I wear two hats physician lawyer. There are many variables as to how you will be treated as a DO. My recommendation first and foremost is you only practice in states with single boards of medicine NOT a state with both an MD and DO Board. Florida is perhaps the best worst example so I will use it. In Florida, a DO must attend the State Required CMEs in person. An MD may take them online. There is no difference in content whatsoever. So there is no special Osteopathic content. But the MD cost is $69 online and the Osteopathic cost is roughly $400 plus hotel and travel and time away from the practice. In simple direct terms, the DO is treated much the same way as Black persons have been treated historically with poll taxes and other impediments to equality. The DO is very much a second-class citizen in the eyes of the state of Florida.
Secondly, since the CME credit for DO and MD are not the same. The State Requirements are therefore different and unequal. This is discrimination on its face in Florida which is a RIGHT TO WORK STATE. This situation cannot occur in a single board state.
Malpractice insurance. Some MD Carriers will not carry DO medmal. In fact, it was so bad twenty years ago the DOs had to start their own medical malpractice insurance company.
To a great extent DO physicians are isolated in separate but unequal facilities. In fact in Florida, there still remain the remnants of Osteopathic Hospital. For example, there is a hospital Chain called Florida Hospital. DOs are relegated to a lesser facility called Florida Hospital East. While they do the same procedures and are competent physicians, they are treated as lesser by pure prejudice. The DO specialists, in particular, have marginal practices. Many very competent DO general surgeons leave those practices at the height of their skill levels because they just don't want to fight the second class citizen status any longer.
The worst part for the DO is that the Foreign Medical Graduate who went to school in God knows where comes to the US and immediately seems to feel a superiority to the American Trained DO. This is very evident in South Florida where English is hardly the primary language spoken. It is here that Cuban trained doctors flood Miami.
So it is everything. From hospital privileges to cmes, to insurance. The DO is treated lesser. Then even patients don't know what a DO is. In spite of the essentially worthless attempts to differentiate DOs the public thinks they are Chiropractors. Australia hasn't helped by designating Osteopaths as non-physicians.
If you want to practice overseas as a DO, you are more or less dead in the water. The British won't accept the DO. Once again the second class citizenship extends to other foreign countries as well. As one FMG attending said to a troop of DO residents, "There is no shade under the MD umbrella for the DO."
DO schools and the awful AOA and other DO associations focus on primary care has caused great harm to the DO. Primary care is now referral medicine. It is the lowest paid and Osteopaths are lower paid by far statistically than their MD counterparts. The notion, the utterly stupid notion of the AOA pushing Obamacare with the idea that primary care would be on top was flatly WRONG! The bottom never goes on top except for the Bible where we are told the meek shall inherit the earth. That will NEVER happen in medicine. In medicine, the meek will get meeker. Look at the encroachment from PAs to Nurse Practitioners the primary care doctor turf is eroding.
In every way, it is probably better to go to a Foreign medical school and come back to the USA like an FMG than a DO.
Equality means you are treated equally. That may never happen to a Black person based on physical identifiers such as dark skin. The same kinds of prejudices apply to the DO. A dual board in a State is essentially an admission that the DO is not equal to the MD. I believe and I am not certain about this but there are 13 states that have dual boards. I would be very leery about practicing in such states. The DO that I worked with in Florida regretted licensing in Florida. Last year the medical malpractice caps were declared unconstitutional in the state so it is a very dangerous litigious state because the population is heavily migrant and predators abound. In some ways, Florida is cruddy, hot as hell, bug infested state.
My advice for what it is worth is joining the military if you want equality, though military doctors are not by any stretch exceptional. Our biggest medmal cases are colossal out of military hospitals and clinics. Go to states where the medical need is high. Doctors are treated well there. Avoid California, and Florida and New York. Avoid states with lots of regulation that Tax doctor's licenses and have layers of mandatory CMEs. Those states are leviathan nut job, bureaucrats.
Personally, I would avoid the field of medicine entirely and go to vet school and you will have nice patients and no government. Doctors in the future will make 75 to 100 k in primary care. That is not enough for the overhang of medical malpractice. Even though doctors win most of their cases, they are never the same after such an attack. Punitive states will pile drive them. It is truly awful.
Think about it. Why doesn't insurance just pay for accidents? Why do they have to treat the doctor like a murderous criminal? As doctors, you are not supposed to be tough as nails. You are supposed to be gentle decent people. This profession is dying.
Back in the 1960's, a primary care doctor would go to the hospital in the Am see patients, scrub for surgery and assist or deliver some babies, then go to their office and see patients. They would then go back to the hospital do rounds. They may get calls at night. Doctors loved this life and their skill levels were high. It's gone. 66% of all private doctor's practices have closed since Obamacare. A doctor is an employee towing the line for production numbers. It is now nothing but referrals. No scrubbing for surgery, no delivery of babies.
if you are in medicine then make the best of it. If you are deciding, don't give in to the impulse of the prestige of being called Doctor. It doesn't carry the weight it once did and it sure doesn't carry the money. Best wished to all of you. You are heading into a tough competitive life that you may actually hate. 70% of doctors I know say they deeply regret their decision to go into medicine. It is only going to get more infested with Government control.
