Ibn Sina MD said: Thank you very much for taking the time to do this. Excuse any rude responses, some people on this site don't seem to have manners.



1. Do you believe there should still be a distinction between Osteopathic Medical Physicians and Medical Physicians?



2. Are there any parts of OMM you believe deserves discontinuation in use? Some DO students seem to really dislike things like Cranial, and ever claim its useless. Any thoughts on this? Click to expand...

It is theory built on theory. The foundation hasn't been adequately verified (to what degree the sutures are mobile, that there is a CRI, that the SBS can carry strain and that this is physiologically relevant to disease).

The diagnosis is based on feel rather than objective testing

The primary thing being felt is through bone and inches away from the fingers. Even if this is possible, which i suspect it is, it would take an incredible amount of calibration to make sure you are feeling what you think you are feeling in order to claim any confidence in your diagnosis. People who do this are way too confident given the data they have...

Inter-rater reliability for diagnosis is sometimes way off by people that teach these courses. This not at all surprising given the last point, but it doesn't lend credibility to the field.

Hello Dr Sina,I appreciate your politeness. Professionalism is one of the 6 priorities in the development of a physician per the ACGME. I spend a lot of time with medical students and residents correcting them on professionalism missteps with patients, staff, each other and their attendings. Physicians are human just like everyone else, just held to a much higher standard which can sometimes be pretty hard. In this environment of anonymity I expect the frustrations to come out, so some disrespect doesn't surprise me. I don't see a lot of positive and informed voices on here regarding Osteopathy, which is why I decided to do this regardless.I believe Dr Still founded Osteopathy hoping to create a different kind of medicine. His idea was to have it based on science (unlike most of the modern medicine of his day) and to have it address the cause of disease whenever possible rather than just manage disease. He prioritized the self-healing mechanisms of the body, and a minimally invasive approach. I can see why he wanted his students to have a different set of initials. I also think his students fell short of what he was hoping for, and I also think in the modern era many MDs do a great job of addressing a number of these things.To answer your questions- I believe in principle there is a lot of value to practicing medicine in an "Osteopathic" way, and to do this correctly takes a lot of additional training. I am not sure that the DO initials have the distinct meaning that they once did, and Im not sure what I would say if someone proposed a merger today... there could be a lot lost but I see a number of advantages too. ACGME allows both MDs and DOs to apply to our program- and given the right applicant with the right pre-requisite training and recommendations I would certainly consider an MD for one of our spots. The lines have truly blurred.As for cranial. I believe there is value there. I have table trained for cranial courses (but they wouldnt let me lecture- I think they were afraid of what I'd say). I have used some of the cranial techniques to great effect. There are a number of big problems with it.AT Still was very clear- he said "don't believe any untested theory" and that every treatment should be based on a foundation of anatomy and basic science. He wouldn't like cranial in its current form. Those that follow AT Still's work should at least know the most important things he was saying and follow his advice. In summary, I would keep Osteopathic treatment of the head very simple as we do with the rest of the body. Hypothesize the diagnosis based on your knowledge of pathophysiology matched with what you feel, verify with palpation to reproduce the symptom in question, fix abnormal anatomy to remove symptoms on the spot, leave patient in remission. This is what we should be doing clinical research on, and what Osteopathy is really about. Cranial theory may still hold some value, but it is too complicated and depends on too many unknowns to treat it as a science. This is why I believe it should be removed from schools and tests.