Medicine

What Being a D.O. Means To Me

 

DO pic

When approaching the door leading to my office, patients often look at the signage and proceed to ask one of the most frequently asked questions I receive: “What’s a D.O.?”

Several books and articles exist on explaining the background, history, and differences between being a D.O. (Doctor of Osteopathic Medicine) versus an M.D. (Doctor of Medicine).  Also, debates on which degree is better persist, though I personally find the feeds quite annoying and amusing at the same time (mostly because I remember diligently reading these forums before applying to medical school, which were predominantly biased towards M.D., but I’m able to confidently say that myself and all of my classmates/colleagues that I know of from my D.O. program turned out just fine).  So let me be clear that my purpose is NOT to exacerbate the debate between which degree to choose, but rather convey what being a D.O. means to me.

But first, let’s get the basics down regarding the two degrees (if you’re already aware of the basic similarities/differences, skip to the next paragraph):

  • What’s the same:
    • both undergo four years of medical school education (some schools actually offer both MD and DO programs where students attend the same lectures/classes, such as Michigan State and Rowan University).
    • both undergo the same amount of residency training depending on the program
    • both are fully licensed to practice medicine in the United States
  • What’s historically a bit different:
    • Different licensing exams: DOs take the COMLEX while MDs take the USMLE
    • DOs receive > 200 hours of osteopathic manipulative medicine training; MDs do not.
    • DO programs are historically known to accept the non-traditional applicant (for example, the average age of students are a bit older, may be non-science majors, or seeking a second career)
    • In 2008, 7% of practicing physicians in the U.S. were DO graduates and 68% were graduates from a U.S. MD schools (I tried to find more recent statistics, but couldn’t find an accurate source)
    • Osteopathic medicine is distinct in its philosophy that “all body systems are interrelated and dependent on one another for good health” (American Association of Colleges of Osteopathic Medicine)

I applied to both MD and DO programs for medical school and remained open to attending either one.  I interviewed at both types of programs, but only received acceptance letters from DO schools.  Perhaps I didn’t have the highest MCAT scores, GPA, or my interview responses weren’t impressive enough?  Well, whatever the reason, I was just happy that the DO admissions committee gave me the chance to prove that I’d make a good doctor.

The whole concept of a more holistic approach to medical practice offered by DO programs sounded ideal to me, yet at the time I was more focused on getting through school and graduating rather than on how the philosophies would impact my practice as a physician.  After graduating from medical school, I had the option to apply to either DO or MD residency training programs.  I applied to both, yet decided to pursue the osteopathic route when I heard about the opportunity to be a part of the first osteopathic psychiatry residency on the west coast.  As the oldest of 33 grandchildren, it was inherent of me to jump on the opportunity to help trailblaze a new program (my program director nicknamed me Hiawatha).  I knew that my decision posed potential limitations in obtaining a future job since a few organizations still don’t accept psychiatrists certified under the osteopathic board.  However, I took the risk because I saw more value in being the first to graduate from and help shape a new, developing program.

For me, being a DO fits my personality and what I’ve grown to stand for in my practice: being integrative, holistic, and preventative.  I truly believe that without such an emphasis on integrative medicine as one of the main tenets of the program, I wouldn’t be the physician that I am today.  Therefore, it’s no wonder that 50% of the graduates from DO programs become general practitioners (family practice, internal medicine, emergency medicine, etc).  I initially despised having to attend osteopathic manipulation classes, and even failed my very first practical exam.  Yet, the hands-on approach made me unafraid to touch my patients.  Each psychiatrist is different, but for the most part human touch provides a sense of comfort and connection.  A few of my patients politely ask for a hug, and if appropriate, I unhesitatingly oblige.

And in some unique way, I feel that being a DO caused me to work harder in a field predominantly filled with MDs to make my presence and way of practicing known.  When a large, metropolitan county declined to consider me for a job due to my credentials, I utilized the rejection as motivation to persevere rather than a barrier.

And most importantly, I used to feel bombarded by the numerous, large framed portraits of osteopathic medicine’s founder, Andrew Taylor Still, MD, which hung in almost every corridor of each osteopathic institution.  However, after feeling frustrated with several aspects of current practices in medicine, I’m undoubtedly far more appreciative and understanding of AT Still’s motivation in the 1800s as an MD to create a method of practice that rose from adversity (he lost 3 of his 12 children to viral meningitis with no method of saving them even as a physician himself) and frustration (an over-dependence on medications and the sometimes harmful medical practices of the time).  I actually wish his story was more widely publicized because he epitomizes successful individuation from mainstream medical practices amidst much scrutiny and opposition.

In the field of psychiatry, where Western medicine can’t always explain nor provide the most adequate treatment via pharmaceuticals, wouldn’t it be great if we had more modern day AT Stills to branch off and create a newer system of viewing and practicing mental health?  I’m truly frustrated with the current practices particularly the overemphasis on medications alone.  The number of overdoses (100 people die from drug overdoses everyday in the U.S.), medicated children as early as infancy, continue to rise.  Medications are only one component of treatment, but greater emphasis should be placed on developing resiliency, acknowledging the individual’s unique traits, and treating the person holistically rather than symptomatically.

AT Still put it best when he said the following:

“An absolute demand for revolution is before us at this date and time, for there is a demand for a progressive step in the line for treating disease.  For a number of days I have been haunted by the feeling that we are in danger of getting into a rut unworthy of higher consideration than should fall to mere imitation.  Let us not be governed to-day by what we did yesterday, nor to-morrow by what we do to-day, for day by day we must show progress.”

23 thoughts on “What Being a D.O. Means To Me

  1. I believe your skepticism about many psychiatrists over-reliance on pharmacology puts you in good company. Your blog’s namesake, Freud, as I understand it, was troubled by the American tendency to try to fit psychoanalysis into the medical model.

    Quite a compliment for your program director to identify you with the early or maybe pre Michigan hero, Hiawatha. Perhaps some day your path will lead you to visit the shores of Gitche Gumme, aka Lake Superior.

    • hi tom, how did i know to expect a Michigan-related comment from u?? will make my way to MI one of these days. and yes, i wouldn’t mind being in the same company as freud 🙂

  2. Thank you for sharing your thoughts and experiences. Hard to come by such detailed and thorough information on this subject like you have done here.

  3. I have been going to a osteopath for several years. There is school in Ft. Worth. I find it humorous that one would consider an osteopath any less worthy than a medical doctor. It has been refreshing to have one as my confidante.

    Frankly, my osteopath is less inclined to use pharmaceuticals. In fact, he was the one that recommended Deplin and has always been more orientated about helping the body heal itself internally rather than use external resources. With that being said, he certainly not afraid to prescribe.

    Around here, we have quite a few them. Many of them practicing right along with the MD peers. Yes, this is Texas.

    • Hey Brent, i appreciate you sharing your own personal experience with a DO. That’s wonderful that you have a great connection with your doc. sounds like he practices right in line with the osteopathic philosophy of treating. We have a large, growing number of DOs here in CA as well (perhaps not as many as in states like Michigan though) and often people don’t realize that their treating doc is actually a DO!

      • I think you are right. Many people do not realize. We do have quite a few of them. Frankly, I think have more respect for them than I do with medical doctors. Western medicine is far too allopathic and MD’s seem to want stay in that box.

          • Yea, there is realization that there has to be some kind of integrative approach. I have a friend who is a “wellness MD.” The problem that she has is with insurance companies. Go figure…

            • I work in the Texas Medical Center and was pleasantly surprised to find out that there are quite a few anesthesia and general surgery residents who have a DO. I think if you look at allopathic medical schools across the country, there will be several DOs on faculty. I believe the MD/DO distinction is becoming more and more like the DDS/ DMD (i.e. not a big difference).

              • True, there’s a lot of DOs in training and practicing alongside MDs at almost all institutions. I think one of DOs biggest challenge is educating the public about the degree as most people have never heard of it unless they’ve been treated by a DO or knows someone who trained as one. Thank u for your comment!

  4. There is a bunch of MDs out there that were once DOs. UC Irvine’s medical school started out as an osteopathic medical school until the 1960s AMA was successful in lobbying to eliminate DOs in CA for a short period of time. The practicing DOs were allowed to be grandfathered in and awarded MD degrees.

    I wished more DOs would practice the holistic approach aand use the education they received on OMM (frankly all physicians should practice holistic approach, especially PCPs…. and I’m jealous and curious about the OMM). However, I remember telling a pt to schedule the next appt w/ a co-resident that was a DO to learn more about OMM. I was only disappointed to learn know none of my DO colleagues remembers much about OMM let alone practice it. 😛

    • Hi Lyanne! Thanks for your comment! Was hoping for a comment like yours because you highlight one of the main reasons I wrote this post. Many DOs abandon osteopathic principles once they graduate for various reasons, though many of those who chose to move on to becoming general practitioners may have been influenced by the whole-person approach in some way even if they don’t practice OMM. I don’t practice OMM (frankly I don’t think I’m very good at it) but I mentioned in my post how learning the techniques and hands-on approach influences my holistic approach towards patients. Many choose to pursue further training or offer OMM in their practice, which I admire. Continuing to practice osteopathic principles is a choice. Just like the 80’ish % of the CA DOs in the 1960s made a choice to go w/ the merger or stand by their degree. Most of the posts online comparing MD and DO tend to put down osteopathy and label DOs as being less than MD, quacks, or cultist references, so my goal was to articulate my pride in being a DO and how its history and influence have impacted my practice in a positive way. 🙂

  5. Thank you for this. I came across your blog doing a search. I also applied to both MD and DO programs, and interviewed at both. Like you, I have only been accepted to DO. As a first-generation student, I feel very blessed for an opportunity to practice medicine.
    I spent way too much on studentdoctornetwork, and many of the forums definitely talk down on the osteopathic degree. When I got my first DO acceptance, one of my closest mentors – an orthopaedic surgeon – told me to drop it and reapply. It was disheartening. I struggled with the fear of not getting into and MD school for awhile. I do feel a bigger connection to the osteopathic philosophy, and I am glad to have come across your honest feedback. I’m very much excited to start medical school this fall!

    • Hi Pam, congrats on getting accepted! how funny because that forum network you mention is the one i was referring to..i swear i was on there ALL the time, but it’s actually super amusing to go back and read what everyone says esp having gone to both DO med school and residency. Many of my classmates secured residency, fellowship, and jobs highly sought after. Enjoy your summer before you start, and if you have any questions along the way, feel free to ask! 🙂

  6. Pingback: Interview with Dr. Vania Manipod, D.O.: Why Mental Health Is Important | Wonderland Organics

  7. Great distinction.
    I run into similar issues with laity – though not in medicinal practice. I have had plenty of friends or family members – upon hearing a colleague or student refer to me as Doctor, say: “Wow, and your’e not even a real doctor… ” 🙂
    It’s not important enough that I correct this misconception (I’m a Th.D., neither an M.D.) for people, that it’s the degree that makes one a doctorate, not the field of practice.
    I find it interesting the term doctor in most minds brings to head, medicine. Perhaps doctor has been colloquialized by routinization of interaction of MD/DO, historically? It seems the term healer must not have seemed as credible on a diploma?! 🙂
    At any rate, welcome to the realm of licensed healing, doc!

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