Diminished use of osteopathic manipulative treatment and its impact on theuniqueness of the osteopathic profession

Purpose. To determine whether osteopathic manipulative treatment (OMT), a k ey identifiable feature of osteopathic medicine, is becoming a "lost art" i n the profession, and whether the long-term evolution of osteopathic medici ne into mainstream medicine and particularly specialization has had a simil ar impact on the use of OMT by family practitioners and specialists. Method. In April 1998, a two-page questionnaire was mailed to 3,000 randoml y selected osteopathic physicians in the United States to assess factors af fecting their use of OMT Descriptive statistics, linear regression analyses , and analysis of variance techniques were used to test for differences. Results. The response rate was 33.2%. Over 50% of the responding osteopathi c physicians used OMT on less than 5% of their patients, and analysis of va riance revealed OMT use was significantly affected by practice type, gradua tion date, and family physicians versus specialists. For specialists, 58% o f the variance regression was attributed to barriers to use, practice proto col, attitudes, and training, whereas for family physicians, 43% of the var iance regression was attributed to barriers to use, practice protocol, and attitudes. More important, the eventual level of OMT use was related to whe ther postgraduate training had been undertaken in osteopathic, allopathic, or mixed staff facilities, particularly for osteopathic specialists. Conclusions. The evidence supports the assertion that OMT is becoming a los t art among osteopathic practitioners. Osteopathic as well as allopathic me dical educators and policymakers should address the impact of the diminishe d use of OMT on both U.S. health care and the unique identifying practices associated with the osteopathic profession.