"The Dao of Osteopathic Medicine"
By Justin H. Ezell UNTHSC/TCOM Chapter President
According to Meriam-Webster dictionary, Confucianism defines dao as a morally correct path or behavior. How does this relate to osteopathic medicine? Simply put, the mark of a true professional is the constant honing of one’s skills. After all, the mark of a professional is the quality of his product.
“I fear not the man who as practiced 10,000 kicks once, but I fear the man who has practiced one kick 10,000 times.” -- Bruce Lee
In osteopathic medical school, students are shown and tested on numerous techniques. The intent is obvious. Students must be properly exposed to and skilled in the various approaches to OMT to be well rounded physicians as well as being prepared for COMLEX. However, some students are quickly frustrated that they do not appreciate many of the subtle changes in somatic dysfunction and are quick to reject OMT as a viable treatment option stating that it “doesn’t work.” But OMT is a procedure and like all procedures, it is a skill that is developed with practice and time.
This author recently realized that OMT is the only procedural based skill all students are expected to have a baseline competency in prior to graduating from a medical school. And though this author completely agrees with this approach, many students feel frustration because they have not practiced enough to see the value in OMT. This is analogous to thinking sutures are useless because the first time tying sutures resulted in an uneven stitch. Students need the constant reminding that though a baseline understanding is required of all OMT, many practicing physicians find one or two approaches that work very well for them and then practice that thousands of times over.
“…the magic number for expertise: ten thousand hours.” – Malcolm Gladwell
How can students be convinced to spend more time utilizing OMT? Obviously, the skill is developed through practice. But motivation is what is required to have the energy to put in the hours needed to gain the skill. Different people have different motivational triggers. For some, it is the concern of OMT being financially advantageous. Certainly supporters of SAAO should consider providing more education into OMT billing and reimbursements. Another motivator is the utility of OMT. Many students have a difficult time buying into OMT as a legitimate treatment strategy when the only patients they treat are healthy medical students in their early twenties. SAAO chapters need to constantly encourage members to treat people within the community to not only advertise osteopathic medicine, but also to expose students to real pathology early in their education and demonstrate how OMT can positively impact patients.
“It’s not daily increase but daily decrease. Hack away at the unessential.” – Bruce Lee
Bruce Lee’s quote exemplifies this author’s overall point. Following the idea of “The Dao of OMT”, it is important for students to be guided into a process to simply an approach to patient care and simplify their techniques. As a teaching assistant, I constantly encourage students to not focus on the step by step cookbook techniques listed in the atlas, but to understand the premise of the underlying technique. Muscle energy and counter-strain are much easier when one considers the origin and insertion of a muscle and then sets the technique based upon that information. The student must be guided to look past the words and into understanding the principle.
The “Dao of OMT” is an attitude of striving for excellence. It is a constant desire and purposeful effort to refine one’s skills to a point approaching perfection. At first glance, it may seem odd to “hack away at the unessential”. But hacking away the unessential includes removing attitudes, practices, and beliefs that are inefficient. It is refining one’s art to a point where it seems almost effortless. It is an acceptance that the way you practice today will be completely different in the years to come.
If you can’t explain it simply, then you don’t understand it well enough. – Albert Einstein
In conclusion, I encourage everyone to follow this path. To put in the hours to become an expert, to constantly whittle at the unnecessary, and learn how to explain seemingly difficult concepts simply.
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