NMM/OMTORIGINAL ARTICLE

Impact of osteopathic manipulative medicine training during graduate medical education and its integration into clinical practice

Joanna L. Kramer, DO, MPH; Kirby Trombetti, DO; Kathleen De Asis, DO, MS; Vivian Mai, DO; and Edward Swing, PhD
Notes and Affiliations
Notes and Affiliations

Received: April 25, 2024

Accepted: July 16, 2024

Published: October 7, 2024

  • Joanna L. Kramer, DO, MPH, 

    Phoenix Children’s Hospital, Phoenix, AZ, USA

  • Kirby Trombetti, DO, 

    Former Medical Student at Midwestern University – Arizona College of Osteopathic Medicine, Glendale, AZ, USA

  • Kathleen De Asis, DO, MS, 

    Attending Pediatric Physician, Skagit Regional Health, Arlington, WA, USA

  • Vivian Mai, DO, 

    Resident Physician, Phoenix Children’s Hospital, Phoenix, AZ, USA

  • Edward Swing, PhD, 

    Academic Research Program Manager, Phoenix Children’s Hospital, Phoenix, AZ, USA

Abstract

Context: Osteopathic manipulative medicine (OMM) is a unique skill set consisting of physical manipulations that treat the neuromusculoskeletal system. Although OMM can improve patient outcomes such as functionality and pain, as well as increase physician reimbursement, its use is declining. Barriers to its use include a lack of proficiency, support, reimbursement, and time. Knowledge gaps remain as to how OMM training during graduate medical education (GME) affects OMM use.

Objectives: This study describes relationships between OMM exposure during GME and the use of OMM in practice.

Methods: An online survey of physicians in a variety of medical fields during late 2022 assessed the impact of OMM education during postgraduate training on its use in clinical practice. Survey data were analyzed to compare training characteristics and OMM use via chi-square tests and binary logistic regression.

Results: A total of 299 surveys were completed. Respondents who received formal OMM education during residency were more likely (59.8 %) to utilize OMM in medical practice than those who practiced OMM informally (37.8 %, p<0.001) and those who had no OMM exposure during residency (10.3 %, p<0.001). Respondents who trained with more osteopathic attendings (p<0.001) and co-residents (p=0.012) were also more likely to utilize OMM. Those who completed residencies that were accredited by the Accreditation Council for Graduate Medical Education (ACGME) with an Osteopathic recognition track, by the American Osteopathic Association (AOA), and were dually-accredited (ACGME/AOA), were all more likely to utilize OMM (60 %, 56 %, and 53 %, respectively) than those who completed residencies with ACGME accreditation alone (22 %, p<0.01).

Conclusions: Although OMM can improve patient outcomes, it is underutilized by Doctors of Osteopathic Medicine (DOs) in practice. Lack of training after medical school has been identified as a contributing factor to its disuse. The results of our study illustrate that there is a positive association between OMM education during postgraduate training and OMM use in clinical practice.

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