Mind, body, and Shenanigans

CONTEXT: My dear friend is in Australia and considering applying to DO school. I’m trying to show him my viewpoint of said philosophy and decided to share it, slightly modified. Here’s a quick excerpt/summary from Wikipedia:

Osteopathic medicine was founded by a man named A.T. Still in 1874, who decided conventional medicine (at the time, allopathic medicine aka MDs aka blood letting and leaches and all that) was insufficient to treat disease after watching 3 of his children die from spinal meningitis. He believed that the body’s health was based on the bones and fascia. The 4 basics of osteopathic medicine are:

1. The body is a unit: mind, body, and spirit.
2. The body possesses self-regulatory mechanisms, having the inherent capacity to defend, repair, and remodel itself.
3. Structure and function are reciprocally inter-related.
4. Rational therapy is based on consideration of the first three principles

 And now, to a wall of text, with some added comments for context:

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Not sure if you know what osteopathic manipulation looks like because I know I sure as hell didn’t before my first OPP (osteopathic principles and practices) class, so here two videos.

Something I would use (start at 1:28): http://www.youtube.com/watch?v=1q70NMsXw2o

Border-line retarded and something I would never use (start at 1:15): http://www.youtube.com/watch?v=lPB9LfYqFMc

(previous part of letter leading into)still on the edge about osteopathic techniques. They might work to relieve “pain,” usually musculoskeletal, but I think it’s only a temporary measure or a placebo effect. I got treated yesterday for my back pain, and it felt good for a few hours, now it hurts like a mo’fo’. That being said, is a temporary relieve from pain enough to justify learning these techniques? Is the possible placebo effect worth it if my patient’s feel like it’s helping? I can’t help but feel that I’m deceiving them, but I’ve always been a skeptic of anything that doesn’t have research supporting it. All osteopathic “research” was done in the 20s-60s and is shenanigans. I think they need a huge study on lower back pain where one group of people receive osteopathic care, one receive medications, one receive placebo medication, and one receive nothing. Then they would have to rate on pain relief, total cost/time for treatment, and how satisfied they were with their healthcare. That would show if all this stuff might be worth it, but the old guard is far too afraid of the implications if their techniques were proven to be shenanigans. Stupid in my opinion, since if the opposite is true and it does prove to decrease pain and increase patient satisfaction, maybe it would be regarded as more of a probable treatment. Right now, the only “proof” our teachers give us is anecdotal evidence of how this one time OMT cured someone of ever pain after they had been to all those silly MDs and their modern medicine. Stupid.

(After further ramblings about my life, my friends responds with an email detailing “that darkest day in osteopathy.” tl;dr: In 1962, DOs in California could buy an MD degree for $65, 86% which did, and the DO school became UC-Irvine. Now my cuss filled response.)

Yeah, we are taught that story the first day of OPP, and are forced to memorize the dates as well. We also have to know the dates of A.T. Still's birth, when he 'threw the banner of osteopathy into the wind and broke from allopathic medicine', when he opened his first school, and when he died. We also have to know who 'invented' the OMT (osteopathic manipulative techniques) we learn and they all have these little back stories too.

Yeah, I guess that is fucked up, but people are scared of change, and those MDs were afraid back then. Now that former DO school is one of the top MD schools in the nation, and I bet they make no mention of DOs. 

In fact, I bet it's safe to say that all MD schools never mention DOs or our philosophies (I almost wrote 'their philosophies'). Why? Probably cause it doesn't matter to them at all, while here at DO school, we are always told about how we are the minority and how we will have to defend ourselves and our philosophies and how we are 'more complete physicians' than MDs since we have better palpatory skills and know OMT. The president of the AOA (American Osteopathic Association) said something along the same lines. Something about maintaining an identity or some shit.

I say FUCK ALL THAT!!! Fuck being divided or separate or unique or whatever. You know how many patients give a shit if you have an MD or DO? Very little. Hell, ask a random person on the street and they'll be like 'WTF is a DO?" You know why? 'Cause there isn't a difference in a clinical setting. You walk around a hospital and you can't tell the difference. You walk around a primary care clinic, and you probably will be able to tell the difference since that's where DOs practice osteopathic techniques and people go for treatment. Why? Probably because manipulation doesn't fix any major medical problem that people are hospitalized for. 

What they don't tell you on wikipedia is that the DO match is 2 weeks before the MD match for residencies. If you get matched into a DO residency, you are automatically pulled from the MD match. So I have shitty choice ahead: do I even bother applying for DO residencies when there are only 4 in Colorado (none of which I care for), or forego the DO match and hope like hell I can match in MD? Isn't it wrong that MDs can't match into DO residencies, but we can take theirs? Why is there a difference? Why shouldn't they all be the same? Because DOs want to keep their uniqueness or some bullshit like that.

MDs and DOs should be united in helping patients, yet the current DOs in charge of both LECOM and the AOA are soooooo caught up in being unique and holding a grudge, I think they are hurting patient's in the end by trying to plant these seeds of distrust and making it more difficult for all doctors to become practicing physicians. 

I'd say over 90% of the students here are not here because they 'believe' in osteopathic medicine, but because we didn't get accepted to an MD school. Do people believe in it after being treated or learning the techniques? Sure. Hell, I've treated (my roommate) for back and rib pain, and he felt better. I've been treated and felt mildly better. That being said, I've NEVER had back or neck pain until I got 'treated' here. I think the body strikes a balance with your life style, and being treated with OMT shifts that balance, causing pain somewhere else, which once treated, will lead to pain somewhere else. Eventually, will you get all the musculoskeletal problems (called somatic dysfunction), but without lifestyle changes or posture changes or even your normal gait changes, your body is going to try and reach that balance again and then you have to be fixed again.

It’s like if I gave you a drug that you can only get with an office visit. You had no/mild pain but I told you that you had somatic dysfunction (because everyone does). Once treated, that causes pain somewhere else, which can be treated with the same drug. Eventually, you have no more somatic dysfunction. But the pain/discomfort comes back, and you have to return to me to get the drug every time you have the same pain, which is probably every week. Every office visit and treatment with this drug costs money. Aren’t you better off not being treated in the first place? Wouldn’t it be better for your body to strike that balance again?

Of course, if a patient comes in with musculoskeletal pain, and it can be ‘cured’ with OMT, I’ll do it, but I’ll try to find the root of the problem first or teach the patient how to treat themselves before I tell them to come back every time (and pay money) when they have neck pain.

I have A LOT of problems with osteopathic medicine, but it’s my personality. Unless I see it myself, or see peer reviewed evidence of it, I’ll keep questioning its validity and be skeptical when the professor tells me that this technique can help with blah blah blah or this one time no MD could help so all this DO did was crack her this way and it was all ok.

True story, one question we had on an OPP test was: a patient is having left sided chest pain which is radiating to their arm. They are also in respiratory distress. Do you: A) crack their cervical spine B) take them to the ER C,D,E)foils. You know what the answer was a couple of years ago? CRACK THEIR FUCKING CERVICALS! BECAUSE THAT’LL HELP WITH A HEART ATTACK APAPRENTLY. I say a couple of years ago because one of the non-OPP professor was like “Are you serious?!?!?! If you said you did this in front of all your fellow physicians, MDs and DOs, they would remove your license in a heartbeat since that’s not what is 1)proven 2)any other doctor would do 3) incredibly dangerous to the patient.

It’s shit like that which pisses me off. They think that OPP is this miraculous, magical, cure all when it’s not. Sure, it can help with everyday pain. But with SERIOUS medical issues? Not even close. Fuck man, not even in the same universe. I’m leaning towards ER medicine, you can bet your ass I’m not going to use OPP on my patients. Friends, family with back pain? Sure, I’m down to try and treat them, but I don’t feel like OMT is something that people should have to pay for.

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/end rant

First year is done in 6 weeks. Can’t say I feel any smarter or anymore prepared to have strangers trust me with their lives. I also can't say I feel any close to my peers here, but that another post (which is likely not happening anytime soon).