I’ve always been vaguely aware that there are both physicians who have “M.D.” after their name and physicians who have “D.O” after their name. I was further aware that the M.D. = Doctor of Medicine and that D.O. = Doctor of Osteopathic Medicine.
For whatever reason I’ve never come close to caring enough to look into it further than that.
But on a whim I looked up D.O. on wikipedia, and the first paragraph genuinely leaves me completely puzzled as to why schools issue these degrees at all, they don’t seem to be meaningfully differentiated from M.D.s:
Training in one type of therapy doesn’t seem sufficient reason to create a whole other degree, many M.D.s are trained in all kinds of different therapies.
I’m just really confused about why these two degrees exist. Can a D.O. get the same jobs as an M.D.? Such as becoming a surgeon? Are D.O.s usually considered inferior?
My father was a D.O. He went through the exact same classes as the M.D.s and got some additional training in things like hypnosis and chiropracty. There are a lot of people who think a D.O. is inferior (if you’re not an M.D. you’re not a “real” doc), which I don’t understand because they get the same training.
My father was a family practitioner. I don’t know about career limitations, but the other D.O.s I know personally also happen to be family practitioners.
Osteopaths (as reckoned from the name) used to place a lot of emphasis on manipulation of the bones. Think back-cracking. Think, to take a short-cut, chiropractic (your Wiki entry refers to this, albeit in rather euphemistic terms). The “movement” started out as one of many (okay, this is GQ so I will not say “cultic”) almost-ideological health theories (think “The Road To Wellville” and all the colonic irrigation weirdos).
Well, people made fun of osteopaths (just as they still do of chiropractors). Difference is (very short version) osteopaths cleaned up their act, started teaching way more orthodox medical stuff and de-emphasizing the bone-popping, and succeeded in getting themselves recognized as “real” doctors.
The perception of inferiority (much attenuated) lingers on because of history (and, FAIK, because of a perception that (unless you were really a closet chiropractor) the only reason to obtain a DO rather than an MD would be iffy academics).
There are and have been several D.O.s in the Pathology residency program at my institution. At the moment, one is training in forensics to become an M.E. From a systems biology point of view, there is a certain amount of sense in the theory behind D.O. training (holistic medicine). But that sense goes out the window if they rely on unproven, anti-establishment or magical thinking-type of medical practice.
By and large, DO schools in the United States are currently significantly less competitive to gain entrance to than MD granting medical schools. However, MD admissions are insanely competitive at this point and DO admissions are only slightly less competitive.
There is a very significant cross-over between DO and MD career tracks now. MD students take a board exam called the USMLE Step-1 after their first two years of medical school and DO schools take a very similar COMLEX exam, but DO students that hope to have the widest range of career options will sit for the USMLE Step-1 and possibly for the USMLE Step-2 (taken during the final year of medical school) as well and then apply to allopathic (MD) internships and residencies.
Having a DO as opposed to an MD degree is a very, very small disadvantage for otherwise comparable applicants.
So, there is tremendous intermingling of DO and MD career tracks now, and I’d say the degree themselves are virtually synonymous except for the DO’s additional training in osteopathic manipulation, which AFAIK, has little evidence base and is sort of a minor, atavistic component of most DO programs from the DO students I speak with.
IMHO, there’s no reason to prefer treatment from an MD over a DO if either is board certified or in the process of gaining board certification in their practice specialty.
I’m an allopath, but I’ve worked alongside many DO physicians, chosen to have DOs as my and my family members physician at times, and my cousin is presently going thru DO school.
As has been pointed out above, the differences overall aren’t great. Or they don’t have to be, anyway.
But my cousin tells me that a significant minority of his fellow classmates plan to pursue careers more closely allied to ‘oldstyle’ osteopathy (think lots of manipulation, closer to what chiropractors do), and talk about combining it with naturopathy, homeopathy, and herbal medicine. :rolleyes: (Herbs may be a great source of future effective drugs, but very very very few herbal treatments currently stand up under scientific scrutiny for safety or effectiveness.)
It’s true that many allopathic students also veer off in this and other non-evidence-based directions, but I got the distinct impression from him and other DOs I’ve know that this percentage may be rather higher in the osteopathic schools.
I speculate it may be because osteopathic manipulation is such a core part of their curriculum, despite evidence indicating it’s of no long-term benefit. My cousin adds that at least some osteopathic schools are refuges for some very hard-core DO traditionalists, where they serve as professors .
Virtually all the osteopaths I’ve worked with over the decades (in mainstream medicals settings one and all) have given up doing osteopathic manipulation.
Anecdote warning. We chose DO’s as primary care physicians back in the day because they did not tend to prescribe unnecessary antibiotics for every sniffle. Never experienced any of the manipulation stuff others are talking about. The ones we used also seemed to be more personable than typical MD’s.
I’ve always gone to a DO. He has a lot of the same equipment as a chiropractor. It’s nice to have 1-stop shopping for medical care. He’s very good at what he does.
That’s when you tell them that the only “real” doctor is a Ph.D., i.e. Doctorate of Philosophy. We are “doctors” (noun), while MDs “doctor” (verb)! Ok, just kidding and don’t mean to start any problems, but you are dead on in that people naturally rank themselves. I take solace in the fact that everyone out there has someone “better” than them…Ph.D.s get to hear it from MDs. MDs have to deal with cocky surgeons, cocky surgeons have to deal with cocky neurosurgeons, and so on…I’m not sure where the chain ends and who is ‘officially’ the top dog.
I have students interested in osteophathy, and have a very strong leaning towards herbs, supplements, vitamins, etc. Several actually go to conferences around the country that push these points of view. Some of their therapies involve sleeping on certain stones due to the magnetism or something. Regardless, I’m always sure to push one angle - “don’t believe anything you hear without a true double-blind study on the matter, performed by an independent researcher”. I’m not sure what percent of osteopathy survives such a treatment, but I believe it to be low.
That being said, I do like the D.O.'s view of the human body as a huge intermingled organism, that must be treated as a whole. I hope I’m not generalizing too much, but from what I gather D.O.'s might be a little bit more inclined to look for the source of a problem from the whole body, rather than just treating the symptoms.
We have a small number of osteopaths in Australia, I guess the idea was to take over from the chiro’s however the reality was the chiropractors simply turned the tables and qualified as osteopaths though bridging courses.
As of this moment, I’m involved with a law firm that is representing me as a result of an automobile accident. In that accident, my back got more than a little bit messed up and the law firm has sent me to a D.O. for treatment. The D.O. is part of an Orthopaedic group that has its own Physical Therapy section, to whom I have been sent for therapy; that therapy did involve a lot of spinal manipulation which has done nothing to alleviate my back pain. Rather than insist on further therapy, my D.O. has now sent me to a Pain Management Group and I have been given a steroid injection by an M.D. which seems to have been helpful. If I have a point, it is that this particular D.O. has treated me in a manner consistent with what I would have expected from an M.D. Even so, it did take a while for him to acknowledge the physical therapy he prescribed wasn’t, in my case, helpful.
My only complaint has been that on my last visit, he left me in an exam room for better than thirty minutes while he and and his staff chowed down on pizzas right outside my door. I was very hungry, the smell of the pizzas was driving me nuts and all the folks outside the door were laughing and having a great time. They could have at least opened the door and tossed me a slice; if I had been the office guard dog, they probably would have.
25 years ago when a good friend of mine was getting her DO, she told me that DO’s tended to do their residencies in smaller, more rural settings. I’m not sure if that’s still the case but I do know that here in rural SW Oklahoma, the number of DO’s exceed MD’s by a pretty good margin.
I think we should distinguish American DO’s from DO’s in other nations. In the United States, the DO track has largely come to parallel the allopathic track, but in other nations, they’re much more likely to be vastly different with the DO’s tending towards the non-evidence or medical science based practices.
