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Little Etoile

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So I've long had the age-old MD vs DO debate with myself. Whenever I reviewed the osteopathic principles, however, DO always won out, hands down. I was always particularly impressed by the following philosophies:

-The human organism is self-regulating and self-healing.
-Disease in any body system will affect the entire body.
-The work of the physician includes assisting the patient’s own body in fighting disease.

On Tuesday I interviewed at my first DO school, Touro-CA. I asked our student tour guide a curiosity that's been plaguing me: How exactly are these more holistic philosophies integrated into the curriculum? In other words, how exactly or in what capacity is DO taught differently than MD? Particularly after learning that some (or maybe just one?) DO school students take the classes in their first two years side-by-side with MD students, I'm more interested than ever to learn the distinction between MD and DO curriculum.

Our tour guide's response was that he found that the holistic aspects of osteopathic medicine were a myth and basically the main difference between MD and DO is the incorporation of OMM in the latter. Is this true? What do you guys think?

Thanks for your help in advance!
 

Bond8204

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Is this true?

It's total opinion and it varies from person to person. I'd say, yes, it is true--reason being that there's no reason an MD can't consider a patient holistically with how much the lines are being blurred these days.

Prepare for a bunch of joke responses.......now.
 

TexasTriathlete

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I think the "holistic" thing is just a catch-phrase to attract a certain type of applicant who might feel they identify with something like that. In reality, any good physicians will probably be similar in their approach to patient care, MD or DO. There just isn't that much wiggle room to vary the curriculum, under the accreditation guidelines and our laws.

Knibb High football rules!
 
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Little Etoile

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It's total opinion and it varies from person to person. I'd say, yes, it is true--reason being that there's no reason an MD can't consider a patient holistically with how much the lines are being blurred these days.

I understand that either DO or MD can practice holistically, but I was under the impression that osteopathic schools better prepare you for this given that the principles are, perhaps arguably, more in line with this approach. So if this is false and there is no difference, then where exactly in the curriculum are the osteopathic principles taken into account? Is the only difference, then, the incorporation of OMM? If that's the case, it kind of seems like osteopathic schools fall short or are misleading in how the present themselves b. Why, then, the emphasis on the fundamental differences in principles between MD and DO?
 

DrMidlife

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I suggest you read the Gevitz book on the history of DOs.

A long time ago it was relevant for DOs to claim ownership of the 3 principles, and these stood in stark contrast to MD philosophy. Not any more. Now they're simply two parallel medical education systems
 

DrMidlife

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More to the point, what do you mean by, "holistic?"

It either means that we ninja-sneak up on patients and heal them by singing kumbaya, or it means we're not ***holes to our patients.
 

DragonWell

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Perhaps I've grown a little cynical over the last two years, but IMO, the main reason the term "holistic" gets attached to osteopathic medicine is political. The AOA is the main organization I hear using this term, and they use it often, almost every time they describe osteopathic medicine. The livelihood of the AOA is heavily invested in maintaining the distinctiveness of the DO degree, whether it actually still exists or not. Hence the incorporation of terms like holistic to describe the "DO difference". The only practical difference is OMM, and while it does incorporate some holistic ideas, they basically remain strictly confined to the realm of the OMM lab.

There are DOs who practice "holistic medicine" just as there are MDs who do so, but, in almost all cases, whether DO or MD, this training is obtained in addition to the standard curriculum required to obtain either degree. (BTW, by holistic medicine, I specifically mean medicine which integrates concepts of CAM, something along the lines of this.)
 

EastWestN2grt

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Being originally trained in a true "Holistic" medicine-Chinese medicine, I agree with other posters that Osteopathic medicine is really far from being truly holistic--meaning the philosophical incorporation of the mind, the body and the spirit in philosophy as well as treatment is lacking. Osteopathic medicine and Allopathic medicine are based on the same tenets of Aristotlean logic and science; (remember we use the same books-except for FOM and a few others). The only difference is that a DO gets practice in OMT from the first week of school.

IMO, the biggest advantage in DO education( OMT) compared to MD education is that OMT introduces touch at the very beginning of medical education. OMT/Touch changes the patient-doctor interaction and I think sets the trend for a more humanistic interaction. By the time a DO student begins rotations we have interacted with dozens/hundreds of different patients via OMT class (even if this is the ONLY place a DO student practices OMT). Now its true the majority of DOs never use OMT again once out in practice, but i think the early experience can make, in general, a better clinician.
 

VALSALVA

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Being originally trained in a true "Holistic" medicine-Chinese medicine, I agree with other posters that Osteopathic medicine is really far from being truly holistic--meaning the philosophical incorporation of the mind, the body and the spirit in philosophy as well as treatment is lacking. Osteopathic medicine and Allopathic medicine are based on the same tenets of Aristotlean logic and science; (remember we use the same books-except for FOM and a few others). The only difference is that a DO gets practice in OMT from the first week of school.

IMO, the biggest advantage in DO education( OMT) compared to MD education is that OMT introduces touch at the very beginning of medical education. OMT/Touch changes the patient-doctor interaction and I think sets the trend for a more humanistic interaction. By the time a DO student begins rotations we have interacted with dozens/hundreds of different patients via OMT class (even if this is the ONLY place a DO student practices OMT). Now its true the majority of DOs never use OMT again once out in practice, but i think the early experience can make, in general, a better clinician.

I pretty much agree with this post. I may not use OMT, but my palpatory skills are really good because of all the "hands on" practice touching patients.

I don't think that DO's are, inherently, any more "holistic" than MD's. In these modern times, I think you'd have a hard time finding any doctor who didn't agree with the osteopathic tenants in principle. I bet if you asked 100 DO's what the three tenants of osteopathy were, very few would be able to give you the answer (or even one or two).
 

AdamWest

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I think the "holistic" thing is just a catch-phrase to attract a certain type of applicant who might feel they identify with something like that. In reality, any good physicians will probably be similar in their approach to patient care, MD or DO. There just isn't that much wiggle room to vary the curriculum, under the accreditation guidelines and our laws.

Knibb High football rules!

Mr. Triathlete, what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.
 

DrMidlife

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Mr. Triathlete, what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

OK, first, he doesn't care what you think, and second, he's Big Man on Campus and now you'll never get a prom date, and third, what are you, new?
 
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AdamWest

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OK, first, he doesn't care what you think, and second, he's Big Man on Campus and now you'll never get a prom date, and third, what are you, new?

Clearly you spent your adolescence on sdn and not watching 90's movies.

and no I will not make out with you. Did ya hear that? this girl wants to make out with me in the middle of class. You got Chlorophyll Man up there talking about God knows what and all she can talk about is making out with me. I'm here to learn, everybody, not to make out with you. Go on with the chlorophyll.
 

DrMidlife

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Oh I'm so busted. Note however that Al Gore did not invent the internet until I was about 25.
 

AdamWest

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Oh I'm so busted. Note however that Al Gore did not invent the internet until I was about 25.

hopefully by the time i'm 25 i'll stop quoting adam sandler movies. but don't count on it.
 

Marthea007

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hopefully by the time i'm 25 i'll stop quoting adam sandler movies. but don't count on it.

There is nothing wrong with that at all. Maybe you could just move on to another Adam Sandler movie. Shall I suggest Happy Gilmore? Billy Madison is great, but I have my favorites...
 

metalmd06

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The DO that interviewed me at NYCOM said some interesting things about this subject. He is a proponent of the whole patient view and the integration that is associated with osteopathic medicine. He said that many patients are becoming disinfranchised with the way that modern medicine treats them. Patients feel like the are being treated less like people and more like bags of organs. He places great importance in practicing medicine while not fragmenting the patient, and I think this is a great way to look at it. It seems self-expalatory doesn't it? Most of our organs and systems are not isolated from the rest of our bodies. So while he doesn't necessarily practice holistic medicine (like one of the posters mentioned as is with traditional chinese medicine, mind, body and soul), he practices integrated medicine.
 

Lamborghini1315

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The DO that interviewed me at NYCOM said some interesting things about this subject. He is a proponent of the whole patient view and the integration that is associated with osteopathic medicine. He said that many patients are becoming disinfranchised with the way that modern medicine treats them. Patients feel like the are being treated less like people and more like bags of organs. He places great importance in practicing medicine while not fragmenting the patient, and I think this is a great way to look at it. It seems self-expalatory doesn't it? Most of our organs and systems are not isolated from the rest of our bodies. So while he doesn't necessarily practice holistic medicine (like one of the posters mentioned as is with traditional chinese medicine, mind, body and soul), he practices integrated medicine.

You are missing the point here..holistic is an ideology not a physical tool. Every good doctor practices holistic medicine (MD or DO) by that i imply that good doc's don't just look at the lesion site but look around the site and elsewhere to rule out other pathological processes. Even radiologists will tell you to scan through an MRI, CT to make sure you are not just trying to isolate the lesion but as well looking for red flags in other locations. The whole argument here is a pre-med student hearing a current osteopathic med student's perspective but the truth is OMM is the only thing that separates us from the MD's. Its how people envision OMM in their practice makes them further off tangent from the straight line we all try to draw. Osteopathic schools "use the holistic ideology" to emphasize its importance in day to day practice but at the end of the day even MD's know not to just look at your back pain and prescribe you analgesics but rather search for clues elsewhere than the region of the pain to better diagnose. In regards to patients feeling more comfortable with the osteopathic approach is absolutely true..no one including myself wants to feel like a robot when you see a doc and he treats you like some machine that's malfunctioning. These things are innate and osteopathic schools will stress these subtle yet imp aspects of a physician's overall makeup but that doesn't mean MD's don't hear these things..ofcourse they do!! I have seen great MD's who are extremely passionate and heck feel as comfortable to touch the patients as DO's. So wat's the point? The point is the same old story of OMM being the only entity that gives us a new dimension and rest is just a good ol advice to prospective doctors. Always understand that during your residency training and beyond your experiences will mold your skills and perspective on medicine. In med school us poor med students are more worried about grades, learning everything for the first time and dreaming about better days!! Ok i rest my case.
 

DragonWell

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.... By the time a DO student begins rotations we have interacted with dozens/hundreds of different patients via OMT class (even if this is the ONLY place a DO student practices OMT). Now its true the majority of DOs never use OMT again once out in practice, but i think the early experience can make, in general, a better clinician.

Interesting, so you actually work on real patients with problems during OMM lab time? How many hours are spent actually treating patients each week?

Here we learn everything on each other, and the only "patients" we work on are friends, family, etc.

I think working on actual patients is essential, but I wonder how much time it would eat up in the pre-clinical years.
 

spicedmanna

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Interesting, so you actually work on real patients with problems during OMM lab time? How many hours are spent actually treating patients each week?

Here we learn everything on each other, and the only "patients" we work on are friends, family, etc.

I think working on actual patients is essential, but I wonder how much time it would eat up in the pre-clinical years.

Precisely. I agree. I've only worked on a few actual patients using OMT so far, the rest, meaning the vast majority, were classmates, although some did present with certain somatic dysfunctions in lab. But, yeah, there is a world of difference between working on a patient with chronic, radiating, low back pain who can barely walk (and is overweight, smokes two packs a day, has diabetes, hypercholesterolemia, and HTN), and a relatively healthy medical student.
 

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[YOUTUBE]http://www.youtube.com/watch?v=TWw2AD6RzrA[/YOUTUBE]
 
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