Posts Tagged Medical Academia

Osteopathy in the NICU: False Claims and False Dichotomies

I would like to preface this post by stating that I have worked with many DOs (Doctors of Osteopathy), and I have helped train many pediatric residents with DO degrees. I have found no difference in the overall quality of the training these students have received, and some of the very best clinicians I have ever worked with have been DOs. I would never prejudice my assessment or opinion of a physician based on whether they have an MD or a DO after their name.

Now, on to the discussion at hand.

I recently stumbled upon an article entitled, “Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: a randomized controlled trial”. There is nothing particularly exciting or interesting about this study, as there have been many published on the use of osteopathic manipulative therapy (OMT) in children. There aren’t that many RCTs, however, and this particular one, although published in the open-access BioMed Central Pediatrics (impact factor 1.98), was chosen to be included in AAP Grand Rounds. AAP Grand Rounds is a publication put out by the American Academy of Pediatrics (AAP) to help pediatricians “Stay current and save time with monthly critical, evidence-based summaries of clinical content from nearly 100 journals.” Because the AAP found this important enough for mention in this widely read publication, with a distribution of 19,000 (source: AAP, 2014), I thought it would be interesting to take a closer look at it. I am also interested in the very odd existence of the two, distinct paths to becoming a physician in this country, osteopathic and traditional medical school training. The distinction between the two is rarely discussed, even within the halls of academia or in our health care centers. That’s not to say that the topic isn’t discussed at all (in fact it was highlighted very recently right here on SBM), it has just remained a somewhat politically incorrect subject, sliding mostly under the radar. Having worked with and trained pediatricians with osteopathic degrees, I can tell you that discussions about this are considered taboo. This is primarily because osteopathic physicians have become mainstreamed over time (see below), and discussing the validity of the existence of their “specialness” is an awkward proposition. After taking a look at the paper in question, I’ll address this issue some more as I think it deserves additional attention.

Effect of osteopathic manipulative treatment on length of stay in a population of preterm infants: a randomized controlled trial.

This was a single-blinded RCT conducted at Santo Spirito Hospital in Pescara, Italy to explore whether OMT could shorten the length of stay among premature infants in their neonatal ICU (NICU). Secondary outcomes studied were the differences in daily weight gain and total cost of the NICU stay.

I’ll discuss the methods in a moment, but first let’s review the results.

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Looking for quackademic medicine in all the wrong places

One advantage of having a blog is that I can sometimes tap into the knowledge of my readers to help me out. As many readers know, a few of the SBM bloggers (myself included) will be appearing at the Northeast Conference on Science and Skepticism (NECSS) on Saturday, April 17. Since the topic of our panel discussion is going to be the infiltration of quackademic medicine into medical academia, I thought that now would be a very good time for me to update my list of medical schools and academic medical centers in the U.S. and Canada that have embraced (or at least decided to tolerate) quackademic medicine in their midst. After all, the list is over two years old and hasn’t been updated.

My list is long past due for an update, and I want to post that update right here, either right before or right after NECSS. But I need your help. Please peruse the previous roll of shame. Then either post here in the comments or e-mail to me any examples of quackademic medical programs in the U.S. and Canada (I’ll leave Europe to others better qualified to deal with it) that I may have missed. Equally important, if there are programs I listed before that no longer peddle woo, let me know that too, so that I can investigate and decide if I should remove the program from my list.

I’m particularly interested in the most egregious examples (although your submitting all examples is greatly appreciated). Yoga and meditation don’t bother me that much, for example. Neither do dietary studies, because diet and exercise are science-based medicine that have all too often been coopted by purveyors of woo. Homeopathy and reiki, on the other hand, do bother me. A lot. I’m also particularly interested in educational programs in CAM that are funded by the National Center for Complementary and Alternative Medicine (NCCAM).

Please help me construct the definitive list of academic programs in the U.S. and Canada that have adopted quackademic medicine.

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