What is the distinction between MD and DO?

[12glaucoma34]

This isn't intended to tear down the DO profession.

Going into medical school, I thought the difference between MD and DO was the musculoskeletal and manipulation aspects, ya know, OMM.

However, the "Doctors that DO" campaign is a bit confusing (to say the least) because on the website and magazine advertisements, these types of statements are made:

"Doctors of Osteopathic Medicine are complete physicians who practice in every medical specialty. DOs are trained to first consider the person within the patient."

"It makes a difference when your physician is trained to truly listen. To pay more attention to you than your chart. To take the time to get to know you as a whole person."

Lets carefully analyze the second quote. First, there are only two types of physicians....MD and DO. By stating DOs "truly listen" and "pay more attention" and "get to know you as a whole person" is equivalent to stating MDs do not do these things.

BTW, could someone explain what is meant by "whole person" or "whole person healthcare?" I find those talking points to be undefined.

"DOs believe good health is about more than the absence of pain or illness. Preventive medicine is at the heart of our holistic approach toward wellness. We aim to help patients be truly healthy in mind, body and spirit."

Again, does that mean MDs don't?

I find this whole series of talking points to be all smoke and mirrors. Can anyone cite specifically how the DO training as more adequate than MD training in regards to any of these aspects?

As a DO student, I don't understand how any of my training has prepared me to better listen, pay more attention, or treat the whole person.

Home - Doctors That DO | Doctors of Osteopathic Medicine

---

Members don't see this ad.

 

[ortnakas]

I don't think anyone on SDN (pro-DO included) is really in favor of this ad campaign.

 

[12glaucoma34]

I don't think anyone on SDN (pro-DO included) is really in favor of this ad campaign.

Who is in favor of this campaign? Is it just a few people at the AOA separated from reality. This type of crap is exactly why I have little desire to maintain my AOA membership. The AOA doesn't seem to represent most physicians in general.

 

[BorntobeDO?]

This kind of ad campaign is why people think we are like their Chiropractor or an ND when we try to explain what a DO is. We are just Doctors, freakin real doctors who do residency, surgery, prescriptions, and everything else MDs do plus OMM. Its like the AOA wants us to get confused with other 'practitioners' who have basically no scope compared to us.

 

[zero0]

Meaningless fluff. Pay it no mind. The difference is OMM, worse clinicals (courtesy of COCA), and an extra garbage board exam you have to take. Still better than waiting an extra year to matriculate imo.

 

[Kkshake]

Honestly, what they're trying to put out there is that MDs treat the illness, DOs treat the patient....Sometimes it's true, sometimes it's not. It's whatever you decided to do with your degree and how you wish to practice, patient centered approach or illness centered approach...Many DOs agree (despite schools not admitting it) that there is no difference between a DO and MD aside from OMM.

 

[12glaucoma34]

Meaningless fluff. Pay it no mind. The difference is OMM, worse clinicals (courtesy of COCA), and an extra garbage board exam you have to take. Still better than waiting an extra year to matriculate imo.

Completely agree with the bold text. After my MCAT retake, my application was easily competitive for MD schools, but I didn't get scores back soon enough to apply to many of the MD schools I wanted. I wouldn't change to MD if it meant I would only be a 3rd year now.

 

[12glaucoma34]

Honestly, what they're trying to put out there is that MDs treat the illness, DOs treat the patient....Sometimes it's true, sometimes it's not. It's whatever you decided to do with your degree and how you wish to practice, patient centered approach or illness centered approach...Many DOs agree (despite schools not admitting it) that there is no difference between a DO and MD aside from OMM.

I think it is more doctor dependent than degree dependent.

 

[12glaucoma34]

This kind of ad campaign is why people think we are like their Chiropractor or an ND when we try to explain what a DO is. We are just Doctors, freakin real doctors who do residency, surgery, prescriptions, and everything else MDs do plus OMM. Its like the AOA wants us to get confused with other 'practitioners' who have basically no scope compared to us.

Patient: What is the difference between DO and MD?

Me: We do everything MDs do plus manipulation [patient only hears manipulation]

Patient: Oh.....um....so you're like a chiropractor?

Me: No, chiropractors don't practice medicine like MDs and DOs

And the rest of the conversation is about the difference between DOs and chiropractors.

 

[IsWhat]

The only thing which separates MDs from DOs is OMT. Interestingly, I recently found out that after the GME merger there will be a push to increase 'crash' courses for MDs to learn and ultimately bill for OMT procedures. The whole point of the DO degree existing is literally being tossed down the toilet. I can't figure out if this is just poor DO leadership, or if this is a planned coup by the LCME/ACGME.

 

[Kkshake]

Does that mean MDs will have to take the COMLEX if they're learning OMM?

 

[CoomassieBlue57]

This kind of ad campaign is why people think we are like their Chiropractor or an ND when we try to explain what a DO is. We are just Doctors, freakin real doctors who do residency, surgery, prescriptions, and everything else MDs do plus OMM. Its like the AOA wants us to get confused with other 'practitioners' who have basically no scope compared to us.

Actually I think it has done a poor job at associating DO with chiropractors for people who don't know DOs even exist. I've overheard heard plenty of conversations from random people who talk about back pain or whatever, and say "I need to go see a chiropractor". Never have I heard a conversation where they say I need to go see a DO. This could be a good thing (not associating with chiropractors), or a bad thing (we're forced to learn OMM, yet many don't use it).

If they actually wanted to take over the manipulative field they should start focusing on the choose DO over chiropractor. I'm glad they don't do this though.

 

[CoomassieBlue57]

Does that mean MDs will have to take the COMLEX if they're learning OMM?

No. COMLEX nor USMLE have anything to do with residencies, but rather state licensure to practice. If an MD applies to a residency that has "Osteopathic Distinction" (an old DO residency or a MD residency that wants to attract DOs), they will have to provide some sort of demonstration of interest in Osteopathy i.e. a short course or something along those lines.

 

[12glaucoma34]

The only thing which separates MDs from DOs is OMT. Interestingly, I recently found out that after the GME merger there will be a push to increase 'crash' courses for MDs to learn and ultimately bill for OMT procedures. The whole point of the DO degree existing is literally being tossed down the toilet. I can't figure out if this is just poor DO leadership, or if this is a planned coup by the LCME/ACGME.

OMT is not a good reason IMO for there to be two separate degrees. There is nothing inherently difficult about OMT that requires separate training. I appreciate history and am not for the idea of making all DO schools MD, but the idea we need two separate accrediting bodies and board examinations is purely political. An MD could learn OMT very quickly and it doens't require going to a DO school. And if OMT is so effective, why wouldn't we want as many physicians as possible to use it?

The leadership has been poor and not represented the DOs well says almost every DO I have ever spoke with about this matter.

 

[12glaucoma34]

Actually I think it has done a poor job at associating DO with chiropractors for people who don't know DOs even exist. I've overheard heard plenty of conversations from random people who talk about back pain or whatever, and say "I need to go see a chiropractor". Never have I heard a conversation where they say I need to go see a DO. This could be a good thing (not associating with chiropractors), or a bad thing (we're forced to learn OMM, yet many don't use it).

If they actually wanted to take over the manipulative field they should start focusing on the choose DO over chiropractor. I'm glad they don't do this though.

Agree, just mentioning DO and chiropractor in the same sentence does not do the DO degree any favors.

I believe the reason why most (over 95%) don't regularly use OMT on patients is because of its questionable effectiveness and it is time consuming. I know several DO physicians who regularly refer to chiropractors.

I believe that much of OMT is below the skills we are trained to use. We are trained as physicians, not physical therapists or massage therapists. It is a waste of resources for the highest trained medical providers to be wasting time on OMT when they could be done far more valuable work.

 

[IsWhat]

OMT is not a good reason IMO for there to be two separate degrees. There is nothing inherently difficult about OMT that requires separate training. I appreciate history and am not for the idea of making all DO schools MD, but the idea we need two separate accrediting bodies and board examinations is purely political. An MD could learn OMT very quickly and it doens't require going to a DO school. And if OMT is so effective, why wouldn't we want as many physicians as possible to use it?

The leadership has been poor and not represented the DOs well says almost every DO I have ever spoke with about this matter.

You are exactly right. My only frustration with the whole thing is the fact DO students spend a lot of time learning OMT - and taking a separate board exam - during medical school when MDs will be able to just take a 'crash course' later on in their training. The politics of keeping the degrees separate always hinged on OMT and the Osteopathic philosophy. Is there even an argument for keeping the degrees separate anymore?

 

[IslandStyle808]

This isn't intended to tear down the DO profession.

Going into medical school, I thought the difference between MD and DO was the musculoskeletal and manipulation aspects, ya know, OMM.

However, the "Doctors that DO" campaign is a bit confusing (to say the least) because on the website and magazine advertisements, these types of statements are made:

"Doctors of Osteopathic Medicine are complete physicians who practice in every medical specialty. DOs are trained to first consider the person within the patient."

"It makes a difference when your physician is trained to truly listen. To pay more attention to you than your chart. To take the time to get to know you as a whole person."

Lets carefully analyze the second quote. First, there are only two types of physicians....MD and DO. By stating DOs "truly listen" and "pay more attention" and "get to know you as a whole person" is equivalent to stating MDs do not do these things.

BTW, could someone explain what is meant by "whole person" or "whole person healthcare?" I find those talking points to be undefined.

"DOs believe good health is about more than the absence of pain or illness. Preventive medicine is at the heart of our holistic approach toward wellness. We aim to help patients be truly healthy in mind, body and spirit."

Again, does that mean MDs don't?

I find this whole series of talking points to be all smoke and mirrors. Can anyone cite specifically how the DO training as more adequate than MD training in regards to any of these aspects?

As a DO student, I don't understand how any of my training has prepared me to better listen, pay more attention, or treat the whole person.

Home - Doctors That DO | Doctors of Osteopathic Medicine

It hasn't. You could do all of the following as an MD, yes even take courses in OMM. These advertising campaigns are nothing more than "sound bites" to make DOs look like something distinct from everyone else, when we really aren't.

 

[12glaucoma34]

You are exactly right. My only frustration with the whole thing is the fact DO students spend a lot of time learning OMT - and taking a separate board exam - during medical school when MDs will be able to just take a 'crash course' later on in their training. The politics of keeping the degrees separate always hinged on OMT and the Osteopathic philosophy. Is there even an argument for keeping the degrees separate anymore?

The main argument is probably that with out DO schools, OMT will essentially vanish because so few DOs actually use it and virtually no MDs do.

We spend so much time learning OMT because much of it contains useless information and content that is frankly embarrassing to our profession. Examples include cranial, counterstrain, and a bunch of the other direct/indirect treatments. Really, has anyone ever seen or heard of a physician diagnosing the tibia with internal rotation preference or the clavicle with inferior glide, this crap is just ignorant and garbage.

 

[12glaucoma34]

No. COMLEX nor USMLE have anything to do with residencies, but rather state licensure to practice. If an MD applies to a residency that has "Osteopathic Distinction" (an old DO residency or a MD residency that wants to attract DOs), they will have to provide some sort of demonstration of interest in Osteopathy i.e. a short course or something along those lines.

Is it required to be DO to bill for OMT? I could see an MD picking the useful parts of OMT and billing for them.

 

[AnatomyGrey12]

Is it required to be DO to bill for OMT? I could see an MD picking the useful parts of OMT and billing for them.

No but you have to have taken an official course. Our OMM lab the other day was lead by an MD

 

[12glaucoma34]

No but you have to have taken an official course. Our OMM lab the other day was lead by an MD

Who does these "official courses" and how and why would an insurance company care if an MD or DO did the treatment? I'm surprised that health insurance covers OMT and chiropractic to begin with. Charging for cranial manipulation is analogous to fraud.

 

[flasheroonie]

There's no bloody difference between MDs and DOs. DOs just learn to do a few extra things with their hands that may help some patients. (I'm an MD)

 

[GUH]

OMT is not a good reason IMO for there to be two separate degrees. There is nothing inherently difficult about OMT that requires separate training. I appreciate history and am not for the idea of making all DO schools MD, but the idea we need two separate accrediting bodies and board examinations is purely political. An MD could learn OMT very quickly and it doens't require going to a DO school. And if OMT is so effective, why wouldn't we want as many physicians as possible to use it?

The leadership has been poor and not represented the DOs well says almost every DO I have ever spoke with about this matter.

There doesn't need to be a good reason for there to be two separate degrees. DMD and DDS are the same and nobody makes a fuss.
Don't go to a DO school if you don't want to be a DO. SDN is full of wishful thinkers who want an MD but never earned it and they think the way to do it is to argue that the DO degree shouldn't exist.

 

[GUH]

Who does these "official courses" and how and why would an insurance company care if an MD or DO did the treatment? I'm surprised that health insurance covers OMT and chiropractic to begin with. Charging for cranial manipulation is analogous to fraud.

Not all OMT is cranial. It's perfectly reasonable to bill insurance for evidence-based OMT for indications such as chronic low back pain.

 

[pseud0]

In reality its just MD with OMT but whenever your school asks you (on an exam, etc) you have to say the whole "we're more *~holistic*~" spiel because reasons

 

[IsWhat]

There doesn't need to be a good reason for there to be two separate degrees. DMD and DDS are the same and nobody makes a fuss.
Don't go to a DO school if you don't want to be a DO. SDN is full of wishful thinkers who want an MD but never earned it and they think the way to do it is to argue that the DO degree shouldn't exist.

I don't know about that... I'm someone who wants to be a DO, which is why I am allowed to be critical of the Osteopathic leadership basically throwing away any leg they had to stand on for 'distinction'. The whole 'treat the person not the disease' thing doesn't fool anyone - at least OMT is a tangible set of skills. I understand MDs have been able to learn OMT for a long time, but the AOA will now be actively recruiting MDs to learn OMT. It makes the whole system seem completely silly to me.

From what I understand the DMD/DDS degrees don't actively try to set themselves apart from each other. Pretty big difference.

 

[W19]

I don't know about that... I'm someone who wants to be a DO, which is why I am allowed to be critical of the Osteopathic leadership basically throwing away any leg they had to stand on for 'distinction'. The whole 'treat the person not the disease' thing doesn't fool anyone - at least OMT is a tangible set of skills. I understand MDs have been able to learn OMT for a long time, but the AOA will now be actively recruiting MDs to learn OMT. It makes the whole system seem completely silly to me.

From what I understand the DMD/DDS degrees don't actively try to set themselves apart from each other. Pretty big difference.

Well, NP use it to fool the general public.

 

[IsWhat]

Well, NP use it to fool the general public.

I don't think NPs really 'fool' anyone. It's more the lobbyists for nursing in Washington, DC and various states around the country are really quite powerful.

 

[DrfluffyMD]

Here's what I would want.

All MD and DO schools grant MDs, all DO schools to be accredited by LCME and need to meet LCME standard.

All students take the USMLE.

COCA remains, but only to oversee the osteopathic portion of education in historically DO schools.

Amend the laws so that DO becomes an additional degree MD students at historicallly DO schools earn. All previously DO students now earn two degrees: MD and DO.

The DO degree is now only responsible for the osteopathic part, and students take a separate DO board exam after first year.

No more OMT in second year and on as the MD, DO students already earned their DO degree.

 

[W19]

Leave OMT for Chiro i.e. fake doctor... DO are not Chiro.

 

[hallowmann]

The main argument is probably that with out DO schools, OMT will essentially vanish because so few DOs actually use it and virtually no MDs do.

We spend so much time learning OMT because much of it contains useless information and content that is frankly embarrassing to our profession. Examples include cranial, counterstrain, and a bunch of the other direct/indirect treatments. Really, has anyone ever seen or heard of a physician diagnosing the tibia with internal rotation preference or the clavicle with inferior glide, this crap is just ignorant and garbage.

Leave OMT for Chiro i.e. fake doctor... DO are not Chiro.

There seems to be a very narrow view of OMT espoused throughout this thread.

First off, OMT wouldn't disappear without US DOs. It already exists and is well established in PT and other fields. Whenever you send your patients to PT, remember that they'll be getting plenty of manipulations, stretches, and exercise Rx that you learned in your OMM classes.

Second, Chiro pretty much relies purely on HVLA (or even HVHA) and has along with it an anti-evidence and anti-medications culture that OMM in general doesn't share.

Third, counterstrain actually works quite well when I use it. Granted I ignore the predetermined tender points, and find my own based on anatomy and the musculature of the patient, but still the actual technique (indirect, relaxation, passive return) works pretty well on a lot of people. When you have the patience for it, it works.

Now as far as the ad campaign goes, it was started because the AOA hired a famous PR agency to run a pro-DO campaign and this is what they came up with. It's a basic ad campaign. I really don't get why people get all worked up about it. Most ad campaigns are stupid, this is no exception.

Personally, it annoys me that this is even a new thread. We've had at least 3 threads discussing this ad campaign, and I swear this one feels like deja vu with all the same talking points.

 

[zero0]

Leave OMT for Chiro i.e. fake doctor... DO are not Chiro.

Some OMT is legit and some isn't. Chiros didn't get their reputation from using OMT. They got it from peddling stuff like this...

http://www.worldwidehealthcenter.net/treatments-using-natural-cures/flush-gall-stones-naturally/

Website is by an ND but tons of chiros advocate this "treatment"...

Don't go buying those epsom salts just yet though...

The Truth about Gallbladder and Liver "Flushes"

 

[deleted407021]

There seems to be a very narrow view of OMT espoused throughout this thread.

First off, OMT wouldn't disappear without US DOs. It already exists and is well established in PT and other fields. Whenever you send your patients to PT, remember that they'll be getting plenty of manipulations, stretches, and exercise Rx that you learned in your OMM classes.

Second, Chiro pretty much relies purely on HVLA (or even HVHA) and has along with it an anti-evidence and anti-medications culture that OMM in general doesn't share.

Third, counterstrain actually works quite well when I use it. Granted I ignore the predetermined tender points, and find my own based on anatomy and the musculature of the patient, but still the actual technique (indirect, relaxation, passive return) works pretty well on a lot of people. When you have the patience for it, it works.

Now as far as the ad campaign goes, it was started because the AOA hired a famous PR agency to run a pro-DO campaign and this is what they came up with. It's a basic ad campaign. I really don't get why people get all worked up about it. Most ad campaigns are stupid, this is no exception.

Personally, it annoys me that this is even a new thread. We've had at least 3 threads discussing this ad campaign, and I swear this one feels like deja vu with all the same talking points.

This.

Chiropractors have little transparency in how they're trained, but in practice mostly they just crack backs so we can assume they don't get the breadth of training in manipulation that we do. The PT point is excellent -- having shadowed an orthopedic surgeon and peeked at what his PT colleagues we doing, it looked like they we doing ME, HVLA and postural examinations, palpation, etc.

I'm sure the actual impact this ad campaign has is very small. I live in a big city and have seen absolutely zilch. Sure, it could be better but it's cute enough and no one cares aside from the neurotics on SDN.

 

[Neopolymath]

The issue is that it is embarrassing, not merely stupid. It's transparent, cringe-worthy, and the dialogue transitions to differentiating between DO physicians and other professions that aren't MD (you know... the people we are trying to prove we are just as good as). Awareness could have been achieved in so many better ways.

 

[BorntobeDO?]

Patient: What is the difference between DO and MD?

Me: We do everything MDs do plus manipulation [patient only hears manipulation]

Patient: Oh.....um....so you're like a chiropractor?

Me: No, chiropractors don't practice medicine like MDs and DOs

And the rest of the conversation is about the difference between DOs and chiropractors.

I think I am going back to comparing DDS/DMD to DO/MD. Any time I bring up manipulation it goes down the wrong track also. People when they find out there are two ways to become a dentist, at least seem to understand that, and then they get the DO thing. Just another way to become a doctor.

 

[Giovanotto]

I'm going to get made fun of for saying this, but I'm a firm believer in the fact that the name of our degree "DO" is one of the main issues here. We are not Doctors of Osteopathic medicine, or rather, I sure as hell won't be when I graduate. I'll be a MEDICAL doctor that also spent some time learning OMM. Therefore, the degree at the very least should be called MDO a la Medical doctor of osteopathy, which is still inaccurate, but at least we are including the part that I'm a medical doctor. "Doctor of Osteopathic Medicine" sounds like a PhD degree in PT or kinesiology and I can never blame people for being confused about what a DO is/does.

 

[Light at end of tunnel]

Who does these "official courses" and how and why would an insurance company care if an MD or DO did the treatment? I'm surprised that health insurance covers OMT and chiropractic to begin with. Charging for cranial manipulation is analogous to fraud.

Perhaps she told it like it really is all too well.

Ruffled too many feathers.

RIP.

 

[Misrepresenting Reality]

Perhaps she told it like it really is all too well.

Ruffled too many feathers.

RIP.

Happens over and over and over on SDN while they pose as a welcome place to foster discussion about different ideas and perspectives. Completely fake and misleading.

 

[Misrepresenting Reality]

There doesn't need to be a good reason for there to be two separate degrees. DMD and DDS are the same and nobody makes a fuss.
Don't go to a DO school if you don't want to be a DO. SDN is full of wishful thinkers who want an MD but never earned it and they think the way to do it is to argue that the DO degree shouldn't exist.

Nowhere did the opening post state anything about wanting to be DO instead of MD, what are you referring to? The amount of work to earn a DO degree is the same as MD, it isn't like DNPs taking the easy road to be called doctors. No one said the DO degree shouldn't exist. It should continue to exist. The politics of how the degree programs are operated and advertised is the problem.

 

[Misrepresenting Reality]

I'm going to get made fun of for saying this, but I'm a firm believer in the fact that the name of our degree "DO" is one of the main issues here. We are not Doctors of Osteopathic medicine, or rather, I sure as hell won't be when I graduate. I'll be a MEDICAL doctor that also spent some time learning OMM. Therefore, the degree at the very least should be called MDO a la Medical doctor of osteopathy, which is still inaccurate, but at least we are including the part that I'm a medical doctor. "Doctor of Osteopathic Medicine" sounds like a PhD degree in PT or kinesiology and I can never blame people for being confused about what a DO is/does.

What do you mean, didn't your school teach you how to do an osteopathic physical exam? Personal preference, but I would rather be DO than MDO.

I think a more effective ad campaign would involve advertising with MD and DO next to each other so those unaware of DOs would conceptualize them as equivalent instead of the DOs treat the WHOLE patient.

 

[GUH]

No one said the DO degree shouldn't exist....

Literally though

...Therefore, the degree at the very least should be called MDO a la Medical doctor of osteopathy, which is still inaccurate, but at least we are including the part that I'm a medical doctor...

 

[Misrepresenting Reality]

Literally though

??

Not all OMT is cranial. It's perfectly reasonable to bill insurance for evidence-based OMT for indications such as chronic low back pain.

It is also perfectly acceptable (legally, not ethically in my opinion) to bill for cranial. There is nothing evidence based about cranial.

 

[GUH]

??



It is also perfectly acceptable (legally, not ethically in my opinion) to bill for cranial. There is nothing evidence based about cranial.

So yes; people are arguing that the DO degree shouldn't exist.
And I never said that cranial was evidence-based. But not all OMM is cranial.

 

[Reveler]

MD student here. I've worked with several visiting DO students and DO residents on rotations. There's absolutely no palpable difference in their approach to patients. Once the merger takes place, the differences will be further blurred. I understand that the individual school confers the degree, but wouldn't it be nice to have the ability to switch from DO to MD after residency completion if so desired? I have several friends at DO schools that often fantasize about that prospect..


Sent from my iPhone using SDN mobile

 

[kenjixshadow]

 

[Peach Newport]

View attachment 223015

Can we make that image a sticky?