Can DOs still 'circle the wagons'? Reflections on the use of osteopathic manipulative treatment.
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Biomedical subjects
Publications and source records attributed to L J Fry.
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The literature suggests that the extent to which osteopathic physicians actually use osteopathic manipulative treatment (OMT) and the factors that predict the use of OMT remain virtually unexplored. A mailed survey of practicing osteopathic physicians was used to query respondents about their use of OMT and about the effects of a number of factors on use of OMT. The survey showed that 71% of 100 practicing physicians used OMT with 5% or more of their patients, and 14% in 50% or more of their patients. Multivariate statistical procedures revealed that a physician's having learned a new OMT format since graduation from medical school was the primary predictor of the use of OMT, followed by interest in OMT during internship. The other predictor was whether the respondent had a family member who was also a DO. Physician's specialty, emphasis on OMT during graduate and postgraduate training, and the era during which DOs received their training were not significant predictors of OMT use. These results indicate a need for further research on OMT use and the variables examined in this study.
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Human immunodeficiency virus (HIV) testing and pretest/posttest counseling are central components in prevention efforts in the United States. Yet, not all persons return for their test results and posttest counseling. Based on an exploratory study at four community health centers in South Florida, the authors determined the percentage of patients who returned to these clinics. They also examined those sociodemographic and HIV antibody test-related factors that predicted patient return. Less than 50% of those patients tested returned. Younger, urban, minority group patients whose HIV serostatus was likely to be negative were the least likely to return for test results. The authors describe a direction of future research to address these disturbing findings.
Osteopathic medical schools are in an excellent position to cooperate with managed care providers because of an overlap of their common objectives. The authors maintain that osteopathic medical schools and managed care providers need to work together to promote integrated graduate medical education-managed care systems or face the possibility of being at the mercy of a fragmented healthcare reform movement. Issues related to common objectives and barriers to integrated graduate medical education-managed care systems are discussed, along with possible solutions.
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