Limited training in manual therapy techniques offers very modest benefit compared with high-quality (enhanced) care for acute low back pain. Outcomes may have been modified by failure of some participant physicians to undertake the required sequence of maneuvers. Intensity of manual therapy may be a factor in improving patient outcomes and needs further study.

Asthma has become a serious challenge to clinical medicine today, with an increase in incidence, morbidity, and mortality over the past two decades. Asthma continues to be a problem despite increased knowledge of the pathophysiology of asthma coupled with the development of a variety of new and innovative medications that can be used to treat asthma. Five areas involving asthma management are reviewed and involve a failure to do the following: (1) identify disease instability and progression; (2) adopt an optimal pharmacologic treatment plan; (3) identify and help the patient avoid environmental triggers; (4) evaluate and treat certain disruptive psychodynamic issues; and (5) use essential non-pharmacologic modes of therapy such as osteopathic manipulation, nutritional considerations, physical training, and controlled breathing techniques that may help to favorably modify the asthma disease process.

The importance of increasing scholarly activity has been highlighted among residency programs currently accredited by the American Osteopathic Association (AOA) to ensure a smooth transition to the single accreditation system. The Scholar 7 program, a series of seven 2-hour sessions, was created to aid faculty and residents in the pursuit of scholarly work and to facilitate change in an entire community hospital system's environment by creating a self-replicating scholarly culture in a timely and cost-efficient manner. Skills were taught by means of preparation and submission of a research protocol to the institutional review board (IRB) along with grant proposals. The authors tracked scholarly work, IRB submissions, and grants awarded to participants during the 2015-2016 academic year. The results were compared in a post-hoc fashion with previous classes since 2007-2008 within the same hospitals system. The Scholar 7 program successfully aided faculty in achieving their required pursuit of scholarly work in 8 months. This program has the potential to help AOA-focused residency programs meet the scholarly requirements of the Accreditation Council for Graduate Medical Education.

Context Rib raising is an osteopathic manipulative treatment modality that can help patients with various respiratory conditions to improve their work of breathing. However, the tolerance of this technique in hospitalized patients has not been assessed in a systematic manner. We hypothesized that rib raising would be a well-tolerated treatment modality for hospitalized patients admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and/or congestive heart failure. Objective To determine hospitalized patients’ tolerance of rib raising through a prospective pilot study. Methods The study included patients at University Hospitals–Richmond Medical Center and University Hospitals–Bedford Medical Center who were admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and/or congestive heart failure between November 1, 2016, and October 31, 2017. Each patient was treated with rib raising, which was performed in a standardized fashion. Immediately after treatment, patients were asked to rate their tolerance of the procedure on a scale of 0 to 10, where 0 represented no discomfort and 10 represented maximum discomfort. Results The study population consisted of 87 hospitalized, non–intensive care unit patients. The mean tolerance score for rib raising was 1.18, and the median score was 0. The score was between 0 and 3 in 80 patients (92.0%), between 4 and 6 in 6 patients (6.9%), and between 7 and 10 in 1 patient (1.1%). Conclusion Rib raising was shown to be well tolerated by the majority of the patients in the study population.

, wrote his reflective article "My Medical Conspiracy" during an era his children would never know. 1 His conspiracy involved using an assumed name to sit in classrooms not open to osteopathic physicians in the 1950's. A legacy to his progeny was to obtain the best possible training in medicine, commitment to patient centered care and the value of the osteopathic perspective. Upon entering osteopathic medical school in the 1980's, those barriers had been replaced by unique obstacles from that stage in medicine yet to be adequately addressed. Those obstacles would prove to be opportunities for growth and healing from all sides of medicine.