Utilization of Osteopathic Manipulative Treatment within an Academic Practice Setting




Jamrog, Jennifer DO
Willingham, Krista
Fernando, Shane PhD
Crow, Thomas


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Introduction: Osteopathic manipulative treatment (OMT) has historically been the foundation of treatment used by osteopathic physicians. This study assesses the utilization of OMT across multiple specialties in an academic practice setting. Hypothesis: OMT is underutilized in multiple clinics within an osteopathic academic institution. Methods: Electronic medical records for all clinics at the University of North Texas Health Science Center (UNTHSC) were retrospectively reviewed. All patient records which were billed with CPT codes 98925-98929, indicating use of OMT, from September 2004 through September 2015 were included. The multiple specialty clinics within the UNTHSC system were combined into seven categories. The number of office visits in which OMT was utilized in each specialty was compared to the total number of office visits within the same specialty over the same time period. Results: A total of 35,333 records that included billing codes for OMT during the specified time period were reviewed. These encounters were found to represent 7,148 unique patients, ranging in age from 0 to 98. Females made up 67% of patients, while 33% were male. Caucasians made up nearly 74% of the patient population, accompanied by 9% African Americans and 2% Asians. In neuromusculoskeletal medicine, 74.93% of total office visits included billing for OMT; in family medicine, 0.52%; in sports medicine, 1.61%; in obstetrics, 0.01%; in pediatrics, 0.03%; in internal medicine 0.34%; and in surgical specialties, 0.01%. Conclusions: This study shows that the vast majority of OMT in this academic clinic setting is provided by osteopathic neuromusculoskeletal specialists, with sports medicine and family medicine as distant runners-up. This was not unexpected, due to the unique skill set acquired by osteopathic neuromusculoskeletal specialists. However, this study does highlight the lack of OMT provided in the primary care setting, and shows even lower use among specialists and surgeons. This presents a need for ongoing education and support to encourage osteopathic physicians outside of an OMT specialty to integrate the use of musculoskeletal manipulation into their practices.