Increasing Resident Comfort in Providing Osteopathic Manipulative Treatment (OMT) to Pediatric Patients in a Family Medicine Residency Program
Scott Brown, DO; Alissa Cohen, DO; Eva Schwartz, MD; Lori Stiefel, MD; Jacqueline Weaver-Agostoni, DO, MPH
Background:
OMT is a safe, effective adjunct for multiple conditions, but delivering OMT to pediatric patients can be challenging in a Family Medicine residency program. We sought to identify barriers, develop interventions to overcome them and increase resident comfort with OMT.
Methods:
Residents were surveyed about barriers to OMT. Residents received hands-on training, sample office notes, and step-by-step treatment guides to address barriers, along with reviews of how to refer to OMT clinic, and how to document and bill for OMT encounters. Residents who completed training received repeat surveys. Additionally, we tracked the number of pediatric patients diagnosed with somatic dysfunction or treated with OMT to gauge the impact on patient care. The UPMC Quality Improvement Review Committee approved this project.
Results:
40% (12/30) of residents completed training for over six months. After training, 75% (6/8) felt more comfortable referring patients for OMT, 88% (7/8) felt more comfortable treating pediatric patients with OMT, and 88% (7/8) would recommend this training to colleagues. Residents recommended OMT for the conditions in question, either providing treatment or referral, for 15% (13/89) of patient presentations during the intervention period, compared to 0% in the two years preceding this project.
Discussion:
This project identified and addressed barriers to OMT use, successfully increasing resident OMT use. Limitations include a small number of MD participants and challenges generalizing the findings to all pediatric conditions.
Conclusion:
A multifaceted training program within a Family Medicine residency can increase resident comfort in providing OMT to pediatric patients, as an effective adjunctive treatment.