D.O.????????????

Discussion in 'Medical Students - DO' started by s42brown, Nov 15, 2002.

  1. s42brown

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    Ok I have a serious question. I have interviews at the three schools that I applied to and have stats equall to that of most mid to upper tier allopathic schools. I applied to only D.O. schools because of the philosophy and OMM. I am currently working I a level I trauma center next to both DO's and MD's and see no difference in the way they treat and diagnose their patients. My question is this, with allopathic schools beginning to teach the whole person philosophy. and look at mary as mary not room 153 what are the chances of the AOA agreeing to be absorbed by the AMA and making one standard medical doctor across the board? I have read every osteopathic history book and am very proud of the philosophy, but the AMA has been trying to absorb the AOA for about eight years. They already did it once but failed in California because at that time there was a great difference in the philosophy of osteopathic and allopathic medicine. As time goes on the is a merger of the philosophies. What happens when they overlap?

    just a question

    cutty:p
     
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  3. oceandocDO

    oceandocDO Senior Member

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    It'll never happen. First off, the AMA is not an accrediting body. It's not much more than a political organization created to tell people how great MDs are. Although, they are organized and do present themselves well, hence the wow factor and MD prominence over the past 75 years. The AOA is an accrediting body and takes on many more responsibilites than the AMA. If the AOA were to be "absorbed" by the AMA, residency programs would be thrown into turmoil and political fallout would be very messy, not to mention the disadvantage osteopathic students would have in now not depending on residency programs of their own.

    When are people going to realize that the AOA is a very strong, active, and intelligent body? Give the group some credit. The Executive Director, John Crosby (a lawyer actually), used to work for the AMA. He switched sides and while he's gearing the profession towards a more mainstream sail, I dont think he or the AOA in general is interested in giving up what thousands and thousands have worked for in years past.

    My take is this: the number of DOs has doubled in the last 10 years or so, in the process becoming the quickest growing segment of health care delivery. As a result, these doctors are young, the average age of a D.O. is probably not much older than 40. Hence, we need another 10-15 years of maturation before these doctors climb the ladder and slowly but surely gain wide positions of influence in the health care and political realms that were traditionally held by MDs. Once this happens, you have almost instant recognition and "respect", albeit for the wrong reasons. It just takes time and numbers and is already happening.

    As any marketing guru will tell you, two things are important in selling your product. One, having a good product. Two, location, location, location. D.O.s have a superior product. The training is simply more complete and is the epitome of what the american public is starting to demand in a doctor. Believe that. The location part is what is taking time. Geography still dictates much of where a D.O. can go and be successful. This brings me back to the leadership issue. Put the leaders in the right locations and bingo, you have a recognized and respected partner in health care.

    Be patient, and let's get off the "if you cant beat em, join em party bus." If we do join em, the very philosophy and pride that's causing you to go D.O. will be lost, probably forever.
     
  4. Dr JPH

    Dr JPH Banned
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    I want to buy this guy a drink.

    One of the most clear and well thought out posts I have seen around here in months (besides mine :) ).
     
  5. Pitt Panther

    Pitt Panther The Best Baller in PA

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    I'll second that. While we're buying each other drinks here, I'll go ahead and pick up the next round....

    One drink goes to OceandocDO for authoring the perfect post and the other goes to JPHazelton for having the most objective and informative posts throughout the SDN.

    Good luck to both of you throughout your careers.

    Pitt Panther
     
  6. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Where did you get the idea that the AMA has been trying to absorb the AOA for eight years?

    The separate doctrines by which MDs and DOs practice, at least in theory, have never shared many similarities. They both agree in a common goal, which is to cure the sick. Their approaches, however, are supposed to be different.

    What happened in California in the 1960s was a sign that there was huge trouble within the osteopathic system. It failed for reasons that were a heck of a lot less lofty than a "great difference n the philosophy of osteopathic and allopathic medicine." It's really not as if a California DO woke up one mornig and exclaimed, "Man, I'm really doing in my profession. I better stop this right now."

    The movement to make osteopathy a more mainstream practice of medicine started in the 1950s. There was an effort to standardize the curriculum across all osteopathic institutions and to bring it in-line with contemporary allopathic thinking, while still attempting to maintain that osteopathic identity. As schools began to comply with this plan, more and more graduating osteopathic students were practicing like MDs.

    The AMA, for years, had a growing animosity toward the AOA and its osteopaths. It sought a variety of ways to get rid of the DOs. The AMA looked to the State of California and the California Medical Association (CMA). At the time this attack was about to begin, there had been a shift in the DO intelligentsia to California. California DOs, flying under the banner of the California Osteopathic Association (COA) generally felt superior to DOs from other states. Despite their alleged intelligence, however, California hospitals were unanimously opposed to the idea that a DO could have admitting privileges. Now if they were MDs, they'd have that right to admit patients to a hospital. Further they'd be MDs, and at the time, as it is now among premed circles, the MD was thought to be superior to the DO.

    In steps the CMA with a plan to finally rid California of the COA and the DOs. The CMA was willing to give what the DOs in California most wanted, and that was an MD. In talks between the two groups the following was worked out:

    1. The College of Osteopathic Physicians & Surgeons in Irvine, CA, would be turned into an allopathic medical school called the California College of Medicne.

    2. DOs in the State of California would get an MD from the California College of Medicine for a fee. No additional schooling was required.

    3. The COA would cease to exist and be absorbed into the CMA.

    Close to 3,000 DOs in the State of California took part in getting an MD from the California College of Medicine. It was probably the single biggest defeat for the DOs as a whole. California DOs rationalized that with MDs they'd have admitting privileges to all the hospitals in California, that each DO would also be able to rid himself of the DO and become an MD, and they could finally show-up the rest of the DOs in other states that they were truly superior.

    In the 1960s DOs could only work in osteopathic hospitals. Allopathic hospitals in any state generally never allowed DOs admitting privileges. The problem for the DOs, however, was that there were very few osteopathic hospitals. The few that did exist were all financially strapped and were on the brink of collapse and bankruptcy. The profession was losing its ability to support itself without an adequate hospital system. They needed to be able to work in allopathic hospitals, of which there were many, many more and most were not running into the ground financially.

    The merger of the 1960s in California failed. While these newly-minted MDs who were formerly DOs were licensed as MDs, each and every hospital in California denied their entry into the hospital as admitting physicians. Shunned by the allopathic hospitals and shunned by their former osteopathic colleagues, they were stuck in the middle without hospitals. It was a big mess for the now disbanded COA.

    This wasn't about philosophy. Osteopaths have always held a different philosophy from allopaths on an official level. How each DO practiced, however, was pretty individual and because of their training (which became more and more mainstream, in other words, more allopathic) they seemed as if they were more MD in nature than DO.
     
  7. oceandocDO

    oceandocDO Senior Member

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    Ummm, the AMA has offered the AOA a seat in it's House of Delegates continually over the past decade. The AOA has consistently turned down the offer on the basis that osteopathic medicine is not a subspecialty of mainstream American medicine, nor should it be. In fact, the D.O. philosophy is slowly replacing the allopathic philosophy, not vice versa, as the demanded vehicle in the practice of medicine in American health care. While many MDs see D.O.s as "alternative", the public doesnt really care. More Americans took "alternative" remedies (herbs, accupunture, etc) last year than presciption drugs. I'm not saying D.O.s buy or prescribe to this complimentary path 100% of the time, but D.O.s are more accepting of it, at least not dismissing it outright. My point is that the American public is sick of being drugged and the D.O. ideology is becoming the DOC (discipline of choice) to American patients. I dont know the exact numbers, but I think you have at least 4 new D.O. medical schools opening in the past 5-6 years. How many MD schools have opened? The growth is there, and will will undoubtedly serve as momentum in attracting the attention of patients. IMO, history will one day look very kindly upon D.O.s as the leader in the metamorphosis of health care delivery which we will soon see. Bank on it.

    I'll take that drink, please. Jack and coke. Easy on the coke :)
     
  8. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Your posts suggest to me that you see the currently cordial relationship between MDs and DOs as anything but that, and you're one of those hell-bent, militant osteopathic students whose mission in the future will be to topple organized medicine. I trust that the majority of your colleagues don't share your views. Osteopathic medicine is no longer a profession that's struggling to be accepted, but you seem to characterize it as such. Lighten up, dude. But, hey, I will bite because I happen to enjoy reading about osteopathic medicine and the development of the profession.

    The AMA's effort to extend a hand to the DOs by offering seats in its House of Delegates is not an attempt to absorb the osteopathic profession. I'm willing to bet that even if the AMA wanted to absorb the AOA, every effort, ridiculous or not, would be thwarted by a very strong-headed AOA leadership. Considering that more and more DOs today seek post-graduate training in allopathic institutions, I'm sure the AMA felt it would be nice to include DOs in on policy-making sessions that would ultimately affect their graduates. But, well, I guess they were just beating down another attack, huh?

    Before you begin writing of the "osteopathic philosophy," please define that and define the "allopathic philosophy" while you're at it. This is an area of much debate amongst the DOs themselves, some of whom don't even believe there's a pure difference between MDs and DOs on a philosophical level. If you are able to distinguish these two professions on the basis of something as nebulous as their respective philosophies, you will have settled decades of debate.

    Many of your arguments lack proof. While your assertion that the American public is "sick of being drugged" may hold water, your implication that these patients now seek out the osteopathic philosophy does not. A recent study found that osteopathic physicians, despite their training in the "osteopathic philosophy" and their training in such drugless alternatives as OMT, actually prescribed more medication on average than their MD counterparts. To most DOs in this country the osteopathic philosophy is a concept that is entirely unclear. Heck, most DOs don't even practice OMT after graduation from med school.

    As for the supposed increased rate of growth of the osteopathic profession as compared to the allopathic profession, you have again misinterpreted the findings. You are correct in that there have been more new osteopathic medical schools established over the last 10 years than allopathic medical schools. Understand that it is generally accepted by the American Medical Association, the US Department of Labor, and the US
    Department of Health & Human Services that there has been an oversupply of physicians in this country. For the last 10 years there have been repeated recommendations to reduce class sizes at the 125 Allopathic medical schools, some of whom have complied. There is also a recommendation to disallow any establishment of new allopathic medical schools, which explains why there have been no new allopathic med schools.

    However, the American Osteoapthic Association has added to the physician oversupply by establishing new medical schools when there is no need for more physicians. You can argue that areas such as the Appalachian Mountains and other rural parts of this country suffer from lack of physician care, but this is due to factors not related to the need for more doctors. I will credit the AOA for founding at least one of these schools in an area which needs more doctors (Pikeville (KY) College School of Osteopathic Medicine), but institutions such as SFCOM, NSUCOM, and AZCOM, the other new med schools, are sort of adding to the problem of oversupply.

    Thus the founding of four new medical schools within the last 10 years is not an indication that the demand for DOs is high. It is merely an avenue by which the osteopathic profession can continue to swell its ranks with new physicians. But when you have 600,000 MDs versus 50,000 DOs in the US, and about 15,000 new MDs every year versus 2,500 new DOs, the osteopathic profession can't really catch up.

    As for your last comment regarding the intended "metamorphosis" of American healthcare, I doubt even your fellow DOs see it as that. I don't even believe the leaders of today's AOA are actively planning to make the osteopathic concept a universal thing.

    Seeing that you are so gung-ho and hard-core when it comes to osteopathic medicine, I sincerely applaud your devotion to your profession and wish you luck in your career as a physician. However, if I were you, I'd change my view of this MD vs. DO thing and accept the fact that the two professions co-exist cordially. You do realize that the rest of your professional life will involve major interaction with MDs, don't you?

    I will make the following arrogant presumptions based on your having enrolled at NYCOM (my favorite osteopathic school, by the way):

    1) You will train at an MD institution when you graduate DO school.

    2) You will be taught mostly by MDs.

    3) You will not have further training in OMT after med school.

    4) You will probably never use OMT as a resident (unless you head into PM&R).

    5) You will limit your use of OMT to less than 10% of your patients in private practice.

    6) You will be on faculty at an MD hospital.

    Good luck to you!
     
  9. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Oh and by the way, the AMA and AOA are both accrediting bodies for their respective institutions. For example, the Association of American Medical Colleges (AAMC), which is an arm of the AMA, is the accrediting body for the 125 medical schools in the US. The AOA's Bureau of Professional Education is the accrediting body for the 19 osteopathic schools.

    I'm convinced that a lot of what you write is mere opinion and not based on any hard evidence. Don't think I'm attacking you for being an osteopath. JPHazleton can attest to the fact that I have long been a fan of osteopathic medicine. I am, however, trying to give you a fact-based perspective into the relationship between MDs and DOs.

    Debate without adequate research and proof is not debate at all. Look stuff up before commenting, dude. You'll be a better doctor for it.
     
  10. oceandocDO

    oceandocDO Senior Member

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    "Dude", first, the AMA does nothing in the way of accrediting it's physicians or residency programs. The ACGME is reponsible for that, and it's a private, professional organization. The AOA is responsible for all accreditation of its residency programs. The AMA did not offer the AOA a seat in its HOD so they can be part of the "process". If the AOA would have accepted the seat, it would have told the AMA that D.O.s are merely a subspecialty, equivalent to the American College of Family Practice or Surgery, etc. The AOA, and DOs, are anything but that. The DOs that take part in MD residency programs are more than welcome to join the AMA or talk to the ACGME and have a voice.

    What study is this? Author? If true, I'd like to read it.

    While we're on the subject of not looking stuff up before commenting, dude. There will be a massive physician shortage, in all specialties, by 2020. Here's something for you to read:
    http://www.rsna.org/publications/rsnanews/jun02/physhortage-1.html Hence, the opening of D.O. schools does serve a purpose. MD growth has been stagnant in the face of physician shortages.
    Many MD schools are on the verge of bankruptcy to begin with. Few medical schools legally own hospitals anymore, so most arent technically "MD" hospitals, even though they may have ACGME programs within.

    Speaking of basing your argument on nothing but opinion. It's nice of you to comment on the mindset of 50,000 physicians. Actually, it is pretty clear. It's that D.O.s are generalists first and specialists second, and there's nothing finer than a specialist who has an excellent foundation in general medicine. This philosophy is not taught in a single class or book, it's a conglomerate of the entire educational system, eg- the osteopathic rotating internship requires you to taste and learn in all areas of medicine before delving into your specialty. You really can explain it until you experience it.

    As for my "metamorphosis" metaphor, I meant that the approach to a patient has been through many changes in the past 20 years, and will be through even more in the next 20.
    I never claimed that D.O.s will take over mainstream medicine or even outnumber MDs. I merely stated that the swing in the demands of the american patient poulation are starting to switch to a theme that's more harmonious to the philosophy of osteopathic medicine.

    By speaking of the opening of more D.O. schools (by the way, there's 20 now, soon to be 21), I was exemplifying the fact that there has been tremendous growth in the profession, and there will continue to be growth, suggesting the supply/demand curve has not yet been satisfied. I'm anything but a hell-bent osteopathic medical student. I choose the D.O. route because it simply is a better training, really. Whether or not I use OMT in my practice will depend on many factors, but at least I'll have the tool. I will be training in some of the very same hospitals you train at, so maybe I can treat your patient someday for you.

    I appreciate your broad generalizations of my future career. I'll refrain from reciprocating. :clap:

    My post was not very antagonistic, IMO. Yours however, was a bit more than "healthy debate". I hope you take a different approach to your patients. Thanks for letting me know I'll be working next to MDs. Gosh, I'm honored.

    Thats enough for now I suppose, sorry for the sarcasm.
    Good luck to you!
     
  11. tlh908

    tlh908 Senior Member

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    Just out of curiosity, where is the 21st osteopathic medical school going to be located? And when is it going open? I have heard rumors that LECOM is trying to open one in FL, is the one you are referring to?
     
  12. oceandocDO

    oceandocDO Senior Member

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    I believe there is one in Utah that is set to begin the accredidation process.
     
  13. s42brown

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    Oh wow... I really screwed up. So, like, it's 4AM and in an effort to reply to s42brown's comments, I ended up editing his post. Oh well. Can't change it now. In any event, I apologize to s42brown for editing his post. I kept all his statements in quotes and responded accordingly. What follows is MY RESPONSE.

    Sorry.

    ------------------------------------------------------

    Yes, this was implied in my statement.

    No, I'm sure that's not the reason. If you read what I wrote carefully, you'll see that I believe the founding of a school in Pikeville, KY, was warranted as the Appalachian Mountain area is in desparate need for physicians. This country suffers from an oversupply of physicians, plain and simple. Despite this oversupply, however, many areas such as the Appalachian region and other RURAL areas lack physicians. On top of the oversupply of doctors, there's a MALDISTRIBUTION of physicians across the US. These places now seek out ways to attract physicians to their tiny towns. Some places offer loan repayment programs for med students who commit to practicing in an area that has an acute need for doctors. Others will go so far as to establish med schools for that explicit purpose. And others will even offer work visas for foreign-trained MDs to come! Calm down, dude.

    I would tend to agree, but since most DOs are concentrated on the East and West coasts (according to a table of DO distribution, broken down by state, provided to me by the New York College of Osteopathic Medicine), exactly where the oversupply of physicians exists, I think your colleagues would tend to disagree with you.
     
  14. s42brown

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    BLAH BLAH BLAH

    Yeah Tim read that book too.:p
     
  15. Castro Viejo

    Castro Viejo Papa Clot Buster

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    My original statement was that the AMA, through the AAMC, was responsible for accrediting the 125 medical schools in the US. This is true, as the LCME is composed of members of the AMA and AAMC. I wrote nothing of the AMA's role in accrediting physicians or residency programs. But since you brought it up, while the ACGME is directly responsible for the accreditation of residency programs, it is also composed of members of the AMA.

    I'll assume this is your opinion. And your evidence for this is?

    Allow me some time to find the article. I know it's on my computer somewhere. I got it after Dave Russo and I discussed it once (it was actually he who had informed me of it).

    Did you actually read the article that was cited? I bet not. If you did, you'd see that the Health Affairs article cited predicts a physician need based on an analysis model different from those used in the past by the many, many other articles that predict a physician surplus. The US Department of Labor still believes in a physician oversupply.

    About 3 years ago a private university lobbied to open a med school in the State of Florida. It was denied because of a predictions from the US Department of Labor and its Bureau of Labor Statistics that the country did not need more doctors.

    Source? Now if you stated that many hospitals, which happen to be allopathic institutions, are on the verge of bankruptcy, I'd agree, but medical schools? I don't believe so. Not in the ten years that I've been following this do I recall ever having read a medical school shut down due to financial trouble.

    If a hospital is a teaching institution accredited by the ACGME, which has members of the American Hospitals Association (AHA) sitting in on the meetings, then it is an allopathic institution. Oh, and by the way, guess whose members sit on the AHA? I'll give you a hint: it ain't the AOA. (The answer is: AMA)

    That's a lot of hand-waving. Once and for all, define the osteopathic philosophy and then define the allopathic philosophy. Please tell me how they are different. If you don't, then speaking of the osteopathic philosophy by using a lot of smoke and mirrors makes you sound like you're pulling stuff out of thin air.

    I did not argue that point. I agree that the osteopathic profession is experiencing tremendous growth, but I believe your analysis that the supply/demand curve for being the reason for this growth is incorrect. That's what I wrote.

    Considering that you will likely train in an allopathic institution, I am sure that you will be training at a similar institution. And once you finish your training, as has been for the last 40 years, you will be more than welcome to treat the very same patients that I treat.

    No, your posts have not been very antagonistic. I do enjoy a good quality debate, though, and it is my intention to challenge you on some of your points. I don't agree with many of them but if you can provide a base for making these statements, in other words form educated opinions, then you can shut me up. Until then, though...

    My patients have been nothing but happy with my role in their care as a fourth-year med student. And, yes, I do have proof of this. :D

    Just out of curiosity, what will you do with the osteopathic philosophy when you start residency? Do you believe you can adequately apply the osteopathic concept to your patient's care while training in an allopathic institution? Or will you train in an osteopathic program so that you can definitely receive post-graduate training in the osteopathic approach? I'm really not trying to be a pain in your butt, but I'd like you to answer these questions.

    And, oh yes, define the osteopathic philosophy, the allopathic philosophy, and please compare and contrast them. :)
     
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  17. Castro Viejo

    Castro Viejo Papa Clot Buster

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    So if you did, in fact, read that book why did you say the merger failed because the philosophies were so damn different? See what you've started? If you didn't write that, I wouldn't have countered, and the osteopathic advocate over there wouldn't get all militant on me. :)
     
  18. me109cito

    me109cito Banned
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    Get real cowboy. D.Os will always look up to the allopathic phylosophy. If not why are so many of your counterparts (and you too) trying to get allopathic residencies? Cuz you know they are better than those sorry-ass osteopathic residencies.
     
  19. s42brown

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    me109cito


    WOW your a real clever one. Do you have a clue about what you?re saying or did you get in wasted last night and start punching keys like an epileptic chicken? Why in the hell would you think that osteopathic residencies suck, considering that residence are trained by both MD's and DO's with many rotations spent at allopathic hospitals? If I do an ortho residency here in St. Louis I will be based out of Des Peres hospital (osteopathic) but rotate through SLU (allopathic) and Washington University's Barnes hospital, which I believe was ranked sixth best in the country last year. However, the vast amount of my time will be spent at Des Peres hospital. Yeah your right, despite the great hospitals and instructors I will work with since it is considered osteopathic it probably sucks. Sober upand get a life:mad:
     
  20. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Well, that's not the reason why most DOs will eventually do allopathic residencies. It all has to do with logistics.

    But before I begin, I don't appreciate this kind of grand-standing and don't believe it's conducive to a discussion of the relaive merits of osteopathic and allopathic philosophy. If you don't feel you can contribute constructively, then please refrain from posting. Try the Lounge instead. :)

    Probably none of the osteopathic med schools own their own hospitals. While not many of the allopathic med schools own hospitals, a great majority of them have major affiliation agreements with allopathic hospitals. It's often the case where you have an MD hospital that has an MD residency program dominating the services provided by a particular department. DO schools haven't really done the same, and haven't expanded to the point where they could train each and every one of their own graduates.

    What happens then is that DO graduates rarely get a chance, as postgraduate trainees, to expand on their own philosophy of patient care. Unless the DO happens to be in a PM&R residency, OMT will almost never be a part of the curriculum and will never be a part of patient care. That's only one of the major problems with the situation currently for the osteopathic profession.
     
  21. BrooklynDO

    BrooklynDO Senior Member

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    ignorance is bliss aint it. So just to recap about how much osteo residencies "suck" :
    many allo residency and fellowship directors have a DO next to their name.
    most residency programs that have DO students rotating through in the msIII and IV years are happy to have those same people as residents.
    allopaths cant get an osteo residency, while DO's outcompete allopaths for allopath residency positions.

    Its clear now, osteo residencies really do suck, I think Ill unlearn everything I ever learned in OMM just so I can be an allopath. hahaha
    as for osteopaths "looking up" to the allopathic philosophy....the "whole patient approach " was taught by osteopaths while the allopaths were still using mercury drugs.
     
  22. oceandocDO

    oceandocDO Senior Member

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    For the love of god, another DO vs MD debate.

    I wont comment on me109cito. God help your patients.

    Mr. Wu, in response to your post...


    Yes, you are accurate. Unfortunately I was originally referring to the residency accredidation, which is more of a dynamic, hot topic than medical school accredidation. The ACGME may be made up of members of the AMA, but they are SEPARATE entities. In fact, D.O.s can belong to the AMA, so they can offer advice to the AMA and ACGME if need be. Hence the reason why the AOA has denied the offer to have a seat in the AMA's HOD. Do you know how the HOD works? If the AOA were to have an offical seat and "voice", it would be on the same voting level as the ACFP, for example. Osteopathic medicine is not a specialty college with the AMA. Your arguement of the invitation as an "offer to give input on the process" holds no water, as D.Os can already do this as members of the AMA.


    Thanks for the advice on reading the article. I wonder if you practice what you preach. The article claims that this study counters what earlier studies have stated. I dont know where your Labor Dept stats come from, as you offer no evidence, but I'd rather have a leading member of the profession offer his advice over the feds opinion. What motives would this gentleman have in erroneously stating the facts of physician supply? None that I can think of. What motives would the government have? Hmmmm... lots actually. Most importantly, they use it as evidence why more residency programs should not be funded. I can go on.

    What private school in Florida was denied accredidation? Again, you bark at me for not offering evidence.

    One example: Hahnemann came within weeks of closing its doors a few years ago before Drexel came in and saved them. Most med schools live paycheck to paycheck and are a governmental budget cut away from severe trouble. Ask your dean how much your school has banked away.

    I love whan the only arguement is to act confused as to the tennets of each schools philosophy. I thought I was pretty good in explaining it. A D.O. is inherently trained to be a generalist first and a specialist second. Evidence of this is the rotating internship, something that MDs actually created but relinquished as their trainining objectives changed. OMT is a tiny part of the overall contrast between the philosophies. Whether or not D.O.s use it, the extra, hands-on training in biomechanics, kinesiology, lymphatic function, nervous system influence, etc does not hurt one's medical knowledge. I dont blame you for not understanding this, but please dont voluntarily hang our hat on OMT as being the basis for the profession. It's a supplement, an extra tool, that's all.

    Do you really think that if the demand was absent these colleges and foundations would invest the millions it takes to get these schools off the ground? The new D.O. school in virginia is opening with a foundation of $100 million. This money doesnt come from the AOA, or even some rich D.O. It came from private foundations who recognize the shortage of physicians and can forcast the direction that the approach to a patient is taking. As of now, that approach is more in line with what D.O.s promote. Simple as that. Do you think that if these foundations went to the AMA with $100 million they would be told to go home? Ummm, no. In fact, I've been told by officials at the AOA, who used to work for the AMA, that the accredidation process is a bit harder in the AOA than the AMA.

    I look forward to bringing my approach to a patient to any hospital, whether it have MDs or DOs "sit in on meetings". I think DOs and MDs should work shoulder to shoulder. Different viewpoints and approaches are very healthy for the system, and thus for patients. Choice is what this country is all about. Competition is something that has been lacking in the medical realm for 75+ years. I look forward to the challenge.
     
  23. DrQuinn

    DrQuinn My name is Neo
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    Tim Tim Tim Tim Tim....

    I feel sorry for you in this debate... only because the past several posts from the very pro-DO aren't very constructive and in fact are down-right embarassing...

    I will post some thoughtful advice soon... after all the football games are done.

    Q, MS4 NSUCOM (applying to MD EM residencies... don't jump on me yet though)
     
  24. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Please teach us. :)
     
  25. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Unfortunately that's what this has degenerated into. Again I reiterate that the original purpose of this was to ask you to define the osteopathic philosophy and the allopathic philosophy. Once you did that I had hoped you would then compare and contrast them, proving to everyone out there in internet land that osteopathic and allopathic physicians were, in fact, different. You thus far have yet to write anything solid that doesn't include the phrase, "well you can't really understand it until you're a part of it."

    Gee, well, on with the show!

    The only idea I can identify as being a good, solid reason for sitting in on the House of Delegates meetings is so that you bring the very-specific concerns of your group to the floor for debate and hopefully to effect change in AMA policy.

    Your reasoning doesn't make sense, as your model of how policy is changed within the AMA is akin to having an area of the United States that is DEVOID of any Congressional seats (i.e., no seats in the House of Representatives and no seats in the Senate). Now you can argue that these people in this area who lack representation can still effect change -- by being citizens of the United States (thus having a voice, thus being a "member) -- but that will be pretty damn hard. The whole point of having a House of Delegates is so that the AMA doesn't have to deal with the hundreds of thousands of voices that would be coming in suggesting this policy change or that policy change. Without seats in the House of Delegates, DO members who wish to change AMA policy affecting the osteopathic community will have a pretty hard time. In fact, they won't even really have that opportunity.

    My guess is that the AOA's refusal of taking any seats in the House of Delegates stems from the idea that the AOA is the sole governing body of the 50,000 osteopathic physicians in the US. While this is true the AOA fails to realize that most of its new graduates are training in programs affected by AMA policy. This is a GUESS.

    I never invalidated this study. The fact that this study has been published, however, does not mean everyone must follow its lead. Studies are published and it's up to the scientific community to vaidate it or not. I never wrote that the author of this particular study "erroneously" stated any facts. I simply wrote that these authors used a different model and that the US Department of Labor's Bureau of Labor Statistics still predicts a physician surplus in the coming years.

    As for the source of these, try going to the Department of Labor website and following the links.

    And on, and on, I'm sure. If your basis for rejecting data from a federal agency is simply that there's some big government conspiracy, then I pity you and the profession that decided to inherit and train you.

    While we're on a tangent and discussing the idea that data is required, can you show me data that shows OMT, in certain instances, has similar effect to pharmacotherapy? This isn't a trick question. Studies such as this exist, but I'm wondering if you can find it. :)

    I provide evidence when it is requested. And I must admit, I misspoke. The private school was Duquesne University in Pittsburgh, PA, and the other school was Florida State University in Tallahassee. As for the rest, I'm not about to do your homework for you.

    Hmmm... "Hahnemann" [sic] was in financial trouble because of its clinical enterprise, not because the med school was running out of money. The merger between Hahnehmann University and the Medical College of Pennsylvania was a cost-cutting measure, one replicated throughout the country (NYU and Mount Sinai, Columbia and Cornell, etc.) to save their respective clinical enterprises and not their medical schools. Sheesh...

    As for how much my school has banked away, it is not my school that's in financial trouble. The clinical arm of the State University of New York (the three university hospitals in Brookyln, Syracuse, and Stony Brook), however, according to a recent article in the New York Times, is in the red. The reason why they are in financial trouble has to do with many factors, many of the same ones shared with other teaching institutions.

    Trust me, this ain't no act. I've been a part of SDN for over six or seven years now (when it used to be called "O-net") and never has an osteopathic student or physician ever defined the osteopathic philosophy clearly. And we, meaning those who discussed this earlier, concluded that the philosophies were not all that different but that we must have missed something. If there was not a difference in philosophy, how can one justify the existence of two separate, but equal professions in healthcare? Now if you can define it, that'll be great.

    Generalist first, and specialist second, huh? So this means that DO students are trained to do everything (generalist) and then can chosoe to do something really specific (specialist). Now what about the MD students? Do they not also learn all that stuff (third and fourth years between MD and DO schools are virtually identical)?

    The rotating internship isn't even a commonality amongst your people. Not all osteopathic physicians seek the rotating internship, so what about those DOs? Are they, then, not really DOs because they're not "generalists first, specialists second?"

    So the difference between the MDs and the DOs is the extra-training in OMT, biomechanics, kinesiology, lymphatic function, and nervous system influence?

    Are there other DOs on SDN who agree with this?

    And I'm sure you have a source to back up your claim that some foundation that founded the DO school at Virginia Tech did a study on physician shortage and patient preference in regards to practice philosophy, right?

    Look to the example of Duquesne University in Florida, around 1998 or 1999, and their bid to found a new medical school.

    And they do now.

    What competition? Between whom?

    I've worked with NYCOM students on the floor, and through our discussions on the differences in philosophies, we found nothing different. They approached the patient no differently than the way I approached the patient. Their presentations to the attending were similar to my presentations. They didn't speak of "somatic dysfunction" or of "blocked lymphatics" as the cause of the problem. They quoted Harrison's, not DiGiovanni! :)

    You'll see when you finally start third-year that your expectation of the differences between our two professions is virtually nonexistent. Oh, and I wouldn't suggest you begin using that osteopathic-lingo when you present to your attending. ;)
     
  26. njdesi

    njdesi Senior Member

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    "CAN'T WE ALL JUST GET ALONG????????"




    :love:
     
  27. Castro Viejo

    Castro Viejo Papa Clot Buster

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    Source? ;)

    Seriously, I don't have any hard feelings toward the militant one. I just hope he doesn't arm a group of similarly militant DOs and go around snapping necks of the non-believers. :)
     
  28. oceandocDO

    oceandocDO Senior Member

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    Wowzas. I've never been called militant in my life. I guess everyone should have a cause. Believe me, I'm not a hell-bent D.O. who hugs trees or puts the profession above the allopathic model. If I come off like that, I apologize, but dont mistake enthusiasm for arrogance. I will do the same. As I stated, OMT to me is a tool, not a foundation or even a reason to go D.O.

    No, the original purpose of this thread was to explain why the AOA will probably never be swallowed up by the AMA. I gave a logistical and historical perspective and you turned it into a "you should join the AMA because the philosophies are the same anyway" arguement. Your analogy of the US Citizen without representation in the US Congress is wrong, because that citizen is welcome to run for office if he/she wishes to do so, just as a D.O. can do so in any college within the AMA. A D.O. actually heads the anesthesiology college I think. If the AOA holds a seat in the AMA, then the AMA should hold a seat in the AOA, since both bodies tackle issues which are similar at times, yet different at times too. Do you think the AMA would align themselves in that manner? I said the merger would be tough logistically because of the accredidation procedures and you turned it into a semantics argument.

    Yes, I agree. This is the exact reason D.O. schools gave up their hospitals. M.D. schools are just learning that it's hard to make money in today's climate of healthcare by owning and operating a hospital. One major reason is shrinking federal budgets, hence my reasoning for the Dept of Labor statistics.

    Actually, I did your homework....a search from the Dept of Labor. You're wrong my friend. As of 2001, the US Department of Labor estimates that the demand for physicians from 1998 to 2008 will lead to approximately 212,000 openings. http://www2.mms.org/pages/img_workforce.asp I think this qualifies as a shortage from the very source you claim finds a surplus. While there are many complexities (geography, specialty, etc) that go into the prediction, the shortage remains. Maybe the Dept has another study you remember? The government certainly likes doing studies. The shortage will be even more amplified now that visas are being restricted for IMGs. My reasoning was not due to a liberal government conspiracy slant either. Anyone will admit to a conflict of interest in the feds providing numbers about programs that they fund, or choose not to fund.

    Hardly. You asked for examples, I provided them to you. If I'm so uninformed, why dont you give me your opinion on why the philosophies are so similar? Yes, they are similar, probably in more quantitative ways than they are different. But the differences, albeit few in number, add up to a tremendous amount of contrast in the inner philosophy of health and the vehicle of delivery of health. D.O.s may present 99% of patients in the aesthically same exact manner that an MD will present. However, that 1% of the time, maybe a D.O. has a little bit more to offer, if you're the patient, that 1% means a whole lot. Just an opinion.

    No, they're a private foundation and can do whatever the hell they want. This particular group saw a need for Osteopathic physicians. Why? Primarily because of the shortage of PCPs in the southeast and D.O.s success at producing good FP docs more so than MDs who concentrate on specializing. I dont know the particulars of Duquesne, but I imagine there is more to that story, money probably being at the heart of it.

    Competition between schools of thought, not between doctors on a floor. A pseudo-checks and balances system for each philosophy to learn from the other. Is it hard to put into words what the tennents of each are? Yes, because a DO will rarely experience an MD training and vice versa. Actually, if you ask one of NYCOM's APEP students, foreign MDs who come to the states to be retrained as a DO, they admit to a philosophical difference. Many have a hard time putting it into words, but they say there is a different feeling to the individual training regimens. Just an opinion though. No, you wont find treatment modalities in harrisons different.

    I wasnt the one who used the osteopathic lingo. You were. But, thanks for the advice, chief. I'll remember it, I promise. ;)
     
  29. s42brown

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    Both of your points of view are valid. While one standard American physician might be important, is it worth losing the growing check and balance that the osteopathic profession offers to millions of patients. In the end time will only tell.:)
     
  30. me109cito

    me109cito Banned
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  31. Dr JPH

    Dr JPH Banned
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    Timothy Wu knows more about osteopathic medicine, it's history, and it's philosophy than 90% of the D.O. students in the country. Quite possibly 95%.

    He has always been able to stand behind his posts by citing facts and references, as he has done here.

    I find his insight a realistic view, not meant to belittle any future physician, MD or DO. Tim has always been a proponent of osteopathic medicine, and I believe he knows several NYCOMers. Don't take his posts as an attack again osteopathy.

    Please continue with the discussion...it is quite interesting, but remember to play nice!

    Josh
     
  32. me109cito

    me109cito Banned
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    see, here's one of your own going for an allo residency. I wonder why? hmmmm......
     
  33. oceandocDO

    oceandocDO Senior Member

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    I agree with that. Pretty dry book. Supposedly they're coming out with a new edition soon, hoping to address those criticisms. I've opened that book 3 times maybe. DiGiovanni retired, as did Schiowitz. While they both did alot for the profession, their time had come, and gone.

    Harrisons aint much better on the readability scale though.


    As for me109cito, it's good to know your 16th post here consisted of something so well thought out. How many of the other 15 posts have consisted of bashing D.O.s? Seriously, thank god there will be doctors like you around to catch all of our mistakes. Or have you even started medical school yet?
     
  34. BrooklynDO

    BrooklynDO Senior Member

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    me109:
    1. persuing allo residencies or matching in them is a matter of doing the math....there are more of them and therefore they are not as difficult to get. yes the most competative ones are still mostly allo as far as I know...but do the math, there are simply more allo schools.
    2. philosophy has little to do with residency. philosophy is a mindset, which you can choose to practice or choose not to. It really doesnt have much to do with residency.
    3. there were several people here asking if as MD's they could do a DO residency. hmmm
    as for people in residency directorships , I am not going to use people's names without their permission, but they are there.
    And as for your challenge to name people in top 10 positions... with about 125 md schools and 19 osteo schools, do the math...if there is even ONE in the "top ten" or even top 20, I would think that would quiet your concerns. As for everything else, if you dont like osteopathy or think its somehow worthless, do some reading on history of medicine. Better yet, have the experience I had where the only person who didnt turn away a family member because they couldnt help him was an osteopathic physician...oh and this doctor did help...
    hmmmmm
     
  35. pafbdoc

    pafbdoc Member

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    First time poster, casual lurker.

    I agree with most of what oceandocDO has to say. Tim Wu may be able to stand by his facts usually, but here he's wrong. There will definitely be a physician shortage in the coming years, especially in some specialties and some areas. Who knows how the whole PLI reform issue will work out either. Docs are leaving practice, particular specialties especially, in record numbers because of the malpractice crisis. This will open up huge holes, quicker than even the studies that oceandoc refers to. Tim is a bit argumentative, the thread went in a different direction because he started to split hairs. I also agree with the right of the AOA to remain soverign. My dad is an MD. Just talked to him about this and even he admits that the AMAs offer of a seat in the HOD for the AOA has ulterior motives. He's an orthopedist and his partner is a D.O. The D.O. founded the practice and makes a boatload of cash. I will be starting med school next fall at a D.O. institution. My father encouraged it as the hospitals we rotate through are some of the ones he works at and his partner uses OMM on his patients and sees great results. He doesnt do the real controversial stuff, just the "basics", but he sees results and has taught my dad alot. He said it's basically physical therapy with a fancier name, so why not get more bang for the buck? Hence, my dad gave his blessing for DO school.

    Anyway, thanks for the entertainment folks. Night!:p
     
  36. DrQuinn

    DrQuinn My name is Neo
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    enough. I will explain why I am choosing to apply to MD residencies only. I am applying for Emergency Medicine. The DO residencies are 4 years long, whereas the majority of the MD residencies are 3 yrs long (some are PGY 1-4, some are PGY2-4). The main reason I am applying to MD only is because I simply do not want to do the osteopathic internship, or that extra year. I want to be out as an attending in 3. There is no need for Emergency Medicine to be 4 years unless you really want to pursue more administrative or academic areas, which I'm not exactly interested in (at this point). I know many people who have done the DO EM residencies and are just as well-trained as many MD trained physicians I know..................................
    ok my brain is fried after working the night shift.

    Flame on.
    Q
     
  37. Dr JPH

    Dr JPH Banned
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    Wanna talk to my dad?

    :)


    Good post.
     
  38. Sweaty Paul

    Sweaty Paul Senior Member

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    Tim,

    here is the osteo philosophy in a nutshell (according to my understanding). It was based on four tenets that A.T. Still himself thought up and expressed far more verbosely than I will below. However, what I scribe below is the essence and the core of the osteopathic medicine as taught to me at KCOM. It is the basis for all of the stuff regarding "lymphatic flow, nerve impingement, and maximizing range of motion, etc." It is from these 4 tenets that A.T. deduced the Rule of the Artery: The Artery is Supreme (i.e. got to get blood to an area for the tissue to be healthy).

    1. A patient is composed of mind, body, and spirit.

    2. Structure and Function are interrelated.

    3. The body contains mechanisms for self-healing and self-regulation

    4. Treatment of the patient requires an incorporation of the above 3 tenets.

    Now on to my opinions:

    I may irritate some of my fellow osteo students with some of these and if so, remember these are my opinions only, based on my experiences thus far as a student.

    Osteopathic medicine NO LONGER HOLDS THE PATENT ON TREATING THE PATIENT NOT JUST THE SYMPTOMS...WE DON'T, SO LET IT GO!! At one time I believe that Osteopaths likely did have this as corner on this belief, however, it is one that all physicians realized to be important and now, mostly, employ. Take pride osteo students that our forefathers brought this to the mainstream and in so doing have had a profound affect on how med is practiced today.

    I think the fundamental difference in philosophy between osteopathic and allopathic medicine is in the four tenets that A.T. articulated clearly. These tenets were the basis for his approach and all osteopaths approach to the effective treatment of any patient. The reason these are the difference is that I have never heard of an allopathic equivalent to the above 4 tenets and they spell clearly the expectations A.T. Still had of an osteopath treating patients. These four simple tenets then, can be applied and utilized not only for patient care, but, for teaching patient care too. I have read on earlier posts about the hippocratic oath as the basis for an allopathic philosophy, but D.O.'s do that oath too. Subsequently the only diff goes back to the 4 tenets.

    The four tenets in 1878 (when he first "flung to the breeze the banner of osteopathy" A.T. Still) and in 1892 when he opened the first school, were highly contrary to what was being taught in traditional medical schools. Now we know that in fact "structure and function are interrelated" in virtually everything biologic: enzyme shapes, muscle attachment locations, eye placement etc. We also know that the body can and does have self-regulating and healing mechs, however, in 1892 these weren't well known or elucidated and the very idea that some "quack" in MO was verbalizing them pained the establishment and the establishement reacted predictably.

    Ultimately, in my humble opinion, there are very few differences between the professions. Both become fully licensed physicians. D.O.'s, however, have manipulation as a tool to use to treat patients and all of the applied anatomy that goes with this tool. It is a tool that may be used infrequently, but, it can be used and in that regard it does seperate a D.O. from an M.D. Most important, osteopaths have the four tenets that A.T. established so long ago that have withstood the test of time and proven him not so crazy afterall.

    I've enjoyed reading this post and I look forward to more open and well-thought discussions.

    Sincerely,

    Sweaty Paul MS-III
    KCOM
     
  39. John DO

    John DO A.T. Still Endowed Chair

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    Sweaty, Sweaty, Sweaty,

    I can't possibly let you get away with such a GRAVE error!! The banner of Osteopathy was flung to the breeze in 1874, not 1878. How easy you forget when you leave the fold!!
     
  40. Sweaty Paul

    Sweaty Paul Senior Member

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    johndo,

    oops, 1874. I stand corrected. I shall go lash myself 30 times for my blasphemy.

    Sweaty
     

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