ok, i finally signed up for the blog. sorry it takes me so long to do this stuff... as i alluded to before, i'm kind of in an "i don't wanna" phase when it comes to school. and as a result, my "jaded osteopath" meter is running a bit high these days. i guess i'm just low on energy in this arena. i do believe this is something that ebbs and flows for us over the course of our careers... at least, from what i've seen with the practitioners i know. i'm only now starting to get my act together researching residencies...
interestingly, my enthusiasm to treat patients with my hands never seems to wane. it continues to feel completely natural, applicable, and surprisingly easy to fit into a time-restricted environment. i think that as we develop our manipulative skills over time, the patient assessment process becomes very intuitive. there's no need to do a 'standing flexion test' when you can just look at a patient and tell which SI joint is misbehaving. why take the time to motion test individual vertebrae when you can lay a hand on the patient's back, feel the momentum of the entire spine and the (mal)position of several key ribs and determine that the crucial restrictions are actually coming from their shoulder?
i'm actually pretty mystified as to how this transformation occurred... perhaps you all can comment based on your personal experiences. i worry at times that i am becoming less "scientific" about my approach to patients, but medicine seems to be every bit as much 'art' as it is 'science' in my (limited) experience. i enjoy the opportunity to work as an artist, bearing in mind of course that my work must complement or at least not fly in the face of modern medical science.
but i'm always afraid that patients will leave after a treatment and not improve... i rarely have those doubts when recommending to them more 'traditional' standardized courses of treatment... antibiotics, steroids, and the like. perhaps it is because of the research issue that martha raised. i think it is also in part because of the 'art'. i haven't yet learned to trust my muse in the same way that i trust what i read in my textbooks. this is sad to me, but perhaps understandable, given that i've been in academia for the majority of my life and i've only been involved in osteopathy for 3 years. the more i trust my instincts, the more they grow and the less often i struggle in my approach to patients... with both OMT and 'conventional' methods.
it is still very prominent in my consciousness, however, that i must ask permission to shift into 'osteopathic gear' from my preceptors and lay hands on my patient to heal... not just to palpate the precordial impulse or percuss the liver. i look forward to a time in my career where all my activities as a physician can blend together in a more organic fashion. as i look at residencies, this is something i am trying to keep in mind... it would be nice to find a program that allows me the support and freedom to practice medicine the way i want.