How adopting OMT can improve both patient outcomes and physician satisfaction

Recent data has suggested a decline in the use of osteopathic manipulative treatment (OMT) among osteopathic physicians. The reason for a decline of OMT use may be attributable to several factors, and the situation warrants further research.

I am an osteopathic physician who has been performing OMT for over 13 years and I use it frequently in practice. I care deeply about osteopathic medicine and believe our profession can realize new potentials as more osteopathic physicians incorporate OMT into practice. I have personally had many conversations with osteopathic physicians who want to adopt or reconnect with OMT in their practices, but they are unsure of how to do this effectively, efficiently and with confidence.

This article will focus on strategies that an osteopathic physician can take to re-engage with OMT.

The case for OMT

The osteopathic medical profession is generally recognized as a growing, holistic, compassionate and well-trained group of health care professionals. DOs are known for being well-prepared to meet community health care needs in all specialties and in all areas of the country. OMT fits exceedingly well within this brand, and can augment most osteopathic physicians’ practices, regardless of their specialty.

Furthermore, OMT can improve patient outcomes. Additionally, I can share that from my own personal experience working with many DOs who have recently re-engaged with OMT, using OMT can improve physicians’ job satisfaction and reduce burnout. These DOs often share with me that they feel a greater sense of connectedness to their work and a stronger sense of fulfillment.

As health care has become more fragmented and complicated, and administrative burdens have infiltrated many workflows, OMT can be a way for physicians to strengthen their sense of purpose.

The financial impact of adopting OMT will depend on your practice setting. OMT can potentially improve your bottom line and be a significant boost to your income. Some physicians have successfully adopted lucrative cash-pay models, whereas others have found success with insurance-based models. In a value-based care environment, OMT adoption could reduce downstream costs.

We as an osteopathic family can fulfill an increased demand for safe and effective treatment options with increased adoption of OMT.

Analyzing your work situation

If you are considering adopting OMT, you may wish to start with an analysis of what you currently know about OMT, your current patient population and how OMT can fit in with your current practice of medicine. Even if you have had no experience with OMT after medical school, the training you received in your undergraduate medical education means you will not be starting at “ground zero.” You can build on what you already know and, perhaps more importantly, use patient feedback to adjust your techniques as your OMT use increases.

Here is an example of an “OMT Adoption” worksheet that osteopathic physicians can use to help structure their adoption of OMT:

Internal questions

1. What is it about OMT that I like or enjoy? 
2. How can OMT adoption improve my job satisfaction, pay structure or work environment?
3. What techniques do I currently feel comfortable with?
4. What are some of my weaknesses that I’d like to improve upon?

External questions

1. What resources would I need to adopt OMT that would meet my patients’ needs and help me feel confident providing it (i.e., education of practice billing staff, OMT table, EHR templates, intake and scheduling workflows, CME courses, etc.)?
2. How can I use community resources (i.e., local college of osteopathic medicine or faculty that can help mentor, CME courses, etc.)?
3. What are the most common conditions my patients have that OMT could help with? 
4. How can I otherwise structure my work environment to accommodate OMT?

Resources to consider

OMT training videos and CME courses

• The American College of Osteopathic Family Physicians (ACOFP) OMTotal resource (free for ACOFP members, $199 yearly for nonmembers)
• ommeducation.com (various bundles and courses available on-demand, ranging in price from $250 to $1,500)
• Michigan State University College of Osteopathic Medicine (MSUCOM) (various online and in-person courses available from free to $1,700)
• The American Academy of Osteopathy (AAO) Intro to OMT course (physician fees range from $784 to $1,384 for in-person events in Indianapolis)

OMT table manufacturers

The Hill Labs HA90 model is priced at $2,350 for a new table, but these can also be found in used conditions as well via marketplaces. Electro-Medical sells portable OMT tables starting at $3,000 for new models, and other used models are sold on marketplaces such as Amazon, with prices ranging from $130 to $600.

OMT billing tips

Physicians can purchase the “Guide to Coding & Documentation: Osteopathic Manipulative Treatment – 2nd Edition” from the AOA for $35 from the AOA’s online store. AOA members can contact the AOA for personal guidance via email at [email protected].

You may also want to check local Medicare LCD coverage policies online on the Centers for Medicare & Medicaid Services website.

OMT electronic health record (EHR) templates

While physicians can check with their EHR vendor directly for templates, I would recommend connecting with local physicians who are high users of OMT, or contacting AOA Physician Services for guidance by email at [email protected].

It is important to document somatic dysfunctions (via changes in texture, asymmetry, restriction, tenderness or otherwise) clearly in the “physical exam” component of your EHR to justify the OMT code that you bill for and the areas that you choose to treat with OMT.

Mentorship opportunities

Look for mentorship opportunities through local osteopathic societies, colleges of osteopathic medicine osteopathic manipulative medicine (OMM) departments or local osteopathic neuromusculoskeletal medicine (ONMM) residency programs.

Consider reaching out to local osteopathic physicians who would be willing to have you in their office for a few hours. Consider asking specific questions to other osteopathic physicians on ideal hand or patient placement, as well as feedback on successes and struggles.

‘A unique skill set’

We as an osteopathic physician community have a unique skill set that can serve our patients and our communities well. The adoption of OMT can be done safely and effectively in your practice without much strain on practice resources. OMT use can be a great way to increase your sense of purpose as a physician.

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