Why do you, honestly, want to be a DO?

[Praxis8]

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Caribbean schools are those cars that you cannot bring back to the US without making major modifications, think Proton Renault and Citroen. LOL. Or that Korean car that got banned from the US a while back Daewoo.

Kia ain't a bad car. I rented one from Hertz a while back, it actually drove pretty good but the gas mileage was mediocre, my Japanese Hondas and Toyotas are way better.

Lol Sethjoo 🙄🙄🙄 I love my Honda CRV. Back to the books, it was fun talkin with ya'll.

 

[Promethean]

If you have data that supports this I'd love to see it. In my experience being trained by and now practicing with DOs, practice habits are indistinguishable. (This is in OB/Gyn.)

Fair request. Give me a minute to see what I can dig up to support my assertions.

I will say that I'm mostly focused on primary care / family practice. I think that the more specialized the setting, the less variation will be noticed between MD and DO colleagues. Which is why I find this whole Kia vs Benz talk to be total and complete B.S. Most of the DOs I've worked with are subspecialist surgeons and anesthesiologists in a top university affiliated academic hospital system. Several of them teach at the associated allopathic medical school. There were no Kias among them, I assure you.

 

[22031 Alum]

Fair request. Give me a minute to see what I can dig up to support my assertions.

I will say that I'm mostly focused on primary care / family practice. I think that the more specialized the setting, the less variation will be noticed between MD and DO colleagues. Which is why I find this whole Kia vs Benz talk to be total and complete B.S. Most of the DOs I've worked with are subspecialist surgeons and anesthesiologists in a top university affiliated academic hospital system. Several of them teach at the associated allopathic medical school. There were no Kias among them, I assure you.

For what it's worth, I don't buy that Kia/Benz analogy either. It might make sense on the medical student level, but doesn't hold up in practice. (Edit- I mean that a medical student might believe it, while someone who is out in practice would know better.)

If most of the DOs you've worked with are subspecialist surgeons and anesthesiologists, that makes me even more interested to know where you get the impression that they touch more and use pharmaceuticals less. Particularly the anesthesiologists-- unless they are pain specialists, I can't see how touch>drugs applies in their day-to-day practice. I consider myself primary care, and honestly have yet to see any philosophical or practice differences that fall along MD/DO lines. Practice habits come from one's personal characteristics and experience in training (residency/fellowship), not the medical school one happened to go to.

I might be persuaded that an AOA vs. ACGME residency may produce a different product, though that also doesn't hold up with the relatively few AOA-trained OBs I know. However, once you've gotten past both the med school and residency stage it becomes blatantly obvious to me that the latter is far, far more influential than the former. So if we must make declarations about what makes people practice certain ways, I'd leave medical school out of it.

Now, if a medical school interviewer isn't satisfied with an answer of "I want to care for patients as a physician," and tries to draw some statement of superiority out of you, then just do what you need to do in the moment. Compose a symphony extolling the virtues of DO and the horrors of MD if that's what they want to hear. There's really no need to take it from there and actually go on to construct a belief in some artificial difference.

 

[radkat101]

SDN must not be mistaken for reality. Probably fewer than 10% of my class has ever posted here, even once. They may or may not have dropped in to read, but they haven't participated in discussions.

Those who have are not a random cross section. They will tend to share certain attributes at a higher frequency and amplitude, just by being the kinds of people who decided to be active here.

That will necessarily create a skewed impression, if they are taken to represent all med students.

As for abolishing the DO degree... I am glad that you explained your opinion better, @jonnythan. I had misunderstood your intention and originally thought you quite hostile, even disrespectful toward DOs and their degree. I still think that it is pretty presumptuous to assert that there is no difference and that the degree has no distinctiveness at all. Just because something has been loudly and often repeated on SDN does not make it more true. That was why I took the time before to write that there are people who chose the DO route because we did want that small difference, however slight it may be. Otherwise, you might start to believe that what you hear in the echo chamber is true.

Saying DO=MD is like saying DDS=DMD, but I've never heard anyone say that DDS degrees shouldn't exist. There is history and tradition behind it, even though there is no difference whatsoever between types of dentists. DOs do at least have some particular training to set them apart. Even if you don't accept that there is anything to Osteopathic Philosophy, the additional focus on the musculoskeletal system and physical exam does make some difference between DO and MD education... and practice. Yes, all good doctors treat their whole patients, but DOs do tend to use touch more, to be more sparing with pharmaceuticals, etc... even when they don't do OMM. Not all, not all the time, but enough to constitute statistical signifigance.

I'm not saying that makes DOs better, but there is at least a wisp of difference, which I think would get lost if we just discarded the degree entirely. If you want to argue about whether that difference is enough to justify having two kinds of physicians, that might be a worthy discussion to have. I just think that it does everyone a great disservice to minimize it to the point of denying that it even exists. Especially without having investigated the matter beyond reading the prevailing opinions on SDN.

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The problem with this statement is that we all face negative consequences because people are hung up on maintaining the distinction (unlike DDS/DMD). The longer DO students perpetuate the idea that there's any significant difference between MD and DO, the longer the rest of us trying to move on will have to put up with sub-par match lists and hospitals that don't want anything to do with us 3rd and 4th year. These days, the cons of having this distinction far outweigh the pros. It frustrates me when I hear students continue to defend the "uniqueness" of the degree because nothing good will ever come out of doing that. We can't sit around waiting for the public to accept that we're the same as MDs because the fact that it's so hard to explain will never allow it to happen.

 

[Promethean]

If most of the DOs you've worked with are subspecialist surgeons and anesthesiologists, that makes me even more interested to know where you get the impression that they touch more and use pharmaceuticals less. Particularly the anesthesiologists-- unless they are pain specialists, I can't see how touch>drugs applies in their day-to-day practice. I consider myself primary care, and honestly have yet to see any philosophical or practice differences that fall along MD/DO lines. Practice habits come from one's personal characteristics and experience in training (residency/fellowship), not the medical school one happened to go to.

I repeat that my assertion about more hands on, fewer drugs is really focused on primary care, particularly family med settings.

I was going to write something about how, of course, I didn't see any anesthesiologists using OMT instead of succinylcholine, but I thought, "nah, they'll know that I am not saying anything so ridiculous as that." I see I should never leave anything to chance. And I don't even see you as someone who is trying to misunderstand me, as some here would happily do.

So, no, I never saw my DO anesthesia friends recommending holistic alternatives to propofol. I did know an MD anesthesia guy who did a pain fellowship and started jabbing acupuncture needles into people, so woo isn't restricted to osteopathic physicians.

Since you brought up your anecdotal experience, I will share mine. I have experienced a difference in style from the patient standpoint, which is part of where my opinions come from. My MD docs have always told me to lose weight, and some have gone so far as to suggest that would mean eating less and exercising more. But I can't say that I was ever really counselled about preventive care, with more than a cursory mention, until I started seeing a DO physician. who wrote an actual prescription for exercise and really spent a little time making sure that I knew what she was asking me to do... and then she followed up on that the next visit. That is a very small "n," and hard to quantify... but qualitatively, the difference was there.

But you wanted hard data. I'm still on its trail. Here is what I've found so far:

stylistic differences:
Do osteopathic physicians differ in patient interaction from allopathic physicians?
http://www.ncbi.nlm.nih.gov/pubmed/12884943

more touch, less drugs:
OMT associated with reduced analgesic prescribing and fewer missed work days in patients with low back pain
http://www.ncbi.nlm.nih.gov/pubmed/24481801

And interestingly - this study which suggests that osteopathic soon-to-be graduates outperformed allopathic on measures of musculoskeletal competency (29% passing a competency exam over 18%,) as well as on a similar measure for internal med (33% vs 22%,) but which focused on the fact that the majority of students of both flavors failed to achieve the desired outcomes, rather than the marginally better osteopathic scores.
http://www.ncbi.nlm.nih.gov/pubmed/16790542

There were other studies that said that DOs spend more time with patients, but I felt these were balanced out by a larger one that said no difference. And length of visit isn't really the rubric that speaks to me, anyway.

 

[Promethean]

The problem with this statement is that we all face negative consequences because people are hung up on maintaining the distinction (unlike DDS/DMD). The longer DO students perpetuate the idea that there's any significant difference between MD and DO, the longer the rest of us trying to move on will have to put up with sub-par match lists and hospitals that don't want anything to do with us 3rd and 4th year. These days, the cons of having this distinction far outweigh the pros. It frustrates me when I hear students continue to defend the "uniqueness" of the degree because nothing good will ever come out of doing that. We can't sit around waiting for the public to accept that we're the same as MDs because the fact that it's so hard to explain will never allow it to happen.

Conversely, I see people who feel that they have something to gain by denying a difference trying to sweep any that might exist under the rug so that they can be more quickly mainstreamed. I think that the osteopathic profession as a whole stands to lose out by doing that, and that the only thing we have to gain is something you could have had by becoming an MD, if that is what you wanted.

 

[radkat101]

Conversely, I see people who feel that they have something to gain by denying a difference trying to sweep any that might exist under the rug so that they can be more quickly mainstreamed. I think that the osteopathic profession as a whole stands to lose out by doing that, and that the only thing we have to gain is something you could have had by becoming an MD, if that is what you wanted.

By making the degrees the same, there's no reason DO schools can't continue doing what they've been doing, as long as they are meeting standards that apply to all medical schools in the US. If you want to learn OMM fine, but you are still going to get an MD so you are competitive for all residencies. All I'm saying is that having two different degrees that ultimately produce equally competent physicians is pointless if a whole chunk face negative consequences because of two letters. By doing this, you would also improve the quality of students because DO schools would see a huge jump in competitiveness. We'd also get a better clinical education because we'd have more rotation sites opening their doors to us. Those two letters do so much harm for nothing.

The only people against this are the DOs who honestly believe they are better than MDs.

 

[22031 Alum]

I repeat that my assertion about more hands on, fewer drugs is really focused on primary care, particularly family med settings.

I'm not willfully trying to misunderstand, but you did make that statement without qualifications initially, and then immediately mention that the DOs you know are subspecialists. So you can see how those two assertions wouldn't seem to go together? I do get what you're saying with the clarification.

The assertions of DO superiority always seem to eventually come down to an indvidual's own experience with providers. There's no countering that, but it doesn't take much mental gymnastics to realize that maybe, just maybe an individual experience (or even a handful of them!) may not justify making sweeping statements about an entire field.

Actually writing out an Rx for exercise doesn't particularly strike me as a great example of "hands-on" care. It's an approach I've seen physicians of all stripes do, just as I've also seen physicians of all stripes who would spend over an hour in counseling a patient, but still roll their eyes at the idea of putting the word "exercise" on a prescription pad.

Ultimately I'm not trying to convince you either way. Your experiences are yours, mine are mine. Just know that in my opinion generalizations like you made are rarely productive. We're all on the same team- you'll see that once you get out here.

 

[el_duderino]

How much experience can a student who hasn't even started school yet have with the overall different treatment practices of DOs and MDs?

 

[Promethean]

How much experience can a student who hasn't even started school yet have with the overall different treatment practices of DOs and MDs?

Me? I've started... I just haven't fixed my profile. Also, I worked alongside doctors of both flavors for several years before deciding to go to back to school.

You, however, have said that you didn't interview or even apply DO, but you have strong opinions about what should be done with the degrees of people who did. No disrespect intended, just saying that if we are going to get into questioning one another's right to voice opinions, someone is going to be able to call out something discrediting about everyone else. If I were further along in school, the complaints would be that I have no idea what practice is like... or that I have had too much Kool Aid. The meaningful discussions end when the ad hominems start.

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[22031 Alum]

How much experience can a student who hasn't even started school yet have with the overall different treatment practices of DOs and MDs?

Experience as a patient, as the relative of a patient, as a non-physician provider.

 

[DOFOSHO]

Me? I've started... I just haven't fixed my profile. Also, I worked alongside doctors of both flavors for several years before deciding to go to back to school.

You, however, have said that you didn't interview or even apply DO, but you have strong opinions about what should be done with the degrees of people who did. No disrespect intended, just saying that if we are going to get into questioning one another's right to voice opinions, someone is going to be able to call out something discrediting about everyone else. If I were further along in school, the complaints would be that I have no idea what practice is like... or that I have had too much Kool Aid. The meaningful discussions end when the ad hominems start.

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Aren't you prohibited from being in possession of soft drinks on your campus? I believe its a class IV student code of conduct violation?

 

[Promethean]

Aren't you prohibited from being in possession of soft drinks on your campus?

Wow. I love how ridiculously exaggerated the stories here get.

You just can't eat in classrooms / study rooms. It really isn't that bad.

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[TUVIX]

Hopefully my acne would distract them, interviewers, from listening to me. And thanks! I hope I get some love this cycle!!!

Have you tried any treatments for your acne? (Serious question)

 

[Seth Joo]

The problem with this statement is that we all face negative consequences because people are hung up on maintaining the distinction (unlike DDS/DMD). The longer DO students perpetuate the idea that there's any significant difference between MD and DO, the longer the rest of us trying to move on will have to put up with sub-par match lists and hospitals that don't want anything to do with us 3rd and 4th year. These days, the cons of having this distinction far outweigh the pros. It frustrates me when I hear students continue to defend the "uniqueness" of the degree because nothing good will ever come out of doing that. We can't sit around waiting for the public to accept that we're the same as MDs because the fact that it's so hard to explain will never allow it to happen.

The distinction between DDS/DMD is nothing like DO and MD, DDS and DMD is basically a choice of naming the degree but all Dental schools are essentially same with a similar curriculum, some of the more "prestigious" schools tend to award the DMD.

There is a very big difference in how DOs and MDs are educated and how the schools are run, MD schools tend to be more research based, most of them have tertiary teaching hospitals, some of the bigger ones own networks of hospitals and medical centers, they are really big institutions.

Many DO schools are not much more than an academic building with some labs. Also there is the issue of OMM, more emphasis on primary care, more emphasis on rural medicine and inner city health care, areas that tend to be under served by physicians.

For many premeds out there the Holy Grail is the MD and premeds are a discriminating snobby bunch, so many premeds would look at a DO school the way they would look at a KIA. That being said a KIA is not a bad car 🙂, its just not something that is a status symbol like a Mercedes or something with a storied record of reliability and recognizability like a Toyota or a Honda. As Americans we are into brands.

 

[Seth Joo]

Wow. I love how ridiculously exaggerated the stories here get.

You just can't eat in classrooms / study rooms. It really isn't that bad.

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Which school do you go to? My school people brought food from outside, mostly because a sandwich and a drink from the cafeteria was like 8 bucks.

 

[radkat101]

The distinction between DDS/DMD is nothing like DO and MD, DDS and DMD is basically a choice of naming the degree but all Dental schools are essentially same with a similar curriculum, some of the more "prestigious" schools tend to award the DMD.

There is a very big difference in how DOs and MDs are educated and how the schools are run, MD schools tend to be more research based, most of them have tertiary teaching hospitals, some of the bigger ones own networks of hospitals and medical centers, they are really big institutions.

Many DO schools are not much more than an academic building with some labs. Also there is the issue of OMM, more emphasis on primary care, more emphasis on rural medicine and inner city health care, areas that tend to be under served by physicians.

For many premeds out there the Holy Grail is the MD and premeds are a discriminating snobby bunch, so many premeds would look at a DO school the way they would look at a KIA. That being said a KIA is not a bad car 🙂, its just not something that is a status symbol like a Mercedes or something with a storied record of reliability and recognizability like a Toyota or a Honda. As Americans we are into brands.

My school probably has better clinical sites than all but a few of the MD schools here in the state, and I don't think the school is run much differently either. I know it was ultimately my choice to go here, and I feel like I'm getting a great education, but I really didn't know at the time I applied how little emphasis there would be on all the thing that were supposed to make DOs unique . Maybe it's just an exception to the rule, and one of the reasons I'm more outspoken, but if DO schools just changed the letters of the degree they offered, the competition to get into these schools would increase, and more hospitals would be open to having the students rotate at their sites. A lot of hospitals would rather be affiliated with MD offering institutions for the reason mentioned in the last sentence of your post. All the major the downsides of being a DO come from those letters and little else. If the schools want to keep teaching OMM and emphasizing primary care, let them keep doing it, but maintaining the distinction for a couple of silly reasons is crazy considering all consequences we face from them doing that. If the residencies we all end up going to will be accredited under the same body (with some programs emphasizing OMM), then what makes it so hard for the schools to standardize their teaching in a similar way?

Also, I don't think the holy grail is the MD just for branding reasons. Residency opportunities and having to learn OMM are very valid concerns for choosing an MD school over DO.

 

[Seth Joo]

My school probably has better clinical sites than all but a few of the MD schools here in the state, and I don't think the school is run much differently either. I know it was ultimately my choice to go here, and I feel like I'm getting a great education, but I really didn't know at the time I applied how little emphasis there would be on all the thing that were supposed to make DOs unique . Maybe it's just an exception to the rule, and one of the reasons I'm more outspoken, but if DO schools just changed the letters of the degree they offered, the competition to get into these schools would increase, and more hospitals would be open to having the students rotate at their sites. A lot of hospitals would rather be affiliated with MD offering institutions for the reason mentioned in the last sentence of your post. All the major the downsides of being a DO come from those letters and little else. If the schools want to keep teaching OMM and emphasizing primary care, let them keep doing it, but maintaining the distinction for a couple of silly reasons is crazy considering all consequences we face from them doing that. If the residencies we all end up going to will be accredited under the same body (with some programs emphasizing OMM), then what makes it so hard for the schools to standardize their teaching in a similar way?

Where do you go to school?

 

[radkat101]

Where do you go to school?

TCOM. We have a monopoly in Fort. Worth (for now, because we have an MD school coming in the future that will share all our facilities) with a large Level 1 trauma center and our own Pediatric Hospital. But when the MD school plans were announced this year, even more hospitals in the area suddenly had all these rotation spots open up that weren't available before just because they'd rather be associated with an MD school.

 

[Promethean]

LECOM. Our cafeteria is pretty cheap and the portions are almost too plentiful, and many of us do have water bottles, despite rumors here about security taking them away.

People are just not allowed to take food / drink into classes. And I understand why. I was talking to one of the housekeeping staff, who said that even with the rule, someone smuggled food into a study room and made a huge mess that he had to deal with. People complain about having rules means that they are being treated like children... but then they go and demonstrate that they actually are irresponsible.

It isn't like there aren't places on campus to eat and study. First world problems, I tell you.

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[DOFOSHO]

I repeat that my assertion about more hands on, fewer drugs is really focused on primary care, particularly family med settings.

I was going to write something about how, of course, I didn't see any anesthesiologists using OMT instead of succinylcholine, but I thought, "nah, they'll know that I am not saying anything so ridiculous as that." I see I should never leave anything to chance. And I don't even see you as someone who is trying to misunderstand me, as some here would happily do.

So, no, I never saw my DO anesthesia friends recommending holistic alternatives to propofol. I did know an MD anesthesia guy who did a pain fellowship and started jabbing acupuncture needles into people, so woo isn't restricted to osteopathic physicians.

Since you brought up your anecdotal experience, I will share mine. I have experienced a difference in style from the patient standpoint, which is part of where my opinions come from. My MD docs have always told me to lose weight, and some have gone so far as to suggest that would mean eating less and exercising more. But I can't say that I was ever really counselled about preventive care, with more than a cursory mention, until I started seeing a DO physician. who wrote an actual prescription for exercise and really spent a little time making sure that I knew what she was asking me to do... and then she followed up on that the next visit. That is a very small "n," and hard to quantify... but qualitatively, the difference was there.

But you wanted hard data. I'm still on its trail. Here is what I've found so far:

stylistic differences:
Do osteopathic physicians differ in patient interaction from allopathic physicians?
http://www.ncbi.nlm.nih.gov/pubmed/12884943

more touch, less drugs:
OMT associated with reduced analgesic prescribing and fewer missed work days in patients with low back pain
http://www.ncbi.nlm.nih.gov/pubmed/24481801

And interestingly - this study which suggests that osteopathic soon-to-be graduates outperformed allopathic on measures of musculoskeletal competency (29% passing a competency exam over 18%,) as well as on a similar measure for internal med (33% vs 22%,) but which focused on the fact that the majority of students of both flavors failed to achieve the desired outcomes, rather than the marginally better osteopathic scores.
http://www.ncbi.nlm.nih.gov/pubmed/16790542

There were other studies that said that DOs spend more time with patients, but I felt these were balanced out by a larger one that said no difference. And length of visit isn't really the rubric that speaks to me, anyway.

name 1 serious illness from Harrisons or Robins or Uptodate that OMM is shown to be superior to standard medical/surgical care.

 

[Iridescent]

LECOM. Our cafeteria is pretty cheap and the portions are almost too plentiful, and many of us do have water bottles, despite rumors here about security taking them away.

People are just not allowed to take food / drink into classes. And I understand why. I was talking to one of the housekeeping staff, who said that even with the rule, someone smuggled food into a study room and made a huge mess that he had to deal with. People complain about having rules means that they are being treated like children... but then they go and demonstrate that they actually are irresponsible.

It isn't like there aren't places on campus to eat and study. First world problems, I tell you.

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I love this side conversation going on

 

[Promethean]

I love this side conversation going on

When they can't bust on anything real, they can always bring up these juvenile complaints. And the more those get repeated, the more dramatic the stories get. It comes up every time my school gets discussed. The people who haven't been here don't have anything more substantial to say about it, but think that they know something because they heard it here.

SDN campfire tales.

BOO!

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[Promethean]

name 1 serious illness from Harrisons or Robins or Uptodate that OMM is shown to be superior to standard medical/surgical care.

Not playing your game.

First, OMM is not an "instead of" modality. It is an adjunct, not an alternative to other treatments. And it is not purely a treatment, but also a diagnostic tool. I have been to quite a few PCP appointments where there was no physical exam at all, where the doctor never even touched me other than the handshake. An aide took my vitals and the doc popped in to talk for 3-5 minutes before writing a prescription or two. No touching.

OMM provides an opportunity to pick up on a disease process early if for no other reason than that it involves the physician actually touching the patient. Certainly MDs could do that too, but it is inherent to OMM.

Finally, OMM treats somatic dysfunction, which can accompany any disease. It addresses pain, discomfort, and the restriction of movement. Your question is as unfair as "What major disease does morphine cure?" Unless you are denying that patient comfort and function are meaningful treatment outcomes... in which case, I begin to wonder if you aren't discounting some of that "whole patient" that you mock some DOs for emphasizing.

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[DOFOSHO]

Not playing your game.

First, OMM is not an "instead of" modality. It is an adjunct, not an alternative to other treatments. And it is not purely a treatment, but also a diagnostic tool. I have been to quite a few PCP appointments where there was no physical exam at all, where the doctor never even touched me other than the handshake. An aide took my vitals and the doc popped in to talk for 3-5 minutes before writing a prescription or two. No touching.

OMM provides an opportunity to pick up on a disease process early if for no other reason than that it involves the physician actually touching the patient. Certainly MDs could do that too, but it is inherent to OMM.

Finally, OMM treats somatic dysfunction, which can accompany any disease. It addresses pain, discomfort, and the restriction of movement. Your question is as unfair as "What major disease does morphine cure?" Unless you are denying that patient comfort and function are meaningful treatment outcomes... in which case, I begin to wonder if you aren't discounting some of that "whole patient" that you mock some DOs for emphasizing.

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name 1 serious illness or disease process that OMM is superior (or even adjunct) to standard physical exam or advanced diagnostic/imaging techniques.

 

[Promethean]

name 1 serious illness or disease process that OMM is superior to standard physical exam or advanced diagnostic/imaging techniques.

Wow. You only have the one trick, huh?

How about: the serious illness or disease that the doctor doesn't even think about ordering an advanced imaging scan for because they never felt the abnormality and the patient felt too rushed to mention it?

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[DOFOSHO]

Wow. You only have the one trick, huh?

How about: the serious illness or disease that the doctor doesn't even think about ordering an advanced imaging scan for because they never felt the abnormality and the patient felt too rushed to mention it?

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just name 1...

 

[Promethean]

just name 1...

I'm not your monkey.

I won't be pushed to overstate my case so that you can hold that up to discredit the entirety of Osteopathic Medicine, along with anything else that I have ever said.

At least show a little creativity in your tactics. I've seen this one done before, by far better rhetoriticians than you. Up your game.

Try making a statement yourself. Then we can see if you actually have points of your own.

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[NontradCA]

The distinction between DDS/DMD is nothing like DO and MD, DDS and DMD is basically a choice of naming the degree but all Dental schools are essentially same with a similar curriculum, some of the more "prestigious" schools tend to award the DMD.

There is a very big difference in how DOs and MDs are educated and how the schools are run, MD schools tend to be more research based, most of them have tertiary teaching hospitals, some of the bigger ones own networks of hospitals and medical centers, they are really big institutions.

Many DO schools are not much more than an academic building with some labs. Also there is the issue of OMM, more emphasis on primary care, more emphasis on rural medicine and inner city health care, areas that tend to be under served by physicians.

For many premeds out there the Holy Grail is the MD and premeds are a discriminating snobby bunch, so many premeds would look at a DO school the way they would look at a KIA. That being said a KIA is not a bad car 🙂, its just not something that is a status symbol like a Mercedes or something with a storied record of reliability and recognizability like a Toyota or a Honda. As Americans we are into brands.

Keyword premeds.

 

[NontradCA]

Not playing your game.

First, OMM is not an "instead of" modality. It is an adjunct, not an alternative to other treatments. And it is not purely a treatment, but also a diagnostic tool. I have been to quite a few PCP appointments where there was no physical exam at all, where the doctor never even touched me other than the handshake. An aide took my vitals and the doc popped in to talk for 3-5 minutes before writing a prescription or two. No touching.

OMM provides an opportunity to pick up on a disease process early if for no other reason than that it involves the physician actually touching the patient. Certainly MDs could do that too, but it is inherent to OMM.

Finally, OMM treats somatic dysfunction, which can accompany any disease. It addresses pain, discomfort, and the restriction of movement. Your question is as unfair as "What major disease does morphine cure?" Unless you are denying that patient comfort and function are meaningful treatment outcomes... in which case, I begin to wonder if you aren't discounting some of that "whole patient" that you mock some DOs for emphasizing.

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OMM is a small part of a physical exam. All physicians learn H and P day one of medical school, so I'm not sure why you're equating it with OMM. I'd concentrate on learning basic tenants of a physical exam before questioning a physician on which parts to use during a patient encounter.

 

[22031 Alum]

it involves the physician actually touching the patient. Certainly MDs could do that too, but it is inherent to OMM

Touching the patient is inherent to a physical exam. I honestly don't have anything against DOs- I'm actually the biggest advocate for my program accepting DO applicants, which it has never done. In my mind, MS4s are MS4s- there are good ones and not-so-good-ones. But this is a glaring example of overstating the "specialness" of DO. You learn physical exam techniques that allopathic students do not, sure. Observational studies give evidence that this could positively affect patient care, I'll give you that as well. But to say that touching a patient is inherent to OMM, like it's not inherent to anything MDs do but simply something we "could do?" Just comes across as... silly, I suppose. Like reaching unnecessarily for something to distinguish yourself by.

 

[Gandyy]

Can we end this debate with the following true statements?

1. DO and MD are both physicians who practice medicine
2. It is in fact harder to get more competetive specialties as a DO
3. If people are skeptical of cranial OMM, they cannot be blamed too much.
4. MD clinical education in 3rd and 4th year is usually better than the DO counterpart.
5. At the end of the day, the doctor makes the degree, not the other way around.
6. There are plenty of DO neurosurgeons.

 

[Promethean]

Touching the patient is inherent to a physical exam. I honestly don't have anything against DOs- I'm actually the biggest advocate for my program accepting DO applicants, which it has never done. In my mind, MS4s are MS4s- there are good ones and not-so-good-ones. But this is a glaring example of overstating the "specialness" of DO. You learn physical exam techniques that allopathic students do not, sure. Observational studies give evidence that this could positively affect patient care, I'll give you that as well. But to say that touching a patient is inherent to OMM, like it's not inherent to anything MDs do but simply something we "could do?" Just comes across as... silly, I suppose. Like reaching unnecessarily for something to distinguish yourself by.

I'm not saying that MDs don't ever touch their patients. I said that I've been treated by a few who didn't touch me at all. Don't magnify that to make it mean more than I said.

I'm saying that OMM is all about touch. Touch is what it is. That is what I meant by inherent. It doesn't take anything away from MDs at all, to say that.

 

[DOFOSHO]

I'm not saying that MDs don't ever touch their patients. I said that I've been treated by a few who didn't touch me at all. Don't magnify that to make it mean more than I said.

I'm saying that OMM is all about touch. Touch is what it is. That is what I meant by inherent. It doesn't take anything away from MDs at all, to say that.

That's really creepy. There are better places than a doctor's office to go to if your obsessed with touching and being touched.

 

[235009]

I'm not saying that MDs don't ever touch their patients. I said that I've been treated by a few who didn't touch me at all. Don't magnify that to make it mean more than I said.

I'm saying that OMM is all about touch. Touch is what it is. That is what I meant by inherent. It doesn't take anything away from MDs at all, to say that.

Recent study showed no advantage to doing a routine physical exam. So unless you came in with a specific complaint that requires a physical exam then the doctors did nothing wrong and are practicing evidence based medicine. Also to those who are more knowledgeable about it, is OMM really used as a diagnostic tool beyond physical exam?

 

[SouthernSurgeon]

Touching the patient is inherent to a physical exam. I honestly don't have anything against DOs- I'm actually the biggest advocate for my program accepting DO applicants, which it has never done. In my mind, MS4s are MS4s- there are good ones and not-so-good-ones. But this is a glaring example of overstating the "specialness" of DO. You learn physical exam techniques that allopathic students do not, sure. Observational studies give evidence that this could positively affect patient care, I'll give you that as well. But to say that touching a patient is inherent to OMM, like it's not inherent to anything MDs do but simply something we "could do?" Just comes across as... silly, I suppose. Like reaching unnecessarily for something to distinguish yourself by.

I've yet to meet a medical student - MD or DO - who can do anything more than a rudimentary abdominal exam and even reliably identify basic pathology such as an acute abdomen.

You don't learn to proficiency/expertise in medical school, DO or otherwise. And if you don't build on and use those skills in training and practice, any special bone magic they've learned will quickly erode.

 

[Gandyy]

I've only seen some OMM or OMT. Some patients say it really works for them, and others say it doesnt help at all. But for those that it does help, that is a plus, dont you guys think?

 

[22031 Alum]

I've only seen some OMM or OMT. Some patients say it really works for them, and others say it doesnt help at all. But for those that it does help, that is a plus, dont you guys think?

I think so!! And I think the concept of having an extra "tool in the toolbox" is a worthwhile discussion point if asked the Why DO? question. My point is that it's perfectly possible to discuss what appeals to you about one path without putting down another. The same way you wouldn't tell your interviewers why you should be accepted by berating the other candidates. It's not a good look.

 

[Gandyy]

I think so!! And I think the concept of having an extra "tool in the toolbox" is a worthwhile discussion point if asked the Why DO? question. My point is that it's perfectly possible to discuss what appeals to you about one path without putting down another. The same way you wouldn't tell your interviewers why you should be accepted by berating the other candidates. It's not a good look.

Yes, I fully agree.

 

[deleted245139]

I'll say this... While I don't use omm skills in the ED as taught, I feel like it gave me a leg up in general palpating skills, and I've caught more than a few subtle acute abdomens well before the imaging returned. I wasn't a fan of omm then, and never really do it now, but those physical exam skills are gold in the ED

 

[mathnerd88]

I got asked this question at my interview. Just be realistic and explain why you wanted to be a DO. It could be your shadowing experiences and what you've learned from it.

My interviewer told me how he really liked my response, in that I did not mention OMM as the reason why I wanted to be a DO. Being a DO is NOT about OMM. It is much more than that. I briefly talked about seeing OMM in action, but what I really liked about it is how it particularly works well with primary care physicians and my philosophy in how to treat patients.

All my interviewers (3 of them) were impressed. Just don't be immature and make your responses sound sincere and how it relates to your goals in life.

 

[Seth Joo]

Can we end this debate with the following true statements?

1. DO and MD are both physicians who practice medicine
2. It is in fact harder to get more competetive specialties as a DO
3. If people are skeptical of cranial OMM, they cannot be blamed too much.
4. MD clinical education in 3rd and 4th year is usually better than the DO counterpart.
5. At the end of the day, the doctor makes the degree, not the other way around.
6. There are plenty of DO neurosurgeons.

Point 1 Correct
Point 2 well, DOs actually have no real issues specializing because of AOA residencies, the issue is ACGME residencies, you really do not see tons of DOs training to be CT surgeons at Harvard and Hopkins, if you are going to DO school with the dream of becoming some Nobel prize winning Academic physician....Dream on.
Point 3 a lot of people are skeptical about Cranial, and some people think its downright dangerous, look up an MD in North Carolina Dr. Barrett, he is an MD who is vocally critical of DO manipulation, also there is a Hopkins professor who trashed the entire profession in Forbes magazine a few years ago.
Point 4 Totally agree here, only a few DO schools have strong clinical education, and some are really horrific, like having rotations in trailers.
Point 5 Not quite true, going to Harvard, Stanford, Duke Medicine ain't the same as going to some DO school in some inner city ghetto or in the middle of some country town, most MD schools have world class faculty, facilities, and of course the name.
Point 6 I would not quite say there are plenty of DO neurosurgeons, but they do exist.

 

[Gandyy]

Point 1 Correct
Point 2 well, DOs actually have no real issues specializing because of AOA residencies, the issue is ACGME residencies, you really do not see tons of DOs training to be CT surgeons at Harvard and Hopkins, if you are going to DO school with the dream of becoming some Nobel prize winning Academic physician....Dream on.
Point 3 a lot of people are skeptical about Cranial, and some people think its downright dangerous, look up an MD in North Carolina Dr. Barrett, he is an MD who is vocally critical of DO manipulation, also there is a Hopkins professor who trashed the entire profession in Forbes magazine a few years ago.
Point 4 Totally agree here, only a few DO schools have strong clinical education, and some are really horrific, like having rotations in trailers.
Point 5 Not quite true, going to Harvard, Stanford, Duke Medicine ain't the same as going to some DO school in some inner city ghetto or in the middle of some country town, most MD schools have world class faculty, facilities, and of course the name.
Point 6 I would not quite say there are plenty of DO neurosurgeons, but they do exist.

Wait what, number 2 is totally correct. Just because you can get a residency as a DO doesnt mean its not harder than a MD. Its harder to get a residency in a competitve field as a DO. Didnt we just literally agree on this a few pages ago?

Point 3 you agree with. Point 1 you agree with. Point 4 you agree with. Point 5, I see where you are coming from. Point 6, well there are so few neurosurgeons, MD or DO anyways. I guess the word "plenty" is subjective anyways.

 

[Dr. Death]

Point 1 Correct
Point 2 well, DOs actually have no real issues specializing because of AOA residencies, the issue is ACGME residencies, you really do not see tons of DOs training to be CT surgeons at Harvard and Hopkins, if you are going to DO school with the dream of becoming some Nobel prize winning Academic physician....Dream on.
Point 3 a lot of people are skeptical about Cranial, and some people think its downright dangerous, look up an MD in North Carolina Dr. Barrett, he is an MD who is vocally critical of DO manipulation, also there is a Hopkins professor who trashed the entire profession in Forbes magazine a few years ago.
Point 4 Totally agree here, only a few DO schools have strong clinical education, and some are really horrific, like having rotations in trailers.
Point 5 Not quite true, going to Harvard, Stanford, Duke Medicine ain't the same as going to some DO school in some inner city ghetto or in the middle of some country town, most MD schools have world class faculty, facilities, and of course the name.
Point 6 I would not quite say there are plenty of DO neurosurgeons, but they do exist.

Disagree on point 5. Fact is, there are plenty of crappy MDs and DOs and plenty of exceptional MDs and DOs. Being a great doctor is subjective, as a patient I want a doctor with good interpersonal skills and extensive knowledge base. You can definitely get those in a trailer. Having tons of research and world class facilities does not inherently make good physicians.

 

[Seth Joo]

Wait what, number 2 is totally correct. Just because you can get a residency as a DO doesnt mean its not harder than a MD. Its harder to get a residency in a competitve field as a DO. Didnt we just literally agree on this a few pages ago?

Point 3 you agree with. Point 1 you agree with. Point 4 you agree with. Point 5, I see where you are coming from. Point 6, well there are so few neurosurgeons, MD or DO anyways. I guess the word "plenty" is subjective anyways.

Its harder to specialize as DO, its just not much harder to the level that its nearly impossible, that is mostly because of the presence of AOA specialty residency programs that DOs can opt for at the present moment. Most people want to train at ACGME not AOA programs because they want to make sure they can get jobs wherever they want after residency, some places discriminate against people with AOA residency credentials, its usually fancy academic medical centers in coastal cities.

Its kind of a weird catch 22, you can try for the ACGME, not get anywhere or try for the AOA program, and then later on in life realize a lot of places do not respect your training. I think this was the big motivating factor for the merger, so the AOA residency programs could get more recognition.

 

[Promethean]

Its harder to specialize as DO, its just not much harder to the level that its nearly impossible, that is mostly because of the presence of AOA specialty residency programs that DOs can opt for at the present moment, but with the merger this option will go away in the future.

A lot of schools claim that their graduates "self select" for primary care, I can tell you as fourth year, that is complete propaganda, many of us are just like the our Allopathic counterparts, we are in debt up to our eyeballs, and we want to go into high paying specialties to get out of that pile of debt as fast as possible.

It isn't complete propaganda. True, there are DOs who want specialties. Most of the DO attendings I know are subspecialists. But my class is thick with people who earnestly want to do primary care. There are about a dozen of us already in a dedicated primary care pathway, and plenty more who are all about it.

Just because it doesn't apply to you doesn't mean that it isn't true that there are a lot of self selectors.

Sent from my SM-N910P using Tapatalk

 

[Seth Joo]

It isn't complete propaganda. True, there are DOs who want specialties. Most of the DO attendings I know are subspecialists. But my class is thick with people who earnestly want to do primary care. There are about a dozen of us already in a dedicated primary care pathway, and plenty more who are all about it.

Just because it doesn't apply to you doesn't mean that it isn't true that there are a lot of self selectors.

Sent from my SM-N910P using Tapatalk

I just know many of my friends who went through this year's match who were aiming for specialties and wound up in primary care. The schools put out the message that students are on a holy mission to become primary care doctors for rural and inner city communities, in reality many of my classmates could be in MD institutions but just did not make it there, including myself, and many of us are just like our MD counterparts in terms of career goals.

 

[Gandyy]

I just know many of my friends who went through this year's match who were aiming for specialties and wound up in primary care. The schools put out the message that students are on a holy mission to become primary care doctors for rural and inner city communities, in reality many of my classmates could be in MD institutions but just did not make it there, including myself, and many of us are just like our MD counterparts in terms of career goals.

So wait, which one is it Seth Joo? Its not much harder to get into a specialty as a DO, but then many of your friends all matched primary care after gunning for a competitive specialty? You are now confusing me.

 

[Seth Joo]

So wait, which one is it Seth Joo? Its not much harder to get into a specialty as a DO, but then many of your friends all matched primary care after gunning for a competitive specialty? You are now confusing me.

Specialty training paths for DOs is currently split into two paths ACGME which is the MD path, and AOA the DO path, you can pick only one. A lot of people take the gamble on the ACGME path and many wind up losing. Its easier to specialize via the AOA path in comparison, that is why I think its doable to become a medical specialist as a DO. Some people think though if your credentials come from an AOA program you might have trouble down the road getting a job because people might not respect your training. Now that the merger went through that won't be an issue no longer.

A lot of people still want to go to well known residency programs where there are mostly MDs and then they wind up getting rejected or their applications just get thrown in the trash.

 

[Gandyy]

Specialty training paths for DOs is currently split into two paths ACGME which is the MD path, and AOA the DO path, you can pick only one. A lot of people take the gamble on the ACGME path and many wind up losing. Its easier to specialize via the AOA path in comparison, that is why I think its doable to become a medical specialist as a DO. Some people think though if your credentials come from an AOA program you might have trouble down the road getting a job because people might not respect your training. Now that the merger went through that won't be an issue no longer.

A lot of people still want to go to well known residency programs where there are mostly MDs and then they wind up getting rejected or their applications just get thrown in the trash.

I knew the distinction between the two, I was just having a hard time figuring out what your overall point was. That makes it clear though.

So you are telling me that there are a considerable number of DO medical students that apply to Harvard ACGME or something who realistically think they are going to get in there?