Whats wrong with a D.O.?

[Beau Geste]

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T






And yes, EBM is still taught. Pt will still get beta-blocker, ASA, nitro, and cathed with an MI. Pt with diabetes will still be put on an ACEI. Whether or not to treat an ear infection in an infant greater than 6 months of age is still being debated. Believe it or not, standard of care is no different between an osteopathic emergency physician and an "allopathic" emergency physician.

OMM is still being researched. Cranial is the ugly step-child that no one wants to talk about. But the vast majority of education in undergraduate medical and postgraduate medical ... are standard stuff that is no different from MD/DO.

I think this is probably true in most clinical settings, and definitely true from what I've seen. I have a DO PCP and the ER doc I've seen here in town is a DO and they don't have any outrageous rx that an MD wouldn't make.

 

[Beau Geste]

And because of what I just wrote, I'm applying both to MD and DO schools, especially since I'm not out to be the Surgeon General, just to find a nice niche and do my job.

 

[Jack Daniel]

I think the key words here are "in practice". In school there actually may be a difference.

It's my understanding that MD schools do not hold to any philosophy, preferring that everything be subject to evidence-based medicine. However, DO schools, while certainly teaching evidence-based medicine, also stress 4 principles which form the osteopathic philosophy. This is taught in all 26 schools. While MD programs probably teach the same principles, especially ones that focus on primary care as a mission, I don't think all the MD schools emphasize them or have them integrated into the curriculum.

I don't know what those principles are but I hope they're not magical principles. The only magic in medicine is your ability to talk to patients and convince them to do what you think is best for their health.

I have no idea what you mean by this. I guess our philosophy of finally taking medicine out of the dark-ages by subjecting every aspect of it to scientific review might not be much of a philosophy, earning us no points from the ignoratti, but I'm thinking we're going to stick to it.

The principles I wrote about have been well clarified by group_theory's post. As you can see, they're certainly not mysterious and they're certainly not private knowledge of the osteopaths. It's a common sense approach to medicine. When I say these principles are taught in DO schools as the osteopathic philosphy, I mean that each of the 26 schools presents these four tenets to the students as a part of the curriculum. Do all of the ~125 MD schools do this? Probably not. Why? Because they don't subscribe to a single philosphy. Is this a bad thing? Nope.

As for magic in medicine, as you put it, you forgot to include craniosacral therapy in addition to patient compliance.

Finally, from the tone of your last response, it seems you think I'm bashing evidence-based medicine. Believe me, I'm not. I agree both DO and MD programs use EBM to provide the same standard of care.

 

[Faze2]

I think this is probably true in most clinical settings, and definitely true from what I've seen. I have a DO PCP and the ER doc I've seen here in town is a DO and they don't have any outrageous rx that an MD wouldn't make.

It's funny you should say that. I was going to post this earlier. There is this doc in the ER I work in who has been here for while. Today their was a trauma, GSW to the head, and he was the one charge telling everyone what to do and where to go. (Except for the attendings of course) But he is usually the guy in charge of all the traumas, and I believe he is actually the chief resident. I usually don't see him in his white coat, but today he had it on. I happened to read it and sure enough it said D.O.

I guess the point is, he is a doctor, plain and simple, and he does the EXACT same thing as the other ER MD docs. He is resepcted and looked at as an equal. No one questions his treatment (patients or staff) because he got his medical degree from an Osteopathic school. He is "Dr. X" not "D.O. X"

 

[CatsandCradles]

While it is true that there are too many DO FM residency positions (as evidenced by the # that are left open after the match & scramble), there are other things at play here.

1) As already mentioned, when med students and residents have been polled, location is the #1 factor in choosing residency programs of interest. This is true on both the DO and MD sides. That is a big reason why you'll find a lot of DOs in MD primary care residencies like FM & IM.

2) There are DO residencies in nearly every specialty (I know, for example, that we don't have any in pathology anymore). True there aren't many spots in some very competitive specialties, but there aren't many DOs taking up MD positions in those specialties either.

I know back in the 90s they axed a lot of the funding - but I thought NSU still has a pathology residency program. At least its listed on the AOA residency/OPTI site.

 

[mitawa]

And because of what I just wrote, I'm applying both to MD and DO schools, especially since I'm not out to be the Surgeon General, just to find a nice niche and do my job.

In case you were out to be a Surgeon General, note that the former surgeon general of the US Army was a DO.

 

[dctrgreen]

😴 😴 😴 😴 😴 😴

can someone just put me out of my misery...do not care if you are D.O. or M.D.

 

[oldpro]

I was just reading all about osteopathic and I think I like their philosophy better. However, with reading everybody's posts most people seem to think the allopathic is better and is a better education. Am I not hearing everything about D.O. school? Or are allohpathic just better?

This has been beat to death and DO versus MD is really useless since you have to be accepted into both for a choice. That said

DO you have to learn a philosophy that is a little different then MD, as others said, OMM

MD is changing to include the whole patient approach I know I have been taught that in Basic sci here at the end.

Really it comes down to a personal choice, I for one do not like the OMM, that does not mean it's right or wrong (PLease lets be mature) I just do not believe in it enough to want to practice it or learn it. I have had arguments that it is ok to go DO if you do not believe nor want to be DO and I have the belief that you must embrace your teaching to do well, many premeds just give me hell and tell me I'm wrong and DO is just another way to MD practice. To me thats not the right attitude, you should be proud to be a DO.

Anything worth doing is worth doing and enjoying it, why else work this hard?

So bottom line is I think you should become a DO not because its second choice but because it's what you want to do.

 

[ForbiddenComma]

I predict that within 20 years, the degree of D.O. will be abolished and graduates of osteopathic schools will be called M.D... as they probably should be. There is now only slight difference between the degrees (D.O. is more primary-care oriented, M.D. has a little more science) but even those differences will disappear in a generation. OMM will probably become an elective at osteopathic schools, and M.D. schools will further embrace the holistic, feel-good "treat the patient, not the disease" model. Former COMs will just be M.D. schools that focus more on primary care.

And most importantly... there will be no more D.O. vs. M.D. threads on SDN!

 

[QofQuimica]

And most importantly... there will be no more D.O. vs. M.D. threads on SDN!

If that day ever comes, we'll seriously have nothing left to talk about on SDN, save for the "what are my chances" threads.

 

[oldpro]

I predict that within 20 years, the degree of D.O. will be abolished and graduates of osteopathic schools will be called M.D... as they probably should be. There is now only slight difference between the degrees (D.O. is more primary-care oriented, M.D. has a little more science) but even those differences will disappear in a generation. OMM will probably become an elective at osteopathic schools, and M.D. schools will further embrace the holistic, feel-good "treat the patient, not the disease" model. Former COMs will just be M.D. schools that focus more on primary care.

And most importantly... there will be no more D.O. vs. M.D. threads on SDN!

It can't come soon enough for me................Really I'm just tired of seeing these threads, to me it's really if you are accepted, this isn't as easy to pick as a Caribbean school where most times most can be accepted, US schools and the system does not allow such a choice for most.

 

[Taty]

If that day ever comes, we'll seriously have nothing left to talk about on SDN, save for the "what are my chances" threads.

Lol 🙂

 

[Haemulon]

You know, I support this idea of merging the two. After all, if there is really no difference between DO and MD, then there is no need for two separate degrees.

Obviously the only true difference in training is OMM, and maybe slightly different emphases in other coursework (but all the basics are the same). If MD programs offered OMM as well (and I don't think they should require it, but just offer it as maybe an elective track or something) then there really would be nothing special/different being offered by osteopathic programs. A large percentage of DO's never actually incorporate OMM into their practice anyway. I should also say that I discount the idea of "treating the whole patient" as a difference because any good physician should be doing this anyway, allopathic or osteopathic.

I respect the training of DO's just have a hard tme understanding the need for two completely different sets of training if they both end up at the same place. Oasteopathy started because of perceived problems with the state of medicine, but medicine has come a long way in the past century.

 

[ExtremeUnderdog]

I predict that within 20 years, the degree of D.O. will be abolished and graduates of osteopathic schools will be called M.D... as they probably should be. There is now only slight difference between the degrees (D.O. is more primary-care oriented, M.D. has a little more science) but even those differences will disappear in a generation. OMM will probably become an elective at osteopathic schools, and M.D. schools will further embrace the holistic, feel-good "treat the patient, not the disease" model. Former COMs will just be M.D. schools that focus more on primary care.

And most importantly... there will be no more D.O. vs. M.D. threads on SDN!

In principle I could not agree more... if it looks like a duck and it quacks like a duck... but sadly as nonsensical as the divide is becoming with time (and I agree with you that it will become even more unsubstantiated in the future), let's not forget the "leadership". There are governing bodies - carefully built administrative bureaucracies, which will defend their turf with an obsessive ferocity... that's just the nature of the beast. 🙄

 

[albaniandoc]

I was set on DO when I started the application process but soon changed my mind. This happened for several reasons:

1. When I checked with AOA, DOs do not have practice privileges in my home country. (that was number 1 reason)
2. I decided to specialize and thought that my best option to go to a prestigious residency would be to go MD.
3. The cost of some DO schools as compared to most MD state schools are outrageous.
4. Decided that I did not want to explain to people every day that DOs are real doctors. My parents are still not convinced (my parents are from the old country).

My first and foremost reason is not being able to practice internationally. But if I didn't get any Md acceptances I would have been extremely happy with NSU-COM. NSU is an awesome awesome school.

 

[Haemulon]

In principle I could not agree more... if it looks like a duck and it quacks like a duck... but sadly as nonsensical as the divide is becoming with time (and I agree with you that it will become even more unsubstantiated in the future), let's not forget the "leadership". There are governing bodies - carefully built administrative bureaucracies, which will defend their turf with an obsessive ferocity... that's just the nature of the beast. 🙄

Very true. I still have no idea why MD graduates cannot apply for DO residencies, for instance, unless it is merely because of the leadership. If both programs provide equivalent training, and if DO and MD residencies produce equivalently certified specialists, then there is no reason why it should be like that. Training or lack of training in OMM certainly has no bearing on whether one can be a competant dermatologist, or surgeon, or cardiologist, etc ... And if DO grads can learn everything they need to know from MD residencies, then clearly OMM is not a particularly important part of residency training. Thus, there is no logical reason MD's should be banned from DO residencies. Ah well. Somethings just are the way they are. I just wish they would make up their mind. Either the degrees provide the same training and competancy or they don't. Can't have it both ways.

 

[albaniandoc]

Very true. I still have no idea why MD graduates cannot apply for DO residencies, for instance, unless it is merely because of the leadership. If both programs provide equivalent training, and if DO and MD residencies produce equivalently certified specialists, then there is no reason why it should be like that. Training or lack of training in OMM certainly has no bearing on whether one can be a competant dermatologist, or surgeon, or cardiologist, etc ... And if DO grads can learn everything they need to know from MD residencies, then clearly OMM is not a particularly important part of residency training. Thus, there is no logical reason MD's should be banned from DO residencies. Ah well. Somethings just are the way they are. I just wish they would make up their mind. Either the degrees provide the same training and competancy or they don't. Can't have it both ways.

Again, I think NSU is the first DO school to have a residency program that is open to both DOs and MDs. I think it's in preventive medicine.

 

[CatsandCradles]

Again, I think NSU is the first DO school to have a residency program that is open to both DOs and MDs. I think it's in preventive medicine.

Really?

This is new to me. I thought that osteopathic residency programs will not allow allopathic graduates into DO residencies.

I am a DO student and think that it is wrong that an MD cannot apply to a DO program.

So I hope you are correct.

 

[pushinepi2]

Before intubating people on my Trauma anesthesia rotation, I perform a cranial examination to assess for any underlying sphenoid bone dysfunction. I then paralyze my patients before they have the chance to ask what the "DO" letters stand for on my ID badge.

Technically speaking, it is good to remember several key factoids:

1) Even farm-raised / pure bred allopaths have trouble getting into 'competitive' residencies.

2) Strictly speaking, there is NO difficulty in securing state licensure in the United States. It may be easier for internationally minded graduates to earn reciprocity, but my classmates have had NO trouble working overseas as an American trained osteopathic physician.

3) There most definitely is prejudice out there, and DO's may occasionally be asked to explain the subtle differences in their education. The bottom line, however, is that there is absolutely NO difference in practice. I can say with complete confidence that I've not met with any professional disrespect during any of my rotations.

Good luck with the application process,

-Push

 

[pushinepi2]

Really?

This is new to me. I thought that osteopathic residency programs will not allow allopathic graduates into DO residencies.

I am a DO student and think that it is wrong that an MD cannot apply to a DO program.

So I hope you are correct.

Cats is correct. The preventive medicine program at the Palm Beach County Public Health Unit accepts MDs and DOs because it is a DUALLY accredited program (ACGME/AOA). Unfortunately, programs that are only AOA sanctioned do not permit MD applicants. That is a source of continued debate and consternation.

-P

 

[albaniandoc]

Cats is correct. The preventive medicine program at the Palm Beach County Public Health Unit accepts MDs and DOs because it is a DUALLY accredited program (ACGME/AOA). Unfortunately, programs that are only AOA sanctioned do not permit MD applicants. That is a source of continued debate and consternation.

-P

That was one of the main reasons I loved NSU-COM. There are DO schools that are almost cult-like about the osteopathic profession and then schools like NSU are very open to both MD and DOs. There was no attitude like DOs are the best and MDs do not know what they are doing. I loved the idea of having MD professors in a DO school.