STUDENT OSTEOPATHIC MEDICAL ASSOCIATION
VOLUME 3 • ISSUE 2
THE FUTURE D.O.
DECEMBER 2025
EDITORIAL BOARD
Rhea is passionate about integrating technology, clinical medicine, and environmental studies. She worked as a data scientist before focusing on population health amongst our diminishing coastlines on the eastern seashore. Now, she brings that same attention to detail and passion for collaboration to SOMA and patient advocacy. She is so excited to serve our patient's healthcare needs in the future and be a voice for all.
THE FUTURE DO • VOL 3 • ISSUE 2
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Ahana's journey through medicine is driven by a love of research and advocacy. Growing up in San Diego, CA, she was inspired by the city’s rich biomedical landscape and developed a curiosity for the science behind medicine, while her passion for advocacy stems from her family's experiences navigating healthcare disparities. With a strong background in neurobiology-focused research and a passion for mentorship, she aspires to become a pediatric neurologist, continuing to champion vulnerable populations. In her free time, she enjoys baking, creating art, running, and all things spooky.
ALEXANDRA STECK (OMS-IV, Touro COM - HArlem) CO-EDITOR-IN-CHIEF LAYOUT & DESIGN
Funding for The Future DO is provided by the SOMA. Views expressed in The Future DO publications are solely those of the authors and do not necessarily reflect the opinions of the editorial board, The Future DO, or SOMA unless specified.
Ahana Chakraborty (OMS-III, CHSU COM) CO-Editor-In-Chief
Alexandra is deeply committed to advancing women’s health through research. She has a strong background in oncology research from institutions such as Memorial Sloan Kettering and Sidney Kimmel Cancer Center, with work focusing on ovarian and prostate cancer, liquid biopsy diagnostics, and health equity. She has co-authored multiple peer-reviewed publications and presented at national conferences. Alexandra aspires to become a gynecologic oncologist, aiming to integrate patient care with translational research to improve outcomes for women diagnosed with cancer. She enjoys spending weekends exploring Upstate with her husband and dogs, Reagan and Nori, and experimenting with new recipes from The New York Times Cooking collection.
CONTENTS
MEET THE EDITORIAL BOARD
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Rhea Agarwal (OMS-II, WVSOM) Contributing Editor
About the Cover Artist: Emily Murdakhayev is a second-year student at LECOM. "This piece reflects how I see knowledge as the light that guides us through the noise of misinformation in healthcare. The skeleton represents the medical student within me, always learning, always seeking truth, even when surrounded by myths and misconceptions. The D.O. light bulb symbolizes the moment of clarity that comes from understanding and compassion, values at the heart of osteopathic medicine. For me, this artwork is a reminder that learning is healing , and that through knowledge, we can bring light to others."
Co-Editor-In-Chief Ahana Chakraborty Alexandra Steck Layout & Design Adriana Gonzalez-Borrell Caitlyn Nguyen Cèline Zalamea Editorial Board Rhea Agarwal Valerie Bakly Alex Biera Tanvi Chitre Nanak Pabla Viraj Padhiar Rebecca Slay Research Director Clayton Rawson On The Cover The Anatomy of Truth, Digital Drawing by Emily Murdakhayev The Future DO is a magazine for the advancement and education of the osteopathic medical student. It is published biannually by the Student Osteopathic Medical Association (SOMA).
Editorial Board '25-'26.................................... Greetings from Editor-in-Chief....................... Editorial...................................................... Letter to the Editor......................................... Featured Perspective: Elevating Osteopathic Voices ...... Abstracts: Basic Science & Clinical Research....... Featured Perspective: Slavery, Choice, or Public Health? Featured Perspective: From Awareness to Action.......... Abstracts: QI & Public Health........................... Abstracts: Case Reports........ ........................... Abstracts: Literature Reviews............................ Perspective Articles........................................ Osteochats.................................................... Message from the Research Director..................
Tanvi is an OMS-III with a passion for advocacy and narrative medicine. She is particularly interested in pediatrics and hopes to integrate her love of writing, communication, and patient-centered advocacy into her future career as a physician. Outside of school, she enjoys cooking, going to concerts, and spending time at the beach.
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Alex is currently an OMS-III at The University of the Incarnate Word School of Osteopathic Medicine (UIWSOM) in San Antonio, Texas. When not on rotation or studying, Alex enjoys her time serving as the Chief Information Officer for The Latino Medical Student Association Southwest Region. Outside of school and extracurricular obligations you can find this self-proclaimed foodie checking out the restaurant scene.
Rebecca Slay is a fourth-year osteopathic medical student attending Lincoln Memorial University – DeBusk College of Osteopathic Medicine in Harrogate, Tennessee. She earned a Bachelor of Science in Biology and minor in music from The University of Tulsa. This is her first year engaging as an editor for The Future DO. Rebecca is from Hot Springs, Arkansas and has dedicated much of her life to artistic pursuits as a musician – both as a pianist and percussionist – and is ecstatic to broaden those pursuits as a collaborator to showcase your experiences, ideas, and research! Rebecca is a member of multiple professional societies, including SOMA, AMA, ACOP, and CMDA. She is also proud to be an inductee of Omega Beta Iota and the Gold Humanism Honor Society. Rebecca is an aspiring Pediatrician and hopes to pursue a career in Neonatology in the future.
Alex Biera (OMS-III, UIWSOM) Contributing Editor
Born and raised in Toronto, Canada, Viraj developed a deep appreciation for community-centered healthcare, a passion that ultimately led him to the United States to pursue medicine. Before medical school, he earned a Master of Science in Aging and Health, which further strengthened his commitment to supporting vulnerable populations. As a third-year medical student at NSU-KPCOM, he is now interested in pursuing a career in anesthesiology, with a potential subspecialty in critical care, where he hopes to combine clinical precision with compassionate, patient-centered care. Outside of medicine, he enjoys spending time with his fiancé, exploring new restaurants and cafés, and staying active through various sports.
Tanvi Chitre (OMS-III, xx CHSU-COM) Contributing Editor
Nanak Pabla (OMS =II, ATSU SOM) Contributing Editor
Valerie Bakly (OMS-III, LECOM - Seton Hill) Contributing Editor
rebecca slay (OMS-IV, LMU-DCOM) Contributing Editor
viraj padhiar (OMS-III, NSU KPCOM) Contributing Editor
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Valerie is a third year osteopathic medical student at Lake Erie College of Osteopathic Medicine (LECOM) at Seton Hill. She is excited to be part of the editing team for The Future DO. She enjoys conducting research and volunteering at her local food bank, where she has always had a strong interest in improving access to nutritious food and promoting community health. Beyond academics, Valerie loves spending time outdoors: rock climbing, camping, and hiking.
Nanak earned her bachelor's degree, graduating Summa Cum Laude, from San Jose State University. Growing up in rural India, she developed a deep commitment to health equity and a passion for serving underserved communities which led her to join ATSU–SOMA as a first-generation medical student. Nanak’s interest in research began during her undergraduate years, when she contributed to a lab studying the regenerative properties of cardiomyocytes which inspired her to become actively involved in the National SOMA Research Committee. In her free time, Nanak enjoys trivia, hiking and stargazing.
Caitlyn is passionate about mentorship and advancing educational equity in medicine. She has worked with Heights Philadelphia on multiple initiatives, including serving as a mentor in a pilot program for high school students interested in STEM careers. Through Heights, she has also helped first-generation students navigate the college application process, securing acceptances to universities like Carnegie Mellon and Northeastern. Caitlyn also runs a college prep newsletter, making guidance more accessible to students with limited support. Caitlyn hopes to become an anesthesiologist and continue fostering mentorship and advocacy throughout her career. In her free time, she enjoys crocheting and watching Gilmore Girls.
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Adriana is a third year osteopathic medical student at BCOM. She is passionate about mentoring, teaching, and community engagement. When she isn't studying or volunteering, she enjoys baking, crafting, hiking, and reading nonfiction. Adriana hopes to build a career in pediatric medicine centered on connection, curiosity, and making healthcare feel less intimidating for children and their families.
AHANA CHAKRABORTY, OMS-III
Caitlyn Nguyen (OMS III, PCOM) LAYOUT & DESIGN Editor
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KNOWLEDGE IS MEDICINE: CONFRONTING MISINFORMATION IN MODERN HEALTHCARE
As I enter my second year of being on The Future DO magazine team, and my first year as Co-Editor-in-Chief with Alexandra Steck — who has been an endlessly supportive partner— I have been able to truly appreciate how relevant this edition’s theme is to the current state of our society. As a third year medical student, still quite new to the healthcare world, I’ve found myself often disheartened and frustrated by the seemingly vast amount of misinformation in a rapidly changing world where artificial intelligence and political views, instead of evidence-based medicine, are increasingly shaping healthcare policy and patient awareness. I’ve continuously wondered, “How can I as a trainee help fight medical misinformation for my future patients?” While I still don’t necessarily have a clear answer to that yet, our theme for this edition, “Knowledge is Medicine: Confronting Misinformation in Modern Healthcare,” provides a glimpse into dealing with this new epidemic. This edition’s case reports and research abstracts precisely showcase the essential role of evidence-based medicine in shaping patient outcomes. Furthermore, our insightful artwork and opinion pieces – including perspective articles, Letters to the Editor, and our new OsteoChats submissions – provide further proof that medical providers and trainees can have a meaningful impact on fighting misinformation by first educating themselves, and then helping patients understand their own circumstances in a manner that is empathetic and direct. A lot of hard work was put into bringing this edition to life, both on the part of our authors and our wonderful editing and publishing teams. I hope that you, the reader, find this edition insightful and eye-opening, and I truly thank you for taking the time to enjoy our magazine.
Cèline Zalamea (OMS-II, PNWU COM) LAYOUT & DESIGN Editor
EDITOR-IN-CHIEF
Adriana Borrell (OMS-III, BCOM) LAYOUT & DESIGN Editor
Cèline's experiences training in a rural community have shaped not only who she is, but also the kind of physician she hopes to become. Seeing how limited resources affect both patients and learners has pushed her toward advocacy and motivated her to speak up for communities that are often overlooked. Through SOMA, Cèline has been able to turn that commitment into meaningful work, both in representing students and in strengthening support for rural care. Additionally, serving on the SOMA research team has allowed her to bring a rural perspective into national projects, ensuring that the unique challenges faced by these communities are reflected in our data, discussions, and solutions.
The SOMA Research Committee regularly provides opportunities for osteopathic medical students to engage in meaningful discussions and workshops. The monthly Journal Club serves as a forum for students, both SOMA members and non-members, to analyze and delve into current clinical research across various medical specialties, with a focus on topics such as breast cancer, diabetes, and neonatal abstinence syndrome. The research topic discussed above was presented in the September 2022 SOMA Journal Club. In addition, Research Workshops offer education on a range of subjects, including IRB approvals and writing a systematic review, to assist students in gaining practical research experience and developing the necessary skills to succeed in their careers. Join us at our next Journal Club & Workshop! Look for an announcement in either SOMA Weekly* or by following @national_soma on Instagram.
"Misinformation thrives when knowledge is diluted. If we, as future physicians, contribute to that dilution, we undermine the very evidence-based medicine we aspire to practice"
EDITORIAL
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Numbers vs Knowledge: The Hidden Cost of Low Quality Research
CAITLYN NGUYEN, (OMS-III, PCOM)
In an age where misinformation can spread faster than facts, medical students are taught to practice evidence-based medicine. We learn to anchor our decisions in data and confront falsehoods in patient care and public discourse. Within academic medicine, however, a quieter form of misinformation is taking root, fueled by the growing pressure on students to produce research for the sake of residency applications. As the residency match becomes increasingly competitive, research has become a key metric of success. The implementation of pass/fail USMLE Step 1 and COMLEX Level 1 board exams, along with wider adoption of pass/fail grading in pre-clinical curricula, has placed more weight on USMLE Step 2 scores and research productivity to differentiate a sea of homogenous applicants. According to the 2024 NRMP Charting Outcomes of US D.O. Seniors, matched applicants in competitive specialties like dermatology and orthopedic surgery now average double digit publication counts of 15.4 and 11.2, respectively1. However, prior to implementation of pass/fail USMLE Step 1 and COMLEX Level 1, the 2022 NRMP Charting Outcomes of US D.O. Seniors showed matched applicants in dermatology averaging 9.8 publications and matched orthopedic surgery applicants averaging 7.0 publications2. This escalating numbers race has led some students to pursue research not out of genuine curiosity, but out of necessity. Additionally, the advent of AI-driven writing and data generation tools further enables the mass production of papers, sometimes with minimal human oversight. While AI is undoubtedly a useful tool in scientific research, some authors have used AI tools to write entire papers even including references fabricated by AI3. To compound the issue, some predatory journals have created a “pay to win” environment that prioritizes profit over research integrity. These journals collect author fees and publish papers with little editorial review, allowing AI-generated papers with false references to reach publication4. The end result is an avalanche of hastily written case reports, redundant reviews, or poorly designed studies that often add little to scientific conversation. At first glance, these low quality projects may seem harmless. Once published, however, these papers enter the same scientific ecosystem as rigorously peer-reviewed research and contribute to the noise that makes it increasingly difficult for clinicians and researchers to identify truly impactful studies. In addition, while experts in the field may have little difficulty spotting the flaws in a dubious paper, for the general public it isn’t always so clear. A poorly conducted literature review that overstates treatment efficacy may seem trivial in isolation, but when these findings are cited and amplified on social media, it can mislead thousands. The consequences extend beyond immediate misinformation as flawed research erodes trust in the scientific and medical community as a whole. Patients are left to wonder, 'how credible is the evidence-based medicine my doctor is practicing if there is low quality medical research being published?' In a world already struggling to separate science from speculation, flawed student research adds another layer of confusion to an already crowded information landscape. This is not to say that students should avoid research altogether. Meaningful participation in research cultivates the skills necessary to practice medicine: curiosity, skepticism, and analytical thinking. But when research becomes a box to check rather than a question to explore, we risk producing work that weakens rather than strengthens the scientific foundation of our profession. The problem is not simply that some students are producing weak papers, ---- it is that the system inherently incentivizes doing so. Residency programs have the power to play a critical role in addressing this problem. When a selection committee recognizes the value of thoughtful research, whether it leads to a publication or not, it helps foster a healthier research culture that emphasizes integrity over output. Misinformation thrives when knowledge is diluted. If we, as future physicians, contribute to that dilution, we undermine the very evidence-based medicine we aspire to practice. Our responsibility is not just to consume knowledge, but also to protect its quality to ensure that the science behind our clinical decisions remains something our patients can trust.
*SOMA Weekly is a weekly email circular for all SOMA-related news and events. You must be registered as a SOMA member to receive the newsletter. Register to join SOMA at studentdo.org!
SOMA Journal Club & Research Workshops
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About the Author I am a second-year osteopathic medical student at the Orlando College of Osteopathic Medicine who chose medicine out of a deep respect for its responsibility and impact. I am driven by a commitment to understanding patients beyond their diagnoses and approaching care with intention, curiosity, and integrity. I am actively involved in student leadership as a National Liaison of our SOMA chapter, supporting advocacy, service, and meaningful student engagement. As I continue my training, I strive to advocate for my patients through thoughtful listening, critical thinking, and compassionate care.
The article “Medical Devices and Darker Skin Tones” in Vol. 3 Issue 1 of The Future DO brings critical attention to an issue that has long been overlooked in medicine: the ways in which bias in medical technology design contributes to ongoing health disparities. I strongly agree with the authors’ perspective that devices such as pulse oximeters, when not validated across diverse populations, can produce misleading data that directly impacts patient outcomes. It is deeply troubling that pulse oximeters, trusted as objective tools, frequently overestimate oxygen saturation in individuals with darker skin tones. This means that patients who appear clinically stable may, in fact, be hypoxemic. As the authors pointed out, these inaccuracies have led to delayed diagnoses and missed opportunities for timely and life-saving interventions, an issue that became especially evident during the COVID-19 pandemic. Accurate, inclusive data must be the foundation of equitable healthcare, not a privilege afforded to a single demographic. As an osteopathic medical student, I believe this issue strikes at the core of our philosophy of treating the whole person. To truly embody that principle, we must also treat the systems and technologies that serve our patients with the same scrutiny and care. By advocating for inclusivity in medical device research and design, we take a vital step toward restoring trust and achieving fairness in healthcare delivery.
Elevating Osteopathic Voices in Medical Scholarly Activity
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"Enhancing scholarly activity training does not mean sacrificing osteopathic identity"
There is great opportunity for osteopathic physicians (DO) to strengthen their academic contributions through expanded osteopathic scholarly activities. Community physicians, such as primary care physicians (PCP), play a critical role in shaping the future of medicine, not only through clinical practice but through scholarly activity. In primary care, where many DOs practice, the need for evidence-informed decisions is acute. Despite their essential role in healthcare delivery, DOs remain vastly underrepresented in academic publishing. From applying preventative strategies to interpreting evolving guidelines, PCPs consistently engage with scholarship and are the interface between patients and scientific research. With limited scholarly contribution from DOs, there is an increased risk of excluding vital insights from the frontline of community-based patient-centered care. We present a unique opportunity to empower more DOs to become active contributors to research early in their medical training, advancing not only the osteopathic profession but also the healthcare of the communities we serve. While DOs constitute a substantial portion of the physician workforce, particularly in primary care settings, we produce comparatively few research publications. In the 2024 Match, DOs placed into family medicine at nearly equal rates to allopathic physicians (MD).1 In pediatrics, DOs matched at a rate of approximately one for every three MDs.2,3 However, a recent study found that DOs are 0.98% of all authors and 0.41% of senior authors in three pediatric journals over a four-year period.4 Even in competitive specialities, such as general surgery, DO faculty had a median of five publications compared to 35 among MD colleagues.5 Such academic underrepresentation begins early: graduating DO students in 2024 produced an average of 4.4 scholarly works per applicant, compared to 10.2 for their MD counterparts.2,3 Despite similar clinical training, the scholarly contributions of DOs remain disproportionately low. This is not because of lack of capability or interest, but rather of access, training, and institutional support. Among many contributing factors, deficits in research training during osteopathic education stands out as a root cause and a clear opportunity for reform. In 2018, 65 MD institutions had mandatory research requirements integrated into the curriculum, along with many MD institutions providing NIH-funded research programs for students.6 Colleges of osteopathic medicine (COM) are not held to the same scholarly output standards.7 DO students carry a heavier curricular load, including 500–1,000 additional hours in osteopathic manipulative medicine, which reduces time for scholarly pursuits.8 A 2023 survey found that only 44% of COMs required scholarly involvement, and 12% of COM student research programs had external funding.9 Over half of DO students reported a lack of access to research projects or mentorship, with 53% feeling overwhelmed on how to get started.10 This data points to a structural problem. Without early exposure to research processes, fewer DO students graduate with the skills, confidence, or mentorship needed to continue scholarly activity in residency or beyond. The lack of exposure to scholarly activity impedes these physicians from providing evidence-based care in their future practices. We implore COMs to reimagine how scholarly activity is integrated into medical education. Enhancing scholarly activity training does not mean sacrificing osteopathic identity; rather it prepares graduates to contribute to evidence-based medicine. Advancements could include implementing scholarly activity pathways, honors tracks, or dual-degree programs. Accreditation standards from the Commission on Osteopathic College Accreditation should explicitly encourage scholarly engagement and funding mechanisms, supporting faculty and students alike.7, 9 Mentorship is crucial, faculty development programs that train DO educators to become research mentors can cascade success throughout entire institutions. Partnerships with nearby universities or hospitals can bridge infrastructure gaps, allowing DOs to join ongoing scholarly activity. NIH funding disparities are stark, with COMs collectively receiving <0.2% of NIH’s total funding in 2024.11,12 These internal improvements would position COMs to more effectively compete for peer-reviewed funding. Moving forward, the osteopathic profession must actively advocate to prioritize scholarly activity, building the capacity to support future physician-scholars. Federal agencies, journals, and academic conferences all play a role in amplifying osteopathic voices; however, the greatest change must come from within. COMs must emphasize building a robust pipeline of students trained in research and DOs in practice by supporting the translation of clinical insights into scholarly documents. We further call on the next generation of DOs to recognize each publication, grant submission, and successful mentorship as steps towards more robust scholarly output. Increased DO academic contribution will reflect the real-world diversity of PCPs and their patients, advancing community care. Expanding DO scholarly activity participation is not about prestige; it is about enriching the medical evidence base with diverse clinical insights, especially from PCPs rooted in community care. With intentional investment in research training and structural support, DO voices will be better represented in the discovery that shapes patient care.
PERSPECTIVES
Shikshita Singh BS1; Isabelle G. Eldridge BS1; Marco Lybbert BA1; Krey Ramsey BS1; Dylan McKeighan BS1; Aura T. Teles1; Oluwagbenga Dada1; Inder Sehgal PhD2; Laura Rosch DO3 1OMS-II, Rocky Vista University COM, Ivins, Utah 2Department of Biomedical Science, Rocky Vista University COM, Ivins, Utah 3Campus Dean, Associate Professor Internal Medicine, Rocky Vista University COM, Ivins, Utah
"By advocating for inclusivity in medical device research and design, we take a vital step toward restoring trust and achieving fairness in healthcare delivery "
Letter to the Editor: Medical Devices and Darker Skin Tones, Vol. 3 Issue 1 (Esemaya, Thompson, McLune, Ancheta)
Aishwarya Kalluri Orlando College of Osteopathic Medicine
"only 44% of COMs required scholarly involvement, and 12% of COM student research programs had external funding"
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About the Authors: Shikshita Singh, Isabella Eldridge, Marco Lybbert, Krey Ramsey, Dylan McKeighan, Aura Teles, Oluwagbenga Dada and are second-year osteopathic medical students at Rocky Vista University College of Osteopathic Medicine, Southern Utah campus. They wrote this piece under the guidance of RVUCOM's Physician Scientist Track. Dr. Sehgal is a pharmacology educator and researcher. He received his research training at the Mayo Clinic and the Baylor College of Medicine and has been funded by the NIH, DoD and private company contracts. He served as Director of RVUCOM's Physician Scientist Track in Utah in 2024 and 2025. Laura Rosch, DO, MS, FACOI is a board-certified Osteopathic Internal Medicine physician who currently serves as the Campus Dean for Rocky Vista University in Ivins, Utah. She serves on the Board of Deans for the American Association of Colleges of Osteopathic Medicine, the Executive Committee for the American College of Osteopathic Internists, and as a board member for both the American Osteopathic Foundation and the Rural Health Association of Utah.
David J. Grossfeld1, Allison B. Reiss1, Lora J. Kasselman1, Heather A. Renna1, Aaron E. Katz1 1Medicine, NYU Winthrop Hospital, Mineola, NY, United States dgrossfe@student.touro.edu
Gershon Zinger1†, Nia Kepes2,Ron Kenett3,Amos Peyser5, Racheli Sharon-Gabbay1† 1Hand Unit, Department of Orthopedic Surgery, Shaare Zedek Medical Center, Faculty of Medicine 2Department of Neuroscience, Michigan State University Lyman Briggs College 3The KPA Group 4The Samuel Neaman Institute 5Department of Orthopedic Surgery, Shaare Zedek Medical Center †These authors contributed equally to this work. kepesnia@msu.edu
Introduction: Lipoaspirate has become the preferred source for regenerative cells. The mechanical processing of lipoaspirate has advantages over enzymatic processing but has a lower yield of regenerative cells. A review of the literature shows different techniques of extraction, but the ideal method or combination has not been determined. Methods: A comprehensive literature search was focused on the mechanical processing of lipoaspirate, without the use of enzymes. Data from the articles were integrated by utilizing a multivariate meta-analysis approach and used to create a statistical-based predictive model for a combination of multiple variables. Results: Starting with 10,000 titles, 159 articles were reviewed, and 6 met the criteria for inclusion and exclusion. The six studies included data on 117 patients. Sixteen factors were analyzed and six were identified as significant. The predictive profilers indicated that the optimal combination to maximize the cell yield was a centrifuge force of 2000× g, a centrifuge time of 10 min, a cannula diameter of 2 mm, and an intra-syringe number of passes of 30. The optimal patient factors were a higher BMI and younger age. Conclusion: The novelty of the method used here was in combining data across different studies to understand the effect of the individual factors and in the optimization of their combination for mechanical lipoaspirate processing.
"Kidneys" Artist: Neeharika Nallapati, OMS-IV TouroCOM - Harlem
A Multivariate Meta-Analysis for Optimizing Cell Counts When Mechanically Processing Lipoaspirate for Regenerative Application
Introduction: Activating the immune system and altering tumor microenvironments are emerging strategies for prostate cancer (PCa) treatment, aimed at harnessing the body’s intrinsic anti-tumor immune response. We evaluated cytokine profile changes following four different types of prostate cancer treatment. These findings could be used to assess response to treatment and patient outcomes. Methods: This 4-arm study enrolled 32 patients treated as described in 4 groups, including Stereotactic Body Radiation therapy (SBRT), Radical prostatectomy (RP), Total Cryotherapy (TC), and Focal cryotherapy (FC), for histologically proven prostate adenocarcinoma. Patients with metastatic disease or known immunologic disorders were excluded. Urine samples were analyzed at 3 time points: before PCa treatment, immediately following treatment (2 ± 1 week) and 3 months post-treatment. A comprehensive cytokine panel was obtained. Results: We performed an interim analysis on PCa urine from Groups 1-4. Interleukin 10 (IL10) levels increased during visit 2 in the radical prostatectomy cohort, then decreased close to baseline during visit 3, showing a significant interaction (p = 0.036). Similar trends were observed for IL6 and IL1a. IL1a levels changed significantly over time (p = 0.0175). In the TC and FC cohorts, IL1a levels increased at visits 2 and 3 relative to baseline. In the SBRT group, IL1a levels only increased at visit 3, representing the largest percent change in this cohort. Conclusion: Pre- and post-treatment cytokine levels differ in patients receiving SBRT, RP, TC, or FC. In the SBRT group, IFN-y elevation was sustained. However IL10, IL6, and IL8, and IL1a levels in the RP group drops at visit 3. Notably, IL4 levels appeared to rise gradually postoperatively in 2 out of the 4 groups. These findings suggest that inflammatory cytokine profiling may serve as a useful indicator of treatment response and prognosis.
BASIC SCIENCE & CLINICAL RESEARCH
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Changes in Cytokine Profile with Prostate Cancer Treatments
Evaluating the Association Between Caregiver IBS and Pediatric Constipation in the Central Valley
The Potential Use of Atypical Antipsychotics for Treatment of Aggressive Prostate Cancer Cells
The Transcription Regulation Mechanism of Eiger by Puckered Gene in Fly Glial Cells
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Introduction: Constipation–infrequent, difficult bowel movements, often with fecal incontinence or stool withholding–differs from irritable bowel syndrome (IBS), which includes broader symptoms like abdominal discomfort and irregular bowel habits. Existing literature suggests a familial link in gastrointestinal conditions. This study explores non-genetic factors, including social determinants of health and socio-demographic factors, that influence the relationship between caregiver IBS and pediatric constipation at Valley Gastroenterology Institute in Fresno. Methods: We surveyed primary caregivers (age>18) of pediatric constipation patients at Valley Gastroenterology Institute. An IBS Severity Score was calculated from responses. Surveys were available in English, Spanish, Punjabi, and Hmong. Data was compared across four caregiver-child groups: A: Caregivers with IBS whose children have constipation ; B: Caregivers without IBS whose children have constipation; C: Caregivers with IBS whose children do not have constipation; D: Caregivers without IBS and children without constipation (control) Results: Preliminary analysis suggests a potential association between caregiver IBS and pediatric constipation, shaped by socio-demographic factors. Of 100 surveys returned, 68 met inclusion criteria, with 8 caregivers reporting a formal IBS diagnosis—7 of whom had children with constipation (p = 0.055), indicating a trend toward significance. Conclusion: Caregivers with IBS severity scores above 75, who had clinically significant symptoms but no formal diagnosis, were excluded. As additional responses are analyzed, inclusion of these individuals may enhance the observed association. These preliminary findings highlight the need for a family-centered approach to pediatric gastrointestinal care. Future studies with larger samples should include subclinical IBS and examine interventions targeting caregiver health/education.
An Open-Source Reproduction and Enhancement of CheXNet for Chest X-ray Disease Classification
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Shuyan Zhou, Zhecheng Jin, PhD, Nancy Bonini, PhD Department of Biology, University of Pennsylvania zhoushu8@msu.edu
Introduction: Traumatic brain injury (TBI) due to external forces to the head leads to systemic inflammation and neurodegeneration. This study explores the role of eiger, a tumor necrosis factor (TNF) superfamily ligand, and its regulatory mechanisms in a Drosophila model of TBI. Previous research shows activation of the activator protein-1 (AP-1) pathway in Drosophila brains post-TBI modulates expression of puckered (puc), a phosphatase that increases upon TBI, leading to elevated brain vacuolization. Our study further explores the dynamic between puc and eiger. Methods: Our research incorporates three different transcription factor binding site (TFBS) prediction sources to explore transcription factors potentially regulating eiger. We used RNAi screening to find transcription factors that influence eiger expression during puc upregulation. Additionally, we tracked the lifespan of fly lines that overexpressed, underexpressed, and normally expressed glial eiger under sham, mild, and severe TBI severities to examine the effects of modulating glial eiger expression on lifespan under various TBI severities. Results: From 37 candidates, we pinpointed five transcription factors that influence eiger expression during puc upregulation. Both eiger knockdown and upregulation generally reduced lifespan, highlighting the complexity of its regulatory role under TBI stress (n=85, p=0.00021; n=89, p<0.0001, respectively). The findings suggest glial eiger expression is modulated upon TBI and is required for maintaining the optimal responses to TBI, emphasizing its significance in stress homeostasis within Drosophila. Conclusion: This research underscores the intricate regulation between eiger and puc in TBI, suggesting avenues for further investigation into their nuanced roles in neurodegenerative disease.
*R. Beltran1, *A. Chakraborty1, *A. Naouai1, E. Bebla1, N. Mohebati1, M. Khan1, D. Badr1, Y. Tao2, S. Pattipati PhD1, M. Rahman PhD1, H. A. Wang MD2 1California Health Sciences University COM 2Valley Gastroenterology Institute khan2663@chsu.edu
Introduction: Repurposing atypical antipsychotics for metastatic castration-resistant prostate cancer (mCRPC) is an unmet clinical need. Some antipsychotics exhibit anticancer properties, offering potential therapeutic benefits with fewer side effects than first-generation treatments. This study investigates the anticancer effects of four atypical antipsychotics—cariprazine, xanomeline, pimavanserin, and iloperidone—by evaluating their ability to inhibit cell proliferation and migration while inducing endoplasmic reticulum (ER) stress. Methods: Cytotoxicity assay was conducted to determine the IC50 for each drug, while colony formation assay assessed long-term clonogenic survival. Transwell migration assay was performed to evaluate the ability of these drugs to inhibit cell migration. Immunoblotting was used to determine whether pimavanserin induces ER stress by upregulating key markers, including CHOP, BiP, Calnexin, PDI, and phosphorylated ERK. Results: Pimavanserin demonstrated the highest potency in reducing cell viability, clonogenic survival, and migration, making it the lead candidate for further study. Western blot analysis is ongoing to confirm its role in ER stress induction, with preliminary results suggesting the upregulation of key ER stress markers. Conclusion: Among the four tested antipsychotics, pimavanserin exhibited the strongest antitumor activity, supporting its potential as a novel therapeutic option for mCRPC. Further investigation is needed to elucidate its precise mechanisms, particularly its role in ER stress, to determine its suitability for preclinical and clinical development.
Introduction: Chest X-ray classification is a crucial task in medical imaging, where deep learning models detect thoracic diseases from radiographic scans. The landmark study, known as CheXNet, introduced a 121-layer DenseNet convolutional neural network that reportedly outperformed radiologists in detecting pneumonia. However, the source code and test set for this model are not publicly available. We replicated the original CheXNet model, optimized performance metrics (AUC-ROC and F1 scores) across all 14 disease classes, and explored whether Vision Transformers (ViTs) could offer performance improvements over traditional convolutional neural networks. All code is publicly available: https://github.com/dstrick17/DacNet. This project promotes transparency and reproducibility in medical artificial intelligence by providing a fully open-source, end-to-end training and evaluation pipeline. Methods: We trained a DenseNet-121 model on the NIH ChestX-ray14 dataset (100,000+ frontal-view X-rays, labeled with up to 14 diseases). We then developed DACNet, an enhanced model, using Focal Loss, the AdamW optimizer, and Color Jitter augmentations. Models were evaluated using AUC-ROC and F1 score, with patient-level data splits to ensure reproducibility. Results: The best model achieved an average AUC-ROC score of 0.85 and F1 score of 0.39 across all 14 disease classifications present in the dataset. Conclusion: Our model, "DACNet", demonstrated meaningful improvements to the original architecture using all open-source code for full reproducibility. DACNet also introduced novel F1 score evaluations for all 14 diseases in the NIH dataset, demonstrating its potential for advancing open-source medical AI research.
daniel strick, carlos garcia padilla, anthony huang 1touro college of osteopathic medicine 2boston university dstrick@student.touro.edu
Grace Lee, Berony Geneste, Dalal Dawud, BPharm, Zakaria Y. Abd Elmageed PhD Department of Biomedical Science, Discipline of Pharmacology, Edward Via College of Osteopathic Medicine glee@vcom.edu
“Slavery, Choice, or Public Health? The Language We Use Matters”
"The question remains: what role should physicians play when political figures misuse medical language?"
About the Author: My name is Claudia Pedreira, and I am a third-year medical student (OMS-III) at Nova Southeastern University’s Dr. Kiran C. Patel College of Osteopathic Medicine. I was born in Cuba and immigrated to France at the age of five, where I lived until I was ten years old before coming to the United States. As the daughter of hardworking immigrant parents who sacrificed everything to build a better life, I carry with me a strong sense of resilience, gratitude, and responsibility to make a difference in the world. I pursued a Bachelor of Science degree at Florida International University (FIU), where I laid the foundation for my path in medicine. Growing up across different cultures gave me a unique perspective on people and healthcare. I learned that medicine is not only about treating illness, but also about understanding the stories, challenges, and environments that shape patients’ lives.
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CLAUDIA PEDREIRA, OMS-III (NSU KPCOM - FT LAUDERDALE)
For many immigrant families,including my own, health literacy is not guaranteed. Access to reliable information is often limited by language, cultural barriers, or lack of trust in institutions. In today’s world of medicine, where diseases like polio or measles have faded into memory, many no longer realize the devastation these illnesses once caused. Without that lived experience, vaccines can feel optional instead of essential. As a Cuban immigrant and future DO training in Florida, I feel called to bridge this gap by bringing accurate, compassionate, and culturally competent knowledge to the communities I serve. In this landscape, the words we use are not just descriptors; they shape whether families embrace protection or reject it. As future physicians, we must also recognize the power of our words. Headlines that equate vaccine mandates with “slavery” do not merely invite debate; they distort the truth and undermine the progress of modern medicine. Language shapes lives, and our role is not only to heal the body but also restore meaning to conversations clouded by fear and distortion. Vaccines are not chains; they are shields. The stakes of this debate are not abstract. They are measured in lives. Children are our future, and we must do everything in our power to protect them. When vaccination rates decline, it is children with compromised immune systems, those too young to be vaccinated, and those from families with limited access to healthcare who suffer first. The CDC has documented that measles, one of the most contagious viruses, can cause serious complications, including pneumonia, encephalitis, and even death, with the highest risk among young children and immunocompromised individuals.¹ In 2019, the U.S. experienced its largest measles outbreak in nearly three decades since the disease was declared eliminated, with most cases linked to unvaccinated communities.² Similar patterns are seen globally; the World Health Organization warns that disruptions in routine immunization continue to place children at risk of outbreaks of measles, diphtheria, and polio.³ These examples underscore a simple truth: prevention through vaccination remains one of the most effective tools we have to protect the most vulnerable among us. The question remains: what role should physicians play when political figures misuse medical language? Some argue that doctors should remain neutral, focusing only on clinical care. But neutrality in the face of distortion is not neutrality. It is complicity. Research shows that false news spreads more rapidly, broadly, and deeply than true news online, especially in political contexts. This spread is fueled not by bots, but by human tendencies to amplify novel and emotionally charged content.⁴ As future DOs, we must be guardians of both science and trust. Our responsibility is not just to provide treatment, but to advocate for truth, empower patients with knowledge, and protect communities from the consequences of misinformation. Confronting misinformation is not limited to the clinic alone. We face it at home, in conversations with friends, and everywhere within our community. These discussions are rarely comfortable, but they are essential. Family members who are not in medicine may see headlines or social media posts and repeat them with conviction. In those moments, we must learn that facts alone are not enough; respect and patience must come first. Navigating these tensions with humility is part of what it means to be a future physician: listening, guiding, and planting seeds of truth, even when the soil is resistant. This is the essence of osteopathic medicine. Healing requires not only treating disease but restoring trust, meeting patients where they are, and understanding the social forces that shape their health. Knowledge, delivered with humanity, is its own form of healing.
"Our responsibility is not just to provide treatment, but to advocate for truth, empower patients with knowledge, and protect communities from the consequences of misinformation."
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Health literacy allows individuals to utilize and comprehend health-related information and services. This allows people to be actively involved in their own care and make informed decisions. The goal of health literacy is to provide the public with the framework and knowledge about their care, in hopes of increasing health equity. Different factors affect an individual's level of health literacy, such as education level, socioeconomic status, culture, language, race, and ethnicity. Having limited health literacy is a major barrier to accessing healthcare, especially in marginalized populations. Often, health information is not written at the reading level that individuals belonging to these communities possess. This creates strains while trying to understand medical information that was given to the patient or a family member. The inability of healthcare providers to identify those with limited health literacy creates a dangerous power structure between the patient and the provider. Historically, those with limited health literacy are often taken advantage of due to their lack of knowledge to accurately be aware of what is occurring regarding their health. Focusing on the improvement of health literacy in public populations may lead to the increased use of preventative measures and promote overall health/well-being, ultimately creating better health outcomes for individuals. Despite ongoing efforts to promote equity, many Americans, especially those from underserved or marginalized communities, continue to face significant challenges in navigating the U.S. healthcare system due to low health literacy. These difficulties can result in delayed or inadequate care, worsening health disparities and outcomes. Although recent healthcare reforms have expanded coordinated care initiatives, the complexities of the system remain overwhelming for many. Nearly half of U.S. adults do not fully understand basic health insurance terminology, hindering their ability to make informed decisions about their healthcare. This issue is particularly acute among low-income individuals, racial and ethnic minorities, and non-English-speaking populations who often encounter additional obstacles such as limited numeracy skills and communication barriers. Improving health literacy, especially in financial and insurance-related matters, is essential for empowering patients to navigate the healthcare system with confidence. Enhancing both written and verbal communication between healthcare providers and patients can reduce confusion, increase trust, and promote a more inclusive system. The perception and understanding of health information is inexplicably tied to an individual's cultural context. Therefore, the key to processing how an individual approaches their healthcare is dependent on their race, personal beliefs, cultural identities, and in some cases, religion. Consequently, when there is a dichotomy between cultural norms and healthcare practices, patients cannot pursue adequate care management even with adequate health literacy. On the other hand, there is a link between socioeconomic status and racial disparities, which can contribute to low educational and healthcare management attainment. The framework to spread health literacy to all patients irrespective of race, sex, and gender in a culturally competent manner involves meaningful engagement of patient backgrounds and mindfulness of the patient population being served. The first step consists of enhancing provider-patient communication since healthcare professionals should respect cultural values and norms, offering nutrition and lifestyle guidance that aligns with patients' backgrounds, and approaching questions sensitively to foster understanding. Secondly, care management should include diverse teams to address a vast amount of medical and social needs, provide culturally relevant education, and connect patients with community resources. Finally, efforts should focus on reducing medical jargon, ensuring language accessibility in health materials, promoting diversity in representation, and training the workforce in cross-cultural communication skills. Resources such as the Agency for Healthcare Research and Quality’s Health Literacy Universal Precautions Toolkit provide resources that assess healthcare staff’s current impact on ensuring patient medical understanding and provide ways to improve the quality of communication with patients. As providers, it is essential not to let the education status or wealth of patients lead to bias in determining a patient's health literacy status. To help assess a patient's health literacy, quick surveys such as the Rapid Estimate of Adult Literacy in Medicine can be incorporated into healthcare visits. Incorporating interpretive services and providing written materials in colloquial terms in the patient’s preferred language helps strengthen trust between patient and provider, reducing gaps in the patient’s understanding of their health. Given that many patients with low health literacy come from marginalized backgrounds, it is crucial for physicians to forge meaningful connections with them. Health literacy goes far beyond the walls of the clinic and requires a more holistic approach to patient care. Rather than focusing solely on issues like non-compliance, healthcare providers should recognize and address the barriers that often prevent patients from fully understanding and managing their health. Offering resources such as medication logs, appointment reminder calendars, and visit summaries can enhance a patient’s ability to recall important health information. By integrating these tools into practice, providers can deliver meaningful solutions that lead to improved patient outcomes.
"THE PERCEPTION AND UNDERSTANDING OF HEALTH INFORMATION IS INEXPLICABLY TIED TO AN INDIVIDUAL'S CULTURAL CONTEXT"
From Awareness to Action: Strengthening Health Literacy in Diverse Communities
KAITLYNN ESEMAYA, Alexis Thompson, Annique McLune, Anamaria Ancheta, and Beatrice Odhiambo (BURRELL COM)
"As providers, it is essential not to let the education status or wealth of patients lead to bias in determining a patient's health literacy status"
About the Authors: Kaitlynn Esemaya (OMS IV), Alexis Thompson (OMS IV), Annique McLune (OMS IV), Anamaria Ancheta (OMS III), and Beatrice Odhiambo (OMS IV) are dedicated students attending Burrell College of Osteopathic Medicine with goals of becoming physicians who are skilled and compassionate. These students are passionate about serving underrepresented and underserved communities while deepening their understanding of national and international medical affairs. As writers and editors of the Medical Ethics Newsletter, they are committed to shedding light on critical issues within the medical field. Kaitlynn Esemaya founded the newsletter in 2022 to address past and present medical injustices faced by minority groups. The newsletter aims to educate students, faculty, and healthcare professionals about these ethical concerns, encouraging reflection and discussion on how to create a more just and equitable healthcare system. Each edition of the Medical Ethics Newsletter covers a different topic that explores historical and contemporary ethical dilemmas in medicine. Included in the newsletter are thought-provoking reflection questions, resource recommendations such as videos and books, and other educational tools to help readers deepen their understanding of these complex issues. The newsletter is crucial in preparing future medical professionals to advocate for fairness and inclusivity in healthcare by fostering critical thinking and ethical awareness. Through their dedication to this initiative, Kaitlynn, Alexis, Annique, Anamaria, and Beatrice are not only expanding their knowledge but also giving them the unique ability to inspire their peers to engage in meaningful conversations about ethics, justice, equity, and the responsibilities of medical professionals.
"Hate is a virus" Artist: Abigail Coachie, OMS-II, TouroCOM
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QI & PUBLIC HEALTH
Introduction: New Mexico (NM) averages 450 new cases of melanoma annually. This project aims to determine if promotora education, which empowers community health workers to become patient educators, in NM can improve the recognition of suspicious lesions, encouraging individuals to seek care. Current literature focuses on the self-reported confidence of CHWs in recognizing skin cancer. However, no studies actually test this newfound confidence, which our study aims to accomplish. Methods: 52 promotoras were sampled through a Qualtrics quiz asking whether skin lesion photos are suspicious and to rate their confidence in recognizing suspicious skin lesions and comfort in addressing them from 1 to 5. Participants then read an educational flyer about the “ABCDEs” of melanoma (Asymmetry, Border, Color, Diameter) before repeating the quiz/ratings. Results: The mean number of correct responses increased from 5.9 (pre-quiz) to 6.4 (post-quiz), an 8.47% improvement (p =0.04283). Pre- confidence ratings averaged 2.9 while Post- confidence averaged 3.3, an increase of 13.79% (p=0.0009678). Similarly, pre- comfort levels averaged 3.0 and rose to 3.4 on the post quiz, a 12.18% increase (p=0.0008325). Conclusion: An educational model targeting promotoras significantly improved lesion identification accuracy, confidence, and comfort. Promotoras could be an additional line of defense against melanoma, helping save lives. Other non-physician healthcare personnel could be an ideal future population for education.
Unrecognized Chronic Conditions in Metro-Detroit Populations: Assessing Awareness, Barriers to Care, and Access Gaps through Community Screenings
Introduction: Incarcerated individuals face significant health disparities, including high rates of mental illness, substance use, and chronic diseases. Limited access to care in correctional settings increases avoidable emergency department (ED) use. However, current data on ED use frequency and common conditions among this population are limited. This study examined ED utilization trends, demographics, and common diagnoses in incarcerated individuals to guide healthcare interventions within correctional facilities. Methods: This retrospective cross-sectional study analyzed 2022 Healthcare Cost and Utilization Project (HCUP) data to identify incarcerated individuals. Descriptive statistics characterized demographics, ED visit patterns, and common diagnoses. Results: The sample included 100,034 incarcerated individuals, mostly male (82.5%). Most visits were by White (45.8%), Black (27.3%), and Hispanic (19.4%) patients. Many were from the lowest income quartiles (37.6%) and were uninsured or on Medicaid (28.5%). The top ED diagnoses were nicotine dependence (19.5%), hypertension (18.0%), and hyperlipidemia (13.2%). Other diagnoses included type 2 diabetes (11.9%), chest pain (9.4%), asthma (7.8%), and anxiety disorders (6.7%). Notably, 31% of visits involved injury or suicidal ideation, highlighting high trauma and mental health crisis rates. Conclusion: These findings highlight critical healthcare gaps among incarcerated individuals. Targeted approaches, like smoking cessation, disease management, and integrated behavioral health, may reduce ED visits by addressing the root causes of common presentations and improving ongoing care. Enabling EDs to promptly identify incarcerated patients and guide them to follow-up and preventive resources could further support continuity of care, potentially lowering readmissions and recurring health crises.
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The Potential of Promotoras in Melanoma Detection
Introduction: Language barriers in healthcare contribute to disparities in patient outcomes, particularly among patients with Non-English Language Preference (NELP). Despite growing linguistic diversity, medical students often lack formal training in interpreter use and language-access legislation. This study aimed to enhance professional development by equipping OMS I and OMS II students with foundational knowledge and clinical skills to care for NELP patients. Methods: A quasi-experimental design was used to evaluate a structured medical interpretation workshop. The session included a pre-survey, didactic introduction, expert panel, small group video-based discussion, and post-survey. Content addressed terminology (LEP vs. NELP), interpreter modalities, workforce statistics, and legislative frameworks including Executive Order 13166 and Section 1557 of the Affordable Care Act. Students reflected on clinical scenarios and proposed inclusive strategies. Results: Twenty students completed both pre- and post-surveys. Participants received a score between 0 and 18 based on correct responses to true/false questions. Mean scores increased from 13.65 to 16.1 (p < 0.001), indicating improved understanding of interpreter use, legislation, and ethical considerations. Notable gains were observed in responses regarding interpreter briefing, positioning of physician relative to the interpreter and patient, and legal obligations. Qualitative feedback emphasized increased confidence and awareness of systemic barriers. Conclusion: The workshop significantly improved student knowledge and attitudes toward language equity in clinical care. Participants advocated for annual training, expanded interpreter access, and culturally competent intake practices. This initiative demonstrates the value of structured interpretation education in medical curricula and calls for future integration in OSCE simulation and patient-centered evaluation.
Emergency Department Utilization Among Incarcerated Individuals: A Descriptive Analysis of Demographics and Diagnoses
Sowgand Bashiri, Cinthya Cherian, Grecia Rodriguez Salazar, Hannah Kim,Danielle Fastring PhD William Carey University College of Osteopathic Medicine sbashiri628444@student.wmcarey.edu
Mary Beth Burton, Emily Guseman PhD, Sharon Casapulla EdD Ohio University Heritage College of Osteopathic Medicine – Athens mb191018@ohio.edu
Rania Aqrawi¹, Seema Shah¹, Katherine Urek DO¹, Srikala Yedavally-Yellayi DO¹, Carolina Restini, PharmD PhD FAAPE¹²³ ¹College of Osteopathic Medicine, Michigan State University, Macomb University Center, Clinton Township, MI, USA ²College of Osteopathic Medicine, Michigan State University, Detroit Medical Center, Detroit, MI, USA ³Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI, USA aqrawira@msu.edu
Simran Bhakta, Tyler Peters, Debra Bramblett PhD Burrell College of Osteopathic Medicine, Las Cruces, NM simran.bhakta@burrell.edu
Introduction: Hypertension and diabetes remain leading causes of preventable morbidity, particularly in socioeconomically underserved communities. National data indicates that nearly one in five adults with hypertension and over four in five with prediabetes remain undiagnosed, reflecting persistent diagnostic and access inequities. This study assessed chronic disease awareness, healthcare access, and perceived barriers among adults attending Community Integrated Medicine (CIM) screenings in Metro-Detroit. Methods: A cross-sectional observational survey (N=20) was administered during CIM community health fairs (IRB_ID:STUDY202500493). Participants underwent standardized measurements for blood pressure, glucose, HbA1c, BMI, and vision, followed by a structured questionnaire evaluating health awareness, access to care, nutrition, and whole-person wellness. Results: 50% of participants were overweight or obese (BMI 25.1–40.8), 38% had elevated systolic blood pressure (130-144) or diastolic blood pressure (80-90), and 40% demonstrated abnormal glucose (105-142 mg/dL) or A1c (6.4% - 8.9%) levels. Only 45% reported prior awareness of a chronic condition, and 40% had a primary care provider. Reported barriers included cost (35%), transportation (15%), and occupational/family constraints (10%). Over 35% experienced food insecurity, and 40% reported limited physical activity. Conclusion: Findings reveal a high prevalence of unrecognized cardiometabolic risk factors and socioeconomic barriers to care. Student-led, community-based screenings serve as effective models for early detection and engagement of underserved populations. Expanding bilingual education, affordable referral pathways, and preventive health literacy initiatives may enhance disease recognition and reduce inequities.
CASE REPORTS
Enhancing Language Equity in Medical Education: A Quasi-Experimental Workshop on Medical Interpretation
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Alexis Desany, Holly Griffith, Karolin Markarian, Amanda Scalmanini, Nikoleta Vasileva, Sherli Koshy Chenthittayil PhD Touro University Nevada College of Osteopathic Medicine adesany@student.touro.edu
Introduction: The media has been shaping public perception of nicotine use for decades. From Joe Camel to the Centers for Disease Control and Prevention’s “Tips From Former Smokers,” young consumers have been a large target. The rise of TikTok and influencers has given Gen Z users access to a broad spectrum of information about nicotine use. This project explores the current information shared on TikTok about three different nicotine products-Zyns, vapes, and cigarettes. Methods: Seventy-five TikTok videos (25 per nicotine product) were collected based on the number of likes, to capture content with the greatest audience engagement. Each video was analyzed for creator type (influencer, health professional, or general user) and tone (positive, negative, or neutral) to evaluate patterns in nicotine-related messaging on TikTok. Results: This study highlights TikTok as a major platform for nicotine-related content, with messaging dominated by influencers and general users rather than health professionals. Vaping-related content generated the greatest engagement, though it was framed negatively, while Zyn-related content demonstrated lower visibility and a more balanced tone. Conclusion: By understanding the messages reaching the general public, and the creators propagating the information, we can determine TikTok’s effect on the health behaviors of young social media users. TikTok plays a significant role in shaping young audiences’ perceptions of nicotine products, yet health professionals are largely absent from social media conversation. The prevalence of influencer-driven content raises concerns about misinformation.
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Increased Patient Utilization of a Community Resource Desk Following Patient Education Regarding How to Obtain Resource Assistance
Introduction: Depression and loneliness have been linked to cardiovascular disease (CVD), but few studies explore their combined impact. A 2022 AHA statement identified loneliness as an independent CVD risk factor, while depression has been tied to elevated atherosclerotic cardiovascular disease (ASCVD) risk. This study examined relationships between UCLA Loneliness scores, PHQ-9 depression scores, and ASCVD risk in patients at a South Carolina free clinic to determine if correlations could be found. Methods: Thirty-one English-speaking adults aged 20–64 with a recent lipid panel completed the PHQ-9 and UCLA Loneliness Scale as part of this cross-sectional correlational study. Scores were calculated per standard guides, and 10-year and lifetime ASCVD risks were computed using online ASCVD calculators. De-identified data were analyzed in Excel for correlations, scatter plots, and regressions. Results: Data from 30 participants, excluding one outlier were analyzed. Multiple regression revealed PHQ-9 and UCLA scores had a moderate, significant effect on total cholesterol (R=0.51, p=0.017). Stratification by statin use revealed no significant correlations. PHQ-9 and UCLA scores correlated strongly (R=0.66, p<0.001). Associations with 10-year and lifetime ASCVD risk were weak and nonsignificant. Conclusion: No significant link was observed between psychosocial scores and ASCVD risk, likely due to small sample size. However, the significant association with cholesterol suggests depression and loneliness may influence cardiovascular health. Larger studies are warranted and should focus on the psychosocial impact on diet and exercise. Additionally, future studies should include non-English speakers and patients 65 years and older.
Melisa Fletes, Sofia Ferrezza, Brenda Canine PhD, Heather Harvey DrPH Touro College of Osteopathic Medicine - Montana Campus mfletes@student.touro
Influence and Perception: Nicotine on TikTok
The Impact of Wildfire Smoke Exposure on COPD Outcomes in Montana
Introduction: It is established that social determinants of health (SDOH) like food, housing, and transportation are critical to a person's health status. A community health center (CHC) in Northern Arizona used a community resource desk (CRD) called “Health Partners”, staffed by college students whose role is to talk to patients about SDOH and provide information about appropriate community resources to address identified needs. We aimed to increase awareness and utilization of the Health Partners program by implementing a marketing campaign to educate patients that resource assistance is available, ultimately addressing SDOH and improving overall well-being for community health center patients. Methods: Posters (96), brochures (200), and prescription pads (40) (English and Spanish) advertising the resources offered by the CRD were displayed throughout the clinic. Project participants were all patients who utilized the CRD within a 10-week time frame after marketing implementation. Results: There were 36 encounters and 29 individuals in the spring 2024 and 63 encounters and 43 individuals in the spring 2025 who utilized the CRD desk for a total of 99 encounters and 72 individuals. There was a statistically significant increase in utilization averaging 3.6±2.2 visits/week in 2024 and 6.3±3.2 visits/week in 2025 (p-value 0.04). Conclusion: The CRD is a beneficial but historically underutilized resource. Our marketing intervention demonstrated that when patients are given the knowledge to help themselves and address barriers to their care, they act on it.
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in Montana, where wildfire frequency and severity have risen in recent years. Smoke from wildfires, rich in particulate matter and pollutants, may exacerbate respiratory illness, particularly in rural communities with limited access to care. This study evaluated the relationship between wildfire exposure and COPD prevalence in Montana from 2018 to 2021. Methods: Wildfire data were obtained from the Montana Legislature Fiscal Division, and COPD prevalence estimates were sourced from the Centers for Disease Control and Prevention (CDC). Analyses included a one-tailed t-test to assess associations between wildfire events and COPD prevalence, Cohen’s d to measure effect size, and odds ratios to estimate risk. Residual normality was confirmed with a Q–Q plot. Statistical significance was defined as p < 0.05. Results: The t-test showed a significant association between wildfire frequency and COPD prevalence (t = 3.373, p = 0.0004). Cohen’s d (0.289) indicated a small effect size. Odds regression revealed a 2% increased COPD risk in wildfire-exposed areas (OR = 1.02), though prevalence declined in 2019 (OR = 0.93). Conclusion: Wildfire exposure is associated with higher COPD prevalence in Montana. Even small increases in disease burden can strain rural communities with limited healthcare access. These findings highlight the need for wildfire preparedness, targeted interventions, and policies to protect vulnerable populations in Montana.
Exploring the Association Between Loneliness, Depression, and Heart Disease Risk in a Free Medical Clinic
Bailey Cook, Christian Weeks, Laken Fulmer, Mary Price, Lisa Carroll MD Edward Via College of Osteopathic Medicine- Carolinas’ Campus acook01@carolinas.vcom.edu
Aya Andos, Lauren Hays, Camilla Freestone, Donna Cottrell, Yash Sanghvi, Sultan Akbar, Tiffany Harmanian, Benjamin Hewson, Surekha Appikatla BDS MPH, Joy H. Lewis DO/PhD, Chad Taylor DO A.T Still University School of Osteopathic Medicine sa210864@atsu.edu
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Bridging the Knowledge Gap: Patient Misconceptions About Radiation in Medical Imaging
Navneet Kaur1, Lan Nguyen1, Abigail Colwell1, Olympia Swaby1 , Thomas Miller DO2 1Touro COM - Montana Campus 2Primary Care Department nkaur16@student.touro.edu
Skin cancer education among community health workers
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Public Perception of Osteopathic Manipulative Medicine as an Effective Treatment for Musculoskeletal Disorders: A National Survey Study
Krina D. Patel, Nadiya A. Persaud, Sapna Rama DO Orlando College of Osteopathic Medicine kpatel1@students.ocom.org
An Investigation into Medical Students Access to Primary Health Care
Introduction: Community Health Workers (CHWs) are public health workers that are not medically trained but support clinical activities. Their effectiveness in correctly identifying lesions suspicious for melanoma is critical as melanoma incidence continues to rise. This study evaluates CHWs’ foundational knowledge in melanoma recognition and confidence in communication about skin health in New Mexico and Florida. Methods: We distributed a three-part Qualtrics survey to CHWs in New Mexico and Florida. The first part included a 16-question pre-questionnaire regarding CHW demographics, assessment of melanoma recognition, confidence, and comfort in communication about skin health. The second part consisted of an educational ABCDE flyer on melanoma. It concluded with a post questionnaire re-evaluating skills and attitudes. Inferential statistics, including standard t-tests, were used to compare variables. Results: Pre- vs. post-quiz scores showed significant improvement in comfort (p= 0.0046) and confidence (p= 0.0006). Differences between New Mexico and Florida overall score improvements were not significant (p= 0.395). Data collection is ongoing to compare additional variables. Conclusion: We expected higher baseline melanoma recognition and confidence among Florida CHWs, as their state’s higher incidence provides greater exposure and experience with melanoma, guiding their recognition of such lesions. Contrary to expectations, pre- vs. post- quiz scores did not show significant improvement, likely reflecting a higher baseline knowledge of melanoma in Florida, leaving little room for improvement. However, improvement in comfortability and confidence demonstrated that our flyer enhanced perceived self-efficacy. Future goals include exploring additional strategies to improve CHW dermatological knowledge and help bridge gaps in community skin healthcare.
Introduction: Medical imaging plays a critical role in diagnosis and management across healthcare settings, yet misconceptions about radiation exposure are common among all patient populations. Prior studies suggest that patients often lack knowledge about which imaging modalities use ionizing radiation, contributing to anxiety, avoidance, and unrealistic expectations. This study aimed to evaluate community awareness of imaging procedures, focusing on beliefs about radiation exposure. Methods: We conducted a retrospective cross-sectional survey of 50 community participants at a single-center hospital. An anonymous questionnaire collected data on education level, prior imaging experience, and knowledge of radiation use in common imaging modalities, including X-ray, CT, MRI, and ultrasound. Responses were analyzed descriptively, and associations with education level were examined. Results: Among respondents, 82% incorrectly believed that MRI uses ionizing radiation. X-rays were most frequently perceived as the imaging modality with the highest radiation exposure, followed closely by CT scans. Only 30% of participants reported receiving detailed counseling about imaging risks and benefits, while 28% reported little to no counseling. Misconceptions were present across all education levels, with no significant association between education and the accuracy of knowledge regarding MRI radiation use. Conclusion: This study highlights a community-wide gap in awareness regarding radiation exposure from medical imaging. Misunderstandings were not limited to individuals with a certain level of education, suggesting the need for broader patient education strategies. Improved communication by healthcare providers may reduce unnecessary anxiety and increase compliance with recommended imaging. Future research should explore targeted educational interventions to address these persistent misconceptions.
Introduction: Osteopathic Manipulative Medicine (OMM) is increasingly recognized as a non-invasive, evidence-based treatment option for musculoskeletal disorders (MSDs). However, public perceptions and understanding of OMM remain limited. This study aimed to assess public perception of OMM and its effectiveness in treating MSDs, with the ultimate goal of informing strategies to enhance understanding and utilization of osteopathic principles. Methods: A nationwide, cross-sectional survey was conducted among 174 U.S. adults aged 18 and older using Random Device Engagement (RDE) sampling. The 12-item questionnaire evaluated demographics, awareness of OMM, perceived effectiveness, and personal experience with OMM treatment. Results: Most respondents first learned about OMM through healthcare professionals (61.7%). Perceptions were favorable, with 59.4% open to using OMM and 87.0% of prior users willing to recommend it. Common treatment areas included back pain (40.2%) and neck pain (33.3%). Key perceived benefits were improved mobility (74.1%) and pain relief (69.6%). Conclusion: Findings reveal positive perceptions of OMM for musculoskeletal disorders among informed individuals but highlight public knowledge gaps. This study emphasizes the need for education promoting OMM as a safe, evidence-based, noninvasive initial alternative to traditional pharmacological treatments. Results support integrating osteopathic principles into mainstream care, reducing opioid reliance, and guiding future research on the broader clinical applications of OMM.
Alessandra Merenna,Natalie Govea, Britany Hartshorn, Michelle Moye, Elizabeth Robbins, Alexa Ware, Debra E. Bramblett PhD Burrell College of Osteopathic Medicine alessandra.merenna@burrell.edu
Introduction: Healthcare utilization by medical students is underexplored, despite their knowledge of preventive care. Students are expected to model healthy behaviors, including regular primary care visits. However, most studies on this topic are outdated, non-US based, or focus solely on mental health, lacking clarity on general health management. This study examines utilization patterns, access, and barriers among first- and second-year osteopathic medical students across Touro College of Osteopathic Medicine (TouroCOM) campuses. Methods: A cross-sectional survey was administered to 108 OMS-I and OMS-II students at TouroCOM Great Falls, California, Middletown, and Harlem, with 90 responses. The survey measured primary care visit frequency, importance, access, and barriers. Responses were analyzed descriptively. Results: Of 90 respondents (44 OMS-I, 46 OMS-II), 78 participants were aged 21–30. While 80% rated primary care as highly important, only 62% reported their own annual visits. Main barriers included time constraints and insurance, particularly for 50% of those aged 31–40. No significant associations were found between age, campus, or visit frequency. Conclusion: Although medical students recognize the importance of primary care, many do not consistently engage with the healthcare system as patients. While this study did not yield significant findings – scheduling, insurance complexity, and provider availability likely affect access. Future research should explore larger sample sizes and include third- and fourth-year medical students, and incorporate qualitative methodologies to capture more nuanced, campus-specific barriers and experiences. Identifying gaps in access as medical students progress through their training may help develop tools that improve both their health behaviors and their understanding of future patients’ behaviors.
Lipi Patel1, Shiv Patel DO2 1Touro College of Osteopathic Medicine - Middletown 2Department of Family Medicine, Garnet Health Medical Center, Middletown, NY lpatel2@student.touro.edu
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Introduction: Thoracic trauma is a significant cause of morbidity and mortality in the United States. Blunt and penetrating injuries differ in both presentation and outcomes, with penetrating trauma often resulting in rapid death and blunt trauma leading to prolonged hospitalization. However, limited large-scale data describe hospital length of stay (LOS), specifically among patients who die during admission. This study aimed to use the National Trauma Data Standard (NTDS) for comparison of LOS among trauma deaths by mechanism of injury (MOA). Methods: A retrospective review of 10 million trauma cases from the NTDS between 2012 and 2023 was conducted. Comparisons were made between blunt and penetrating thoracic injuries and further stratified by MOA, including motor vehicle collisions (MVCs), falls, gunshot wounds (GSWs), and stabbings. Patients with a discharge disposition indicating death were included. LOS was standardized across reporting years, with implausible or negative values corrected. Results: Across all study years, penetrating trauma deaths demonstrated shorter hospital stays compared to blunt trauma deaths. Median LOS for penetrating injuries was consistently <2 days (GSWs <1 day; stabbings 1–2 days), whereas blunt trauma deaths showed longer courses (median 3–6 days; MVCs ~5 days). These trends were consistent across years, with blunt trauma demonstrating greater variability and occasional prolonged ICU stays. Conclusion: Patients die rapidly following penetrating trauma, requiring fewer inpatient resources, while blunt trauma deaths involve longer hospitalizations before death. These findings highlight differences in resource utilization and may inform trauma system planning and critical care management. Future studies should evaluate how injury severity, surgical interventions, and complications influence LOS among trauma deaths.
INTERESTED IN BECOMING AN EDITOR FOR THE FUTURE DO?
Length of Stay Among Thoracic Trauma Deaths: Blunt vs. Penetrating Injuries
Dalia Shaaban1, Andrew McCague DO2 1Touro College of Osteopathic Medicine - Montana 2Desert Regional Medical Center dshaaban@student.touro.edu
The Future D.O. Research Magazine is looking for new members to join the 2026–2027 Editorial Board! This is an exciting opportunity for osteopathic medical students interested in research, medical writing, peer review, and publication design. Editorial Board members play a key role in shaping each issue of The Future D.O. by: Scoring and editing abstract submissions Providing editorial feedback to student authors Applying graphic design and creative skills to help assemble and format the magazine Gaining insight into the academic publishing and peer-review process Whether you’re passionate about research, storytelling in medicine, or visual design, there’s a place for you on our team. Stay tuned for application announcements via SOMA Weekly Or visit www.studentdoresearch.org for updates and additional information We look forward to receiving your applications and welcoming the next group of student leaders to The Future D.O. Editorial Board!
Bethany Powers DO, Christian Weeks, Paula Lisazo, Cheryl Monson RN; Lisa Carroll MD Edward Via College of Osteopathic Medicine - Carolinas Campus czweeks@gmail.com
Introduction: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that mimics severe sepsis, delaying definitive therapy. This case presents an adult with sepsis-like presentation who rapidly fulfilled multiple HLH-2004 features, highlighting the importance of early recognition. Patient Description: A previously healthy male in his 20s presented with 6 days of fever, myalgia, nausea, vomiting, and diarrhea. He was febrile and tachycardic on arrival. Past history was notable for obesity and occupational livestock exposure. Findings: Lab results showed leukopenia, thrombocytopenia, coagulopathy (elevated PT/INR/PTT, low fibrinogen), transaminitis (AST >2000U/L), AKI (Cr ~3.0mg/dL), hypertriglyceridemia (>3000mg/dL), and hyperferritinemia (~33,500ng/mL). Blood, CSF cultures and meningitis/encephalitis PCR were negative. Nasopharyngeal PCR detected rhinovirus/enterovirus. Chest X-Ray revealed bilateral pulmonary opacities with small effusions while abdominal CT demonstrated hepatosplenomegaly, ascites, and anasarca. Treatment/Intervention: Broad-spectrum antibiotics were initiated during infectious workup. DIC was supported with FFP/cryoprecipitate. Meeting several HLH-2004 criteria by hospital day 6 and 7 (fever, cytopenias, hypertriglyceridemia, hyperferritinemia, organomegaly), the patient was given dexamethasone plus etoposide. Insulin infusion addressed severe hypertriglyceridemia. The course was complicated by atrial fibrillation with RVR and suspected seizures; Posterior Reversible Encephalopathy Syndrome was considered. Transfer to a tertiary center was arranged. Discussion/Conclusion: This case underscores that “culture-negative sepsis” with cytopenia, elevated ferritin and triglycerides, and organomegaly should trigger immediate HLH evaluation. While a broad infectious work-up is still essential, HLH treatment should not be delayed when this criteria is met.
Sandi Assaf1, Daniel Cano MD2 1Sam Houston State University College of Osteopathic Medicine 2Internal Medicine at Citizens Medical Center ska029@shsu.edu
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Introduction: Tumor lysis syndrome (TLS) is a serious medical condition in which the lysis of tumor cells results in a variety of abnormalities including elevated uric acid, potassium, phosphorus, decreased calcium, seizures, arrhythmias, and acute kidney injury (AKI). TLS most often occurs in hematologic cancers and after chemotherapy, whereas cases that arise without chemotherapy are termed spontaneous TLS (STLS). Patient Description: An 81 year old female with a PMH of HTN and COPD initially presented to the ED for left lower back pain. Her hospital stay was complicated by a worsening AKI that was refractory to fluids and the discontinuation of nephrotoxic medications. Findings: Biopsy of a bony metastatic lesion in the patient's left iliac crest, initially detected by CT, confirmed a neuroendocrine tumor of the lung, consistent with a separate mass appreciated on lung CT. Uric acid, urine studies, lactate dehydrogenase and metabolic panel ruled out other causes of her kidney injury and ruled in a diagnosis of STLS . Treatment/Intervention: The patient was started on fluids, rasburicase, sodium bicarbonate, lokelma (potassium binder), and sevalamer (phosphate binder). A goals of care discussion revealed that quality of life was most valued. Therefore, she opted for inpatient hospice care with comfort measures only. The patient died 14 days after her initial presentation to the hospital. Discussion/Conclusion: Although the majority of TLS cases originate from hematologic malignancies and in response to chemotherapy, STLS should be considered in refractory AKI in cancer patients, particularly small cell lung cancer (SCLC).
Incorporating Osteopathic Manipulative Treatment in Electrical Hand Injury Care: A Case Report
Sepsis-Like Multiorgan Failure Revealing Secondary HLH in a Young Adult
Pityriasis Rubra Pilaris Associated with HIV and Syphilis: A Case Report
Introduction: Pityriasis rubra pilaris (PRP) is a rare chronic papulosquamous disorder characterized by follicular hyperkeratosis, erythematous plaques, and palmoplantar keratoderma. An HIV-associated subtype (Type VI) has been described, often presenting more severely and with poorer response to conventional therapies. Co-infections may further complicate disease course and management.1-3 Patient Description: A 38 y.o. male with no known past medical history presented with diffuse erythematous plaques, islands of sparing, and scaling consistent with PRP. He had limited prior medical care. Workup revealed newly diagnosed HIV infection and reactive syphilis serology. Findings: Examination showed diffuse erythematous plaques with islands of sparing, palmoplantar hyperkeratosis, onychomycosis, and scattered papules on the extremities and abdomen. MRI of the left foot demonstrated cellulitis without abscess or osteomyelitis; wound cultures grew Staphylococcus aureus. Laboratory results revealed HIV positivity, reactive RPR confirming Treponema pallidum infection, and histopathology consistent with PRP—showing follicular plugging, alternating ortho- and parakeratosis, and psoriasis form hyperplasia. These findings supported the diagnosis of HIV-associated PRP in the setting of syphilis co-infection. Treatment/Intervention: Initial empiric therapy with vancomycin and terbinafine was discontinued after confirmation of PRP. The patient received doxycycline for MSSA cellulitis, intramuscular penicillin G for syphilis, and was referred for antiretroviral therapy initiation. Dermatology follow-up was arranged for topical and systemic management. Discussion/Conclusion: HIV-associated PRP tends to occur in younger individuals than classic PRP and can present with more severe, refractory disease.2-4 Co-infection with syphilis emphasizes the importance of comprehensive infectious evaluation. Early recognition of PRP and coordinated multidisciplinary management are essential to optimize outcomes.
Spontaneous Tumor Lysis Syndrome in a Metastatic Neuroendocrine Tumor of the Lung: A Case Report
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Jonathan L Graber1, Marina Makram DO2, Elie Joseph El-Charabaty MD2 1Touro College of osteopathic Medicine - Harlem 2Northwell Health - Staten Island University Hospital jgraber2@student.touro.edu
Introduction: Electrical burns present unique diagnostic and therapeutic challenges with variable injury patterns. While care often prioritizes wound management and systemic complications, limited literature exists on osteopathic manipulative treatment (OMT) for functional impairments following electrical injury. Patient Description:A 44-year-old male presented to a free clinic in Upstate South Carolina with entry and exit wounds on the medial and palmar aspects of his left hand after an electrical burn. He reported pain in the palmar wrist and digits one and two, which impaired daily activities and work. His history included prior musculoskeletal injuries from a motor vehicle accident. Findings: A physical exam revealed tenderness at the wrist with carpal-tunnel-like features, identified by a positive carpal compression test. Somatic dysfunctions in the thoracic and lumbar vertebrae were identified in the trunk, likely related to the fall sustained during the incident. An electrocardiogram showed no cardiac abnormalities, suggesting limited systemic current travel. Treatment/Intervention: In addition to wound care, OMT techniques, including lymphatic drainage and musculoskeletal treatments (muscle energy, myofascial release, and HVLA), were provided over five sessions in two months. Techniques were chosen in accordance with the patient’s comfort level. Initially, direct manipulation of his palm was avoided to protect suture integrity. As healing progressed, techniques like opponens roll advanced closer to wound sites. The patient reported improved hand mobility, decreased soreness, and enhanced functional activity, including piano playing. Discussion/Conclusion: This case highlights OMT’s potential as safe adjunctive therapy to promote healing, restore function, and address somatic dysfunctions in patients who have suffered from electrical burns. Although pain improved, persistent carpal-tunnel-like symptoms such as numbness and tingling suggest continued OMT with further interventions as needed to possibly reduce inflammation, thereby reducing burden on the median nerve.
Julienne Zhou MS1, Raquel Wescott MD2, Sara Azim MD2, Ramesh Nathan MD2 1Touro University Nevada College of Osteopathic Medicine 2Los Robles Medical Center, Thousand Oaks, CA jzhou5@student.touro.edu
LITERATURE REVIEWS
Introduction: Women experience a greater occurrence of adverse health outcomes due to an increase in sensitivity to anesthetic agents. Sex-based differences in pharmacodynamics and pharmacokinetics (PD/PK) of anesthetic agents account for these adverse health outcomes because sex is not included as a direct variable in conventional anesthesia dosing. Target-Controlled Infusion (TCI) systems personalize anesthesia dosing through precise PD/PK modeling. The adoption of TCI in the United States warrants further study by the U.S. Food and Drug Administration (FDA). Our study explores the technological and research-based progress required for TCI systems to meet FDA safety standards. Methods: A literature review was conducted in PubMed, Google Scholar and other databases. A total of 11 articles were reviewed. Search terms included: “Sex-based Disparities in Anesthesia Dosing”, “TCI Models”, and “Eleveld Model”. Results: We investigate limitations in previous TCI models like the Schnider and Marsh models. Their lack of FDA approval was due to limited generalizability and the need for standardized clinical protocols. Use of advanced TCI models, such as the Eleveld model, improves generalizability and integrates covariants, including sex-specific PD-PK variability. However, the model lacks a built-in dose monitoring system in real time to adjust for anesthetic dose delivery. Real time Bispectral Index (BIS) monitoring measures anesthetic depth, avoiding the underdosing or overdosing of anesthesia in patients. Conclusion: The Eleveld Model has the potential to gain FDA approval through integrating real time BIS monitoring. In addition, advocating for targeted clinician training to address sex-based disparities in anesthesia delivery is necessary to promote patient-centered care.
The Role of ACE Inhibitors in Managing Cardiac Complications in Pediatric Duchenne Muscular Dystrophy: A Literature Review
Zehra Abbas, Fizza Abbas, Minahil Humayun, Ayham Alkiswani, Blaine Jacobs PhD The University of the Incarnate Word School of Osteopathic Medicine zabbas@student.uiwtx.edu
"The Modern Medicine Cabinet" Artist: Hunter Parker, OMS-III, Touro COM - Middletown
Introduction: A gap in literature exists for the best therapeutic interventions of major manifestations of Duchenne Muscular Dystrophy (DMD). This literature review highlights the significance of early diagnosis and key intervention of Angiotensin Converting Enzyme Inhibitors (ACEi’s) in DMD, specifically their efficacy towards delaying myocardial fibrosis (MF), decreasing risk of heart failure, and maintaining Left Ventricular Ejection Fraction (LVEF). Methods: Key terms used included ARBs, childhood mortality, cardiomyopathy, lisinopril, losartan, and childhood muscular dystrophy. The Yale MeSH analyzer enhanced the search. The search string was applied to PubMed, JSTOR, ScienceDirect, and Still One Search. Zotero screened for doubles or papers that did not pertain to ACEi usage in DMD-related cardiac complications. Results: Treatment with ACEi’s exhibited significantly delayed progression of MF, with one longitudinal study showing preservation of ejection fraction in the setting of MF. ACEi’s also lowered mortality for dilated cardiomyopathy (DCM) in the setting of DMD. One study displayed a survival rate of 100% at 1 year, 87.5% at 3 years, and 70% at 5 years. In Left Ventricular (LV) dysfunction, ACEi therapy alone at early stages of DMD improved stroke volume and cardiac output, reduced maximum systolic pressures, and positively affected in vivo left ventricular calcium homeostasis. Another study showed ACEi’s increased ejection fraction from 36±11% to 53±12%. Conclusion: Addressing early markers of DMD like tissue remodeling and LV dysfunction helps delay the natural progression of DCM associated DMD. Using ACEi’s in DMD optimizes long-term cardiac outcomes and quality of life, as they can reshape the trajectory of DMD-associated cardiomyopathy, myocardial fibrosis, and LV dysfunction.
Sex-Related Disparities in Anesthesia Dosing: The Role of Target-Controlled Infusion and Physician Education in Providing Equitable Care
Janette Chammas, Nageen Ahmad, Jewel Nicole Reaso, Danish Javed MD A.T Still University School of Osteopathic Medicine nageen.ahmad@atsu.edu
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Introduction: While the relationship between psychological stress and vision or hearing loss was reported independently, whether stress affects vision and hearing through shared biological impact is largely unexplored. This study aims to systematically summarize current evidence on how stress contributes to visual and auditory dysfunction through shared mechanisms and to illustrate evidence-based interventions that may mitigate these effects. Methods: A literature review was conducted on publications from 1993 to 2025. Conditions examined included glaucoma, age-related macular degeneration (AMD), and sensorineural hearing loss (SNHL). Selected articles focused on stress-related mechanisms affecting vision or hearing in humans, and/or investigated the role of stress reduction modalities in these pathological vision and hearing conditions. Results: Chronic stress contributes to neurovascular dysregulation, increased oxidative damage, and immune imbalance, all of which are implicated and shared in the progression of visual and auditory diseases. Evidence suggests that stress may exacerbate glaucoma, AMD, and SNHL, while sensory impairment itself can amplify psychological stress, forming a detrimental feedback loop. Emerging data indicate that mindfulness-based stress reduction (MBSR) and other stress management interventions may reduce intraocular pressure, improve vascular perfusion, and alleviate tinnitus-related symptoms. Conclusion: Psychological stress plays an important role in the progression of vision and hearing dysfunctions, possibly through shared mechanisms. Future research should focus on parallel longitudinal studies on vision and hearing loss to directly investigate these shared mechanisms of stress and assess the efficacy of stress-reduction therapies in preventing or slowing dual sensory decline. The possible bidirectional relationship between stress and sensory health highlights the need for integrated care models that combine medical management with behavioral interventions.
Introduction: Gardner–Diamond Syndrome (GDS), or psychogenic purpura, is a rare psychodermatological condition characterized by recurrent and painful ecchymoses triggered by psychological stress. Despite first being described nearly 70 years ago, its etiology remains poorly understood and is often misdiagnosed. This review examines numerous stress-related triggers, neuroimmune mechanisms, and management strategies better to define the mind–skin relationship central to GDS. Methods: Narrative review of literature from 1955–2025 included any articles describing GDS presentation, pathophysiology, diagnosis, treatment, or outcomes. Database searches identified sources and reference chaining without language, age, or geographic restrictions. This broad search yielded 82 results. Results: Findings indicate that 70–76% of GDS patients experience acute emotional stress preceding purpura. Major depressive and anxiety disorders were present in over half of reported cases. Cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) achieved remission in 71% of patients at one year. At the same time, integrated dermatology-psychiatry models demonstrated improved quality of life and reduced recurrence of symptoms. Conclusion: GDS illustrates the bidirectional influence of stress on cutaneous immune function. Psychoneuroimmunologic dysregulation involving the HPA axis, mast cell activation, and neuropeptides most likely contributes to lesion formation. Multidisciplinary management, which includes combining dermatologic, psychiatric, and behavioral interventions, remains the most effective approach. Future research should establish standardized diagnostic criteria and explore biomarkers for stress-induced dermatoses.
The Bidirectional Associations Between Stress and Sensory Loss
Psychodermatological Perspectives on Gardner–Diamond Syndrome: Stress-Triggered Purpura, Neuroimmune Crosstalk, and Multidisciplinary Care
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Introduction: Effective management of chronic conditions relies heavily on medication access and adherence, both of which are significantly determined by the social determinants of health (SDOH). Although medication non-adherence costs the U.S. over $300 billion annually, interventions often focus on patient factors and overlook systemic SDOH barriers.This "integration gap" contributes to persistent health disparities and stalls progress in chronic disease management. This narrative review synthesizes evidence across the five CDC-defined SDOH domains to create a framework for understanding how these factors impede medication access and adherence for adults with chronic illnesses in the U.S. Methods: A narrative review was conducted using PubMed, Scopus, and Web of Science to identify studies published between 2010 and 2025 examining associations between SDOH and medication access or adherence. Studies were categorized under the five SDOH domains. Both quantitative and qualitative study types including systematic reviews, observational studies, and case reports were included. Results: Economic instability was the primary driver of cost-related nonadherence, forcing patients to ration essential therapies. Neighborhood inequities, particularly "pharmacy deserts" and rural hospital closures, created significant physical access barriers. While strong provider trust improved adherence, low health literacy was a key barrier linked to medication errors. Finally, multidisciplinary healthcare models showed promise for improving outcomes. Conclusion: This review finds that strengthening social support networks and provider relationships, expanding equitable healthcare infrastructure, and promoting health literacy are critical to improve medication access and adherence, especially in underserved populations. These strategies can close systemic care gaps and foster sustainable, patient-centered chronic disease management.
Beauty or Biohazard? Microbial Contamination in Shared Makeup Testers and Public Health Implications: A Narrative Review
Maryam Babar; aymen Arain, MS Edward Via College of Osteopathic Medicine - Louisiana mbabar@vcom.edu
Conghui Chen1, Kevin C. Chan PhD2, Yingzi Xiong PhD3 1Ohio University Heritage College of Osteopathic Medicine 2Stanford University 3Johns Hopkins University cc973124@ohio.edu
Cyril Blavo DO/MS/MpH/TM/FACOP, Rachel Amsellem, London Danchulis, Dakota Taylor, Mayur Parmar PhD/BPharm/Ms Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine ra1533@mynsu.nova.edu
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Aymen Arain, MS1; Maryam Babar1; Vaishnavi Tetali2; Klea Ahmet, MS3; Sam Nader4; Arisha Arain5; Muhammad Hussain, MS6; Danny Lee, md7 1Edward Via College of Osteopathic Medicine – Louisiana Campus 2Texas College of Osteopathic Medicine 3Nova Southeastern University's Dr. Kiran C. Patel College of Allopathic Medicine 4Touro College of Osteopathic Medicine 5Wayne State University School of Medicine 6Windsor University School of Medicine 7Department of Medicine, University of California San Francisco aarain@vcom.edu
Social Determinants of Health: Impact on Medication Access and Adherence
Introduction: Cosmetic testers in retail environments are widely used by consumers to sample products before purchase. However, these shared-use items are often exposed to repeated handling without sanitation protocols, creating potential reservoirs for microbial contamination. Despite this risk, little is known about the microbial profiles of in-store testers or their implications for consumer health. This review explores microbial contamination in shared makeup testers, identifies commonly isolated organisms, examines associated clinical risks, and highlights key regulatory and research gaps. Methods: 10 articles of peer-reviewed literature were identified through PubMed searches using terms such as “cosmetic contamination”, “public testers”, and “pathogens in makeup”. Articles on personal-use cosmetics, salon-shared products, preservative efficacy, and regulatory policies were reviewed to provide context. No formal inclusion/exclusion criteria or systematic review protocol was applied. Results: Opportunistic pathogens like Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, and Bacillus species have been found in both personal and shared cosmetics, including unopened items. Contamination is notably higher in communal-use settings like salons. Despite this, no studies have assessed microbial loads or infection risks from public makeup testers. Vulnerable users face heightened risks of infection. Regulatory oversight remains minimal, with no mandated sanitation, expiration tracking, or microbial testing for testers. Conclusion: Public makeup testers may serve as unrecognized vectors for microbial transmission and infection. Research is needed to evaluate the safety of these products in real-world settings and to establish evidence-based hygiene protocols. Recognizing the clinical relevance of this issue is essential for guiding future policy, public health measures, and consumer education in cosmetic safety.
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Rushil Mehrotra Touro College of Osteopathic Medicine Montana rmehrotra@student.touro.edu
Ariana Kaxon-Rupp*1, Ahana Chakraborty*1, Naiomi Desai*1, Reena Lamichhane Khadka PhD1, Gisou Mohaddes, PhD1 1California Health Sciences University College of Osteopathic Medicine *EQUAL CONTRIBUTION kaxon-rupp2582@chsu.edu
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#Skincare: A Review of the Influence of TikTok on Dermatology
Psilocybin-Assisted Musical Therapy: A Novel Integrative Approach for Narcissistic Personality Disorder
Taylor Glanz1, Kassidy Patton1, Erica Noe1, Lynne Graves Stephenson MSEd2 1Rocky Vista University College of Osteopathic Medicine 2Library Services, Rocky Vista University kassidy.patton@ut.rvu.edu
Introduction: Abortion is one of the most common yet underacknowledged reproductive experiences. Nearly one in four U.S. women undergo the procedure by age 45 yet over 70% of abortions go unreported and two-thirds are rarely – or never – disclosed in clinical contexts. This nondisclosure poses challenges to patient safety and research integrity. This review examines current literature to understand how abortion nondisclosure impacts reproductive health data, clinical outcomes, and decision-making. Methods: A systematized literature review was conducted across PubMed, Embase, Open Evidence, and Google Scholar using search terms including ‘abortion’, ‘disclosure or nondisclosure’, ‘stigma’, ‘provider–patient interaction’, and ‘qualitative or survey research’. Of 650 articles screened, 89 met the inclusion criteria, focusing on adult populations, disclosure behaviors, and clinical implications. Results: Nondisclosure most frequently affected reproductive data, continuity of care, and patient safety. Underreporting skewed reproductive health statistics, limiting accurate policy development, resource allocation, and research validity. Withholding abortion history undermined continuity of care, leading to incomplete records, missed contraception counseling, and inappropriate management. Nondisclosure was consistently rooted in stigma, confidentiality concerns, legal risk, and fear of judgment. Conclusion: Abortion nondisclosure limits data accuracy, care continuity, and patient safety. Addressing this issue requires neutral language, provider training, abortion education in curricula, confidentiality safeguards, and expanded patient education to ensure reproductive healthcare and research reflect patients’ true experiences.
Introduction: Dementia encompasses a group of neurocognitive disorders, including Alzheimer's disease, vascular dementia, frontotemporal dementia, and Lewy body disease, that are characterized by injury to various brain regions, resulting in progressive cognitive decline. Emerging evidence suggests an association between the gut microbiota and nervous system, via the gut-brain axis. We aim to explore the relationship between the composition, diversity, and dysbiosis of gut microbiota on the pathogenesis of neuroinflammation and the potential therapeutic effects of diet. Methods: We utilized a literature search via PubMed, Google Scholar, OpenEvidence, and ResearchGate. Examples of keywords included “neurodegeneration”, “gut microbiome”, “Alzheimer’s dementia”, “gut-brain axis”, “Mediterranean diet”, “DASH”, etc. As of April 2025, our search has yielded nearly 108 references published within the last 10 years. This collection is continuously growing and being stored on SciWheel, a reference management tool. Results: The human microbiome, largely composed of Bacteroidetes, Firmicutes, and Actinobacteria, produces short-chain fatty acids, cytokines, and other microbial metabolites that can exert either neuroprotective or neurodegenerative effects. Studies show that alterations in some microbiota, such as a high Bacteroidetes-to-Firmicutes ratio, have been linked to pro-inflammatory gut dysbiosis, which may compromise intestinal barrier function and increase permeability of both the intestinal mucosa and blood-brain barrier. This disruption of the gut-brain axis propagates systemic inflammation, contributing to neuroinflammation, cognitive decline, and the progression of dementia. Conclusion: This study highlights the intricate relationship between microbiota composition and neurodegenerative diseases, offering valuable insights into potential strategies for the prevention and management of dementia, especially through dietary modifications.
Introduction: TikTok has quickly emerged as a popular social media platform and a major source of health-related information, particularly in dermatology. Its algorithm-driven, visually engaging format enables rapid dissemination of both accurate and misleading content, shaping public perception and health behaviors. This study systematically reviews published literature on dermatology-related content on TikTok, assessing content type, creator characteristics, and information quality. Methods: A comprehensive literature review was conducted using MEDLINE via PubMed and Embase. Two reviewers independently screened studies and extracted data based on predefined criteria. Eligible studies, published in English from 2016 onward, analyzed dermatology or skincare content on TikTok. The search identified 134 articles; after removing duplicates, 105 were screened, and 53 met the inclusion criteria. Results: The most frequent topics were acne and systemic therapies (n = 13), followed by cosmetic dermatology and social media trends (n = 10). Seventeen studies analyzing 1,934 TikTok videos reported on content type, revealing that personal experiences were the most common format (38.8%). Twenty-one studies analyzing 3,204 videos reported on creator type; 64.2% were influencers or vloggers, and 20.6% were board-certified physicians. The DISCERN score, a validated instrument for assessing the reliability and quality of consumer health information, was higher on average in physician-generated content (2.7) than in nonphysician-generated content (1.98), indicating superior informational quality. Conclusion: This review highlights an increasing reliance on TikTok for dermatologic information, predominantly from non-professional sources. The findings emphasize the need for greater dermatologist participation in providing accurate, evidence-based content that improves the quality and reliability of dermatology-related information.
Unspoken Histories: The Impact of Abortion Nondisclosure on Clinical Safety and Patient Outcomes
Introduction: Narcissistic Personality Disorder (NPD) devastates relationships and resists most treatments, causing profound patient isolation and therapeutic failure. This review explores if Psilocybin-Assisted Musical Therapy (PAMT) can address NPD’s neurological roots, aligning with osteopathic principles of treating the whole person: mind, body, and spirit. Methods: We conducted a systematic review (PubMed, PsycINFO, 1972-2024) on psilocybin's effects on three brain regions central to NPD: the anterior insula (self-awareness), anterior cingulate cortex (cognitive flexibility), and supramarginal gyrus (empathy). We focused on how psilocybin promotes healing through neuroplasticity and why music amplifies these effects. We included peer-reviewed empirical studies examining psilocybin’s neurobiological and psychological effects and music’s therapeutic role. Non-English and theoretical works were excluded. Fifty studies were synthesized. Results: Studies demonstrated that dendritic spine density increased by 7 to 12% within 24 hours and remained stable for over a month. Neuroimaging revealed enhanced global brain integration, particularly between the default mode and salience networks, along with improved cognitive flexibility. Clinical trials (n = 24-93) reported significant reductions in depression, end-of-life anxiety, and increases in emotional openness. When combined with music, psilocybin’s effects intensify as music activates limbic and paralimbic regions while psilocybin enhances emotional salience, fostering insight and empathic connection. Conclusion: PAMT may offer NPD patients connection with themselves and others, which conventional treatments cannot. This approach exemplifies osteopathic principles by treating beyond symptoms to address disconnection at NPD's core. Despite regulatory barriers, osteopathic physicians can advocate for research access and integrate complementary music therapy, honoring the full complexity of human healing.
Dysbiosis and Dementia: Microbial Signatures of Neurodegeneration
Madeline Langenstroer1, Caitie Naasz1, Jeremy Sporrong DO1 1Rocky Vista University College of Osteopathic Medicine madeline.langenstroer@ut.rvu.edu
Antibiotic Stewardship Program Adherence in Pediatric Telehealth Before and After the COVID-19 Pandemic: A Scoping Review with Stakeholder Analysis
Gabrielle Tapley1, Kaitlyn R. Schuler PhD2, Brian E. Bunnell PhD1 1Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida 2Department of Psychology, University of North Carolina Wilmington
Introduction: Over 20% of individuals in the US are affected by mental health disorders such as anxiety, depression, and substance-use disorders. Despite the availability of effective treatments, many individuals do not receive or complete treatment due to many barriers. Untreated mental health disorders can negatively impact a person’s career, health, and well-being. Understanding these barriers is crucial to increasing engagement with mental health services. The purpose of this narrative review is to provide a comprehensive synthesis of barriers to mental health treatment as they pertain to a variety of mental health disorders and patient populations in the US. Methods: Pubmed and PsychINFO were searched utilizing systematic search methods to find peer-reviewed journal articles on barriers to mental health treatment published in English between 2010 and 2024. Abstracts and full-text articles were screened and reviewed to determine eligibility. A content analysis was then performed. Results: A total of 3,083 articles were initially identified, 114 of which were eligible to be included. Barriers largely fell thematically within the following categories: financial limitations, providers, negative treatment beliefs, knowledge and understanding of treatment, family/social circumstances, cultural barriers, lack of mental health resources, and mental/physical health symptoms interfering with treatment. Conclusion: These findings highlight stigmatization, low mental health literacy, and limited cultural competence amongst individuals, providers, and institutions. Misinformation perpetuates these barriers, emphasizing the need for education and future research to develop strategies to improve treatment access and engagement, especially for populations disproportionally affected by mental health disorders and treatment barriers.
A Narrative Review of Barriers to Behavioral Mental Health Treatment
Introduction: The rapid expansion of telehealth in pediatric primary care during the COVID-19 pandemic has transformed healthcare delivery but introduced new challenges for antibiotic stewardship. Limited physical examinations and altered patient–provider interactions may contribute to antibiotic overuse and misdiagnosis. Despite the importance of antibiotic stewardship programs (ASPs) in promoting appropriate prescribing, their use within pediatric telemedicine remains poorly characterized. This study aims to assess ASP utilization in pediatric telehealth, evaluate changes in prescribing adherence before and after the COVID-19 pandemic, and identify effective implementation strategies. Methods: A systematic scoping review was conducted using PubMed, SCOPUS, and the Cochrane Library to identify studies from January 2010 to January 2024 that examined ASP implementation in pediatric telehealth. Eligible studies focused on antibiotic prescribing patterns, adherence to guidelines, and ASP effectiveness before and after the pandemic. Two reviewers independently screened and extracted data using a standardized tool, resolving discrepancies by consensus. Results: Of 208 identified studies, 39 met the inclusion criteria—37 conducted during the pandemic and 2 pre-pandemic. Telehealth visits showed increased antibiotic prescribing and decreased adherence to guidelines compared with in-person encounters. Few studies described formal ASP integration in telehealth, and inconsistent documentation limited assessment of stewardship outcomes. Conclusion: Findings reveal significant gaps in antibiotic stewardship within pediatric telehealth. Tailored, multidisciplinary ASP strategies and telehealth-specific prescribing guidelines are needed to mitigate overuse. Future research should evaluate targeted stewardship interventions to ensure safe, effective, and evidence-based virtual pediatric care.
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Laila Serraj Andaloussi1, Catherine Hylas Saunders PhD2, V. Lynn Foster-Johnson PhD2 1University of New England College of Osteopathic Medicine 2Geisel School of Medicine at Dartmouth, Hanover, NH lserraj@une.edu
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TAYLOR MOSS (OMS-II, TOURO UNIVERSITY - CALIFORNIA)
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Twelve years ago, my father walked into a doctor’s office and told the truth. He said, “I need help. I’m struggling with addiction.” His primary care physician looked at him and shrugged. “Well… what do you want me to do about that?” I wasn’t in the room. But I’ve replayed that sentence in my head hundreds of times. The weight of it. The finality of it. The missed opportunity. What my dad needed in that moment wasn’t a miracle. He needed compassion. Instead, he was met with judgement, not just from that physician but also from the broader culture that too often dismisses addiction as a personal failing rather than a medical condition. More than a decade later, my father died of an overdose. While I will never know exactly what might have changed had he been met with empathy instead of indifference, I know this: words matter. Moments matter. As future physicians, we will each face moments like these, and the way we respond can mean the difference between despair and recovery. My father’s story isn’t an isolated tragedy. It’s part of a much larger pattern that we are all too familiar with. Across the United States, more than 100,000 people die each year from drug overdoses. Despite addiction being a treatable medical condition, only about 10% of people with a substance use disorder receive treatment. Even fewer are offered evidence-based therapies like medication-assisted treatment (MAT), which can reduce the risk of death by more than 50%. While addiction recovery is multifactorial, it is clear that many aspects of the healthcare system are not making this situation any easier. Waitlists for treatments can last months, and insurance companies often deny coverage for longer-term care. Additionally, the health care industry itself is not incentivized to support sustained recovery as readmission provides greater profit. Beneath all of that is stigma. Addiction is still framed, even by some in medicine, as weakness. Something you brought on yourself. Something you should be able to “just stop.” We don’t say this about cancer or diabetes. But we still say it, and believe it, about addiction. People don’t develop substance use disorders in a vacuum. Addiction often takes root in trauma, mental illness, chronic pain, isolation, or all of the above. Treating it successfully means understanding these layers. That’s where the osteopathic model shines. It is built on the idea that healing requires more than managing symptoms, it requires understanding the whole person: mind, body, and spirit. As future D.O.s, we’re being trained to ask better questions and to meet people where they are. We are taught to touch, to connect, and to treat people as people. That’s not just a philosophy, it’s a tool. And in addiction care, it’s one that can change outcomes. I often think about what it would’ve meant if my dad’s doctor had approached him with curiosity instead of judgment. What if he had said, “Thank you for telling me, I know that must have been hard. Let’s talk through your options.” Would my father still be alive today? I can’t say. But I know he would’ve left that room feeling seen. This isn’t just about medical education, though that matters. It’s about culture. The way we talk about addiction. The assumptions we make and the way we, even unintentionally, project shame instead of safety. We need to reframe addiction as what it is: a chronic, relapsing condition. Not a moral failure. Not a flaw. Just like any chronic condition, it requires long-term, compassionate care. That small shift from “What do you want me to do about that?” to “How can I help?” is everything. As the future of Osteopathic Medicine, we are the next generation of physicians. That means we don’t just inherit its practices, but we have the power to reshape them. We can model what it looks like to treat addiction with dignity. We can ask the hard questions when the system fails our patients. We can speak up when we hear dismissive language in clinics or on rounds. And we can push for policies that prioritize recovery, not relapse. I wish my father had been met with compassion that day. I wish he had heard, “You’re not alone- let’s get through this together.” He didn’t. But that doesn’t mean others can’t. As future D.O.s, we can’t afford to say, “What do you want me to do about that?” Instead, we must say, “How can I help?” Because that shift, that single sentence, might be the difference in someone’s recovery.
“What Do You Want Me to Do About That?” Why Our Responses to Addiction Matter
About the Author: Taylor Moss is an OMS II at Touro University of Osteopathic Medicine, California. She holds an MPH in community health and hopes to become a Family Physician and board certified Addiction Medicine Specialist.
About the Author: Lauren is a third-year medical student at A.T. Still University -School of Osteopathic Medicine in Arizona. She has a B.S in biomedical sciences, B.S. in Chemistry, B.A. in Modern Languages with an Emphasis in Spanish and M.S. Prior to medical school she worked as a case manager at a community health center advocating for patients and assisting them in overcoming social determinants of health. During her time in medical school, she has focused on not only social aspects in individuals lives which shape their health, but also the social, political, and environmental factors which shape medicine.
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"Knowledge is medicine. When it is ignored, misinformation fills the gap, and public health suffers."
When Legislation Enters the Exam Room: The Cost of Ignoring Medical Knowledge
One of the fundamental tenants of medical education is shared decision making. Care plans have been shown to be most effective when the provider and the patient discuss options and agree on the best therapy for them. This process is disrupted when additional parties enter the conversation. When the party is a family member, it can be valuable because they have additional insight about the patient’s situation, but when the additional party is local legislature one may wonder what knowledge they must lend about the patient in front of you. Medical abortion is a topic with an emotional presence for many and an epitomic example of when shared decision making is necessary. During my first rotation of my third year of medical school, I met a patient during an ultrasound appointment who was 8 weeks pregnant. She was overjoyed and she and her husband sent pictures of their ultrasound to their family while in the exam room. After they left, the ultrasound technician showed me that there was an abnormality, but she said she felt that it was not her place to tell this to the patient when she did not have the answers to the questions that would surely follow that news. The next time I saw this patient was in pre-op for a surgical abortion following her miscarriage. I spoke with my attending physician and asked why surgical abortion was the optimal treatment choice for this patient as opposed to medication with misoprostol and mifepristone. My research showed that American College of Obstetricians and Gynecologists (ACOG) and World Health Organization (WHO) recommend a combination of mifepristone and misoprostol as the most safe and effective medication therapy for medical abortion up to 10 weeks or 70 days. This treatment regimen is evidence based and widely accepted and could have been an option for this patient. They explained to me that in our state, to obtain mifepristone, a patient needs two separate in-person appointments with a physician – not a nurse practitioner or physician assistant – with a 24-hour waiting period. Following that, the medication cannot be obtained through the mail or at a retail pharmacy. For this patient, who was experiencing one of the most devastating periods in their life, this was too much to ask. The shared medical decision to undergo a surgical procedure was largely shaped by the distress that the hoops instilled by the legal system would put on the patient. This patient’s ability to choose her care plan was affected by legislative barriers, and despite these, she was fortunately able to receive treatment to stay healthy and safe. Some patients under different circumstances may struggle to trust their providers’ recommendations when they hear how cumbersome therapy is to obtain, or that it may even be illegal to obtain. When a physician presents to their patient that the current recommendations are not easily available or in some states not legally available at all, this can introduce doubt into the process of shared decision making. Doubt in the system and confusion due to conflicting advice makes it hard for patients to make a confident decision. It certainly is challenging for a provider to present options, pros and cons of each treatment, and overcome misconceptions within a singular appointment. Shared decision making is not just a tool for medical education. Patients deserve to make choices based on trust, understanding, and evidence. Standards of care exist so that every patient can rely on the same science-based treatment regardless of geography. However, abortion care has become an exception, where political boundaries dictate medical access. This inconsistency distracts from the shared knowledge that should unite our health system: evidence, expertise, and patient safety. Knowledge is medicine. When it is ignored, misinformation fills the gap, and public health suffers. Endorsing evidence-based standards supported by ACOG, WHO, and decades of clinical research should not be controversial. It should be the basis for compassionate, competent care, and open discussion in the exam room.
LAUREN HAYS (OMS-III, ATSU - ARIZONA)
The More We Know…?
About the Author: Cara Quie is a second year medical student at Idaho College of Osteopathic Medicine. In her (limited) free time, Cara enjoys reading non-fiction books related to outdoor adventures, nutrition and healthy living. She loves camping and backpacking, and one of her favorite moments is waking up in the morning in a tent, making coffee, and sitting amongst the mountains. Cara has goals of becoming an OB-GYN or Emergency Medicine doctor, while perhaps holding a political office at the same time.
CARA QUIE (OMS-II, IDAHO COM)
"what do we do when the knowledge we have doesn’t produce the outcomes we hope for? "
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As doctors in training, we seek to know. We seek to know how the intricacies of the body work, how pharmacological agents work within cells, how a certain disease will progress, and how to tell a patient difficult news. We are masters of obtaining knowledge, it is really the only way to come out on the other side of medical school with the letters DO behind our names. Yet, what do we do when the knowledge we have doesn’t produce the outcomes we hope for? This is the question I ask myself, as someone who knew of the cloud of depression surrounding my brother, and yet my knowledge of this did not change his ultimate outcome, which was him taking his own life. Suicide can be similar to cardiac arrest in medicine, in some ways. On the surface, it is often sudden and without many signs, yet upon further evaluation, a patient’s history will often point toward these outcomes and perhaps seem almost inevitable. Yet, what does one do when interventions are made, but the outcome remains the same? I knew of my brother’s depression. My family knew of my brother’s depression. We also knew of him not seeking care in the behavioral health emergency department due to costs. We knew of him refusing to be on any medications due to his goals in the military. The local police department knew of the guns he owned that they could not legally take away from him. There was so much knowledge to be had of the situation, yet he still committed suicide, much to both our surprise and chagrin. As I seek to reconcile this situation in my mind, I come back to the belief I had, which was that I, somehow, should have been able to solve my brother’s mental health crisis. Whether that belief stems from being a medical student or just a Type A personality is less important. What actually matters is how I, how we, proceed as future physicians with humility, with the understanding that we will not ever have enough knowledge sufficient to meet the needs of all 7 billion people on this earth. In a field where knowledge is paramount, and in a world where misinformation runs rampant, it is of no surprise that we hold tighter than ever to what we know to be true. As a physician in training, I remain hopeful in the promise of education being the great unifier, and that through education, we can share the wealth of medical knowledge that we’ve acquired with our future patients. As a human on this earth though, I contradictingly also believe that knowledge is not the savior that we can presume it to be. I saw this firsthand in the suicide of my brother while I was, and am, deep in the midst of medical school. While the knowledge being learned is ever-abundant, there was not more knowledge that I could have obtained to prevent my brother from doing what he had set out to do. As I dream of providing care for my patients one day soon, I must remind myself to hold tight to the truth of what it means to live in tension. As physicians, there is an understanding and expectation that we are to be constantly learning, growing, to be advancing our field. It is additionally important to remember in this tension that there is not a ratio of the knowledge acquired to the ability to change, or treat, or cure every person. We must succumb to the human condition, which is often times more outside of our control than we allow ourselves to think.
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Preoperative evaluation has become a cornerstone of surgical safety, encompassing cardiac clearance, laboratory testing, and anesthetic assessment. Yet one fundamental determinant of recovery, nutritional status, remains largely absent from standardized preoperative protocols. Although the relationship between malnutrition and poor surgical outcomes is established, nutritional assessment is not consistently performed before patients enter the operating room. As the surgical field continues to emphasize patient-centered and outcome-driven care, incorporating structured nutritional screening preoperatively should be viewed as a necessary component of surgical preparation. Malnutrition remains both prevalent and underrecognized among surgical patients. Estimates suggest that 20–50% of individuals undergoing elective procedures exhibit some degree of nutritional risk (Keerio et al., 2024). Deficiencies in protein and micronutrients compromise collagen synthesis, immune function, and angiogenesis—processes essential for wound healing and recovery. Multiple studies have demonstrated that patients with poor nutritional status face higher infection rates, longer hospitalizations, and increased postoperative morbidity and mortality (Hou et al., 2024; Ford et al., 2022). Despite this evidence, nutrition screening continues to vary widely across institutions. In a recent survey of perioperative clinicians, only about two-thirds reported conducting any screening, and fewer than half used validated tools such as the Malnutrition Universal Screening Tool (MUST) or Nutritional Risk Screening (NRS-2002) (Bellafronte et al., 2024). The result is a persistent gap in care, patients most vulnerable to malnutrition often go unidentified until complications emerge. Why does such an evidence-backed practice remain so inconsistently applied? The reasons are largely practical. Many hospitals cite limited time, staff, or institutional support to integrate screening into already burdened workflows. Others point to the lack of a single universally accepted instrument. Each screening tool (MUST, NRS-2002, Mini Nutritional Assessment, or Perioperative Nutrition Screen) has its nuances, and predictive accuracy varies across patient populations (Cheung et al., 2024). Guidelines also differ across systems and specialties: some Enhanced Recovery After Surgery (ERAS) pathways formally include nutrition optimization, while others mention it only briefly. Even when protocols exist, implementation frequently lags behind recommendation. These challenges highlight an even broader issue, which is the evolving nutritional landscape of modern patients. The widespread use of GLP-1 receptor agonists such as semaglutide and tirzepatide has introduced a new subset of surgical patients who appear metabolically healthy yet are nutritionally depleted. These medications suppress appetite and alter gastric motility, sometimes leading to reduced protein intake, lean-mass loss, and micronutrient deficiencies reminiscent of post-bariatric surgery states. Early observational data and position statements from professional societies now caution that prolonged GLP-1 therapy may necessitate nutritional surveillance prior to surgery, particularly for patients with significant weight loss or poor oral intake (Joshi et al., 2023). In this context, the absence of standardized preoperative nutrition screening is not simply an oversight, it represents a growing blind spot. The solution: brief, validated tools can be incorporated into existing preoperative assessments with minimal disruption. A simple checklist or limited laboratory panel: albumin, vitamin D, or B12 can identify deficiencies early enough to intervene before surgery. Standardization would also enable benchmarking across institutions, moving nutrition screening from anecdotal practice to measurable quality improvement. As medicine advances toward precision and prevention, overlooking nutrition undermines both aims. Screening for malnutrition should be as routine as measuring blood pressure or reviewing medications. It is among the few modifiable factors entirely within reach that can meaningfully influence surgical outcomes. .
About the Author: I’m originally from Pittsburgh, Pennsylvania, and I completed my undergraduate degree at Virginia Tech, where I studied Human Nutrition, Foods, and Exercise. My academic background sparked a lasting interest in the role of diet and lifestyle in overall health. Before starting medical school, I spent a gap year working in orthopedic trauma and spine surgery, an experience that strengthened my desire to pursue a surgical path. As I continue my medical training, I hope to bridge my interests in surgery and nutrition, integrating both into a patient-centered approach to recovery and long-term wellness.
A Call for Standardized Nutritional Screening in the Preoperative Timeframe
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"the absence of standardized preoperative nutrition screening is not simply an oversight, it represents a growing blind spot."
MARIO ROTUNNO (OMS-I, PCOM)
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ANJALI DHAWAN, STEPHANIE SAWICKI (OMS-II, TOURO COM - MONTANA )
"AI literacy should become an essential skill that future osteopathic physicians utilize with respect to patient care."
Neural Networks and Human Touch: Balancing AI-Generated Health Information with Osteopathic Empathy
Instead of turning to Google to identify the scar on their arm, many people now look to generative AI for answers. Patients are arriving at clinic visits with chatbot summaries, differential diagnoses, and treatment suggestions—often drawn from platforms like ChatGPT. Phrases such as “just ask Chat” or “ChatGPT said…” have become normal in everyday conversation, highlighting how artificial intelligence is beginning to fill a space once reserved for physicians. Yet, the accuracy of these responses remains uncertain. Some answers may be misleading, leaving patients with false reassurance or unnecessary worry. As future osteopathic physicians, we stand at a vital intersection: embracing technology as a tool to expand access to knowledge while preserving the empathy and human connection that is vital to the osteopathic principles of healing and care. For many patients, AI has become the first touchpoint for health questions—quicker and more convenient than scheduling an appointment or picking up the phone. In underserved and rural communities, generative AI offers an immediate avenue for information and reassurance in moments when medical access is limited or scarce. When used correctly, AI can translate medical jargon, summarize after-visit instructions, create medication reminders, and present scientific information in a more digestible manner to users. AI has the potential to simplify the path to understanding and can assist patients in taking the necessary steps sooner to engage with healthcare professionals. However, the promise of AI has predictable downsides, many of which pose a threat to the safety of patients. Generative AI often confidently presents false or misleading information, colloquially referred to as hallucinations. These systems can create false citations, miss critical information, and risk overlooking key findings. In a recent publication of 471 references for systematic reviews, large language models produced high hallucination rates (GPT-3.5 39.6%, GPT-4 28.6%, Bard 91.4%) and very low precision (9.4%–13.4% for GPT models; 0% for Bard), underscoring unreliable citation generation1. Given these error rates, the authors concluded that LLMs should not be used as the primary or exclusive tool for systematic reviews and that any AI-generated references require rigorous human verification1. Furthermore, AI models often provide medical analysis without adequate contextual understanding to do so, ignoring comorbidities, social determinants of health, or past medical history. The confident tone in which the information is conveyed often projects an illusion of expertise that may mislead patients. In the future, AI will become further integrated into healthcare, and osteopathic medical education will have to evolve accordingly to address these future developments. AI literacy should become an essential skill that future osteopathic physicians utilize with respect to patient care. Specifically, clinical communication skills have an additional issue at hand, one that osteopathic students should begin learning to address: how to communicate effectively with patients who arrive with AI-derived plans. Providing physicians with the necessary training and tools to navigate conversations with patients who prioritize AI-generated responses over qualified medical advice can place physicians in a proactive position and ultimately provide better quality patient-centered care. AI presents future osteopathic physicians with resources that they may find beneficial, such as improving access to information and assisting with early detection for patients. Combining this with the physician’s ability to ensure that empathy and ethical judgment are at the center of patient care will allow the industry to build a bridge between AI-generated medicine and osteopathic medicine. The DO philosophy encourages physicians to adopt the tools being presented to us, not as a replacement for human care, but as an extension that can aid in our commitment to whole-person medicine.
Evolving with Intelligence: Strengthening OMM Education in the Age of AI
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About the Authors: Maryam Babar, BS, and Aymen Arain, MS, are second year osteopathic medical students at Edward Via College of Osteopathic Medicine – Louisiana (VCOM-Louisiana). Maryam serves as the Public Relations Director for Student Osteopathic Medical Association and a Region II Resolutions Committee member, as well as Chair of General Surgery for the American College of Osteopathic Surgeons at VCOM-LA, with interests in transforming healthcare, international medicine, and equity and advocacy in healthcare. Aymen serves as Vice President of the American Medical Women’s Association chapter at VCOM–LA and Chair for Dermatology at the American College of Osteopathic Internists chapter at VCOM-LA, and is deeply passionate about preventive medicine, patient advocacy, and addressing health disparities in underserved communities. Together, they are dedicated to advancing research and dialogue that unites innovation, empathy, and osteopathic principles to improve the future of healthcare. .
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About the Authors: Anjali Dhawan and Stephanie Sawicki are second-year medical students at Touro College of Osteopathic Medicine (TouroCOM) – Montana. Anjali, who grew up in the San Francisco Bay Area, earned her Bachelor of Science in Biology and a Master’s in Biotechnology from the University of San Francisco. Stephanie, who grey up in Boca Raton in Florida, earned her Bachelor of Science in Biology from Florida State University. Both are passionate about integrating innovation and empathy into osteopathic medicine to advance patient-centered, technology-informed care.
The Future DO publishes student abstract submissions and perspective articles twice annually. We welcome students to submit abstracts and articles for consideration to be featured in our next issue. Students are not required to be SOMA members to submit an abstract. In addition, TFDO will also be accepting student artwork for print either on the cover or within the body of the magazine! Stay tuned for email announcements from SOMA Weekly or check out our research website: www.studentdoresearch.org for updates and announcements. We look forward to receiving your submissions!
While osteopathic medicine is taught by the book,it is open to innovation for the benefit of the patient and physician. As artificial intelligence (AI) becomes a tool more utilized by students worldwide, osteopathic medical students are navigating an exciting but unfamiliar landscape. In a recent study we conducted, Evaluating the Accuracy and Educational Utility of ChatGPT in Osteopathic Manipulative Medicine (OMM) and Treatment, our team explored how effectively AI could interpret and explain OMM and OMT concepts. The results offered both optimism and a reminder of how our field can continue to evolve to best support student learning. ChatGPT correctly answered 64% of COMLEX-style OMM questions. While that number shows potential, the explanations varied widely in accuracy and osteopathic reasoning. Some were strong and clinically relevant, while others revealed confusion about key principles or terminology. Rather than viewing this as a limitation of AI alone, the findings highlighted how diverse OMM teaching methods can be across schools. This diversity reflects the strength of osteopathic philosophy, recognizing its ability to be taught through multiple perspectives. However, it can also make it difficult for emerging technologies to align with our unique principles. These findings point toward an opportunity rather than a flaw. As AI continues to contribute to how students study and understand medicine, there is value in ensuring that osteopathic education evolves alongside it. Creating shared academic resources, unified terminology, and open-access teaching tools could help both students and AI platforms engage with OMM material more accurately. Creating a standardized foundation, without losing the flexibility that defines our profession, could promote fairness, reduce confusion, and improve the effectiveness of supplemental tools like AI. Recent literature supports this growing intersection of AI and medical education. A 2023 study in JMIR Medical Education reported that over half of medical students have incorporated AI tools into their study routines, citing improved comprehension and efficiency. This reality emphasizes the need for thoughtful integration rather than avoidance. By collaborating with faculty and researchers, students can learn to use AI responsibly by evaluating sources, verifying accuracy, and applying technology as a complement to, and not a replacement for, hands-on learning. Osteopathic medicine has always encouraged balance between structure and motion, as well as tradition and progress. The same balance applies to education. As AI becomes an everyday companion in our studies, the goal should not be to replace the human element but to strengthen it by using technology to support reasoning, curiosity, and mastery of our distinct philosophy. The path forward is about ensuring that the next generation of osteopathic students has every tool they need to thrive, with AI as a supplemental ally in our pursuit of excellence.
MARYAM BABAR; AYMEN ARAIN, MS (OMS-II, VCOM LOUISIANA)
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Tackling Medical Misinformation in the Digital Age
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Charlotte Cheng, Aryanna Ryan, Tessa Levin, Hannah Crowe-Butler, and Aarthi Muthukumar (OMS-II, RVU - UTAH)
"Without proper education and guidance on AI, we risk losing the opportunity to personalize patients' health in an accessible way that benefits their lives."
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Between physician shortages and convoluted hospital systems, people are turning to generative artificial intelligence (AI) for instant medical advice. As this occurs, physicians find themselves addressing misinformation their patients learned from interacting with an open-source AI interface. Our goal is to develop a framework that mitigates AI-driven misinformation while strengthening the partnership between patient and physician within the digital health space. The technological world is developing so rapidly that it is beginning to outpace the rate of human adaptation. While often discussed in the tech industry, this issue remains largely unknown to the general public. Thus, people are increasingly placing blind trust in AI-generated content, valuing clarity and readability over accuracy and truth3. The consequences of this result in a few outcomes: patients with questions will either wait until their next appointment, message their doctor through the patient portal, or proceed with potentially false information given by AI. This flood of administrative tasks on top of already heavy patient loads fuels physician burnout. Physicians, unfortunately, have been the scapegoats for the lack of risk stratification2. They have become liable, if not legally, then socially, for the resulting mistrust, delayed ethical standards, and the spread of misinformation. The large scale in which misinformation may spread overshadows the benefits of AI and digital health tools by the increased need for combating false information in addition to the already extensive expectations of physicianhood3. The consequences are not merely academic; they translate into real economic and personal costs. Patients who follow misinformation may pursue unnecessary treatments, delay seeking appropriate care, or make decisions that worsen their health outcomes, all of which increase healthcare costs. Meanwhile, physicians spend valuable appointment time correcting misinformation rather than providing care, contributing to inefficiencies in an already strained system. Without proper education and guidance on AI, we risk losing the opportunity to personalize patients' health in an accessible way that benefits their lives. It is critical that, as physicians, we help improve the digital health literacy of patients. On average, physicians spend two to five minutes discussing each topic raised during a typical medical visit4. Creating a systematic approach of explanation can help reduce the time burden while putting the patient’s digital health literacy at the forefront. This can be done by breaking down the conversation around Large Language Models (LLMs), which are artificial intelligence systems trained on vast text corpora to predict the next word and generate useful text in relation to the user’s input, into four simple pillars: Positive Abilities, Limitations, Privacy Concerns, and Partnership with the Healthcare Team. Starting with the first pillar, begin the conversation on an uplifting note by teaching patients that LLMs can support their learning about medical topics, understand test results, and facilitate discussions with their healthcare team more effectively and efficiently. For example, instruct patients to prompt the AI as if it were a physician specializing in a particular disease. Then, ask it to explain the patient’s symptoms or answer questions at a sixth-grade reading level to help simplify medical terminology. While LLMs have great potential within healthcare, it is important to acknowledge its limitations. One example is how often LLMs will make up an answer, referred to as ‘hallucinations’. When given health information regarding patient cases, LLMs such as GPT4o and Distilled-DeepSeek hallucinated 50.0-82.7% of the time1. In forgetting that AI is not a truly cognitive entity, we fall into the trap of following multi-faceted responses supported by hallucinated articles and data. To combat this, advise patients to ask the AI to list its sources. Then, advise patients to use the same prompt with a second LLM; if both responses align, the information is likely more reliable. LLM education should also warn patients of privacy concerns. LLMs are trained through the prompts and inputs of the user, so the more personal information a user gives, the higher the likelihood of unintentional data leaks, which increases the risk of the user being exploited. Lastly, AI is not meant to replace the physician-patient relationship. If patients are having difficulty understanding what is going on with their health, the physician is still the main point of contact for their healthcare. These tools are meant to enhance the physician-patient relationship, but certain precautions should be highlighted through this four-pillar approach. Generative AIs, like LLMs, have the potential to increase shared decision-making between physicians and patients, resulting in higher-quality care. Physicians should be prepared for the impact AI has on healthcare and equip themselves with the necessary tools to use it effectively in their practice. Confronting misinformation is a shared responsibility between health care providers, patients, and systems that propagate information. As medicine evolves alongside technology, everyone has a part to play in ensuring that knowledge heals, rather than harms.
"The idea that knowledge becomes medicine when shared with empathy is at the core of healthcare."
I will never forget the night a patient’s daughter looked at me and said, “Please don’t give my dad that medication. I read online that it could slow down and stop his heart.” Her voice trembled, her phone still open to a post from a stranger claiming a prescribed beta-blocker “shuts down the heart.” As a CVICU nurse, I had cared for patients on that medication countless times, especially during a hypertensive crisis. Yet in that moment, I saw how powerful misinformation could be. It didn’t just create confusion; it created fear and mistrust, even in a hospital room full of professionals. Misinformation in healthcare has become its own epidemic. Whether it’s false claims about vaccines, “miracle cures,” or misleading TikTok trends, I’ve seen how easily it spreads and how deeply it affects patients’ decisions. As healthcare providers, we’re trained to treat diseases, but misinformation is a disease of its own, and the only antidote is knowledge. This problem now extends far beyond the hospital. My parents, who immigrated from Vietnam decades ago, still struggle to find reliable health information. Like many in our community, they rely on one particular Vietnamese source for news and advice, but too often, the information is biased, inaccurate, or shaped by political agendas. Once a misconception takes hold, it roots itself deeply, becoming part of their worldview. No matter how many studies I cite or explanations I give, especially in my limited Vietnamese, the misinformation often feels more familiar and trustworthy simply because it comes in their language through voices they’ve relied on for decades. It’s a never-ending battle, not just against falsehoods, but against decades of cultural habits, fear, and familiarity. That struggle has taught me that misinformation isn’t always about willful ignorance; it’s often about accessibility and trust. My parents’ generation didn’t grow up navigating healthcare systems or searching medical databases. They rely on voices that speak their language, even when those voices don’t always tell the truth. To fight misinformation effectively, we need to reach people in ways that respect their culture, meet them where they are, and rebuild trust from the ground up. I’ve cared for some of the sickest patients imaginable. Accurate information can mean the difference between life and death, but simply knowing the science isn’t enough. What matters just as much is how we share that knowledge. Many patients don’t reject medical advice because they distrust medicine; they reject it because they don’t feel heard or respected. I’ve seen the power of compassion in communication. During emergencies, when alarms blare and families panic, I pause and explain what’s happening in simple, reassuring terms. “We’re giving this medication to help his heart pump more efficiently,” I’ll say, meeting their eyes. The look of relief that follows reminds me that understanding itself can heal. Every conversation at the bedside, whether it’s explaining a lab result, walking through a treatment plan, calming a worried family, is an opportunity to replace uncertainty with understanding. The idea that knowledge becomes medicine when shared with empathy is at the core of healthcare. When I donned my white coat and recited the osteopathic oath, I swore to provide compassionate, quality care, to listen, to teach, and to treat with respect. Medicine is not just about fixing what’s broken; it’s about empowering patients with understanding so they can take part in their own healing. The oath wasn’t just a promise, it was also a reminder of the responsibility that comes with knowledge and the importance of using it to bridge gaps rather than widen them. My experience as a nurse has shown me the profound impact that education and empathy can have. I’ve witnessed patients transform from fear to confidence as they learn how their bodies respond to treatment. I’ve seen families regain hope simply because someone took the time to listen and explain. These moments have taught me that medicine is not just about procedures or evidence-based interventions. In the textbooks, knowledge exists as data points and graphs; in the hospital, it takes on a life of its own, it has a heartbeat, a family, a story. Bridging these two worlds has shown me that knowledge is most powerful when it is both accessible and grounded in compassion. I hope to continue bridging the gap between science and compassion. Whether at the bedside, in a clinic, or through outreach to underserved communities, I see every interaction as an opportunity to replace misinformation with understanding and to provide care that is both scientifically sound and profoundly personal. I invite you to do the same: listen deeply, communicate clearly, and use both knowledge and empathy to make a difference in the lives of those around you.
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About the Authors: Charlotte Cheng (OMS II), Tessa Levin (OMS II), Aryanna Ryan (OMS II), Hannah Crowe-Butler (OMS II), and Aarthi Muthukumar (OMS II) are students at Rocky Vista University (RVU) in St. George, Utah. As students in RVU’s Digital Health Track, we are passionate about innovation, equity, and creative solutions in the digital health space. Every week, we engage with healthcare leaders spearheading digital solutions to everyday health challenges, exploring topics such as telemedicine, genomics, mobile apps, and wearable technology. Our passion for integrating technology and medicine inspires us to continually reimagine how digital tools can improve care for our future patients.
MICHELLE TRAN (OMS-I, ORLANDO COM)
“Where Knowledge Heals: Rebuilding Trust in Healthcare One Conversation at a Time”
Prescriptions for the Mind: Why Knowledge Is Our Strongest Medicine
About the Author: Michelle Tran was born and raised in Texas. She is a nurse, scientist, and lifelong learner who loves connecting knowledge with real people. She holds a master’s in biomedical engineering, along with bachelor’s degrees in nursing and biology, giving her a unique perspective on both the science and the human side of medicine. Her healthcare journey has taken her from scrubbing in the OR to bedside nursing in the CVICU, and now to her role as an OMS-I at the Orlando College of Osteopathic Medicine. She is building on these experiences to provide care that is both compassionate and holistic.For Michelle, medicine isn’t just about data or devices—it’s about people, families, and stories. She is passionate about making complex medical knowledge understandable and meaningful for those she cares for, while continually learning and growing herself. When she’s not at work or school, Michelle enjoys exploring nature, traveling, spending time with her mini Goldendoodle, Mochi, or crossing off MLB stadiums on her boyfriend’s bucket list—while stuffing her face with all the stadium foods along the way. Every day is an opportunity to learn, to help, and to connect, and that is what makes her journey not only exciting but also rewarding.
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LONDON DANCHULIS (OMS-II, NSU KPCOM TBR CAMPUS)
". . .Knowledge is most powerful when it is both accessible and grounded in compassion."
"Misinformation is not just a gap in knowledge but an active pathology."
When I began medical school, I assumed that power in medicine lived in vials and pills, all neatly quantified. It surprised me to discover that the most essential prescription I will ever offer carries no dosage at all. Knowledge can heal. It can restore trust, reframe fear, and change outcomes. That kind of knowledge is medicine in its purest form. On a medical outreach trip to the Galápagos Islands, I encountered a powerful belief rooted in history and loss. For many locals, going to the hospital meant never coming home. Families had watched relatives enter hospitals and never return, so the community began to equate medical care with death. This belief shaped their health decisions in profound ways. One woman, suffering from worsening asthma, told me she delayed seeking care because she believed stepping into the hospital was the same as stepping into a grave. We talked about how early intervention for respiratory problems saves lives, how inhalers keep airways open, and how waiting often means losing the opportunity for recovery. She nodded and said she would seek care sooner next time. What shifted was not only her treatment plan but her perception. The real medicine in that moment was knowledge, carefully shared and respectfully delivered. This experience illustrates a truth that extends far beyond Ecuador. Misinformation is not just a gap in knowledge but an active pathology. The World Health Organization now identifies the infodemic as a public health crisis, noting its role in eroding trust and worsening outcomes1. A recent study of online behavior found that people encounter misinformation frequently, with some ignoring it, others challenging it, and still others accepting it as truth2. In mental health, researchers reported that over half of the most viewed TikTok content contained misinformation, evidence that false narratives can shape the decisions of vulnerable populations3. Some argue that the best way to counter these threats is through new technology, stronger public health policy, or better access to care. These solutions are undeniably important, but they cannot stand on their own. Even the most advanced treatments or well-designed policies will falter if patients do not understand or trust them. Communication itself must therefore be recognized as a therapeutic act, one that gives meaning to interventions and restores agency to patients. For osteopathic physicians, this challenge is central. Our philosophy emphasizes the body as a unit and healing as a partnership of structure, function, and environment. Communities fractured by misinformation cannot achieve health. If misinformation is the insult, then communication is the remedy. Knowledge must be accurate, accessible, and culturally relevant. It must also be delivered with humility, acknowledging the fears and histories that shape beliefs. Of course, countering misinformation is not easy work. Correcting misconceptions requires more than fact-checking; it requires time, patience, and empathy. Research confirms that patient centered dialogue is more effective than confrontation alone and improves both adherence and trust4. Teaching becomes a form of treatment when it respects fear and replaces it with understanding. We also must recognize that health systems themselves sometimes nurture misinformation. Dense jargon, inaccessible data, and a history of inequity all weaken trust. Patients who have been dismissed or harmed understandably view medicine with suspicion. Rebuilding trust means combining facts with transparency and humility. It means listening as much as we explain. The effort can be demanding, yet it carries moments of joy that remind us why the work matters. Each patient who feels safe enough to seek care because they finally understand what hospitals provide is a victory. Each parent who consents to vaccination after a respectful conversation is progress. Each community that begins to see medicine as a resource rather than a threat is healing. I think of this as herd immunity for ideas. The more people who carry accurate knowledge, the harder it is for misinformation to spread. As osteopathic students and future physicians, we cannot treat misinformation as an afterthought. Knowledge is not supplemental. It is therapeutic. And when we offer it with persistence, empathy, and clarity, it may become the most powerful prescription we ever write. In the end, medicine is not only about what we prescribe or the procedures we perform. It is about the clarity we bring to confusion and the trust we rebuild through conversation. Knowledge, shared with honesty and care, is medicine, and it is a medicine that never runs out.
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About the Author: London Danchulis (OMS-II) is a medical student at Nova Southeastern University’s Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa Bay Regional Campus. With a background in public health, she is deeply committed to advancing health equity and serving vulnerable populations through both research and outreach. She earned her B.S. in Public Health from the University of South Carolina, where she cultivated her interests in health promotion, community-based service, and global health. She currently serves as President of the International Medical Outreach Club, where she helps connect students with opportunities to serve underserved communities and expand awareness of global health issues. She has participated in medical service trips to Jamaica and Ecuador, collaborating with physicians to provide care and health education. These experiences have strengthened her dedication to outreach and inspired her to pursue more global health initiatives in the future. Outside of medicine, London volunteers weekly with Neuroshifts, supporting neurodivergent young adults through mentorship and community engagement. In her free time, she enjoys traveling, experimenting with recipes she finds on TikTok, and playing with her cats. She aspires to integrate her training in osteopathic medicine with her public health background to promote equitable healthcare access on a global scale.
"As osteopathic students and future physicians, we cannot treat misinformation as an afterthought"
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CHRISTIAN WEEKS (OMS-II, VCOM-CAROLINAS), LEX AJELLO (OMS-II, LMU-DCOM)
"We cannot provide the highest quality care without first establishing a foundation of safety, honesty, and belonging."
To live authentically as a queer person has never been for the faint of heart. Choosing openness about one’s identity often means navigating a world that is not always kind, not always safe, and not always willing to listen. For many LGBTQIA+ individuals, resilience is a necessity. For generations, discrimination, oppression, and violence have shaped the health and well-being of people whose identities do not align with cisgender and heterosexual norms. These realities are not distant memories; they are part of the living fabric of medicine and society. In the 1980s and 1990s, for example, misinformation about the HIV/AIDS epidemic fueled stigma against men who have sex with men (MSM).1 Fear displaced compassion, and silence often replaced care. That legacy continues to influence health outcomes today, reminding us that progress can be fragile. To come out – whether in a clinic, a classroom, or a family gathering – remains an act of profound bravery. As future physicians, we must understand that disclosure is not guaranteed; it is only possible when patients trust that their identities will be met with respect. Creating this environment is not a peripheral part of medicine, it is at its core. We cannot provide the highest quality care without first establishing a foundation of safety, honesty, and belonging. Notably, an article published in the Journal of Osteopathic Medicine highlights that the process of a patient coming out to their provider reflects the self-healing and regulatory principles that lie at the heart of osteopathic philosophy.2 When a patient walks into an exam room, their whole self comes with them: their history, their relationships, their fears, and their joys. A transgender teenager sharing their pronouns, a same-sex couple seeking fertility counseling, or a nonbinary patient navigating cancer treatment all deserve the same standard of care that we promise every patient. For us to fulfill that promise, we must do more than tolerate diversity; we must actively affirm it. And yet, the cultural and legal momentum gained in the 2010s now feels precarious. Recent years have brought unsettling attempts to reverse progress: proposed cuts to HIV prevention programs, renewed political resistance to LGBTQIA+ research funding, and efforts to dismantle diversity, equity, and inclusion (DEI) initiatives.3,4,5 In April 2025, the Commission on Osteopathic College Accreditation (COCA) announced that DEI initiatives will not be considered in the accreditation process for osteopathic medical schools until at least May 1, 2026.6 This decision follows a series of presidential executive orders that, in COCA’s own words, have made it “increasingly complicated for colleges of osteopathic medicine (COMs) to interpret and adhere to COCA’s requirements under the related elements.” This uncertainty risks slowing the important progress being made to advance diversity and to strengthen initiatives that support LGBTQIA+ individuals, as well as other historically marginalized communities, including BIPOC populations. Despite decades of advocacy, our nation has yet to pass the Equality Act, which would prohibit discrimination on the basis of sex, gender identity, and sexual orientation. These policy gaps send a clear message: equality remains conditional, contingent on shifting political winds. But health equity cannot be conditional. The right to live free from discrimination should not be up for debate. Science, empathy, and professional ethics demand better. When our politics fail, the practice of medicine must prevail. As osteopathic medical students, we inherit a philosophy that emphasizes treating the whole person. This principle carries particular weight in LGBTQIA+ health, where mental, physical, and social well-being are tightly interwoven. A patient struggling with depression after experiencing family rejection, or one facing increased cardiovascular risk due to chronic stress from discrimination, needs a physician who sees the full picture. Advocacy is not something separate from clinical practice; it is inseparable from it. To advocate for our LGBTQIA+ patients means committing to education: learning about gender-affirming care, recognizing intersectionality and the impact of minority stress, and staying informed on evolving standards of care. It means ensuring that our exam rooms are places where patients never have to hide fundamental truths about themselves. It means lending our voices to policy conversations that determine whether care is accessible at all. The truth is simple: if we cannot stand with our LGBTQIA+ patients, we have chosen the wrong profession. To heal is to advocate. To advocate is to affirm humanity. And for LGBTQIA+ people, the time for that affirmation has always been – and will always be – now.
LGBTQIA+ Advocacy in Medicine: The Time Is – And Has Always Been – Now
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About the Authors: .The authors of this perspective piece, Christian and Lex, are both members of SOMA's Diversity, Equity, and Health Initiatives (DEHI) Committee. They are passionate about advancing LGBTQIA+ visibility in osteopathic medicine and expanding access to affirming care. Alongside other members of the LGBTQIA+ task force within the DEHI committee, they envision a future where topics like transgender medicine and intersectionality in healthcare are standard in osteopathic medical curricula across the nation. Together, they aim to be part of a more inclusive generation of physicians who see diversity as integral to the practice of medicine.
The waiting room at Shepherd’s Hope, a free clinic in Central Florida, reveals a fundamental truth about American healthcare: for many, the greatest barriers to health are not medical, but systemic. As a volunteer and health information manager coordinator, I have observed how theuninsured—predominantly immigrants working in physically demanding, non-benefited jobs—navigate a system that has largely excluded them. Their experiences demonstrate that clinics like Shepherd's Hope provide medicine in its most essential forms: access, trust, and knowledge. This commitment to restorative access was the catalyst for Dr. William Barnes, who founded Shepherd’s Hope in 1997 to bridge the deepening healthcare void in his Central Florida community. In the decades since, the clinic has treated over 350,000 patients, transforming Barnes’ vision of care for the uninsured into a scalable reality. By establishing this sanctuary for those the system has overlooked, the clinic serves a dual purpose: it restores individual dignity while simultaneously mitigating the systemic strain on local emergency departments (EDs) often burdened by non-emergent cases. A primary function of the clinic is to serve as a crucial buffer for local emergency departments (EDs), which are often strained by non-emergent visits. While the patients I see have acute needs—uncontrolled hypertension, a lingering cough, an empty bottle of metformin—they rarely require emergent intervention. These visits often stem from underlying socioeconomic barriers manifesting as acute medical needs. This reality reflects a national trend where the ED becomes a provider of last resort for basic care. Research shows a primary driver for these visits is a simple lack of medication; one study found nearly 30% of ED patients with chronic illnesses were there just for a prescription refill [1]. By providing a medical home, however temporary, Shepherd’s Hope directly addresses this inefficiency and allows for the practice of a core osteopathic principle: treating the whole person, which must include their socioeconomic reality. The patient population at Shepherd's Hope is not abusing the system; they are locked out of it. Most work in construction, landscaping, and hospitality—physically demanding jobs that fuel our local economy, yet rarely provide health insurance. This observation mirrors a stark national reality: half of all likely undocumented immigrant adults in the U.S. are uninsured [2]. They do not forgo care by choice, but because of a combination of prohibitive cost, fear, and logistical barriers. Consequently, the clinic often serves as their first and only point of contact with the American healthcare system, a place where they are seen without having to first produce a credit card or an insurance card. But access is only the first step. In the exam room, the clinical phenomenon of “white coat syndrome” is common—a high blood pressure reading that normalizes after ten minutes of conversation. I have seen firsthand how a patient's entire demeanor changes when they connect with a provider, especially one who shares their cultural or linguistic background. This is a documented effect; studies show that patient-provider racial concordance can significantly improve communication, participation, and trust [3]. This foundation of trust is a prerequisite for effective patient education. Without it, crucial health information is just noise. With it, our “knowledge”—about managing blood pressure with diet, about stretching to protect a strained back, about when to truly go to the ED—becomes medicine. It empowers patients to take ownership of their health long after they leave our doors. Of course, free clinics are not a permanent solution. Some may argue they are a patch on a broken system, allowing systemic inequities to persist. But until that system is fundamentally reformed, clinics like Shepherd’s Hope are not just helpful; they are essential. They embody the osteopathic principle of seeking health, not just treating disease. My time there has taught me that the most powerful prescription we can write is one for knowledge, but it can only be filled in an environment of trust, dignity, and access. That is a medicine money can’t buy.
". . .the most powerful prescription we can write is one for knowledge, but it can only be filled in an environment of trust, dignity, and access. That is a medicine money can’t buy."
MARIANA VALDEZ (OMS-I, ORLANDO COM)
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The Medicine Money Can’t Buy
About the Author: I am an OMS I at Orlando College of Osteopathic Medicine with a deep commitment to addressing health disparities. My passion for serving vulnerable populations was the driving force behind my volunteer work at Shepherd's Hope, a free and charitable clinic in Central Florida. Through this experience, I witnessed firsthand the systemic barriers that uninsured and immigrant communities face when trying to access basic healthcare. I wrote this piece to highlight the critical role that free clinics play in promoting public health and to explore how the osteopathic principles of holistic care and patient-centered trust are essential in serving these communities. Looking forward, I hope to pursue a career in emergency or internal medicine where I can continue to advocate for health equity. In my free time, I enjoy rock climbing and line dancing with my friends.
OSTEOCHATS
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"HEALING REQUIRES THE CLINICIAN TO SHOW UP AS BOTH A SCIENTIST AND A FELLOW HUMAN BEING"
When I first sat down to speak with Dr. Bucco, once an Italian Studies major and now a faculty member at Philadelphia College of Osteopathic Medicine, I expected to learn about the science behind Osteopathic Medicine and her specialty, Internal Medicine. Instead, I was reminded that knowledge in medicine is not only learned in classrooms but also cultivated in the quiet spaces within a patient’s words. Dr. Bucco began our conversation with a story that captured her philosophy. She described a patient whose medical history seemed ordinary—until she realized there was more behind his silence– “I could tell from his mannerisms that there was more behind his symptoms. By watching closely and listening not just with my medical mind but with my human heart, I realized his illness was tied to his work. When I asked him about it, his eyes widened. It was something he’d never told anyone. I knew his healing began the moment he knew he [had been] heard.” She emphasizes that this is the heart of osteopathic medicine—looking beyond the body and into the patient’s story. In her view, knowledge isn’t just about mechanisms; it also involves understanding the person behind the illness. When I asked how Dr. Bucco defines knowledge as a physician, she smiled and said, “Yes, scientific knowledge matters—but it’s only half of the equation. How a body receives treatment depends on how open a patient is to it emotionally and spiritually. Healing requires the clinician to show up as both a scientist and a fellow human being.” Her answer echoed the osteopathic tenets that body, mind, and spirit are inseparable. As we spoke more it became clear that her approach to care is deeply intertwined with her work in Narrative Medicine—a discipline that teaches clinicians to “close-read” stories, art, and music. Dr. Bucco described how she became certified through Columbia University’s Narrative Medicine program and the workshops she leads for physicians and hospice teams–“In these sessions, we study a text together—a poem, a song, a painting—and we listen for what speaks to us. Then we write reflectively, not as experts but as human beings…It’s not therapy, but it is therapeutic. It reminds us that before we can listen to patients, we must learn to listen to ourselves.” Her favorite poem, Ada Limón’s The Raincoat, describes a mother shielding her child through illness—a metaphor for protection and care. Dr. Bucco uses pieces like this to help physicians reconnect with empathy–“It’s amazing how reading one poem together reveals how differently—and deeply—people feel. It reminds us that our patients, too, bring their own poetry into the room.” As a medical student, I found this conversation both grounding and challenging. We spend so much time memorizing pathways, mechanisms, and dosages that it’s easy to equate knowledge with facts. Yet, Dr. Bucco reminded me that medicine also requires empathy–the ability to understand another’s experience with compassion. When I asked what advice she had for medical students like me who sometimes feel that empathy is lost within rigorous curriculum, she didn’t hesitate. “Start small,” she said. “Create spaces where you and your classmates can practice close listening—share a poem, a song, or a reflection. It builds empathy, resilience, and community. Healing begins with being heard.” After our interview, Dr. Bucco followed up with a reflection: “...I do have encounters where I am literally asking patients to ‘Tell me your story.’ When I was introduced to the practice of Narrative Medicine, my first thought was, ‘I do this every day.’ It is very impactful to be invited to share one’s story as a patient. The insights that patients have about themselves and their illness, and are willing to share in a clinical space that is sacred and created by the desire to listen, start the healing before a clinical exam is completed, a study ordered, or a treatment prescribed.” Her words also agree with a 2024 article in Academic Medicine by Michelle Loy, MD and Rachel Kowalsky, MD, MPH, which describes a Narrative Medicine Shared Medical Appointment program at Weill Cornell Medicine. In group visits, patients engage in writing prompts and storytelling that help address anxiety and isolation. Participants reported feeling hopeful, empathetic, and safe, while clinicians themselves experienced greater empathy and professional well-being. Hearing Dr. Bucco’s perspective and reading how narrative medicine continues to evolve in patient-care settings reminded me that the pursuit of medical knowledge extends beyond mastering and memorizing facts. It also means being fully present—listening deeply and honoring each patient’s story as part of their healing. In Dr. Bucco’s world, knowledge is more than information; it is a form of care. It is the gentle act of noticing and hearing what the patient’s heart is trying to say. I believe that is the truest medicine of all.
"Create spaces where you and your classmates can practice close listening—share a poem, a song, or a reflection. It builds empathy, resilience, and community. Healing begins with being heard.”
Heart to Heart: A conversation about Knowledge in Medicine
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JINA PARK (OMS-II, PCOM)
As a practicing family medicine physician at the Philadelphia College of Osteopathic Medicine, George Spyropoulos, DO, has a message to all healthcare professionals, “We are never going to have all the information, so you have to keep on top of it, stay ahead of the game, stay sharp.” Rooted in the belief that healthcare should address the whole person, osteopathic medicine emphasizes the practice of preventative medicine through vaccinations. A September 2025 statement from the American Osteopathic Association (AOA) recognizes that it is a physician’s duty to confront misinformation and promote evidenced-based healthcare. The AOA statement reads, “The AOA…believes in a patient-centered approach to care that relies on shared decision-making rooted in trust built between patients and physicians. As a physician organization dedicated to promoting public health, we regard vaccination as one of the most powerful tools to prevent infectious diseases and avoidable illness.” In his clinic, Spyropoulos embodies the idea of providing transparent vaccine recommendations that are rooted in credible authority and dada-supported research. “There's a big misunderstanding of the benefit of vaccines and immunizations, whether it's pediatric immunizations, or the things that we use to protect us against covid, flu, shingles and HPV. Patients still have preconceived notions based upon what they've heard, what they've seen, what their neighbor told them, or what they read,” said Spyropoulos. As technology continues to shape how patients access health information, questions arise about the accuracy and reliability of information from the internet. Spyropoulos noted that the growing influence of artificial intelligence has added new challenges to patient’s medical literacy. “Unfortunately, we are going to uncharted territory with AI and sometimes people aren't going to know if the information is truly accurate,” Spyropoulos said. “I think a lot of patients are relying on people that they trust, even if it is someone from the internet. I think if we have face to face discussions versus, interacting through some screen, that's one way to prevent the problems from being compounded.” Through empathetic conversations, Spyropoulos uses open dialogue to build trust, clarify misconceptions, and support informed choices that protect patients and their families. “As long as we have good evidence-based data that we can present, that's our job to present it, and then people will interpret that and do whatever they see is in their best interest,” Spyropoulos said. “Every little bit of information that leads to what I believe is a positive end result, is only going to hopefully provide the stimulus for that patient to then educate somebody else.” At PCOM, educating a patient starts with the first person that comes into the room. Often, a medical student or resident first assesses the patient. This structure provides students with a valuable educational experience in communicating medical information without jargon and offers patients an early introduction to preventive health measures, such as vaccines, available through the clinic. “You want to listen to the patient, take them seriously, and present the information upon the education level that you have and do it in such a way that you are offering it to the patient rather than making a patient feel like they do not have a choice,” Spyropoulos said. “Our intention is to do right, do no harm, and present data that informs the patient. It is about continuing education and gaining people’s trust. Patients don't want to be just treated like a number; they need to be treated with respect as an individual." As Spyropoulos explained, conversations should be tailored to the patient’s personal health history. This can be a moment to engage patients in shared decision-making and emphasize the role of annual vaccination in maintaining wellness. “One of my big teaching points is that I want every patient to be offered a flu shot, especially in the flu season,” Spyropoulos said. “When our students and our residents go in first, the patient will have been asked, ‘Do you want a flu shot?’, and many of them have said no. But once I go into the room and put in my two cents of why I feel it's important based upon their individual history, and since some people have significant morbidity, mortality risk, sometimes they’ll change their minds.” Finally, Spyropoulos recognizes that as a physician mentor, there is always an opportunity to educate others and learn. “I was hired to do both, to see patients and teach, but we learn on an everyday basis…it’s an ever-evolving process,” Spyropoulos said. His approach to patient education and compassionate conversations when addressing vaccine concerns with patients highlights the necessity of confronting medical misinformation as an essential strategy to preventive medicine. Resources: AOA Urges Evidence-Based and Routine Vaccination for Patients.” American Osteopathic Association, 24 Sept. 2025,
The Future DO publishes student conversations with physicians that inspire them twice annually. We welcome students to submit conversations for consideration to be featured in our next issue. Students are not required to be SOMA members to submit an article.Stay tuned for email announcements from SOMA Weekly or check out our research website: www.studentdoresearch.org for updates and announcements. We look forward to receiving your submissions!
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IS THERE A PHYSICIAN THAT INSPIRES YOU? SUBMIT YOUR CONVERSATION TO THE SPRING 2026 ISSUE OF THE FUTURE DO
Staying Sharp and Up to Date with Vaccines: A Conversation with Dr. George Spyropoulos
About the Author: Jina Park is a second-year DO student at the Philadelphia College of Osteopathic Medicine. Her career goals include pursuing primary care and narrative medicine, which combines her interest in the humanities and medicine. In her free time, she enjoys being a pet sitter, watching the Eagles team, and traveling to National Parks.
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LAUREN MARIE RAZIANO (OMS-II, PCOM)
“As long as we have good evidence-based data that we can present, that's our job to present it, and then people will interpret that and do whatever they see is in their best interest,”
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About the Author: Lauren Raziano is a second-year medical student at Philadelphia College of Osteopathic Medicine with a strong interest in medical education and health communication. Lauren was raised in Wilmington, Delaware and obtained her B.S. in Biology from Manhattan University in Bronx, New York. In the future, Lauren hopes to combine her passion for science and storytelling by pursuing a career in medical journalism, using clear and compassionate communication to build public trust in medicine.
"Our intention is to do right, do no harm, and present data that informs the patient. It is about continuing education and gaining people’s trust."
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What drew you into osteopathic medicine? I didn’t choose osteopathic medicine—it’s what I grew up with. My father, triple-boarded in Urology, Surgery, and Family Medicine, and a former AOA president, raised us with osteopathic philosophy and manipulation. As a student shadowing him, I learned the art of medicine is an instinct shaped by common sense and experience which is not easily taught. Tackling the Misinformation Epidemic How do you talk to patients who get their health information from social media? When patients bring in ideas from social media, I make it a point not to dismiss them. Listening with empathy and curiosity builds trust. Sometimes the information is accurate and can be thoughtfully incorporated into care; other times, it’s misleading or harmful. In those cases, I engage in respectful, evidence-based discussions to clarify misconceptions. Sharing clinical experiences has allowed me to address patient’s misinformation through clear communication. For example, explaining how certain medications may cause weight gain in specific populations can help patients feel heard and supported in shared decision-making. Have you treated patients misled by misinformation? How did you respond? Yes. When patients are influenced by misinformation, I focus on clear, logical explanations rather than confrontation. Tone and delivery matter as much as content; the goal is to educate without alienating. If a situation raises safety concerns, such as possible neglect or abuse, it’s essential to escalate appropriately, which can include contacting Child Protective Services. How do you handle patients who believe misinformation but still want your advice? Respect for autonomy is key. I present multiple treatment options, including the one the patient prefers, and carefully explain the risks and benefits of each. When patients feel respected, they are usually more open to medical guidance. If an idea is incorrect or potentially harmful, I clarify why with compassion and evidence. Sometimes patients’ preferences align with our own treatment plans, such as choosing fluoxetine because it helped a family member. Research shows that familial medication response can sometimes predict therapeutic success, so their reasoning may be partially valid. Have you found that osteopathic principles provide a unique perspective in addressing misinformation? Absolutely. As an osteopathic physician, I often use Osteopathic Manipulative Medicine before considering more invasive treatments. Many musculoskeletal issues can be effectively managed through OMM alone. I also emphasize the importance of listening. For instance, one patient once arrived with a list of twenty concerns, and the last item was concern for a breast mass. That experience reminded me that even what the patient may consider minor complaints warrants careful attention. What trustworthy sources do you recommend to patients? I prefer to provide reliable, easy-to-understand handouts or patient portal materials. When I do recommend online sources, I highlight reputable ones such as the CDC or NIH and explain why they’re credible. I also remind patients that medical websites may use technical language that can be misinterpreted, and I encourage them to bring questions back to their visits. How does misinformation affect trust in the healthcare system? Misinformation can greatly undermine trust in the healthcare system by creating confusion and skepticism about medical advice. In the 1960s-1980s, patients were more likely to follow their doctors’ recommendations without questioning their treatments, but today, the growing influence of insurance companies and the spread of false information online have shifted that dynamic. Patients are more likely to question medical guidance and doubt their providers’ intentions, which weakens the physician–patient relationship and makes it harder to deliver effective care. This mistrust can ultimately lead to poor health outcomes and greater resistance to evidence-based medicine. Guiding the Next Generation of Physicians How can we combat this mistrust in our communities? “Trust is huge—and it starts with avoiding judgment and meeting people where they are.” One of the best ways to build trust is through genuine community involvement: hosting free wellness events like yoga classes or setting up educational booths on important topics such as diabetes. We need to ground the next generation of physicians not only in evidence-based medicine, but also in empathy.” That means breaking down medical jargon into simple, accessible language so patients truly understand. Knowledge is only powerful if it’s shared in a way that people can connect with. What do you wish you knew at the start of your clinical career? I wish I had learned about functional medicine earlier. By addressing root causes through nutrition and lifestyle, it promotes true healing. I saw this firsthand when my daughter’s chronic stomach pain and acne improved with dietary changes. Once overlooked, concepts like the gut microbiome now highlight a shift toward viewing health as the restoration of balance, not just the absence of disease.
Featuring Dr. Stephany Esper, DO, Clinical Professor and Assistant Director of Osteopathic Manipulative Medicine at LECOM.
Stephie Thomas and Heli Butala (OMS-III, LECOM)
Truth, Trust, and Tomorrow’s Doctors: A Conversation on Healthcare Misinformation
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Still Needed: Why Osteopathic Physicians Matter, Even When the World Tells You Otherwise
Clayton Rawson (OMS-III) Noorda College of Osteopathic Medicine
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MESSAGE FROM THE RESEARCH DIRECTOR
At some point in medical training, almost all of us encounter a moment that shakes us. A rejection email. A dismissive comment. A comparison we didn’t ask for. Sometimes it’s subtle, an implication that our path is different. Other times it’s explicit: Why DO? Why osteopathic medicine? The subtext is familiar. Are we enough? Do we bring something truly distinct to the table? As osteopathic medical students, we learn early that our journey is not always the most straightforward. We explain our degree more often than we should. We work just as hard, often harder, to prove what we already know to be true: that we belong here. But somewhere along the way, many of us internalize the noise. We start to believe that rejection is a verdict rather than a redirection. It isn’t. Osteopathic medicine has never been about taking the easiest road. It has been about choosing a philosophy, one that values the whole person, not just the diagnosis. One that teaches us to listen with our hands, our eyes, and our instincts. One that reminds us that medicine happens not only in lab values and imaging, but in posture, breath, touch, and trust. We are trained to think in systems, to recognize how structure and function influence one another, and to appreciate that healing is rarely linear. That mindset doesn’t disappear when we step into residency, research, leadership, or advocacy, it shapes how we show up in every room we enter. And yet, rejection is part of the process. Residency applications. Research submissions. Leadership positions. Opportunities we thought were perfect fits that quietly passed us by. These moments hurt, not because we are fragile, but because we care deeply. Caring is not a weakness; it is evidence that we are invested in becoming physicians who matter. The fact of the matter is, that other people or groups not seeing your worth is not a reflection on you. It is on them! What I have learned, both in research and in medicine, is that rejection often has very little to do with your worth and everything to do with timing, fit, and perspective. Data does not always support the hypothesis, and that doesn’t mean the question was wrong. Sometimes it means the system wasn’t ready for the answer yet. The same is true for people. As osteopathic physicians-in-training, we are uniquely positioned to bridge worlds. We speak the language of evidence and inquiry, but we are grounded in human connection. We understand that innovation and empathy are not competing forces, they are complementary. Research without compassion is hollow. Compassion without rigor is incomplete. We are trained to hold both. In an era where efficiency is celebrated and speed is rewarded, osteopathic medicine quietly insists on something radical: presence. Being fully with a patient. Sitting in uncertainty. Recognizing that healing often begins before a treatment plan is finalized. No algorithm can replicate that. No rejection can take it away. When someone underestimates you because of your degree, your path, or your persistence, remember this: osteopathic medicine was built by individuals who believed there was room for something more in healthcare. More listening. More integration. More humanity. Every DO student today carries that legacy forward, not by shouting louder, but by practicing better. If you’ve been told no, let it sharpen you, not shrink you. Let it refine your purpose. Let it remind you why you chose this profession in the first place. You are not behind. You are not less capable. You are not replaceable. You are becoming a physician who understands that medicine is not just something you do, it is something you embody. As I reflect on my time serving as Research Director for SOMA, I am deeply grateful for the students who continue to show up with curiosity, resilience, and heart, often without recognition, but always with intention. This role has reminded me that leadership in osteopathic medicine is not about titles; it’s about service, mentorship, and believing in one another when the path feels uncertain. To my fellow osteopathic medical students: keep going. Keep asking hard questions. Keep choosing connection over convenience. The world may not always recognize your value immediately, but your patients will. And that has always been enough.
About the Authors: Stephie Thomas is a third-year medical student at LECOM, where she is working toward her goal of becoming a physician. She graduated summa cum laude with a Bachelor of Science in Biology from Adelphi University, where she participated in biological research and held leadership roles as a Resident Assistant and an Honors College Mentor. During medical school, she has been involved in the Women’s Health and Medical Society as the Marketing Chair and was recognized as one of the Top 10 Volunteers in the Class of 2027 for her community service efforts throughout her time in medical school. In her free time, Stephie enjoys traveling, painting, and reading. Heli Butala graduated from the University of Louisville with a Bachelor of Arts in Chemistry and was a member of the Honors College. She also earned a Master of Science from Lake Erie College of Osteopathic Medicine (LECOM), where she is currently pursuing her medical degree. She has served on the SOMA Research Committee, advocating for increased access to research opportunities at osteopathic medical schools and supporting student abstract submissions, poster presentations, and research awards. Currently, she is involved with the Osteopathic Family Physician (OFP) peer-review team, where she advocates high-quality, evidence-based osteopathic literature by reviewing and improving manuscripts before publication. In her free time, she enjoys creating henna art, traveling, and exploring new local foods.
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ipsa scientia potestas est "Knowledge itself is power"” ― SIR FRANCIS BACON
VOLUME 3 • ISSUE NO. 2