Purpose: To determine whether osteopathic manipulative treatment (OMT), a key identifiable feature of osteopathic medicine, is becoming a “lost art” in the profession, and whether the long-term evolution of osteopathic medicine into mainstream medicine and particularly specialization has had a similar impact on the use of OMT by family practitioners and specialists.
Method: In April 1998, a two-page questionnaire was mailed to 3,000 randomly selected osteopathic physicians in the United States to assess factors affecting their use of OMT. Descriptive statistics, linear regression analyses, and analysis of variance techniques were used to test for differences.
Results: The response rate was 33.2%. Over 50% of the responding osteopathic physicians used OMT on less than 5% of their patients, and analysis of variance revealed OMT use was significantly affected by practice type, graduation date, and family physicians versus specialists. For specialists, 58% of the variance regression was attributed to barriers to use, practice protocol, attitudes, and training, whereas for family physicians, 43% of the variance regression was attributed to barriers to use, practice protocol, and attitudes. More important, the eventual level of OMT use was related to whether postgraduate training had been undertaken in osteopathic, allopathic, or mixed staff facilities, particularly for osteopathic specialists.
Conclusions: The evidence supports the assertion that OMT is becoming a lost art among osteopathic practitioners. Osteopathic as well as allopathic medical educators and policymakers should address the impact of the diminished use of OMT on both U.S. health care and the unique identifying practices associated with the osteopathic profession.
Dr. Johnson is professor and Dr. Kurtz is professor, Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing.
Correspondence should be addressed to Dr. Johnson, B-209-E West Fee Hall, Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824-1316. Reprints are not available.
The authors acknowledge funding support of the project by the American Osteopathic Association and the Department of Family and Community Medicine in the College of Osteopathic Medicine at Michigan State University. In addition, they thank the osteopathic family physicians and specialists who reviewed or responded to the survey instrument, J. C. Kurtz for statistical consultation, David Bordinat for editorial assistance, and Dan Koop Liechty for technical assistance with the project.