Volume 97, Issue 2

A questionnaire was mailed to 2000 randomly selected osteopathic physicians to assess use of osteopathic manipulative treatment (OMT). In all, 1055 responses were summarized for the study. The contention is supported that OMT is being used less and less by practicing physicians. Only 6% of the respondents treated more than 50% of their patients with OMT, and nearly one third used OMT on less than 5% of their patients. A progressive de-emphasis of OMT use correlated with more recent graduation from osteopathic medical colleges. Thirty-eight percent of the variance regarding OMT use was attributed to two factors: barriers to use, and OMT protocol used. Perceptions by physicians of insufficient OMT training were not predictive of decreased use of OMT. Significantly more OMT was used in solo practice as opposed to other settings. The results present a wake-up call for the osteopathic medical profession. The profession must strive. to remove barriers that preclude OMT use by justifying to policymakers, health professionals, and the public the cost-benefits of OMT in holistic healthcare.

Virtually all National Collegiate Athletic Association (NCAA) Division I universities have physicians who evaluate and treat athletic injuries and other medical conditions. The relationship of these physicians to these institutions ranges from a very loose arrangement to full-time employment. The specialties of the physicians working with the athletes of NCAA Division I universities vary as well. This study attempts to determine the specialty of current team physicians at NCAA Division I universities and their qualifications as well as the preferences of athletic directors when they are seeking to employ a team physician for their university. By comparing IA and non-IA Division I institutions, an attempt is made to determine the possible reasons for differences. This information will then be useful both for physicians-in-training who aspire to be team physicians at the university level and for administrators at these institutions who will be recruiting physicians with the most desirable credentials in the future.

Delusional parasitosis (DP) is a psychiatric syndrome in which the patient falsely believes he or she is infested with parasites despite clear evidence to the contrary. Patients with DP generally think that mites, lice, or other insects have invaded their skin and most frequently seek treatment from dermatologists or family practitioners. These patients are usually reluctant to seek psychiatric care or to accept a referral to a psychiatrist. This article provides a comprehensive biopsychosocial understandingof the complexities of DP and suggests a practical strategy for evaluation and treatment by the family practitioner. Treatment with antipsychotic drugs, such as pimozide, is discussed as is a treatment team approach involving a psychiatrist, dermatologist, and family practitioner.

Colon carcinoma is an unusual tumor during childhood. The authors report a case of metastatic colonic adenocarcinoma diagnosed in a 14-year-old boy during inguinal hernia repair. To the authors' knowledge, this is the first reported case of this rare disease presenting as an inguinal hernia.

In the patient described, brachial plexopathy was caused by a large anticoagulant-induced hematoma and pseudo aneurysm. The patient was seen at the hospital 2 weeks postarteriography with weakness, numbness, and pain in the left arm, as well as diffuse left-sided ecchymosis. Noncontrast computed tomographic scans of the axilla confirmed the diagnosis by showing an organized hematoma in the axillary compartment. Color-flow Doppler ultrasound studies showed blood flow in a pseudoaneurysm. This is a rare complication of arteriography that requires surgical intervention to remove the hematoma, decompress the brachial plexus, and repair the puncture site responsible for the pseudoaneurysm. Even if there is a delayed diagnosis, surgery should be performed urgently. Prognosis is based on prompt recognition and timely surgical intervention.

It is widely known that family practice osteopathic physicians actively use osteopathic manipulative treatment (OMT) as a part of their everyday practices, but many DOs in other specialty areas fail to use OMT at all. Physicians who use this modality often limit its use to musculoskeletal complaints. This pattern likely begins during undergraduate training at the time that OMT is taught. To warm student attitudes to OMT and provide a more integrated OMT training background, the University of North Texas Health Science Center at Fort Worth/Texas College of Osteopathic Medicine has added to the clinical curriculum a required 1-month rotation in manipulative medicine. With the rotation in place for a full academic year, it was important to determine the efficacy of the rotation curriculum. This assessment has been accomplished using a specialized protocol designed to gauge student attitudes and opinions regarding OMT, osteopathic medicine, and their own OMT skills.