1st rotation: The not-so standard of care

I asked, “Where does it hurt? How would you describe the pain?” I can’t forget to ask about their life – what’s new, how are the kids doing, how’s that house renovation going, how are you doing (besides the nasty back pain). Next, explain that I’m going to use my hands to feel around that area. 80% of the time it’s pain in their low back. But after looking at that area, I move on to feel the pelvis, the neck, the shoulders, the legs, and even arms. I do a quick neurological exam. Listening to the heart and lungs is not mandatory, unless there is a reason to check. One hour appointments. This is unheard of at other clinics, but this was the norm at my 1st rotation in OMM – osteopathic manipulative medicine. Most of these patients have sought care in many other areas and doctors before getting to you. Many are understandably frustrated with their pain. Some want to get off their opioid addiction. Halfway through my month-long rotation, I have encountered many different personalities and come to see what OMM is really like in practice.

I was never strong in OMM during the pre-clinical years. I studied just to get by, because who’s going to even use it besides those who plan to specialize in OMM? I know this isn’t the right idea to think about it. Other people will cry, why did you even go to a DO school? But the truth is, we learn the same stuff as MD schools – we just learn extra OMM stuff. However, the general consensus is that board scores will manifest into what specialty you could end up in. This made it easier to put OMM on the back burner, while focusing more on the board-relevant Step 1 subjects. Anyways, clinical rotations are much different that pre-clinical learning. You learn by doing. You can put stories to somatic dysfunctions, and it makes learning OMM more bearable, and dare I say, even enjoyable. It kind of blew my mind how many of these patients come to the clinic in so much pain, and report feeling so much better after the appointment. I realized that OMM has many treatment modalities. Besides the muscle treatments and joint cracking, there is a certain amount of therapeutic value to being able to talk to a caring provider for an hour. Most patients expressed joy after talking about their pain, even if it is to just the attentive listening ears of medical students. I can report getting hugs from patients before leaving. It demonstrates how much a small amount of humanism can be valued.

I’m glad that this is my first rotation. After the intense study schedule for boards, it is nice to be at a laid-back (but still educational) rotation. It has been a good rotation to review basic anatomy again. I have been able to focus on humanism, rather than rush to get to the next patient.

OMM is supposed to be what makes us osteopathic students unique. And although many of us don’t plan to use it in our future practices, it is not just our skill to manipulate muscles or to palpate, but rather our idea of “looking at the whole body” to evaluate and treat these disorders that makes us unique. I always thought that was a cliche idea, but a few patients even brought it up as an observation from going through many areas of the healthcare system. I think that is something to feel good about as a DO student. There are so many factors that can impact ones health. One of my preceptors emphasized how important it is to see the person, not the disease, and I was thankful for that lesson early in my 3rd year.


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