MD vs DO Guide

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efle said:
You just dont understand the ND holistic approach Cyber. Surgery treats a symptom while people like myself and jl lin want to treat "at the level of body, mind and spirit". You just dont get m̶y̶s̶t̶i̶c̶i̶s̶m̶ holisticism
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Oh man, you are an ignorant person--attacking a person online in the extreme. Good job. So many nasty people that hide behind online monikers, so little time. It's ignore time.
 
Tired said:
I agree with you.

But then I also remember how many arthritic knees I've injected with corticosteroid (limited benefit), hyaluronic acid derivatives (specifically recommended against by our national Academy), and PRP (very low-quality equivocal evidence with multiple variations on preparations).

Then I feel sad about my specialty.

Then I have another beer and everything is better again.
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What about OATS? Is it really better than microfracture surgery?
 
OP, when someone told you to Google it, they probably meant for your own understanding, not to repost back on here the gazillionth quatrillionth time and open Pandora's box yet again
 
Grace184 said:
OP, when someone told you to Google it, they probably meant for your own understanding, not to repost back on here the gazillionth quatrillionth time and open Pandora's box yet again
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You make a good point, but these threads often produce at least a few informative posts. @Tired's post about the spine study is an example.
 
Tired said:
I always hear this, but have never seen the citations. Can you throw a few up here? Would like to read these.
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Can't really say I have any. I thought one of the journal watches my school auto-subscribed us to had one of decent sample size and methodology published in JAMA, but I can't find it, so I probably misread it. A quick Googling turns up everything to OMT being superior to medication as well as sham therapy, to equal results between sham OMT and "real" OMT. The PT or maybe PM&R guys might be able to come up with something more supportive, possibly calling it something different than OMT, but as a guy who's pretty disinterested in the topic and bad at it (as well as going into an ACGME emergency medicine program), I've got nothing. Personal experience would say that it works for self-limited aches and pains at least, as SouthernSurgeon said, but the plural of anecdote is not data.
 
jl lin said:
Nice effy. If patients had to wait to be treated until everything was 100% proven by EBP , everyone would be dead or healed.
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People do wait to receive treatments until they've been tested. And yet...not everyone is dead or healed.

jl lin said:
Oh man, you are an ignorant person--attacking a person online in the extreme. Good job. So many nasty people that hide behind online monikers, so little time. It's ignore time.
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No idea what you're talking about. How dare you insult ND! You are the ignorant worshiper of evidence and logic!

But really...get a thicker skin dude
 
You'd be surprised how we try to squeeze that other 200 hours in!


Law2Doc said:
Um no. Both schools are the same length and most people are maxing out the learning hours over this journey.
So the equation is really "MD + OMM = DO MINUS about 200 hours of other medicine". people trying to promote osteopathy sometimes try to say it's an "MD plus" degree, but that's completely bogus. For everything you spend more time on in med school you necessarilly spend less on something else.
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Tired said:
I always hear this, but have never seen the citations. Can you throw a few up here? Would like to read these.
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I have a bud In DO school right now. I had right hip pain from driving a lot for my job. He diagnosed that I had a something(can't remember what it was) out of place just by measuring my legs and determining one was longer. He had me lie down, bend the leg of the painful hip, and push back against his hands. Instantly fixed and hip pain was gone. He has expressed that some OMM is a little "woohoo" science like massaging skull sutures for headaches. I don't think it's all a ton of crap.

Edit: He measured my legs just with his hands.
 
If the 2 educational paths are so similar, why even have 2 paths...

And if DO education has something unique that works well, why keep it only for DO training?
 
Goro said:
You'd be surprised how we try to squeeze that other 200 hours in!
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Sure. Like the pro athlete that gives it 110%. I've seen enough med school and osteo grads to know that the amount of time doing medical work versus free time is about the same. There's no "plus" in this system without a corresponding "minus".
 
Banco said:
I know but having 2 distinct, yet functionally identical, degrees seems inefficient.
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See: BA vs BS

But, really, I think, that it's because, of historical differences, not because, of distinctions, in their ultimate scope, of practice
 
efle said:
I'm not sure how to interpret this.

I'm gonna go with "Doh! That's right! I totally meant to go to the doctor but just forgot and ambled around with one quite painful leg hanging further down."
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There may be multiple ways to interpret it, that's one of the wrong ways.
 
Since the modern technicalities of MD vs. DO are covered already, I thought I'd throw this history tidbit in.

Per Wikipedia:
"The practice of osteopathy began in the United States in 1874. The term "osteopathy" was coined by physician and surgeon Andrew Taylor Still, MD, DO.. Still named his new school of medicine "osteopathy," reasoning that "the bone, osteon, was the starting point from which [he] was to ascertain the cause of pathological conditions." Still founded the American School of Osteopathy (now A.T. Still University of the Health Sciences) in Kirksville, Missouri, for the teaching of osteopathy on 10 May 1892. While the state of Missouri granted the right to award the MD degree, he remained dissatisfied with the limitations of conventional medicine and instead chose to retain the distinction of the DO degree. In 1898 the American Institute of Osteopathy started the Journal of Osteopathy and by that time four states recognized the profession."

https://en.wikipedia.org/wiki/Doctor_of_Osteopathic_Medicine

Kind of cool. I didn't realize the DO degree was this old. Apparently, as the founder of osteopathic medicine, AT Still held both degrees - I wonder if that's happened since then?

I don't think DO's treat "the whole patient" any more than MDs do; I feel like any physician who is intuitive enough can feel out the idiosyncrasies of his/her individual patients. Yes, I hear that the musculoskeletal system can make a big difference in pain, especially in chronic stress. There are different ways to help the patient overcome this and each patient responds differently to different treatments.

That's about all I can meaningfully contribute.
 
gettheleadout said:
I'm gonna refer OP to the following thread, just because I contributed there and thought it was productive in general. 😉

Why is MD so much more popular than DO?
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Impressive perception, as usual. You need to look at the social aspects of entering medicine to figure out why people pick MD over DO, given the choice, despite the fact that people outwardly say there's little difference between the two.
 
Banco said:
If the 2 educational paths are so similar, why even have 2 paths...

And if DO education has something unique that works well, why keep it only for DO training?
Click to expand...

And here we go:
:beat:
 
leonardoson said:
I have a bud In DO school right now. I had right hip pain from driving a lot for my job. He diagnosed that I had a something(can't remember what it was) out of place just by measuring my legs and determining one was longer. He had me lie down, bend the leg of the painful hip, and push back against his hands. Instantly fixed and hip pain was gone. He has expressed that some OMM is a little "woohoo" science like massaging skull sutures for headaches. I don't think it's all a ton of crap.

Edit: He measured my legs just with his hands.
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I'm assuming you either had an anterior or posterior innominate rotation dysfunction. It's basically when one of your innominates gets rotated and 'stuck'. The way he measured your leg length was just by having you even your hips and looking at the heights of your ASIS and malleoli. I could teach a 2nd grader how to do that in less than a minute and it's certainly not unique to DOs. Almost every PT and even an MD did the same test to me with my leg injuries, the only difference was they gave me a lift instead of doing OMM (which wouldn't have helped, since one of my legs is legitimately longer than the other, not just 'stuck' in a misaligned position). Chances are you would have probably popped it back into the right place on your own through normal activity since it was an acute occurrence, your buddy just did it for you.


I'd also add that I've had 'muscle energy', an OMM technique, performed on me by athletic trainers, PTs, and even MDs in the past but they just called it stretching. @Tired , I'll see if I can't find some solid studies on ME after this weekend and post them here as I feel it's probably the most relevant and sound method we would use as a DO. After all, the whole basis of ME is based off the golgi tendon reflex, which is a very well-documented physiologic response. Not saying all OMM is useful for every field (I don't think I'd ever use it if I went into EM), but for some fields, like PMR, I think some patients would benefit significantly from some of the techniques we learn.
 
jl lin said:
And here we go:
:beat:
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I don't understand your issue with what I said? IF DO-specific training/education has an unique benefit to the patient, then why should other doctors (i.e. MD's) not learn about it? If it is already so similar, then why have 2 distinct paths?

efle said:
See: BA vs BS

But, really, I think, that it's because, of historical differences, not because, of distinctions, in their ultimate scope, of practice
Click to expand...


Excellent use of commas.
 
Banco said:
I don't understand your issue with what I said? IF DO-specific training/education has an unique benefit to the patient, then why should other doctors (i.e. MD's) not learn about it? If it is already so similar, then why have 2 distinct paths?




Excellent use of commas.
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There are differences in the doctrine im told.
 
Goro said:
Different doctrine as to how to approach the practice of Medicine.
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JDoctor said:
There are differences in the doctrine im told.
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But I often hear DOs say that they are functionally equivalent to MDs (and they are).

I just don't see why we need to have 2 distinct degrees that end up doing the same thing. If one degree has something unique that helps the patient (i.e. OMM), then it shouldn't be exclusive and should be shared among the medical community - in which case, there is no need for 2 separate paths. I think historical significance is the main driver here.
 
Banco said:
But I often hear DOs say that they are functionally equivalent to MDs (and they are).

I just don't see why we need to have 2 distinct degrees that end up doing the same thing. If one degree has something unique that helps the patient (i.e. OMM), then it shouldn't be exclusive and should be shared among the medical community - in which case, there is no need for 2 separate paths. I think historical significance is the main driver here.
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Very well could be the case. To be frank JDoctor MD sounds better than DO
 
Tell that to the AOA! It's like saying Marines and Army both know how to use the bayonet and rifle, why have two different branches of the service?


I just don't see why we need to have 2 distinct degrees that end up doing the same thing. If one degree has something unique that helps the patient (i.e. OMM), then it shouldn't be exclusive and should be shared among the medical community - in which case, there is no need for 2 separate paths. I think historical significance is the main driver here.
 
Goro said:
It's like saying Marines and Army both know how to use the bayonet and rifle, why have two different branches of the service?
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Finally a decent example. @Goro are you my night in shining armor? or... is it white-coat armor?
 
JDoctor said:
Finally a decent example. @Goro are you my night in shining armor? or... is it white-coat armor?
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He's a PhD, he's lucky to afford some used, dented rusty armor


Goro said:
Tell that to the AOA! It's like saying Marines and Army both know how to use the bayonet and rifle, why have two different branches of the service?


I just don't see why we need to have 2 distinct degrees that end up doing the same thing. If one degree has something unique that helps the patient (i.e. OMM), then it shouldn't be exclusive and should be shared among the medical community - in which case, there is no need for 2 separate paths. I think historical significance is the main driver here.
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Is the blue just for me :claps:
 
Goro said:
Tell that to the AOA! It's like saying Marines and Army both know how to use the bayonet and rifle, why have two different branches of the service?


I just don't see why we need to have 2 distinct degrees that end up doing the same thing. If one degree has something unique that helps the patient (i.e. OMM), then it shouldn't be exclusive and should be shared among the medical community - in which case, there is no need for 2 separate paths. I think historical significance is the main driver here.
Click to expand...

Well the marines and army are trained/deployed for fundamentally different operations. What would you say the main difference in doctrine and practice between MDs and DOs is?
 
Banco said:
I don't understand your issue with what I said? IF DO-specific training/education has an unique benefit to the patient, then why should other doctors (i.e. MD's) not learn about it? If it is already so similar, then why have 2 distinct paths?




Excellent use of commas.
Click to expand...


IDK, I guess b/c it will likely devolve into so many of those DO v. MD threads, of which there is no shortage here at SDN. Point: If you search, you will see many of the back and forth arguments. They converge by intimation or more at your question/point well enough...but I guess, have at it.
 
efle said:
He's also at a DO school, in case that takes him from knight to peasant in your eyes or something you narcissistic **** 🙂
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Nah, I'm not saying it's less at all..

I am saying personally I like MD, rather than DO in pure on-paper.
 
jl lin said:
IDK, I guess b/c it will likely devolve into so many of those DO v. MD threads, of which there is no shortage here at SDN. Point: If you search, you will see many of the back and forth arguments. They converge by intimation or more at your question/point well enough...but I guess, have at it.
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Most MD v. DO arguments turn into why MD is better or DO is just as good for residency and what not. That's not what I am talking about. Just to be clear I am not disparaging DOs or anything, I just want to understand the significance of having a distinct yet functionally same training pathway.
 
Banco said:
Most MD v. DO arguments turn into why MD is better or DO is just as good for residency and what not. That's not what I am talking about. Just to be clear I am not disparaging DOs or anything, I just want to understand the significance of having a distinct yet functionally same training pathway.
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Like I said it's the same reason some universities award BAs and others BSs
 
Banco said:
Most MD v. DO arguments turn into why MD is better or DO is just as good for residency and what not. That's not what I am talking about. Just to be clear I am not disparaging DOs or anything, I just want to understand the significance of having a distinct yet functionally same training pathway.
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I hear you; but it seems unlikely to change anytime soon.
 
I'm going to get flak from my MD colleagues on this, but I have observed this with my own eyes and have literally experienced this, as have family members.

The DOs I've encountered in the clinic treated us like the cliche come to life...we were treated like a whole person. When my father-in-law was in an ICU with pneumonia, his doctor, a DO a colleague of mine at my school, yelped in frustration "to his cardiologist, his heart's OK, and to his pulmonologist, his lungs are OK, but he's NOT OK!!"

My wife injured her chest ducking a kicked soccer ball. The pain manifested like it could have been an M.I. Her doctor, an MD, literally never touched her in the exam room. We switched to a DO (a Western grad, BTW) and sure enough, he spent a good long time looking her over, actually touching her and gave her a treatment plan.

With me, having developed chronic sinusitis, he played detective, trying to figure out the cause, instead merely saying "here's a scrip for Flonase, go see Pharmacy A"

So, n = 1, and yes, I'm engaging in the sin of solipsism, but these guys practice what they preach.

Now, in defence of all my MD colleagues, I wonder if the nature of managed care, with its mania for having doctors see 8 patients an hour, have forced more doctors to become the stereotypical doctor who never takes his/her eyes off the computer screen or chart. And there being more MDs than DOs out there, the MDs bear the brunt of the HMO turning Medicine into an assembly line.

My wife's experience with her MD was the ONLY bad experience ever with an MD. Her Ob/Gyn is great, when she's had to have surgery, her surgeons were great, the specialists we seen were all great too. I am blessed with great MD and DO colleagues too.

So all of you chill...you're all going to be working together someday! I do hope to have some of you as my students, though.
🙂

Banco said:
Well the marines and army are trained/deployed for fundamentally different operations. What would you say the main difference in doctrine and practice between MDs and DOs is?
Click to expand...
 
Goro said:
So, n = 1, and yes, I'm engaging in the sin of solipsism, but these guys practice what they preach.
Click to expand...

I guess I'll start the flak: you meant to say "These guys in these specific examples practice what they preach."

I just don't understand how so many intelligent people can spout this "treating the whole patient" nonsense as if they truly believe every MD goes around treating patients like a walking [insert organ here]. To be sure, there are more super sub-specialized MDs than DOs. But that's simply a function of the hyperfocused subspecialties (e.g. pediatric urology, or neurotology) being more open to MDs. If a generalist-type MD is less "holistic" than a DO, it's an individual personality thing, not a function of the letters. It's not as if our curriculum has a course on "Treating Symptoms Not Causes of Disease."
 
Goro said:
I'm going to get flak from my MD colleagues on this, but I have observed this with my own eyes and have literally experienced this, as have family members.

The DOs I've encountered in the clinic treated us like the cliche come to life...we were treated like a whole person. When my father-in-law was in an ICU with pneumonia, his doctor, a DO a colleague of mine at my school, yelped in frustration "to his cardiologist, his heart's OK, and to his pulmonologist, his lungs are OK, but he's NOT OK!!"

My wife injured her chest ducking a kicked soccer ball. The pain manifested like it could have been an M.I. Her doctor, an MD, literally never touched her in the exam room. We switched to a DO (a Western grad, BTW) and sure enough, he spent a good long time looking her over, actually touching her and gave her a treatment plan.

With me, having developed chronic sinusitis, he played detective, trying to figure out the cause, instead merely saying "here's a scrip for Flonase, go see Pharmacy A"

So, n = 1, and yes, I'm engaging in the sin of solipsism, but these guys practice what they preach.

Now, in defence of all my MD colleagues, I wonder if the nature of managed care, with its mania for having doctors see 8 patients an hour, have forced more doctors to become the stereotypical doctor who never takes his/her eyes off the computer screen or chart. And there being more MDs than DOs out there, the MDs bear the brunt of the HMO turning Medicine into an assembly line.

My wife's experience with her MD was the ONLY bad experience ever with an MD. Her Ob/Gyn is great, when she's had to have surgery, her surgeons were great, the specialists we seen were all great too. I am blessed with great MD and DO colleagues too.

So all of you chill...you're all going to be working together someday! I do hope to have some of you as my students, though.
🙂
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What school do you teach?
 
SouthernSurgeon said:
As a follow-up thought on this whole holistic DO nonsense.

We as physicians are much more the product of our residency training than our medical school.

At the end of medical school, I like to analogize a medical student to a pluripotent stem cell. Not yet fully differentiated and can go a lot of different directions.

It is residency that helps determine your outlook, philosophy, and approach to patients.

In other words - do I, at the end of my many years of residency training take care of patients in a fundamentally different way than my co-chief residents who went to Penn or Harvard? Or do we all take care of patients similarly, since we've spent 10000 hours training in the same residency system together?
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Probably similar but if you're training with people from top schools in a top program, my guess is that you'll be much better than the ones who went to a bottom of the barrel program filled with dos and caribs
 
I could tell you, but then I'll have to reject you.

JDoctor said:
What school do you teach?
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Focus! That's why I started the reply with my n=1 and sin of solipsism comments.
I guess I'll start the flak: you meant to say "These guys in these specific examples practice what they preach."


I'll tell you one more thing: this is the last time I'm stepping into this pile!
 
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Goro said:
I could tell you, but then I'll have to reject you.



Focus! That's why I started the reply with my n=1 and sin of solipsism comments.
I guess I'll start the flak: you meant to say "These guys in these specific examples practice what they preach."
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I didn't mean to over-step.
 
Lawper said:
Probing adcoms where they work violates the privacy agreement on SDN and will get you banned. Just a caution.
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Yeah, I just thought in the context I would ask. I didn't mean to nor have I asked before or will continually ask.
 
22031 Alum said:
I guess I'll start the flak: you meant to say "These guys in these specific examples practice what they preach."

I just don't understand how so many intelligent people can spout this "treating the whole patient" nonsense as if they truly believe every MD goes around treating patients like a walking [insert organ here]. To be sure, there are more super sub-specialized MDs than DOs. But that's simply a function of the hyperfocused subspecialties (e.g. pediatric urology, or neurotology) being more open to MDs. If a generalist-type MD is less "holistic" than a DO, it's an individual personality thing, not a function of the letters. It's not as if our curriculum has a course on "Treating Symptoms Not Causes of Disease."
Click to expand...


B/c it depends upon who has mentored them and what their actual, applied philosophy is. This will vary from doc to doc as in person to person. But I think the feeling is that certain philosophical emphasis of NOT EVER forgetting the whole person is distributed throughout DO schools and programs. There will ALWAYS be many exceptions, but you have to start somewhere. It's like a business having a mission and values statement. Now, time will tell if they really practice that mission and those values or not.
 
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