Osteopathic manipulative treatment use among family medicine residents in a teaching clinic

Osteopathic Principles and Practice (OPP), including osteopathic manipulative treatment (OMT) is the core foundation of the education provided by osteopathic medical schools. Multiple studies performed over the past 25 years have demonstrated that a dwindling number of osteopathic physicians utilize OMT in their practice, despite 95% of osteopathic family physicians perceiving OMT as an effective treatment modality.

The objective of this study is to quantify how often OMT is being performed by residents in an osteopathically recognized family medicine training clinic and to identify the perceived barriers to performing OMT.

Fifteen family medicine residents were given access to an anonymous written survey for three 2 week periods. The survey allowed them to input the total number of patient encounters for their half clinic day, the encounters in which OMT was perceived to be appropriate, the encounters in which OMT was performed, and the reasoning for encounters in which OMT was not performed. Surveys were collected anonymously, and data were input into a datasheet in which results were calculated.

A total of 101 survey responses were collected for a total of 304 patient encounters. OMT was performed in 5/304 (1.6%) encounters, yet it was perceived to be appropriate in 60/304 (19.7%) encounters. The primary documented reason that OMT was deferred was due to time constraints (42/50 responses, or 70.0% of the encounters in which OMT was deemed appropriate).

This study highlights time as the main reason OMT is deferred by residents in a teaching clinic. This provides insight into potential interventions in a training clinic to increase the use of OMT by family medicine residents.