Just some random stuff here....
1) Why do so few DOs use OMM? (some may argue that more than the stats indicate use OMM due to insurance issues etc...but, if OMM is the one of the defining differences between MDs and DOs, I'd think that more would use OMM) I thought of some reasons
* Perhaps most DO students/grads really wanted to goto MD schools and settled on DO schools just to become physicians. After all, a physician is a physician regardless of the letters after one's name. So, the DO students never really had strong interest in OMM anyway....hmm..can this be it?
* Perhaps, OMM really doesn't work in more cases than say pharmacological methods to deal with medical issues. So, students learn it but since it doesn't really work as well unless you are very good at it they end up not using it....could this be one of the reasons?
* Perhaps, it works well if done correctly. But, it's just not taught in ways that encourages/shows the beauty of OMM. I've heard from an OMM specialist that the students don't really see how it works during the 1st 2 yrs when they learn it and rarely get to see it in action (at least not a lot) even in the 3rd and 4th yr unless you do an OMM rotation.
* Perhaps the outcome from OMM txs are not as apparent as say the effects you get from taking meds....could this be the reason why not many use OMM?
I get the feeling the real reason (along with insurance reimbursement issues) is a some combination of some or all of the above.
2) I know why I initially applied to DO schools and the reason was a logical one. But, when I asked myself why someone who's just finishing up a 4 yr college degree without a lot of medical background be interested in a DO degree despite the well known discrimination against DOs by some MDs, I couldn't understand their interest in a DO degree. I know some buy into the "holistic" approach the DO schools advertise. But, I'd think that those people are the minorities of the DO applicants. I'm sure many applicants have had good experiences with DOs and became interested in the degree. But, what is interesting is that for some reason, most of the (note that I said MOST, not ALL) DO applicants have stats significantly lower than typical MD matriculants.
What I really think is that since most with lower stats know they have low chance of an MD admission, they settle for a DO degree. Again, there are, I'm sure who even chose a DO school over an MD school. But, I bet you those are a small/tiny exceptions. I bet that 75% of DO applicants, if given a MD acceptance, they'd forego with the DO acceptance and go the MD route. You may argue with me on this. But, it is strange that most people gung ho about DO school are the ones with low stats who likely couldn't get into an MD school (again not ALL, I'm sure. I'm sure some of you have stats good enough for MD schools and preferred DO over MD).
But, it is unfortunate that there is a "stigma" against DOs that may make some DO applicants feel they'd prefer an MD degree since the didactic is pretty much the same.....it's just the matter of the letters at the end of the name....and.......
3) The clinical years during the 3rd and 4th yr in DO school. From what I hear, many allo residencies are a bit wary of DO students because the consistency in the quality of education during the rotation years is much more varied than the MD school 3rd and 4th year rotations. So perhaps, places like PCOM and CCOM have good rep due to solid rotation sites and controlled quality of rotation experience compared to some others. I've heard that this aspect of DO education is thought by the MD world as being significantly inferior to the MD counterpart. This isn't my opinion. This was the opinion of an MD residency director.
4) Except for 1 MD I spoke to, I'd say all others didn't have the best opinions about the DO degree. Knowing this I wondered if I became a DO, how I'd feel working with MDs.
I bring these pts up because I really feel that it's unfortunate the MD and DO thing is the way it is. It's unwarranted. A good physician is a good physician no matter what the degree. But, in our world, there are pecking orders, prejudices and other issues. I mean, even in the MD world there are pecking orders.....family med physicians are looked down upon by way the orthopods......physical medicine docs are looked down upon by the neuro surgeons etc...... I've been told about this by numerous MDs. It's too bad. But, what I can control is getting a good education, working hard and servicing my patients the best way I can.
I too have chosen the MD route. Easier obtaining residencies (don't need to feel like I need to take 2 licensing exams!), less discrimination and the perception by the residency directors that my schools' clinical rotation experiences were likely superior to the DO counterparts are the reason I chose to go MD over DO. I wished there weren't such issues because I really wanted to stay in Socal where my DO acceptance was.
The best thing that ever happened in my life was my acceptance to KCUMB in 1979. It gave me the opportunity to practice emergency medicine as a Staff physician for the last 20 years. As can be seen from my previous posts I come from a family that has close ties to KCUMB going back almost 90 years. Reading Ocwaveoc's post I found myself bristling at some of the things he said. In the back of my mind was "here is some ignorant pre-med who got accepted into an MD program, and now enjoying a bit of a taunt at the Osteopathic Profession". However, life has taught me that it far easier to dismiss criticism on the assumption that the person doing the criticism has an agenda other to reread and look for some truth. A couple of the points Ocwaveoc brought up reminded me of something I had posted 3 years ago on SDN. It is below.
"Since my graduation in 1985 few days have gone by that I have not felt blessed to have been accepted to (and than a graduate of) what was then UHS-COM). It has enriched my life beyond any expectations. Without it I fear my life could well have been a step by step plod through the years doing work I barely tolerated "just for the dough" and at the question "Have you tried to put as much or more into this world than you have taken out", perhaps the answer would not be the positive one it is today. My family roots in Osteopathy go back a long way (87 years), but in all honesty, it took about 6 months into my first year to figure out that some of the "party line" the AOA put out was ridiculous. They were doing it then and in essence some of it's the same old nonsense. I believe D.Os. are unique and always have strongly felt (empirically) that D.O.s had an excellent reputation for "bed side manner" which as you go on through Medicine you realize is such an important part of being a competent physician. D.O.s are different (or at least most are) but I believe the AOA shoots itself in the foot when it declares that it is the superior of M.D. education and with the old saw about "Looking at the whole patient and not just the disease." This often stirs up deserved disbelief and hostility among our M.D. "team mates" and I personally don't believe that most D.Os on medical school graduation believe it themselves.
Probably because it isn't true. For D.O.s to infer they have a corner on this "holistic" approach to disease is patently ridiculous.
Osteopathic Medicine has infrastructure flaws that are every bit as pronounced as when I graduated 21 years ago. Flaws that are beyond the intended scope of this post but which are apparent to all save the most "clue less" graduate of an Osteopathic Medical School. In some places an almost untenable post graduate (beyond Pgy1) educational model . An appalling lack of outstanding or even acceptable clinical opportunities in the 3rd and 4th year in some colleges. Fortunately it appears to be much better than when I was in school and traveled to 12 different cities to complete my clinical rotations.
The AOA still maintains it's "head in the sand" approach to the ongoing reality that the majority of D.O. grads head into ACGME programs after graduation or after a year of Internship. This fact of life is never going to change (and should not) and the AOA never seems to approach this reality "head on".
I wish the AOA would stop repeating some of the PR mantras of the past. I never really saw the good it did. I guess eventually the AOA will "wise up" but it will be a while. Most D.O students are savvy enough after a year or so in school to separate "fact from fiction". Osteopathic Medicine has a glorious history and so much to be proud of. As an institution it can and should aim for the stars." (Posted 09/2006)
I think it is a disgrace that the AOA in concert with their colleges have not implemented changes over the years that would insure quality clinical rotations for all students as well as uniformly quality post graduate programs. In 1986 (and in the bottom quarter of my graduating class in 1985), there was a shortage of Internship slots, especially for those with less than stellar stats. I ended up in a hastily assembled Internship with 6 slots in a rural county hospital (Almost all Allopathic staff) in the Everglades of Florida. The program director as a middle aged woman who had graduated from MIT and for reasons never clear to me attended and graduated from MSUCOM (Osteopathic). She routinely informed the Interns that "you guys have the wrong degree, as do I, and had better start getting used to it."
She was an arrogant, unfair and unpredictable witch who (much to my astonishment in retrospect) routinely condemned the very profession in which she had been assigned such an influential position to guide young D.O.'s. I still cannot recall her memory without feelings of disgust and anger. Luckily for me there were many opportunities for learning there but you had to seek it out with a vengeance. The program folded after one year as it was too much of an embarrassment for even the AOA to tolerate. I was lucky enough to transfer mid-year to Normandy Osteopathic Hospital which had an excellent 35 year old Internship program that did a fine job of graduating competent Interns.
My feelings for the D.O. profession are much like someone might have for a beloved but deeply flawed spouse. You love her deeply but are constantly reminded of her grave shortcomings, and wish that would change. The profession is enlarging and improving in increments. I suspect in 10 years D.O.'s will find themselves in a much more influential position than now in Organized Medical care in the United States. The AOA to my thinking desperately needs far sighted leaders who have no problem accepting reality and are strong enough to incist on the changes needed in our pre and post graduate educational infrastructure. In the 1980s (though members of my family) I had the oppurtunity to meet the major Osteopathic (AOA) leaders of that time. I am afraid there were few Martin Luthurs in the bunch, and most were still emotionally entangled in the MD/DO squabbles of their past, which was quickly losing relevance as a significant issue confronting Osteopathic Medicine in the 1980's.
As to why an "old punk" such as myself is bothering to read and post on occasion in the pre-Osteopathic and Osteopathic forums, it's because I love my profession, and many of you people will be my colleagues in the not so distant future. I have a (largely intuitive) feeling that the AOA is on the brink of making radical positive changes in the Osteopathic Educational Infrastructure in the next decade. If they do not, I suspect the damage will be incalculable. I my case, retirement is just a couple years away, but I am concerned beyond measure about what awaits newly minted D.O.'s in the next 2 decades.
As for the type of criticism an ocwaveoc brings to the table. It should be welcomed, although I feel relief he is not entering an Osteopathic college. We don't need any more D.O.'s that could care less about their profession. I bet he makes a fine M.D., and that is where he belongs. doing something he believes in.
ugh how embarassing! thank you dr. lisa!!!
