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:
- The body is a unit: mind,
body, and spirit.
- The body possesses self-regulatory
mechanisms, having the inherent capacity to defend, repair, and remodel itself.
- Structure and function are reciprocally
inter-related.
- Rational therapy is based on consideration of
the first three principles
And now, to a wall of text, with some added comments for
context:
================
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.
(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.
==========
/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).
