Please explain the difference in training of an MD vs a DO

[LKPAC]

Just curious about what most of us think.  

[marktheshark89]

Same training except DOs get trained in OMM as well. 

[sas5814]

about 300 hours of osteomanipulation. I call it chiropracter light

[MCHAD]

13 hours ago, sas5814 said:

about 300 hours of osteomanipulation. I call it chiropracter light

 I would also add that the majority of DO's never use osteopathic manipulation.  At least in my experience...I've worked or interacted with probably 40-50 DO's...1 practiced osteopathic manipulation.

[HmTwoPA]

I've seen one Osteopath using manipulation on my marines and they loved him for it. He'd often "set their hips back in place". IDK if its a real thing, because we never took xrays before and after. My marines seemed to feel like it really helped though. I asked a DO what the difference was and she said it goes back to when bleeding patients was still in practice and the 2 professions had different thoughts on it. 

[2234leej]

They learn osteopathic manual therapy skills, specifically soft tissue techniques, joint manipulation (i.e. what chiropractor's call adjustment) and joint mobilization. As a PT, I have seen some DO's use their skills, but most are not great at it because they don't use it enough. It's a shame, because that is one area in which they could market themselves apart from MD's. A lot of the techniques are great first option adjunct treatments for a significant number of orthopedic musculoskeletal conditions.

[rev ronin]

DOs will tell you they are NOT chiropractors and "not addicted to *crack*" :-).  My Outpatient Internal medicine preceptor and my current Family Medicine SP are both DOs.  They both seem to be pretty down to earth, but the former practices OMM while the latter does not.

[2234leej]

Haha yeah DO's are definitely NOT chiropractors. DC's belong in their own category (which I will not discuss :)). It's a lost treatment for DO's; I feel like many of them stopped using these techniques to distance themselves from DC's and imitate the MD allopathic profession.

[primadonna22274]

The fundamental philosophy of restoring homeostasis is what makes DOs different.
Four tenets of osteopathic medicine:
1. The body is a unit. Mind, body and spirit are interconnected.
2. Structure and function are reciprocally interrelated.
3. The human body possesses natural self-regulating and self-healing properties.
4. Rational treatment consists of integrating these three principles.

That's the short version. (Yes, they make us memorize this...and a lot of other dumb facts like A.T. Still's birthday etc.)

DOs spend four hours a week (on average) for the first two years of med school learning and practicing osteopathic manipulation. One of the most valuable parts of this training is that we quickly get over any fear of touching another body. Granted, as a PA first I got over that a long time ago...but this was different. We develop a competency in physical examination and "listening" to the body that hones diagnostic skill.

I was frustrated that I wasn't immediately good at OMM (osteopathic manipulative medicine). I had to really work at it. I failed a couple practicals and it was intimidating. But I still use those skills most days--not on every patient, but on the ones I know I can do something quickly and easily to help. So many treatments are less than 2 minutes and make a huge difference and my patients are very thankful.

The founder of osteopathic medicine, Andrew Taylor Still, was an MD who became disillusioned with allopathic medicine in the post-Civil War era. Keep in mind the science of medicine was still quite rudimentary then. We had very few treatments that had any scientific basis and many were frankly poisons (arsenic for syphilis, anyone?). Dr Still lost his wife and two or three of his children to influenza and was convinced that the bleeding that was standard treatment for febrile illness at the time contributed to their deaths. He started studying other ways to regulate homeostasis--specifically, how to target the autonomic nervous system by palpating the major spinal and cranial ganglia to regulate PNS and SNS. While this was rudimentary, it took off and 140 years later we have quite an body of science into the physiology of OMM. It's cool to see it work in real time.

Early DOs eschewed modern medicine aka "pills" and tinctures. Remember most of these were poison. After the Flexner report in 1914 many osteopathic and allopathic medical schools closed but the ones that survived were better and produced more scientifically sound physicians.

There's a much longer history than that...you can read about it yourself if interested. http://www.aacom.org/become-a-doctor/about-om/history

As for any real day-to-day differences, I tell patients I'm a physician who's good with her hands. [emoji4]

I've had people seek my out because I was a DO and they hoped I did manipulation. I do some--but not as much as others. It's kinda funny that I somehow developed a reputation in my residency as the osteopath guru--to the point of a ridiculous roast skit at graduation involving manipulation with a wine bottle [emoji23]All in good fun!


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