Doctor or not?

Osteopaths and chiropractors are on a par here, even from a private health coverage perspective.

Thus my surprise!

[Phoebe]

My husband is a DO. He wanted to be an osteopath and didn't apply to MD schools. He was in a DO sponsored peds residency, but there was an MD peds residency within the same hospital and they did the same clinical rotations mostly geared towards primary care. However, many people in DH's residency went on to subpspecialties.

Certain states seems to have more DOs. One ped in our practice is a DO and there is a sign posted that explains osteopathic medicine because no one knows what it is or think it isn't the same as MD.

Ah, I feel bad about posting my story about DO vs. MD. The resident who made the comment is just an arse! He says stupid things like that often and leaves everyone around him feeling very uncomfortable. The family practice DO was very offended and rightly so.

I was talking to DH about this thread. He said they have a DO residency program in orthopedic surgery here. I'm assuming they have DO residency programs in other fields as well although it sounds as though DOs can and do apply to MD residencies as well.

There are good MDs and bad MDs, good DOs and bad DOs and good FMGs and bad FMGs ......


kris

I think Kris says it best.

After the match last year my DH was talking to the chief resident at one of the programs he had interviewed at about how their match went. The guy said it went great, they "didnt even get down on their rank list to where the DO's or FMG's were". As if that is the most important thing about a candidate. Makes me so

My DH almost went to a DO school, but decided against it because as Tenshi says, the qualification is not recognised outside the US, including in Canada.

It's been my experience that US MDs think of DOs overall as people who couldn't get into MD med school. I realize that this is not true in all cases, but I think some use DO schools as backups to MD school. I think they're roughly thought of similarly to a US-born Caribbean school grad. It's much rarer for a DO to obtain an allopathic residency in a competitive specialty.

I've only personally worked with one DO (peds resident), and she was pretty cool. However, I never saw her utilize any of the manipulations that DOs learn.

Now that I've been through it, I realize that getting into medical school is a huge crapshoot and try to keep my judgments to individuals rather than groups.

[peggyfromwastate]

Mac did work with a DO in a FP in Virginia thru one of his med school rotations. The DO did do a lot of manipulations,and tried to show Mac how to do them. He convinced me to be his guinea pig for a couple of them, and.... let's just say it must take a lot of training b/c I felt "maladjusted" for a long time. Now when Mac offers to give a massage, I decline... quickly.

Anyway, I would say that having just come off the match process, Mac rotated with DO and MD candidates. Since Mac was trying to match in a really competetive field (it was the most competitive match for the military this past year ), the upper years who were "advising" the applicants told the DOs that they wouldn't even have a chance. Didn't matter about test scores or anything. They were going to match MDs only.

So bias does exist, but location is important and out west there is a real shortage of med schools, and so more DO schools are cropping up. I think it's good to get more docs in the system, whether they be DO or MD.

[madeintaiwan]

Some of our good friends are DOs and are great doctors. DS was delivered by a DO. Although I don't agree with it, I can see where the skepticism comes from. There are good and bad docs, DO or MD.

I do know that for a short period of time DOs were not allowed to practice in the state CA and such a lot of the older generations (my grandma, DH's grandma ect) do not like to go (and will not go) to DOs because they really don't think they are "real" doctors. A couple of months ago DH's grandma called to ask about a DO neurologist that her partner had been referred to (he had a very large brain tumor and died last month). DH really had to convince her that he was a "real" doctor and that her partner would be fine going to see him. She was very adamant about it because of the history and how they weren't allowed to practice in CA. It was during the 60s that they were banned from practicing and all DOs were asked to convert to MDs. And DOs trying to come into CA during the ban were not granted MD licenses. UC Irvine's medical school used to be DO and was turned into an allopathic school during the ban.

This is a letter that I wrote to the editor of American Baby. There are some states that still look down on the DO v MD. Louisiana and Washington to name a couple...things are changing, mostly due to the PLI issues.
I think what trisha2486 meant was, to the everyday person there are only MD's...along the same lines that women are only nurses (no offense, just a point). For those of us married/dating a DO, we ALWAYS have to define/defend the difference and the fact that, yes, they are REAL doctors.
My wife is sought after for adjustments by her staff, and the staff of a few other clinics. It is quite amazing to see a DO using the manipulation, done properly, to help patients. DW has a couple teenagers that she has used it for and alievated headaches without meds.


Dear Editor:


Upon receiving the current issue of American Baby, I was please to read several articles and came across one that really stuck with me. The article ‘Choosing Dr. Right’ really made an impression on me. In the piece, you list many good ideas and I agree with most. Although, I was quite shocked when I read the insert ‘Who’s Who’.
The trouble with this piece was the listing of the doctors as ONLY MD. In today’s society there is a wealth of outstanding physicians that are D.O.’s. That is, they are Doctors of Osteopathy. I am sure that you are aware of them; they have been around since 1874! The fact is that both D.O.s and M.D.s are fully qualified physicians licensed to perform surgery and prescribe medication in all 50 states. Is there a difference between the two kinds of doctors? Yes and no.
Applicants to both D.O. and M.D. colleges typically have a four-year undergraduate degree with an emphasis on scientific courses. Both have completed four years of basic medical education. After medical school, both D.O.s and M.D.s can choose to practice in a specialty area of medicine- such as psychiatry, surgery, or pediatrics- after completing a residency program which requires an additional two to six years of training (or more). Both D.O.s and M.D.s must pass state licensing examinations. Both practice in fully accredited and licensed health care facilities. The difference is that osteopathic medical schools emphasize training the medical student in primary care. D.O.s also receives extra training in the musculoskeletal system, and incorporate osteopathic manipulative treatment (OMT) in their training and practice. With this skill, (OMT), D.O.s use their hands to diagnose illness and injury and help encourage the body’s natural tendency toward good health. When included with other medical procedures, D.O.s offer patients the most comprehensive care available in medicine today.
With more than 48,000 D.O.s in practice today, it seems negligent not to include them in your periodical. This is brought home more so in that more than half of practicing D.O.s are doing so in primary care, i.e. pediatrics, family medicine, OB/Gyn and internal medicine. Most practice in medically underserved areas and rural settings.
As a spouse of a 2nd year pediatric resident who graduated from an Osteopathic School of Medicine, I felt compelled to respond to this article. Hopefully this will cause you to think twice before limiting some very well trained physicians in the future.


Sincerely,

Matt Black
Mission, KS

[SuzySunshine]

Very well written Matt - I personally don't know anyone that has gone to a DO school. I do know that some of our friends used the DO school in KC as "back-up" (their words) if they didn't get into KU Med. I think the fact that they do the same residencies and take the same licensing should aleviate some of the "concern" but I can see from the responses in this thread it hasn't.

Very interesting...

[Liz2254]

in PM&R DH actually feels at a bit of a disadvantage to the DO docs because they are much more familiar with all of the processes and exams. But maybe that's why people seem to frown on his specialty too?

No idea why the big distinction.... but I also worked in the land of big phamra medicinal chemistry where if you didn't get your PhD from one of 6 or 7 advisors at Harvard, Berkeley, MIT or Cal Tech you might as well not have spent the last 7 years getting the degree.

When did it become so difficult to be respected for bringing your particular gifts and interests to your field?

[Laker]

I agree with the letter except I would be careful to not go too far the other way...

"When included with other medical procedures, D.O.s offer patients the most comprehensive care available in medicine today."

When I was in law school I developed bad lower back pain from constant studying. I went to the health clinic and the D.O. I saw wrote me a script for the physical therapy clinic. :huh:

3 weeks and the pain was gone, permanently.

I would like to know how many DO's actually use the OMM in their practices. Anyone have data on that?

Looks like I unknowingly opened a can of worms here. It sounds like this is quite a contentious issue in the US? It is very interesting for me to hear of alternative therapies working side by side with doctors (you know, the other kind! ) Surely this will be the direction of the future.

I would like to ask though, if DO's are not recognised as doctors outside of the States, does this not mean that there is some difference in their qualifications?

And what are the FMG's that Kris mentioned? Is this another type of doctor you have?

[SuzySunshine]

Correct me if I'm wrong but the only difference between a DO and an MD education wise is their school. After their degree all of their residencies, boards, etc. are the same - I'm not sure why other countries wouldn't recognize them.

FMG's are Foreign Medical Grads meaning they attended medical school outside of the US but are doing a residency in the US. In all specialties it is usually harder for an FMG to get into a US residency, in some its pretty much impossible. Some programs here just aren't familiar enough with their schools to know what type of training they have and haven't received.

I would like to know how many DO's actually use the OMM in their practices. Anyone have data on that?

I am sure that it is very little. I only know of one office in Tulsa Ok that works as only OMM, as in that is all that they do. They do very well, as it is typically not covered by insurance. Thus the reason that not many practicing docs will use it...it is pretty time intensive and with the need to rush patients through clinics (read: double booked 25-40 patients per day) it is usually easier to move on to the next patient and get a higher/better RVU per the insurance.

would be careful to not go too far the other way

Yeah, I realize that is possibly reaching...but I had to defend (the profession of) my lady fair!

[diggitydot]

Oh, holy crap. What a can of worms.

My DH is a fourth year DO student. Some of the information put forth here is been erroneous, at best. Some is spot on.

DH applied, interviewed, and was accepted to several schools, both osteopathic and allopathic. He elected to attend the DO school for several reasons, but mainly because he really liked the philosophy and general atmosphere of the school. And we've been pleased with not only his education, but his classmates as well. (DH has gained a spectacular education and is competitive for any specialty he wants.) There are some seriously great people are in his class. They go out of their way to help each other out, whether it be with studying, babysitting, moving...whatever. We've been told this is pretty rare so we feel extremely grateful.

The two main difference between DO and MD educations is that DO students are taught OMT (osteopathic manipulative therapy), which are the manipulations that are similar to the chiro type treatments. (That's in addition to the same subjects taught at MD schools.) I've had OMT done on me by students and by some exceedingly well trained/educated docs. Some are great at it, some shouldn't bother. Not all DO's do these treatments once they get into practice, but many do. The other main difference is that many DO schools tend to put a heavy stress on rural and family practice. Certainly not all DO schools, but many.

In the US, DO=MD when it comes to practice rights. A DO and an MD can both apply to all the same specialties. (Your ob/gyn, oncologist, dermatologist, neurologist, neurosurgeon, etc, can all be MD's or DO's.) A competitive candidate is a competitive candidate. There are very few residency programs that dismiss DO's out of hand for simply being a DO, anymore. Also, most DO students attempting to get into tough residencies will take the USMLE's along with the COMLEX and put themselves on as much of an even field as they possibly can.

I've been around docs all my life. Some are DO's, some are MD's. Once out in the "real world", no one cares which initials are behind the name so long as they're a competent physician.

Just some clarifications from previous posts:

• 1.) DO's do not usually specialize in alternative medicine. They are educated as western style docs. The only kind of "different" thing they do is the OMT. (Which I love, personally.)
  2.) Once out of school, there is very little of the "DO vs. MD" stuff.
  3.) In the states, DO's can be any specialty that MD's can be. They have the same practice rights. Insurances pay the same for treatment from a DO as they do for the same ones from an MD.
  4.) DO schools do tend to have looser entrance requirements compared to MD schools. But many DO schools have significantly higher pass/match rates than many of their MD counterparts.
  5.) DO's tend to be older or non-trad students, but certainly not always.

Really, this is all just semantics. A good doc is a good doc. I'll jump down off my soapbox now.