I. What is a D.O.?
This stands for Doctor of Osteopathy. Osteopathy, or Osteopathic Medicine, is a parallel profession of medicine to the more familiar Medical Doctor, M.D., who practices the Allopathic version of medicine. DO’s study for four years in an osteopathic medical school, using many of the same texts as the MD’s, and follow these years with a residency in many of the same specialties as the MD’s. They are fully licensed in all 50 states of the USA to practice medicine and surgery and to prescribe medications. The person who first started the Osteopathic profession was an MD!
II. What is the difference between an MD and a DO?
The doctor who started the profession was a country, frontier doctor in the late 1800’s in the Midwest: Andrew Taylor Still who, after losing several children to infectious diseases, postulated that the body should have the capability to heal itself and that there must be ways that he could help the body do its work better. He had many ideas that were way ahead of their time about how he could help the body improve its functioning, including some hands-on ways of working with the body and, as these techniques seemed to be helpful, Dr Still started teaching others his methods and philosophy. He termed his new philosophy Osteopathy which implied that the body can fight off disease if there is a proper functioning of all the tissues, including the structural elements and not just the organs.
III. What are those “hands-on ways” of working with the body?
Dr. Still’s ideas and methods were expanded, modified and evolved and new properties of the body were discovered over the decades to the point that there are now 24 or 25 different modalities or techniques with which to use the hands to treat the body. Of those I use the following –
- Muscle massage/stretching
- HVLA – High Velocity/Low Amplitude (which can cause a “clicking” or “cracking” sound as the area adjusts)
- Muscle energy, or Isometric Stretch
- Lymphatic drainage or pump
- Range of Motion, eg. Spencer Techniques
- Percussion Vibrator use, from Robert Fulford, DO
- Osteopathy in the Cranial Field, or Biodynamic Cranial Osteopathy
During your initial visit I will briefly describe what each of these entail and whether I will likely use them on you.
IV. What kinds of medical problems do you treat?
Many types – the list is far too long to name each one – but mainly musculoskeletal and some neurologic problems of the arms/shoulders, hands, fingers, legs/hips/knees, feet and toes, all areas of the spine – neck, thorax/ribcage, low back, plus the head! Many headaches cases can be improved or minimized with the Osteopathic treatment. Many cases of chronic pain, from whatever reason, are often helped, anywhere from a small to a very large degree.
V. What don’t you treat?
I don’t presume to lower blood pressure, eliminate diabetes or cancer, remove cholesterol from the blood or eliminate the need for surgery if it is warranted. Some medical and psychiatric or psychological problems may receive a boost in response to conventional therapies if the Osteopathic approach is used as an adjunctive and complementary therapeutic strategy. I am Board-certified in Family Practice and Osteopathic Manipulative Treatment but I am not providing primary care services in my current practice, only the manipulative treatments.
VI. How long is a treatment and how often will I need to come back?
The initial visit takes an hour, which does include the hands-on treatment, and the follow-up visits are scheduled for half an hour to 45 minutes. The typical period of time for the actual body work is anywhere from 20 to 25 minutes, though more or less time may be required.
Most people become very relaxed during the treatment and I have heard more than a few gentle snores over the years. The response from there varies quite a bit. There are several commonly-heard accounts that I’ve noted which I will detail, but the most important thing to remember is that those healing qualities of your body which I am accessing and utilizing are in there working continuously, so that the Treatment continues for up to 2-3 weeks after our encounter. For that reason I treat people 2-3 weeks apart for several visits and, if the situation is improving I then try to lengthen the time between visits gradually. There are many exceptions to these averages, of course and I don’t have a rigid pattern that we must follow. Everyone is different and I base my recommendations on what is actually occurring with each patient.
VII. What effects will the treatment have on me?
Some common responses are – 1. you feel very relaxed and good, euphoric even, and then you get home and have to take a two hour nap; 2. you feel mildly improved and the next day you feel very tired, sore, weak, like the proverbial truck hit you; this usually only lasts a day or two and I will need to know if it lasts longer than that; you may then feel a little or a LOT better than when you came in or instead, return back to your normal; 3. you don’t feel much happening during the treatment and for a week afterward and then you realize that something has changed – sometimes dramatically; 4. you may have a total resolution of your symptoms with one treatment! Sounds improbable and this IS rare, but it has happened…
VIII. What are the risks with the Osteopathic approach?
The types of body manipulation which I utilize are very gentle and slow-paced, and the risks of serious bodily harm are extremely low. As I noted above some people will have a slight worsening of symptoms on a very temporary basis but this is rarely worrisome from a medical standpoint. I make sure that everyone of my patients has a PCP for their routine medical care and I am ready to refer you to a specialist if you and I determine that other help is needed. I also can order x-rays and other imaging studies like MRI scans, but these are very infrequently needed in my experience.
IX. Do you take insurance and if not, what are the charges?
Yes, I take all the main insurance carriers for this area – Aetna, Anthem Blue Cross/Blue Shield, Cigna, Connecticare, United Healthcare; and I DO accept Medicare. I don’t take Husky or Medicaid and cannot accept the CONNect card for Medicare QMB recipients. I am also not credentialed by the Massachusetts universal coverage system.
For those with no insurance, or if you have Medicaid and want to pay out-of-pocket, the initial hour-long visit is $200 and the follow-up visits are $150, due at the time of service.
X. What is the age-range of people you will treat?
I am happy to see human beings from their first weeks of life till their old age. There is no limit. Sorry, but no dogs, cats, horses or iguanas.
XI. Do you work in the hospital?
The short answer is – no. I have to have approved credentials at one or more local hospitals in order to qualify for reimbursement from some of the insurance companies and I am on staff at both the Hartford Hospital and St. Francis Hospital and Medical Center. I do no active hospital care, however.
X. What are you doing to prevent transmission of the coronavirus?
There are five pillars of strategy which we must all follow to be as safe as possible and each one is as important as the others; neglect one and you can negate the benefits of the others. These are – screening, hygiene, masks, distancing and culture.
Screening – it is absolutely essential that you (and we) are honest in reporting ANY possible symptoms of illness and avoid coming if one or more are present; you’ve all heard these many times, but to be clear – fever, coughing/sneezing, shortness of breath, chills (with or without shaking), recent loss of taste or smell, sore throat, nasal or chest congestion/runny nose, unusual body aches, headaches or malaise, unusual gastrointestinal or urinary symptoms. Also – if, within the past two weeks, you have had a positive test or been in contact with anyone who had a positive test for COVID-19, flown on an airplane, attended an event or been around large groups of people (more than 10), please respect the need to stay at home until at least two weeks of non-symptomatic time have passed.
Hygiene – we request that -if at all possible – you shower and shampoo prior to coming, and wear clean clothes; also – we will ask each of you to wash your hands when you enter the treatment room, even if you arrived wearing gloves or used the hand-sanitizer on arrival. This may be deemed redundant by some, but we can almost not be too safe. I will wash my hands immediately before starting the treatment and right after I finish the manipulation.
This also includes the guidelines to clean our equipment and environment. Donita will be cleaning the tables after each patient and will be using an ultraviolet wand over the table and any surfaces you may have touched. She will be similarly cleaning the water cooler and counter-top if you have used these. The front door to the office will remain open and one of the doors to the treatment rooms will be open during your treatment to allow for fresh air flow through the room; with the windows open and the heater/cooler fan on, the temperature stays in a comfortable range; I will be the one to touch and open any door. The restroom keys will also be wiped with disinfectant after each use. The landlord is also having common-areas cleaned often.
Masks – please arrive wearing one; if you need one let us know, we should have a few extras to give out. It doesn’t really matter if it’s cloth or a surgical mask and definitely doesn’t have to be an N95 or KN95 type; I will be wearing one of those while in the treatment room, plus a face shield. I have been thinking a lot about this and have decided that you’ll need to keep your mask on also, though you can lower it if you’re on your belly with your face in the slot in the table, until you roll over. Because micro-droplets with virus particles are expelled with each expiration and this is increased when talking, even with masks on, we must reduce the amount of conversation to a minimum. This will be difficult when wanting to catch up with Donita and me, but we really must insist on this measure.
Distancing – the six-foot rule still applies, though we won’t have much problem with this. Donita will not be taking all of your vital signs except she will be taking your temperature. We are going to start scheduling an hour for each patient to hopefully avoid as much interaction in the waiting room as possible. If you need to bring a spouse or partner, that is acceptable.
Culture – our world has obviously changed and we must all buy into the need to keep up our extensive efforts to help each other by adopting the measures noted above and keep each other as safe as possible. There should be no question regarding the validity of the danger from this virus and we must all affirm internally that any reminders others give us if we are not “following the rules” come from the commitment to the principle – never be the one to make someone else sick.
Update March 1, 2021
For the last nine months we have been very strict with our screening process with patients and both Donita and I have successfully avoided becoming ill with the virus. Many patients have postponed and rescheduled appointments after possible or real exposure and we have been impressed with how conscientious everyone has been. We both completed our two-shot vaccination process on Feb. 5th, so that after Feb. 19th we are deemed as protected as we can be at this point. Although this has not been proven 100%, this also means that we are a lot less likely to pass on the virus to others (you).