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Assessing usage and perceptions of osteopathic manipulative treatment (OMT) and self-identity among osteopathic physicians
Mangla, M. [2]
Asif, S. [1]
Asif, S. [1]
Terzella, M. [17]
Yao, S. C. [76]

Journal: Journal of Osteopathic Medicine Date: 2021/12, 121(12):Pages: A61-A62. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2021-2000/html)

Keywords:

clinical practice [24]
cross sectional study [842]
OMT [3752]
osteopathic manipulative treatment [3772]
osteopathic physicians [203]
perception [131]
USA [1656]

Abstract:

Context: Understanding viewpoints towards OMT and degree of OMT usage can identify factors influencing its practice.1,2 Given the recent single accreditation, exploring how osteopathic physicians (D.O.) believe their education sets them apart can highlight what aspects of osteopathic training should be maintained.3-5 The notion of stigma against D.O.s will also be investigated. In doing so, we can establish how to support positive D.O. self-identity and even societal perceptions of OMT. Objective: To explore the degree to which D.O.s were exposed to OMT in training and currently practice OMT. We also seek to understand barriers and facilitators to the use of OMT. Finally, we examine how receiving osteopathic training might influence clinical practice, future opportunities, and growth as medical professionals. Methods: All members of the New York State Osteopathic Medical Society (NYSOM; N=300) were surveyed on their use of OMT during training and in present clinical practice. The survey collected demographic information, perceptions of the osteopathic profession, thoughts on the future direction of osteopathic medicine, and anecdotal data on how being a D.O. might have influenced career advancement. The survey was sent to all members via email using REDCap. Follow-up efforts included weekly emailed reminders for one month from the first send date in June 2021. Statistical analyses were performed to establish factors influencing use of OMT during training and practice. Results: In total, 22.0% (65/300) of distributed surveys were completed during the recruitment period. Of the sample, 49.0% (32/65) practice primary care (family medicine, internal medicine, pediatrics, or geriatrics), 75.0% (49/65) have been in practice for over 10 years, and 71% (46/65) completed an osteopathic residency. 80.0% (49/61) of respondents reported that osteopathic training gave them an advantage over allopathic counterparts. Next, 57.0% (37/65) reported observing OMT and 78.0% (47/60) reported utilizing OMT during training. At present, 48.0% (30/62) of respondents practice OMT. When assessing barriers to the practice of OMT, 49.0% (27/55) of respondents stated time, 33.0% (18/55) indicated reimbursement, and 25.0% (14/55) noted confidence level in OMT skills as important reasons preventing use of OMT. Other barriers include patient population, physical space, institutional support, and patient and colleague skepticism about OMT. 54.0% (32/65) of respondents also shared that their allopathic medical colleagues have expressed interest in osteopathic principles and techniques. 88% of respondents agreed or strongly agreed to both statements that that OMT positively enhances the doctor-patient relationship and yields positive effects on patient health outcomes. When asked about stigma, 41% (28/65) reported discrimination due to training as an osteopathic physician. Analysis of qualitative responses highlights missed professional, teaching, and training opportunities due to respondents’ osteopathic medical degrees. Finally, while 46.0% of respondents agreed or strongly agreed that there is a stigma associated with osteopathic medicine in the medical field, 31.0% (14/45) disagreed or strongly disagreed with this statement. Conclusion: Observation and utilization of OMT were greater during training then in clinical practice post-residency. Barriers to OMT that were most influential included time, reimbursement, and physician confidence in OMT skills. Most respondents indicated that they found OMT helpful for patients and noted that it built a therapeutic alliance between patient and provider. Unfortunately, many physicians noted stigma associated with their medical training. Lack of professional recognition, fewer hospital privileges, fewer residency sites, and lost teaching opportunities comprised many of the stated reasons. It is important to note some limitations of this study. First, there could be a regional bias as the survey sample was only from New York. Also our overall sample size is small so our claims might not extend reliably to a larger sample of osteopathic physicians. As the osteopathic profession evolves, gleaning viewpoints towards OMT and osteopathic education from D.O.s can help shape future efforts to support positive D.O. identity and maintain what distinguishes the profession.

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