Business Profile
  • South Central Wisconsin
  • February 2015
Written by 

Madison Manual Medicine — Meet Dr. Jed Downs

Madison Manual Medicine was established in 2011. My wife and I moved to the area to be close to family. Concomitantly, I decided to break from traditional medical practice and pursue osteopathic manipulative medicine full time. In my practice as an occupational medicine physician, I had ethical dilemmas of varying import. The first was that many people had ongoing pain complaints post injury that did not respond satisfactorily to standard medical practice of injections, medications and exercise protocols. There were injured workers who pursued surgical corrections that occasionally left them in a worse condition than before surgery. Starting in 1995, I introduced myself to osteopathic manipulative medicine (OMM). The skills of OMM gave me greater insight into mechanisms of ongoing pain and discomfort due to improper body function that was different than pain due to anatomic injury. These problems could often be corrected or minimized with nothing more technical and nothing less amazing than human touch and guidance.

There were other ethical issues. Many times the injured worker had simply aggravated a pre-existing condition that was secondary to prior injury, birth trauma, postural habits, obesity or other factors that were not work related. The worker’s compensation system’s goal is that people be able to return to work in their pre-injury capacity. Many times, once broken, the person couldn’t be returned to health without addressing the pre-existing condition. The worker’s compensation system does not work well with this continuum of care. Moreover, primary insurance does not kick in if a problem is considered to be work related.

There are other problems providing OMM within the insurance framework. What insurers reimburse is determined by cookie cutter, CPT codes. There are 9 different regions of the body that can be coded for OMM reimbursement. The more areas treated, the higher the reimbursement. If I worked on a patient’s needs of the day, I might treat 2 or I might treat 9 different areas in an extended time block. As the resource being utilized is the time spent on application of skills in treatment, I objected to the pressure to code fraudulently or to get poorly paid. After 20 years, my solution was to move outside of the insurance company constraints and try to offer osteopathic services at a reasonable price as simply as possible.

The list of conditions treatable by osteopathy is huge but not infinite. It’s not appropriate for cancer patients when fighting active disease. It can be appropriate as a comfort measure if someone is on hospice status. It will not repair major anatomic tears, such as ACL tear of the knee or a fully torn rotator cuff muscle. It is often contraindicated if there are clinical signs of bleeding.

I decided that if I was going to provide osteopathic care I needed to get as skilled as possible at the craft. I had applied to fellowships within the USA to obtain training in get American certification and training. As an MD I was precluded from qualification. I instead pursued traditional osteopathic training in Canada. The Canadian training qualifies me to practice in Europe, Australia, New Zealand and is recognized by the World Osteopathic Health Organization.

Madison Manual Medicine

2940 Chapel Valley Road, #1B, Fitchburg


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