Thesis (Ph.D.)--Ohio University, March, 2007. / Includes bibliographical references (leaves 114-120)

The two types of physicians in the United States healthcare system differ based on the type of medical education they receive. The first type train at allopathic medical schools and upon completion, students are awarded their Doctorate of Medicine and are then known as MDs. The second, less known type of medical education is that of osteopathy. Students that go to osteopathic medical schools earn a degree of Doctor of Osteopathic Medicine, and are thus considered DOs. This literature review analyzed public satisfaction with MDs or DOs since there are fundamental differences in the core philosophies of the two. It also answers whether this translates into better clinical outcomes and a more positive prognosis for the patient. The purpose of this study was to find any noticeable differences that translated into actual practice and discuss the implications they may have for the future of healthcare. Although no conclusion could be made, based on findings discussed throughout this paper, one may speculate that patients are more satisfied with a DO as opposed to an MD. Furthermore, as a patients' satisfaction is indicative of their health related quality of life, it is possible that patients that visit DO physicians would most likely have a better health related quality of life.

The purpose of this study was to determine and compare faculty perceptions of areas of concern that have been identified by osteopathic medical education administrators as having a relationship to institutional needs and goal setting. Specifically, a Delphi research technique was used to examine faculty perceptions of osteopathic perspective in relation to (a) the philosophical and functional orientation of the curriculum; (b) actual design, structure, and implementation of the curriculum; (c) location and design of the physical facilities and the campus environment; (d) faculty issues of tenure, promotion, salary, and merit; (e) teaching, and the evaluation of teaching; (f) student characteristics and admissions policies; and (g) administrative structure and communication networks.

<p> Osteopathic physician (D.O.) residency programs that do not achieve accreditation under the new Single Accreditation System (SAS) standards by June 30, 2020 will lose access to their share of more than $9,000,000,000 of public tax dollars. This U.S. Centers for Medicare &amp; Medicaid Services (CMS) funding helps sponsoring institutions cover direct and indirect resident physician training expenses. A significant financial burden would then be shifted to marginal costs of the residency program&rsquo;s sponsoring institution in the absence of CMS funding. The sponsoring institution&rsquo;s ability or willingness to bare these costs occurs during a time when hospital operating margins are at historic lows (<i>Advisory.com /Daily Briefing /May 18, 2017 | The Daily Briefing / Hospital profit margins declined from 2015 to 2016, Moody's finds</i>). Loss of access to CMS funding may result in potentially cataclysmic reductions in the production and availability of primary care physicians for rural and urban underserved populations. Which osteopathic residency programs will be able to survive the new accreditation requirement changes by the 2020 deadline? What are some of the defining attributes of those programs that already have achieved <i>&ldquo;initial accreditation&rdquo; </i> under the new SAS requirements? How can the osteopathic programs in the process of seeking the new accreditation more effectively &ldquo;pivot&rdquo; by learning from those programs that have succeeded? What are the potential implications of SAS to both access and quality of health care to millions of Americans? This report is based upon a study that examined and measured how osteopathic physician residency programs in the U.S. are accommodating the substantive structural, financial, political and clinical requirements approximately half way through a five-year adaptation period. In 2014, US Graduate Medical Education (GME) physician program accreditation systems formally agreed to operate under a single accreditation system for all osteopathic (D.O) and allopathic (M.D.) programs in the U.S. Since July 1, 2015, the American Osteopathic Association (AOA) accredited training programs have been eligible to apply for Accreditation Council for Graduate Medical Education (ACGME) accreditation. This agreement to create a Single Accreditation System (SAS) was consummated among the AOA, the American Association of Colleges of Osteopathic Medicine (AACOM) and ACGME with a memorandum of understanding. As this research is published, the ACGME is transitioning to be <i>the</i> single accreditor for <i>all</i> US GME programs by June 30, 2020. At that time, the AOA would fully relinquish all its GME program accreditation responsibilities. The new SAS operates under published ACGME guidelines and governance. Business policy and health care resource allocation question motivated this research. Failure of osteopathic programs to &ldquo;pivot&rdquo; to the new standards could result in fewer licensed physicians being produced in the high demand primary care field. Potential workforce shortage areas include urban and especially rural populations (<i>CRS Report 7-5700 R44376 Feb 12, 2016</i>). Large physician shortages already have been projected to care for a rapidly aging US population without considering the impact of the GME accreditation changes currently underway (<i>Association of American Medical Colleges 2017 Key Findings report www.aamc.org/2017projections</i>). The goal of this research is to provide osteopathic GME programs practical insights into characteristics of a sample of osteopathic GME programs that have successfully made the &ldquo;pivot&rdquo; into SAS requirements and been accredited by ACGME and those that have not. The study seeks to better understand the experiences, decisions, challenges and expectations directly from osteopathic programs directors as they strive to meet the realities of the new SAS requirements. Do programs that are already accredited differ significantly from those that have not? How do characteristics such as program size, geographic locations, clinical program components, program sponsor structure, number and experience of faculty and administration, cost planning and perceived benefits of the movement to SAS factor into successfully meeting the new requirements before the 2020 closing date? A cross-sectional research survey was designed, tested and deployed to a national sample of currently serving osteopathic GME program directors. The survey elicited data about each program&rsquo;s &ldquo;pivot&rdquo; from AOA GME accreditation practices and guidelines to the new Single Accreditation System (SAS). The survey instrument was designed to obtain information about patterns in osteopathic GME program curricula, administrative support functions, faculty training, compliance requirements and program director characteristics shared by those programs that have been granted <i>&ldquo;initial accreditation&rdquo; </i> by the Accreditation Council for Graduate Medical Education (ACGME) who administer SAS. Thirty five (35) osteopathic GME program directors responded to the 26 question survey in June 2017. Descriptive statistics were applied and central tendency measures determined. The majority of survey respondents were Doctors of Osteopathic Medicine (D.O.s) from specialty residency programs sponsoring an average of 16 residents. (Abstract shortened by ProQuest.) </p><p>

Osteopathic manipulative treatment (OMT) training during residency is essential for development of these unique skills and principles as we go out into our future careers. One of the challenges that we have faced over the course of our residency tenure is having on-hand and online OMT resources to further promote learning and retention of knowledge and skills. The purpose of this research project was to gauge the family medicine residents’ OMT fundamental knowledge while also providing a designated preceptor area location for OMT resources for quick access, when needed, during our OMT clinic. At the same time, the residents were also lectured on common musculoskeletal dysfunctions and simple techniques that could be used for quick treatment options during clinic. First, the family medicine residents were first given a 10 question OMT pre-survey (five questions were knowledge based and five questions were short answer) to gauge their baseline fundamental osteopathic clinical knowledge and their knowledge about the pre-existing OMT resources and their locations in our clinic. After the residents completed the OMT pre-survey, the new OMT resources were placed in the new location in our precepting area and then two weeks later the residents were given a lecture about the fundamentals and common contraindications of OMT and the basic approaches to treatment of some routine chronic conditions, including low back pain, neck pain, headaches, and migraines. Also, included at then end of the lecture was the newly acquired OMT resources, including books and online website links, that were compiled for the clinic, and the new designated spot for these materials making them easily accessible during our OMT clinics. The OMT post survey, using the same one as above, was then done by the residents to see the impact on their OMT fundamentals and OMT resource knowledge. The Results from the pre and post surveys were then compared, and the data was graphed accordingly to show the changes. Questions one through five were graded on having “correct” vs “incorrect” answers, and the short answer questions (6-10) were graded on the premise of “positive” vs “negative” answers. Answers were considered positive if they were optimistic, which includes the response “yes”, accurate location in the precepting area, any form of OMT resource, or any amount of time spent in learning, review, or preparations of OMT material for OMT clinics. Answers were considered negative if they were the opposite of the above description. The first eight questions showed a strong positive increase/improvement in the residents’ OMT knowledge and showed that they know the new resources and their location in the clinic, which was the purpose of our project. The last two questions had slightly different outcomes than expected which was addressed if similar research is done in the future.

No description available.

Osteopathic Manipulative Therapy (OMT) is underutilized in addressing lung function and symptoms in asthma patients. The objective of this study was to determine if a single session of OMT can improve lung function and symptoms in patients suffering from asthma, and if patients can be taught a self-administered home OMT protocol to control their symptoms, in order to develop a protocol by which physicians can apply OMT to address lung disease in patients. This was a purposive randomized controlled quasi-experimental study which took place in family practice, pulmonology, and asthma specialist offices in southwest Virginia. The intervention was a ten-minute semi-individualized OMT protocol and a self administered home OMT education session. Variable baseline, within-subject study design was utilized, allowing each person to serve as his or her own control. Pre and posttest measurements included: participant spirometry FEV1, FVC, and PEF; thoracic excursion upper and lower rib cage motion; and a five-question rating scale to determine current asthma symptoms. A ten-minute OMT session included an individualized thoracic and rib screening and treatment, suboccipital release, diaphragm release, and thoracic pump. Comparison between pre- and post-OMT lung function and symptoms portrayed change. For the second part of the study, the participants were divided into two groups with group two receiving a ten-minute home OMT education session and a handout of the home OMT techniques. All participants returned two weeks later for a follow up lung function assessment. Statistically significant (p<.05) improvements after initial OMT were documented for 8 of 10 measurements. Only two spirometry values, FEV1 and PEF, did not significantly improve. The group who participated in the home OMT education session had statistically significant improvements in 3 of 10 measurements, including the upper and lower thoracic excursion measurements and the overall asthma symptoms rating. With a simple, easy to repeat, 10 minute semi-individualized OMT session, researchers demonstrated improved lung function and symptoms in this group of participants in Southwest Virginia. The addition of a home OMT education session was demonstrated to be at least partially beneficial. Future studies should expand on this pilot study with the researchers recommending using a larger patient population including patients with lower pre-treatment spirometry values in order to accurately monitor potential for change. / Ph. D.

Thesis (Ed. D.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on February 13, 2008) Vita. Includes bibliographical references.

Thesis (M.Ost.)--Unitec New Zealand, 2008. / Includes bibliographical references (leaves 75-83).

In standard anatomical textbooks, the formation of the cervical plexus is well defined; however the accurate differentiation into superficial and deep plexuses, their emerging patterns, and gross anatomical relations are not documented as expansively. In order to obtain detailed anatomical knowledge of the superficial and deep cervical plexuses, the investigation aimed to clarify the anatomy and variations of these plexuses, define possible anatomical landmarks, and record the relationship of the external jugular vein and muscles of the posterior triangle of neck to the branches of the superficial cervical plexus, and the relationship of the common carotid artery, internal jugular vein, sympathetic chain, cervical verterbrae, and vertebral artery to the deep cervical plexus. The studies utilized the gross anatomical dissection, morphological and statistical analyses of forty fetal and fifteen adult cadaveric, formalinized specimens. The branches of the superficial cervical plexus emerged from the posterior border of the sternocleidomastoid muscle at the great auricular point (situated in the middle third of the muscle) and was described as ascending (lesser occipital, great auricular, transverse cervical nerves) and descending (supraclavicular nerves). Further, these branches were recorded according to their branching patterns, relations to the external jugular vein and variations. The branching patterns are described as single, duplicate and triplicate. The external jugular vein was constantly located inferior to the great auricular nerve, superior to the transverse cervical nerve and intertwined with the branches of the supraclavicular nerves. Variations of the branches of the superficial cervical plexus were observed only in fetuses and classified according to their course, branching patterns and communications. The emerging point of the branches of the superficial cervical plexus on the sternocleidomastoid muscle, were determined according to the seven types of “emerging pattern” classification by Kim et al., (2002). In order to record the deep cervical plexus, the sternocleidomastoid muscle was reflected with the following observation: the ventral rami of the second and third cervical nerves emerged between the scalenus anterior and scalenus medius muscles, and the third and fourth cervical nerves was located at the lateral edge of scalenus medius muscle. The deep cervical plexus was described as communicating, muscular, ansa cervicalis, and phrenic nerves. The superior cervical ganglion constantly communicated with the ventral rami of the cervical nerves; and the hypoglossal communicated with the superior root of the ansa cervicalis. The muscular branches were observed to the scalenus anterior and scalenus medius muscles with an anomalous branch to the sternocleidomastoid muscle. The ansa cervicalis demonstrated a degree of variation with regard to its origin, course and formation of the loops. The phrenic nerve arose from the ventral rami of the third, fourth and fifth cervical nerves and descended on the lateral border of the scalenus anterior muscle. The precise understanding of the anatomy of the superficial and deep cervical plexuses together with variations may assist anesthetists and surgeons to accurately identify the vascular, neural and muscular structures and reduce the risks of complications when performing neural blocks in regional anesthesia, facial rejuvenation surgery and parotidectomies. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Westville, 2010.