The objective of this survey was to determine the prevalence of Osteopathic Manipulative Treatment (OMT) use, barriers to its use, and factors that correlate with increased use.
The American Osteopathic Association (AOA) distributed its triannual survey on professional practices and preferences of osteopathic physicians, including questions on OMT, to a random sample of 10,000 osteopathic physicians in August 2018 through Survey Monkey (San Mateo, CA). Follow-up efforts included a paper survey mailed to nonrespondents one month after initial distribution and three subsequent email reminders. The survey was available from August 15, 2018, to November 5, 2018. The OMT questions focused on the frequency of OMT use, perceived barriers, and basic demographic information of osteopathic physician respondents. Statistical analysis (including a one-sample test of proportion, chi-square, and Spearman’s rho) was performed to identify significant factors influencing OMT use.
Of 10,000 surveyed osteopathic physicians, 1,683 (16.83%) responded. Of those respondents, 1,308 (77.74%) reported using OMT on less than 5% of their patients, while 958 (56.95%) did not use OMT on any of their patients. Impactful barriers to OMT use included lack of time, lack of reimbursement, lack of institutional/practice support, and lack of confidence/proficiency. Factors positively correlated with OMT use included female gender, being full owner of a practice, and practicing in an office-based setting.
The authors concluded that OMT use among osteopathic physicians in the US continues to decline. Barriers to its use appear to be related to the difficulty that most physicians have with successfully integrating OMT into the country’s insurance-based system of healthcare delivery. Follow-up investigations on this subject in subsequent years will be imperative in the ongoing effort to monitor and preserve the distinctiveness of the osteopathic profession.
What can one conclude from a three-year-old survey with a 17% response rate?
The answer is almost nothing!
Yet, it seems fair to say that OMT-use by US osteopaths is not huge. It might even be fair to speculate that, in reality, it is smaller than 17%. It stands to reason that the non-responders in this survey were the ones who could not care less about OMT. I would argue that this would be a good thing!
5 Responses to Do US osteopaths still use manipulation?
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Yes, osteooaths, physical therapists and MDs should not be doing spinal manipulation under their current training programs.
But they do have this, oh wait, nevermind.
Moderate certainty evidence shows that the effect of SNRIs on pain and disability scores is small and not clinically important for back pain, but a clinically important effect cannot be excluded for osteoarthritis. TCAs and SNRIs might be effective for sciatica, but the certainty of evidence ranged from low to very low.
https://www.bmj.com/content/372/bmj.m4825.full
I have to wonder why (some) DOs want to continue to differentiate themselves from MDs? Surely the priority should be providing the best quality care for their patients rather than trying to artificially make themselves “different”? I can only hope that the current trend continues and over time the use of OMT by DOs actually largely dies out. That would be the best thing for patients.
true!
These are the WHO benchmarks for OMT. The story behind the benchmarks is interesting. It was neither a scientific nor a critical historical expertise. It simply was a pure marketing concept of the largest European and British schools, which earn the most money with OMT, to set their curricula as internationally binding and to implement and define their content internationally for all countries and schools which teach OMT for osteopathic manipulators. https://www.who.int/medicines/areas/traditional/BenchmarksforTraininginOsteopathy.pdf