This Fall's SOMA Spotlight comes from Des Moines University College of Osteopathic Medicine. We were pleased to interview Erika Jaworski, OMS II, about her experiences at DMU's Amish OMM Clinic. Erika is the Professional Development Director on DMU's SOMA Executive Board.
What OMM project are you involved in at your school?
DMU’s OMM department really strives to give students the opportunity to work with a variety of patient backgrounds. One avenue through which DMU increases our cultural competency as future physicians is through Amish OMM Clinic. This project is the creation of Dr. Jose Figueroa, a well-respected PM&R physician in the Des Moines community who is also renowned for his skills in OMM. Every month, we get the opportunity to provide OMM and family medical care to an Amish community from Northern Iowa. They travel hours to come to DMU and receive OMM treatment approximately once a month.
What makes this project so unique?
This is a very unique opportunity because we are working with a group of people that have a very different lifestyle and culture. Learning how to be sensitive to cultural differences is always important for our future success as physicians, as we will be working with patients who come from different backgrounds. Especially in the realm of OMM, there are ways to talk and interact with the patient that allow a patient to have a positive experience. These clinics also progress our OMM skills well beyond just treating classmates as we address the needs of adults, children, and even neonates. Furthermore, the language of the Amish community we work with is a German-Dutch dialect, so working through language barriers with the children (who don’t always speak English) is always a fun challenge.
What aspect of this project do you enjoy the most?
What I enjoy the most about this clinical experience is getting to combine all of our skills as future D.O. physicians. Prior to OMM treatments, we take a thorough history, perform a physical exam, and choose a diagnosis. We get to utilize the skills learned in our clinical medicine course before proceeding to the OMM portion of the visit. This is so important because it allows us to synthesize the information we obtained in the History and Physical with the information we obtain through osteopathic structural screening. Making those correlations between historical complaints and Somatic Dysfunctions is a useful skill to learn now so that we can better serve our future patients. It teaches us to view the patient’s complaints through the Osteopathic lens so that we can utilize every tool we have to help treat the patient.
Can everyone at your school participate in this project?
During the first semester of the year, Amish clinic is limited to 2nd year D.O. students. The only requirement is attendance at didactics that are held before each clinic. These training sessions allow us students to learn new OMM skills from Dr. Figueroa that we will be able to use on our Amish patients that week. Once our first year medical students have completed one semester, they are also welcome to volunteer at Amish Clinic. This allows them to have obtained some palpatory, diagnosis, and treatment skills during the fall before they begin helping treat in the spring.
How does this project help spread osteopathy in your community?
First, this project has been going on for years under Dr. Figueroa’s direction. There is an entire population of Amish People who firmly believe in the power of OMM as a modality of treatment to maintain health and wellness. This is evident as we see people from the community continuing to come to clinics over and over again. It’s really great to be a part of an activity where you can treat a patient who has been attending clinics for over 10 years. That kind of confidence in OMM is inspiring, especially to first year students who may not have had any exposure to manipulation before attending medical school. Second, I think that by allowing students to practice OMM in a primary care setting, you are encouraging the use of OMM once the student is a physician. If a student is able to practice their skills and gain the confidence to do a full body treatment well, I think they are much more likely to utilize it in practice. This is creating a multitude of physicians who will continue to spread osteopathy throughout the state of Iowa through the use of OMM as a tool for patient care.
How has your involvement in this project impacted your future as a physician?
First, I believe the cultural competency aspect is huge. We have had to learn how to appropriately and respectfully interact with a group of people that we are unfamiliar with. This is important because in our future practices, even if we are not knowledgeable about a person’s culture, we have the skills to ask the patient what their values are and make sure we respect those values.
Second, I think that by doing a history, physical, and OMM treatment, I have started to develop my own flow and style of treatment. During Amish clinic, I have the time to critically think about what I receive through a patient’s history and what I perceive about the patient’s system through palpation and osteopathic diagnosis. Synthesizing this information into an effective treatment has progressed my OMM skills far beyond simply remembering techniques for exams. It’s great to develop that sense of comfort with what I’m doing so early in my medical career because it is something I will continue to use in order to help my future patients.
Has your involvement in this project assisted you in your personal professional development?
This clinic really encourages us to synthesize our knowledge and skills, while being a safe environment for us to admit we don’t know everything. Dr. Figueroa and the patients have definitely helped all of us students grow professionally, as the clinic is a time for us to exercise our knowledge and take what we learn in a class room to the next level. I think that because the clinic is a great representation of what we will experience as physicians, I have learned to think critically about my patient’s care to give them the best outcome possible. I believe this experience is something that will always impact how I developed professionally as an Osteopathic physician.