D.O. refers to doctorate in osteopathic medicine. Unfortunately, as many osteopaths can attest, this does little to elucidate what professional training, licensure, patient care philosophy, and scope of practice a D.O. brings to patient care or the subtle differences from those with medical doctorates (M.D.). Osteopathic physicians (D.O.s) are equivalent to Doctors of Medicine (M.D.s) and are considered fully licensed physicians (medical doctors) to practice medicine and surgery. D.O.s currently comprise approximately between 17-20 % of the all physicians serving patients in these United States, though there are noticeably increased numbers of osteopaths in Michigan, Iowa, Oklahoma, New Jersey and the most overall in Pennsylvania. Osteopathic schools grow in number and class size each year.
First and foremost, an individual is granted the degree of D.O. after successful completion of four years of medical school training. In point of fact, the schools themselves are referred to as “Osteopathic Medical Schools.” The training in osteopathic medical schools parallels that of allopathic medical schools (those that confer the M.D. degree) with several notable exceptions. Academically, the curriculum is nearly identical; the discrepancies can be found in the additional training in osteopathic manipulation treatment modalities and the emphasis on osteopathic principles and their impact on patient care.
Following graduation from osteopathic school, D.O.s that choose to pursue psychiatry training can be trained at either allopathic (M.D) or osteopathic residency programs. These programs have equivalent training criteria. Most importantly, osteopathic trained physicians are licensed to provide all services that M.D. physicians are licensed to provide. Hospital privileges, scope of practice, and prescribing privileges are all equivalent to M.D. physicians. So where did the divide begin and why do these two degrees exist?
Osteopathic medicine was first established in 1892 in Kirksville, MO by Andrew Taylor Still at what is now the A.T. Still University School of Osteopathic Medicine. Dr. Still was a frontier physician that had previously obtained his medical doctorate, but broke away from his colleagues in forming osteopathy as a form of protest against what he felt was the dogmatic approach of allopathic training to treat disease rather than focus on preventative care.
The principles of osteopathy are taught to every osteopathic medical student (OMS) during their time in pre-clinical training. These principles are that 1) the body is a unit; a person is a unit of body, mind and spirit, 2) the body is capable of self-regulation, self-healing, and health maintenance, 3) structure and function are reciprocally interrelated, and 4) treatment should be based on the understanding of these principles. In other words, the body is capable of incredible things when functioning at optimal levels physically, mentally and spiritually. Osteopathic teaching offers that with focus on prevention and attention to health with the aim of optimal function, the reciprocal relationship between a problem in one portion of the body and symptoms in another could be better treated when approached from this perspective.
Through the many evolutions, osteopathy has undergone, its’ philosophy towards illness and patient care have remained constant. Furthermore, what was once theory has shown true through countless studies in the more modern practice and understanding of medicine. Our understanding of the relationship between mind, body and spirit and the impact on health and function can be seen through our understanding of stress on gastrointestinal illness, autoimmune diseases, immune function, heart function and other metabolic and hormone related pathologies. Research has also shown the impact of positivity and optimism on morbidity and mortality in various diseases. The once far-fetched has now become commonplace medical understanding.
Osteopathic manipulative medicine or treatment (OMM/OMT), refers to a set of treatments that are designed to be less invasive and take advantage of somatic dysfunctions and their physical manifestations, as these are the treatment targets of OMM therapies. These techniques are similar to what many persons would understand chiropractic manipulation to be; however, it would do OMM an injustice to limit it to this concept. Using hands-on only approaches coupled with the full scope of medical knowledge a D.O. possesses, treatments are aimed at improving function/range of motion, decreasing pain, expediting recovery, and positively impacting immune and nervous systems. The average D.O. will receive approximately 300 hours of training in body manipulation therapies.
Osteopathy was once labeled as a “cult” by the American Medical Association (AMA) making it a code of ethics violation for any of its members to voluntarily associated with a D.O. Finally, in 1969 osteopaths gained full and active membership in the AMA and ultimately the AMA invited a representative of the American Osteopathic Association to sit as a voting member in its house of delegates. Despite the barriers Osteopaths have faced, D.O.s are being considered side-by-side with their M.D. colleagues for physician positions. Some notable D.O.s include Ronald Blanck who served as the first osteopathic Surgeon General to the Army in 1996, numerous professional sport team physicians, and other countless faculty members at the most prestigious medical centers in the country. Nevertheless, many still feel that D.O.s are lesser physicians, or that the only reason they chose osteopathic training was related to their ability to perform on medical school entrance examinations and not the offered training or philosophical preferences of applicants. This stigma is not based in the realities of the training received by a DO or the quality of patient care provided.
Understanding the training your provider received and the nature and extent of his or her experience is necessary to determine if that provider is capable of offering the services you seek. The quality of care you receive will not be dependent solely on the MD or DO degree of your provider.
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