While studies have reported that allopathic family medicine residents are interested in OMT, there is not much evidence concerning the opinions of MD medical students towards OMT. The goal of this study was to  evaluate the awareness and interest of allopathic medical students in learning OMT, as well as what this interest and awareness stemmed from. About one-third of the students who completed the survey were aware of OMT, while the majority were interested in learning about OMT. Students who had a previous exposure to OMT, have a friend or family member with exposure to a DO, are pursuing a primary care field, or interviewed at an osteopathic medical school were more likely to report interest in learning about OMT. This study showed that exposure to OMT in some form may have a positive impact on the amount of interest that allopathic medical students have in learning about OMT.

The study consisted of a short "Foundations of Osteopathic Medicine" lecture that was given to a group of allopathic attending physicians and residents. A small hands-on portion was also included. They were surveyed on their perceptions and beliefs regarding osteopathic medicine before and after the presentation. The study found that a majority held positive beliefs about osteopathic medicine even before the presentation, however the number increased even further afterwards. After the event, no physicians believed that OMT was "not effective" in the treatment of somatic conditions and 93% had further interest in learning more.

The objective of this article was to determine whether osteopathic medical students felt hindered by their osteopathic identity in allopathic medicine, which is a majority of preceptors in the U.S. After a qualitative study was done on third and fourth-year medical students, results showed that despite lack of DO supervision, limited time, and limited MD knowledge, osteopathic medical students felt that they belonged to the field. Two key reasons had to do with being able to work in a team and using manual medicine as a technique to differentiate themselves from allopathic students. In summary, there was no conversion within the discussion or in the focus group about the perceptions others have toward DOs or misconceptions about the practice. They highlighted what may be a limiting factor to keeping your osteopathic physician identity but did not discuss how others view osteopathic tenets and teachings along with OMT.

Large cohort study (134,369 patient visits) explores the clinical practice characteristics of osteopathic and allopathic physicians at AHC vs non AHC sites. This study used data from NAMCS from 2002-2006. This study looks at patient demographics, patient visit context, time spent with patients, amount of drugs ordered, and amount of OMT done at time of visit. In conclusion the study showed that osteopathic physicians at academic health centers (AHC) did not show a distinct osteopathic approach to care. However, an osteopathic approach was much more likely to be found at a non-AHC community center. This is even larger in non metropolitan areas. The implications for this study highlight the importance of role modeling and mentoring by osteopathic faculty to continue fostering distinct osteopathic aspects in current medical practice.

Family medicine residents were surveyed in this study on how comfortable and knowledgable they were on treating common sports medicine injuries.  Compared to MD's, DO residents felt more comfortable and held a higher accuracy over all in diagnosing and treating sports medicine injuries. The teaching and application of OMT aided in comfortability and accuracy of diagnosing and treating sports medicine injuries for osteopathic residents.

This article conducted surveys at The Ohio State University, assessing the attitudes and perceptions of health professional faculty regarding the CAM use. It points out the shift in attitudes from 2002 to 2010 with changes in the embedded CAM research and educational curriculum. This article overall signifies the importance of implementing CAM use in the curriculum of health care professionals and in health care. This study seeks to assess the attitudes and perceptions of health professional faculty regarding complementary and alternative medicine (CAM) usage and changes in these markers over time since 2002. Surveys were anonymous and included questions regarding self-use of CAM, referral frequency, and which CAM modalities are considered essential for health care education. The results show that faculty have significantly increased self-use of CAM and increased likelihood of referring for CAM modalities, including manipulative and body-based methods. There was also an increase in faculty who considered manipulative and body-based modalities and mind-body modalities an essential part of healthcare education.

A total of 225 faculty in the Health Sciences Schools and Colleges at The Ohio State University responded to the 2002 survey and 271 faculty responded to the 2010 survey. In 2002, twice as many respondents were male > female. In 2010, respondents’ gender was more evenly split. For both surveys, the majority of respondents were between 30 and 60-years-old.

The osteopathic philosophy dictates the delivery of care that treats the person as a unit of body, mind, and spirit. Research has shown that osteopathic physicians can use osteopathic manipulative treatment (OMT) as a primary treatment to alleviate specific conditions such as acute and chronic back pain. That said, more research is required to determine whether OMT can either serve as a helpful supplemental treatment or become a primary treatment for other conditions or health states such as chronic migraines, neck pain, postoperative status, pneumonia, and irritable bowel syndrome. For the aforementioned conditions, studies have been conducted, but more extensive studies should be undertaken to ensure generalizable results.

This article argues that DO's are limited in their choices for specialties compared to MD's due to the availability of AOA accredited residencies. With the AGME accepting DO's more, it is theorized that more DO's are choosing primary care due to the ease of acceptance into these programs. However, it also mentions that schools and AGME/AOA programs have tried to increase the amount of DO's in specialty programs which could be a reason why less DO's would choose primary care programs.

This article discusses the increase in osteopathic physicians and internal medical graduates to fulfill the shortage of physicians. This article specifically mentions how there has been a significant increase in osteopathic physicians in emergency medicine and family medicine specialties. Furthermore, the article addresses the significant decrease in allopathic physicians in primary care residencies (specifically family medicine and internal medicine). In exchange, osteopathic physicians are seen less in competitive surgical specialties which are primarily dominated by allopathic physicians. The article discusses the limitations for osteopathic physicians in applying for MD residencies and residency programs dominated by allopathic physicians.

The authors employ an extensive and robust systematic review in order to summarize and encapsulate patient experience, satisfaction and perception as well as expectations of OMT. The 2019 study has a well developed criteria with which 322 references were narrowed selectively to 16 final studies. The authors differentiate these between 7 qualitative, 8 quantitative and 1 mixed method study. In final analysis authors found quantitative overall support for OMT as a positive treatment as well as the qualitative evidence being culminated in what is described by the authors as patient-centered, holistic and thorough.

Osteopathic physicians in the United States are uniquely positioned to manage chronic pain because the holistic approach DO have. It embraces the biopsychosocial model and they are trained in the use of osteopathic manipulative treatment (OMT) to complement conventional medical care. This narrative review provides current perspectives on the osteopathic approach to chronic pain management, and states that family medicine physicians are most likely to perform OMT in the practice.

In 2018, the 25 x 2030 initiative was created to encourage medical students consider specializing in family medicine to increase the FM match rate from 6.1% to 25% by 2030. Retrospective review of the match data shows that there has been little to no increase in FM interest. It is suggested that the 25 x 2030 goal may have actually discouraged students from going into FM by highlighting the stigma associated with the specialty. Strong discouraging factors for FM include but are not limited to the following: perceived lack of prestige, lack of FM mentors, potential income, high expectations, limited experience in the field, and perception of FM not being intellectual. It is expected that the 25 x 2030 initiative will fail.

Licciardone provides important data that captures current awareness and use of osteopathic physicians by the general public, showing that approximately half of the population in 2000 was aware of the osteopathic physician and almost 1/4 of the population has used an osteopathic physician for their medical care.  Importantly, the author claims this percent currently using an osteopathic physician has increased since the 1998 study of similar methodology.   However, no additional information is provided beyond these data points of percent awareness and use. Therefore, the answer as to why only half of the people that are aware of osteopathic physicians actually have used one and an even smaller number continued to use one remains unanswered. It is unclear what the perceptions were at the time that may have limited their use.  The survey included statistics based on race, but the low representation of minority groups in the survey respondents makes those statistics less reliable. Additionally, as the author points out, the geographic distribution should be cautiously used for conclusions because the study did not account for anyone that may have moved and used an osteopathic physician in a previous location.  Ultimately, this article provides a great snapshot in time of the use of general use of osteopathic physicians across the US in 2000. 499 randomly digit dialed participants were contacted for a survey to assess the public awareness and and use of osteopathic profession/physicians. 64% of contacts answered the survey with results indicating only 7% currently used an osteopathic physician and 16% had used one during their lifetimes, with this number slightly varying dependent on ethnicity. Overall, the article concluded that greater work needed to be done to promote the osteopathic profession.

Authors suggest that greater rates of student debt found amongst osteopathic medical students might be an effect of varying individual factors. The single greatest predictor of graduate medical debt was found to be greater financial support from a student's family. Other predictors noted to produce higher medical debt was increasing student interest in specialty fields.

The article describes an increasing percentage of osteopathic medical students intending to practice in rural areas. The author attributes this increase to an increase in student debt that osteopathic students face and the availability of loan forgiveness/scholarship options that are focused on physicians who choose to practice in underserved areas. The article also urges policy-makers to continue funding these scholarship programs to continue to draw physicians to rural areas.

Overall summary from conclusion was that CHIP was valuable in reducing multiple chronic disease risk factors.

After the OPME sessions, respondents reported improved practical skills (98 of 170 [57.6%]) and increased level of confidence in applying OMM (87 of 170 [51.2%]). Nearly half of respondents reported that being treated by a faculty member (100 [49.0%]) was very likely to increase their level of interest in OMM, followed by treating other classmates (77 [37.7%]) and being treated by classmates (73 [35.8%]).

Programs like comprehensive ACT and biomedical sciences enrichment programs seem to be effective ways to motivate high school students to attend college and potentially pursue a career in osteopathic medicine. A majority of students that participated in this program reported in interest in pursuing a medical career after attending, with close to 60% reporting an interest in osteopathic medicine specifically. In addition, students felt more informed about osteopathic manipulation techniques along with osteopathic medicine. The program seemed to be effective in encouraging a majority of students to attend college and pursue STEM majors based on a follow up inquiry.

This study found that in individuals living in Appalachia with high food insecurity levels were more likely to have higher levels of medical mistrust than those with lower levels of food insecurity. Family physicians should screen individuals for food security in order to provide information on available resources. More research may need to be conducted in order to determine other confounding variables, including social support, knowledge about other available assistance programs, and general mistrust of others.

Even though DO and MD students will use the same process to match into residency programs, there is continued bias between degree types throughout this process. This study sought to highlight some of these continued biases in radiology residents, of which included both DO and MD students. Some of the findings of this study include the following three ideas: 1) More DO students than MD students reported that their degree type altered their medical career. 2) More DO students were advised to not pursue a radiology residency based on degree type. 3) A large majority of both DO and MD students felt that radiology residency selection is favored towards the allopathic students.

The author is a DO who feels that the AOA is not inclusive. They applied to have their first year of residency trainings at ACGME to be approved by the AOA, as the previous residency program that they considered was not deemed a high quality program, and the author had heard rumors of the hospital closing. He felt ostracized by the AOA with the several refusals of approving the internship. He expresses that he is a member of the American Academy of Family physicians and AMA and have been welcomed with open arms.

Educational outreach programs for high school students interested in careers in STEM are helpful in encouraging students to pursue careers in osteopathic family medicine, as based on positive survey results from program participants. In Oklahoma, two programs, OKstars and Native OKstars seek to encourage interested high school students to pursue osteopathic family medicine and other careers in STEM. These programs primarily seek to encourage high school students from rural, diverse, or medically underserved backgrounds in order to assist in the shortage of primary care physicians in rural and medically underserved areas. Encouraging interested students in high school will hopefully allow them the confidence and motivation to succeed in academic endeavors.

The study objective was to explore positive influences on long-acting reversible contraceptives (LARCs) placement for pediatricians compared to providers in other specialties that cared for women. The study focused on two research questions: 1) How do attitudes, perceived norms, perceived behavior control, and intentions to place LARCs differ according to provider specialty? 2) Does the relationship between these variables (attitudes, perceived norms, and perceived behavior control, and intentions to place LARCs) vary according to provider specialty? For the first question, they found that across these variables internal medicine and pediatrics reported lower attitudes, perceived norms, perceived behavioral control, and intentions to place LARCs than family medicine and OB/GYN, in that order. For the second research question, increases in favorable attitudes and perceived norms significantly positively related to intentions to place IUDs for family medicine practitioners. For OB/GYN, internal medicine and pediatrics, increases in favorable attitudes and perceived behavioral control is positively, but not significantly, related to intentions to place IUDs.

This is a letter to the editor that addresses the need for increased awareness of osteopathic medicine and ways in order to do so. These suggestions included making a magazine, teaching more young people about the field and profession, and increasing the number of D.O.s with dual degrees and D.O.s doing research.

The article is a letter to the editor by a 2nd year osteopathic medical student from Des Moines University College of Osteopathic Medicine elaborating the increased efforts needed to promote primary care specialties to osteopathic medical students. Most incentives to practice in primary care come from loan repayment options within in-state Iowa or rural/underserved areas in efforts to increase physician availability. Additionally, loan repayment programs seem to be due to political intentions to increase Medicare reimbursements according to information that the student received from AOA and ACOFP. In his opinion, these options are not enough in promoting primary care. More primary care DOs need to share their experiences one-on-one with osteopathic medical students on practical aspects of the profession such as lifestyle, economics, etc. Additionally, he believes that there needs to be more accessible osteopathic primary care residency programs in locations that students want to live in as he believes that residency location often plays a role in selecting a medical specialty. This article addresses the seeming lack and or lackluster methods of recruitment of osteopathic students into primary care specialties and offers ways in order to better promote primary care to osteopathic students.

The article discusses the distinctions between osteopathic physicians (DOs) and allopathic physicians (MDs) and notes that prejudices against osteopathic physicians are diminishing. The piece delves into the historical disparities between the two medical professions, the educational differences, and the increasing recognition of DOs in the healthcare field. The article highlights how DOs provide similar levels of care as MDs and that both should be respected equally within the medical community. The evolving perception of DOs is mentioned as a positive shift in attitudes toward these healthcare professionals. The article focuses on emphasizing the difference between osteopathic and allopathic medicine including the approach to treating a patient and the use of OMT in practice. The article discusses the differences between allopathic and osteopathic residencies in 2014. The article also claims that D.O.s have been facing less and less prejudice from residency programs, patients, and M.D.s.

Ultimately, the survival of the osteopathic medical profession depends on its visible commitment to basic teaching programs that elevate the status of OPP teaching and provide evidence-based interpretations of the clinical effectiveness of distinctive osteopathic modalities. Faith alone will not suffice.

Experiential exposure to pathology, and direct mentorship from pathologists may present an opportunity for pathology professional organizations, and pathology residency programs to partner with osteopathic medical schools to increase interest in the field, and aid in pipeline development.

Like allopathic students, top factors osteopathic applications look for are program personality, faculty enthusiasm and how happy the residents appear. Unlike allopathic students, geographic location of the program to osteopathic applicants was unimportant.

Through this research, authors found that CHIP reduced cardiovascular risk factors and improved almost every risk factor.  The primary focus of CHIP was the consumption of whole foods, such as fresh fruits, vegetables, whole grains, legumes, nuts, and 8 ten-oz glasses of water daily. This program is short, but also designed to prepare participants to maintain a healthy lifestyle.

The research article concluded that Comfort with Uncertainty did not play a role in specialty selection (particularly concerning family medicine or primary care) for residency in the medical students that were surveyed. However, the study did find pertinent data that suggested that osteopathic medical students are more likely to choose family medicine for their chosen residency than allopathic medical students.

Physician burn out rates are rising, and family medicine is no exception. 69% of osteopathic family medicine residents reported burn out, with women reporting burn out 1.8 time more than men. In addition, 87.9% of osteopathic family medicine residents reported symptoms of depression. However, almost 60% still reported being very satisfied with their decision to pursue family medicine. More research is needed to discover factors that contribute to higher burn out rates in osteopathic family physician residents as well as all physicians nationwide.

Sleep Medicine has multiple requisites, pathways, requirements, and methods to practice. Many different organizations, including the American Osteopathic Association, are working to create structure and consistency in sleep medicine practice.

Even though the merger to a single accreditation residency program opened possibilities for DO students to match into more competitive specialties, there is still a statistically significant disparity between MD and DO match rates in more competitive specialties, specifically in dermatology. More research and education is needed to determine the attitudes and biases that lead to this disparity.

Undergraduate osteopathic medical students tend to underestimate the BMI and BFP of their patients. However,  students approximate the BMI and BFP at a rate that is consistent with the actual measurements of BMI and BFP. This would then suggest that further education is needed in osteopathic medical schools on determining BMI and BFP.

Having experience in osteopathic medicine adds value to a primary care providers’ experiences while diagnosing and treating low back pain. According to this study there is a slight increase in osteopathic providers over general pcp’s that understand that lower back pain may depend on the patient’s biological sex. This may increase accurate and timely diagnoses.

36 graduates from diabetes fellowships were surveyed upon completion of their training. Most reported feeling very comfortable with insulin treatments and new skills developed. However, there were also high barriers to putting this fellowship into practice as diabetology is not recognized as a specialty. Further, a lack of board certification limits their impact. While only a majority of these fellows were DOs, this does have an impact on primary care, a field which many DOs work in.

Cross-sectional survey and analysis of responses from about 300 German general practitioners showed about 91% of the GPs who responded had already given a recommendation or referral for OMT. However, of those who rejected making a formal recommendation for patients, they cited lack of evidence or considering other therapies to be more effective as the most often reasons.

DO physicians are more likely than MD physicians to work in solo and single-specialty group practice organizations, rather than multi-specialty, institutional settings, and group practice arrangements.

Few systemic investigations of the perceived importance of OR by osteopathic medical students, residents, and faculty have been published. The Osteopathic Recognition Task Force (ORTF) at the Michigan State University College of Osteopathic Medicine (MSUCOM) developed a cross-sectional online anonymous survey to examine these three osteopathic cohorts' perceived importance of Osteopathic Recognition (OR). Of the 733 people who responded to the survey, 278 were medical students, 359 were residents, and 94 were GME faculty. The authors found that 497 respondents (68.2%) indicated OR was perceived as somewhat important, important, or very important. Of these, 224 students (80.8% of students) selected one of these options, showing that preclerkship and clerkship osteopathic medical students are interested in pursuing GME programs with OR. The total sample of residents reported lower perceived interest in OR than students and faculty; however, those in primary care specialties reported a greater perceived OR importance. For example, residency programs (eg, family medicine) were significantly likely to select higher OR importance responses than others (eg, emergency medicine). The results were similar between primary care and non-primary care residents and faculty. The three most frequently selected challenges to OR implementation by faculty were related to perceived administration time, availability of trained faculty, and number of requirements related to OR. Composite barrier scores were calculated, and the mean score across all program specialties was 19.8 out of a maximum possible score of 36. After analyzing the data on perceived barriers to OR implementation, reviewing reports on strategies to integrate osteopathic training into ACGME-accredited residences, and reviewing the OR requirements and milestones, SCS ORTF designed a conceptual framework categorizing the requirements and created educational modules, workshops, and resources to support each. The subcommittee is currently developing an expanded online educational module that would provide participants with an OMT provider completion card upon successful completion.

The study is conducted to determine whether training in Allopathic (ACGME), osteopathic (AOA) or dually accredited programs has an impact on the level of satisfaction of recent osteopathic medical school graduates. The investigators found no statistically significant difference in the level of satisfaction among osteopathic family physicians.

This article found that, although not all statistically significant, OMT may benefit pediatric patients with asthma. More details would be needed to see if repeated OMT treatments yield better and more statistically significant clinical results. Additionally, any further studies should use a larger sample size to increase the reliability of any results

Patient satisfaction surveys conducted at a large university family medicine clinic demonstrated that student involvement does not reduce patient satisfaction with their providers. This research confirms previous studies' findings that students do not reduce patient satisfaction. These findings are important because they provide evidence that ensures patients are getting satisfactory care while osteopathic students are introduced to the clinic and receive clinical training.

This article employed theoretical modeling techniques to better understand why the number of medical students going into primary care has not increased despite efforts to increase recruitment to the field. The study found that multiple categories of factors affect these students differently, including demographics, the medical school experience, student interests, perceived specialty characteristics, lifestyle and financial considerations, the health care environment, identity development, and the choice process. The study found that rural-born, lower-socioeconomic-status, older, and married students are more likely to enter primary care specialties. They suggest that we must work with communities and undergraduate institutions, including community colleges, to find, support, and recruit these students.

Author claims wellness is an integral quality of healthcare regardless of the discipline, specialty, or medical philosophy of a provider, and advocates for more patient advising. Wellness has been a core component of proper healthcare for centuries, and the most successful providers currently emphasize wellness within their care unlike the majority of providers currently. The author claims wellness can be achieved through a fulfilled prescription of five lifestyle components and elaborates with examples under each component, as well as their contributions to wellness and enhanced quality of life. The five lifestyle contributions are: fitness, proper nutrition, stress reduction, enhanced interpersonal relationships, and spirituality.

This was a narrative review that focused on, “individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians.” This study reviewed 83 articles that met their inclusion criteria. The authors suggest that the development of a ‘rural identity’ and ‘rural physician identity’, along with preferences of family members are key elements consistent with whether a physician chooses to practice in rural medicine or not. The rural identity is essentially the psychological state in which a physician feels like he/she belongs within a rural setting. This is reinforced by factors such as: rural upbringing, rural exposure, being service oriented, participating in rural rotations in medical school, integration within rural communities, etc. The authors heavily emphasized rural upbringing as being a very strong predictor for physician placement in rural settings. Students with rural upbringing are 4x as likely to pursue rural medicine than urban students, however they noted that statistically 50%-74% of practicing rural physicians are from urban environments. From their findings, the authors suggest that medical schools should consider recruiting rural students as well as integrate rural training to better prepare students to live in rural towns and practice within the rural setting.

Overall, respondents agreed that the AOA program is a strength to the UMKC Family Medicine Residency Program. One reason residents chose this program was that they have the ability to use and improve their OMT skills. Respondents also noted that OMT is an integral part to their practical skills and they intend to use it. Research also found that respondents thought that OMT is beneficial to patients, maintains hands-on skills, and they are learning to integrate OMT into their office regimen.

Osteopathic physicians are facing an issue applying for family medicine residencies that there are not enough spots for the large number of incoming residents applying. Compared to allopathic residency programs, osteopathic residents face tough competition to share slots among MD residents. This article hypothesizes that the large number of unfilled family medicine residency seats provoked ACGME residencies to seek out dual accreditation to also accept osteopathic applicants. The article also notes that allopathic graduates will "monopolize the most competitive ACGME programs" while DO graduates will "fill the voids" in those programs. The article has a negative connotation towards DO's with the assumption that they only pursue family medicine because they have no other choice.

The article discussed the American Osteopathic Association's recent decision to change CME requirements. As a result, " these changes will challenge the osteopathic medical community to answer several questions, including how osteopathic CME is defined and whether there is value to osteopathic CME that is distinct from other programs." The article noted how DO physicians will no longer be required to complete osteopathic CME credits. However, the article suggested that "holistic" healthcare perspective will be maintained and incorporated into existing CME credits by applying osteopathic principles as a subset of the existing CME credit. For instance, if a CME requirement is a presentation on concussions, then the presentation may incorporate the five models of care to the topic of concussions. Defining osteopathic CME could potentially affect the community in how it's valued especially in family medicine.

The article separates out osteopathic physicians and general practitioners but also looks at chiropractors' perceptions of chronic musculoskeletal pain and how many cases of chronic musculoskeletal pain they had in terms of patients interviewed. The osteopathic and general practitioners felt that the degree to which patients were willing to take responsibility for their condition impacted the care that they sought. If the patients were more willing to take responsibility for their condition, then the treatment went smoother as well. This study was published in Family Practice in 2012 and was conducted in Great Britian where osteopaths are limited to manual therapy and are more like physical therapist. This study concentrated on assessing CMP treatment in a primary care setting by chiropractors, osteopaths, and physiotherapists. They obtained a 60% response rate (2504/4171) to the questionnaire survey. 313 had CMP and of these 69% (217) agreed to be interviewed. 22 patients from the interviewed group took part in the focus group. One hundred health professionals were approached (25 private physiotherapist, 25 NHS physiotherapist, 25 osteopaths and 25 chiropractors. They identified the following themes: 1. The evolving nature of the patient and practitioners understanding of CMP 2. Legitimating suffering, 3. Development and tailoring of consultation and treatment strategies. The study demonstrated how many CMP patients expressed some dissatisfaction with their GP care.  Patients’ dissatisfaction appeared to their GP’s in ability to get to the root cause and not legitimizing their pain. Adopting a shared decision-making approach to treatment may be more useful for chronic conditions such as CMP.

Osteopathic physicians acknowledged that physicians sometimes don't understand osteopathic terminology. On the flip side, physicians were aware that they might not understand or know all the osteopathic terminology but they were under the impression that osteopaths would provide a simple explanation of the treatment plan in language that they can comprehend. This study was published in the International Journal of Osteopathic Medicine in 2017 which is a reputable journal. The author provided appropriate background information from previous analysis and from governmental organizations and NGOs. The study was conducted in Canada where osteopaths are manual therapist only. The concept of the study has importance for the practice of osteopathic family medicine in the USA where communication between physicians about the procedures of OMM need to be clearly articulated. This study found that physicians write referrals to osteopaths but due to  difficulty in describing their manual therapy and osteopathic terminology, communication back to the referring physician is lacking. The study concluded that osteopaths have  difficulty in expressing information obtained from palpation to physicians and although physicians admitted that they do not understand or know all the osteopathic terminology, they expect osteopaths to provide a simple explanation of the treatment plan in a comprehensible language.

Not a lot of information is known about whether osteopathic physicians collaborate with other clinicians or healthcare professionals so this article helped to amplify that it is greatly impactful for the clinicians to work with other health care professionals. This study was published in Musculoskeletal Science and Practice and was conducted in Australia where osteopaths are more like physiotherapist and chiropractors. They are only required to complete a 1-2 year masters program. This study concentrated on understanding the collaboration between physiotherapist, chiropractors and osteopaths as all three of these professions in Australia concentrated on some form of manual therapy for musculoskeletal complaints and do not treat non musculoskeletal conditions. Therefore, this study has little to do with the influence of osteopathic medical students and residents in pursuing osteopathic family medicine as a specialty. US trained osteopathic family medicine physicians’ scope of practice is not limited to manual therapy.

The study acknowledged the importance of developing osteopathic physicians ability to address patients' beliefs in relation to weight lifting (such as using a spinal brace). They also found that a lot of times the osteopathic family physicians' beliefs (even if they are not completely accurate or if they have negative views towards different types of lifting) will play a key role in forming patients' views towards recovery from lower back pain. They think that osteopathic family physicians need more training actually on addressing beliefs and misconceptions regarding weight lifting and lower back pain to positively contribute to patients' views and beliefs regarding their back and how they use it. 

The purpose of the study was to examine the differences in residency programs in the use of OMM for spinal pain in an outpatient clinical setting using electronic medical records (EMRs). The extra year of training in the NMM/OMM specialty environment for these residents may influence their use of OMT. The use of OMT for spinal pain varied between residents with the FP/OMT residents least likely to use OMT for spinal pain. While the American Osteopathic Association requires that osteopathic principles and practice be integrated in all of its accredited specialty residency training programs, the 4 residencies with the most integration of osteopathic manipulative medicine (OMM) have differences in the extent of training and degree of integration of OMM. Family Practice/OMT diagnosed cervicalgia and somatic dysfunction in fewer other body regions and incorporated OMT less often than the residents in the other 3 programs. This is deemed to be likely related to residents in the Family Practice/OMT specialty encountering a greater number of other medical problems during patient visits as well as variations in the patient population types between family practice and osteopathic manipulative medicine specialty clinics. Residents in the other 3 residencies utilized OMT to an equivalent degree; it was suggested that the additional (4th) year of training in neuromusculoskeletal medicine/osteopathic manipulative medicine residencies further influenced their greater use of OMT, which was most frequently utilized for musculoskeletal conditions followed by neurologic and then respiratory conditions.

A section of this article clarified the misconception that osteopathic students are more likely to match into FM residencies due to an increased interest in FM. Instead, results showed that the trend that more osteopathic students match into FM programs has been a result of transitioning from AOA-accredited programs to ACGME-accredited programs, instead of an actual interest.The article found that while osteopathic schools do send more graduates into family medicine programs compared to allopathic schools, there are less overall students entering family medicine residencies. The increase in students choosing family med residencies does not seem to be due to student choice but rather an overall increase in the number of students and a shift to ACGME residencies over AOA residencies. Newer osteopathic schools send less graduates to FM programs and private osteopathic schools also tend to send more graduates to FM programs. This article only looked at ACGME programs and not AOA programs. 

This study explored the perceptions of geriatric medicine. It aimed to address barriers of ageism by confronting limited training in this field with an educational series and assessing perceptions. After conducting a geriatric medicine survey, it was found that family medicine residents and medical students were hesitant to work with elderly patients because they were not as adaptable to new ideas, do not respond well to treatments and largely have feelings of loneliness and isolation. Following this an educational series was conducted, which showed minimal changes in attitude. Results revealed that many of the residents did not prefer working with older did not prefer working with elderly patients. They also discovered the predominant belief that residents felt like resources should be used for younger patient populations. Overall, the strongest bias voiced by students was that they did not want to work with geriatric patients in the future.

Musculoskeletal pain commonly presents in primary care offices. They tested the use of complementary + alternative medicine (CAM), which included OMM, to be an effective pain management tool. It was found that OMM was an effective Primary Care technique to decrease MSK pain. This represents as a unique feature of Osteopathic Family Medicine, that emphasizes preventative medicine and extra technique to treat MSK pain. The article "The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain" discusses the prevalence and use of complementary and alternative medicine (CAM) among patients with chronic musculoskeletal pain. The study found that CAM is highly prevalent among this population, with 84% of participants reporting using at least one CAM treatment in the previous year. Most CAM users also use conventional treatments, with 69% of participants using a combination of both. The most commonly used CAM treatments for chronic musculoskeletal pain are glucosamine and fish oil. Most CAM users report that their treatments are helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. The study also found that the ratio of over-the-counter CAM use to care from a CAM provider was 3:2. This suggests that most CAM users are self-treating, which could raise potential safety concerns. Overall, the study provides evidence that CAM is a widely used and accepted treatment for chronic musculoskeletal pain. More research is needed to better understand the safety and efficacy of CAM treatments, and to develop strategies to help patients use CAM safely and effectively.

Since 2006 to 2016, there is an increase in US DO graduates, and thus a proportional increase in DO Family Medicine Residency graduates (14% to 20%), displacing IMG MD. There is also an increase in DO residents who take the American Board of Family Medicine exam (ABFM). Thus, DO's are representing a greater proportion of Family Resident graduates, and are also taking the ABFM exam as well. The article "The Single Graduate Medical Education (GME) Accreditation System Will Change the Future of the Family Medicine Workforce" discusses the potential impact of the single accreditation system on the family medicine workforce. The article notes that the transition to a single accreditation system is expected to result in an increase in the number of osteopathic physicians completing family medicine residency training, as well as a decrease in the number of international medical graduates (IMGs) completing family medicine residency training. The article also notes that the take rate for the American Board of Family Medicine certification exam is generally rising for osteopathic physicians, but stable for US medical graduates (USMGs). The article concludes that the transition to a single accreditation system is likely to lead to further shifts in the composition of the family medicine workforce.

The findings indicate that despite efforts to increase the number of medical students and residency positions, the US is not making significant progress in increasing the percentage of generalist physicians. Family medicine remains an essential but relatively small component of the primary care workforce, and trends suggest that most physicians will continue to specialize rather than become generalists. In 2017, 24% of osteopathic applicants chose family medicine, suggesting that osteopaths are more likely to pursue this specialty compared to other applicants. Although the number of physicians who matched in 2017 increased by 8483, only 579 (7%) entered family medicine residencies. Family medicine was the first choice of only 9% of US MDs. Osteopaths and US international medical graduates were approximately 3 times as likely to choose family medicine than US MD graduates. The article also noted a 37% increase in DOs matching.

The Authors sent a survey to 60 programs for directors and residents to fill out for the purpose of identifying attitudes regarding osteopathic culture and importance of the curriculum delivered to osteopathic students. The curricular component had the lowest score which indicated that it was the most important per the surveys. They concluded that they valued the OMT that a osteopathic student can perform in their residency program

This paper was conducted via a literature review. The conclusion was that while there is correlation between psychosocial problems and somatic pain, there is no clear evidence as to what tools to use to measure psychosocial evaulations, or which combinations of psychosocial evaluations correlate with somatic pain etiologies

From 2014-2015, 36 osteopathic physicians were surveyed for over 300 patients they have seen for osteopathic care. 61% women and 39% men. They found that over 75% of the time receiving osteopathic care was due to the patients election for it. The conclusion was that the average patient receiving care in spain was a middle aged person presenting with complaints of chronic spinal pain. These patients mainly seeked out the OMM on their own accords.

The author sent out a census to 656 participants all of whom are members of the AOA and questioned their diagnostic practice. Most reported their osteopathy was used in MSK and neurological systems with a limited consideration for other systems. The practioners revealed they referred their patients to OMM specialists about 68.5% of the time "occasionally"

AOA-approved programs have failed to attract residents; more osteopathic graduates are seeking ACGME-accredited residency training opportunities. levels of dissatisfaction among family medicine physicians was comparable to that among surgeons and obstetricians. The author sent a survey to over 2000 osteopathic family medicine doctors, and were questioned on if they had AOA, ACGME, or dually accredited training. The results showed there was no significant difference between the satisfaction of where the training occurred and what type of program they were in.

423 Primary care physicians responded to a survey assessing their attitudes and practices of CAM. The demographic was mainly male (78.3%) and Caucasian (93.2%). Complementary and Alternative Medicine (CAM) was frequently suggested to patients dealing with persistent issues such as headaches, backaches, and pain management, especially when conventional treatments proved ineffective, or for psychiatric and behavioral disorders. A notable trend emerged among family physicians and internists, female practitioners, and physicians aged 35 years and younger, who were more inclined to recommend CAM to their patients as well as incorporate it into their own healthcare practices. Among the various CAM therapies, massage therapy was the most commonly used, accounting for 18.9% of cases, followed closely by chiropractic manipulation at 31.4%. Notably, 40.7% of referrals were made for massage therapy, indicating its widespread acceptance and utilization among medical professionals.

In an exploratory cross-sectional study conducted among French-speaking primary care providers in Switzerland, the perceived usefulness of conventional and complementary medicine for treating chronic low back pain was investigated. A total of 2085 was surveyed by post. The questionnaire utilized was based on a literature review. Among complementary treatments, osteopathic therapy was notably ranked highly. 78.4% of surveyed providers perceived osteopathic treatment as useful. Female physicians under the age of 56, those trained in or utilizing complementary medicine, found these treatments to be particularly useful. However, barriers to recommending these therapies included a lack of knowledge about reliable providers, absence of insurance coverage, and practitioners not being recognized as part of the established medical system in Switzerland. Moreover, providers tended to prescribe treatments they did not rate useful. These findings highlight both the preferences of physicians and the challenges faced in integrating complementary therapies into mainstream medical practices in the country.

This study investigates the awareness of osteopathic medicine (OM) and osteopathic manipulative medicine (OMM) within the Chinese community in Manhattan's Chinatown, New York City. The research reveals a significant lack of awareness of osteopathic practices, especially among the elderly, with age, English proficiency, and education level being contributing factors to this lack of knowledge. Younger adults under 30 demonstrated a statistically significant relation with knowledge of osteopathic practices. The study emphasizes the complexities in perception due to linguistic and historical nuances separating allopathic and osteopathic practices. Additionally, challenges arise from the lack of osteopathic medical schools in Asia and the differentiation between osteopathic physicians and chiropractors, which can lead to clinical care that is indistinguishable from allopathic physicians. The study suggests the need for nuanced educational initiatives and further research to explore osteopathic awareness within diverse immigrant communities. However, the study acknowledges limitations, such as the sample being limited to Manhattan's Chinatown and suggests future studies comparing multiple Chinese communities and other Asian communities. There is a lack of knowledge of osteopathic medicine among immigrant minorities that should be addressed.

A survey was sent to 3,000 osteopathic physicians inquiring about the frequency and likelihood of a provider to use eleven types of Osteopathic manipulative techniques, 955 responses were received. The results were: "family physicians were more apt to use high-velocity low-amplitude thrust than other primary care or non-primary care osteopathic physicians." 

A family medicine residency tracked allopathic family medicine physicians, 1 to 7 years post residency, who completed an elective OMT for allopathic residents course to determine if the participants felt comfortable treating back pain with OMT, frequency of utilizing OMT, and if they referred patients for OMT more than their peers. In regards to back pain, participants were asked their comfortability managing back pain, from physical exam, creating a treatment plan, then performing OMT. The elective participants were more likely to feel more comfortable performing OMT than the control group, 37% and 33% respectively. In regards to frequency of performing OMT, there was not a statistically significant difference. Ultimately, 70% of all participants performed OMT less than monthly or never. The allopathic physicians who completed the elective were more likely to refer patients for OMT than the control group. Both groups identified limited number of DOs as the largest barrier to referring patients for OMT.

Half of the MDs who completed the training but did not do the elective still perform OMT, showing that didactic sessions are still valuable too. Graduates refer patients to DOs, showing how valuable they are for patients, especially because more and more patients want nonpharmacologic therapy. There was also a meaningful increase in comfort while doing OMT on their patients.

This patient had many symptoms that supported FM as well as non-typical findings that could support other diagnoses such as: recurrent infections (ddx: immunodeficiency, chronic infection), cold extremities + cyanosis (ddx: Raynauds, scleroderma), dry skin/eyes (ddx: sjogrens), ANA+ and anti-dsDNA+ (ddx: lupus), and more. Because FM is not well understood, it has become a diagnosis of exclusion; however, the guidelines are available and this patient met all of them.

The quantitative findings included a 4.1 point increase in open-book assessments as compared to closed-book assessments. Qualitative findings included exploration of test preparation and if having access to a resource during a test affected how students prepared. Some students studied earlier due to non-academic related events, such as running in a marathon. Others familiarized themselves with resources. Something that was interesting is that people did not do as much memorization because they had access to the actual resource. Rather, they tried to understand the concepts and points. More people focused on understanding rather than memorizing results.

The article used reviews left by patients on Healthgrades to compare patient perceptions of IM vs FM physicians, DO vs MD physicians, and female vs male physicians regionally. Both MDs and DOs were generally highly rated, however, in the Northeast, MDs of both genders consistently received higher scores than DOs. The opposite was true in the Southeast, with male DOs being more highly rated than MDs. There was a significant difference between the scores of MD IM vs FM practitioner ratings, but DO physicians, whether IM or FM, received almost identical ratings. Female physicians, whether MD/DO or IM/FM were rated lower than male counterparts, which was especially pronounced in the Midwest. The authors attributed the discrepancies between female and male physician ratings to the fact that only 34% of actively practicing physicians are female. The authors also discussed the fact that there is approximately a 3:1 of MDs compared to DOs practicing in the US. The authors expected that in the Midwest, were there is a high density of DOs practicing, there were would be higher satisfaction scores, but this is not found to be true. 

"For MDs, IM doctors had higher ratings than FM doctors (4.8 vs 4.5). For DOs, they both had 4/5 acerage ratings. Overall, female doctors were rated lower than male doctors. There was regional variation in ratings by medical doctor credentials and gender. Female doctors only had lower ratings in the Midwest. MDs had higher ratings than DOs in the northeast overall. Male doctors had higher ratings than female doctors in the southeast overall. I thought it was interesting that office staff ratings tended to follow doctor ratings for the most part. There was no difference in wait times as well, showing that long wait times did not contribute to negative ratings.

Overall, this study was focused on osteopaths in Germany, which is a different profession from the osteopathic phsyicians in the United States. However, in the discussion of the article, the relationship of osteopathy to primary care and its consideration as a critical part of the treatment of children was discussed. It was determined that osteopathic treatment for children is not an integral part of their system and that it is this way in most other countries. Rather, it is viewed as a supplemental treatment sought out by parents, especially when other treatments have failed. The study was rather small and did not contain a large enough scope to determine a valid quantitative assessment. It did open a discussion on the role of osteopathic medicine in the treatment of children for common disorders.

As more parents in Germany seek help from osteopaths for their newborns' health concerns, the authors saw a need for greater research on the effectiveness of osteopathic treatments and sought to identify the most common health concerns presented in osteopathic clinics. These included idiopathic infant asymmetry, plagiocephaly, excessive crying, and feeding/sleep disorders among others. Aside from the main findings, the authors cited from sources that suggested an increased demand for osteopaths in treating newborn health issues. As is the case sometimes in the U.S., the authors suggest that osteopathic treatments for newborns are considered supplemental care after "usual care" is attempted. However, a key difference between Germany and the U.S. may be that in the U.S., osteopathic medicine is increasingly regarded as an important part of primary care and the treatments are reimbursable.

This article is written by Mark Cummings, PhD from Michigan State University. Dr. Cummings discusses the changing landscape of residency with ACGME merger. He discusses the requirements from the AOA as compared to ACGME and the challenges that will face AOA accredited residency programs in their future. He provides some opinions of the less strict nature of AOA accreditation as compared to ACGME and also discusses the challenges of meeting new requirements for AOA programs that choose to merge, especially from a financial and infrastructure perspective. These AOA programs are going to have to meet new requirements, fill more positions in specific specialties and likely will not receive federal funding for these spots because the ACGME has a larger residency number requirement. In addition, in 2015, there are more and more medical students and the demand for all residency programs is increasing. Dr. Cummings discusses how hospitals will need to reallocate resources and positions in order to reduce the number of sponsored positions per hospital. The other interesting note Dr. Cummings discussed, is the historical trend of osteopathic programs being located in rural areas as compared to heavy academic environments of ACGME programs. Therefore, the faculty requirements and compensation for faculty or even longitudinal career growth of faculty are considerations that these newly credited AOA programs will have to address. Dr. Cummings made some important points and did a nice job of addressing the growing needs of AOA programs and the challenges they face in achieving and maintaining ACGME accreditation.

The Lankenau Medical Center collaborated with medical students at PCOM to develop an interdisciplinary team that addressed the health needs and non-medical barriers to care for underserved populations in Philadelphia County. As members of the Medical Student Advocate (MSA) program, PCOM students identified the patients' barriers to keeping up with regular health screenings, follow-up appointments, and medication adherence. This program helped students understand the effects of psychosocial needs on health outcomes, which aligns with the osteopathic approach to healthcare to focus on the whole person (mind, body, and spirit) rather than individual symptoms.

Overall, this study utilized a Likert scale survey to determine the attitudes of residents in an ACGME-accredited program on osteopathic skills and accreditation. This survey had a 31% response rate. The article concluded that this lack of response rate was due to time constraints in residency but disinterest in osteopathic medicine should not be ruled out. This could have played a large role in altering the date received from this survey. Overall, the responses from DO residents indicated that the process to become dual-accredited was challenging, included misinformation, and lacked mentorship compared to the allopathic process. In addition, one written response indicated that they should not have to complete more than one application. The article discussed the need for osteopathic organizations to provide better support to their residents to promote inclusiveness, especially for those in ACGME-accredited trainings. This was also evident in the free response section where several responses indicated a bias from the AOA toward DO residents in ACGME programs. This article did a nice job of assessing why DO residents are not continuing their osteopathic training. The difficulty of achieving dual-accreditation, the lack of infrastructure and support from the osteopathic community, in addition to the increased expenses required to achieve board certification provide distinctive barriers that outweighed the desire to continue osteopathic training.

This study surveyed osteopathic family medicine residents in ACGME-accredited programs to assess their interest in continued involvement with osteopathic medicine. According to the survey, a majority of the participants wanted to continue their osteopathic training and become certified with the AOBFP. However, a significant barrier was the confusing and contradictory steps for applying for board examinations and accreditation with the osteopathic organizations. Many osteopathic family residents initially pursue training with the ACGME because there are not many AOA programs available. However, some feel penalized afterwards due to disapproval of DO colleagues and a more complicated process to gain recognition through AOA/AOBFP after completing the ACGME program.

A letter to the editor that describes how the author was perceived as a "family practitioner" by the Mayo Foundation for Medical Education and Research because she is an osteopathic physician even though she is trained in internal medicine. Despite being certified in internal medicine by the American Osteopathic Association and the American Board of Internal Medicine, Dr. Linda Ha was a victim of ignorance from well-known medical establishments because of her title as an osteopathic physician. When requesting to receive a subscription to Mayo Clinic Proceeding, she was denied access as the Mayo Foundation wrongfully considered her a “family practitioner”, even with her board certifications. Dr. Ha’s chief resident, who is also an osteopathic physician, experienced a similar situation with Cleveland Clinic, where their institute sends numerous DOs and MDs to attend the Cleveland Clinic’s Internal Medicine Board Review and Recertification course. It is concerning that highly reputable medical institutions seemingly lack education regarding osteopathic medicine and physicians. In order to promote equality between allopathic and osteopathic physicians, it is necessary to target the source of this ignorance and unawareness.

West Virginia School of Osteopathic Medicine’s mission was to provide physicians to serve rural and underserved areas of Appalachia and West Virginia. Preference is given to prospective students who are likely to practice in these regions. It is also emphasized that primary care specialties are important, and prospective students should realize the school's goal of providing more primary care physicians to Appalachia and West Virginia. WVSOM places importance on having a stable faculty that supports the mission of the school and values osteopathic principles. The school also places an importance on community service, incorporating community service into clinical training. Though there are benefits, there are also deterrents to placement in West Virginia and Appalachia such as malpractice, low community qualities, disparity of third-party funding, and student debt accumulation.

Osteopathy was founded on the principles of manual manipulation of structure to improve function. While osteopaths in other countries like the UK have maintained this focus, those in the US have lost a lot of that identity. The pressures to deliver evidence based medicine in our cultures has led to a decreased use of OMT.

This study surveyed all first-year students enrolled at the Ohio University Heritage College of Osteopathic Medicine. The survey showed that majority of students value physician activity but lack the correct knowledge of appropriate guidelines. Many osteopathic physicians serve as primary care physicians and implement physical activity into the plan for 5th rlatients. This survey demonstrates that while the osteopathic philosophy encourages physical activity, more concrete training needs to be given to physicians about the proper recommendations and exercises they can give to patients.

This study delves into the evolving landscape of pediatric healthcare, where increasing numbers of parents seek both conventional medical care and complementary and alternative medicine, such as osteopathy, for their children. Focusing on Quebec, Canada, the study examines the development of interprofessional collaboration (IPC) between physicians and osteopaths in primary care. Through surveys and interviews with 274 physicians and 297 osteopaths, the research identifies key enablers and barriers to this collaboration. Positive clinical outcomes reported by parents emerged as a significant enabler, along with factors like the osteopath's training background, mutual respect for professional boundaries, perceived safety of osteopathy, and parental requests. However, barriers included language differences, organizational and legal challenges, role uncertainty, limited interprofessional interactions, and a lack of scientific evidence. These findings offer insights into fostering productive collaboration and patient-centered care between these healthcare practitioners.

In 1996, the Wilson Family Practice Residency program, accredited by both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA), began offering combined osteopathic and allopathic family medicine training. This article discusses the challenges facing dually accredited family practice residency programs and trends in family medicine training. Over the past five years, there has been a decline in the number of graduates from both osteopathic and allopathic medical schools pursuing family practice residencies. Despite the increasing number of AOA-approved positions, they often remain unfilled. Additionally, the article highlights the preference of osteopathic students for dually accredited programs due to perceived higher quality and better educational opportunities. It calls for improvements in funding, curriculum integration, and increased dually accredited programs to ensure the competitiveness and quality of osteopathic family practice residencies. Overall, this paper highlighted the wave of students moving towards applying to dual accredited or allopathic family medicine residency programs. There was a perceptions of better education and high prestige of training when attending one of these programs. This highlighted the perception on osteopathic family medicine residency programs and the wave for more students to move toward a dual accredited program.

Providers were categorized between having high empathy versus low empathy to patients with chronic pain, and were later able to give these patient OMT treatment to evaluate the differences in treatment response and improvement of their pain given the type of empathy the provider supplemented. It showed that higher empathy allowed for more tolerance of pain and faster effects of treatment. Despite other confounding factors that could contribute to the results (including nonspecific pain duration, concomitant medications, no systemic investigation...), there is clear evidence of the effects of greater amounts of empathy on OMT for patients' chronic pain.

Osteopathic assessment was an important theme in this study in assessing a patient's headache, but it made it more difficult to specifically pinpoint the type or cause of a patient's headache in order to create a specific treatment plan. This study was focused on getting an insight on osteopathic practitioner's experiences of diagnosing a headache in patients. Osteopathic providers also highlighted different treatment methods and working with other healthcare professionals to come up with an optimized patient outcome despite the apparent increase in pinpointing an accurate headache diagnosis using osteopathic principles of assessment. The main diagnostic tools of an osteopathic physician primarily include in depth patient interviews on their current medical complaint and osteopathic examination, both of which guide a physician's diagnosis and treatment plan development. The study by Tripodi, et al., takes a closer look at how osteopaths diagnose and treat the common chief complaint of headaches, along with the challenges faced by these physicians. Due to the multifaceted aspects of the development and diagnosis of headaches, Tripodi states "an accurate diagnosis was reported to be difficult to achieve" and continues on to discuss obstacles including multiple treatment interventions, interprofessional care teams, difficulties with patient compliance, and an insufficient level of patient resources available. Studies completed by Whalen, et al. [https://doi.org/10.1007/s11916-018-0736-y] and Cerritelli et al. [doi: 10.2147/JPR.S130501] indicated that treatment of headaches with OMT can be an effective form of management, however emphasized that the current evidence is low and further studies need to be completed to strengthen the foundation of this claim.

The process of implementing a training for osteopaths to engage in more psychosocial models of treatment along with their osteopathic knowledge not only allows providers to create a broader spectrum of treatment to the patient, but also results in improved pain coping and a more positive patient perspective towards their condition. The improvement and changes in provider behavior had an impact on patient care and patient learning and behavior changes in a positive way.

Overall, this article assessed the perspectives of Canadian osteopathic medical students on whether they would practice in the United States, with OMM, and whether they would continue in a non-primary care residency. This article used a 10 question survey sent to 17 COMs and compiled data to assess student perception. Only 66 students completed the survey out of 102 so this sample size was somewhat small. Canadian applicants made up 86% of the international applicant pool in 2013 and the number of practicing DOs is increasing in Canada. Based on the survey results, Canadian osteopathic students slightly prefer non-primary care specialties at 61%, ACGME accreditation, and to practice in Canada.

Does not directly address perception or misconceptions of osteopathic family medicine. Around 65% of participants responded to the questionnaire. Of the respondants, there is a strong desire to practice in Canada but wanting a ACGME residency that sponsors a H1B visa. Most respondents want to incorporate OMM into practice, but are not choosing a primary care speciality. While most respondents incurred more than 200K of debt, they did not factor that into their specialty of choice.

Linde et al set out to study the difference in belief and use of complementary and alternative medicine (CAM) amongst German orthopaedists, family physicians, and internists in 2012.  CAM treatments include homeopathy, vitamins/micronutrients, herbal medicine or physiotherapy, acupuncture, Classical Natural Healing Procedures, chirotherapy, and osteopathy. The questionnaire looked at overall belief in CAM as an effective treatment option and the use of each type of CAM. To the authors surprise, orthopaedists utilized CAM the most, but that is speculated to be due to the lack of other orthodox treatment options for chronic pain and musculoskeletal problems.  The authors explained that most internists take a more orthodox view of medicine; therefore, they were not surprised to see the results of very few internists utilizing CAM or believing it to be an effective treatment option.  Family physicians were closer to orthaepedists in their belief and use of CAMS, and tended to utilize placebos and non-specific treatment more than the other specialities. Regarding family physicians in particular, they agreed with heterodox views more than the other two specialties and also agreed more than the others with the need for more time and building relationships between patient and doctor.  Of the CAM treatments surveyed, family physicians were most active with chirotherapy.  Herbal remedies and osteopathy were close behind as the 2nd and 3rd most active CAMs, respectively.  Importantly, the authors explained these CAM treatments are only minimally taught in medical training. However, all are provided as options for continuing education post graduation.  The lack of inclusion of these modalities, including osteopathy, in the mainstream medical training could be limiting the use of these treatments in practice regardless of belief in their effectiveness. The study polled multiple types of physicians in Germany on various types of alternative or complementary medical therapy modalities, including vitamins, herbal therapy, acupuncture, homeopathy, etc. Osteopathy was consistently one of the least well known and least used, except by orthopedists.

The goal of this study was to assess the technological readiness and attitudes of primary care osteopathic physicians in small group practices towards pay-for-performance (P4P) programs. It was found that the majority of small-practice physicians who responded did not think their practice could meet P4P initiatives. Obstacles to this issue were found to consist of lack of investment capital, lack of training, and lack of necessary technological equipment. While P4P may be helpful for incentivizing physicians to focus on specific goals for common diseases, it may not be applicable to all patient visits, even those in which the physician provides meaningful care. Additionally, P4P may penalize physicians practicing in areas in which patients do not have a the resources to follow all of the prescriptions or recommendations from their physician.

The authors in this article created an OMM-Mini-CEX to fill this skills assessment gap and determined whether this CEX was perceived as effective evaluation tool for assessing the OMM core competencies of family medicine residents. The surveys were taken from the Wright Center for Graduate Medical Education National Family Medicine Residency program.  The result showed that this assessment is a direct observation evaluation tool to be used to assess residents. The OMM Mini-CEX is a direct observation evaluation tool used to assess OMM core competencies for family medicine residents, especially for allopathic physician candidates who apply to programs with Osteopathic Recognition and have not been assessed with COMLEX-USA Level 2-PE. The results show support of Mini-CEX being a useful and effective tool for evaluation of OMM competencies for family medicine residents, especially for assessing professionalism, patient care, and procedural skills. However, there was not strong support regarding the usefulness of the Mini-CEX in assessing practice-based learning and medical knowledge. Additionally, there was only 51% agreement among preceptors and residents about the overall effectiveness of the Mini-CEX. Further research is needed to determine the effectiveness of this tool, especially for undergraduate medical education and other specialties.

This study examines the practices of primary care providers in the United States regarding food insecurity (FI) screening and nutrition care. The results show that providers in clinics that screen for FI have higher perceptions of team-based care, but their nutrition competence remains similar. Providers who spend more time counseling patients about nutrition exhibit a patient-centered care culture. The findings suggest that promoting team-based care may improve FI screening and nutrition care. 

The survey of dual-accredited family medicine programs sheds light on several significant issues facing these programs. One notable finding is that the primary motivation for allopathic programs seeking osteopathic accreditation is to attract more US graduates rather than a desire to enhance program quality. Despite this, about a quarter of program directors felt that osteopathic accreditation improved their program's reputation. However, the survey did not explore other potential benefits of dual accreditation.The data also suggest that a substantial number of DO residents from dual-accredited programs do not take the allopathic board exam (ABFM), primarily due to the cost of maintaining both ABFM and ABOFP certifications and the wide acceptance of AOA board certification. This discrepancy raises questions about how to address the performance gap between DO graduates on the ABOFP and ABFM exams. The administered surveys wishes to elicit what kind of issues dual-accredited family medicine programs face like the cost of maintaining dual accreditations, DO residents' choice of certification by ABOFP or ABFM, and DO residents' board performance. The expansion of dual-accredited family medicine programs is driven by two key factors. Firstly, family medicine has historically been a less preferred specialty among US MD graduates, making it more attractive to DO graduates. Secondly, many programs prefer US-trained DOs over international medical graduates (IMGs), and DO graduates have proven to be high-quality residents in allopathic family medicine residencies. A large number of osteopathic residents graduating from dual-accredited programs are not seeking board certifications by ABFM, but the study participants are confident that their programs will still maintain dual accreditation. 

The aim of this paper was to investigate the experiences of a group of Australian osteopaths with the Medicare Chronic Disease Management (CDM) program to develop an understanding of current osteopathic practice methods and opinions concerning the program. With a response rate of 70.8%, fewer than half reported that they had "moderate" knowledge of the chronic disease program (CDM). The authors concluded that the sampled group did not have a thorough knowledge of CDM program requirements and that the patients referred to them under this program have more complex problems than their usual patients. They believe that further education on CDM program policies for practitioners is necessary. Patients under the CDM plan would require an average of 8-20 consults per year to provide optimal benefits from osteopathic treatment. This sample of osteopaths do not have thorough knowledge of requirements of CDM. 

Osteopathic patients' expectations about communication between osteopaths and physicians are poorly met. This study aims to explore when, why, and how osteopaths and physicians communicate with each other. Results show that communication between osteopaths and physicians involved with pediatric patients occurs most often in the context of referrals for specific patient situations and that the types of communication interaction mainly used (one-way) between osteopaths and physicians do not fit the intention behind those communication attempts.

Yellow flags are psychosocial issues that are often experienced by patients with musculoskeletal (msk) complaints. These issues tend to negatively impact the success of pain therapy, leading to ongoing chronicity of msk complaints. The OMPQ is a self-report questionnaire used to predict the influence of yellow flags on msk complaints in work related injury populations. However, this questionnaire is difficult to use because it is very long, so the OMPQ-10 was developed as a shortened version. The authors investigated the association between OMPQ-10 scores and patient demographics and determinants of health, finding that OMPQ-10 scores have a very limited relationship with the latter domains. They concluded that further work is needed to make a yellow flag screening tool suitable for patients with acute and chronic msk complaints.

The purpose of this study was to determine patients' perceptions of health care with respect to primary care. Patients were given a survey regarding their perceptions of the healthcare system and their providers. When patients were asked whether their health had improved, 65% perceived that their symptoms had improved, 15% were uncertain, 6% perceived no change, and 3% reported some exacerbation. Over 90% of patients reported they were satisfied with their treatment. 7% had reservations, 1% were not satisfied, and 1% did not give a clear response. For the patients who had dissatisfaction with their treatment methods, a common theme for these patients was confusion, lack of clarity: different diagnoses or treatments from different students or tutors, the feeling no one could get to the root of the problem, poor continuity of care, or failure of the booking system and loss to follow up.

This article describes osteopaths and not osteopathic physicians and the techniques used by osteopaths, the type of patient population they see, how often they are seen, their most common complaints, and how osteopathic techniques, characteristics and care differ by country.

A survey was taken of patients attending a teaching osteopathy clinic in the UK, and ~250 responses were received. Patients' reasons for visiting the clinic were varied and included checking the value of this clinic against others, curiosity about osteopathy, and referrals. The values they expressed generally fell under the themes of seeking hope, communication, respect (including especially listening and privacy), and trust. The analysis of the 21 patients with negative comments in one or more of these categories showed a surprising resilience: only one patient expressed dissatisfaction in all three domains. The common theme for these patients was confusion, lack of clarity: different diagnoses or treatments from different students or tutors, feeling no one could get to the root of the problem, poor continuity of care, or failure of the booking system and loss to follow up.

This article primarily dealt with the OMT aspect of family medicine. The purpose of this article was to determine and assess patient satisfaction and clinical outcomes with osteopathic manipulative treatment. Furthermore, this article also looked at which aspects of primary care that patients expressed more dissatisfaction with. Patients were given the PSQ scale. In terms of OMT, a physician's overall performance and their interpersonal manner scored higher on the PSQ scale. Finances with clinical appointments scored lower on the PSQ scale. Patients reported improvement in mobility and pain after receiving osteopathic manipulative treatment. However, the most common dissatisfaction was in relation to shortage of OMT services through primary care.

Osteopathy has recently been recognized as a regulated healthcare profession in Italy. It is focused on preventing and maintaining health, as well as rehabilitation and functional psychosocial recovery. Osteopaths are described as healthcare practitioners who deliver person-centered care focused on the musculoskeletal system and the concept of somatic dysfunction. While this is a positive development, there are critical points in the Italian law regarding the validity of osteopathic care models and the role of osteopaths in health promotion and prevention. It is important for legislative developments to be grounded in robust research and critical appraisal of osteopathic conceptual models. A pan-European curriculum alignment is needed to ensure the mobility of osteopaths across different jurisdictions in Europe is not affected.

A study was conducted to evaluate the effectiveness of osteopathy in treating irritable bowel syndrome (IBS). 30 patients were randomly assigned to receive either osteopathy or a sham procedure, with follow-up conducted at 7 and 28 days. The primary outcome was a 25% improvement in IBS severity score at day 7, and secondary outcomes included quality of life, psychological factors, and bowel habits. Both groups showed a decrease in IBS severity at days 7 and 28, but at day 7, patients receiving osteopathy had a significantly more marked decrease than those receiving the sham procedure. Anxiety and depression scores decreased without a difference between groups, and stool frequency and consistency were not significantly modified. In conclusion, osteopathy should be considered as an effective complementary alternative medicine in the management of IBS symptoms.

Offers an explanation of 2 hypothetical cases of erectile dysfunction and how they can present: 1) The patient only answers if the physician asks, and may lie to protect his self-esteem, and 2) The patient wants the doctor to "figure out" the problem without having to tell them. Then the text walks through the treatments for ED: PDE-5 inhibitors, invasive therapy, oral agents, hormone replacement, and the like.

The purpose of this study was to develop items for a patient self-reported questionnaire that assesses patients' perceptions of a single OCF treatment. The result of this study was the creation of a 35-item 'Patient Perception Measure of Osteopathy in the Cranial Field (PPM-OCF)' questionnaire.

This is a survey study that looked at the results of a SF-36 questionnaire distributed to the patients of six osteopathic training clinics. The survey was a short self reported form in English and Spanish that eventually showed poorer health status reporting in patients who attended these clinics. There was also differences in health reports of patients who attended each specific clinic. Finally, English speaking patients had better reported health fields than their Spanish speaking peers, but the Spanish speaking peers reported better vitality.

This article discusses A.T. Still university and how the institution has developed a rubric to objectively measure professionalism within the first and second year curriculum. The focus of the article is on assessing professionalism in medical education, especially int he osteopathic context. The conclusion drawn was that emphasis on professionalism throughout medical school is critical.

Headache disorders are exceedingly common and yet underdiagnosed and undertreated. Their commonality leads to their presentation in a variety of clinical settings, including osteopathic offices. However, little is known about how these practitioners approach the chief complaint. This study utilized a qualitative thematic analysis design. The collection of data used for this study comprised of semi-structured interviews. Ten current practicing Australian osteopaths were surveyed. These osteopaths largely focused on the importance of a thorough history and osteopathic assessment in formulating a diagnosis and individualizing eventual treatment to each patient. OMT specifically generally included direct techniques, though participants admitted that there is a lack of high-quality supporting evidence for the use of manual therapy in treating headache disorders. Patient education and adherence to lifestyle modification recommendations are also significant obstacles to headache management.

The study in question builds on a previous study in which the patients of osteopaths received Acceptance and Commitment Therapy (ACT) in isolation to now provide ACT and OMT together in order to treat chronic pain by taking an integrative approach. Patients underwent a six-week course in which they were instructed in the principles of ACT while receiving regular OMT targeting their pain sites. Treatment focused on functions relevant to individual capacities and goals, activities chosen by patients and mindful movements. Changes in quality of life and coping with pain showed significant correlations with increased psychological flexibility and slightly weaker associations with mindfulness, and a section of the study population also reported decreased medication use. This course in this study also aimed to strengthen osteopaths' abilities to work with psychosocial factors. Osteopaths were encouraged to work the patient through the dissonance between expectations and sensory experiences, which seemed to enhance patient learning and lead to behavior change. Practitioners were able to guide the patient through the embodied experiences of pain using a flexible approach, tailored to individual capabilities, values and goals.

Osteopathic practitioners can be the first point of contact for those experiencing chronic pain, and fortunately, the osteopathic models of care are well-suited to integrate a biopsychosocial component along with treatment of the physical body. Acceptance and Commitment Therapy (ACT), which focuses on enhancing psychological flexibility and adapting to the present moment rather than falling into habits of avoidance of negative stimuli, is one such integrative therapy. Participants in this study enrolled in a six-week ACT course, before, during, and after which their overall quality of life and approach to chronic pain was evaluated. At the end of the study, participants recorded improvements in activity engagement and quality of life. After three months following the conclusion of the study, improvements in activity engagement were sustained, but changes in quality of life were smaller and more variable. Most participants also reported that the mutual support of participating in the group setting was helpful. Those who completed self-report questionnaires about participating in the study demonstrated small but sustained improvements in psychological flexibility. Participants also described how the course had created opportunities for new conversations about living with pain, with osteopaths providing their ongoing treatment.

Osteopathic practitioners tend to score very highly when it comes to patient satisfaction, though areas consistently identified for improvement by patients include fully understanding their (the patient’s) concerns, helping patients to take control, and making a plan of action with the patient. It is believed that joining forces with regulatory bodies can help identify solutions to these relative deficiencies before harm to the patient-provider relationship occurs. A series of workshops hosted by the major British osteopathic and regulatory bodies were organized in the late 2010s to do just that. These workshops sought to identify common patient and provider values, how they manifested in hypothetical situations, how predictable their application was going from patient to patient, and how these values manifested (or notably did not manifest) in past clinical encounters. Analysis revealed an emphasis on tailoring each approach to each unique patient and developing a shared understanding of treatment goals. Meanwhile, notable patient concerns consistently surround communication and consent.

This study investigated the prevalence of complementary and alternative medicine (CAM) recommendations by dentists in Germany and assessed their perceived effectiveness. The findings revealed that dentists frequently recommend a range of CAM remedies, including plant extracts like Arnica montana and chamomile, relaxation therapies, homeopathy, and osteopathic medicine. CAM proponents, who tend to be female, have more experience, work fewer hours, and exhibit higher self-efficacy and work engagement, rate these treatments as more effective than CAM opponents. Despite the limited scientific evidence for many CAM approaches in dentistry, there is a notable demand for CAM in dental and oral health, especially for acute conditions. This study underscores the need for further research on CAM use in dentistry and its effectiveness.

The article discusses the rising popularity of Complementary and Alternative Medicine (CAM) in the UK, with approximately 5 million adults seeking CAM therapies each year, a portion of which is provided within the National Health Service (NHS). The growth of CAM is attributed to factors such as increased patient choice, disillusionment with certain aspects of conventional medicine, and a desire for patient-centered care. CAM therapies, including acupuncture, chiropractic, and herbal medicine, are used alongside conventional treatments. Women and younger individuals are more likely to turn to CAM, and it is often sought for long-standing health conditions. Despite its popularity, integrating CAM into the NHS faces challenges due to the evidence-based nature of healthcare and the need for further research on CAM's effectiveness.

A telephone survey in 1998 asked 1106 community members about their experience with osteopathic physicians and osteopathic manipulative treatment. The study found that osteopathic patients were more likely to be satisfied with their care, especially in the fields of family medicine, MSK, surgery, and ob-gyn. However, MSK was the most likely to show benefit to patients in regards to OMT. Patients were filtered based on their familiarity with osteopathy, and it was determined that those who were more familiar with the field and the treatment methods were more likely to be satisfied with this form of care. However, it was also determined that OMT was less likely to be utilized if it was not covered by insurance, and the physician was not receiving compensation for it. This leaves room for further research and advocacy regarding compensation and increased utilization of OMT.

Australian osteopathic students at Victoria University were asked to record BPs on patients they were seeing, and the frequency at which this was done was reported. The findings demonstrate that 70% of patients did not have their BPs checked, raising concerns regarding the lack of measurements conducted by osteopathic medical students.

This article describes osteopaths and not osteopathic physicians and the techniques used by osteopaths, the type of patient population they see, how often they are seen, their most common complaints, how osteopathic techniques, characteristics and care differ by country.

Per the report, acute low back pain (LBP) creates a significant proportion of patient cases for osteopathic physicians and other manual therapy professionals, yet there are few studies that delve into the efficacy of these providers' treatments. This report is part of a larger cohort study that follows patients who have been dealing with previously acute LBP for a year and seeing their primary care provider for it. While family medicine practitioners are not mentioned in name, it is notable that osteopathic physicians in Australia helped compose the treatment force. Over the course of a year, the patient satisfaction scores that were measured via Likert scale style questions found that patients who noted greater satisfaction were also more likely to have fewer visits with their PCP, fewer days of symptoms, and lower pain scales. These findings can assist in the prognosis of acute LBP and reinforce the perception that osteopathic practitioners and manual therapy professionals can effectively treat/manage patients' acute LBP.

The article refers to Osteopaths as non-physician primary care health care practitioners, which may be confusing in the use of the term Osteopath in America versus in other countries.

The purpose of this study was to gauge the impact on patient satisfaction of having students involved in a patient’s medical care at the family medicine clinic of a large southwestern osteopathic medical school. This study was conducted in a family medicine clinic comprised of six full-time family medicine clinical faculty members. Findings indicate that the presence of medical students during clerkship rotations does not negatively affect patient satisfaction. Patient satisfaction scores are a valuable resource for assessing medical student performance and improving education in medical students.

Following manual therapy, patients report effects that are often regarded as adverse by practitioners. This paper investigates how the patients themselves view their post-treatment experiences. The authors find suggestions of a disparity between patient perceptions and clinical definitions of adverse events. Non-clinical factors, such as feeling respected, understanding more about their condition and its treatment, and service efficiency were important to patients and can modify their perceptions of what is adverse. Expectations are but one of the influences on patient perceptions of what might be considered an adverse post-treatment experience. Managing the patient’s overall experience of osteopathy may be an important determinant of perceptions of ‘adverse’ effects.

There is debate over how real the apparent benefits of manipulation are as a treatment for back pain. The UK BEAM trial aimed to determine if manipulation provided additional benefits to "best care" of back pain. The results of the study showed a small, but statistically significant additional positive effect from the manipulation package. Whether the size of this positive effects is clinically meaningful remains a point of discussion.

Patients seeking support for their weight loss journey used various systems with varying degrees of satisfaction. Women perceived having more human support than men did, and family members were the most common sources of human support for patients. Interestingly, only 27% of respondents listed a professional as part of their human support team. Patients used various apps for support, with the majority (42%) using fitness/activity tracking apps. While few patients used social media as a support, those who did use social media as support reported lower satisfaction with social media than those who used humans or apps as support.

The purpose of this article was to determine patient responses to treatment in response to chronic lower back pain with surgery versus osteopathic methods. Patients were given a survey to assess their self-satisfaction within different areas of treatment. It was determined that patients with low back pain were more satisfied with osteopathic management than with management from other primary care providers. Although overall levels of satisfaction were high for all three sub-scales of satisfaction (competence, quality of care, and efficacy) for both the general practitioners and the osteopaths, there were no correlations with the levels of pain or disability reported by patients. High levels of satisfaction with osteopathic management were unlikely to be a result of increased hope and expectation of a new treatment.

In the past, DOs had to apply to residency through MRM or AOA, of which AOA did not offer pathology. When they were combined into a single GME accreditation, this created a greater opportunity for DOs to pursue pathology. Now, US MDs have seen a drop in those applying for pathology. However, DOs have remained stable. More research has to be done as to why.

MD and DO integration is still an unexplored territory in medicine and in pediatrics. Few DOs still do OMT in their practice, making them very similar to an MD. Yet, stigma remains. Residencies want USMLE scores and MD applicants, even though 96% DOs pass USMLE on their first attempt (comparable to MD 98%). More research and integration is still to be done with MDs and DOs in pediatrics.

This text highlights the importance of community health screenings to gauge the health of a community. It was found that more intervention is needed to educate the public. Higher educated and younger individuals were more aware of osteopathic physicians and would prefer them. But lower levels of education correlated with not seeking medical care when necessary, and a lower awareness of the options for care that are available to them, such as osteopathic physicians.

An interesting look at subacute back pain treated with osteopathic manipulative treatment. 66 patients completed the 6 month evaluation, randomized to test OMT, sham OMT, and no intervention. The OMT patients reported better functionality and mental health, as well as fewer cotreatments.

OMT was successfully used to allow a patient to deliver without the use of pain medication, despite the patient's spine dysfunction. The labor was faster than labor without OMT. The article cited several sources for the use of OMT in the prenatal period and now presents its use during labor to allow for natural birth.

This 1998 study investigated the use of Osteopathic Manipulative Treatment (OMT) among osteopathic physicians in the United States. A national mail survey was conducted, involving 3,000 randomly selected osteopathic physicians, resulting in 955 usable responses. The study revealed that OMT was employed more frequently by specialists and family physicians when compared to other primary care physicians. Specifically, OMT specialists used this treatment on a higher percentage of patients (mean score of 4.73), followed by family physicians (mean score of 2.01). In contrast, other primary care physicians and non-primary care specialists had lower mean scores of 1.43 and 1.36, respectively, indicating a trend of reduced OMT utilization. The study also found that participating physicians, across 46 specialties and subspecialties, reported employing OMT for various conditions. Notably, 71% of respondents identified an average of 3.3 conditions and diagnoses treated with OMT. The most commonly treated conditions were associated with the musculoskeletal system (51.5% of conditions). Specific conditions included low back pain (10.2%), headache/cephalgia/migraine (8.57%), neck pain (3.6%), and sinusitis (2.49%). The study underscored the need for further research to substantiate the benefits of OMT and its role in modern medicine, especially as healthcare continues to evolve.

This article is a condensation and summary of the principles of the patient-centered medical home and how it may be implemented into primary care practices. At its core are the maintenance of patient care, access to care, and a patient-centered model of care. Most of these values are supported by physicians, but the implementation proves to be challenging to some as the amount of unpaid labor seems to increase for the physician, however physicians trained in OFM programs are trained with a wholistic, patient centered mindset, augmented by OMT training, which provides additional benefits and ease of implementation for PCMH in practice.

The purpose of this article was to determine expectations that patients have towards their osteopathic physicians in order to improve patient-physician interactions. Researchers created their own questionnaires regarding expectations and distributed them to patients. 34 of the 50 prevalent expectations were perceived by the participants to be met well. Examples of the most prevalent expectations for when participants expect to go to osteopathic physicians are: I expect to be able to ask questions, I expect the osteopath to listen to me, I expect to be treated with respect, I expect to be given a clear explanation of my problem that I understand, and I expect the osteopath to treat one patient at a time. Newer patients had slightly more unmet higher expectations than did older patients. Furthermore, around 10 out of the 50 expectations had a general consensus of unmet expectations by osteopathic physicians. Examples of prevalent expectations that were unmet include: I was made aware that there is a complaints procedure should I need to use it, there was communication between my osteopath and general practitioner about my problem, I was informed of the risks and side effects of the treatment, there was access for people with delivery, and the osteopath was able to refer me elsewhere when my symptoms didn't improve.

Patient satisfaction and patient experiences demonstrated significant enhancements when their general practitioners (GPs) possessed expertise in manual therapy techniques like OMT tailored to their patients' specific conditions, or when they embraced a compassionate "communicator's role" in providing comprehensive, holistic, and patient-centered care. It is noteworthy that although these improvements were not explicitly attributed to family practice, several of the conditions treated (e.g., lower back pain and non-specific spinal pain) are commonly encountered within a family practice context, and the data indicate positive correlations between patient satisfaction and experience and both OMT treatment and the holistic OMT approach to patient care.

The statistics (Table I) was pulled from Healthgrades to measure how patients perceived their interaction with a provider, being able to list the number of female and male DO vs MD providers in either FM or IM.

This study was conducted in 1998 amongst the medical students and residents at Carson City, Nevada Hospital. Participants answered a survey about their familiarity with Occupational & Environmental Medicine (OEM) topics subdivided into clinical topics and non-clinical topic areas (which included use of osteopathic manipulative treatment). The majority of respondents felt that they did not receive adequate education on OEM topics in their medical school nor residency. Eight of those respondents then went on to a 10 week OEM training session (which included learning about OMT from licensed osteopaths). Afterwards 50% responded that they felt that they would utilize the "nonclinical topics" in their practice.

The purpose of this study was to determine to what extent OMT benefited patients' pain and wellbeing - with the variable of an adjunct audio recording of either a) the history of OMT, or b) a guided mindfulness meditation. The result of the study provides empirical evidence that OMT may increase the distribution of pleasant sensations reported by pain patients while decreasing the distribution of unpleasant sensations reported.

The primary purpose of the study is to determine physician's perception on how they treat patients with mood disorders. Specifically this study surveys a population of osteopathic physicians working in New Zealand (N = 62). With respect to how physicians feel their osteopathic training affects their management of this patient population, between 50-60% feel that some dimension of osteopathy (diagnostic, treatment) helps with mood disorder.

The article investigates patient experiences and perceptions of osteopathy, specifically focusing on structural osteopathy int he cranial field in New Zealand. This dives into the emotions patients report during and after their treatments; specifically talking about how positive perceptions of their treatments were associated with sensations of relaxation. This does not specifically discuss osteopathic family medicine perceptions.

The authors of this study are affiliated with the Integrated family medicine and neuro-musculoskeletal residency program in Florida. The article discusses the financial and the physical impact of postoperative ileum in the US and it estimated the total cost to be between 750 million to 1 billion per year. There was another study referenced which estimated that 42% of patients who had major non cardiac surgery had post operative GI tract dysfunction. Ultimately, the goal of the paper was to investigate whether or not OMT would lead to improved outcomes for these patients and reduce the length of hospital stay. The authors used a chart review of 655 patients with a code of ileus on their chart between 2003 - 2006. The records were divided into two groups: those who did receive OMT and those who did not. The data was analyzed by ANCOVA (analysis of covariance). The results showed those who did get OMT had a significant shorter length of hospital stay being 11.8 days compared to the non-OMT group which was 14.6 days. The importance of the study was that there may be both a patient benefit and an economic benefit to the use of OMT post operatively.

The Osteopathic Survey of Health Care in America (OSTEOSURV) is a decennial telephone survey which is used to measure trends in the population's perceptions of osteopathic medicine, care/treatment quality of osteopathic physicians, and current health care issues. The article does not cover the results of the survey, but it does discuss the methods, exclusion criteria, margin of error, demographics, response rate, and other aspects of the survey which would contribute to the validity of the survey. The advantage of the OSTEOSURV is that it is statistically powerful despite its being delivered every 10 years and it accounts for shortcomings of other national surveys (hypothesis limited by survey responses, lacking patient perspectives of health topics) by also addressing patients' perceptions and experiences with osteopathic medicine, ratings of satisfaction with health care, and awareness of healthcare topics. Included in the appendix is the questionnaire asked on the telephone to respondents.

The Patient-Centered Medical Home (PCMH) model utilizes 7 joint principles (A Personal Physician; A Physician-Directed Medical Practice Team; Whole Person Orientation; Care that is Coordinated and/or Integrated; Quality and Safety are Hallmarks; Enhanced Access to Care is Available; Payment Appropriately Recognizes Value) and channels the osteopathic philosophy of holistic care to optimize longterm patient care. As fewer medical students chose to specialize in family medicine, physician burnout increased, the aging population developed more chronic health conditions requiring more costly care, and costs rose for healthcare with lower patient satisfaction, physicians and other health professionals formed teams and began utilizing the PCMH model to deliver continuous, comprehensive, timely, personalized care for patients. Many of these sites utilize electronic health records, texting/emailing modalities, and patient portals to communicate with their patients. In general, coordinating the team members and patient care allows for greater responsiveness to patient concerns, better patient health outcomes/quality of life, lower costs for care in the longterm, greater physician/provider wellbeing, and great patient satisfaction with care.

This article does not specifically focus on family medicine, but it does examine rural medicine, which often intersects with primary care. The study involved a small sample of 190 OSU graduates, with about 30% choosing to practice in rural areas. The data suggests that increased exposure to rural primary care may have influenced this decision, as some students participated in an optional rural rotation.

A northern US family physician wants to move to a sunny place that does not deal with lawsuits, social work, and other "not actual medicine" problems. As she is explaining to her patients that she is leaving, she realizes how much she helped the population she lived with. In the end, she still decides to move on with her life to a warmer place.

The topic of osteopathic medicine and its practices, having a focused practice to offer the global medical community, is being called into question. Additionally, there is pressure on the field of osteopathic medicine to define what separates it from similar fields in medicine, which still yields varied answers depending on where the osteopath is practicing. The results of this analysis suggest that the identity of the osteopathic profession is too broad a topic to assign a single or overarching definition to, especially in the global community. Work will need to be done to branch the understanding of an osteopath to the global community.

Family medicine residents need more training and guidance in conducting research. Before, many of them just didn't have adequate program support for research, and some doctors even believe family doctors don't need to complete research. The DEAR at UNT was established to increase research, and support/guide resident progress. This project has shown that the research output has increased from the DEAR's implementation.

The article mentioned that having osteopathic trained primary care physicians taking care of sports teams may improve sports teams overall. The article mentioned the osteopathic trained primary care physicians coached a group of players from a collegiate lacrosse team may have helped team performance for that year compared to previous and subsequent years, although this needs to be looked into more. The coaching sessions involved a more holistic approach to sports, including nutrition, spirituality, stretches to prevent injury, motivation, etc that most allopathic trained physicians had not done for the team in the past. Although further studies need to be done to confirm this, it is proposed that having an osteopathic trained primary care physician on sports teams will improve the overall well-being of the athlete and improve their performance.

The numbers of family medicine positions increased and was attributed to the COVID-19 pandemic. The versatility of family medicine was highlighted by the pandemic and transformed the profession as "indispensable." Based on the 2020 National Residency Match Results, family medicine were at a record high despite the adjustments made in previous years. Family physicians were able to fulfill different roles in unique settings.

While the article does not state relevant information or findings related to perceptions/misconceptions of osteopathic family medicine specifically, there was no reported differences between MDs and DOs. It can be reasonably inferred that there aren't perceived or support in differences between osteopathic and allopathic family physicians in regards to how they go about in conducting patient care.

Other specialties in medicine are unwilling to recommend treatment by osteopaths because they do not understand what they do or know what they do well enough to entrust they'll provide benefit to a patient's back pain. Most practitioners may not try to delve deeper into potentially causes for a patient's back pain in primary care. Osteopaths are described as trying to find more specific causes for the back pain before making a treatment plan. Practitioners will try to tweak a patient's back pain treatment so it make not necessarily follow guidelines, but are often unsure and therefore unwilling to refer treatment to Osteopaths, chiropractors, etc due to their lack of understanding of what those professionals can provide/do for the patient. The article suggests that teaching professionals during their school training or fostering interpersonal professional education could improve understanding regarding the capabilities of Osteopaths (acupuncture, and chiropractors).