As a Doctor of Osteopathic Medicine (DO) and a former osteopathic teaching fellow, entering the allopathic match (National Resident Matching Program) last year instead of the osteopathic match (AOA Intern/Resident Registration Program) could have meant leaving behind my skills and passion for osteopathic manipulative treatment (OMT).
Every spring, medical students learn where they will complete residency training in a specialty of their choosing, a process informally known as “the Match.” Because of my desire to pursue a more public health focused residency, I entered only the allopathic match and was thrilled to join Duke Family Medicine in July 2014.
I was relieved to find that with five of our twelve current residents holding degrees from osteopathic medical programs, I felt well supported in my desire to continue to use and improve my OMT skills while at Duke Family Medicine.
Osteopathic manipulative treatment (OMT) is a methodology practiced by osteopaths that involves using one’s hands to both diagnose and treat musculoskeletal, as well as lymphatic, cardiovascular and cranial dysfunction. The treatments range from gentle stretching and manipulative treatments similar to a physical therapist or massage therapist to more aggressive techniques similar to what a chiropractor might use. Most importantly, all of these techniques incorporate a solid knowledge of how the musculoskeletal, cardiovascular, lymphatic and nervous systems interrelate.
These last few weeks in particular have reminded me of the joy that is part of OMT. Recently, I hosted ten friends who also happen to be co-residents, their partners, and Duke midwives for an evening of OMT discussion and social interaction. I viewed the night as a pilot for future, larger events to gauge interest and feasibility. During the evening, we had a discussion of different applications for OMT and the philosophy behind the practice.
One of my favorite parts of being a DO is using the four tenets of osteopathy in my practice. The four tenets are:
- The body is a unit; the person is a unit of body, mind, and spirit.
- The body is capable of self-regulation, self-healing, and health maintenance.
- Structure and function are reciprocally interrelated.
- Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.
Remarkably and fortunately, these ideas are not unique to osteopathic medicine but are also practiced regularly by the providers at Duke Family Medicine Center, which did not go unnoticed by those in attendance at the event at my home.
I was delighted at the wonderful conversation and questions that came from the group. In an effort to continue this enthusiasm, I would like to host more events focused on the discussion of OMT.
In addition to this experience, I was able to lead our residency journal club discussion on March 31. My fellow residents and I discussed an article focusing on the efficacy of OMT in the treatment of lower back pain. It was a lively dialogue that highlighted the challenges in designing studies of any hands-on modality when a placebo is desired.
Professions like osteopathic medicine and physical therapy face a difficult task when designing a randomized trial trying to examine if a hands-on treatment is effective because creating a “placebo” means trying to mimic a hands-on skill in a way that does not actually deliver a treatment but where a patient believes they have received a therapy.
After this journal club, I was again appreciative of all of the wonderful questions the article generated. I was thrilled to see the level of interest in the topic from all of those present, regardless of training background.
I am truly grateful for the diversity I have encountered at Duke Family Medicine. Our faculty and residents are not only open to various types of practice, but also actively interested in them. I could not imagine a better place to train.
Vanessa Solomon is a first-year resident at Duke Family Medicine. Anyone interested in learning more about OMT or attending an evening of OMT discussion, email vanessa.solomon@duke.edu.