Specific example of DO philosophy differing from MD philosophy?

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cmudan

I was hoping someone could give me or point me in the right direction in finding a particular instance of where a DO would treat a patient differently than an MD. I have read many DO philosphy websites, but I feel as if I only have book knowledge of the subject. (wholistic apprach, etc...)I am hoping a "real life" example will help clarify things for me.

Here is an example that comes to mind: A patient comes in complaining of back pain. MD: concentrate on back (x-rays, etc...) DO:not only do I check back, but also check legs, knees, ankles, and feet to look for something that is out of wack.

Is this example a true example and should I use it during an interview. Other examples would be helpful.

Thanks,
Cmudan
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My father was going to an MD who would prescribe Rx for every problem. Meds were the only tx ever considered. This led to even having multiple Rx to deal with the side effects of previous meds. He ended up on somewhere around 30 different meds. He changed to a DO who took him off of nearly everything. He was willing to consider tx other than meds. My dad felt much better once his meds were cut back.

Now, that all said, both your example and mine show what any good physician should do. There are definitely many MDs that practice in the same way...and there are DOs that don't. In my experience, however, I've seen a much higher percentage of DOs than MDs that in everyday practice do more thorough exams, look at various tx modalities, etc.

I would hesitate using your example in an interview as a decent MD should do the same. The actual differences between the two arenas are much smaller than many in DO academia would like to think. I would stick to how the DO holistic training will make it a natural part of your practice to look at the "whole person" and to consider different tx modalities. I would definitely mention the benefits of having OMM as a tx option (especially since this is the only tangible difference between DO and MD).
 
Definitely use OMT as an example. To use your back pain example, the MD could only offer drugs or surgery as options (perhaps refer the patient to a PT?) while the DO could offer to use OMT first as a drugless alternative to treat back pain, and if that's not sufficient, then the DO can offer drugs or surgery as well. Remember that OMT has been proven as effective as drugs for lower back pain. Also, the DO is more likely to ask the patient how the back pain is affecting his/her life (Not able to play with the grandchildren? Not able to concentrate at work?) and try to alleviate those, whereas the MD is more likely not to ask those questions and concentrate on the physical back pain alone. Please note that's "on the average." There are holistic MD's and there are non-holistic DO's out there.

You could also quote this great article (thanks to OceandocDO for the link): http://www.acponline.org/journals/news/nov03/communication.htm
 
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The emphasis that DO's put on a holisitic approach to medicine is overrated and overpromoted. DO students rotate alongside their MD counterparts and are forced into the same treatment methodologies as everyone else. Every patient, whether treated by a DO or MD student, has a plan organized by organ system (which is about as reductionistic as you can get). I have yet to see a patient focused, problem-based note/approach by a DO that is any different from an MD student.

I would disagree with the statement that DO's are any more thorough than their MD counterparts. From what I have seen, I would have to say that the MD students perform at a higher level clinically when compared to DO students at the same level of training.
 
Originally posted by Ponyboy
From what I have seen, I would have to say that the MD students perform at a higher level clinically when compared to DO students at the same level of training.
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that is simply not true. many programs are now seeking DO's because they are more competant at physical examinations.

Though what type of a doctor one will be depends on the person more then whether they have an MD or DO behind their name. I know MD's who are very hollistic and treat teh whole person and I also know DO's who subscribe to the traditional model of disease and not to the biopsychosocial model that DO school uses

Therefore it all depends on your personal philosophy 😛
 
Originally posted by Ponyboy
The emphasis that DO's put on a holisitic approach to medicine is overrated and overpromoted.
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I don't disagree. Any decent physician should have a holistic approach and most schools teach this way (whether it is mentioned as holistic or not).

Originally posted by Ponyboy
I would disagree with the statement that DO's are any more thorough than their MD counterparts. From what I have seen, I would have to say that the MD students perform at a higher level clinically when compared to DO students at the same level of training.
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This is mostly variable from student to student, rather than an actual MD vs DO difference. There are some difference among schools as to how well they prepare their students clinically. Again, it isn't really a MD vs DO difference, rather a school to school difference.
 
Originally posted by DrMom
There are some difference among schools as to how well they prepare their students clinically. Again, it isn't really a MD vs DO difference, rather a school to school difference.
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To be honest, its probably more of a student to student difference.

Q, DO
 
Originally posted by moniagrl
that is simply not true. many programs are now seeking DO's because they are more competant at physical examinations.
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Not by my experience. Clinical performance entails more than a physical exam. It also includes reaching a diagnosis, having a differential and taking care of your patients. The MD students have consistently performed better than the DO students who have rotated at my hospital (there are always exceptions. of course). I'll admit that there may be a sampling bias but this is what I have seen. I have yet to see a top program actively recruit DO's over MD's.
 
Originally posted by QuinnNSU
To be honest, its probably more of a student to student difference.

Q, DO
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True, although I do think there are a few schools out there that a weaker clinically. They are the exception, though.
 
Originally posted by Ponyboy
Not by my experience. Clinical performance entails more than a physical exam. It also includes reaching a diagnosis, having a differential and taking care of your patients. The MD students have consistently performed better than the DO students who have rotated at my hospital (there are always exceptions. of course). I'll admit that there may be a sampling bias but this is what I have seen. I have yet to see a top program actively recruit DO's over MD's.
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where are you? just generally, not specific hospital.

i wouldn't say either group consistently performs better than the other. it depends largely upon the students and their individual strengths and weaknesses. that, and your definition of what makes a student "better". i've seen terrible students from both schools, and great students from both.
 
In the NorthWest.

I originally didn't have any concerns about DO students as a student myself. But after a string of poor students, I've begun to reconsider my opinions.
 
That's interesting. I've been told just the opposite by a residency program director here in Texas. He feels the TCOM students are equal to or stronger than many of the allopathic students he sees from one of the state's largest allopathic schools. When I asked the director of the Peds residency program at the same hospital about students from TCOM (this was before I was accepted), his response was a very enthusiastic, "We love TCOM students!"

As scientists, we simply HAVE to resist making broad generalizations based on a few personal experiences. While it may be true that Ponyboy has experienced some sub-par osteopathic students, there are many more examples of performance between students being equal.

As students, the goal needs to be how to help each other become better physicians FOR THE PATIENTS, not how we can categorize one another into hierarchies and create further divisions. My example above is not meant to say that DO students are superior, by the way. I was simply providing an instance in which the opposite of Ponyboy's comments could be true.
 
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Cmudan,

I would listen to what DrMom advised. I think it is bad idea to compare DO philosophy to MD philosophy. You may be asking for trouble if you provide an example like you mentioned. I would stick to talking about why the osteopathic principles and practice fits your ideals as a future physician.
 
DO students very rarely rotate in Canada.

As a physician, I have to recognize patterns from what I observe. If I simply brush off five patients in a row who have influenza as simple coincidence, I will miss the epidemic. As a scientist (rrrright, are physicians really scientists?), I have to learn to make inductions from specific cases (Newton and the apple and such).
 
MD's and DO's prescribe meds for every patient complaint because patients go to the doctor wanting a prescription for something. At least the vast majority do. This is true even in the ER. Even when we see patients with nothing, we give them a script to improve patient satisfaction which in turn decreases your likiehood of being sued.
 
md=do-they-are-great-degrees.dos-have-the-advantage-of-knowing-more-then-chiropracters-in-my-opinion
 
One thing that disappoints me is it seems that DO's are getting away from OMT...at least this is true in my area. I have chronic back pain from a bad car accident and would love to have OMT, but the docs who used to do it have moved/retired, and I can't find anyone who does it with enough frequency to be proficient.

That's a shame, because I think it's a great "extra" to be able to offer patients. There's even an osteopathic hospital in my area, yet no one who really seems interested in doing OMT.
 
Originally posted by Dr.Wolkower
md=do-they-are-great-degrees.dos-have-the-advantage-of-knowing-more-then-chiropracters-in-my-opinion
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How-can-you-type-like-this?--Its-not-very-efficient.--You-should-probably-use-your-spacebar.

stomper
 
Originally posted by Ponyboy


As a physician, I have to recognize patterns from what I observe. If I simply brush off five patients in a row who have influenza as simple coincidence, I will miss the epidemic. As a scientist (rrrright, are physicians really scientists?), I have to learn to make inductions from specific cases (Newton and the apple and such).
Click to expand...

This is an entirely different example than judging an entire group of doctors based on a few that you deem to be poor students. Think about it.

I could do the same for the allopathic medical profession. I had a string of bad MDs then one great DO who fixed what the MDs could not. I wouldn't dream of judging the entire group of individuals holding the MD degree based on my experience.
 
Well thanks for the input, unfortunately we kind of got off the subject.

So when it comes up at an interview I feel that it might be better to leave an example out during my explanation. I will just stick with the cliche of: wholistic approach and OMT.

Can't go wrong with that right?

What I really feel like saying: DO and MD's actually use the same methods in many instances. The "DO Philosphy" is just something to quiz interviewees on.
 
Originally posted by sophiejane
This is an entirely different example than judging an entire group of doctors based on a few that you deem to be poor students. Think about it.

I could do the same for the allopathic medical profession. I had a string of bad MDs then one great DO who fixed what the MDs could not. I wouldn't dream of judging the entire group of individuals holding the MD degree based on my experience.
Click to expand...


Unfortunately, I live in the real world. If I have had several students who have provided poor medical care to my patients, have poor clinical skills, and have terrible work ethic (all while doing try-out electives at my hospital) and all of these students come from DO schools, I would be an idiot to not more closely supervise another DO student who comes onto my service. In the same light, my hospital is instituting new rules for NP's because of the what we've experienced with our current team of NP's. This is the real world, you manage patients, delegate responsibility and make judgements about ability on what you have experienced. If you want to make a judgement about MD's based on your knowledge as a pre-med, you go right ahead. However, if you (as a first year medical student) want to debate clinical abilities (with a resident, whose opinions are shared by other residents), I would say that you're on shaky ground.

Like I said before, I originally held DO students in the same regard as MD students. It's been only after having DO students who consistently required additional supervision and help, that I've begun to reconsider my opinions.
 
Sorry about this Cmudan, but I'm keen to hear a tad morfe from Ponyboy...

Ponyboy...

What skills in particular are your DO students lacking?

Do they demonstrate skills in other areas that your MDs are lacking?

What's your sense of why your DOs aren't up to scratch?

What constructive advice would you have for DO students and their instructors to remedy the situation?
 
Originally posted by coreyw
Sorry about this Cmudan, but I'm keen to hear a tad morfe from Ponyboy...

Ponyboy...

What skills in particular are your DO students lacking?

Do they demonstrate skills in other areas that your MDs are lacking?

What's your sense of why your DOs aren't up to scratch?

What constructive advice would you have for DO students and their instructors to remedy the situation?
Click to expand...

check pony's post history and you'll see he's canadian (U of A i think)-- so his exposure to DO's, like he stated in a previous post, is very limited. i wouldn't use his opinions about US DO's to base any decisions on.
 
I really am eager to read Ponyboy's answers. And I'm not being sarcastic either. I start next fall at a DO school, and I'd like to know exactly how DO students are falling short.
 
Ponybony,

Can you stick to talking about the main subject of this thread? Many of us are getting sick and tired of hearing you whining that DO students at your hospital are inferior to MDs. Your reasoning sucks! I've run into MD students that are utter *****s but it still doesn't concludes that all MDs are inferior to DOs. Your comments sound immature and ignorant. The original poster did not intend to make this a thread for b**ching and moaning which group is better. You are always talking about who is better: Canadians vs. American MDs, DOs vs. MDs. You are again sounding like a broken record. Please stick to the topic. You are continually digressing.

Back to the main topic at hand.

Cmudan,

"Wholistic" is not an okay term. I remember during my first week at NYCOM, one OMM professor seemed to resent that term because fields like acupuncture and other alternative fields also say they are wholistic. I would also talk more about osteopathy's focus on "wellness" of an individual. Also mention on the greater focus on the musculoskeletal system and structure-function.

You may have seen this link but here it is again:
http://www.aoa-net.org/Consumers/whatdo01.htm

Good luck!
 
I've previously had little contact with DO's but now that I'm doing a residency in a hospital where DO students and residents frequently do electives, I've had a lot of contact with them (as a rough estimate, about half to a third of the trainees that I have rotated with are DO's or DO students). As a student, I had rotated with a few DO's and found no difference with them. However, with increasing exposure (almost every other student or resident that I've worked with has been a DO), and after working with several that have caused me grief, I have begun to question my opinions.

I find that DO students are not fully aware of the issues and developments of their patients. Now some of this is dependent of the level of training. However, compared to their MD counterparts, who are typically on top of their patient's care, there is a noticeable difference. A possible reason for this discrepancy ( according to one DO student) may be that third year rotations are with voluntary preceptors who may or may not regularly have trainees, or do not appropriately incorporate the students into the management of their patients. Additionally, students are often spread all over in different cities for their rotations and are not given a cohesive educational continuum that comes from having an organized rotation director who dictates the clinical and didactic curriculum for every student.

Opinions are like noses, everyone (except a few people with leprosy and necrotizing fasciitis) has one. Dr.Mom thought DO's are more thorough, I think otherwise. I'm sure you'll find people who will support both.
 
Originally posted by Ponyboy
Dr.Mom thought DO's are more thorough, I think otherwise. I'm sure you'll find people who will support both.
Click to expand...

You are misrepresenting my post. I was giving another example like the OP's, not making a broad statement. For review, here is what I said:

Originally posted by DrMom
In my experience, however, I've seen a much higher percentage of DOs than MDs that in everyday practice do more thorough exams, look at various tx modalities, etc.
Click to expand...

As you can see, I was simply stating my experience and not making broad statements about MDs and DOs.

I went on to explain that differences in clinical practice are usually due to the individual rather than MD/DO. I have been emphasizing my view that the OP not use these kinds of examples in an interview as "evidence" of how DOs treat patients differently because they aren't accurate broad statements to make.

I most certainly have nothing against MDs. My daughter's pediatrician is an MD, as is my husband's ENT, and my orthopod. Our family physician is a DO, as is the GYN I go to. I choose individual physicians based on thier competence, not their degree.
 
Originally posted by drvlad2004
Ponybony,

Can you stick to talking about the main subject of this thread? Many of us are getting sick and tired of hearing you whining that DO students at your hospital are inferior to MDs. Your reasoning sucks! I've run into MD students that are utter *****s but it still doesn't concludes that all MDs are inferior to DOs. Your comments sound immature and ignorant. The original poster did not intend to make this a thread for b**ching and moaning which group is better. You are always talking about who is better: Canadians vs. American MDs, DOs vs. MDs. You are again sounding like a broken record. Please stick to the topic. You are continually digressing.
Click to expand...

Listen buddy, if you're sick and tired of reading my posts, then don't read them. Dr.Mom said that in her experience she thought DO's were more thorough than MD's. I disagreed from my own experience. Why is it OK for her to make such a statement but the minute someone else has the opposite viewpoint, they run into the guantlet of criticism? Perhaps someone's a little biased? I disagreed with someone's statement once and it's been the other posters who've continually bickered about this point. I'm simply replying.

Does my reasoning suck? It may very well but I know that next time I'm paraoid about such students, I won't have to be surprised by patients who were supposed to be d/c'd home but stayed on the wards for a day and a half without someone rounding on them. Or patients who were reportedly well but within an hour had to go the PICU. When you're a resident, you can go ahead and treat all students the same and get burned when some of them continually fumble the ball but I've learned my lesson.

Perhaps I sound like a broken record. Whatever. I'm signing off this thread and you premeds and medstudents can continue to tell yourselves that your osteopathic, holistic, American education is fantastic without anyone disagreeing with you.
 
As a future DO student, I for one am taking ponyboy's opinion seriously more so than other DO student's opinions who are only 1st or 2nd years. He is a resident and has worked in the hospital so as he stated earlier, how can 1st or 2nd year students argue against that experience.

It is his opinion and people should stop jumping on his back for stating it. However, as it was stated, he is basing his opinion off the few DOs he has worked with. It depends from student to student and I do not agree with his analysis of how the DO students became like that, because it is just his speculation.
 
Originally posted by Ponyboy
I've previously had little contact with DO's but now that I'm doing a residency in a hospital where DO students and residents frequently do electives, I've had a lot of contact with them (as a rough estimate, about half to a third of the trainees that I have rotated with are DO's or DO students). As a student, I had rotated with a few DO's and found no difference with them. However, with increasing exposure (almost every other student or resident that I've worked with has been a DO), and after working with several that have caused me grief, I have begun to question my opinions.
Click to expand...

OK. For me as a journalist of osteopathic medicine, there's some interesting stuff in what you've said - and I'd love to hear a response from the osteos (apart from just 'Bugger Off!').

Pony... again I ask: is there anything that your DOs are better at than your MDs? PM me if you don't want to raise your head out of the trenches just yet.

It's a shame that the word 'w/holistic' has such a bad rap, it's actually rather potent and descriptive. Alternatives like 'contextual' or 'biopyschosocial' are a tad clumsy. In any case, it would seem to me to be much more honest (and less lazy?) to describe what you think 'holistic' means to you.
 
OP:

Just educate yourself as much as you can about osteopathic medicine. Shadow some DOs. Experience is your best friend.

I would avoid using any buzzwords like "holistic" and the like at the interviews. Just give straightforward answers to the questions.

You'll do great.

Good luck
 
Getting back on topic...😳

We've got an MD teaching a clinical correlations class at VCOM who gave a very concrete example...

With his experience, the way he had to treat a thoraic outlet compression problem (sometimes commonly referred to a painter's syndrome) was to send the patient to surgery for a 1st rib resection.

When he encountered this problem in an athlete, he discussed this treatment with his supervisor, a DO. Instead of surgery, the DO performed OMT and the player was back in the game in ~8min versus waiting for surgery and recovery/rehab 🙂

'Course your mileage may vary depending on individual circumstances...but it's a pretty concrete example :clap:

-- Bhaba
VCOM 2007
 
this may be the most entertaining thread i've ever read:laugh: although, i need to throw my 2 cents in. pony, i know you're not in this thread anymore but did you ever look at what school these sub-par DO's come from? i'm speechless, just entertained that is always blamed on the degree................
 
Originally posted by Insert
As a future DO student, I for one am taking ponyboy's opinion seriously more so than other DO student's opinions who are only 1st or 2nd years. He is a resident and has worked in the hospital so as he stated earlier, how can 1st or 2nd year students argue against that experience.


This is the STUDENT doctor network...so as far is the info goes you must consider the source. D.O's and M.D's in the field still remain the best sources. maybe try webmd.com?
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I'm sick and tired of these snooty damn beer drinking, self-righteous, socialized medicine having, hockey loving, french speaking, arrogant canadians. I say drop Iran from the axis of evil and add canada.
 
By the way, I heard somewhere that ALL canadian md's have small penises. Now, I don't know if it's true and I'm not trying to start any rumors or anything, it is just what I heard.
 
Regarding Ponyboys comments, I'd like to add another perspective. Everyone keeps saying that because he's a resident he MUST know what he's talking about. Well, he doesn't! I am a 3rd year resident...a DO at an allopathic institution that also occasionally has DO students. If he says he's had some weak DO students then I am willing to take his word for it. However, to make sweeping, unsubstantiated generalizations about an entire profession is misleading and of course invalid. It is quite unfortunate that a physician would do such a thing as I'm sure he must know that his logic is flawed. There are weak DO students just as there are weak MD students. In comparing both groups clinically, I would have to say I don't see much difference. However, the DO students consistently have a better work ethic. Perhaps it is because most of them are coming here for audition rotations and are trying to make a good impression. Does that mean I think DO students are better team players, harder workers? Of course not! To do so would be to make sweeping generalizations which as we all know would be completely inappropriate. Medical school (DO or MD) is what you make of it. If you work hard you will get a good education at either type of institution...simple as that.😀
 
Originally posted by Ponyboy

Does my reasoning suck? It may very well but I know that next time I'm paraoid about such students, I won't have to be surprised by patients who were supposed to be d/c'd home but stayed on the wards for a day and a half without someone rounding on them. Or patients who were reportedly well but within an hour had to go the PICU. When you're a resident, you can go ahead and treat all students the same and get burned when some of them continually fumble the ball but I've learned my lesson.

Perhaps I sound like a broken record. Whatever. I'm signing off this thread and you premeds and medstudents can continue to tell yourselves that your osteopathic, holistic, American education is fantastic without anyone disagreeing with you. [/B]
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Hey Pony:

Resident to resident, if you have patients on YOUR service who don't get d/c'd on time or patients who are "fine" then go to the unit within the hour, guess who's not doing their job? It ain't the students, partner, it's YOU. If you are blaming the med students for such things, I damn sure don't want you on my team.
 
Soooooooo true!👍
 
I like the thing about small canadian penises...

I am sure there is some validity to it with the cold and all...

why else would a group of people say "aye" all the time...?


(P.S.) My wife is Canadian, granted from Vancouver Island BC and to top it off born to US parents... well on second thought she has canadian citizenship and not really canadian, she is Oklahoman... yeah that is it.... and another broad generalization... We are the best state in ..... Cow Tipping
 
To the OP:

Without spending time to read the other responses, I'll give you my perspective. So I apologize in advance for repeating anything anyone else may have said.

I suffer from low back pain and fairly often will have flare ups of severe low back pain. I have seen many physicians for this problem and feel that in my case I can begin to generalize... insofar as to say that it all depends on the practitioner. The difference between MD and DO philosophy, collectively, is that the DO's have a uniting philosophy whereas the MD's do not. The DO philosophy is to consider both the host and the disease in the continuim of the illness process. We take into account all factors contributing to the host (environment, structure, impaired function, etc.). Many individual MD institutions, and MD students and practitioners have adopted a similar philosophy, but there is no uniting philosophy binding all MD education.

As a further illustration, though, of how it all depends on the practitioner, one must take into account the mindset of the individual applying the treatment. If that person (whether she be a DO or MD) does not have any vested interest in such a philosophy, then their mode of practice will follow suit.

I have been to many a physician (DO and MD) who could care less about the whole patient philosophy. The majority of these have been MD's but that only reflects the proportion of MD's to DO's that I've seen for my dysfunction.

I will say that since becoming a medical student, I have been undergoing a lot of stress (which in my case usually elicits a physical and immune response). I have been less sick (ie fewer colds, URI's and other problems) since I've become a regular OMM guinea pig to my classmates and the second year students. I've also suffered from a case of the flu almost every year since childhood. I have yet to get the flu this year (no vaccine) despite being surrounded by family members who have. Also, the few times I've felt "under the weather," the duration of this sickness has been much less this year. Is this proof that OMM and the DO philosophy works, not necessarily, but it is one more piece of anecdotal evidence.

I welcome anyone who wants to slam my perspective, but as I stated before, this is my perspective and my opinion only.

peace...
 
All i've gotten out of omt is a pain in the neck, literally and figuratively.
 
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