly. I got really tired of explaining to friends and family what a DO is. I'm got very sick of pretentious people telling me that I'm an 'O'MS1, rather than a MS1. As I looked the AOA, I got even more discouraged. Here is an organization that seems bound and determined to keep us marginalized. Look at the nonsense they waste OUR money on: Postcards to TV shows, begging them to insert a DO character. Need I say more.

New DO schools open every year. Yet, the number of osteopathic residencies dwindles, and the ones that stay open are regarded as of questionable quality at best. I'm really starting to feel like I made a mistake in coming to a DO school. I can see people thriving here if they have a personality that leans towards alternative medicine, but I find it oppressive.

The DO world has some major issues that it needs to deal with. Here are my suggestions for change.

1)Eliminate the COMLEX. Why in the world should we have 2 distinct medical licensing exams? If the DO education is equivalent to an MD, then we should take the same test. Make OMM an add-on module just for us.

2)All medical schools, DO & MD should be accredited by the LCME, with oversight on the opening of new schools. It's not fair that we share the same profession as MDs, yet we can open schools left & right without any input from them. Its their future also.

3)Get rid of the osteopathic residencies. Either close them, or bring them up to par with allopathic programs, and open them to everyone.

4)Change the freakin name. There should be ONE set of damn initials for medical professionals, and it ought to be the one that 99% of the lay population recognizes. This is solely a pride issue of the old school DOs who run the AOA.

5)RESEARCH - Osteopathic medicine had leeched off of allopathic medicine since we accepted the use of drugs to treat illness. It's about time we started to contribute something back to the development of medicine.

6)OMM should either by backed up by peer-reviewed research or dropped. Let's shine some light on this - if I works, and can be proven, great. But why am I learning to manipulate the skull bones in one class, but in anatomy class, I'm told they are permanently fused?

I know the odds of any of these reforms happening is almost zero. And for me, I'm stuck and I'll have to make the best of my schooling. I can't transfer out or begin again, for personal reasons. But I sure wish someone had posted something like this when I was applying. I may have thought twice

And what school do you go to again?

 

[medic170]

First off, let me make it abundantly clear that I am NOT trying to start a flame war. I know how touchy these subjects can be. I really want a chance to vent and see if there are others out there who share my opinions.

I'm a first year DO student. While I was in undergrad, I was very, very enthusiastic about going to a DO school. I looked at it as a place where the alleged 'gunner-ism' and competitive atmosphere of the allopathic schools would be absent. My main reasons for wanting to be a DO was a more patient-centered thinking that the schools encouraged. My GPA and MCAT were competitive for MD and DO schools, so its not like I was forced into choosing a DO school because I couldn?t get in anywhere else. I genuinely wanted to be a DO.

But since the beginning of the year, I am getting more and more disgusted and dismayed at the attitudes of some of my classmates and of the faculty. Actually, not all of the faculty, just the OMM department.

I've never been a big fan of alternative medicine, so when my classmates started to talk about acupuncture and herbs and junk, I remained silent. So many of them were so excited about it. I'm skeptical, but I wanted to give OMM a chance. I began the year with an open mind, but at this point, I'm disgusted.

OMM is the sacred cow of the DO world. And the OMM faculty are the ones who enforce the religion. And they treat it like a religion - as if you have to 'believe' in order for it to work. I'm so sick and tired of being forced to 'drink the kool-aid' of a OMM. The fact that cranial osteopathy is even taught nowadays is enough to make me gag. Its embarrassing and frankly, it makes us look like fools as a profession.

The other thing that bugs me is the superiority complex that I see very often. As if in allopathic schools, they tell the student to focus on the symptoms and ignore the patient.

And the constant prattling about "treating the patient, not the symptoms" got very old, very quickly. I got really tired of explaining to friends and family what a DO is. I'm got very sick of pretentious people telling me that I'm an 'O'MS1, rather than a MS1. As I looked the AOA, I got even more discouraged. Here is an organization that seems bound and determined to keep us marginalized. Look at the nonsense they waste OUR money on: Postcards to TV shows, begging them to insert a DO character. Need I say more.

New DO schools open every year. Yet, the number of osteopathic residencies dwindles, and the ones that stay open are regarded as of questionable quality at best. I'm really starting to feel like I made a mistake in coming to a DO school. I can see people thriving here if they have a personality that leans towards alternative medicine, but I find it oppressive.

The DO world has some major issues that it needs to deal with. Here are my suggestions for change.

1)Eliminate the COMLEX. Why in the world should we have 2 distinct medical licensing exams? If the DO education is equivalent to an MD, then we should take the same test. Make OMM an add-on module just for us.

2)All medical schools, DO & MD should be accredited by the LCME, with oversight on the opening of new schools. It's not fair that we share the same profession as MDs, yet we can open schools left & right without any input from them. Its their future also.

3)Get rid of the osteopathic residencies. Either close them, or bring them up to par with allopathic programs, and open them to everyone.

4)Change the freakin name. There should be ONE set of damn initials for medical professionals, and it ought to be the one that 99% of the lay population recognizes. This is solely a pride issue of the old school DOs who run the AOA.

5)RESEARCH - Osteopathic medicine had leeched off of allopathic medicine since we accepted the use of drugs to treat illness. It's about time we started to contribute something back to the development of medicine.

6)OMM should either by backed up by peer-reviewed research or dropped. Let's shine some light on this - if it works, and can be proven, great. But why am I learning to manipulate the skull bones in one class, but in anatomy class, I'm told they are permanently fused?

I know the odds of any of these reforms happening is almost zero. And for me, I'm stuck and I'll have to make the best of my schooling. I can't transfer out or begin again, for personal reasons. But I sure wish someone had posted something like this when I was applying. I may have thought twice.

I disagree with almost everything you said. If its so bad, drop out!

 

[(nicedream)]

And what school do you go to again?

Why does that matter? Nothing he said is school-specific.

 

[(nicedream)]

I disagree with almost everything you said. If its so bad, drop out!

I think most DO students, if they're being honest, would agree with at least some of the OP's sentiments if not most or all. Osteopathic medicine is in a period of flux; it's growing at a tremendous rate, and the natural tendency I think is going to be for it to move more towards allopathic medicine in regards to post-graduate training and board examination. It's almost universally accepted that these two things in the osteopathic world are very sub-par. There are many things about osteopathic medicine that are wonderful, but many things that need improvement, specifically organizational things.

 

[Robz]

quit whining and do something about it....lobby or get involved with politics. Starting a new account on an anonymous board with a post that will piss people off is not a constructive way to go. I don't care how you prefaced it.

 

[(nicedream)]

quit whining and do something about it....lobby or get involved with politics. Starting a new account on an anonymous board with a post that will piss people off is not a constructive way to go. I don't care how you prefaced it.

Well, go ahead and keep whining, but do something about it too. Get involved with the AOA through SOMA, and also the AMA where MD's and DO's mix. This is where the real power to affect change is.

 

[delicatefade]

I would encourage you to stick it out. I'm certainly not thrilled with cranial osteopathy and the "we treat the whole patient" one-liners either but I think you have to realize that the osteopathic profession is fighting its hardest to stress the "uniqueness" of osteopathic medicine when in all reality, allopathic and osteopathic medicine have never been more similar.

If you aren't crazy about OMM, then all you have to do is not use it or pick a speciality in which you wouldn't ever use it anyway. I think a lot of it is useful in a clinical setting. PT's have been using osteopathic muscle energy, myofascial, strain/counterstrain, and manipulative techniques for years, they often work, they are billing for them, and they are being reimbursed.

Much of these techniques ARE being evaluated via peer reviewed research. The PT profession is BIG on evidence based practice and are seeking to review all commonly used PT evaluation and treatment techniques. I haven't seen much of that from the DO community and I would certainly encourage it. Let's find out what works and what doesn't and stop telling DO students to agree with OMM on faith only. I can't tell you how many evaluation and treatment techniques that we have learned already just this quarter that have either been invalidated or shown to have poor enough inter/intrarater reliability that any information you would get out of them would be useless.

 

[DireWolf]

I agree with everything the OP said. It's almost as if he overheard me talking and wrote everything down.

 

[medic170]

It's almost universally accepted that these two things in the osteopathic world are very sub-par.

Oh, it is not! There are plenty of great AOA residencies (granted, not enough), and comlex is not a sub-par exam.

Maybe I am just sheltered to these problems because:

1. MSUCOM does plenty of research, both independent and for NIH (tens of millions of $$$ in grants every year).

2. There is NO DO stigma in Michigan whatsoever

3. Michigan has the greatest number of the most respected AOA and dually accredited residencies in almost every specialty, and MSUCOM has nearly 98% placement in those programs.

I guess what I am saying is, especially to the OP, you can't generalize these statements to all DO's and DO schools, because I know of one school and oine state where these problems hardly exist. Also, to the OP, there was a peer reviewed study on OMM in JAMA a few years back, do a search and you will find it. I agree there needs to be more though.

 

[drusso]

Has anyone been keeping up with the recent advances in OMM research? Cranial is being scrutinized with respect to Traub-Herring wave phenomenon, there's a federally funded OMM research center in Texas that sponsors a NIH K-30 program in training OMM clinical investigators, there is a multi-site pneumonia and OMT trial underway as well as a OMT and carpal tunnel trial. The best way to be constructive is to have all the "inside" information available at your finger tips and bring to those with the power to make changes.

 

[DireWolf]

Oh, it is not! There are plenty of great AOA residencies (granted, not enough), and comlex is not a sub-par exam.

Maybe I am just sheltered to these problems because:

1. MSUCOM does plenty of research, both independent and for NIH (tens of millions of $$$ in grants every year).

2. There is NO DO stigma in Michigan whatsoever

3. Michigan has the greatest number of the most respected AOA and dually accredited residencies in almost every specialty, and MSUCOM has nearly 98% placement in those programs.

I guess what I am saying is, especially to the OP, you can't generalize these statements to all DO's and DO schools, because I know of one school and oine state where these problems hardly exist. Also, to the OP, there was a peer reviewed study on OMM in JAMA a few years back, do a search and you will find it. I agree there needs to be more though.

Who are you trying to shyt? You're not even in medical school. Here's $2, buy a clue.

"Plenty" and "not enough" are contradictions. COMLEX is a joke. Take it before you act like you know what you're talking about.

 

[NotShorty]

**** or get off the pot.

-NS

 

[Ice-1]

I'm sorry to hear that you are so down on osteopathic school after being in it a grand total of maybe one semester. There are many things that need improvement in the profession and I think most of the things you complain about will eventually be done. Right now the AOA doesn't want to cede authority over the schools or residencies to the allopathic world because that would eliminate a major reason for their existence. Those in power at the AOA are not going to do anything to lose that power voluntarily. The older generation of DO's faced a good bit more discrimination than we do, so keep that in mind. In the meantime, you would be better served to keep an open mind as you proceed through school. I don't think you really have enough experience to determine that cranial manipulation (or much of anything else) is a load of crap just yet.

 

[Ratch]

cranial is a load of crap, been there and done that - it beings our profession down by making us look like witch doctors. other aspects of OMM are fun as long as it doesn't involve looking for the magical CRI, personally i think it should be an elective.

 

[TomC727]

I will put in my 2 cents here. I agree with a little of what is being said. I am not a big fan of hearing day in and day out how unique DO's are and how different we are. The pounding of patient centered care can get really old. DO's and MD's in my honest opinion are the same thing, they are medical doctors. Now for OMM, it is a nice side thing to know. It is not like it is very hard material or anything. Also, I agree that maybe the COMLEX should be eliminated and combined where Osteopathic students take an extra OMM part on the USMLE.

And on the subject of Cranial, I think it is a bunch of crap and that is one thing that I am not happy learning. The 3 hours of class I sat in learning that could have been better used for something a whole lot better.

 

[medic170]

Who are you trying to shyt? You're not even in medical school. Here's $2, buy a clue.

"Plenty" and "not enough" are contradictions. COMLEX is a joke. Take it before you act like you know what you're talking about.

Grow up. I was working in the medical field when you were poppin pimples before the prom, I know a thing or two, even though I have not started medical school yet. So I have not learned medicine yet, I know plenty about the politics and about osteopathy, I have been doing this a long time, kid. Best of all, I am entitled to my own opinion without you ridiculing me.

 

[DireWolf]

Grow up. I was working in the medical field when you were poppin pimples before the prom, I know a thing or two, even though I have not started medical school yet. So I have not learned medicine yet, I know plenty about the politics and about osteopathy, I have been doing this a long time, kid. Best of all, I am entitled to my own opinion without you ridiculing me.

I don't care if you're focking Ben Carson. Point remains that you contradicted yourself and that COMLEX is a joke. Take care.

 

[medic170]

I don't care if you're focking Ben Carson. Point remains that you contradicted yourself and that COMLEX is a joke. Take care.

Ok then, I officially change the word "plenty" to "many", are you happy now big guy? My point is, they are not non-existent and the fact that I have not started school yet does not preclude me from any knowledge about the medical field.

 

[delicatefade]

 

[DireWolf]

Ok then, I officially change the word "plenty" to "many", are you happy now big guy? My point is, they are not non-existent and the fact that I have not started school yet does not preclude me from any knowledge about the medical field.

It precludes you first-hand knowledge about COMLEX.

 

[medic170]

It precludes you first-hand knowledge about COMLEX.

OK, you got me there, still, since the state licensing board does not see it as a joke, nether do I.

Not to mention, the OP is in his/her first semester, so he/she has no knowledge of COMLEX either, and therefore, should not opine that there should be only one licensing exam, right?

 

[DireWolf]

OK, you got me there, still, since the state licensing board does not see it as a joke, nether do I.

Not to mention, the OP is in his/her first semester, so he/she has no knowledge of COMLEX either, and therefore, should not opine that there should be only one licensing exam, right?

right.

 

[raspberry swirl]

to the OP- none of the issues you have raised are new issues. ALL of them have been debated countless times on a number of threads. these aren't secret issues you are only exposed to once you've matriculated into an osteopathic school. its obvious to me that you didn't do your research ahead of time-- as in, finding candid DOs and medical students who were willing to discuss with you both the pros and cons of their profession, or really throroughly searching through sdn and other similar sites for a wide range of opinions. that would be your own fault, not osteopathic medicine's.

secondly, all schools are different. had you gone somewhere else, your opinion may have been opposite. therefore, i disagree with your generalization of "regret going to an osteopathic school" instead of inserting your school's name. plenty of other posters have not been afraid to reveal negatives about their specific school, so why are you? perhaps a fabulous professor or a fabulous experience at another school would have made you look more positively on the things in the osteopathic world that need change.

thirdly, despite some of the shortcomings, osteopathic medicine and osteopathic medical school has its benefits-- all those reasons that made you apply DO in the first place, and all those reasons more students are applying DO each year and more schools are opening. not to mention changes are happening. if you had been in san fransisco last week, you would have seen that. wheels are turning, things are in the works. but it's because of students who are postive about osteopathic medicine and want to support what it is, and what it can be.

if you dont like the comlex, take the usmle as well. if you dont want to do an AOA residency, do an ACGME residency. if you hate osteopathic medicine so much, DONT BECOME A DO. you are not doing yourself, any of the rest of us, or your future patients, a favor by becoming something you apparently hate.

that said, im sorry that you are having a bad experience. i knew both the positives and the negatives about osteopathic medicine before i applied, yet i still chose the DO route, and im happy i did. you say you cant transfer or start over for personal reasons, but im sure if thats what you really felt was best for you, you could find a way. life is too short to be miserable. if you made a wrong choice, your best bet is to fix it. either change your school or change your attitude.

 

[hotlikebutter]

as a student about to start DO school next year, i can offer my very limited view on this subject. yes, i too had the "numbers" to get into decent MD as well as DO schools, but i chose DO. yes there is resistance in mainstream medicine and the general public about "what is a DO?" but this cannot be discouraging to you if you looked into the profession ahead of time.

also, what you say about alternative medicine indicates that you have been severely indoctrinated by western style medicine. you need to experience them and keep an open mind. because of what you said, it is easy to see why you are so skeptical of OMM. not your fault really, just your experience and psychology is based on what you see MD's doing.

about the research leeching and use of chemicals, many of the early DO's did not want to incorporate drugs in their practice, but the pressure by the physicians who held both MD and DO urged the profession to incorporate all forms of therapy. after the Flexnor report, the MD schools all allied with academic institutions and DO schools held grass roots level, until modern molecular biology advanced the MD arsenal, the DO's fell behind, and are now accelerating their research programs.

also knowledge is knowledge, no one owns it. just because an MD entity discovered it, should the rest of the world be embarassed to use it?! are we in the profession to care for people or to lay claim to new discoveries? depends who ask i guess.

coming from a very heavy basic science research background, i completely support your call for more research in OMM, and we are not alone. every school i interviewd at asked me what part of the DO profession could use more advancing, and i told them basic research leading to evidence based DO practices, and they all said great answer! then each one of them told me what their school is doing to make this movement happen.

there are people out there on both sides of the fence that want to keep the distinction between DO and MD. for me i dont really care. i will be able by law to use drugs and if I want OMM to treat patients. i also believe that patients should be skeptical of all medical professionals. just earn their respect and you will be fine. the problem comes when someone walks into the room with initials on their badge with a white coat and the patient stops thinking. patients are smarter than the profession gives them credit for. often they know whats wrong with them, they just cant tell you, they need your help.

i encourage you to hang in there. remember you chose it because you saw something in it and the profession saw something in you, and you may be losing sight of it due to mainstream pressure or academic intensity or whatever. just remember that it is not the degree that you hold that predicts what kind of physician you will be, it is you. so if you dont like OMM, you dont have to use it.

but i think you are right, the days of us versus them really need to end, and unfortunately the AOA is a propaganda machine cause if the two fields ever merge, its identity would be swallowed like a black hole by the AMA. but AMA memberships are also at a all time low, could this be that all medical professionals DO or MD no longer feel they are being represented well? maybe.

 

[mcandy]

Sorry to hear you are having a rough go of it your first semester in school. I too was a little skeptical of OMM before coming to school. I was uncertain if all of the things I felt were positive about osteopathy were worth having to continuously answer the "what is a DO" question and having to deal with a "stigma" that really only seems to thrive in the ignorance of the premed realm and amongst the really old MDs. I turned down an ivy league acceptance to go DO and do not regret it for a second!

Have you spent time with a cranial sacral professional? It was CS that actually convinced me of desire to be an Osteopath. I spent several days with Dr. Donald Hankinson (a legend in the field, but you all already knew that being well read) and had the oppurtunity to meet his patients. His work on the days I visited had fixed asthma, chronic ear infections, and had restored sensation and minimized pain in an individual who had had several botched back fusions. These were patients I interacted with and spoke with when the Doc was out of the room (unsolicited)...they were people from all walks of life, a 16 year old cheerleader, an old hippy nurse, and a wealthy lawyer. And no they were not all cured miraculously during the one encounter I witnessed.

My MD cousin recently had a baby which in a resulted sciatica so horrible she couldnt walk and was unable to leave the hospital...her MD husband gave her tylenol and she toughed out the weekend. An osteopathic student, MS4, on clercships visited her floor on monday, did a little OMM, and she was up and walking home within an hour.

I am an injury prone dummy who loves to play hockey and continuously pull my groin (I guess I am supposed to call them adductors know that I am educated)...my MS1, sorry OMS1, girlfriend did a little counterstrain and whalla! I could get out of bed without crying and walk without a limp.

I love the gait training we get as DOs too. I sit at the coffee shop and watch people walk and am begininng to understand that everything is a system and that those crappy flip flops are going to hurt your back and the nerves asscoiated with that region may refer pain elsewhere or disrupt the system and manifest in other problems..it is also awesome to understand the relationships between injuries and what happens up and downstream as a result. There is also something to be said for hands on/palpatory diagnostic skills...enough said about that!

I must quit rambling now...some big exams to study for...I hope you find what makes you happy. Oh and contact the AOA as they can steer you in the direction of a whole bunch of CS study and there is already oodles of research on counterstrain and muscle energy if you take the time to search. And you are right more does need to be done...always and with every part of medicine best of luck with your path. .

PS I wrote one of those dumb cards to the tv shows...I think having more people knowing about us great...TV is god in america so let god educate the masses.

 

[Buster Douglas]

to the OP- none of the issues you have raised are new issues. ALL of them have been debated countless times on a number of threads. these aren't secret issues you are only exposed to once you've matriculated into an osteopathic school. its obvious to me that you didn't do your research ahead of time-- as in, finding candid DOs and medical students who were willing to discuss with you both the pros and cons of their profession, or really throroughly searching through sdn and other similar sites for a wide range of opinions. that would be your own fault, not osteopathic medicine's.

secondly, all schools are different. had you gone somewhere else, your opinion may have been opposite. therefore, i disagree with your generalization of "regret going to an osteopathic school" instead of inserting your school's name. plenty of other posters have not been afraid to reveal negatives about their specific school, so why are you? perhaps a fabulous professor or a fabulous experience at another school would have made you look more positively on the things in the osteopathic world that need change.

thirdly, despite some of the shortcomings, osteopathic medicine and osteopathic medical school has its benefits-- all those reasons that made you apply DO in the first place, and all those reasons more students are applying DO each year and more schools are opening. not to mention changes are happening. if you had been in san fransisco last week, you would have seen that. wheels are turning, things are in the works. but it's because of students who are postive about osteopathic medicine and want to support what it is, and what it can be.

if you dont like the comlex, take the usmle as well. if you dont want to do an AOA residency, do an ACGME residency. if you hate osteopathic medicine so much, DONT BECOME A DO. you are not doing yourself, any of the rest of us, or your future patients, a favor by becoming something you apparently hate.

that said, im sorry that you are having a bad experience. i knew both the positives and the negatives about osteopathic medicine before i applied, yet i still chose the DO route, and im happy i did. you say you cant transfer or start over for personal reasons, but im sure if thats what you really felt was best for you, you could find a way. life is too short to be miserable. if you made a wrong choice, your best bet is to fix it. either change your school or change your attitude.

I'm actually right there with you about the ridding of the COMLEX, needing to be accredited by the LCME, and whacked out marketing stunts of the AOA (i.e."DO's on TV", "treating the patient, not just symptoms", "OMS-#", etc.), but when it comes to OMT and the DO title, I have little sympathy for you.

You wanted to become a "DO" just because the students are less anal retentive gunners? Maybe we should change the name, cause Lord knows there's some gunners in my class. As true or false as the generalization may be, you knew damn well DO = MD + OMT, so whatever dude. As for "needing to believe" to make sure it works... your patients will tell you what does and doesn't work. 99.9% of DO students don't believe in ALL of OMT. As with anything you learn, you use what you know works for you and move on.

Concerning research, DO schools aren't set up like MD schools cause our focus is different. It's even in my schools freakin mission statement that it exists in order to churn out primary care physicians in underserved areas. Not that there's no need for research in the areas of FP, EM, pediatrics, etc., but DO schools will always be behind in research unless there's a dramatic shift in focus from "rural medicine" to "academic medicine", and the AOA mandates that every school be connected to large well-funded universities and ajoining hospitals.

 

[LukeWhite]

5)RESEARCH - Osteopathic medicine had leeched off of allopathic medicine since we accepted the use of drugs to treat illness. It's about time we started to contribute something back to the development of medicine.

All these other grievances aside, what's so awful about leeching off allopathic research? Some would argue that *the* major difference between the disciplines is that allopathic medicine spends extra time on academics in order to better serve people going into research, and osteopathy spends extra time on elements that will help the traditional rural/frontier doc. It's an efficient allocation of resources, and allows students to choose a broad area of focus.

As long as some schools are doing one or the other, I don't see why every school, or even ever discipline, has to be doing both. It would be terribly inefficient to have a medical school that tries to educate both for research and for primary care. So inefficient, in fact, that the only ones that manage to pull this off well are the big state-funded, and therefore usually allopathic, schools.

If you went into medicine for research, osteopathy was probably a bit of a detour. But you surely knew that before applying, right?

 

[babyruth]

I don't think the OP is going to answer any of your questions. Just looks like a rant to me.

 

[sophiejane]

I am wondering why the OP was so excited about being a DO in the first place if he/she was so skeptical of pretty much everything that makes DOs different. It is true the lines are fading, but that is due as much to MDs becoming more saavy to alternative modalities (and yes, OMM is "alternative" in that respect) and treating patients in more holistic way, while DOs have been steadily moving into more mainstream medicine.

We are going to meet in the middle at some point, sooner rather than later.

So just chill out, my friend. Grin and bear OMM if it's not your thing. The things that seem important now will fade away the further you get. And if they don't, you might have made the wrong choice. The point is to become a doctor, which you will do, unless you burn yourself out with negative energy first.

You are going to need that energy, so I'd suggest you find a way to make peace with your situation, find a way to change it, or find a way out of it.

(...and PS: cranial is a little weird at first, but it's pretty cool the first time you use it to fix a headache on the spot. Maybe try to be a little more open-minded. You never know what you might learn).

 

[mfrederi]

Yeah, I too was very frustrated with OMM. Part of the problem is that they force feed you everything like it is gospel truth, when most of it has had neglible results in clinical trials. However, if you have ever pulled a muscle, or really had some pain in your back that was due to some sort of rotation (I know you probably don't even believe in vert rotation, cause neither did I) and someone maniped you, you will know the benefit of manip. Does it cure everything they say it does? No, otherwise I think some freaking neurologist with an open mind would have decided that all these kids getting their autism fixed by squeezing on their head might be a big deal. However, it has some value, and I encourage you to experiment and try it on your own without the high priests of OMM watching over you. Find things that are good, and don't be afraid to use them on friends / family, etc. And take things that are ridiculous (like indirect on the fibula) and forget about them as soon as you are done with them. I really despised the first year of mainp, but in MSII they let you use pretty much whatever method you want to fix stuff, so it is actually alright this year. Good luck, I know its tough, but you are already in DO school. There were times I wanted to transfer last year, but in the end I will be glad I didn't. And, believe or not you will start seeing that yes, there is a little difference b/t DO's and MD's education, and yes, there is more focus on the pt as a whole in DO school. It ain't all its cracked up to be sometimes, but you just gotta find the good things about where you are right now.

 

[FrustratedDO]

Yeah, I too was very frustrated with OMM. Part of the problem is that they force feed you everything like it is gospel truth, when most of it has had neglible results in clinical trials. However, if you have ever pulled a muscle, or really had some pain in your back that was due to some sort of rotation (I know you probably don't even believe in vert rotation, cause neither did I) and someone maniped you, you will know the benefit of manip. Does it cure everything they say it does? No, otherwise I think some freaking neurologist with an open mind would have decided that all these kids getting their autism fixed by squeezing on their head might be a big deal. However, it has some value, and I encourage you to experiment and try it on your own without the high priests of OMM watching over you. Find things that are good, and don't be afraid to use them on friends / family, etc. And take things that are ridiculous (like indirect on the fibula) and forget about them as soon as you are done with them. I really despised the first year of mainp, but in MSII they let you use pretty much whatever method you want to fix stuff, so it is actually alright this year. Good luck, I know its tough, but you are already in DO school. There were times I wanted to transfer last year, but in the end I will be glad I didn't. And, believe or not you will start seeing that yes, there is a little difference b/t DO's and MD's education, and yes, there is more focus on the pt as a whole in DO school. It ain't all its cracked up to be sometimes, but you just gotta find the good things about where you are right now.

I kinda feel like Jerry McGuire after he wrote that diatribe and emailed it to everyone. Of all the posts so far, that one above really struck me as the most insightful by far. I think what turns me off so much about OMM is the attitude with which its pushed on us - as if its the single most important subject we are taught. I don't llike being force-fed it. Yes, some of it works and feels great - my husband likes to be practiced on. But I just can't seem to accept it as the foundation of a whole system of medicine.

Yeah, this was a rant, and I'm sorry if I offended anyone, but my concerns are real. Like it or not, osteopathic medicine has issues which it is going to have to deal with in the future. Like I said, I didn't want to start a flame war, just a dialouge.

 

[Idiopathic]

All these other grievances aside, what's so awful about leeching off allopathic research? Some would argue that *the* major difference between the disciplines is that allopathic medicine spends extra time on academics in order to better serve people going into research, and osteopathy spends extra time on elements that will help the traditional rural/frontier doc. It's an efficient allocation of resources, and allows students to choose a broad area of focus.

As long as some schools are doing one or the other, I don't see why every school, or even ever discipline, has to be doing both. It would be terribly inefficient to have a medical school that tries to educate both for research and for primary care. So inefficient, in fact, that the only ones that manage to pull this off well are the big state-funded, and therefore usually allopathic, schools.

If you went into medicine for research, osteopathy was probably a bit of a detour. But you surely knew that before applying, right?

I agree with Luke (what?) here. I dont value structured research of OMT as much as anecdotal evidence, due to the fact that SO much of OMT Rx is subjective. How easy is it to quantify "how is your pain now?" and "are you as stiff as your were this morning?"...I do believe in testimonials of actual patients however, and I believe in the responses I have gotten diagnosing and treating family members/friends/patients, etc...I am very scientific at heart, and while OMT as medical career has not captured me, OMT as 'tool in doctor bag' has certainly impressed me.

To the OP, I am sorry to hear that you are disappointed, but so are people at NOVA, Harvard, and UT-Galveston. You can't expect to have every expectation met, and you must be able to roll with the punches, so to speak. Learn what you feel your instructors are not teaching you, on your own if you must. Try and absorb that which you need to make you an excellent physician, and go out and happily represent the community of osteopaths that so desperately want to be represented. If you dont feel OMT, then dont practice it. No one will look down on you (although some people will seek you out for it). As with anything in life, 90% of what you learn is self-taught.

 

[Elysium]

Hey Frustrated DO,

I feel your pain. When I first got to DO school I had an open mind about the whole OMM thing and even thought it would be a very valuable tool. After about a month I realized it just wasn't my thing. I'm pretty bad at it (mostly because I don't really buy it) and it's hard to take yourself seriously when you've got someone's leg in your arm and your finger up their ass. (low ilium flare out tenderpoint what?) I try doing this stuff on my boyfriend with a straight face (he's a third year MD student) and we both just start cracking up. Most of our OMM faculty are wonderful (one of them was at PCOM last year), but one of them is a total fruitcake (SophieJane? Know what I'm saying? ). This person is way, way into cranial, says they practice "energy medicine", doesn't know CRAP about clinical medicine at ALL (like how to treat hypertension), says that OMM can cure dyslexsia, etc, and refuses to have lights on in their office because it ruins the "aura". We have to do breathing exercises ("picture the blue light...") and we're called "brilliant children of the universe". Etc. This one instructor has basically turned me off OMM.
So, OMM is not my thing. I resent having to spend over 40 hours memorizing the location and treatment for 118 tenderpoints. I resent the time that is spent NOT learning useful subjects like anatomy and phys and neuro (crap that I might see on the boards). I call OMM my punishment for doing poorly on the MCAT.

Also, I resent that some of the DOs think that osteopathy has the marketed cornered on "holistic medicine". That's a load. There are good and bad MD and DOs. My dad is an MD and he practices "holistic medicine". He spends upwards of hour with EACH PATIENT. I've learned nothing so far that is in anyway different (in approach) than my MD friends. I have sincere doubts that they're being told to ignore their patient and leave the room in under 30 seconds in their Physical Diagnosis classes.

That said, I don't discount that some of it can be useful. I would certainly refer a patient that has chronic back pain or some other MS "somatic dysfunction" to an OMM specialist. It just won't be performing the service.

There are people in my school that are WAY into OMM and most others are pretty middle of the road about it. I knew what going into DO school was about and that we would have to learn OMT. I just didn't know it was going to be so filled with auras and energy. I thought it was going to be more like physical therapy. So I was wrong. Boo hoo.

I'm at one of those new schools and I agree that the AOA needs to open some more quality residencies pronto. We even asked the president of the AOA about this when he came to our school and he honestly had NO ANSWER at all to this quandry. Somebody needs to figure something out. And soon.

So, that's my rant about OMM. I really am proud to be an OMS, though I refuse to refer to myself in such a lame way. I think there's a bit of flexibility in osteopathy, which is to its advantage.

 

[JMC_MarineCorps]

I call OMM my punishment for doing poorly on the MCAT.

Now that is funny! "Now eat your peas..."

For the record, I have no regrets. I am playing the game, having fun and just glad to be here!

 

[Docgeorge]

I was pretty skeptical when I first started OMM. I come to realise that some OMM is really usefull. I was the biggest sceptic when it came to strain/counterstrain. I thought it was a load of cr@p, but sometimes even crap has it's uses.

My uncle had major back pain for over a year. He usually did no physical activity and on a whim he decieded that he had to paint his house. So over the course of a long weekend he painted his house, and almost immediately after he started noticing pain. He went to his PCP, a neurologist, PT's, Pain Doc, after all the meds, and tests he was still in pain. PT helped but it came back 2 to 3 days after treatment. He was told that all that could really be done was to manage the pain, aka flexiril. He got so fed up with the pain he went to india to get an ayurvedic treatment for his back. As you can guess it did'nt help. I come home for a couple of weeks over summer and my mom, ever so proud of her son the "medical student" wanted me to take a look at her brother. I tried to tell her that if 3 doctors and a PT fix the problem, there was no way that this freshly minted MSII would have a snow balls chance in hell of doing any thing. Did she listen? So any way long story short I went over to my uncles took a look at his back. To my utter suprise I found a TTC. It was cold and ropey compared to the rest of his back. Then I started looking for tender points and I found it over the TTC. I gave him Tx for 3 times a week for 2 weeks. My uncle thinks I'm a genius or something now. He says his pain has decreased by 80% and want to to do more of the Strain/Counterstrain when I go home for christmas.

I know that this is purley anticdotal, but sometimes you don't argue with results espically if it makes mom happy. Was it a placebo effect? Maby, but it stopped his pain and made my mom happy so I dont care if it was or not. I'm a firm beliver in EBM, sometimes you dont have the data you need and you treat emprically. My hope is that over the next 10-15 years we as a profession get more data out there on the efficacy of OMM. Ditch the stuff that does'nt work, keep the stuff that works, and teach it to the MD's.

To the OP, for now just keep an open but questioning mind some of it might actually be use full. I cant believe some schools are teaching crainal already. We dont get it untill next sem. I really hope it is'nt all aobut the aura. The only time I like to see an aura is after consuming a certian central american plant after it has been rapidly oxidized.

 

[mfrederi]

Just for the record, the absolute biggest new agey Obi Won Kenobi style manip guy at our school is an MD. Thats right, as not from DO school. So, don't anyone ever think that having some wheels off ideas is only for DOs. You know, I appreciate that profs "interesting" ideas, because it challenges me to think about things in new ways. I don't accept it all, but when I go to church I don't agree with everything the pastor says either, despite fervently believing in Christ. Don't throw the baby out with the bath water. Unfortunately manip dept have an uncanny nack to ruin the good aspects of OMM in order to carpet bomb you with unproven wackiness. Has anybody on here felt the "cranial rhythm?" I was the BIGGEST skeptic, but I have felt it. Do I know what I was feeling (i.e. do I think that it was the rhythmic expanding of the cranial bones)? No, but I did feel something when I really, really expected I wouldn't. There is something to some of this stuff, some of it does not work. Don't be afraid though to try it and find out it doesn't work, because at least you have learned something then, and you will be a better doctor for it.

 

[NMH2001]

Hey Frustrated DO-

I will be honest and frank (even though I may get shunned for this..I really don't care)- I am sitting at a DO school because I did not get into any allopathic schools. That's the honest truth. Am I happy-YES! I am grateful and happy that I have the chance to become a doctor. Do I like OMM? Again to be honest-not really. I tend to dread Tues afternoons horribly! However, I recommend going to your OMM classes with an open mind and see what happens. I have learned some techniques that I think really do work, and I do see my self using someday. Then again there are some other things that I think are complete bull$hit and I don't think will ever use again.

To sum it up-don't be bitter that you didn't get into an allopathic school. Just be happy with what you are doing and stick it out with the OMM. Just remember that you don't have to use it ever again if you don't want to. But keep and open mind with it-you never know!!

 

[daveyboy]

Ok then, I officially change the word "plenty" to "many", are you happy now big guy? My point is, they are not non-existent and the fact that I have not started school yet does not preclude me from any knowledge about the medical field.

It does preclude you from having first hand knowledge of the medical school experience, which is what the OP was commenting on.

 

[medic170]

It does preclude you from having first hand knowledge of the medical school experience, which is what the OP was commenting on.

But I do know of the experiences and comments of many of my personal friends who are D.O.s

 

[medic170]

Here is some recent JAMA OMT Research from a year ago for the OP-just to show you research is being done that shows OMT works and is not all al load of crap:

The Use of Osteopathic Manipulative Treatment as Adjuvant Therapy in Children With Recurrent Acute Otitis Media
Miriam V. Mills, MD; Charles E. Henley, DO, MPH; Laura L. B. Barnes, PhD; Jane E. Carreiro, DO; Brian F. Degenhardt, DO


Arch Pediatr Adolesc Med. 2003;157:861-866.

Objective To study effects of osteopathic manipulative treatment as an adjuvant therapy to routine pediatric care in children with recurrent acute otitis media (AOM).

Study Design Patients 6 months to 6 years old with 3 episodes of AOM in the previous 6 months, or 4 in the previous year, who were not already surgical candidates were placed randomly into 2 groups: one receiving routine pediatric care, the other receiving routine care plus osteopathic manipulative treatment. Both groups received an equal number of study encounters to monitor behavior and obtain tympanograms. Clinical status was monitored with review of pediatric records. The pediatrician was blinded to patient group and study outcomes, and the osteopathic physician was blinded to patient clinical course.

Main Outcome Measures We monitored frequency of episodes of AOM, antibiotic use, surgical interventions, various behaviors, and tympanometric and audiometric performance.

Results A total of 57 patients, 25 intervention patients and 32 control patients, met criteria and completed the study. Adjusting for the baseline frequency before study entry, intervention patients had fewer episodes of AOM (mean group difference per month, -0.14 [95% confidence interval, -0.27 to 0.00]; P = .04), fewer surgical procedures (intervention patients, 1; control patients, 8; P = .03), and more mean surgery-free months (intervention patients, 6.00; control patients, 5.25; P = .01). Baseline and final tympanograms obtained by the audiologist showed an increased frequency of more normal tympanogram types in the intervention group, with an adjusted mean group difference of 0.55 (95% confidence interval, 0.08 to 1.02; P = .02). No adverse reactions were reported.

Conclusions The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant therapy in children with recurrent AOM; it may prevent or decrease surgical intervention or antibiotic overuse.

 

[sophiejane]

Just for the record, the absolute biggest new agey Obi Won Kenobi style manip guy at our school is an MD.

HAAHH!!!



That made me smile.

You gotta love him though. He's so far out there he's almost made a circle back to where he started.

 

[starrdoc]

"I don't llike being force-fed it. Yes, some of it works and feels great - my husband likes to be practiced on. But I just can't seem to accept it as the foundation of a whole system of medicine."

Alright I think you should have done some more research on the field of Osteopathic medicine as a whole. But if you didn't look at what this type is medicine all about, and you are still bitter that you couldn't get into an MD school (if that is the case) I'm terribly sorry. If your school hasn't taught you already the Osteopathic Principles that our profession is based around, let me enlighten you:
1)The body is a unit; the person is a unit of body, mind, and spirit.
2)The body is capable of self-regulation, self-healing, and health maintenance.
3)Structure and function are reciprocally interrelated.
4)Rational treatment is based upon an understanding of the basic principles of the body unity, self-regulation, and the interrelationship of structure and function.

Now please tell me where it says that OMM is the foundation of our profession. They emphasized to us over at LECOM-B and in the world of Osteopathic Medicine that OMM is a tool to use in practice. Understand that this is not the cornerstone of what we do. We are being trained to provide health care(period) Now I do agree there are some advancements that could be made to improve the profession, but that is with any field of medicine (both MD and DO). Please stop whining, and trying to create this stigma that is self-inflicted. Thanks.

 

[FrustratedDO]

Please stop whining, and trying to create this stigma that is self-inflicted. Thanks.

Thank you for your marvelous insight, but I beg to differ with you. Simply because I may voice an opinion that you disagree with does not mean I'm 'whining'. This is exactly the kind of attitude that I rail against in our OMM classes. It's this policy of being looked at as a heretic or a traitor or the dreaded "MD wannbe/reject" if you dare question the holy OMT sacrament.

I opened up the JAOA today when it arrived in my mailbox. I was looking through the letters to the editor section, when I read an article by a DO that I found especially relevant to this discussion. Here it is:

JAOA ? Vol 104 ? No 10 ? October 2004 ? 405-406

The Elephant in the Room: Does OMT Have Proved Benefit?
Bryan E. Bledsoe, DO, FACEP

Midlothian, Texas

To the Editor:

I would like to congratulate John C. Licciardone, DO, MS, et al on another high-quality study, "A Randomized Controlled Trial of Osteopathic Manipulative Treatment Following Knee or Hip Arthroplasty," evaluating the efficacy of osteopathic manipulative treatment (OMT) (J Am Osteopath Assoc. 2004;104:193-202). The results of this randomized controlled trial indicate that OMT in the setting of postoperative knee arthroplasty is ineffective. Further, on one outcome measure, OMT actually decreased rehabilitative efficiency.

This study is an important contribution to osteopathic medicine's knowledge base. It has findings similar to those of Dr Licciardone and colleagues' earlier study that showed no added benefit of OMT over sham treatment for chronic low back pain.1 The earlier study, also a randomized controlled trial, was published in a predominantly allopathic medical journal and has not been openly discussed in the osteopathic medical literature.

In the last paragraph of his article, Dr Licciardone and colleagues state what many osteopathic physicians have come to believe: Healthy patients derive more benefit from OMT than those who are ill or injured. This seems intuitive and supports the hypothesis that OMT has a minimal effect. Such an effect may be all that is needed for people who are healthy; people with injury or illness, however, are not as likely to receive significant benefit from OMT. Moreover, one could argue that when OMT does have an effect, it is little more than the classic placebo effect. It certainly offers some Pygmalion effect; however, which occurs when a persistently held belief becomes a perceived reality

This begs the question of why members of the osteopathic medical profession continue to teach an outdated and ineffective system of healthcare to undergraduate osteopathic medical students.

It is important that osteopathic medical students know the history of osteopathic medicine and the ideas that A. T. Still, MD, DO, professed. But Still lived in the preantibiotic and presurgical era. His findings, though important at that time, are of little more than historic interest today. He did the best with what he had. Likewise, practitioners such as Christian Friedrich Samuel Hahnemann, MD, the founder of homeopathy, did the best with what they had as well. But under the scrutiny of the scientific method, such antiquated practices as homeopathy and magnetic healing have fallen by the wayside.2 It seems that OMT will and should follow homeopathy, magnetic healing, chiropractic, and other outdated practices into the pages of medical history.

I received an excellent undergraduate medical education and am proud to be a DO, but I cannot continue to support an antiquated system of healthcare that is based on anecdote or, in some cases, pseudoscience. As a medical school student, I was taught to critically analyze problems and practice evidence-based medicine. When it came to courses in osteopathic principles and practices, however, my peers and I were asked to put aside our critical, evidence-based medical skills and accept the tenets of OMT on faith. When we questioned such esoteric practices as craniosacral therapy and energy field therapy, we were told that "we needed to believe." Likewise, when less than 5% of the class "felt" the craniosacral rhythm, the rest of the class was derided for a lack of faith?to the point that ejection from the medical school was threatened. When we complained that some students were using barbeque strikers to stimulate invisible "energy fields," we were told that in time, we would come to understand and believe.

In osteopathic medical school, OMT courses were so steeped in history, tradition, and anecdote that a question included on a final examination asked the name of the mascot of the American School of Osteopathy in 1906, a query without any clinical relevance whatsoever. When my classmates and I inquired into the science of OMT, we were given copies of studies that were little more than statements of faith published in the Journal of the American Osteopathic Association more than 50 years ago. As Mark Twain wrote in his book, Following the Equator, "Faith is believing what you know ain't so."

How can the osteopathic medical profession deliberately seek the brightest college graduates to become osteopathic physicians and at the same time, ask those students to believe in and practice modes of therapy that have little or no proved effect? Likewise, how can osteopathic physicians, with a straight face, ask those students to believe that the fused bones of the skull move in a magic rhythm that mainstream researchers have never been able to document?3-6 (Perhaps the findings of these researchers would be different if they had "faith.") How can we ask students to believe that the body has an energy field that cannot be seen or objectively measured or ask students to believe that providing myofascial release will cause the tissues to "remember" the trauma that caused their injury? This is what we were taught; it did not make sense then and makes even less sense now.

Therefore, I express my congratulations to Dr Licciardone and his colleagues. I hope they continue to ask and answer the hard questions. The testament to osteopathic medicine as a profession will be whether it responds to accumulating scientific evidence and modifies its practices accordingly or simply reverts to a call for faith. Osteopathic medicine has found a niche in modern medicine, not one of a medical specialty that practices OMT, but as a medical specialty that produces well-rounded primary care physicians. The future of osteopathic medicine is bright. But, the future is in the continued graduation of competent and compassionate primary care physicians and not in the historic dogma of OMT.

 

[medic170]

Thank you for your marvelous insight, but I beg to differ with you. Simply because I may voice an opinion that you disagree with does not mean I'm 'whining'. This is exactly the kind of attitude that I rail against in our OMM classes. It's this policy of being looked at as a heretic or a traitor or the dreaded "MD wannbe/reject" if you dare question the holy OMT sacrament.

I opened up the JAOA today when it arrived in my mailbox. I was looking through the letters to the editor section, when I read an article by a DO that I found especially relevant to this discussion. Here it is:

JAOA ? Vol 104 ? No 10 ? October 2004 ? 405-406

The Elephant in the Room: Does OMT Have Proved Benefit?
Bryan E. Bledsoe, DO, FACEP

Midlothian, Texas

To the Editor:

I would like to congratulate John C. Licciardone, DO, MS, et al on another high-quality study, "A Randomized Controlled Trial of Osteopathic Manipulative Treatment Following Knee or Hip Arthroplasty," evaluating the efficacy of osteopathic manipulative treatment (OMT) (J Am Osteopath Assoc. 2004;104:193-202). The results of this randomized controlled trial indicate that OMT in the setting of postoperative knee arthroplasty is ineffective. Further, on one outcome measure, OMT actually decreased rehabilitative efficiency.

This study is an important contribution to osteopathic medicine's knowledge base. It has findings similar to those of Dr Licciardone and colleagues' earlier study that showed no added benefit of OMT over sham treatment for chronic low back pain.1 The earlier study, also a randomized controlled trial, was published in a predominantly allopathic medical journal and has not been openly discussed in the osteopathic medical literature.

In the last paragraph of his article, Dr Licciardone and colleagues state what many osteopathic physicians have come to believe: Healthy patients derive more benefit from OMT than those who are ill or injured. This seems intuitive and supports the hypothesis that OMT has a minimal effect. Such an effect may be all that is needed for people who are healthy; people with injury or illness, however, are not as likely to receive significant benefit from OMT. Moreover, one could argue that when OMT does have an effect, it is little more than the classic placebo effect. It certainly offers some Pygmalion effect; however, which occurs when a persistently held belief becomes a perceived reality

This begs the question of why members of the osteopathic medical profession continue to teach an outdated and ineffective system of healthcare to undergraduate osteopathic medical students.

It is important that osteopathic medical students know the history of osteopathic medicine and the ideas that A. T. Still, MD, DO, professed. But Still lived in the preantibiotic and presurgical era. His findings, though important at that time, are of little more than historic interest today. He did the best with what he had. Likewise, practitioners such as Christian Friedrich Samuel Hahnemann, MD, the founder of homeopathy, did the best with what they had as well. But under the scrutiny of the scientific method, such antiquated practices as homeopathy and magnetic healing have fallen by the wayside.2 It seems that OMT will and should follow homeopathy, magnetic healing, chiropractic, and other outdated practices into the pages of medical history.

I received an excellent undergraduate medical education and am proud to be a DO, but I cannot continue to support an antiquated system of healthcare that is based on anecdote or, in some cases, pseudoscience. As a medical school student, I was taught to critically analyze problems and practice evidence-based medicine. When it came to courses in osteopathic principles and practices, however, my peers and I were asked to put aside our critical, evidence-based medical skills and accept the tenets of OMT on faith. When we questioned such esoteric practices as craniosacral therapy and energy field therapy, we were told that "we needed to believe." Likewise, when less than 5% of the class "felt" the craniosacral rhythm, the rest of the class was derided for a lack of faith?to the point that ejection from the medical school was threatened. When we complained that some students were using barbeque strikers to stimulate invisible "energy fields," we were told that in time, we would come to understand and believe.

In osteopathic medical school, OMT courses were so steeped in history, tradition, and anecdote that a question included on a final examination asked the name of the mascot of the American School of Osteopathy in 1906, a query without any clinical relevance whatsoever. When my classmates and I inquired into the science of OMT, we were given copies of studies that were little more than statements of faith published in the Journal of the American Osteopathic Association more than 50 years ago. As Mark Twain wrote in his book, Following the Equator, "Faith is believing what you know ain't so."

How can the osteopathic medical profession deliberately seek the brightest college graduates to become osteopathic physicians and at the same time, ask those students to believe in and practice modes of therapy that have little or no proved effect? Likewise, how can osteopathic physicians, with a straight face, ask those students to believe that the fused bones of the skull move in a magic rhythm that mainstream researchers have never been able to document?3-6 (Perhaps the findings of these researchers would be different if they had "faith.") How can we ask students to believe that the body has an energy field that cannot be seen or objectively measured or ask students to believe that providing myofascial release will cause the tissues to "remember" the trauma that caused their injury? This is what we were taught; it did not make sense then and makes even less sense now.

Therefore, I express my congratulations to Dr Licciardone and his colleagues. I hope they continue to ask and answer the hard questions. The testament to osteopathic medicine as a profession will be whether it responds to accumulating scientific evidence and modifies its practices accordingly or simply reverts to a call for faith. Osteopathic medicine has found a niche in modern medicine, not one of a medical specialty that practices OMT, but as a medical specialty that produces well-rounded primary care physicians. The future of osteopathic medicine is bright. But, the future is in the continued graduation of competent and compassionate primary care physicians and not in the historic dogma of OMT.

I gave you one JAMA(that's right, not JAOA) article with positive effictiveness research, and there are more, so why do you only acknowledge the negative and continue to profess that there is only anecdotal evidence and that OMM is purely believed on faith alone? Some of it has been disproven, but much of it has been proven to help.

 

[medic170]

How can we ask students to believe that the body has an energy field that cannot be seen or objectively measured .

Ever heard of religion? 98% of the world's population believes in it in one form or another. This, like it or not, has a place in medicine, even if it is psychological alone. But really, is 98% of the world just delusional, or maybe there are spiritual forces at work too?

 

[EMTLizzy]

The Elephant in the Room: Does OMT Have Proved Benefit?
Bryan E. Bledsoe, DO, FACEP

Not on the original topic of this thread but....

I think it's great that the JAOA is willing to print this. Not only did they publish an article that, apparently, does not claim to show that OMT works, but they also printed a letter of this nature from a DO.

(Those of you who are in the EMS world are probably familiar with Dr. Bledsoe. I have a bit of hero worship for him. And I am using many of his journal articles in my thesis research.)

I'm not so sure I agree with Bledsoe's belief that OMM should go the way of "outdated practices of medical history", but I do think it should continue to be studied.

At the same time, I don't think DO's should get so defensive about the sacred cow of OMM. Chiropractors are often labeled as "quacks" for cracking peoples backs, but they claim their profession proudly. Being a DO is so much more than OMM. If it works on some people...great. If it doesn't work...too bad and try something else. Do more studies to validate it and promote it or to discredit it (if research is your thing).

I also want to add that I am not in med school yet, but from what I understand you're learning OMM practically from your first day of school. Your other classes are physio, anatomy etc...more along the lines of basic sciences and not clinical sciences. Then isn't OMM your first class where you're learning a "clinical skill"? So your OMM profs are going to be DO's who practice OMM, right? Well of course they're going to be cheerleaders for their work. Wouldn't a cardiologist be proud of his/her work and encourage others to use skills learned there? A neurologist? A GP? Different strokes for different folks.


There are various reasons why I chose to apply to osteopathic schools. Ironically, a large part of it was due to the encouragement of my mom, an MD, who was very impressed with the DO residents rotating with her. She found them to be excellent clinicians and at the same time was disillusioned with many of the MD residents she had who were educated at her alma mater. Also, when beginning the application process I just found the osteopathic schools to have a genuine interest in what type of person they were letting into their school. Not just how did they look on paper, but what was the whole package. I hope I'm not unhappy with my choice when I do get there, but if I was unhappy I would probably consider that medicine as a profession was not for me rather than that it was a DO/MD thing or even just the school.

If you want something badly enough you will find a way to get it. Isn't that how we all ended up where we are now? Either in med shcool or knee deep in the application process? If there is an unpleasantness you have to put up with you accept it as another bump in the road of life. If you choose to never use OMM after you finish medical school then that's your right.

 

[starrdoc]

FrustratedDO:

You totally missed my point, and I'm sorry if I said you were whining. I'm trying to understand where you are coming from. My whole point was that DO's have an extra tool in OMM to use to evaluate somatic disfunction. This **** isn't magic, it is just exploiting the fact you can use palpation, soft tissue, direct techniques, etc. to help alleviate problems presented. Now if your patient comes in with a torn ACL, this stuff goes out the window because obviously you can't use OMM to treat this. You are taking the OMM too seriously, just know your anatomy, and know where everything is so you can best equip yourself to be a good physician. LET ME EMPHASIZE AGAIN: OMM is not Osteopathic Medicine, it is simply a treatment modality, that yes I admit some of the techniques are a little outdated. You are so stuck on proving a point that I think you forgot why you wanted to be a physician in the first place. As a future colleague I'm just suggesting you realize why you chose DO, and I would hope it would be to better the field and to live a fulfilling life. I would just hate for you to be a practicing DO, bashing our line of work, when the profession is thriving so much.

My best advice be a neurosurgeon, and you won't ever have to look or use OMM ever again. And then you could stop whining... j/k of course.

 

[medic170]

Not on the original topic of this thread but....


(Those of you who are in the EMS world are probably familiar with Dr. Bledsoe. I have a bit of hero worship for him. And I am using many of his journal articles in my thesis research.)

I'm not so sure I agree with Bledsoe's belief that OMM should go the way of "outdated practices of medical history", but I do think it should continue to be studied.

.

I had 2 CE courses with Bledsoe at Expo last year. he did not impress too much in person. ZWhen people asked him questions, he was unable to deviate from his prepared lesson plan. Maybe just had a bad day.

 

[nub]

HAAHH!!!



That made me smile.

You gotta love him though. He's so far out there he's almost made a circle back to where he started.

just wait until you rotate with him next year!