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At least 19 recordsLinked to original sources
PubMed2003

Awareness and use of osteopathic physicians in the United States: results of the Second Osteopathic Survey of Health Care in America (OSTEOSURV-II).

The Second Osteopathic Survey of Health Care in America (OSTEOSURV-II), a national telephone survey conducted during 2000 using random-digit dialing, was used to address questions about public awareness of the osteopathic medical profession and use of osteopathic physicians. A total of 499 adult, noninstitutionalized, household respondents were surveyed. The main outcomes included prevalence of and multivariate factors associated with awareness and use of osteopathic physicians. The overall response rate was 64%. The prevalence of awareness, lifetime use, and current use of osteopathic physicians among unscreened respondents was 46%, 16%, and 7%, respectively. Among lifetime users, 84% received primary care; 52%, osteopathic manipulative treatment; and 25%, specialty care. The multivariate factors most strongly associated with awareness of osteopathic physicians were college education (rate ratio [RR], 1.86; 95% confidence interval [CI], 1.43-2.40), 60 or more years of age (RR, 1.52; 95% CI, 1.15-2.01), and Midwest residence (RR, 1.39; 95% CI, 1.05-1.84). Nonwhites, including Hispanics, were less likely to be aware of osteopathic physicians (RR, 0.54; 95% CI, 0.38-0.76). Respondents with college education (RR, 2.34; 95% CI, 1.44-3.79), respondents of intermediate age (RR, 1.71; 95% CI, 1.12-2.61), and women (RR, 1.68; 95% CI, 1.12-2.52) were more likely to report lifetime use of osteopathic physicians. Nonwhites were less likely to report lifetime use (RR, 0.25; 95% CI, 0.11-0.57). Greater promotional efforts are needed to increase awareness of osteopathic medicine and to remove barriers to using osteopathic physicians, particularly among nonwhites.

Awareness↗
PubMed2001

Characteristics, satisfaction, and perceptions of patients receiving ambulatory healthcare from osteopathic physicians: a comparative national survey.

A national telephone survey was conducted in 1998 using random-digit dialing and the first Osteopathic Survey of Healthcare in America (OSTEOSURV-I) instrument to determine patients' satisfaction with their healthcare, as well as their perceptions of osteopathic medicine. Of the 1106 respondents, 243 (22.0%) had received medical care from an osteopathic physician, and another 307 (27.8%) claimed to be aware of osteopathic physicians. Patients of osteopathic physicians reported the highest levels of satisfaction in 8 of the 11 elements studied when compared with patients of allopathic physicians, chiropractors, and nonphysician clinicians other than chiropractors. Respondents perceived osteopathic manipulative treatment (OMT) to be beneficial for musculoskeletal disorders (P < .001). In addition, respondents perceived that healthcare services provided by osteopathic physicians were similar to those provided by allopathic physicians (P < .001), but not to those provided by chiropractors (P = .01). A total of 97.9% of current patients of osteopathic physicians agreed with the statement that osteopathic physicians practiced in their local community, compared with 80.6% of former patients of osteopathic physicians and 67.8% of patients who had never visited osteopathic physicians (P < .001). In general, the most favorable perceptions of osteopathic medicine were reported by current patients of osteopathic physicians, followed by former patients of such physicians. The least favorable perceptions came from patients who had never been patients of osteopathic physicians. The perception that OMT should be covered by health insurance was significantly associated with the use of osteopathic physicians (odds ratio, 3.2; 95% confidence interval, 1.5 to 6.7, among patients who had ever been to an osteopathic physician). The results of our survey suggest that greater access to osteopathic services, including OMT, is desirable and that promotional efforts aimed at encouraging the use of osteopathic medical services among the general population are warranted.

Chiropractic↗
PubMed2003

Use of osteopathic manipulative treatment by Ohio osteopathic physicians in various specialties.

The authors mailed a survey designed to determine the use of osteopathic manipulative treatment (OMT) to the 2,318 active osteopathic physicians registered with the Ohio Osteopathic Association; 871 responses were received, for a response rate of 38%. Approximately 75% of the respondents had not or had rarely used OMT: 44% of these respondents did not use any OMT and 31% reported treating fewer than 10 patients with OMT during the week before the survey. Approximately 25% of the surveyed osteopathic physicians treated more than 10 patients with OMT, and about 6% of these treated more than 30 patients with OMT. Respondents represented 40 specialty disciplines. All of the osteopathic physicians in 17 specialties reported no OMT use, osteopathic physicians in 9 specialties reported using OMT for fewer than 10 patients during the previous week, and osteopathic physicians in 9 specialties reported using OMT for more than 10 patients during the previous week. Of the somatic dysfunctions listed in the survey, low back disorders were treated with OMT most often. Few osteopathic specialists used OMT for patients with asthma or chronic obstructive pulmonary disease. The data suggest that a great opportunity exists to increase the use of OMT by osteopathic physicians, especially those who are specialists.

Data Collection↗
PubMed2003

Osteopathic manipulative treatment techniques preferred by contemporary osteopathic physicians.

Data presented in this study were gathered through a national mail survey of 3000 randomly selected osteopathic physicians. A total of 955 questionnaires were usable for analysis. Osteopathic physicians' likelihood of using eleven osteopathic manipulative treatment (OMT) techniques (articulatory, counterstrain, cranial, facilitated positional release, fascial ligamentous release, functional, high-velocity low-amplitude thrust, lymphatic, muscle energy, myofascial/integrated neuromuscular release, and soft tissue) was determined. The relative frequency of use from most (soft tissue) to least (cranial) used was also determined. Respondents were more likely to use direct techniques than indirect or direct-indirect techniques. Demographic variables of gender, age, and specialty training were found to be related to the techniques used most. Female osteopathic physicians and older osteopathic physicians were more likely to use indirect techniques, whereas male and younger physicians preferred direct techniques. Moreover, OMT specialists used a broader range of techniques than other osteopathic physicians, and family physicians were more apt to use high-velocity low-amplitude thrust than other primary care or non-primary care osteopathic physicians. These results not only have implications for curricular planning in all phases of osteopathic undergraduate medical education, graduate medical education, and continuing medical education programs, but also for research on the quality and effectiveness of various OMT techniques.

Adult↗
PubMed2005

Osteopathic physicians and the family medicine workforce.

Historically, osteopathic physicians have made an important contribution to the primary care workforce. More than one half of osteopathic physicians are primary care physicians, and most of these are family physicians. However, the proportion of osteopathic students choosing family medicine, like that of their allopathic peers, is declining, and currently is only one in five.

Family Practice↗
PubMed1996

Preliminary findings on the use of osteopathic manipulative treatment by osteopathic physicians.

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.

Adult↗
PubMed1987

The dilemma of osteopathic physicians and the rationalization of medical practice.

Years ago, Peter New observed that osteopathic medical students faced a dilemma concerning their identity. On the one hand, they wished to be considered complete medical practitioners. On the other hand, they wished to be seen as different from MDs. There is evidence that osteopathic physicians continue to face that dilemma. I hypothesize that in part this stems from a conflict between classical 'lifestyle commitments' of the osteopathic community (e.g. toward general practice, osteopathic manipulative therapy, holism) and the rationalized model of medicine practiced by MDs (characterized by specialization and scientific elitism). Results of a survey of a local population of osteopathic physicians generally confirm this. Specific findings are that (1) classical elements of osteopathic commitment are not tied to commitment to the profession in general, (2) there appears to be a waning of commitment to general practice, (3) an increasing number of osteopathic physicians used the DO degree as a 'back door' into medicine and are less likely to identify with classical osteopathic norms, and (4) DOs from socially conservative backgrounds are more likely than others to maintain commitment to the classical elements of osteopathic practice.

Attitude of Health Personnel↗
PubMed2006

Characteristics of osteopathic physicians choosing to practice rural primary care.

As increasing numbers of women and osteopathic physicians enter medical practice, it is important to identify their choices in medical specialty and practice location and the implications these choices have for the future of healthcare in the United States. In 2003, data from the Texas Medical Board and the Office of the [Texas] State Demographer were aggregated to compare the rates at which physicians differed in their choices to practice primary care specialties in a rural location. In addition, the impact of sex and type of medical degree on these choices was examined. Analyses revealed that male osteopathic physicians were 2.3 times more likely than all other physician groups to practice rural primary care. Analyses also revealed that female osteopathic physicians were more likely than other physicians to choose primary care as a specialty and were 2.5 times more likely than female allopathic physicians to practice primary care in a rural location. Policies intended to produce primary care or rural primary care physicians should take into account the effects of gender and osteopathic training.

Choice Behavior↗
PubMed2000

National study of the impact of managed care on osteopathic physicians.

The study reported here was designed to provide insight into the impact managed care has had on osteopathic physicians' ability to practice medicine, as well as data to substantiate the prevalence of the specific problems encountered by the 40,000 osteopathic physicians in the United States. New data on the extent to which osteopathic physicians use osteopathic manipulative treatment was also obtained, as a review of the literature revealed only two previous surveys on the use of osteopathic manipulative treatment. The American Osteopathic Association hired an independent research company to conduct the survey.

Humans↗
PubMed2003

Do osteopathic physicians differ in patient interaction from allopathic physicians? An empirically derived approach.

Colleges of osteopathic medicine teach osteopathic principles, which provide a different approach to and interaction with patients than principles taught in allopathic medical schools. The authors examined whether osteopathic primary care physicians' interactions with patients reflect the principles of osteopathic medicine when compared with allopathic physicians' interactions. The principles of osteopathic medicine were adapted to elements that could be measured from an audio recording. This 26-item index was refined with two focus groups of practicing osteopathic physicians. Fifty-four patient visits to 11 osteopathic and 7 allopathic primary care physicians in Maine for screening physicals, headache, low back pain, and hypertension were recorded on audiotape and were dual-abstracted. When the 26-item index of osteopathic principles was summed, the osteopathic physicians had consistently higher scores (11 vs. 6.9; P = .01) than allopathic physicians, and visit length was similar (22 minutes vs. 20 minutes, respectively). Twenty-three of the 26 items were used more commonly by the osteopathic physicians. Osteopathic physicians were more likely than allopathic physicians to use patients' first names; explain etiologic factors to patients; and discuss social, family, and emotional impact of illnesses. In this study, osteopathic physicians were easily distinguishable from allopathic physicians by their verbal interactions with patients. Future studies should replicate this finding as well as determine whether it correlates with patient outcomes and satisfaction.

Female↗
PubMed2002

Attitudes of osteopathic physicians toward physician-assisted suicide.

The use of physician-assisted suicide (PAS) in the care of terminally ill patients is controversial. While there are published surveys assessing the attitudes and views of physicians in certain specialties, both nationally and in targeted geographic areas, no such data are available specifically pertaining to osteopathic physicians, who deliver 9% of the primary care in the United States. This article describes a study whose purpose was to identify the views and perspectives of osteopathic physicians on PAS through a national survey. Questionnaires were forwarded to all board-certified internists who are members of the American College of Osteopathic Internists and all surgeons and a random sample of family physicians who are members of the American Osteopathic Association. Physicians were surveyed with initial and follow-up mailings. The 49-item questionnaire was a modified version of the Physician Survey, Center for Ethics in Health Care: Oregon Health Sciences University. Of the 2910 questionnaires that were mailed, 1028 were returned in a usable form, for a 35% response rate. Respondents were predominantly (81%) male and from all parts of the country. Most (58%) would not be willing to prescribe a medication for a competent, terminally ill patient to use with the primary intention of ending his or her own life, and most (55%) would oppose the legalization of PAS. Thirty-three percent of osteopathic physicians admit to receiving requests by terminally ill patients for PAS. Most (53%) osteopathic physicians indicate that the osteopathic principle of holistic care has influenced their decision-making on this issue, and a significant minority (44%) responded that the osteopathic oath influenced their view on PAS. Religion and the degree of prayer frequency were important predictors of the decisions to support or oppose PAS. When compared to other physician surveys, this survey of osteopathic physicians demonstrates some similarities in response but also significant differences. These data suggest that osteopathic education and training may result in a perspective on PAS that reflects the distinctiveness of the osteopathic profession.

Adult↗
PubMed2002

Perceptions of philosophic and practice differences between US osteopathic physicians and their allopathic counterparts.

Data were gathered through a random national mail survey of 3000 US osteopathic physicians. Nine hundred and fifty-five questionnaires were usable for analysis. Through open-ended questions, osteopathic physicians identified philosophic and practice differences that distinguished them from their allopathic counterparts, and whether they believed the use of osteopathic manipulative treatment (OMT), a key identifiable feature of the osteopathic profession, was appropriate in their specialty. Seventy-five percent of the respondents to the question regarding philosophic differences answered positively, and 41 percent of the follow-up responses indicated that holistic medicine was the most distinguishing characteristic of their profession. In response to the question on practice differences, 59 percent of the respondents believed they practiced differently from allopathic physicians, and 72 percent of the follow-up responses indicated that the osteopathic approach to treatment was a primary distinguishing feature, mainly incorporating the application of OMT, a caring doctor-patient relationship, and a hands-on style. More respondents who specialized in osteopathic manipulative medicine and family practice perceived differences between them and their allopathic counterparts than did other practitioners. Almost all respondents believed OMT was an efficacious treatment, but 19 percent of all respondents felt use of OMT was inappropriate in their specialty. Thirty-one percent of the pediatricians and 38 percent of the non-primary care specialists shared this view. Eighty-eight percent of the respondents had a self-identification as osteopathic physicians, but less than half felt their patients identified them as such. When responses are considered in the context of all survey respondents (versus only those who provided open-ended responses) not a single philosophic concept or resultant practice behavior had concurrence from more than a third of the respondents as distinguishing osteopathic from allopathic medicine. Rank and file osteopathic practitioners seem to be struggling for a legitimate professional identification. The outcome of this struggle is bound to have an impact on health care delivery in the US.

Attitude of Health Personnel↗
PubMed1994

Managed care: an opportunity for osteopathic physicians.

Managed care plans now enroll 38.6 million persons in the United States, and have increased their enrollment 14-fold in 5 years. The three major health reform proposals before Congress presently make managed care organizations, in one form or another, the linchpin of their reform plans. The authors trace the history of managed care leading to today's spectrum of plans from health maintenance organizations to preferred provider organizations with all their variants. They examine the government and insurance industry records of successes and failures and project the future for managed care with and without government-imposed healthcare reform. They unscramble the "alphabet soup" and detail the problems physicians have encountered in managed care settings. Given the key role of the primary care physician, the authors urge osteopathic physicians to take a proactive role in designing the shift to managed care. By supporting intelligent healthcare reform that brings physicians, hospitals, and insurers together in a practitioner-friendly system, the primary care physician can assume the leadership role in managed care and continue to serve as the patient advocate.

Health Care Reform↗
PubMed1979

Professional and spatial mobility of osteopathic physicians.

The study examines changes in location of osteopathic and medical doctors in a 20-county area of rural Missouri over a 14-year period. Losses of osteopathic physicians were greater than medical doctors. However, there was a convergence over the 14-year period in background characteristics of the two types of physicians. The finding of greater spatial mobility of DOs is placed in the context of professional mobility of osteopathy. It is also argued that as practice opportunities for DOs increase, background factors associated with early socialization become more influential in choice of practice sites. The relationship of practice opportunities to choice of practice sites can be extended to foreign medical school graduates and "new health practitioners."

Adult↗
PubMed2004

AOA membership and board certification of residency graduates: comparison of three programs accepting osteopathic physicians--implications for graduate medical education.

The purpose of this study was to determine membership status in the American Osteopathic Association (AOA) and osteopathic board certification status for osteopathic physicians completing osteopathic, allopathic, and dually accredited residency programs. Rates of AOA membership and osteopathic board certification of osteopathic graduates from a dually accredited residency were compared to rates of osteopathic graduates of an allopathic residency in the same training facility. These same two parameters were compared between the dually accredited residency and an osteopathic residency. Osteopathic graduates from the dually accredited residency had significantly higher rates of AOA membership and osteopathic board certification when compared with the osteopathic graduates of an allopathic residency. Moreover, no significant difference existed between the rates of these two measures for osteopathic resident graduates from the dually accredited residency when compared with graduates of an osteopathic residency. Implications of the results are discussed.

Certification↗
PubMed2003

Using National Medical Care Survey data to validate examination content on a performance-based clinical skills assessment for osteopathic physicians.

Patient characteristics, chief complaints, and diagnoses can be used to specify the examination content for performance-based assessments of clinical skills. The purpose of this investigation was to explore osteopathic and allopathic medical practice patterns and to provide summary statistics that can be used to delimit potential assessment content areas for a clinical skills assessment targeted at osteopathic physicians. Analyses of the National Ambulatory Medical Care Survey indicated that the types of patients seen by osteopathic and allopathic physicians in office-based settings are somewhat different. Furthermore, the reasons that patients seek care, and accompanying diagnostic outcomes, can vary by physician type. These differences suggest that from a content perspective, a performance-based clinical skills evaluation targeted at osteopathic physicians should be characteristically different from one designed for allopathic physicians.

Clinical Competence↗
PubMed2006

Osteopathic physicians in the United States: antibiotic prescribing practices for patients with nonspecific upper respiratory tract infections.

OBJECTIVE: To assess factors related to prescribing antibiotics for nonspecific upper respiratory tract infections (URTIs) by office-based osteopathic physicians. METHODS: Retrospective analysis of physician office visits by patients with URTIs, using the National Ambulatory Medical Care Survey database for a 5-year period. Antibiotic prescribing was analyzed based on patient and physician characteristics. Multiple logistic regression modeling was then used to assess the independent contribution of these factors. RESULTS: Between July 1, 1997, and June 30, 2001, there were 9.6 million patient visits to osteopathic physicians for URTIs in the United States. Antibiotics were prescribed in 56.4% (5.41 million) of these visits. Adults, nonwhites, females, patients with a concurrent condition such as acute bronchitis, acute otitis media, acute pharyngitis, acute sinusitis, or asthma, and patients requiring additional medications for their symptoms were more likely to be given antibiotics. In addition, family physicians, physicians who were not owners of their practices, and those practicing in nonmetropolitan areas were more likely to prescribe antibiotics. CONCLUSIONS: Antibiotics were prescribed in more than 4.8 million (50%) patient visits for URTIs. Greater efforts are needed to address some of the factors that influence prescribing practices.

Adolescent↗
PubMed1990

Factors influencing osteopathic physicians' decisions to enroll in allopathic residency programs.

A survey of osteopathic physicians who were training in non-American Osteopathic Association (AOA)-approved (ACGME-accredited) internal medicine programs was undertaken in 1988. This was done in response to the AOA approval and implementation of the recommendations of the Task Force to Explore Alternative Mechanisms for Approval of Postdoctoral Training. Of the 188 physicians surveyed by mail, 137 physicians' responses provided the data for the results presented here. These respondents represented 39% of those residents who were training in nonosteopathic medical programs in 1988 and whose records were on file with the AOA Department of Education. The questionnaire investigated the factors that influenced these physicians' decisions to enroll in non-AOA-approved (ACGME-accredited) internal medicine residency programs. These reasons are discussed along with suggested solutions to alter this unhealthy trend.

Career Choice↗