This is not, not, NOT meant to be a flame-war

[Flobber]

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Have you guys run across any DO students/docs that have negative biases towards allopathic students/docs? Have any of you noticed differences in the way allopathic students/docs interact with their patients? Again, this is a post PURELY out of curiousity, not meant to start the whole DO vs MD thing, which has been played out to death.

 

[AwesomeO-DO]

Have you guys run across any DO students/docs that have negative biases towards allopathic students/docs? Have any of you noticed differences in the way allopathic students/docs interact with their patients? Again, this is a post PURELY out of curiousity, not meant to start the whole DO vs MD thing, which has been played out to death.

good luck keeping this clean, but I'll try my best...
I've constantly heard from professors and guest DO lecturers about how much better DO's are at patient care over MDs, sometimes they don't outright state MDs are inferior, like "DOs treat don't just treat symptoms, they treat the whole pt, blah blah blah", which insinuates MDs and other medical professionals only treat symptoms and are not as thorough with thier pt care. The AOA is constantly putting this in thier fliers. I find this to be instilling a negative superiority complex in DO students.

 

[my alias]

i think the whole "DOs treat the whole patient" statement is a bit derrogatory towards MDs. It gives the underlying impression that DOs give more time attention to their patients. This is obviously dependent on a person, not their degree.

 

[JohnDO]

The "treat the whole patient" is really a historical ideology.

To answer your question: I've heard a small number of DO and pre-DO students elevate themselves above MD students (not necessarily putting MD students down directly). By far the small minority though. In my experience, I've never heard a practicing DO put down an MD.

The only time I've heard a DO claim to be better than an MD was the administration at a DO school (and it was one guy, not everyone). I doubt that most practicing osteopathic physicians under the age of 40 would ever put down an MD.

I also agree that the AOA needs to strongly discourage this attitude.

 

[group_theory]

The lead author, Timothy S Carey MD MPH, is a professor of medicine at UNC-Chapel Hill School of Medicine. Dr. Carey is the winner of the 2004 George W. Northup DO Medical Writing Award, presented annually by the JAOA. I think this is the first study ever done on this topic (and thus why it is small in size)

Carey TS, Motyka TM, Garrett JM, Keller RB.

Do osteopathic physicians differ in patient interaction from allopathic physicians? An empirically derived approach.

J Am Osteopath Assoc. 2003 Jul;103(7):313-8.

Colleges of osteopathic medicine teach osteopathic principles, which provide a different approach to and interaction with patients than principles taught in allopathic medical schools. The authors examined whether osteopathic primary care physicians' interactions with patients reflect the principles of osteopathic medicine when compared with allopathic physicians' interactions. The principles of osteopathic medicine were adapted to elements that could be measured from an audio recording. This 26-item index was refined with two focus groups of practicing osteopathic physicians. Fifty-four patient visits to 11 osteopathic and 7 allopathic primary care physicians in Maine for screening physicals, headache, low back pain, and hypertension were recorded on audiotape and were dual-abstracted. When the 26-item index of osteopathic principles was summed, the osteopathic physicians had consistently higher scores (11 vs. 6.9; P = .01) than allopathic physicians, and visit length was similar (22 minutes vs. 20 minutes, respectively). Twenty-three of the 26 items were used more commonly by the osteopathic physicians. Osteopathic physicians were more likely than allopathic physicians to use patients' first names; explain etiologic factors to patients; and discuss social, family, and emotional impact of illnesses. In this study, osteopathic physicians were easily distinguishable from allopathic physicians by their verbal interactions with patients. Future studies should replicate this finding as well as determine whether it correlates with patient outcomes and satisfaction.

PMID: 12884943

 

[novacek88]

Mods

Close this thread. I know it was started with innocent intentions but they never lead to anything constructive. You know it's going to turn into a flame war. Whether it be an anti-DO or anti-MD, these threads don't go anywhere.

 

[AwesomeO-DO]

Mods

Close this thread. I know it was started with innocent intentions but they never lead to anything constructive. You know it's going to turn into a flame war. Whether it be an anti-DO or anti-MD, these threads don't go anywhere.

ditto

 

[Flobber]

OK, in an effort to stear the thread into less objectionable waters... what exactly goes into the DO curriculum concerning patient care? I know that, for allopathic, we get the standard course on clinical medicine, rife with all of the "respect your patient, listen, yada yada"... do osteopathic go beyond this level of lip-service, or is it more just that the overall environment is geared toward patient service rather than diagnosis, etc. Not sure if I phrased my question right... hopefully someone can make sense of it. Again, no flaming.

 

[cremaster2007]

OK, in an effort to stear the thread into less objectionable waters... what exactly goes into the DO curriculum concerning patient care? I know that, for allopathic, we get the standard course on clinical medicine, rife with all of the "respect your patient, listen, yada yada"... do osteopathic go beyond this level of lip-service, or is it more just that the overall environment is geared toward patient service rather than diagnosis, etc. Not sure if I phrased my question right... hopefully someone can make sense of it. Again, no flaming.

I am in a DO school and it is too bad that there is so much arguing between MD's and DO's. More for the patients sake than anything. Our curriculum from what I can tell is similar to an MD's. We don't get as much into genetics and hereditary diseases, and yes we have OMM which is more hands on patient care, but most DO's don't even use it in their practices. We are geared a little more to patient service (at least at dmu), where I get the feeling like at the U of I they are geared more toward research and etc. Does that make either of us better not really, we are all in this to help people and better the health care in this country. So all I can say is that hopefully we all realize someday that we are all doctors trying to help people ............. DO vs MD we all have the same goal in mind so why do we have to argue about the two schools of thought all the time. Maybe if we spent that time trying to figure out how to better serve our patients we wouldn't get sued so much because patients don't trust us.........

sorry for the rambling ....I also would like to know what exactly the curriculum is like at an MD school, just to compare it to ours.🙂

 

[kristing]

OK, in an effort to stear the thread into less objectionable waters... what exactly goes into the DO curriculum concerning patient care? I know that, for allopathic, we get the standard course on clinical medicine, rife with all of the "respect your patient, listen, yada yada"... do osteopathic go beyond this level of lip-service, or is it more just that the overall environment is geared toward patient service rather than diagnosis, etc. Not sure if I phrased my question right... hopefully someone can make sense of it. Again, no flaming.

You know I wondered this myself. Since we are all pretty much subject to our won education and don't go sit in other school's classes.

I've done rotations with DOs, MDs, and students from both types of schools, and I think maybe a difference is bigger in people who graduated a while ago than those students in school now or who graduated recently.

I've also often wondered if there is a difference not in TRAINING per se, but in the entering classes that would perpetuate this difference (be it real or not).

 

[cremaster2007]

You know I wondered this myself. Since we are all pretty much subject to our won education and don't go sit in other school's classes.

I've done rotations with DOs, MDs, and students from both types of schools, and I think maybe a difference is bigger in people who graduated a while ago than those students in school now or who graduated recently.

I've also often wondered if there is a difference not in TRAINING per se, but in the entering classes that would perpetuate this difference (be it real or not).

I have heard people that elude to a difference in personality..........as in DO's are different types than MD's, though we are all type A🙂. Or that certain personalities interview better at an MD school, while DO school's like a different kind of candidate. Don't know if there is any truth to it at all though.

 

[kristing]

I have heard people that elude to a difference in personality..........as in DO's are different types than MD's, though we are all type A🙂. Or that certain personalities interview better at an MD school, while DO school's like a different kind of candidate. Don't know if there is any truth to it at all though.

By applying to a DO school, too, you are saying "I will think outside the box."

 

[daelroy]

In general, I think the differences are due to the type of students they attract. It seems like osteopathic schools have a large percentage of students who are pursuing second careers. Many of these students are in their late 20's/early 30's and are married and/or have children. I think this is why many osteopathic students enter primary care because they have families to think about. Many don't want to enter surgical fields or purse long fellowships after residency for this reason. It's a lot easier to spend 7 years pursuing interventional cardiology when you graduate at the age of 26 versus 32-35.

I think this is also why many people feel DO's are more laid back because they are more mature. Think about it! What were you like when you were 22-23? I'm sure you were a lot more cocky and self-assured than you are in your late 20's or early 30's.

Keep in mind, I did say "in general" so I don't want any responses from 22 year old DO's saying that 90% of their class are full of students that are 23. There are always exceptions

 

[cremaster2007]

By applying to a DO school, too, you are saying "I will think outside the box."

or you will "try" to think outside the box, there are plenty of people at my school who got into an MD school and a DO school and chose the DO route. I know too there are some people here mostly cause they didn't get into an MD school or got wait listed. Either way everyone seems pretty happy overall.

 

[cremaster2007]

In general, I think the differences are due to the type of students they attract. It seems like osteopathic schools have a large percentage of students who are pursuing second careers. Many of these students are in their late 20's/early 30's and are married and/or have children. I think this is why many osteopathic students enter primary care because they have families to think about. Many don't want to enter surgical fields or purse long fellowships after residency for this reason. It's a lot easier to spend 7 years pursuing interventional cardiology when you graduate at the age of 26 versus 32-35.

I think this is also why many people feel DO's are more laid back because they are more mature. Think about it! What were you like when you were 22-23? I'm sure you were a lot more cocky and self-assured than you are in your late 20's or early 30's.

Keep in mind, I did say "in general" so I don't want any responses from 22 year old DO's saying that 90% of their class are full of students that are 23. There are always exceptions

Good point though the average age of my class is 25..........I'm a second year and just turned 23 cause I came on early acceptance so I interviewed when I was like 19.............there's always the black sheep🙁 But you are right the majority of my classmates even if they are 24 or 25 are married and have kids......and there is a strong primary care influence here, though I want to do surgery and feel that I should be ok to do that if it is what I really want to do!

 

[JohnDO]

The entering classes for DO schools does seem to be, on average, a bit older. What affect this has would be hard to say. I would like to see a current osteopathic medical student's response to the question posed by flobber. I can't really speak to the questions because most of what I know is based on the course title and brief description given on the school's website (I haven't started school yet). KCOM's curriculum seems very similar to an allopathic curriculum with the exception of Osteopathic Theory and Methods.

http://www.kcom.edu/newcatalog/program/curriculum.htm

Hopefully an osteopathic medical student can give you a better idea.

 

[HNS]

All I know is that I am tired of hearing DOs complaining about MDs treating them badly and then turning around and degrading the MDs. The Harvard study is showing that MD education should be starting to head tward osteopathy in the way that pts are viewed. Within the next few years there will be, as in reality ther is now, very little if any clinical difference between the two groups of physicians. We need to stop teh disparity and try to work together to better the profession before it is hijacked by others.....

Lets start by combining the match and go from there.

 

[Flobber]

A lot of good points were made here, I'm actually really glad I started this thread. 🙂 Especially about the maturity level and the types of people that actually inhabit DO schools as opposed to MD schools. Sounds like its possible that simply being in an environment where people are more patient-oriented may lend itself to actively thinking about patient service, while allopathic schools, which all but require basic research for admission these days, are geared more toward churning out "scientists". Not that I dislike my curriculum, I think it just leaves patient service more up to the individual, which is kind of a shame, especially when you're talking about so many people that are, rightfully so, self-involved and stressed out. Usually doesn't play out too well...

Anyways, thanks everyone! Its nice that we avoided a MD vs DO thread, too.

P.S. Two super run-on sentences in a row. Wow. Med school has destroyed my grammar.

 

[Dartos Vader]

A lot of good points were made here, I'm actually really glad I started this thread. 🙂 Especially about the maturity level and the types of people that actually inhabit DO schools as opposed to MD schools. Sounds like its possible that simply being in an environment where people are more patient-oriented may lend itself to actively thinking about patient service, while allopathic schools, which all but require basic research for admission these days, are geared more toward churning out "scientists". Not that I dislike my curriculum, I think it just leaves patient service more up to the individual, which is kind of a shame, especially when you're talking about so many people that are, rightfully so, self-involved and stressed out. Usually doesn't play out too well...

Anyways, thanks everyone! Its nice that we avoided a MD vs DO thread, too.

P.S. Two super run-on sentences in a row. Wow. Med school has destroyed my grammar.

Flobber, just wanted to say good work starting a thread that honestly compared DO and MD schools, without anyone getting angry. I've rarely seen that happen on SDN. In my opinion, the people on either side of the fence who spend the most time bashing the other side are the ones who are the most insecure. I used to hear a lot of DO vs. MD stuff but now i mostly just ignore it. I think the thing I like the most about being at a DO school (DMU-COMS) is the increased comfort in physical exams. Since we constantly are putting our hands on other people for OMM, it's not as uncomfortable when we have to do exams on patients that can be a little uncomfortable for the doctor and the patient. Good thread!

 

[Flobber]

Flobber, just wanted to say good work starting a thread that honestly compared DO and MD schools, without anyone getting angry. I've rarely seen that happen on SDN. In my opinion, the people on either side of the fence who spend the most time bashing the other side are the ones who are the most insecure. I used to hear a lot of DO vs. MD stuff but now i mostly just ignore it. I think the thing I like the most about being at a DO school (DMU-COMS) is the increased comfort in physical exams. Since we constantly are putting our hands on other people for OMM, it's not as uncomfortable when we have to do exams on patients that can be a little uncomfortable for the doctor and the patient. Good thread!

Another good point... I'm still an MS1, but I've had some patient contact and I'm still awkward and weird about listening to hearts, taking pulses, etc. Not a very touchy-feely person... I could probably use a dose of OMM training!

 

[Pharos]

i think the whole "DOs treat the whole patient" statement is a bit derrogatory towards MDs. It gives the underlying impression that DOs give more time attention to their patients. This is obviously dependent on a person, not their degree.

I was a bit taken back by this statement as well initially, but once you learn a little about the history of osteopathic medicine, it begins to make more sense. (As someone pointed out earlier, it has to do with the history). I don't think that the "DOs treating people, not just symptoms", "DOs treat the whole patient", etc slogans are intending to slam MDs (or at least I certainly hope not). The osteopathic philosophy was a new outlook in treating the whole patient in a time when allopathic medicine was geared toward a mostly symptom-centered approach. Since this time, the allopathic community has adopted the same patient-centered approach and is very comparable in current times in this respect. It's much like how the osteopathic community eventually realized the merits of pharmaceuticals (once they became of higher value and less dangerous) and began to prescribe their use as the allopathic community did. I'd like to think that the professions have learned from each other over the years in a sort of competitive, yet nurturing rivalry. I don't think it hurts to have two different forms of medicine, just like it doesn't hurt to have different political parties - it helps to keep things in check and balanced. The parties involved, and more importantly the patients they serve, will be better off if the two philosophies can continue learning to work together for the benefit of all as we move forward.

In short, you are correct; both philosophies now stress the patient-centered approach, the differences that occur are a result of individual beliefs and approaches, not the general population. Maybe those slogans are outdated and should be changed (because if one isn't aware of the history behind them, it could be easily perceived as derogatory).

 

[Ice-1]

I've been around tons of allopathic med students in rotations and elsewhere. They (and their MD preceptors) are always talking about treating the whole patient. Once I told them that they wee all just a bunch of osteopaths and didn't know it and all felt complimented. There really isn't that much philospohical difference between allopathy and osteopathy re patient care any more. But I have noticed (after being in clinics with them) that most allopathic students aren't as far along in palpatory skills- not their fault, since they don't get as much practice in school as osteopaths.

 

[puddlejumper]

I think both MD's and DO's are capable of treating patients equally well. I do think, however, that DO students are more comfortable touching patients, in the beginning at least. Touching classmates and getting involved in community OMT events as a first year student, forces you to go beyond your comfort zones. I don't even think about the awkwardness of touching anymore. It's automatic that if someone is ill, you touch them to give you clues to figure out why.

 

[OSUdoc08]

I think both MD's and DO's are capable of treating patients equally well. I do think, however, that DO students are more comfortable touching patients, in the beginning at least. Touching classmates and getting involved in community OMT events as a first year student, forces you to go beyond your comfort zones. I don't even think about the awkwardness of touching anymore. It's automatic that if someone is ill, you touch them to give you clues to figure out why.

This is particularly true because D.O. students are spending a couple of hours a week doing hands on palpation and treatment.

This is why you will find that those with much more experience with palpation are better diagnosticians, and will require less use of expensive lab tests and procedures.

 

[Hernandez]

This is particularly true because D.O. students are spending a couple of hours a week doing hands on palpation and treatment.

This is why you will find that those with much more experience with palpation are better diagnosticians, and will require less use of expensive lab tests and procedures.

yup, except for the half of the class that still can't feel anything.......

 

[OSUdoc08]

yup, except for the half of the class that still can't feel anything.......

It's not their fault they get "fluffy" partners.