Effectiveness of osteopathy in the cranial field and myofascial release versus acupuncture as complementary treatment for children with spastic cerebral palsy: a pilot study.
CONTEXT: Case reports and clinical trials have indicated that osteopathic manipulative treatment (OMT) may improve motor function and quality of life for children with cerebral palsy. OBJECTIVE: To assess the effectiveness of osteopathy in the cranial field, myofascial release, or both versus acupuncture in children with moderate to severe spastic cerebral palsy, as measured by several outcomes instruments in a randomized controlled trial. METHODS: Children between the ages of 20 months and 12 years with moderate to severe spastic cerebral palsy were enrolled in a single-blind, randomized wait-list control pilot study. There were three arms in the study: OMT (ie, osteopathy in the cranial field, myofascial release, or both, using direct or indirect methods), acupuncture, and control (ie, nontherapeutic attention). Children who were initially randomly assigned to the control arm were subsequently randomly reassigned to the intervention arms, increasing the sample size. Outcome measures included standard instruments used in the evaluation of children with cerebral palsy. Less traditional measures were also used, including serial evaluations by an independent blind osteopathic physician and visual analog scale assessments by an independent osteopathic physician and the parents or guardians. A total of 11 outcome variables were analyzed. RESULTS: Fifty-five patients were included in the study. Individual analyses of the 11 outcome variables revealed statistically significant improvement in two mobility measures for patients who received OMT--the total score of Gross Motor Function Measurement and the mobility domain of Functional Independence Measure for Children (P<.05). No statistically significant improvements were seen among patients in the acupuncture treatment arm. CONCLUSIONS: A series of treatments using osteopathy in the cranial field, myofascial release, or both improved motor function in children with moderate to severe spastic cerebral palsy. These results can be used to guide future research into the effectiveness of OMT or acupuncture in treating children with spastic cerebral palsy. (+info)
Supporting and promoting osteopathic medicine through community-based family practice preceptorships: a survey-based study.
CONTEXT: Michigan State University College of Osteopathic Medicine (MSUCOM) has long maintained a preceptorship program involving community-based osteopathic physicians who voluntarily provide osteopathic medical students with early clinical experiences in family practice. OBJECTIVE: To investigate the factors that influence osteopathic physicians to participate in the MSUCOM Family Medicine Preceptorship Program. METHODS: A self-administered survey consisting of 28 questions in five categories was mailed to all 177 osteopathic physicians participating in the MSUCOM Family Medicine Preceptorship Program. RESULTS: A total of 168 surveys reached potential respondents. Eighty-nine completed, legible surveys were returned, for a response rate of 53%. The most common reasons given for program participation were the desire to contribute to the medical education of students (99%), to provide "real-life" clinical experiences to students (78%), to share knowledge (72%), and to "give back" to the osteopathic medical profession (71%). A majority of respondents agreed that the preceptorship program would influence students' specialty (96%) and internship choices (79%). Respondents also reported an expectation that their participation would lead to continuing medical education (CME) credit for clinical teaching (65%), opportunities for faculty development (28%) or research collaboration (17%), and professional recognition (12%). CONCLUSION: The primary motivations for osteopathic physicians to participate in the MSUCOM Family Medicine Preceptorship Program are related to a personal sense of "giving back" to the osteopathic medical profession by contributing to the education of future physicians. In addition, the integrated relationship between volunteer preceptors and MSUCOM enriches professional opportunities for CME credit, faculty development, and other academic-related benefits. (+info)
OPTImizing osteopathic postdoctoral training institutions.
Since 1999, all postdoctoral training programs approved by the American Osteopathic Association (AOA) have been required to be part of an Osteopathic Postdoctoral Training Institution (OPTI) consortium. The AOA is improving OPTI operations by revising the OPTI Annual Report, by providing provisional status for new OPTIs, and by using the Residency Management Suite software program (New Innovations Inc, Uniontown, Ohio). The revised OPTI Annual Report is being modeled after the OPTI Standards Inspectors Worksheet (ie, Standards Crosswalk). Onsite inspections using the new scoring tool in 2008 highlighted OPTI best practices by demonstrating that OPTIs received commendations for faculty and curriculum development. Inspections have also shown that OPTIs with accreditation awards of 4 or 5 years are more likely than other OPTIs to be composed of 4- or 5-year postdoctoral training programs. (+info)
Perception of osteopathic medicine among allopathic physicians in the deep central southern United States.
CONTEXT: Relatively few osteopathic physicians (DOs) practice in the deep central southern geographic region as compared to other parts of the United States. OBJECTIVE: To assess the potential effects of underrepresentation on the perception of osteopathic medicine among allopathic physicians (MDs) in this geographic region. METHODS: A 20-item, Likert scale survey was designed to evaluate participant perceptions of the osteopathic medical profession. The instrument was mailed to 468 MDs who reside and practice in the deep central southern region of the United States. RESULTS: One hundred seven individuals completed the survey for a response rate of 22.9%. Although the majority of respondents (71 [66.3%]) recognized the distinctiveness of the osteopathic medical profession, they were not necessarily able to articulate these differences clearly through their responses to other survey items. In addition, survey participants expressed was a belief that residency training programs accredited by the Accreditation Council for Graduate Medical Education were more beneficial to osteopathic medical graduates than those approved by the American Osteopathic Association (94 [87.8%]). Finally, there was a perception that research efforts supporting "the scientific basis of osteopathic medicine" were inadequate (53 [49.5%]). The one demographic factor that had a statistically significant (P<.001) positive impact on perceptions of osteopathic medicine among these MDs was previous contact with DOs. CONCLUSION: Underrepresentation of DOs in the deep central southern region of the United States appears to have an impact on the perception of osteopathic medicine among MDs insofar as direct or indirect contact with osteopathic physicians led to improved perceptions among this cohort. (+info)
The DO difference: an analysis of causal relationships affecting the degree-change debate.
CONTEXT: The academic credential awarded to osteopathic physicians is the doctor of osteopathy or doctor of osteopathic medicine (DO) degree. Public recognition of the degree has been disappointingly low, however, leading some members of the profession to argue for a change in the degree's name and formal designation. OBJECTIVES: To investigate antecedents to the desire among osteopathic medical students to change vs retain the DO degree designation and maintain "the DO difference." METHODS: A self-administered cross-sectional 38-item electronic survey was distributed to 480 students at an osteopathic medical school in the Midwestern United States. The instrument included knowledge-based items about osteopathic principles and practice (OPP) as well as items designed to assess attitudes, subjective norms, perceived behavioral control, and intention to support a proposed degree change. RESULTS: An overall response rate of 45% was achieved (n=214). Structural equation modeling revealed that low levels of OPP knowledge were associated with positive attitudes and subjective norms favoring a degree change with the reverse true for opposing students. Knowledge did not influence perceived behavioral control. Attitudes were the best predictor of intention to vote with 85% variance predicted in our models; perceived behavioral control was the best predictor of intention to debate with approximately 38% variance observed. CONCLUSIONS: As a result of diminished use of palpation and osteopathic manipulative treatment--two historic markers of professional identity among osteopathic physicians--the DO degree designation as an indicator of difference has received increasing scrutiny. Improved student awareness of OPP is essential to maintaining the DO difference in clinical practice and with regard to the DO degree designation. (+info)
Billing and coding for osteopathic manipulative treatment.
Some osteopathic physicians are not properly reimbursed by insurance companies after providing osteopathic manipulative treatment (OMT) to their patients. Common problems associated with lack of reimbursements include insurers bundling OMT with the standard evaluation and management service and confusing OMT with chiropractic manipulative treatment or physical therapy services. The authors suggest methods of appeal for denied reimbursement claims that will also prevent future payment denials. (+info)
Evaluation of an interactive, case-based review session in teaching medical microbiology.
Impact of Medicare Part D on osteopathic physicians.
CONTEXT: Although there is a wealth of information for patients and physicians on the Medicare Prescription Drug, Improvement, and Modernization Act, little research exists related to its impact on osteopathic physicians (DOs). OBJECTIVE: To examine the impact of Medicare's prescription drug benefit-or Part D-on DOs and their practices. METHODS: Two electronic surveys regarding Medicare Part D were e-mailed to DOs randomly selected from the American Osteopathic Association database. The first survey was sent January 31, 2006 (within the first month of Part D implementation), and the second was sent June 1, 2006 (6 months after implementation). Both surveys focused primarily on the challenges experienced by DOs and their staff regarding Part D. Responses were subjected to univariate, bivariate, and Pearson product moment correlation analysis. RESULTS: Of the 10,000 DOs contacted, 603 (6%) responded and met inclusion criteria for the first survey and 343 (3.4%) for the second survey. More than 60% of respondents to the first survey reported challenges such as increased workload, difficulties understanding Part D, difficulties with the physician appeals process, and lack of information and education. These challenges were also reported in the second survey but by approximately 30% fewer respondents. One challenge-changing medications as a result of formulary restrictions-was reported by 17% more respondents to the second survey (P<.01). Respondents in primary care, solo practice, and rural areas as well as those treating large Medicare populations and those who were their patients' primary source of information about Part D reported more challenges. CONCLUSION: Considering the numerous challenges respondents faced with Part D, it is important to remember the role of physicians in successfully implementing healthcare programs, particularly as the US healthcare reform debate progresses. (+info)