Does DO=MD+DPT?

[mathlegend]

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Okay well not quite, but as I'm exploring these careers, it seems like DO can do what MD can do and some of what PT can do (the manipulation part). Am I correct here? I want to do medicine, surgery, therapy...seems like going DO might be a good route (and hopefully matching into orthopedic surgery? :S ) And please discuss any other similarities/differences you see.

 

[MilkmanAl]

I guess that's one way to think about it. Realistically, though, only a very small percentage of DO's actually practice OMM. I think someone quoted it as less than 10%, in fact. From what I understand about OMM, your training will be quite a lot less intensive than a DPT's, also.

 

[mathlegend]

Why dont more DO's use OMM?

And I forgot to say, but PM&R seems to be a good path, just without the surgery?

 

[Gigantron]

A lot of D.O.'s don't use OMM because a lot of them decide to specialize in fields that don't really use OMM. Cardiology, for instance. I shadowed a D.O. cardiologist who never used OMM in his practice...simply because the principles of OMM really don't have any relation to what this doctor did on a daily basis.

 

[Bacchus]

There are several things going against OMM, despite its [debatable] usefulness.

1) Policy usually limits visits to 15 minutes. If you are to do OMM properly, and how you were trained, you need to inspect the patient before putting your hands on them, then perform regional motion testing, and finally determine a modality to use. Well there are several modalities. Picking won't be that time consuming, but doing the technique might be. Before you know it, your visit is over and you have done nothing for the patient besides OMM.

2) I don't think we get "enough" training. I have lab 1.5 hours a week. At the end of this I'm lucky if I have 150 hours of OMM training, excluding use on the wards. Some techniques are easy to perform, but requiring so little of us makes use nervous at times to use it.

3) Not everyone is accepting of OMM. If you're going to use the treatment as a resident and your attending is hesitant you're going to have to explain the science behind what you're doing. If its a temporary fix, is it worth it? Restoring bowel function, lymph drainage, or other things might be worth it.

4) This is a new generation of Osteopathic students. Many don't care for OMM and are doing what they have to become a physician, going through the motions.

Certain fields lend themselves to OMM: PM&R, definitely; FP, to alleviate pain; even surgery post and pre-op to better prepare a patient.

 

[mathlegend]

Yea...I can't seem to imagine OMM working in some specialties.

That sucks, are visits limited to 15 in for all physicians? Even PM&R?

Would a DO with the OMM training in PM&R have more knowledge over a MD in PM&R, ?or would they basically know the same after residency?

 

[derek320]

most physicians try to get their visits done in 5-10 minutes, 15 minutes is actually pretty long for an appointment depending on the type of visit.

The orthopedic who did my surgery reviewed my MRI, x-ray, checked out my knee and scheduled a surgery all within a 10 minute meeting with him and this was the first time I had ever seen this doctor. I expected a much longer appointment, but the way that the appointments are scheduled don't allow a doctor to see a patient for more than 15 minutes, its kind of unfortunate that they schedule patients like this.

 

[Bacchus]

They would know the same after residency, for the most part. I think a better comparison would be family practitioners. If a patient came in with lower back pain both may prescribe antiinflammatories, muscle relaxers, or some other drug. However, if the DO uses OMM he could help alleviate symptoms through HVLA, myofascial release, soft-tissue, muscle energy, counter-strain or another OMM technique.

In the case of PM&R, the practitioner will know how to deal with issues and may not have to augment with OMM. Think of OMM as an augment. Unless you do an OMM residency, you will not be treating with OMM exclusively.

 

[mathlegend]

Yea...I've seen my pediatrician, orthopedic surgeon, podiatrist...sometimes we'd be done talking about my medical condition and stuff in less than 5 min, and just talk about some other random stuff for the next 5.

Thanks. So pretty much the option to use OMM lies with the practitioner? Some just don't like to use it?

 

[JaggerPlate]

Hahaha, interesting way to look at it ... but I don't think the extra 200 hours in OMM constitutes an additional doctorate. Most people look at OMM as interesting, a unique tool, but not something they plan on using (time constraints, reimbursement issues, don't want to keep up with it, field they are in, etc). I'd look at it like this DO = MD ... saying DO is something "more" is usually kind of insulting IMO.

 

[Law2Doc]

Okay well not quite, but as I'm exploring these careers, it seems like DO can do what MD can do and some of what PT can do (the manipulation part). Am I correct here? I want to do medicine, surgery, therapy...seems like going DO might be a good route (and hopefully matching into orthopedic surgery? :S ) And please discuss any other similarities/differences you see.

Med school (whether MD or DO) is a very intense, full, knowledge-packed 4 years. If you spend 200 hours on one thing, you spend 200 fewer hours on something else. So neither degree is the other "plus" something, unless it is also minus something. Truth of the matter is that if you spend time on OMM, you lose out on some breadth in some other areas. It's simple math really -- time is fungible, and you only have so much of it in 4 years, so you can never have 4 years "plus" squeezed into the same 4 years unless you are claiming MD is less intense than DO, which is an untenable claim. DOs tend to have a harder time matching into the more competitive allopathic residencies, so honestly if orthopedics is high on your list, an MD's better odds should be the only "plus" you need.

 

[mathlegend]

Sorry, no way I meant to imply that DO>MD, in my mind the training DO receive kind of seems like MD+DPT, just because of the OMM. But now if most DO's don't really even use OMM, I guess there's not much of a point in going that route, I should probably just go the MD route?

 

[Law2Doc]

Sorry, no way I meant to imply that DO>MD, in my mind the training DO receive kind of seems like MD+DPT, just because of the OMM. But now if most DO's don't really even use OMM, I guess there's not much of a point in going that route, I should probably just go the MD route?

There are IMHO only two reasons to go DO. Either (1) you really prefer the philosophy (see the stickies on the osteopathy board), or (2) your scores/stats necessitate you attending osteo instead of allo. DO has made amazing inroads into many specialties and regions, but still doesn't open as many doors to competitive paths as allopathic medicine. It is not an MD+ anything. If you don't buy into the philosophy (and most DOs don't, it's actually MD- something). It's a path that teaches you OMM instead of the equivalent 200 hours of breadth in your other courses over the same 4 years of intense learning. It's silly to worry about MD vs DO while in high school -- go to college and get the best grades/scores you can, do lots of cool ECs and see where you are after that. If at that point you still think orthopedic surgery is the path you are leaning towards, then yes, allopathic medicine will be the better route for you.

 

[JaggerPlate]

With all that has been said, just wanted to clarify a few points:

Ortho is competitive all around, and is going to come down to the individual student far more than the degree. If you're a lackluster MD student with an average USMLE score, don't expect any favors simply because you're an MD student. Those Ortho spots are going to go to the thousands of other qualified applicants. However, if you're a hardworking, dedicated DO student, don't expect to be doomed to a PC residency in Ohio. Go look at some DO match list, they put people into AOA ortho programs every year. For example ...

In 2008:

KCOM put 5 people into Ortho (and one in ACGME)
DMU put 7 people into Ortho
KCUMB put 7 people into Ortho

etc. Also, here is a link to get to the AOA (DO) Ortho residencies:
http://opportunities.osteopathic.org

The point I'm trying to make is a. You'll probably change your mind in med school b. Ortho is competitive, and not all people have the scores c. If you don't have the scores, a degree isn't going to save you one way or another. Like Law2Doc was saying, there are more opportunities coming from the MD side, but frankly, if you don't have the stats ... it's probably a moot point because there are more than enough highly competitive applicants for all the Ortho spots.

Further more, about the 'choosing a DO school' thing. There are lots of reasons why people choose DO schools. I know several people who've picked it over MD with no qualms, and it has nothing to do with a philosophy or lower scores ... it has to do with cost, location, family, and fit. My advice ... go to college, do the best you can, apply to places that are cheap, in areas where you would want to live, and near your family. When you interview there, make sure it's a 'fit.' I'd put this preference above MD vs DO. If you really want the MD behind your name, or you really buy into the conception that you can go to an MD school, slack off, and still match integrated plastics at Mass General simply because you go to a state MD school and not a DO school ... then good luck.

You've got a ways to go ... focus on more relevant things first.

 

[mathlegend]

Thanks guys. Yep I'm focusing on things to get me into a good college, such as keeping my grades up, SATs, ACTs, etc. I know I don't really have to worry about this stuff for a while, but it doesn't really hurt to have some knowledge about what I will have to decide upon in 3 years or so. And I doubt I will have the numbers for Ortho, so I am exploring other fields in medicine/healthcare.