I still dont understand the whole MD vs DO

[DrMom]

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From the DO end, the medical treatments are exactly the same as MDs are trained to do. The only difference is IF the DO also uses OMM, which only a small percentage do. I do think that I have better palpatory skill from my OMM training.

There is not "we treat the patients, not just the symptoms" issue. There is no "holisitic" training in DO schools. It is standard western medicine + OMM.

 

[MLT2MT2DO]

From now on I am going to rail against any pre-med that posts this kind of BS on the board. I am not picking on you specifically, it just seems like this kind of sentiment gets posted on SDN over and over again. It sounds good but means next to nothing in real medicine.

How are you going to treat ischemic cardiomyopathy any differently? What about hypoxic respiratory failure, osteoarthritis, pneumonia, renal failure... or pretty much anything in medicine. In all of the above you treat the problem and not the symptom. No one treats just the symptom.

The same thing goes with the whole, holistic BS that also gets posted.

I'll use cranial manipulation.

 

[amistret]

Snurpy is an example of a nice well rounded, educated individual. Another lesson is brought about here to all premeds. when you get into medical school and even graduate medical school, why not stay cool like Snurpy and be a a good individual, those are the doctors people want to go see. Not like the other dude who has obviously forgotten what medicine is all about and thinks that since he is now a resident hes better than everyone. And yes you were bashing on me and I will take it that way because it is what you were doing. Your probably not a DO or have never shadowed one who practices OMM, because OMM is truely healing with the hands. Not simply prescribing medicine for a disease but coupling that with OMM to try to figure out why the disease happened if possible. Thats the DO philosophy.

 

[DocEspana]

Snurpy is an example of a nice well rounded, educated individual. Another lesson is brought about here to all premeds. when you get into medical school and even graduate medical school, why not stay cool like Snurpy and be a a good individual, those are the doctors people want to go see. Not like the other dude who has obviously forgotten what medicine is all about and thinks that since he is now a resident hes better than everyone. And yes you were bashing on me and I will take it that way because it is what you were doing. Your probably not a DO or have never shadowed one who practices OMM, because OMM is truely healing with the hands. Not simply prescribing medicine for a disease but coupling that with OMM to try to figure out why the disease happened if possible. Thats the DO philosophy.

you have such good intentions but no clue at all what medical school, forget about medicine, is like. I am an eternal optimist, and I'm going to tell you you're sadly in for aslow onset of reality check.

 

[Sinfest]

Snurpy is an example of a nice well rounded, educated individual. Another lesson is brought about here to all premeds. when you get into medical school and even graduate medical school, why not stay cool like Snurpy and be a a good individual, those are the doctors people want to go see. Not like the other dude who has obviously forgotten what medicine is all about and thinks that since he is now a resident hes better than everyone. And yes you were bashing on me and I will take it that way because it is what you were doing. Your probably not a DO or have never shadowed one who practices OMM, because OMM is truely healing with the hands. Not simply prescribing medicine for a disease but coupling that with OMM to try to figure out why the disease happened if possible. Thats the DO philosophy.

You should tell that to the majority of DO's that do not utilize OMM.

Just worry about getting into medical school. I'm sure a resident knows more about the medical field and proper treatment methods than a pre-med blindly following the "DO philosophy".

 

[JaggerPlate]

Eh, cut him some slack. We've all probably looked back on old SDN comments from pre-medical days and rolled eyez at the error of our ways. He seems genuine ... don't beat the life out of him yet - that's what first quarter of MS 1 is for.

 

[EyeGuy15]

Pretty Straightforward

1. Both can practice the same exact medicine at the same exact hospitals

2. MD students have an advantage for ACGME residency spots over DO students(with identical "stats")- If you really wants to do ACGME Urology, Ophtho, Derm, Plastics, ENT, etc it will not be easy to get interviews if you are a DO applying to ACGME spots, regardless of your USMLE scores.

3. If your MCAT is < 30 and/or your GPA is not too stellar --> apply DO. If MCAT > 30 take a shot at MD programs (I know for a fact my school, which is a middle tier school on a good day, does not interview an applicant unless their MCAT is > 32 or if they are a "URM"). A good friend of mine was one of the "chosen few" who got to be on the admission committee after first year. I see all kinds of posts of people with MCAT scores in the mid 20's who can garner a a few interviews at DO programs. If you are not a URM and score in the mid 20's, 99.9% of MD programs will have the secretary throw your application away.

4. Apply to US MD schools, and if it does not work out apply MD/DO/Carribean.

5. "Same" education, but when applying for competitive ACGME residences, DO's are at a disadvantage. Probably not too fair, but URM stats aside, DO students have, on average, lower MCAT scores and lower GPAs then MD students. It is incredibly hard these days to get into an MD program, and many physicians see the DO route as finding a "back-door" into medical school.

I will still never understand why there are DO's who actually "chose" DO over MD when applying and attending medical school (My friends in DO school are only there after not getting into a single MD school. One friend failed out of his MD school first year some time back and is a 3rd year DO student right now at LECOM). Even if you are 100% sure you want to go into primary care at the start of medical school, you never know what field may perk you interest during clerkships. If this field is a competitive one, you basically put yourself in a tough situation come application/interview time for residency

 

[Kgizzle]

Quote:
Originally Posted by Instatewaiter

From now on I am going to rail against any pre-med that posts this kind of BS on the board. I am not picking on you specifically, it just seems like this kind of sentiment gets posted on SDN over and over again. It sounds good but means next to nothing in real medicine.

How are you going to treat ischemic cardiomyopathy any differently? What about hypoxic respiratory failure, osteoarthritis, pneumonia, renal failure... or pretty much anything in medicine. In all of the above you treat the problem and not the symptom. No one treats just the symptom.

The same thing goes with the whole, holistic BS that also gets posted.

I'll use cranial manipulation.

GANGSTA!

 

[NYRN]

In real life, no difference at all.

The only way I know if someone is an MD or a DO is if I happen to see their name badge. They function in exactly the same role, and I see no difference in performance. I notice that the DO's usually went to med school later in life, and have done another job before they started medical school. Makes for interesting conversation finding out what they did before medicine. In my hospital there is a good mix of DO and MD residents, and certainly I have worked with DO's who are fellows in competitive specialties such as ortho, GI and cardiology.

 

[Torr]

Why is this thread still active? Everything has been discussed in a hundred other threads and forums.

Let this thing die already!

 

[Instatewaiter]

Snurpy is an example of a nice well rounded, educated individual. Another lesson is brought about here to all premeds. when you get into medical school and even graduate medical school, why not stay cool like Snurpy and be a a good individual, those are the doctors people want to go see. Not like the other dude who has obviously forgotten what medicine is all about and thinks that since he is now a resident hes better than everyone. And yes you were bashing on me and I will take it that way because it is what you were doing. Your probably not a DO or have never shadowed one who practices OMM, because OMM is truely healing with the hands. Not simply prescribing medicine for a disease but coupling that with OMM to try to figure out why the disease happened if possible. Thats the DO philosophy.

It's ok. You can name me by name. I'm the bad man. You know how I said I wasn't railing on you specifically... well now I am. This is directed at you.

You know what the difference between me and snurpy is? I'm actually a doctor and take care of patients. Snurpy hasn't even started clinicals. That's not a dig on snurpy at all. He/she will get there. What it does speak to is the fact that I know what the fuc% I am talking about. You don't.

Since you know so much about medicine- diagnose ischemic cardiomyopathy with some OMM or treat it. Ok now go to wikipedia and look up what that means. K. Now are you back? Great. In case you didn't realize you can't do **** with OMM. You know why almost all DO's don't use OMM? Because it is basically useless for most medical problems. You know what works? The proven, evidence based medicine.

Let me list a few diseases you can't do a thing about with OMM
- ischemic cardiomyopathy
- any cardiomyopathy for that matter
- HTN
- HLD
- dissection
- PE
- DVT
- acute or chronic valvular disease
- endocarditis
- pre, intrinsic or post renal failure
- hematuria
- any electrolyte disturbance
- COPD (OMM actually worsens air trapping after treatment... sweet)
- pneumonia
- any ILD
- hypoxic respiratory failure
- hypercarbic respiratory failure
- pneumothorax
- hemothorax
- esophageal dysmotility
- gastroparesis
- GERD
- PUD
- GI bleed of any etiology
- cholangitis/cholecystitis
- gallstones
- liver disease of ANY origin
- Portal HTN
- epididmitis
- torsion
- HPV/CIN/VIN/VAIN
- cancer of any type
- scleroderma
- lupus
- most rheum issues
- vasculitis
- abscesses
- for that matter, pretty much any infection
- anemia of any cause
- torn anything
- ruptured anything
- perf'ed anything
- broken anything
- bleeding anything
- sick anything

Hey guess what works for all of those- medicine or surgery. Guess what doesn't- OMM. In case you missed it I listed almost the entirety of medicine. In conclusion- you're wrong.

 

[snurpy]

Someone's not a happy DO. 🙄

I haven't started clinicals, true, but I did shadow DOs (yes, more than one) who practiced OMM with almost all of their patients (inpatient and outpatient) in addition to providing medication. No osteopathic school is touting OMM as the gold standard of treatment for a disease. It was always symptoms of the disease. Eg, Tx difficulty breathing in diseases like pneumonia.

I understand he's idealistic for a premed, but railing at him and shouting about how all of OMM is bs is not the answer.

Edit: Actually I lied. I forgot that OMM can be used in certain physical ailments, eg nerve pinching, which I guess could be a diagnosis, so you'd be treating the disease, not the symptom.

 

[Torr]

It's ok. You can name me by name. I'm the bad man. You know how I said I wasn't railing on you specifically... well now I am. This is directed at you.

You know what the difference between me and snurpy is? I'm actually a doctor and take care of patients. Snurpy hasn't even started clinicals. That's not a dig on snurpy at all. He/she will get there. What it does speak to is the fact that I know what the fuc% I am talking about. You don't.

Since you know so much about medicine- diagnose ischemic cardiomyopathy with some OMM or treat it. Ok now go to wikipedia and look up what that means. K. Now are you back? Great. In case you didn't realize you can't do **** with OMM. You know why almost all DO's don't use OMM? Because it is basically useless for most medical problems. You know what works? The proven, evidence based medicine.

Let me list a few diseases you can't do a thing about with OMM
- ischemic cardiomyopathy
- any cardiomyopathy for that matter
- HTN
- HLD
- dissection
- PE
- DVT
- acute or chronic valvular disease
- endocarditis
- pre, intrinsic or post renal failure
- hematuria
- any electrolyte disturbance
- COPD (OMM actually worsens air trapping after treatment... sweet)
- pneumonia
- any ILD
- hypoxic respiratory failure
- hypercarbic respiratory failure
- pneumothorax
- hemothorax
- esophageal dysmotility
- gastroparesis
- GERD
- PUD
- GI bleed of any etiology
- cholangitis/cholecystitis
- gallstones
- liver disease of ANY origin
- Portal HTN
- epididmitis
- torsion
- HPV/CIN/VIN/VAIN
- cancer of any type
- scleroderma
- lupus
- most rheum issues
- vasculitis
- abscesses
- for that matter, pretty much any infection
- anemia of any cause
- torn anything
- ruptured anything
- perf'ed anything
- broken anything
- bleeding anything
- sick anything

Hey guess what works for all of those- medicine or surgery. Guess what doesn't- OMM. In case you missed it I listed almost the entirety of medicine. In conclusion- you're wrong.

Wait what was the point of that? You didn't list the "entirety of medicine". I don't think any DO I've ever met believes he/she can cure every disorder known to man with OMM. It's something you CAN use in many conditions but even the DO's I know who use OMM extensively know their limits (limits of OMM that is!)

So, what's wrong with using it sometimes?

 

[Sinfest]

It's ok. You can name me by name. I'm the bad man. You know how I said I wasn't railing on you specifically... well now I am. This is directed at you.

You know what the difference between me and snurpy is? I'm actually a doctor and take care of patients. Snurpy hasn't even started clinicals. That's not a dig on snurpy at all. He/she will get there. What it does speak to is the fact that I know what the fuc% I am talking about. You don't.

Since you know so much about medicine- diagnose ischemic cardiomyopathy with some OMM or treat it. Ok now go to wikipedia and look up what that means. K. Now are you back? Great. In case you didn't realize you can't do **** with OMM. You know why almost all DO's don't use OMM? Because it is basically useless for most medical problems. You know what works? The proven, evidence based medicine.

Let me list a few diseases you can't do a thing about with OMM
.
.
.
Hey guess what works for all of those- medicine or surgery. Guess what doesn't- OMM. In case you missed it I listed almost the entirety of medicine. In conclusion- you're wrong.

Ouch...even I could feel that burn

 

[Torr]

Someone's not a happy DO. 🙄

You dont want to make the DO angry!!

 

[VeeTeeHokies]

UGH ...

1. It's more difficult to place into certain, uber competitive ACGME (MD) residencies as a DO. Keep in mind that these are extremely difficult for MD students as well, and that the MD is in no way, shape, or form an automatic entrance into the ROAD residency of your dreams. Just for some perspective, the most recent numbers showed that 1 out of 4 US MD Ortho gunners failed to get an Ortho spot.

Furthermore, this doesn't take DO exclusive AOA residencies (in every field) into account.

2. Statistically speaking, you're more likely in to end up in primary care (IM, FM, Peds, and OB/Gyn) compared to 'specializing' from an MD school as well.

3. DOs actually have extensive foreign practice rights, and this argument is a misconception on two fronts:

a. Despite what some may assume, it's very difficult to actual establish a practice in a foreign country as a US MD or DO. People naturally assume that the 'MD' will allow you to march into a foreign country and hang a shingle ... not true.

b. 99% of people who 'practice internationally' do so with organizations like doctors w/o boarders, who take care of all the licensing issues, rights, etc, beforehand, and these organizations are 100% wide open to DOs and look at them as equivalent of MDs.

Altogether, it means that the international rights are pretty much a non-issue, not even taking into account the fact that 99% of the pre-medical students who are jazzed about international work in the personal statement fail to do any relief work as a busy attending.

Let's stick with the facts here people and leave the opinions and anecdotes out of the discussion. Additionally, OP, definitely utilizing the SDN search function (if you haven't already) because many of these questions have been addressed before.

I have never seen a more beautiful post in my entire life... Very well done. 👍👍 Two thumbs way up.

 

[snurpy]

I have never seen a more beautiful post in my entire life... Very well done. 👍👍 Two thumbs way up.

Seriously, can we sticky that? I get so tired of seeing these threads. Two very enthusiastic thumbs up. 👍👍

 

[DocEspana]

Let me list a few diseases you can't do a thing about with OMM
- ischemic cardiomyopathy
- any cardiomyopathy for that matter
- HTN
- HLD
- dissection
- PE
- DVT
- acute or chronic valvular disease
- endocarditis
- pre, intrinsic or post renal failure
- hematuria
- any electrolyte disturbance
- COPD (OMM actually worsens air trapping after treatment... sweet)
- pneumonia
- any ILD
- hypoxic respiratory failure
- hypercarbic respiratory failure
- pneumothorax
- hemothorax
- esophageal dysmotility
- gastroparesis
- GERD
- PUD
- GI bleed of any etiology
- cholangitis/cholecystitis
- gallstones
- liver disease of ANY origin
- Portal HTN
- epididmitis
- torsion
- HPV/CIN/VIN/VAIN
- cancer of any type
- scleroderma
- lupus
- most rheum issues
- vasculitis
- abscesses
- for that matter, pretty much any infection
- anemia of any cause
- torn anything
- ruptured anything
- perf'ed anything
- broken anything
- bleeding anything
- sick anything

Hey guess what works for all of those- medicine or surgery. Guess what doesn't- OMM. In case you missed it I listed almost the entirety of medicine. In conclusion- you're wrong.

you missed psychiatric disorders. We had a tour guide say OMM is a useful modality and taught that way (roughly what i taught him to say because its true). An OMM doc heard him and said that *anything* can be fixed through OMM.

he just said 'schizophrenia'.

she walked away chuckling. I was so proud of him.

 

[Bacchus]

OMM isn't going to be much of a cure-all out of MSK disorders. But it will help alleviate symptoms. There are things on that list that OMM can help alleviate the symptoms of and speed up recovery.

 

[MLT2MT2DO]

Seriously, can we sticky that? I get so tired of seeing these threads. Two very enthusiastic thumbs up. 👍👍

This thread would have never been created if the OP would have read the stickies in the first place. So I'm not really sure what sticking that info would do. Don't get me wrong it is good info but I doubt it would even slow down these threads as there is already a ton of info in the current stickies.

 

[LesBois88]

Pretty Straightforward

1. Both can practice the same exact medicine at the same exact hospitals

2. MD students have an advantage for ACGME residency spots over DO students(with identical "stats")- If you really wants to do ACGME Urology, Ophtho, Derm, Plastics, ENT, etc it will not be easy to get interviews if you are a DO applying to ACGME spots, regardless of your USMLE scores.

3. If your MCAT is < 30 and/or your GPA is not too stellar --> apply DO. If MCAT > 30 take a shot at MD programs (I know for a fact my school, which is a middle tier school on a good day, does not interview an applicant unless their MCAT is > 32 or if they are a "URM"). A good friend of mine was one of the "chosen few" who got to be on the admission committee after first year. I see all kinds of posts of people with MCAT scores in the mid 20's who can garner a a few interviews at DO programs. If you are not a URM and score in the mid 20's, 99.9% of MD programs will have the secretary throw your application away.

4. Apply to US MD schools, and if it does not work out apply MD/DO/Carribean.

5. "Same" education, but when applying for competitive ACGME residences, DO's are at a disadvantage. Probably not too fair, but URM stats aside, DO students have, on average, lower MCAT scores and lower GPAs then MD students. It is incredibly hard these days to get into an MD program, and many physicians see the DO route as finding a "back-door" into medical school.

I will still never understand why there are DO's who actually "chose" DO over MD when applying and attending medical school (My friends in DO school are only there after not getting into a single MD school. One friend failed out of his MD school first year some time back and is a 3rd year DO student right now at LECOM). Even if you are 100% sure you want to go into primary care at the start of medical school, you never know what field may perk you interest during clerkships. If this field is a competitive one, you basically put yourself in a tough situation come application/interview time for residency

This entire post would makes sense if DO's were limited to ACGME residencies.
But we're not- AOA residencies are available in every field.

 

[Instatewaiter]

Wait what was the point of that? You didn't list the "entirety of medicine". I don't think any DO I've ever met believes he/she can cure every disorder known to man with OMM. It's something you CAN use in many conditions but even the DO's I know who use OMM extensively know their limits (limits of OMM that is!)

So, what's wrong with using it sometimes?

Nothing is wrong with using it sometimes but acting like OMM is going to be very useful for medicine diagnostically or therapeutically is wrong. And it actually has some evidence behind it for lower back pain, just like chiropractics does. That said, touting it as if it is really a useful treatment modality for anything more than some simple muscle strain is kinda obsurd because if anything, there is evidence against that. Furthermore, acting like it really is a great diagnostic tool is equally dumb. The amount of time you will have to hone your palpatory skills during third year and beyond will dwarf the few hundred hours you spend in OMM lab so those extra awesome palpatory skills are a myth.

OMM isn't going to be much of a cure-all out of MSK disorders. But it will help alleviate symptoms. There are things on that list that OMM can help alleviate the symptoms of and speed up recovery.

Ironically, OMM is great for treating the symptoms but not the underlying problem... But yes, as above it has some decent evidence that it helps with chronic low back pain and a few other MSK disorders.

This entire post would makes sense if DO's were limited to ACGME residencies.
But we're not- AOA residencies are available in every field.

While they are not, most opt for ACGME residencies for a variety of reasons that can be found in a million other threads.

While there may be a few AOA residencies, for specialities they tend to be in pretty crappy locations and there tend to be very, very few of them. Furthermore, with a few exceptions, the volume seen at these AOA centers is miniscule compared to their ACGME counterparts. For some of these reasons, most DOs opt to shoot for ACGME residencies.

 

[LesBois88]

While they are not, most opt for ACGME residencies for a variety of reasons that can be found in a million other threads.

While there may be a few AOA residencies, for specialities they tend to be in pretty crappy locations and there tend to be very, very few of them. Furthermore, with a few exceptions, the volume seen at these AOA centers is miniscule compared to their ACGME counterparts. For some of these reasons, most DOs opt to shoot for ACGME residencies.

Right. I don't think anyone is going to argue any of those points- but they don't address the issue.

People like to say "Going to a DO school will make it significantly harder to match into XYZ." That just isn't true in almost every case.

 

[NotUntilNow]

Right. I don't think anyone is going to argue any of those points- but they don't address the issue.

People like to say "Going to a DO school will make it significantly harder to match into XYZ." That just isn't true in almost every case.

In a way, they're right. Going to a DO school does make it harder to match into certain residencies. The point to take home is that there are viable alternatives to those residencies programs.

You can't realistically claim that DOs and MDs have exactly the same chance in every program. That's just not true. But being a DO won't keep you from being any type of specialist, that's for sure.

 

[NotUntilNow]

The MD matriculant says, "Oh, all of the DO students just went there because they couldn't get into an MD school." This may be true of many DO matriculants, but probably not the majority of them.

I would love to see quantifiable data about that. It would be really interesting. If I'm honest, the reason I'm applying to DO schools is because I know my stats aren't good enough for MD schools. All else being the same, I'd choose a MD program over a DO one.

My goal is to be a physician. All the "holistic" treatment stuff that I hear from other applications seems like BS to me. That seems more a feature of your personality and philosophy about medicine, not training.

 

[Canadakid]

Well my thread has blown up with discussion, I welcome it and thank everyone for their responses.

As for all the parrots that like to repeat "AMG USE DA SERCH FANCTION ITS DDA BEST AND REED STICKEES!"

I did...All of those. The thread was merely looking for explanation about why a distinction is even drawn, and simply confirming what the stickies pointed at, but did not concretely answer.

This is a forum to ask questions - I asked one. If you don't like the title, or its content, it literally takes you a fraction of a millisecond to skip over it when you are reading the subject lines in the main page - you really don't need to come in here and say "ughhh THIS post". I already know what you will respond with "well its da only title in da page becaz everyone asks dis!"...No, they dont, do not exaggerate - it may be common, but not enough to ruin your day, and I had a specific Q that was not addressed.

Thanks to everyone else

 

[Bacchus]

Nothing is wrong with using it sometimes but acting like OMM is going to be very useful for medicine diagnostically or therapeutically is wrong. And it actually has some evidence behind it for lower back pain, just like chiropractics does. That said, touting it as if it is really a useful treatment modality for anything more than some simple muscle strain is kinda obsurd because if anything, there is evidence against that. Furthermore, acting like it really is a great diagnostic tool is equally dumb. The amount of time you will have to hone your palpatory skills during third year and beyond will dwarf the few hundred hours you spend in OMM lab so those extra awesome palpatory skills are a myth.



Ironically, OMM is great for treating the symptoms but not the underlying problem... But yes, as above it has some decent evidence that it helps with chronic low back pain and a few other MSK disorders.



While they are not, most opt for ACGME residencies for a variety of reasons that can be found in a million other threads.

While there may be a few AOA residencies, for specialities they tend to be in pretty crappy locations and there tend to be very, very few of them. Furthermore, with a few exceptions, the volume seen at these AOA centers is miniscule compared to their ACGME counterparts. For some of these reasons, most DOs opt to shoot for ACGME residencies.

I wasn't referring to the MSK. DOs love lymph and as a result have developed several techniques to move it around the body. There are techniques (pumps) for various lung disorders. If you talk to any DO history buffs they'll site the 1918 flu epidemic and how DO hospitals had better healing times, survival rates, etc. Now I don't know exactly where the proof is, but enough people saying it works has some weight (not as much as a trial, of course). We have pharmaceuticals and better techniques now to prevent death, but the pumps help the symptoms and will promote quicker healing.

If you look at this: you'll get a link to a paper discussing what I am talking about and then a rebuttal telling us what we already know, "more studies need to be done"
http://forums.studentdoctor.net/archive/index.php/t-561305.html

 

[munchymanRX]

The DO/MD difference boils down to this, IMO.

Two schools both offer degrees in physics. One school, say the University of Michigan, offers a B.S. in physics, where the other, let's say..UC Berkeley offers a BA (which is actually the norm).

Which student will make a better physicist?

Is it a function of their degree or what kind of work they contribute to the field later on in their careers?

Can we all agree this is just silly, already?

 

[Instatewaiter]

I wasn't referring to the MSK. DOs love lymph and as a result have developed several techniques to move it around the body. There are techniques (pumps) for various lung disorders. If you talk to any DO history buffs they'll site the 1918 flu epidemic and how DO hospitals had better healing times, survival rates, etc. Now I don't know exactly where the proof is, but enough people saying it works has some weight (not as much as a trial, of course). We have pharmaceuticals and better techniques now to prevent death, but the pumps help the symptoms and will promote quicker healing.

If you look at this: you'll get a link to a paper discussing what I am talking about and then a rebuttal telling us what we already know, "more studies need to be done"
http://forums.studentdoctor.net/archive/index.php/t-561305.html

How about we look at the trials relating to OMM and the lung:

1) http://www.ncbi.nlm.nih.gov/pubmed/18519835
Conclusion- OMM worsens air trapping in COPD
Negative study

2) http://www.jaoa.org/cgi/reprint/102/7/371
shows OMM worsens peak flow in asthma... but granted not by much (negligible)
Negative study

3) http://www.jaoa.org/cgi/reprint/100/12/776
Touted that OMM reduces hospital stay and ABX use in pneumonia but there were enormous flaws that invalidate the study
- No vitals on presentation to compare groups- the only thing we know is that the control (ie non-OMM group) had a higher white count by 3000 so was likely sicker than the OMM cohort... but of course they didn't give vitals to prove it or PaO2 values
- No criteria for d/c abx or for discharge from hospital (the 2 endpoints)
- Standard of care was not met for multiple subsets of patients: No steroids for COPD, longer treatment times than standard of care for community acquired PNA brings into question who was treating pt
- no mention of treatment regimens or whether they were even proper for CAP
- questionable treatment practices like repeating x-ray after 5 days of treatment. Any idiot knows resolution of infiltrate doesn't happen for weeks
- all of this calls into question the qualification of the doctors treating
- Questionable at best. Needs a study that is properly controlled for confounders which this was not but at least provocative

4) http://www.ncbi.nlm.nih.gov/pubmed/15710659
Touted as showing that OMT may significantly improve pulmonary function for pediatric patients with asthma ... the only problems, is it has 3 major flaws which invalidate the study:
- Most importantly is that the conclusion is wrong since the change in peak flow was clinically insignificant (change of 12, when a normal peak flow is 400... big whoop, 3% change. If you have an asthmatic do the peak flow multiple times in the course of 10 minutes you will routinely have at least a 10% change). Thus the change is within the error of the test.
- the doctors taking the reading were the OMM docs who weren't blinded
- Negative study

And that is all the trials relating to OMM and the lung.

 

[Bacchus]

The problem is OMM success is like folklore (not in its truth, but in the fact it is passed along). I'm not trying to argue with you. I'm not saying those studies are invalid. No need to be hostile. All I was saying is in certain cases besides MSK complaints it is helpful. No there might not be a study, but we both know not everything in medicine is evidence based. Just some insight into the past and a technique that still happens and works as per the various DOs around the country. Relax.

 

[Instatewaiter]

If you look at this: you'll get a link to a paper discussing what I am talking about and then a rebuttal telling us what we already know, "more studies need to be done"
http://forums.studentdoctor.net/archive/index.php/t-561305.html

Yeah we have zero data on how sick each cohort of patients were.
Find me that data and then we can talk.

 

[Instatewaiter]

4) http://www.ncbi.nlm.nih.gov/pubmed/15710659
Touted as showing that OMT may significantly improve pulmonary function for pediatric patients with asthma ... the only problems, is it has 3 major flaws which invalidate the study:
- Most importantly is that the conclusion is wrong since the change in peak flow was clinically insignificant (change of 12, when a normal peak flow is 400... big whoop, 3% change. If you have an asthmatic do the peak flow multiple times in the course of 10 minutes you will routinely have at least a 10% change). Thus the change is within the error of the test.
- the doctors taking the reading were the OMM docs who weren't blinded
- Negative study

And that is all the trials relating to OMM and the lung.

For reference, a single use of albuterol causes a 20% increase in peak flows

 

[Slack3r]

For reference, a single use of albuterol causes a 20% increase in peak flows

Subsequent peak flow measures can be +/- 100 in each direction. At least every time I've ever used them.

 

[jd1031]

From what I've seen working at a hospital, there is MINIMAL, if any difference, between MD and DO. At the hospital, you can't even tell the difference between MDs and DOs until you look closely at their badge. There is no difference in "holistic" approach - both MDs and DOs use a holistic, methodical approach to care. If anything, the difference is rooted in personality, not title.

Even the bias against DOs is disappearing here in cali. The head anesthesiologist where I work at (a teaching hospital for a "top 20" allopathic school) said that the whole MD vs DO thing is BS. A dermatologist I know also says good things about DOs (one of her close friends, a DO, is a pediatric dermatologist). One of the top radiologists here is a graduate of KCOM. The only people that bad mouth DOs when I ask are some REALLY old docs and surgeons. Where I work, surgeons still seems to hold a strong bias against DOs. Even then, one of the cardiothoracic surgeons - who btw does lung transplants - is a DO.

The MD vs DO difference is rooted in the history of allopathic and osteopathic medicine as well as politics.

Like the attending said earlier in this thread, DO is pretty much modern western medicine + OMM - and most DOs don't even practice OMM.

In the future, I envision the acceptance and evolution of OMM for certain cases, and maybe even a merger between MD and DO (don't know how though).

 

[jd1031]

UGH ...

1. It's more difficult to place into certain, uber competitive ACGME (MD) residencies as a DO. Keep in mind that these are extremely difficult for MD students as well, and that the MD is in no way, shape, or form an automatic entrance into the ROAD residency of your dreams. Just for some perspective, the most recent numbers showed that 1 out of 4 US MD Ortho gunners failed to get an Ortho spot.

Furthermore, this doesn't take DO exclusive AOA residencies (in every field) into account.

2. Statistically speaking, you're more likely in to end up in primary care (IM, FM, Peds, and OB/Gyn) compared to 'specializing' from an MD school as well.

3. DOs actually have extensive foreign practice rights, and this argument is a misconception on two fronts:

a. Despite what some may assume, it's very difficult to actual establish a practice in a foreign country as a US MD or DO. People naturally assume that the 'MD' will allow you to march into a foreign country and hang a shingle ... not true.

b. 99% of people who 'practice internationally' do so with organizations like doctors w/o boarders, who take care of all the licensing issues, rights, etc, beforehand, and these organizations are 100% wide open to DOs and look at them as equivalent of MDs.

Altogether, it means that the international rights are pretty much a non-issue, not even taking into account the fact that 99% of the pre-medical students who are jazzed about international work in the personal statement fail to do any relief work as a busy attending.

Let's stick with the facts here people and leave the opinions and anecdotes out of the discussion. Additionally, OP, definitely utilizing the SDN search function (if you haven't already) because many of these questions have been addressed before.

A masterpiece haha. But seriously good stuff 👍

 

[Slack3r]

The head anesthesiologist where I work at (a teaching hospital for a "top 20" allopathic school) said that the whole MD vs DO thing is BS.

Lol, UCLA? Not too stealthy.

 

[JapaneseSakura]

Unfortunately, there are many here among us who aspire to become doctors simply because it is a challenge. They feel the need to prove that they can be selected into a more competitive program, and anyone who is not admitted must then be 'worse' than they are.

Since DO schools have generally less selective admission criteria, they usually get the butt end of this bias. The MD matriculant says, "Oh, all of the DO students just went there because they couldn't get into an MD school." This may be true of many DO matriculants, but probably not the majority of them.

You are right, as far as work environment and pay go, MD = DO. As far a 'prestige' goes (whatever that means), some MD students would like to rank MD schools higher than DO schools.

Well said. I know some people who either applied to caribbean or DO schools just in case they are not picked to be a MD matriculant. Also, I had a friend who went into the medprep course at NYCOM, found out she got accepted into an MD schoollater on and dropped out of the medprep program fast. I mean, what's the big deal? MD=DO, we are all going to be doctors, riding the same train.

 

[jd1031]

Lol, UCLA? Not too stealthy.

Nope 😉 and I'm not saying anything further

 

[JapaneseSakura]

UGH ...

3. DOs actually have extensive foreign practice rights, and this argument is a misconception on two fronts:

a. Despite what some may assume, it's very difficult to actual establish a practice in a foreign country as a US MD or DO. People naturally assume that the 'MD' will allow you to march into a foreign country and hang a shingle ... not true.
.

Someone who is from a foreign country (Japan) an MD/DO cannot march into there and think they can practice medicine, you are right!! I will speak for Japan. You have to pass test, a test just like the USMLE (in Japanese), take the JPT and pass level 1 and able to read,speak and write Japanese and that can be hard! Also, the residency programs are pretty competitive in Japan and on top of that, a lot of people want a Japanese doctor :s, sorry. It's like, they MAKE it hard for foreigners to practice in Japan. It's not impossible though, there are foreigner doctors there, not as common. A lot of Japanese come over here in America because you guys have A LOT of oppportunities for doctors. In Japan, no. They don't get paid a lot either and have to work long hours. It's harder to pay back loans too! Doctors are short there too because of that. But, the DO doctots over there are way nicer, more helpful, and have less malpractice cases against them than MD :s. If you want to practice as a US doctor, maybe join the military or the UN? I don't know. Anyways, if you want to practice in Japan, you have to get licensure for that. Then you can have a license for Japan and the US! It's a separate thing. A lot of countries have their different policies when it comes to foreigners practicing in their country.