How Often Does this Happen to DO's?

[Torilynn92]

So recently I had a rather infuriating patient at the office where I work, and I wondered if his reaction was commonplace in the medical field. I work with an office where there are both MDs and DOs, and in the office as well as in the hospital they are indistinguishable and treat one another with professionalism and respect. In the two years I've worked here, no patient has made any disparaging statements about any of our DO's qualifications. Until this week. I had a patient who was complaining about post-surgical complications after a surgery performed by another office. He said to me and the doc "You know, I didn't even know before the surgery, but the guy wasn't even a doctor. He was a DO. He didn't even go to medical school, and he's cutting people up! He's some crazy osteopathic man, not a doctor! I can't believe this is legal!"

My physician (M.D.) looked uncomfortable and pointed out that he personally works with many DOs, and his partners are DOs, and he feels that they are just as qualified (and that they do go to medical school), although he apologized for the patient's poor experience and suggested he follow up with another surgeon in the future. He also pointed out to the patient "You know, your PCP is a DO, and you like him, right?" (The patient is always talking quite highly of his PCP, who is considered to be one of the best in the area).

Well, long story short, the patient was *enraged* that his doctors have been "lying to him about being REAL doctors", and he requested his records from his PCP so he could go to an "actual" doctor. The entire time this conversation is happening, I'm like standing in the corner with my ears ringing from rage. I'm like getting tunnel-vision from the sheer force of will it took to not leap in in defense of DOs. Is this kind of behavior commonplace from patients? :/ Just trying to know what to prepare for.

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[AlteredScale]

This is def an abnormal case. I've never heard of a patient getting this upset over the credentials of and MD vs a DO.

 

[Torilynn92]

This is def an abnormal case. I've never heard of a patient getting this upset over the credentials of and MD vs a DO.

That's what the DOs I work with pretty much said. They did get their feathers ruffled a bit, and made a good point - some patients will look for anything to explain what they feel is bad service. If he wasn't blaming his post-op complications on his surgeon being a DO, he'd be blaming them on the fact that she was a woman, and an African-American, and young. Still, it was unsettling for me, since I'm so excited about my future as a DO and I've never seen a patient act like they're second-class doctors before. The area in which I work is verrrrry DO-friendly, so I wondered if this was commonplace elsewhere.

 

[GatorsKW14]

I have never experienced this, but I have heard several patients say that they prefer a DO because of OMM or other osteopathic principles. The majority of patients don't care whether they are seen by a DO or MD (many don't even know that there are 2 degrees), as long as the physician has good bedside manner and is competent. I have only seen premeds and some older MDs discriminate against DOs. If a patient has negative opinions regarding DOs, it seems to be because they are poorly educated about the degree.

 

[docisthegoal]

I have never experienced this, but I have heard several patients say that they prefer a DO because of OMM or other osteopathic principles. The majority of patients don't care whether they are seen by a DO or MD (many don't even know that there are 2 degrees), as long as the physician has good bedside manner and is competent. I have only seen premeds and some older MDs discriminate against DOs. If a patient has negative opinions regarding DOs, it seems to be because they are poorly educated about the degree.

All of this. My father is constantly in the OR and with patients and says patients (majority) do not even care the title of the person who is caring for them as long as it is quality care. Him working in the OR for many years didn't even know that some of the Anesthesiologists/Cardiologists were DOs because title matters so little anymore, especially when the quality of work being done is equal amongst DOs and MDs.
I think we are all in a good place to start pursuing our careers as DOs. Although the fate of the merger is unknown at this point, I have a good feeling it will work out in our favors. There definitely is some discrimination out there still, but as the DO field grows and we continue to show and prove to others we are just as qualified if not even more in some cases I think this discrimination with become nonexistent overtime.

 

[Lawgiver]

i can tell you've never had a real job. welcome to grown up world.

 

[sharpstickie]

Goodness. I love to start off a day with such negativity.

i can tell you've never had a real job. welcome to grown up world.

 

[Lawgiver]

if you think that was being negative then you too have never had a real job.

 

[sharpstickie]

Conclusion without evidence. Let's get back on topic.

if you think that was being negative then you too have never had a real job.

 

[Torilynn92]

i can tell you've never had a real job. welcome to grown up world.

Excuse me?
I've worked full-time in the medical field for 5 years, and through undergrad. But okay? I'm not sure what your lofty determination of a "real job" is. I love what I do, though, and get paid well to do it. I get that you're 31 and non-trad, and that's great, but trolling people you don't know obnoxiously and insinuating they're inferior and naive isn't exactly a phenomenal quality in a future physician…


On-topic though…thanks for all the replies! It makes me feel a lot better knowing that this isn't a common occurrence for most practicing osteopathic physicians, even those in other areas where there are fewer DOs in general. Have a great day, all!

 

[IslandStyle808]

i can tell you've never had a real job. welcome to grown up world.

I don't think you have worked in academia if you are saying this. You can be dealing with just as much BS.

 

[deleted407021]

Non-trads be non-traddin'.

I agree with the doctors you talked to. He wanted to complain about his complications, so he picked up on the 'DO' behind her name and that's what he jumped on. Isolated incident, I'm sure.

 

[IslandStyle808]

Excuse me?
I've worked full-time in the medical field for 5 years, and through undergrad. But okay? I'm not sure what your lofty determination of a "real job" is. I love what I do, though, and get paid well to do it. I get that you're 31 and non-trad, and that's great, but trolling people you don't know obnoxiously and insinuating they're inferior and naive isn't exactly a phenomenal quality in a future physician…


On-topic though…thanks for all the replies! It makes me feel a lot better knowing that this isn't a common occurrence for most practicing osteopathic physicians, even those in other areas where there are fewer DOs in general. Have a great day, all!

You have worked with the same people for 5 year, I am I correct in assuming this? So it seems like one of those "once in a blue moon" moments that happens. The osteopathic doctors one this forum also have mentioned this happing every few years, so best to take it as such. As long as you are a good doctor, you will be fine. Congrats on your acceptance.

 

[Torilynn92]

You have worked with the same people for 5 year, I am I correct in assuming this? So it seems like one of those "once in a blue moon" moments that happens. The osteopathic doctors one this forum also have mentioned this happing every few years, so best to take it as such. As long as you are a good doctor, you will be fine. Congrats on your acceptance.

Thank you! Very good to hear. Working with DOs directly is a new thing for me, and I work in South Florida, which has a ton of DOs. I'm glad to hear that this patient's opinion isn't common in other places where there are fewer DOs, either. Next time it happens - maybe in another 5 years, when I'm a DO myself - I'll hopefully have thought of a good way to handle it with grace and not rage haha

 

[cabinbuilder]

I had an elderly gentleman refuse to see me because I was female (in his day women weren't doctors). Never had someone refuse to see me because I am a DO. I agree that the person was upset overall due to complications, etc. and will find anything to complain about. It's not really a DO thing, but more a frustration/grief/acting out thing.

 

[jordansetron]

When you think of all the "lay-person" websites and tv shows, its easy to see how some people may surprised that the DO degree exists. House M.D., WebMD, ChefMD, etc.
I even saw a drycleaning store called CleanerMD. I personally didnt even know there were 2 dental degrees until recently (DDS and DMD). I wish the DO awareness campaign spent some money to make a physician-witness on CSI a DO. There are some people that think only the ivy league medical school degrees should be respected as well. Some people will always find a way to challenge your credentials

 

[deleted407021]

Saw a DO pathologist on Forensic Files the other night and went *squee*.

 

[cliquesh]

I've seen it happen twice. It's not common enough for it to be a big deal. It does happen, though.

 

[darknecrosforte]

I had an elderly gentleman refuse to see me because I was female (in his day women weren't doctors). Never had someone refuse to see me because I am a DO. I agree that the person was upset overall due to complications, etc. and will find anything to complain about. It's not really a DO thing, but more a frustration/grief/acting out thing.

When you say WAS female, considering this day and age, makes me wonder if there's additional meaning there lol.

Just playing.

 

[j4pac]

The MASS majority of patients don't care. All they care about is whether you are the correct specialty and will you make them better. But I don't think that there is any question that DO's have a shorter rope than MD's. If one DO screws up on a patient, the patient will likely demand to see an MD. If an MD screws up on a patient, the patient will probably just develop a distrust of ALL physicians. He/she won't be running out to find a DO.

I think that there does need to be more education on the topic...likely in the form of entertainment. But what the OP described a very mass minority.

 

[CUNYguy]

I work for a group of cardiologists and the only DO in our practice has the highest patient population vs. the MDs.

Take what you will.. But as a healthcare provider, I see that healthcare moves way faster than society is willing to accept. Some people think the NPs in the practice are doctors even though they just introduce themselves by their first name and have to remind the patients that they're not a doctor but rather an NP.

 

[stantheman08]

That's nothing!

Had a patient recently who was refusing her meds because they were damaging her "spirit"
So she politely has been refusing all meds while waiting on her homeopathic meds to clear pharmacy...on top of that her chiropractor has been telling her she doesn't need to take her real medicine and that the supplements her naturopath have per$cribed her are all she needs.
like several others have said, we're going to catch crap regardless of degree.

 

[deleted407021]

That's nothing!

Had a patient recently who was refusing her meds because they were damaging her "spirit"
So she politely has been refusing all meds while waiting on her homeopathic meds to clear pharmacy...on top of that her chiropractor has been telling her she doesn't need to take her real medicine and that the supplements her naturopath have per$cribed her are all she needs.
like several others have said, we're going to catch crap regardless of degree.

To be fair, the "spirit" concept is part of the DO philosophy ... To my mind, that's essentially describing the biopsychosocial approach, through that model wasn't formally elucidated until the 70s. I don't myself believe in souls or spirits. I interpret that portion of the "whole person" triad as a individual's personal ethos.

 

[Dr Tony T. Chopper]

So recently I had a rather infuriating patient at the office where I work, and I wondered if his reaction was commonplace in the medical field. I work with an office where there are both MDs and DOs, and in the office as well as in the hospital they are indistinguishable and treat one another with professionalism and respect. In the two years I've worked here, no patient has made any disparaging statements about any of our DO's qualifications. Until this week. I had a patient who was complaining about post-surgical complications after a surgery performed by another office. He said to me and the doc "You know, I didn't even know before the surgery, but the guy wasn't even a doctor. He was a DO. He didn't even go to medical school, and he's cutting people up! He's some crazy osteopathic man, not a doctor! I can't believe this is legal!"

My physician (M.D.) looked uncomfortable and pointed out that he personally works with many DOs, and his partners are DOs, and he feels that they are just as qualified (and that they do go to medical school), although he apologized for the patient's poor experience and suggested he follow up with another surgeon in the future. He also pointed out to the patient "You know, your PCP is a DO, and you like him, right?" (The patient is always talking quite highly of his PCP, who is considered to be one of the best in the area).

Well, long story short, the patient was *enraged* that his doctors have been "lying to him about being REAL doctors", and he requested his records from his PCP so he could go to an "actual" doctor. The entire time this conversation is happening, I'm like standing in the corner with my ears ringing from rage. I'm like getting tunnel-vision from the sheer force of will it took to not leap in in defense of DOs. Is this kind of behavior commonplace from patients? :/ Just trying to know what to prepare for.

There are people who don't know that Hawaii is in the US.. Let it go, there are always going to be hilariously misinformed and incorrigible people, its up to us, the future generation of medicine to change that fact a little at a time.

 

[Torilynn92]

Saw a DO pathologist on Forensic Files the other night and went *squee*.

Want a fun time, watch Trauma: Life in the ER -- soooo many of them are DOs. Makes me feel fuzzy inside to see representation.

That's nothing!

Had a patient recently who was refusing her meds because they were damaging her "spirit"
So she politely has been refusing all meds while waiting on her homeopathic meds to clear pharmacy...on top of that her chiropractor has been telling her she doesn't need to take her real medicine and that the supplements her naturopath have per$cribed her are all she needs.
like several others have said, we're going to catch crap regardless of degree.

Oh, no. We had a patient who was told by her naturopath that the way to tell if medications would "work" or "not work" was to hold them in her left hand, hold that hand up to her chest, and extend her right arm. If the right arm felt heavy, it was because her body was rejecting the medicine. No joke. She was absolutely opposed to any kind of treatment that didn't pass this test, including homeopathic methods. Sad ending, she stopped her anticoagulant because it didn't pass the arm-test and ended up in the hospital. She's fine, but just goes to show why DOs should try and distance themselves from naturopaths. Patient was appalled that her DO didn't agree with her "test".

 

[deleted407021]

Want a fun time, watch Trauma: Life in the ER -- soooo many of them are DOs. Makes me feel fuzzy inside to see representation.



Oh, no. We had a patient who was told by her naturopath that the way to tell if medications would "work" or "not work" was to hold them in her left hand, hold that hand up to her chest, and extend her right arm. If the right arm felt heavy, it was because her body was rejecting the medicine. No joke. She was absolutely opposed to any kind of treatment that didn't pass this test, including homeopathic methods. Sad ending, she stopped her anticoagulant because it didn't pass the arm-test and ended up in the hospital. She's fine, but just goes to show why DOs should try and distance themselves from naturopaths. Patient was appalled that our practice's DO didn't agree with her "test".

I've seen patients refuse meds because they prayed about it and "god told them not to".

 

[costales]

Nope. People are too sick to care - they just want their five minutes with a doctor. Not long ago I had a patient who said he was highly dissatisfied with his surgeon. Said he should have picked someone who went to Texas A&M instead of UT Southwestern - because he was an Aggie and Aggies are the best. Go figure. I also had a patient who refused to see a Muslim female resident, and Muslim patients who refused treatment by doctors of the opposite sex. There is not much you can do when it comes to people's pride and prejudices. If they want their runny nose treated by a Harvard-trained MD, tell them to go to a Harvard-trained MD. There is no shortage of patients.

 

[IslandStyle808]

There are people who don't know that Hawaii is in the US.. Let it go, there are always going to be hilariously misinformed and incorrigible people, its up to us, the future generation of medicine to change that fact a little at a time.

LOL I can confirm this statement.

 

[Goro]

Patient must a have been a certain MD resident who frequents these forums!

So recently I had a rather infuriating patient at the office where I work, and I wondered if his reaction was commonplace in the medical field. I work with an office where there are both MDs and DOs, and in the office as well as in the hospital they are indistinguishable and treat one another with professionalism and respect. In the two years I've worked here, no patient has made any disparaging statements about any of our DO's qualifications. Until this week. I had a patient who was complaining about post-surgical complications after a surgery performed by another office. He said to me and the doc "You know, I didn't even know before the surgery, but the guy wasn't even a doctor. He was a DO. He didn't even go to medical school, and he's cutting people up! He's some crazy osteopathic man, not a doctor! I can't believe this is legal!"

My physician (M.D.) looked uncomfortable and pointed out that he personally works with many DOs, and his partners are DOs, and he feels that they are just as qualified (and that they do go to medical school), although he apologized for the patient's poor experience and suggested he follow up with another surgeon in the future. He also pointed out to the patient "You know, your PCP is a DO, and you like him, right?" (The patient is always talking quite highly of his PCP, who is considered to be one of the best in the area).

Well, long story short, the patient was *enraged* that his doctors have been "lying to him about being REAL doctors", and he requested his records from his PCP so he could go to an "actual" doctor. The entire time this conversation is happening, I'm like standing in the corner with my ears ringing from rage. I'm like getting tunnel-vision from the sheer force of will it took to not leap in in defense of DOs. Is this kind of behavior commonplace from patients? :/ Just trying to know what to prepare for.

 

[0dee]

One time this pissed off patient told the PA that she doesn't wanna be seen by the doctor's errand boy. I felt so bad and mad for that PA, he was such an intelligent provider.

 

[deleted407021]

One time this pissed off patient told the PA that she doesn't wanna be seen by the doctor's errand boy. I felt so bad and mad for that PA, he was such an intelligent provider.

Wow -__-

 

[Mr Roboto]

I've seen over 1000 patients, and have heard exactly 1 complain about someone being a DO.

"My old doctor was an osteopath--they believe in more natural things, letting the body heal itself--so he wouldn't prescribe me my pain pills. But you will, won't you, [Dr. MD]?"

 

[deleted407021]

Patient must a have been a certain MD resident who frequents these forums!

OMG Goro how can you be so unprofessional?!1! Teh Interwebz is serious.

 

[Dustbowl12]

I know pockets of hifi millionaire stay at home moms that ask for the DO instead because of OMM, they think it is more luxurious and exclusive to see the DO. You will find silliness everywhere

 

[TUVIX]

Excuse me?
I've worked full-time in the medical field for 5 years, and through undergrad. But okay? I'm not sure what your lofty determination of a "real job" is. I love what I do, though, and get paid well to do it. I get that you're 31 and non-trad, and that's great, but trolling people you don't know obnoxiously and insinuating they're inferior and naive isn't exactly a phenomenal quality in a future physician…


On-topic though…thanks for all the replies! It makes me feel a lot better knowing that this isn't a common occurrence for most practicing osteopathic physicians, even those in other areas where there are fewer DOs in general. Have a great day, all!

You don't need to justify yourself to internet trolls.

 

[TUVIX]

I've seen over 1000 patients, and have heard exactly 1 complain about someone being a DO.

"My old doctor was an osteopath--they believe in more natural things, letting the body heal itself--so he wouldn't prescribe me my pain pills. But you will, won't you, [Dr. MD]?"

DO probably told him how to take better care of himself but he wanted to be lazy and just take medication for the pain. This is an issue that MDs face constantly as well. I know an orthopedic surgeon who was sued by a patient because he refused to give them a refill of opioids.

 

[samac]

So recently I had a rather infuriating patient at the office where I work, and I wondered if his reaction was commonplace in the medical field. I work with an office where there are both MDs and DOs, and in the office as well as in the hospital they are indistinguishable and treat one another with professionalism and respect. In the two years I've worked here, no patient has made any disparaging statements about any of our DO's qualifications. Until this week. I had a patient who was complaining about post-surgical complications after a surgery performed by another office. He said to me and the doc "You know, I didn't even know before the surgery, but the guy wasn't even a doctor. He was a DO. He didn't even go to medical school, and he's cutting people up! He's some crazy osteopathic man, not a doctor! I can't believe this is legal!"

My physician (M.D.) looked uncomfortable and pointed out that he personally works with many DOs, and his partners are DOs, and he feels that they are just as qualified (and that they do go to medical school), although he apologized for the patient's poor experience and suggested he follow up with another surgeon in the future. He also pointed out to the patient "You know, your PCP is a DO, and you like him, right?" (The patient is always talking quite highly of his PCP, who is considered to be one of the best in the area).

Well, long story short, the patient was *enraged* that his doctors have been "lying to him about being REAL doctors", and he requested his records from his PCP so he could go to an "actual" doctor. The entire time this conversation is happening, I'm like standing in the corner with my ears ringing from rage. I'm like getting tunnel-vision from the sheer force of will it took to not leap in in defense of DOs. Is this kind of behavior commonplace from patients? :/ Just trying to know what to prepare for.

There's your answer.

 

[Dr Tony T. Chopper]

Interestingly enough, your parents and nosy relatives are MUCH more likely to poke fun or make comments about your DO or MD letters than any patient ever will.

"Uncle Joseph said you were a bone guy that fixes fractures"

"Can grandma get a free xray from you?"

"Does that mean the nurses will still be all over you? Speaking of which, when the hell are you getting married?"

"Hah! At least the letters DO are IN the word 'doctor'! Does that mean you guys are the real doctors??"

"Son let me get one of those osteopath massages"

 

[DrMikeP]

Patients will find stuff to complain about all the time. I've heard similar comments about MD's having a cure for cancer and keeping it secret, being incompetent for A-Z, only caring about their Mercedes payment, golfing, golfing and golfing, etc. Having worked closely with both MD's and DO's the hate is pretty evenly shared.

That said, I work with a lot of med and other healthcare students whose foundations are rocked by their first patient who insults them personally or professionally, but after a few months they learn to ignore it or it eats them alive. So you might as well get used to patients, especially in a hospital setting saying nasty things about doctors, and it doesn't matter if they are DO's or MD's (or even psychologists). What's even worse is that sometimes the patients are absolutely right, Dr XYZ really is incompetent.

 

[Torilynn92]

Thanks for the great discussion, everybody! Very informative.

 

[docycle]

OP what region are you in?

Some of the older people on the east coast may act in this fashion. My father, for example, makes it a point to never see DOs for any particular sensitive issues/procedures (though he's fine with the fact that in the ER he doesn't have a choice), and he actually understands exactly what they are and the training they go through. He simply thinks that they are less intelligent people due to their weaker academic credentials and therefore does not trust them as much to practice effectively. I do understand and respect his viewpoint, but I would rather he judges a doctor on the basis of his record in practice and patient reviews rather than how he performed academically in undergrad.

But let's be honest -- it's not surprising we are going to have to deal with grossly misinformed patients, on all fronts. As future DOs, I think it's important that we be prepared to be reprimanded by patients, albeit once in a blue moon, simply because of the fact we are DOs. This will usually happen in the aftermath of a negative outcome, as the OP describes.

 

[docycle]

Does anyone know if there is any peer-reviewed reviews of MD vs. DO care out there? i.e. comparison of the number of surgical complications, patient complaints, malpractice suits, etc.? Would be interesting to actually see the statistics.

 

[CUNYguy]

Does anyone know if there is any peer-reviewed reviews of MD vs. DO care out there? i.e. comparison of the number of surgical complications, patient complaints, malpractice suits, etc.? Would be interesting to actually see the statistics.

I'd expect this to be a very different endeavor. It's comparing human to human. You can have a really good MD vs. a really bad DO, and vice-versa.

You'd have to have a very specific set of criteria that doesn't discriminate between the two curriculum.

 

[docycle]

I'd expect this to be a very different endeavor. It's comparing human to human. You can have a really good MD vs. a really bad DO, and vice-versa.

You'd have to have a very specific set of criteria that doesn't discriminate between the two curriculum.

Agreed. Just thought it'd be interesting to do a very superficial evaluation of the two and see how it comes out.

 

[jordansetron]

OP what region are you in?

Some of the older people on the east coast may act in this fashion. My father, for example, makes it a point to never see DOs for any particular sensitive issues/procedures (though he's fine with the fact that in the ER he doesn't have a choice), and he actually understands exactly what they are and the training they go through. He simply thinks that they are less intelligent people due to their weaker academic credentials and therefore does not trust them as much to practice effectively. I do understand and respect his viewpoint, but I would rather he judges a doctor on the basis of his record in practice and patient reviews rather than how he performed academically in undergrad.

But let's be honest -- it's not surprising we are going to have to deal with grossly misinformed patients, on all fronts. As future DOs, I think it's important that we be prepared to be reprimanded by patients, albeit once in a blue moon, simply because of the fact we are DOs. This will usually happen in the aftermath of a negative outcome, as the OP describes.

I hate that viewpoint your father has. When you consider the fact that people can and do apply multiple times, take the MCAT multiple times, and do a Masters/Post-Bacc work that argument loses a lot of ground IMO. Add "knowing someone" on the admissions board and all the complexities of over/underrepresented in medicine and what you have is a system that is more of a roll of the dice than people think.

 

[costales]

That said, I work with a lot of med and other healthcare students whose foundations are rocked by their first patient who insults them personally or professionally, but after a few months they learn to ignore it or it eats them alive. So you might as well get used to patients, especially in a hospital setting saying nasty things about doctors, and it doesn't matter if they are DO's or MD's (or even psychologists).

^This. MD or DO, the moment you do something they don't like - e.g. involving their favorite pain med or discharge - they'll lash out and throw a noisy tantrum, call you uncaring/greedy/incompetent to your face, demand to see your boss or a different doctor, refuse to leave, threaten to come back and do a bounceback on you, threaten to call a lawyer/write the CEO/tell everyone on the net that you're a bad doctor - whatever.

You can't avoid asshats. Thankfully their numbers are small.

 

[deleted407021]

^This. MD or DO, the moment you do something they don't like - e.g. involving their favorite pain med or discharge - they'll lash out and throw a noisy tantrum, call you uncaring/greedy/incompetent to your face, demand to see your boss or a different doctor, refuse to leave, threaten to come back and do a bounceback on you, threaten to call a lawyer/write the CEO/tell everyone on the net that you're a bad doctor - whatever.

You can't avoid asshats. Thankfully their numbers are small.

Ew, not super excited about that. How do you deal with the asshats when they pop up?

 

[Dreamstoo]

I remember a DO I shadowed said he's seen patients turn down care from DOs only a handful of times since he graduated 10 years ago.

He did say, some patients do ask what a DO is once in awhile.

 

[Torilynn92]

OP what region are you in?.

I'm in South Florida, patients in my community are primarily 65 y/o and up. Previously I was in a rural community, and honestly the patients there were much more easy-going. They were happy to receive any kind of care from any kind of practitioner, so long as that care was competent.

 

[stantheman08]

Ew, not super excited about that. How do you deal with the asshats when they pop up?

"uh, ok"
tends to work