Surgery against DO philosophies?????

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NRAI2001

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I don't know much about DO philosophies, but it seems that DO's aim to treat patients with using the least amount of drugs as possible. Would this also extend to surgery? I know that DO's have little trouble getting most of the primary care specialties, but I am asking this bc I am gonna be apply to both DO and MD schools very soon. I m not sure what residency I want to do, but lets say I wanted to go into cardiothoracic surgery. Would I be at a disadvantage at obtaining this as a DO?

Seems that DO's try to treat patients holistically and would try to avoid surgery. Would surgery be going against DO philosophies?

Don't mean to flame, if anyone takes this the wrong way.
 
Dude it's time for you to go buy The DO by Norman Gevitz.
 
but it seems that DO's aim to treat patients with using the least amount of drugs as possible.
I don't know how accurate that statement is. Perhaps some DO graduates can comment. However, I'm inclined to say that by and large, DOs and MDs don't differ in this area.

Would this also extend to surgery?
If a patient needs surgery then they need surgery. It is unlikely that a DO wouldn't recommend surgery where an MD would.

I m not sure what residency I want to do, but lets say I wanted to go into cardiothoracic surgery. Would I be at a disadvantage at obtaining this as a DO?
Short answer: Yes. Long answer: In the scope of things, even MDs have trouble landing ultra competitive spots. Some have said that the remaining stigma against DOs is by and large restricted to surgical fields. Nonetheless, you will find DOs in all areas of surgery, so it's not impossible. But yes, it would probably be a disadvantage to having a DO instead of an MD.

Seems that DO's try to treat patients holistically and would try to avoid surgery. Would surgery be going against DO philosophies?
Nope. I think a lot of physicians (MD and DO) try to avoid surgery if possible. Except maybe surgeons 🙂
 
NRAI2001 said:
I'm not sure what residency I want to do, but lets say I wanted to go into cardiothoracic surgery. Would I be at a disadvantage at obtaining this as a DO? .

General Surgery...not much of a disadvantage by going DO now, but who knows...it's popularity has started rising since the intro of the 80 hr work week. However, if you're set on the more competitive surgical subspecialites like ENT, Ortho, Urology, Plastics, Ophtho, Neurosurgery, etc...you're probably better off sticking to american MD programs. There are DO's in every speciality, and I'm sure you can list anecdotal examples...but overall, i feel that you are at a disadvantage. As far as "treating the whole patient" being contrary to the philosophy of certain surgical subspecialties, I'm gonna leave that controversial topic alone.
 
lets not forget that we have our own programs as well.
 
NRAI2001 said:
I don't know much about DO philosophies, but it seems that DO's aim to treat patients with using the least amount of drugs as possible. Would this also extend to surgery? I know that DO's have little trouble getting most of the primary care specialties, but I am asking this bc I am gonna be apply to both DO and MD schools very soon. I m not sure what residency I want to do, but lets say I wanted to go into cardiothoracic surgery. Would I be at a disadvantage at obtaining this as a DO?

Seems that DO's try to treat patients holistically and would try to avoid surgery. Would surgery be going against DO philosophies?

Don't mean to flame, if anyone takes this the wrong way.


Read up on the DO philosophy to full understand what you are talking about.

Surgery spots are very competitive no matter if you are a DO/MD. So yes, its hard for a DO, but its hard for an MD as well. As well as DO's have their own residencies so its possible to apply to MD and DO surgical residencies as well

Surgery is necessary in some circumstances and DO/MD both realize it. So for it to "go against" the DO philosophy, as stated above, you should read up on what osteopathy really is.
 
mshheaddoc said:
Read up on the DO philosophy to full understand what you are talking about.

Surgery spots are very competitive no matter if you are a DO/MD. So yes, its hard for a DO, but its hard for an MD as well. As well as DO's have their own residencies so its possible to apply to MD and DO surgical residencies as well

Surgery is necessary in some circumstances and DO/MD both realize it. So for it to "go against" the DO philosophy, as stated above, you should read up on what osteopathy really is.

A DO student told me that you really cant apply to both DO and MD residencies, bc DO residencies have an earlier application time. So if you apply to DO spots and match into somewhere, you won't be able to apply to MD spots. If your gunning for a MD spot, then you ll have to skip the DO matches.
 
NRAI2001 said:
A DO student told me that you really cant apply to both DO and MD residencies, bc DO residencies have an earlier application time. So if you apply to DO spots and match into somewhere, you won't be able to apply to MD spots. If your gunning for a MD spot, then you ll have to skip the DO matches.
yes that is the case currently. People are advocating for a joint match for that reason. If that is the case, you can still apply to both and maybe in the next 4 years, the rules will change. If not, that is a chance you must take. If you are just looking for med school as a means to an end, apply only MD then. If you want to be a surgeon, apply to both. You are given two chances at that point. Additionally it depends on where you rank them I am told (by a 4th year surgery applicant who's applying now) 🙂
 
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A DO once told me that surgery is completely in agreement with osteopathic philosophy:
"Find it, fix it, then leave it alone."
 
NRAI2001 said:
I don't know much about DO philosophies, but it seems that DO's aim to treat patients with using the least amount of drugs as possible. Would this also extend to surgery? I know that DO's have little trouble getting most of the primary care specialties, but I am asking this bc I am gonna be apply to both DO and MD schools very soon. I m not sure what residency I want to do, but lets say I wanted to go into cardiothoracic surgery. Would I be at a disadvantage at obtaining this as a DO?

Seems that DO's try to treat patients holistically and would try to avoid surgery. Would surgery be going against DO philosophies?

Don't mean to flame, if anyone takes this the wrong way.

Its a good question, and a common misconception. A.T. Still himself, the founder of osteopathic medicine- was a surgeon in the Civil War. Dr. Still may have hated the drugs of his day, but the goal of osteopathic medicine is not to avoid drugs or surgery where these are appropriate.


The goal of osteopathic medicine (as should be the goal of all medicine, but often isn't)--> "treat the cause"

Far too often the #1 goal of medicine is to treat the symptoms that patients complain about. Any osteopath worth their salt will look past patient's stated chief complaint and will spend most of their time problem solving based on history and physical exam (including the info gained and the reasoning allowed by an osteopath's extensive knowledge of functional anatomy). Often, there are one or two critical pieces of the puzzle that will explain a variety of patient symptoms that are seemingly disconnected- and sometimes these are musculoskeletal (sometimes psych, sometimes genetic, etc.). The idea is that when the body is mechanically working correctly- it should be in good health.

If the cause is severe trauma, surgery might be our best tool to correct the tissue damage and prevent blood loss. This effectively treats the cause of the patient's condition.

Sometimes patients dont present until chronic symptoms have become severe- and these must be addressed to allow the patient to live long enough to address the medical or psych causes conservatively. Surgery or medication may be our best tool at this point.

Very occasionally, our ignorance or the patient's extreme poor health forces us to only address symptoms- with no hope of addressing a cause- but we do everything we can to limit the number of patient's for whom this is the only recourse. (the best MD's follow this conservative approach to patient care as well- though they have fewer tools for diagnosis and treatment to do so).


As a DO you can certainly be a cardiothoracic surgeon. Your advantage as a DO is you have enhanced diagnostic ability pre-surgery and skill to improve post-surgical outcomes due to your heightened knowledge of functional anatomy. You might also consider variations on common surgical approaches to optimize patient outcomes (such as minimizing rib cage damage via thoracotomy with future ribcage mobility in mind, or careful preservation and/or restoration of lymphatic pathways which are often ignored, etc.).

There are both DO and MD specialized cardiothoracic surgery programs, and while the DO undergrad may give you an osteopathic advantage in certain ways- many DO's who enter surgery have forgotten their osteopathic roots (and thus DO surgery attendings may not provide a tangible advantage over MD attendings)- Unless you can find one of those rare gems who remembers their osteopathic functional anatomy and has integrated it into their specialized practice. Thus, you may find that your best educational opportunities are in the allopathic world for residency- and you will need to just bring your osteopathic knowledge with you.

hope this answers the question.

michael
 
bones said:
Its a good question, and a common misconception. A.T. Still himself, the founder of osteopathic medicine- was a surgeon in the Civil War. Dr. Still may have hated the drugs of his day, but the goal of osteopathic medicine is not to avoid drugs or surgery where these are appropriate.


The goal of osteopathic medicine (as should be the goal of all medicine, but often isn't)--> "treat the cause"

Far too often the #1 goal of medicine is to treat the symptoms that patients complain about. Any osteopath worth their salt will look past patient's stated chief complaint and will spend most of their time problem solving based on history and physical exam (including the info gained and the reasoning allowed by an osteopath's extensive knowledge of functional anatomy). Often, there are one or two critical pieces of the puzzle that will explain a variety of patient symptoms that are seemingly disconnected- and sometimes these are musculoskeletal (sometimes psych, sometimes genetic, etc.). The idea is that when the body is mechanically working correctly- it should be in good health.

If the cause is severe trauma, surgery might be our best tool to correct the tissue damage and prevent blood loss. This effectively treats the cause of the patient's condition.

Sometimes patients dont present until chronic symptoms have become severe- and these must be addressed to allow the patient to live long enough to address the medical or psych causes conservatively. Surgery or medication may be our best tool at this point.

Very occasionally, our ignorance or the patient's extreme poor health forces us to only address symptoms- with no hope of addressing a cause- but we do everything we can to limit the number of patient's for whom this is the only recourse. (the best MD's follow this conservative approach to patient care as well- though they have fewer tools for diagnosis and treatment to do so).


As a DO you can certainly be a cardiothoracic surgeon. Your advantage as a DO is you have enhanced diagnostic ability pre-surgery and skill to improve post-surgical outcomes due to your heightened knowledge of functional anatomy. You might also consider variations on common surgical approaches to optimize patient outcomes (such as minimizing rib cage damage via thoracotomy with future ribcage mobility in mind, or careful preservation and/or restoration of lymphatic pathways which are often ignored, etc.).

There are both DO and MD specialized cardiothoracic surgery programs, and while the DO undergrad may give you an osteopathic advantage in certain ways- many DO's who enter surgery have forgotten their osteopathic roots (and thus DO surgery attendings may not provide a tangible advantage over MD attendings)- Unless you can find one of those rare gems who remembers their osteopathic functional anatomy and has integrated it into their specialized practice. Thus, you may find that your best educational opportunities are in the allopathic world for residency- and you will need to just bring your osteopathic knowledge with you.

hope this answers the question.

michael

👍
 
Here is a rather amusing quote from A.T. Still in his typical long-winded style- trying to define what osteopathy is.

This is from "Philosophy and Mechanical Principles of Osteopathy" 1902.
http://www.interlinea.org/atstill.html

It explains his attitude towards drugs and surgery perfectly.




OSTEOPATHY.

What is osteopathy? It is a scientific knowledge of anatomy and physiology in the hands of a person of intelligence and skill, who can apply that knowledge to the use of man when sick or wounded by strains, shocks, falls, or mechanical derangement or injury of any kind to the body. An up-to-date osteopath must have a masterful knowledge of anatomy and physiology. He must have brains in osteopathic surgery, osteopathic obstetrics, and osteopathic practice, curing diseases by skillful readjustment of the parts of the body that have been deranged by strains, falls, or any other cause that may have removed even a minute nerve from the normal, although not more than the thousandth of an inch. He sees cause in a slight anatomical deviation for the beginning of disease. Osteopathy means a knowledge of the anatomy of the head, face, neck, thorax, abdomen, pelvis, and limbs, and a knowledge why health prevails in all cases of perfect normality of all parts of the body. Osteopathy means a studious application of the best mental talents at the command of the man or woman that would hold a place in the profession. Osteopathy has no time to throw away in beer-drinking, nor has it time to wear out shoe-leather carrying a cue around the pool or billiard-table. It belongs to men of sober brains, men who never tire of anatomy and physiology or of hunting the cause of disease. An osteopath answers questions by his learning. He proves what he says by what he does. An osteopath knows that to the day of the coming in of osteopathy, the whole medical world was almost a total blank in knowledge of the machinery and functions of the abdomen of the human body. The medical man today, if we judge his knowledge by what he does, is perfectly at sea as soon as he enters the abdomen. He combats bowel disease by methods handed down to him by symptomatology. Beginning with chronic constipations, he reasons not on the causes. His one idea is to fall onto a successful purgative drug, which never should be used excepting with great caution. When the most active purgatives fail, with the aid of injections, to effect a movement; the bowels filling up and packing the abdominal cavity so full and tight that no organ below the diaphragm can act and all motion is lost, even to the blockage of arterial and venous circulation of the blood; with the stomach crowded with food, then on to vomiting of fecal matter and the vitality low all over the body; what is left for the medical doctor but surgical interference? And he proceeds with his instrumental skill with hope and doubt. The osteopath gets his success with such diseases through adjustment of the abdominal viscera, with the view of relieving the bowels of bulks of fecal matter, either hard or soft, that are laboring to pass away from the body through the natural channels, but meet mechanical obstructions that are caused by kinks, folds, twists, and knots of the bowels, the result of heavy strains, lifts, and falls that have forced the bowels to abnormal positions in the abdomen, deranging the mesentery at various points. The osteopath feels that he is not justified in administering purgatives, nor even injections into the bowels, until he has straightened out the viscera so that no resisting obstruction is liable to block the passing fecal matter. He proceeds as a mechanic.
 
I'm almost speechless at the initial question.

D.O's use a holistic approach which means they look at the entire person mind, body and spirit and use all the valid medical approaches so they have a wider array of options than allopathic medicine. The idea in osteopathy is often described as promoting health.

If you have a patient with a cancerous tumor leaving it there will not typically promote health. So yeah, surgery is totally consistent with D.O. philosophies when it will promote health.

I agree with the people who felt you ought to go do some reading about osteopathy.
 
RetiringInMy80s said:
I'm almost speechless at the initial question.

D.O's use a holistic approach which means they look at the entire person mind, body and spirit and use all the valid medical approaches so they have a wider array of options than allopathic medicine. The idea in osteopathy is often described as promoting health.

If you have a patient with a cancerous tumor leaving it there will not typically promote health. So yeah, surgery is totally consistent with D.O. philosophies when it will promote health.

I agree with the people who felt you ought to go do some reading about osteopathy.

I asked the question bc I am truely interested in becoming a DO, not to bash anyone.

This is what this form is for, to do research. I asked the question in hopes of getting some quick perspective, I don't have the time at the moment to read some of the suggested books bc i m taking mcats in august. But i definitely will after taking the mcat.
 
My family has been involved in Osteopathic Medicine (as D.O.s) for almost a century. The history is fascinating. Since you are not exactly awash in free time I would forget about any suggested books except the one book mentioned before. "The D.O.s" by Gevitz. Read this and you will understand how it happened..when it happened...and why it (Osteopathy) happened. It just underwent a major revision (updated) from its original form published in 1981. It now takes the Osteopathic history up until (almost) the present day. The book is far from dry.....quite interesting. I get the feeling from reading some of your prior posts that a good deal of what you know about D.O.s is from this forum (SDN), which might lack a certain degree of objectivity and, at times, accuracy. Hope you do. It's available in hard and paper back from the Johns Hopkins press. Can be ordered from there via the net.
 
gtleeee said:
My family has been involved in Osteopathic Medicine (as D.O.s) for almost a century. The history is fascinating. Since you are not exactly awash in free time I would forget about any suggested books except the one book mentioned before. "The D.O.s" by Gevitz. Read this and you will understand how it happened..when it happened...and why it (Osteopathy) happened. It just underwent a major revision (updated) from its original form published in 1981. It now takes the Osteopathic history up until (almost) the present day. The book is far from dry.....quite interesting. I get the feeling from reading some of your prior posts that a good deal of what you know about D.O.s is from this forum (SDN), which might lack a certain degree of objectivity and, at times, accuracy. Hope you do. It's available in hard and paper back from the Johns Hopkins press. Can be ordered from there via the net.


Cool, i will look into this book, but probably not untill after i take the mcat (august 20).
 
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