General/Osteopathic Principles, Perioperative Care, and Practice Management
Core concepts
Integrate osteopathic principles: the body is a unit, structure and function are interrelated, and somatic dysfunction can contribute to symptoms. Know that osteopathic manipulative treatment may be considered as an adjunct in appropriate patients, but must not delay indicated medical or surgical care. For perioperative care, master preoperative risk assessment, informed consent, and prevention of surgical site infection (timing of antibiotic prophylaxis, sterile technique). Understand venous thromboembolism prophylaxis based on risk. Recognize that documentation and clear communication are central to practice management and risk reduction. Know basic coding and billing concepts at a high level and the importance of accurate documentation to support them.
Traps
Questions may imply that OMT replaces standard therapy-it does not; it is adjunctive. Another trap is administering prophylactic antibiotics too early or too late relative to incision; timing matters. Also beware of consent questions where the correct answer emphasizes documented discussion of risks, benefits, and alternatives, not just a signature.
Worked example
A patient scheduled for surgery asks about antibiotic prophylaxis. The rule of thumb is to time prophylaxis so adequate tissue levels are present at incision, consistent with institutional protocols.