P2B366: The Impact of Osteopathic Manipulative Medicine (OMM) Training During Graduate Medical Education on the Integration of OMM in Clinical Practice

Background: One way that osteopathic physicians (DOs) differ from allopathic physicians (MDs) is they receive over 200 hours of osteopathic manipulative medicine (OMM) training. OMM consists of physical manipulations that allow physicians to improve functionality, decrease pain, and treat the neuromusculoskeletal system. Although OMM has been shown to improve patient outcomes, patient satisfaction, and increase physician reimbursement, few osteopathic physicians continue to use OMM after training, with lack of time, reimbursement, or proficiency acting as barriers. A literature review revealed a knowledge gap as to how OMM training during residency and fellowship affect OMM use after graduation. The primary aim of the study was to determine if OMM exposure during graduate medical education affects the use of OMM during clinical practice.

Methods: This survey study was created using the Research Electronic Data Capture (REDCap) software. Research approval was obtained from the originating hospital’s Institutional Review Board. The survey consisted of 33 questions assessing OMM training during residency and fellowship, use of OMM in current practice, and several demographic characteristics. The survey was distributed to osteopathic medical school alumni groups, professional physician organizations, and osteopathic social media groups. Survey data were analyzed using SPSS software. Comparisons of training characteristics and OMM use were made through Chi-squared tests, t-tests, and binary logistic regression, as well as descriptive statistics of demographic characteristics.

Results: 451 surveys were collected with 152 eliminated for incompleteness and other disqualifying factors resulting in 299 surveys utilized for analysis. Respondents who received formal OMM education during residency (e.g., lectures, rotations, CME opportunities) were more likely to use OMM in their current medical practice, X2(1,N=299)=40.17, p< 0.01. Respondents were also more likely to use OMM in clinical practice if they had a greater percentage of attendings and co-residents who were DOs, Wald(1,N=299),=11.84, B=.015, p< 0.01. Those who completed residencies that were accredited by the ACGME with an Osteopathic recognition track (60%), American Osteopathic Association (AOA) (53%), and dually (ACGME/AOA) accredited (53%) were more likely to use OMM than those who completed residencies with ACGME accreditation alone, X2 (4,N=299)=35.63, p< 0.01.

Conclusion: OMM is a useful skill that can enhance patient outcomes and is developed over hundreds of hours of training during osteopathic medical school, but many DOs do not apply it in their clinical practice. There are many reasons for this, but lack of training after medical school has been identified as a contributing factor. The results of our survey study fill a gap in the literature, illustrating that OMM education during postgraduate training positively influences OMM use in clinical practice. For those who wish to continue using their OMM skills after medical school, it may be beneficial to seek a training program that offers formal OMM education.