When he was young, Roger Beaumont, DO, suffered a significant back injury during a car accident. His family physician, a DO, treated his injury with osteopathic manipulative treatment (OMT).
Years later, when Dr. Beaumont decided to become a physician, he knew his family physician from childhood was the kind of physician he wanted to be.
“I asked my parents about him,” Dr. Beaumont says. “They said, ‘He’s a DO.'”
Thus began Dr. Beaumont’s journey in osteopathic medicine and love affair with osteopathic manipulative medicine (OMM). He has been practicing medicine for 50 years and is AOA board certified in family medicine and osteopathic neuromusculoskeletal medicine (NMM). For the past three years, he has been practicing at Froedtert & the Medical College of Wisconsin in Milwaukee.
In this edited Q&A, Dr. Beaumont discusses his concerns for the future of OMM, what the profession can do to encourage more early-career physicians to embrace OMM, and his advice for aspiring NMM specialists.
You would like to see more DOs providing OMM in their daily practice of medicine. Why?
Osteopathic manipulation is very effective in many different aspects of health care. I’ve personally seen it alleviate not only back pain and joint pain, but also anxiety and depression. It can be used in many different areas of medicine, more than what we usually think of. Also, our society is wanting the DO experience more and more. I have a number of patients who come to me because No. 1, I am a DO, and No. 2, I do manipulation.
Practicing hands-on medicine gives you an opportunity to connect with patients better. It definitely supports a good bedside manner. I can’t overemphasize what a powerful tool OMM is in the overall care of patients.
What has your practice of OMM looked like over the years?
My practice is typically 80% hands-on OMM and 20% family medicine. I’ve been practicing medicine for 50 years now. I’m AOA board certified in family medicine and neuromusculoskeletal medicine (NMM).
I practiced independently for a long time, but three years ago I decided that that was becoming too challenging for me. I now practice family medicine and OMM with a larger specialty group. I’m the only NMM doc in the whole health system. I’d like to create an NMM department and grow it.
The other doctors will refer patients to me for OMM. A lot of the doctors and staff also come to see me themselves for treatment. I really believe in the power of OMM to help patients, and I want to promote it. Because I am concerned about where OMM is heading today.
What are your concerns about the future of OMM?
I’ve noticed at my employer that the number of DOs who practice OMM seems to be declining. A few years ago, my medical director told me that he had bought an OMM table for a new DO who was working in our other clinic, but that he wasn’t using it.
I spoke to another DO who started working with me two years ago. I was offering to mentor him. But he said he didn’t want to do any manipulation. He didn’t feel that he had the necessary skill set to do it, and he was also concerned about how to code for it.
I understand the coding concerns because I was audited by my employer last fall. My employer’s compliance officer said I was an outlier because of my use of modifier 25 as well as the E&M code 99214. He implied that my use of these was excessive.
But they are not comparing me with other osteopathic physicians who do OMM. They don’t have a taxonomy number for NMM specialists, and there really needs to be one so we can be assessed fairly. Editor’s note: A taxonomy code for NMM specialists exists. The AOA worked with the National Uniform Claim Committee to create one in 2017. AOA members who need coding and billing support can contact AOA Physician Services at firstname.lastname@example.org.
The number of NMM specialists has actually grown in the last 20 years. But I’m worried that we are heading to a landscape where only NMM specialists practice OMM, and that would be a shame because of the tremendous benefits of OMM.
What do you think needs to be done to encourage more DOs to do OMM?
I’d like to see a bigger focus on OMM in residency programs. In my opinion, most residency programs don’t have the rigor that we need to have our DOs be confident with OMM and integrate it into their regular family medicine or internal medicine work.
That could involve changing the requirements for residency programs. It could be something like a requirement that residents spend six weeks in the field with a DO who does manipulation so they get a significant amount of hands-on experience. I know many residency programs do run OMM clinics, but I don’t think those give you the full picture of what providing OMM looks like outside of a residency program.
What advice would you give to students who are interested in specializing in OMM or getting a good education in OMM while pursuing a different specialty?
If I was applying to residency, I would evaluate program directors and DOs within programs who are in charge of OMM education and get a sense of what their background is. I’d also look at what kind of educational experiences they offer when it comes to OMM. I’d be looking for a program with a robust educational program on OMM.
Medical students who are earlier in their studies can try to spend time with a DO who has a good reputation for practicing OMM.
Identify OMM specialists who are willing to be mentors and pick their brains to find out the best, most efficient ways to practice OMM. There is a lot about OMM that you will learn in the field rather than in medical school.
Medical students and residents should try to attend the American Academy of Osteopathy convocation at least once. It is very inspiring. You will learn things that will help propel you forward and help you succeed in this field.