How one M.D. utilized the cross-discipline teachings of D.O. principles to advance her practice in first-of-its-kind program at MSUCOM
When Tara Master-Hunter, M.D., wanted to advance her neuromusculoskeletal medicine skill set, she turned to Michigan State University College of Osteopathic Medicine (MSUCOM).
Dr. Master-Hunter, who has practiced medicine for 26 years, is a clinical assistant professor at the University of Michigan (U of M) Department of Family Medicine and a team physician at Eastern Michigan University (EMU). When looking for additional treatment options to benefit her patients, she decided to broaden her medical practice by incorporating manipulative medicine and acupuncture techniques. She connected with colleagues at MSUCOM, where she had taken several manual medicine continuing medical education (CME) credits previously, to pursue additional training.
She became the first M.D. to formally complete an osteopathic neuromusculoskeletal medicine (ONMM) residency at the MSU College of Osteopathic Medicine.
About OMM and ONMM
Beginning as the Certification in Special Proficiency in Osteopathic Manipulative Medicine (C-SPOMM) under the American Osteopathic Association (AOA), the training evolved into the specialty of neuromusculoskeletal medicine/osteopathic manipulative medicine (NMM/OMM).The residency programs in that specialty are known today as osteopathic neuromusculoskeletal medicine (ONMM) residency programs, said Lisa DeStefano, D.O., professor in the Department of Osteopathic Manipulative Medicine at MSUCOM. “It is and always has been a primary specialty.”
“The principal focus of the discipline is osteopathic and patient-centered; specifically, it embodies structural and functional interrelation, body unity, self-healing and self-maintenance,” said Dr. DeStefano. “My advice to clinicians or D.O./M.D. students would be to consider other reasons why humans have so much lower back, neck pain and arthritis when the human body is made for upright stance and locomotion – aging alone should not mean disability.”
An allopathic journey to learning ONMM
Dr. Master-Hunter’s first exposure to osteopathic manipulative medicine was working with David Alvarez, D.O., a graduate of MSUCOM she met while completing her sports medicine fellowship. Dr. Alvarez was the head team physician at EMU, and she calls him “a wonderful mentor.”
“He introduced me to some of the muscle energy techniques to treat the athletes. From the biomechanical perspective, this made so much sense to me and I knew it was something I wanted to spend more time learning,” Dr. Master-Hunter said. Over the next few years, she took several of MSU’s manual medicine CME courses to improve her knowledge and skills, “but so much of manual medicine is really in the palpatory skills, and in the context of a busy primary care clinic with patients with multiple concerns to be addressed, I struggled to find the time and ability to focus on practicing the skills to enhance my training.”
She decided that optimizing the normal function of the neuromusculoskeletal system was a skill she wanted to hone to better support her patients, and needed to have the dedicated time, opportunity and mentoring to focus on it. So, she started to look for opportunities.
“MSUCOM was a natural fit as I had already taken several of my CME courses there and it was close enough to my home that I could maintain some of my other clinical responsibilities and be with my family,” Dr. Master-Hunter said. “I was fortunate that MSUCOM was willing to consider taking an allopathically trained physician into their program and thankful that the Department of Family Medicine at U of M was supportive of me taking time away to do this training.”
Offering a first-of-its-kind residency program
The ONMM residency at MSUCOM, which is accredited by the Accreditation Council for Graduate Medical Education (ACGME), focuses on the neuromusculoskeletal system, its comprehensive relationship to other organ systems and its dynamic function of locomotion. It is the first time the MSU Collee of Osteopathic Medicine has trained an allopathic physician in their ONMM residency.
It is a three-year program, but there are several entry points, said Dr. DeStefano. Dr. Master-Hunter already did much of ONMM residency’s core work in her residencies and CME, so she was able to complete this ONMM residency in a shorter time frame, while maintaining her sports medicine practice at EMU and primary care practice at U of M.
“During the fellowship, I spent 50% of my time tending to my responsibilities at U of M and EMU and 50% at MSUCOM,” she said. “It was a lot of commuting for two years, but it was so worth it!”
She recalls her favorite part of the program as teaching the MSU College of Osteopathic Medicine medical students in the osteopathic manipulative medicine lab and spending time in the ONMM clinics. “As it often is in medicine, it is the immersion that helps you grow more than the specific isolated experiences. There is so much growth potential by being in proximity to those who are experienced and practicing what you are learning.”
In her residency, Dr. Master-Hunter learned about the normal function of the musculoskeletal system and gained the ability to take the ONMM certifying board exam and offer manual medicine to the patients in her practice at U of M.
Looking forward, Dr. Master-Hunger is eager to provide manual medicine at U of M as a consultation service in addition to the new set of skills she now offers her patients. “Seeing the number of musculoskeletal issues that I do, I cannot even imagine not having the ability to evaluate a patient for somatic dysfunctions that may be contributing to their complaints. It is incredibly helpful for my patients in primary care as well as the athletes I see in the training room.”
Collaborating across disciplines
With one of the largest OMM clinics in the country, the MSU College of Osteopathic Medicine sees at least 27,000 patients per year and helps work toward effective, unique treatments for patients with neuromusculoskeletal disorders.
“The ONMM residency at MSUCOM is very collaborative within the MSU community, as the program requires each resident rotate with other specialists, such as radiology, physiatry, psychology, rheumatology, internal medicine and more,” said Dr. DeStefano. “MSUCOM has greatly benefited from the program, as many of the OMM department’s faculty are former residents.”
The program also demonstrates how M.D.s and D.O.s can partner together to inform and improve patient care, she said. “In the area of the musculoskeletal system, ONMM is cost-effective and addresses chronic pain in a safe and effective way without using opioids.”
Dr. Master-Hunter said, “There is no way I could have improved my knowledge and skills in ONMM to such an extent without having the opportunity to learn from and work alongside the amazing faculty and residents at MSUCOM — they were so welcoming and helpful and supportive throughout my training.”
She looks forward to seeing where these skills take her allopathic career and what collaborations lie ahead for her with the MSU College of Osteopathic Medicine and other osteopathic professionals.
“I am a substantially better provider of ONMM now compared to when I started the fellowship,” Dr. Master-Hunter said. “And there is still so much more to continue to learn.”
Learn more about ONMM at MSU at omm.com.msu.edu.
By Elexi Dailey