Some of the top reasons cited by DOs who do not use OMT in their practice include lack of time, lack of confidence, and inadequate reimbursement. Some medical students have another excuse, they just don't see patients who have a need for it.
If all you have is a hammer, everything looks like a nail. If your hammer isn't working well, you don't see as many nails. There isn't going to be a patient who comes into your office with a sign pointing to a tenderpoint saying, "counterstrain me!" If your last few OMT attempts were lackluster, you're going to subconsciously avoid performing treatment unless a patient comes up and asks you for it. And you might give yourself the excuse, “There just aren't that many people that I come across who would benefit from OMT!”
I know my excuse. I just felt like my skill wasn't good enough. I felt like I could only help a small subset of individuals with my basic knowledge. I had to become a "master" to be able to treat anybody. I feared failure if my go-to technique was ineffective and I had wasted a patient’s time. Soon, even my trusty hammer would return to its case and be placed on display as a faint memory of something I did in osteopathic medical school.
Applying the Fascial Distortion Model has encouraged me to perform OMT again. Even after attending a single module, I’ve discovered the effectiveness of my most precious tool—my hands. And far from being an overhyped uni-tasker like many kitchen gadgets nowadays, I’ve found it to be highly adaptable to a wide range of painful conditions. FDM as a way of thinking is like a pair of night vision goggles that allow me to see through the shadow of patient’s pain and body language.
In fact, as soon as the patient begins to share their history of present illness, the signs and indications for FDM treatment could not be more obvious. In this model, the patient is the expert and intuitively knows what’s wrong with their body. Often, they say exactly what and where their fascial distortion is. The excuse that you haven’t found patients who have a need for OMT is due to a failure to ask.
When you learn a new language, you realize that all those sounds around you meant something. FDM helps me immediately decode the patient's body language. FDM puts a context for understanding the patient's natural history of somatic dysfunction and how what fascial distortions often accompany specific injuries. Once you know what questions to ask, the patient will tell you exactly what's wrong with them. Once you see how much you can do with treatment in a short duration of time, you must force yourself to avoid it.
Upon first exposure to FDM, it can appear to physicians and patients alike that it's like treating somatic dysfunction via hammer-stroke. But after spending more time with Dr. Capistrant and seeing how he treats his patients in his clinic, I found that his thumb was like a chisel, and his forearm the hammer. Far from destroying tissue indiscriminately, it was artfully restoring the body's proper structure and function, just as an archeologist excavates fossils from the bedrock.