Osteopathic News
Safety and Efficacy of Immediate Postoperative Feeding and Bowel Stimulation to Prevent Ileus After Major Gynecologic Surgical Procedures
Context: Postoperative ileus is a major complication of abdominal surgical procedures Objective: To evaluate the incidence of ileus and gastrointestinal morbidity in patients who received immediate postoperative feeding and bowel stimulation after undergoing major gynecologic surgical procedures. Methods: During a 5-year period, the authors tracked demographic, surgical outcome, and follow-up information for 707 patients who underwent major gynecologic operations. All patients received the same postoperative orders, including immediate feeding of a diet of choice and bowel stimulation with 30 mL of magnesium hydroxide (milk of magnesia) twice daily until bowel movements occurred.
Effect of osteopathic manipulative treatment on gastrointestinal function and length of stay of preterm infants: an exploratory study
Significant improvements in neonatal technology utilized in neonatal intensive care units (NICUs) over the last 2 decades, along with evidence-based care guidelines, have significantly improved hospitalization and survival for both low birth weight (LBW) infants and the residual preterm population, albeit at a high cost. A major proportion of pediatric hospital stays in the United States is attributable to neonatal conditions that rank among the most expensive items in the list of services provided for children
An Osteopathic Approach to Type 2 Diabetes Mellitus
The prevalence of type 2 diabetes mellitus (T2DM) has reached epidemic proportions in the United States, the impact of which is seen in all medical practices. The tenets of osteopathic medicine are readily applicable to a proactive approach to patients with T2DM and are (1) the body is a unit; the person is a unit of body, mind, and spirit; (2) the body is capable of self-regulation, self-healing, and health maintenance; (3) structure and function are reciprocally interrelated; and (4) rational treatment is based upon an understanding of these basic principles.
Having raised nearly $1 million, AAO creates FORCE for research, education
Seeking to bridge the gap between research and clinical practice, the American Academy of Osteopathy has established a foundation to fund clinically applicable research in osteopathic manipulative medicine and disseminate research findings. The Foundation for Osteopathic Research and Continuous Education is known by its acronym, the FORCE, which pays homage to A.T. Still’s vision of “unleashing the force of nature to heal patients,” explains academy president Michael A. Seffinger, DO.
Florida’s ‘watered down’ law curbing firearms inquiries OK with FOMA
Pitting the First Amendment against the Second Amendment and children’s safety against the right to privacy, a controversial new Florida law limiting the ability of physicians to ask patients about gun ownership has sparked a lawsuit by three medical specialty societies. But the Florida Osteopathic Medical Association (FOMA) is among the physician organizations that view the legislation as a palatable compromise from the original, more punitive bill.
Advocacy for Fair and Equitable Medicare Payments
AOA President Martin S. Levine, DO, wrote to Centers for Medicare and Medicaid Services (CMS) Administrator Don Berwick on 8/29/11 to provide the AOA’s comments on the 2012 Medicare Physician Fee Schedule proposed rule, published in the 7/19/11 Federal Register. Developed by the AOA Joint Committee on Quality & Payment, the AOA’s comments express appreciation for and support of the effort to promote primary care and new delivery models that place greater emphasis on prevention and wellness. However, we are concerned that provisions in the proposed rule will continue to exacerbate the burdens all DOs face, particularly primary care. Among our 12 pages of comments, President Levine asked CMS to help alleviate physicians’ regulatory burdens and streamline Medicare requirements; identify and correct potentially misvalued service codes; expand PQRS reporting participation options; and more closely align EHR requirements with the PQRS.
Letter from AACOM calls upon President Obama and Vice President Biden to protect GME funding
Dear Mr. President and Mr. Vice President:
On behalf of the American Association of Colleges of Osteopathic Medicine (AACOM) which
represents the nation’s 26 colleges of osteopathic medicine, offering the doctor of osteopathic
medicine (DO) degree at 34 locations in 26 states, I respectfully urge you to protect graduate
medical education (GME) and oppose any potential funding cuts to GME.
Schools keying on writing, verbal skills to deepen students’ clinical acumen
Becoming adept at the multiple aspects of medical communication requires career-long perseverance, observes Arnold Melnick, DO, the founding dean of the Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Fla. “Just as medical schools cannot teach students all of medicine, we cannot possibly instruct students in all facets of medical communication. But we need to give them enough of the basic material that they can build on what they’ve learned, and we need to stimulate their interest so they will want to learn more,” says Dr. Melnick, the author of the newly published book Effective Medical Communication, a compilation of the columns he wrote for The DO.
Best medical schools? Profession mixed on fairness, merits of U.S. Newsrankings
A few osteopathic medical schools fare well in the latest U.S. News & World Report rankings of “Best Medical Schools.” In primary care, which is considered one of the two major ranking categories, the Michigan State University College of Osteopathic Medicine in East Lansing stands at No. 14 and the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC/TCOM) in Fort Worth at No. 20. In addition, the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg ranks 9th in rural medicine and 12th in family medicine.
New Student Resources on Osteopathic.org
Osteopathic.org, the AOA’s new website, has many improved sections geared to osteopathic medical students’ unique needs. The Student/Specialty Clearinghouse, an initiative President Nichols launched, provides all the resources students need to create a student chapter of an osteopathic specialty on COM campuses. The revamped “For Students” section, located under "Education" on the main navigation menu, contains everything students need as they work their way through osteopathic medical school and onto internship and/or residency training. In addition, Osteopathic.org contains quick links to the Opportunities database, the AOA Match Program, financial planning resources, and the Student Resource Guide, Tips, Tactics and Truths: Making the Most of Your Osteopathic Medical Education. Stop by Osteopathic.orgtoday to take a look around!
Great News from AOA Team Members
The AOA is happy to share some great AOA member news! Dixie Tooke-Rawlins, DO, Dean of the Edward Via College of Osteopathic Medicine, has been selected by Virginia Governor Bob McDonnell to serve on both the Virginia Health Reform Initiative Advisory Council and as Co-Chair of the Virginia Health Reform Initiative Capacity Task Force. Dr. Tooke-Rawlins is the only D.O. chosen for the Virginia Health Reform Initiative.
AOA Supports Tax Exemptions for Students
Earlier this month, the AOA provided the U.S. Supreme Court its perspective on the status of medical residents as students in a joint “amicus curiae” (friend of the court) brief in Mayo Foundation for Medical Education and Research, et al., v. United States. The AOA submitted the brief, which supports residents’ eligibility for exemption from taxation under the Federal Insurance Contributions Act, in collaboration with the Association of American Medical Colleges, the American Council on Education, the Association of American Universities, the Association of Public and Land-Grant Universities and the American Association of Colleges of Osteopathic Medicine. The brief states our belief that the court should reverse a lower court’s decision holding that residents are categorically ineligible for the student exemption to FICA taxation.
FDA Issues Drug Warning for Seizure, Bipolar Disorder Medication
The U.S. Food and Drug Administration is informing the public that Lamictal (lamotrigine), a medication commonly used for seizures in children two years and older, and bipolar disorder in adults, can cause aseptic meningitis. The FDA is revising the Warnings and Precautions section of the drug label and the patient Medication Guide to include information about this risk. In most cases, patients' symptoms were reported to have resolved after Lamictal was discontinued.
CDC Releases 2010-2011 Influenza Vaccination Recommendations
The Centers for Disease Control and Prevention (CDC) has issued a letter advising that all individuals age 6 months and older should receive an influenza vaccination. The CDC recommends that physicians offer the vaccine at any opportunity and for every patient. Vaccination efforts should begin as soon as vaccine is available and continue throughout the influenza season. The CDC will continue to reinforce efforts to emphasize the importance of vaccinating high-risk individuals while promoting vaccination for all individuals. Read the letter from the CDC.
MD's in Osteopathic GME Residency Programs
I recently received a question about the ongoing study of the
advisability of allowing MD's to take OGME residency programs. There
were 2 questions that originally led to the idea of doing this study:
1. How to fill unfilled OGME slots
2. How to encourage establishment of new OGME residency programs in
hospitals with predominantly MD staff members who were only interested
in establishing programs if open to MD's and DO's.
DO Nominated to Prevention Advisory Group
President Nichols wrote to HHS Secretary Kathleen Sebelius on 7/28/10 to nominate Robert B. Goldberg, DO, to the Advisory Group on Prevention, Health Promotion, and Integrative Medicine. The Advisory Group will assist the National Prevention, Health Promotion and Public Health Council established under the Affordable Care Act. The Council, chaired by the U.S. Surgeon General (an AOA member!), is charged with developing a national prevention and health promotion strategy. Dr. Goldberg is Dean and Professor of Physical Medicine and Rehabilitation at Touro College of Osteopathic Medicine in New York and Attending Physician in the Department of Rehabilitation at St. Vincent's Hospital and Medical Center of New York City.
American Osteopathic Association Installs First Female President
Not one to back down from a challenge, Karen J. Nichols, DO, embraces her term as the first female president of the American Osteopathic Association (AOA) during a time of historic change in health care. The AOA installed her as its 114th president this afternoon during its annual business meeting in Chicago.
Effects of Rib Raising on the Autonomic Nervous System: A Pilot Study Using Noninvasive Biomarkers
Rib raising is an osteopathic manipulative treatment technique used to address restricted excursion of the rib cage and modulate sympathetic nervous system (SNS) activity. However, the physiologic effects of this technique have not been well documented. This article investigated the effects of rib raising on the autonomic nervous system and the hypothalamic-pituitary-adrenal axis using noninvasive biomarkers. The results of the present pilot study suggest that SNS activity may decrease immediately after rib raising, but the hypothalamic-pituitary-adrenal axis and parasympathetic activity are not altered by this technique. Salivary -amylase may be a useful biomarker for investigating manipulative treatments targeting the SNS. Additional studies with a greater number of subjects are needed to expand on these results.
OMT Guidelines Added to National Guideline Clearinghouse
The AOA's guidelines for osteopathic manipulative treatment (OMT) for patients with low back pain have been posted to the National Guideline Clearinghouse (NGC), a comprehensive database of evidence-based clinical practice guidelines and related documents administered by the U.S. Agency for Healthcare Research and Quality (AHRQ). Developed by the AOA Bureau of Osteopathic Clinical Education and Research's Low Back Pain Subcommittee, the guidelines provide authoritative clinical guidelines on OMT for low back pain. Michael Seffinger, DO, served as Chair of the Subcommittee.
AOA Executive Director John B. Crosby, JD, represented the osteopathic family on Wednesday during a Capitol Hill press conference to call upon the U.S. House of Representatives to support the American Jobs and Closing Tax Loopholes Act (H.R. 4213). The proposed legislation will help preserve access to health care for millions of Medicare beneficiaries until 2014 by preventing the scheduled 21.1% cut to Medicare physician payment and replacing the reduction with at least 1% positive updates until a permanent fix to the flawed sustainable growth rate formula can be implemented.
President Wickless Writes to the Washington Post
President Wickless also wrote a letter to the editor of the Washington Post regarding an article, "Medical schools use outreach programs to make student bodies more diverse," that was published on 6/8/10. Offering all qualified candidates the opportunity to practice medicine is an ongoing mission for the osteopathic medical profession. Last year, the AOA renewed policies calling for programs to encourage increased enrollment of qualified minorities in osteopathic medical schools and for the advancement and integration of minorities into the osteopathic medical profession. In fact, minorities comprise 25% of enrollment at osteopathic medical schools. The Touro College of Osteopathic Medicine in Harlem is among the schools that recently opened its doors to train future physicians while providing access to care in a medically underserved community.
Medicare Payment Extension
As a follow-up to the AOA's press conference in Washington, DC, yesterday, we are advised that U.S. House of Representatives leaders reportedly have modified the Sustainable Growth Rate (SGR) provisions of HR 4213. The new provisions provide 18 months of positive updates instead of the 3.5 years originally proposed and will include a positive payment update of 2.2% in 2010 and 1% in 2011. The formula returns to current law in 2012. The House is expected to consider the bill sometime today - although they still have vote problems. If the House approves the bill, the Senate will attempt to consider the bill this week before adjourning for the Memorial Day recess.
AOA poll: Medicare policies negatively impact access to care
An alarming number of physicians will stop seeing Medicare beneficiaries if current payment policies are not reformed, according to an independent poll conducted on behalf of the AOA. When physicians who have input into what kind of insurance they accept in their practices were asked about the pending 21.3% cut in Medicare payments, only 42% said they would definitely or probably continue seeing their current Medicare patients if the cut were to occur. "These numbers should be a wake up call to policymakers," stated AOA President Larry A. Wickless, DO.
Pedal Pump and Thoracic Pump Techniques Safe in Intracranial Pressure in Patients With Traumatic Brain Injuries
Although osteopathic manipulative treatment (OMT) is used to manage myriad conditions, there has been some hesitation regarding the safety of applying OMT to patients with intracranial injuries or elevated intracranial pressure (ICP). An article the JAOA prospectively enrolled consecutive patients admitted to the intensive care unit (ICU) for traumatic brain injury. Patients between the ages of 18 and 75 years and with abnormal CT scans were included in the present study. Patients with baseline ICP values of 20 mm Hg or lower were assigned to group 1, and those with ICP levels greater than 20 mm Hg, group 2. Although not statistically significant group 1 patients had a slight decrease in ICP values and an increase in CPP values and patients in group 2 also had decreased mean ICP values (-1.20 mm Hg) and increased mean CPP values (2.2105 mm Hg) concluding pedal pump and thoracic pump techniques may be used safely in patients with severe brain injuries.
Understanding Insurance: Will a Public Option or Co-op Get Us Where We Want?
A"public option" (ie, allowing individuals to purchase government-run health insurance) has been proposed as a solution for achieving universal health coverage in the United States. Politicians have told us not to fear a public option because government-run programs such as Medicare work well—without any of the dreaded rationing of care that critics claim would occur. Recent town hall meetings have demonstrated that many elderly Americans are satisfied with their Medicare coverage and will fight fiercely to protect it.......
National Osteopathic Medicine Week is Here
Do you know what a DO is? That’s the question I’d like you to ask people this week. By educating your patients, friends, and neighbors about DOs and osteopathic medicine, you can play an important role in the effort to promote DOs and osteopathic medicine during National Osteopathic Medicine (NOM) Week.
