Questions regarding DO

[aalber9]

I was at my doctors office this week to shadow him and a woman came in with a ankle that was in bad shape, a previous surgery by another doctor (a DO) was done very, very poorly. As we were looking at the x-rays on the computer another doc in the office saw the screen and imediatley ask who the hell did that and said the whole operation was done terribly and the way it was done is something a real doctor would never do.

I asked what he meant. He went on to tell me that he thinks that DO's should not practice any type of surgery and stay in primary care unless they trained in an MD residency program. He said the DO training is far inferior to an MD program. A thought my doc supported. Any thoughts.

[Adcadet]

I've had no direct experiences with DOs (that I'm aware of), so I'll stick with what I think is a very basic, factual response:

a number of months ago at dinner my mother asked me why I wasn't applying to any DO schools. My father replied "because he doesn't want to be a second class doctor." There are many people who hold this view. And there are others (see the pre-DO forum) who think that DOs are as every bit as good as MDs. Everybody agrees that there are good doctors and bad doctors, regardless of training. Many DOs can and do enter allopathic residencies. Looking at numbers alone DO schools are easier to get into - low avg. GPAs, lower MCAT scores.

[Olanzapine]

Actually, one of my radiology prof's had a similar story. His son was away at college and had appendicitis. His son happened to be admitted into a DO training hospital and had his surgery done there. Well, his son ended up having some surgical complication (something about scar tissue obstructing his bowel) as a result of the surgery and had to have corrective surgery for that, and the surgeons who did the operation all told him that whoever did his son's first surgery was incompetent. So he did some research into this DO hospital, and found out that they only took care of some 50 cases of appendicitis per year. Ever since then, he tells people the story about his son and he tells them that they should not go to DO hospitals for surgery. Appendicitis is pretty bread and butter in surgery, if they did not have adequate training/supervision to do that surgery, I'd hate to see how they'd handle something more complicated. DO surgeons trained in MD residencies are probably just as good as their MD counterparts, but I woudn't feel comfortable being operated on by a DO who trained at a DO surgical residency.

[skypilot]

65% of DO's do M.D. residencies. I think that your undergraduate medical degree is not important (DO, MD, MBBS) but where you do your residency is really really important.

Incompetence is not limited to DO's, lots of M.D.s F&*&* up too.
Remember the surgeon who left to go to the bank in the middle of the operation? the one who amputated the wrong foot? the one who put in the organs with the wrong blood type? (All MDs)

[toogood1]

I definitely agree with skypilot. Don't make generalizations about the DO profession because as of lately all the mistakes have been made by MDs. Maybe we should stick to saying that the doctor just messed up and not degrade any degree programs.

toogood1

[ussdfiant]

This thread makes me ashamed to be an allopathic medical student.

[group_theory]

Hmmmm

So here are some posts degrading DOs as second class doctors and incompetent doctors based on 1-2 examples. Then there are comments that goes something like "I'm better than you are, natty natty poo poo" and I sit here thinking, "are these people really that stupid?"

If you want to make an argument that DOs are second class doctors, or are incompetent doctors, make a case for it. Don't make conclusory statements and illogical arguments. Use factual statements like "first time pass rate on USMLE I is lower for DO students than MD students" or "according to the latest NIH study, DOs make 150% more misdiagnosis, are 50% more likely to walk out of surgery, have worse handwriting than PAs, NPs and MDs, etc" - to support your claim. To make the statement that DOs are incompetent because you saw a few examples of incompetent DOs is highly suspect, and I must question your ability of higher reasoning.

Besides, I could care less how you arrive at your negative views of DOs. I guess you view the fact that DOs are at Mayo in Rochester, Hopkins, Penn, UCONN, and CHOP as just a fluke. People will always make fun of other people. They make fun of blacks, jews, asians, muslims, females, gays, red-necks, the cheese eating surrender monkeys, etc. However, to join in and go "yeah, I agree - they are second-class" shows your level of immaturity.

If you really believe that MDs are superior than DOs, then act like it. Show me your moral and intellectual superiority. Be someone that I want to look up to, to want to emulate, to see as a role model. Be someone that I want to strive to. Don't be one of the good old boys who laugh at everyone and anyone they can. Because everyone else will just view you as a bunch of jerks.

P.S. Although you may claim that DOs get no professional respect - they indeed do. Even though DO is the legal equivalent of an MD, they are also the professional equivalent - accorded the same respect from attendings and PDs everywhere. Is it because of some law or court ruling? No - it is because DOs have shown that our education and training is equivalent to our allopathic counterpart. Otherwise, we wouldn't be licensed to practice medicine and have hospital privilages.

Sincerely,

Group_theory
PCOM Class of 2007

[MaggieD]

One of the issues I find most troubling about modern American allopathic medicine is its rampant elitism. Frankly, it disgusts me. It is utterly distasteful and reeks of the snobbish arrogance of a perceived intelluctual superiority. Our castes in this society are just as rigid as any other - and they are stratified by GPAs and MCAT scores and the prestige of one's udergraduate institution. It becomes bloated and perverse and we end up with a surgeon carving the initials of his alma mater into a woman's uterus. How far we have come.

I want no part of it. I'll be quite happy practicing blue-collar medicine as a DO.

[Ischemia]

It's a cheap move to blame a mistake on someone because s/he "is a DO." When people mess up, they mess up; it's really quite simple. There are just as many MDs that mess up as DOs. More accurately, because there are simply many more MDs than DOs in this country, more mistakes are made by MDs every day than by DOs. But, who cares? The goal of any physician, regardless of title, is to treat people. Discussing the unfortunate mistakes is, perhaps, interesting at a cocktail party, but it is essentially irrelevant, or at least should be, in the professional arena.

By the way, Duke is an allopathic institution. Not to be insensitive, but using the same logic as the appendicitis story presented earlier in this thread, couldn't I say to never have transplant surgery done there? Of course I should not. What happened there recently was a horrible, unfortunate accident. However, it was just that. It was not because the hospital is an allopathic one.

I wish people would stop worrying about this type of thing.

[aalber9]

to go a step further with the conversation i had with my docs was, They recognize DO's as doctors and said they can be just as good as a MD. What they said from there experience DO's who go into surgical specilties eg. ortho. without having trained at MD ortho residency are vastly undertrained. They mentioned that any second year resident would know not to preform the type of surgery that was preformed by the cheif of DO ortho program.

[Deuce 007 MD]

Originally posted by Ischemia
There are just as many MDs that mess up as DOs. More accurately, if you want to adjust for the relative number of each type of physician (there are many more MDs than DOs in this country), it is clear that more mistakes are made by MDs every day than by DOs.

I'd like to know where you get these numbers from, please post a link. In the mean time here are some numbers from http://www.studentdoctor.net/boards/index.asp allopathic students have a 93% pass rate USMLE step 1. While DO students have a 77% pass rate. In my mind 93% is an A and 77% is a C, I'll take the A students as my doctor over the C student anytime. From the the princeton review "Complete Book of Medical Schools," the average MD student in the U.S. mcat was 30 and DO student was 24-25. The average on the mcat is usually an 8 in each section so an average mcat test taker would score 24, personally I would want my doctor to be above average. I guess I expect too much from my doctor.

[CatsAreKillers]

Originally posted by Adcadet
Looking at numbers alone DO schools are easier to get into - low avg. GPAs, lower MCAT scores.

I think that says a LOT. If DO's want to be considered as real doctors ( most of the public considers them to be on par, or perhaps a little above, chiropractors, who I'm sure consider themselves to be "doctors"), then their schools should have standards as high as MD schools. And they should take Boards with standards as high as allopathic boards....

[Olanzapine]

There is a difference between making a careless mistake (as all humans do) and being incompetent at what you do. DO programs are usually community programs that see a much smaller volume of cases compared to MD programs, and almost all of the zebra's (rare conditions) get sent to MD university's for them to figure out. Given the choice, most sensible people would prefer the surgeon who has operated on hundreds of people with his condition vs the surgeon who has operated on tens of people with his condition. It's not that unusual to see a DO student complaining on this board about their lack of clinical training and most of the good DO students prefer to train in allopathic residency programs. DO students do have lower pass rates on the USMLE's too. When I go under the knife, I'd prefer the best possible team working on me, and the best teams happen to have trained at MD universities. If Harvard starts pumping out DO degrees, then to DO I will go. It's not the letters, it's the quality of training. For those people that are so gung-ho DO, if your parents or loved onees needed neurosurgery, I wonder how comfortable you would be telling them to go to a DO training hospital out in Debunk Missouri with a DO resident neurosurgeon, a nurse-anesthesiologist, and DO attending surgeons that have never set foot in an MD institution. Those with medical backgrounds know how to look for quality. Unfortunately, not everyone gets quality.

[CatsAreKillers]

Originally posted by Ischemia
By the way, Duke is an allopathic institution. Not to be insensitive, but using the same logic as the appendicitis story presented earlier in this thread, couldn't I say to never have transplant surgery done there?

Actually, I think a lot less of Duke because of their incompetent system. But it's not because they're allopathic...it's because they had an incompetent system and then practiced questionable ethics by doing a cover-your-ass maneuver & giving Jessica a second transplant.

However, the best institutions are allopathic. You don't hear about osteopathic institutions botching up major multiple transplant operations because patients don't trust them to do such an operation on them....that's why there aren't any world-famous osteopathic hospitals.

[Ischemia]

Originally posted by Deuce 007 MD
I'd like to know where you get these numbers from, please post a link. In the mean time here are some numbers from http://www.studentdoctor.net/boards/index.asp allopathic students have a 93% pass rate USMLE. While DO students have a 77% pass rate. In my mind 90% is an A and 77% is a C, I'll take the A students as my doctor over the C student anytime. From the the princeton review "Complete Book of Medical Schools," the average MD student mcat was 30 and DO student was 24-25. The average on the mcat is usually an 8 in each section so an average test taker would score 24, personally I would want my doctor to be above average. I guess I expect too much from my doctor.

I'm sorry to tell you, but SDN is hardly an official source for numbers. So asking me to post a link to my claim and then posting one to SDN for yours is silly, even if the information is accurate. However, I think you misunderstood what I'm saying.

I wasn't referring to STEP 1 scores at all. Besides, except for maybe physiology, a good deal of the stuff you learn in your first two years is almost irrelevant to the average practicing physician. A General Practitioner does not need to recite the steps of glycolysis. S/he does need, however, to be able to efficiently and accurately perform the things s/he will see on a daily basis, and to be able to understood how medicine as an art works. That is stuff not necessarily tested on STEP 1. Ask your seasoned physician if s/he remembers all the biochemical reactions of the Krebs Cycle. Whether DO or MD, s/he will certainly not.

I was referring to the sheer number of medical mistakes made on a daily basis. I believe 90-95% of all physicians in this country are MDs, while the remainder are DOs. I don't have a link. It's on the AACOM site somewhere, I just don't remember where off-hand. All I was saying is that because there are more MDs than DOs, there is a larger number of mistakes made by MDs than DOs. That's a simple, logical conclusion.

By the way, don't think I'm attacking MDs; I'm not. I'm applying to allopathic programs, and by any standard you wish to discuss, I'm more than competitive. So, I'm not an embittered applicant, either.

[Deuce 007 MD]

Originally posted by Ischemia
I'm sorry to tell you, but SDN is hardly an official source for numbers. So asking me to post a link to my claim and then posting one to SDN for yours is silly, even if the information is accurate.

I was referring to the sheer number of medical mistakes made on a daily basis. I believe 90-95% of all physicians in this country are MDs, while the remainder are DOs. I don't have a link. It's on the AACOM site somewhere, I just don't remember where off-hand. All I was saying is that because there are more MDs than DOs, there is a larger number of mistakes made by MDs than DOs. That's a simple, logical conclusion.

If you click the link it isn't a forum, it's an info page on the USMLE step 1 that SDN put up. As for larger number of mistakes, I agree w/you that it is a logical conclusion due to sheer numbers of MDs. But what we really need to look at is per capita, number of medical errors per type of physician. Do you have any info on that? I well admit that some DO schools like CCOM, KCOM, and TUCOM have average mcats 27, which I would consider above average. So I'm sure their end product is pretty good having used better starting materials then the others.

[OphthoBean]

Looking at numbers alone DO schools are easier to get into - low avg. GPAs, lower MCAT scores.

And according to some on this thread, lower grades and lower MCAT scores = inferior doctor while higher grades and higher MCAT scores = better doctor.

This creates a confusing situation where doctors will have to wear their transcripts, MCAT score reports, and personal statements on their lab coats at all times so that patients may differentiate between potentially good and bad doctors.

These materials are necessary because some MD schools, take Howard or the Puerto Rican schools for example, have classes with lower GPAs and MCAT scores than some of the DO schools. Some people earn their MDs at foreign caribbean and mexican medical schools which accept anyone with a pulse and a checkbook. Some people who pursue DO degrees have stellar GPAs and MCAT scores and chose DO school over MD school.

By reading these materials worn by the doctors, patients could find out if they have a good and motivated MD or DO or if they have a bad and lazy MD or DO. The licensing boards could be enlisted to create some kind of color coding to stratify the docs according to good and bad by granting different colored coats after review of the materials. There could be 4 different colors! Red = Good MD. Orange = Good DO. Green = Bad MD. Blue = Bad DO. What a colorful workplace it would be! And there could be different piping along the trim to account for grade inflation in undergraduate education. People that went to state universities where it is easy to get good grades with little motivation or effort could have white piping to modify their coats. People that went to ivies and top ranked liberal arts colleges where the average student is better than the best at a state school could have crimson piping. People that went to midrange universities could have yellow piping.

Upon walking into a hospital or clinic every person would be handed a coat color decoder so that they can decide if their doctor is any good. Afterall, relying on a patient's personal judgement of whether they have a good doctor or not is far too unreliable. Interpreters would be available for the color-blind and patient advocates would be on hand to help the blind.

There can even be a series of patches and pins to signify board scores and gross anatomy grades and rank within a residency program. It will be great.

Oh! And shoelaces...so much can be done with shoelaces....

[UNEOSTEO]

There are DOs in Mass General, Brigham & Women's, Boston Children's, Memorial-Sloan Kettering Cancer Center, Mayo Clinic, Cleveland Clinic, Emory, etc. These DOs aren't only doing IM or FP at these places...they are in specialty areas. Obviously, they didn't get in by being second class. Allopathic students have difficulty in getting into these places, so I would in no way consider DOs to be inferior. I know of DO orthopods that did a DO orthopedic residency and had no trouble getting an MD fellowship at Brigham/Harvard.

By the way, one of our most recent Surgeon General was a DO.

What makes you a good doctor is your willingness to work hard and be a good clinician...not some exam!

P.S: The biggest and most unfortunate medical errors have been performed by MDs.....Duke transplant incident, doc taking the wrong part out of the brain at Cornell, etc.

[ussdfiant]

Originally posted by UNEOSTEO
By the way, one of our most recent Surgeon General was a DO.

That is not true. It was a former Surgeon General of the ARMY that is a DO.

[Rev. Horace]

Originally posted by OphthoBean
And according to some on this thread, lower grades and lower MCAT scores = inferior doctor while higher grades and higher MCAT scores = better doctor.

This creates a confusing situation where doctors will have to wear their transcripts, MCAT score reports, and personal statements on their lab coats at all times so that patients may differentiate between potentially good and bad doctors.

These materials are necessary because some MD schools, take Howard or the Puerto Rican schools for example, have classes with lower GPAs and MCAT scores than some of the DO schools. Some people earn their MDs at foreign caribbean and mexican medical schools which accept anyone with a pulse and a checkbook. Some people who pursue DO degrees have stellar GPAs and MCAT scores and chose DO school over MD school.

By reading these materials worn by the doctors, patients could find out if they have a good and motivated MD or DO or if they have a bad and lazy MD or DO. The licensing boards could be enlisted to create some kind of color coding to stratify the docs according to good and bad by granting different colored coats after review of the materials. There could be 4 different colors! Red = Good MD. Orange = Good DO. Green = Bad MD. Blue = Bad DO. What a colorful workplace it would be! And there could be different piping along the trim to account for grade inflation in undergraduate education. People that went to state universities where it is easy to get good grades with little motivation or effort could have white piping to modify their coats. People that went to ivies and top ranked liberal arts colleges where the average student is better than the best at a state school could have crimson piping. People that went to midrange universities could have yellow piping.

Upon walking into a hospital or clinic every person would be handed a coat color decoder so that they can decide if their doctor is any good. Afterall, relying on a patient's personal judgement of whether they have a good doctor or not is far too unreliable. Interpreters would be available for the color-blind and patient advocates would be on hand to help the blind.

There can even be a series of patches and pins to signify board scores and gross anatomy grades and rank within a residency program. It will be great.

Oh! And shoelaces...so much can be done with shoelaces....

LOL..... this is a great concept. I think that we should go so far as to incorporate every academic experience you've ever had as far back as kindergarten. We could include stuff for those phenoms who learned to tie their shoes first, or if you were lucky enough to be selected to go retrieve milk from the cafeteria. Shoot, we could even incorporate merit badges from cub scouts and brownies!!! Imagine the posibilities!!! Your whole academic history would be in your clothing!!!! Choosing a good doctor would be fail safe endeavour. You would always get the best academically, hence the best all around b/c we all know that that's the only thing that counts!!!

[chopp]

It's truly disheartening to read this thread. I believe in the merits of both allopathic and oseopathic programs, but what is hard to believe is that those of you who claim to be the MD-bound elitists fail to understand what it takes to be a good doctor. A doctor is not and should not be defined by the letters that follow his/her name nor by his MCAT score and GPA. Medicine is a field that uniquely couples intelligence and compassion into one seamless effort. It should not matter what your degree is, but the degree to which you can understand human emotion and disease. I wish that all of you would just step down and try to embrace the unity of MDs and DOs in practice. It's a reality, so get over it. I'm sorry that I've had to read what some of you so ignorantly post.

[Nirvana]

I wish that all of you would just step down and try to embrace the unity of MDs and DOs in practice. It's a reality, so get over it.

It's not MD's that created this. The general population of patients would rather go to a specialist that is not a DO. They screen out DO's. MD's didn't create that atmosphere; it already existed.

[Rev. Horace]

Originally posted by Nirvana
It's not MD's that created this. The general population of patients would rather go to a specialist that is not a DO. They screen out DO's. MD's didn't create that atmosphere; it already existed.

So we should just perpetuate it??

[republicandr]

I was interested in applying to DO schools myself, but couldn't afford to apply to both MD and DO programs. Here are two sites that should help you with learning more about osteopathic medicine:

http://www.aacom.org/

Are DO's losing their unique identity article (this is interesting) http://www.findarticles.com/cf_0/m32...30/print.jhtml

[CatsAreKillers]

Originally posted by Rev. Horace
So we should just perpetuate it??

As long as osteopathic schools have lower standards than medical schools, then they will be leading the way in perpetuating the low quality image of DO's. The public knows that the standards are lower...just like they know that there are low standards to get into a chiropractic school.

[tkim]

http://www.cnn.com/HEALTH/9911/03/back.pain.care.wmd/

"Osteopathic manipulation may effectively treat back pain

Power over pain

November 3, 1999
Web posted at: 5:03 PM EST (2203 GMT)

By Mari N. Jensen

(WebMD) -- People with chronic low back pain who were treated with osteopathic manipulation used less medication and recovered as well as those who received standard medical care, a new study suggests.

Results published in this week's issue of The New England Journal of Medicine show that the two different treatment regimes were equally effective in reducing pain and improving range of motion for people who had low back pain for at least three weeks before they enrolled in the study. No matter which type of treatment they received, more than 90 percent of the patients said they were satisfied and would seek similar treatment again.

"Patients that for one reason or another would prefer manual therapy over medication can confidently choose that alternative," said lead author Gunnar Andersson, M.D., Ph.D., chairman of the orthopedic surgery department at Rush-Presbyterian-St. Luke's Medical Center in Chicago.

One out of five Americans suffers from back pain, said Andersson. About nine out of 10 people older than age 30 will experience back problems sometime in their lives, according to the North American Spine Society, a non-profit organization of more than 2,000 medical professionals who treat spine problems.

For most of these people, the problem will resolve within six weeks, said Andersson, whose study was funded by the American Osteopathic Association. But pain that continues past the six-week mark is more difficult to treat.

Back pain sufferers, the authors said, have traditionally been prescribed pain and anti-inflammatory medications and physical therapy exercises and modalities, such as ultrasound or hot and cold pack treatments.

Osteopathic manipulation literally requires the "laying on of hands," during which the osteopathic physician performs a series of manual maneuvers and techniques to relieve tight joints and muscles, said study co-author Robert Kappler, D.O., an osteopathic physician at the Chicago College of Osteopathic Medicine in Downers Grove, Illinois.

To test whether these manipulations could provide faster recovery and relief, Andersson and his colleagues recruited about 155 patients and randomly assigned them to receive either standard medical therapy or osteopathic manual therapy. People whose back pain stemmed from specific diseases, such as cancer or scoliosis, were not included in the study.

During the 12-week study, people assigned to the standard-care group received a standard course of treatment including physical therapy and medication. People in the osteopathic group received osteopathic manual treatment, in addition to physical therapy and medications as needed.

Patients fared equally well under standard care and osteopathic treatment, according to study results. No matter which treatment they received, the patients had less pain and better range of motion by the end of the study.

Reduced pain may not be the only benefit to osteopathic manipulation, the authors wrote. The reductions in both the amount of medication used and the costs of physical therapy may be important benefits.

Speaking on behalf of the American Osteopathic Association, Boyd Buser, D.O., said the study demonstrates that "when osteopathic manipulative treatment is part of the total approach to patients with this type of back pain, we can achieve just as good outcomes with probably significantly less cost." Buser is an osteopathic physician at the University of New England College of Osteopathic Medicine in Biddeford, Maine and past president of the American Academy of Osteopathy.

But back pain researcher Paul Shekelle, M.D., said that osteopathy doesn't necessarily save money. While the study confirms that manipulation may be a viable way to treat back pain, he said, it would actually be more expensive.

"Let's diverge at the treatment point," explained Shekelle, an internist at the Greater Los Angeles VA Healthcare System. "I give you a month's worth of drugs and tell you to come back; versus treatment point B, where you would get six or eight visits, or whatever, to the osteopath. In the real world, you'd get two doctor visits.

"Now the question is whether you think those six osteopath visits are going to be less than the cost of a month's ibuprofen. No way. No way, man!""

[CatsAreKillers]

So, if you want to talk facts.. the facts are that:
1. Most lay people have no clue what a DO is
2. Usmle Passage rates are lower for DO's than MD's
3. Application GPA and MCATS are significanly lower in DO's than MDs... this *IS* important because MANY studies correlate things such as MCAT scores to clinical ability (as rated by residency director evaluations, grades, etc).
4. DO's can't practice outside of the states...

Now, as far as malpractice and such, i'd be interested to see per-capita studies. *THAT* would be interesting... I have my suspicions...

Although...regarding law suits, that may be skewed. The higher socio-economic segments of society are choosier and probably go to MD's at a higher rate than those in the lower brackets.

This is a guess, but the higher class are probably more likely to sue because they have the financial means and they are more educated and have greater access to the legal system.

Also, the higher class probably can afford to get riskier operations if their health insurance doesn't cover it...therefore, the law suits could be higher for MD's...but that's just speculation on my part.

[Rev. Horace]

Originally posted by CatsAreKillers
As long as osteopathic schools have lower standards than medical schools, then they will be leading the way in perpetuating the low quality image of DO's. The public knows that the standards are lower...just like they know that there are low standards to get into a chiropractic school.

I find this confusing, on the one hand I have people saying that the public has no idea what a DO is and now I'm hearing that not only do they know what DO's are, they also know the standard for admissions to osteopathic schools. I find that very hard to believe.

[tkim]

http://www.newsmax.com/articles/?a=2000/2/15/60447

"1954 Sheppard Case Reopened
UPI
February 15, 2000

Famed criminal defense lawyer F. Lee Bailey testified Monday, the first witness in the third trial of the Sam Sheppard murder case, one of the 20th century's most infamous crimes.

Bailey defended the late osteopathic surgeon during a 1966 retrial, which ended with an acquittal. The case became the basis for "The Fugitive" television series and movie.

Sheppard's son, Sam Reese Sheppard of Oakland, Calif., is now asking a civil jury to declare his late father innocent of killing his pregnant wife, Marilyn, on July 4, 1955. The Sheppard family must obtain such a declaration to file a $2 million wrongful imprisonment lawsuit against the state of Ohio.

Dr. Sheppard was originally found guilty of his wife's death in what then was called "the trial of the century" and served 10 years in prison before the U.S. Supreme Court, in a landmark decision, ruled massive, worldwide pre-trial publicity had deprived him of a fair trial and ordered the verdict overturned. He died in 1970, four years after being acquitted during the second trial."

Perhaps the 'one-armed man' was the patient of an allopathic surgeon?

Just kidding.

I respect anyone who dedicates themselves to the medical profession. We need to move beyond the bickering and sniping and work together. I hope that we can do this.

- Tae

[tkim]

Originally posted by republicandr

Are DO's losing their unique identity article (this is interesting) http://www.findarticles.com/cf_0/m32...30/print.jhtml

Wow - good article. Thanks!

- Tae

[Rev. Horace]

Originally posted by tkim6599


I respect anyone who dedicates themselves to the medical profession. We need to move beyond the bickering and sniping and work together. I hope that we can do this.

- Tae

It won't happen as long as people keep hanging on to board scores, MCAT scores, GPA's and 2 freaking letters that come after your name.

[Adcadet]

Originally posted by tkim6599
http://www.cnn.com/HEALTH/9911/03/back.pain.care.wmd/

"Osteopathic manipulation may effectively treat back pain

Power over pain

November 3, 1999
Web posted at: 5:03 PM EST (2203 GMT)

By Mari N. Jensen

(WebMD) -- People with chronic low back pain who were treated with osteopathic manipulation used less medication and recovered as well as those who received standard medical care, a new study suggests.

If you have access, I would suggest reading not only the article (http://content.nejm.org/cgi/content/...urnalcode=nejm), but also the responses (http://content.nejm.org/cgi/content/full/342/11/817)


I know some people have been excited about that study finding that drug use was less in the osteopath group. If you read the article you see that this is not a primary outcome, and was entirely dependent upon physician prescribing orders (since the drugs were prescription drugs). I would think one getting standard care (MD) would be more likely to be prescribed drugs whereas the DO physicians would be more hesitant to prescribe. The similar primary outcomes, being so similar, suggest that the increased drug usage was not any more effective than OMT, but the study didn't really dive into analysis of drug use.

[batman123]

Originally posted by UNEOSTEO
There are DOs in Mass General, Brigham & Women's, Boston Children's, Memorial-Sloan Kettering Cancer Center, Mayo Clinic, Cleveland Clinic, Emory, etc. These DOs aren't only doing IM or FP at these places...they are in specialty areas. Obviously, they didn't get in by being second class. Allopathic students have difficulty in getting into these places, so I would in no way consider DOs to be inferior. I know of DO orthopods that did a DO orthopedic residency and had no trouble getting an MD fellowship at Brigham/Harvard.

Not to inflame the argument any further, but why then do most premedical students aspire to be MDs rather than DOs, if admissions standards for DO schools are less strigent and both pathways provide the same opportunities, as many DO's insist?

On another note, I think OMM is a good clinical tool. I saw a DO for migraines that plagued me for over 6 months. After some weeks of sessions with the DO, my headaches were gone.

[Deuce 007 MD]

Here check out the archives of family medicine journals of the ama. http://archfami.ama-assn.org/issues/...l/fsa8021.html it states:

"Although many osteopaths use manipulation as an adjunct to treat many illnesses, there are no large controlled trials of the effectiveness of manipulation for conditions other than lower back pain ... Studies that have shown positive effects of manipulation for back pain have been criticized for not adequately controlling placebo effect. Doran and Newell65 concluded after studying 456 patients that although a few patients responded rapidly to manipulation, there were no significant differences compared with physiotherapy, corsets, and analgesics ... Osteopathic medicine is similar to allopathic medicine, but places a greater emphasis on the importance of the musculoskeletal system and normal body mechanics as central to good health. To support this emphasis, more basic research and controlled trials for the effectiveness of manipulation are needed."

[Deuce 007 MD]

Originally posted by batman123

On another note, I think OMM is a good clinical tool. I saw a DO for migraines that plagued me for over 6 months. After some weeks of sessions with the DO, my headaches were gone.

PLACEBO effect.

[tkim]

Originally posted by kreno
The question is, do osteopathic schools have to use such sub-standard, relatively speaking, admission standards???????

Ah, but the corollary would be, do allopathic schools have to use as high of a standard, relatively speaking, for admission?

Few would argue that the hard numbers in every application to medical school are used not only to gauge the odds of completing medical school, but also to filter through the sheer number of applicants for a limited number of seats each school has.

Now, if the average admission stats that are tossed around - being a 3.x GPA, and 3X MCAT, the minimums needed to be successful in med school, then there is are the puzzling examples of people who fall below those averages who do very well, and people above who fail out.

I would be more inclined to agree about the supposed sub-par abilities of osteopaths or their educations, if DO schools had higher dropout rates or a higher incidence of malpractice claims. I Googled to see if such statistics existed, but I couldn't find any.

I've been told quite often by physicians whom I have worked with over the years that surviving in medical school is all about hard work more so than raw intelligence. I believe this to be true.

I would hesitate to draw a straight line from lower admissions standards for DO schools, compared to MD schools, to the conclusion that their students are of lower quality.

- Tae

[SuzyQ]

Gosh..its really sad that there are so many ignorant people out in the world. There are SOOOOO many threads on this topic and the same thing is said over and over and OVER again...I think this topic has been talked to death and it never accomplishes anything because the ignorant people refuse to see the truth...are you guys that insecure with yourselves that you have to try and make other people feel inferior? i really think that is the issue. oh and by the way i'm not directing this towards anyone in particular...thats all i have to say

[rbassdo]

Originally posted by Deuce 007 MD
PLACEBO effect.

Ah yes...how MD students such as yourself attain your self-confidence.

[Deuce 007 MD]

Originally posted by rbassdo
Ah yes...how MD students such as yourself attain your self-confidence.

Let me quote the Journals of the AMA Archives of Family Medicine again for you ""Although many osteopaths use manipulation as an adjunct to treat many illnesses, there are no large controlled trials of the effectiveness of manipulation for conditions other than lower back pain ... Studies that have shown positive effects of manipulation for back pain have been criticized for not adequately controlling placebo effect."

[tkim]

Originally posted by Adcadet
I know some people have been excited about that study finding that drug use was less in the osteopath group. If you read the article you see that this is not a primary outcome, and was entirely dependent upon physician prescribing orders (since the drugs were prescription drugs). I would think one getting standard care (MD) would be more likely to be prescribed drugs whereas the DO physicians would be more hesitant to prescribe. The similar primary outcomes, being so similar, suggest that the increased drug usage was not any more effective than OMT, but the study didn't really dive into analysis of drug use.

Ah, I don't have full access to the NEJM article base. I was trying to point out that osteopathy is perhaps trying to make good on their claims that OMT works.

This is the thing that intrigues me about osteopathy - that I will have an additional skill set for diagnosis and treatment. Granted, it may be all smoke and mirrors, and if it is, then I can prescribe and cut to my heart's desire. But if OMT works, then I have that as well.

Proof's in the pudding, so they say. I get to experience it first-hand soon.

- Tae

[Deuce 007 MD]

Originally posted by tkim6599


This is the thing that intrigues me about osteopathy - that I will have an additional skill set for diagnosis and treatment. Granted, it may be all smoke and mirrors, and if it is, then I can prescribe and cut to my heart's desire. But if OMT works, then I have that as well.

It is just smoke and mirrors, how many times do I have to say this "PLACEBO EFFECT." Since this is obviously not working how about another term "scientific method", did we totally forget about this.

[SuzyQ]

Originally posted by kreno
At michigan state university (i know so much 'cuz i'm an undergrad here), again, there are two medical schools... an osteopathic AND an allopathic...

some more facts:

to pass certain classes in the first year (again, both DO and MD students sit-in on the SAME classes first year, same prof, same room, same time, same everything... except DO students also take some manipulative osteopathic classes), allopathic students are held to a *HIGHER* threshold for passing (i think it's like 65% in anatomy for MD and 55% for DO.. I forget the numbers). I question this.



AGAIN NO ONE ADDRESSED THE *NON* numbers stats of allopathic vs. osteopathic applicants! Again, DO schools rant and rave how they look "beyond the numbers"; i'm curious how they do so... and if indeed they manage to do so at all any more than allopathic schools. ridiculous.

blah blah blah...there is no need to repeat yourself

[Deuce 007 MD]

Originally posted by SuzyQ
blah blah blah...there is no need to repeat yourself

Now those are some valid points, have you ever thought about a JD. Please don't flame me, I love SuzyQs and a glass of milk.

[SuzyQ]

I guess I just don't want to waste my energy on ignorant people...

[tkim]

Originally posted by Deuce 007 MD
It is just smoke and mirrors, how many times do I have to say this "PLACEBO EFFECT." Since this is obviously not working how about another term "scientific method", did we totally forget about this.

I read the article you provided a link to - thanks!

However, it does not dismiss OMT as 'placebo effect.' It mostly states that the studies involving OMT, while mostly having positive results, were not rigorous enough to withstand criticism.

It also went on to explain why such rigor would be difficult to achieve in any study involving OMT - not being able to 'blind' the physician delivering treatment.

You could abruptly dismiss anything you could not tack down as 'placebo effect', or perhaps withhold judgement until serious research is done. Your choice, of course.

- Tae

[rbassdo]

Originally posted by Deuce 007 MD
Let me quote the Journals of the AMA Archives of Family Medicine again for you ""Although many osteopaths use manipulation as an adjunct to treat many illnesses, there are no large controlled trials of the effectiveness of manipulation for conditions other than lower back pain ... Studies that have shown positive effects of manipulation for back pain have been criticized for not adequately controlling placebo effect."

Wow! You're really going out of your way. Hey look...I can appreciate your ability to find problems with OMM, etc. As far as my prior post - I was just MOSTLY messing around. You left yourself wide open with your "placebo" comment.

As for my personal experience with OMM...I will continue to use it occasionally, as long as I can see that it is benefitting patients. It's got to be a case-to-case kind of thing. I don't know of any studies that have directly refuted the effectiveness of OMM. I will admit that the greater osteopathic community has not effectively proved its efficacy. I believe that will be changed soon as I see several research institutes being created at various osteopathic institutions. Quite the paradox since the trend seems to be heading away from the average DO using OMM on a REGULAR basis.

[kreno]

interesting website about osteopaths

http://www.quackwatch.org/04ConsumerEducation/QA/osteo.html

[Rothgar]

Originally posted by Deuce 007 MD
Let me quote the Journals of the AMA Archives of Family Medicine again for you ""Although many osteopaths use manipulation as an adjunct to treat many illnesses, there are no large controlled trials of the effectiveness of manipulation for conditions other than lower back pain ... Studies that have shown positive effects of manipulation for back pain have been criticized for not adequately controlling placebo effect."

Hey Deuce:

Before you go feeling all superior and all, why don't you take a look at the results of an study of Placebo effect and arthroscopic surgery:

http://www.hopkins-arthritis.som.jhm...throscopy.html

My two cents

[Deuce 007 MD]

Originally posted by Rothgar
Hey Deuce:

Before you go feeling all superior and all, why don't you take a look at the results of an study of Placebo effect and arthroscopic surgery:

http://www.hopkins-arthritis.som.jhm...throscopy.html

My two cents

Hey arthroscopic surgery is not one of the founding tennants of the MD, OMM/OMT is the primary distinction/tennants of the DO. Go to the site that Kreno posted and you'll see this from a David E. Jones Ph.D.

"I spent 12 years teaching basic sciences and 7 years as an associate dean at the an osteopathic medical school ... The department of manipulative medicine was completely segregated from the other departments, both in principles and in practice. The osteopathic faculty members in the standard medical departments neither practiced nor taught OMT. Nor did the OMT faculty practice or teach the standard forms of medicine. It was as if OMT was a freestanding form of health care -- one that, unlike other departments, was not necessarily bound by scientific foundations. Being a basic science researcher, I have made attempts to set up an animal model to objectively test the claim that certain harmful forms of sympathetic nerve traffic could be altered by spinal OMT. However, I never received any support from the osteopathic faculty in seeing such a study completed."

Dude, it's getting late, I'll battle with you OMM purest tomorrow. Until then LBC you later.

[DarkChild]

a few points:
1) even if OMT achieves results solely throught the placebo effect, what is the big deal? WTF is the point in explaining to a patient why she's got a headache if you cant do anything about it? If I've got migraines - FIX IT. I dont give an F how you do it, i just want it gone. IMHO at some point medicine really boils down to what works rather than why something works.
2) the whole USMLE pass rate issue is taken out of context. DO students arent taught for the USMLE, they're taught for the COMLEX. I wonder what the path rate for MD students would be on the COMLEX? To berate DO's for a less than stellar USMLE pass rate is ignorant.
3) be wary of the categorical persecution of DO's. nothing good has ever come out of zealous fanaticism. it is good that there is more than one point of view on medical treatment; there is more than one way to skin a cat (btw - who would do that to a kitty anyway?!)
4) and this for me is a philosophical issue that even now makes me wonder what i'm doing going to med school:
as i get closer and closer to entering the medical world i am increasingly concerned with the callous way in which medicine is administered. its one thing to say that residents and interns are overworked and dont have time to care enough emotionally about their patients - but that still doesnt make it right. from what i understand, DOs and MDs have a fundamentally different approach to medicine with DO's being much more hands on.
"I don't know of any osteopathic physician who at some point in the physical exam doesn't have a hand on the patient," says Roy. "It could be a shoulder, back, thigh, or knee. Just the idea that there's a connection being established. That's how we've been trained. Is it subjective, touchy-feely stuff that's hard to document? God, yes! But it certainly goes to the heart of what makes us different."
source: http://www.findarticles.com/cf_0/m32...30/print.jhtml
that is MY idea of a physician. it isnt someone who is there to diagnose your illness, give you a couple pills and send you on your way. maybe I am a little naive, but I want more. we (especially on this board) expect doctors to be more than just booksmart (for instance the sheer number of times people say that getting in to med school is more than stats - e.g. kreno in this thread). yet the only folks who actually embrace this idea are DO's. it should make you think.
and if it doesnt. thats ok - you're wrong.