MD or DO: What’s the difference?

Most of us are quite accustomed to using academic titles such as “Doctor” or “Professor” when addressing someone with a doctoral degree. It is quite natural when referring to someone as “Doctor” to assume that this individual has a degree in the medical arts, but this title also applies to those with doctoral degrees in the fine arts, dentistry, veterinarian science, or law. In the US there are 2 types of doctors licensed to practice the medical arts; allopathic (MD) and osteopathic (DO). A frequently asked question is: what are the differences between a Doctor of Medicine (MD), and a Doctor of Osteopathic Medicine (DO)?

In years past, there were some significant differences between the 2 professions, but today there are many more similarities. Both are capable of practicing the full scope of medicine and specialize in fields like orthopaedics, neurosurgery, cardiology, internal medicine, and family practice. Both attend 4 years of medical school with similar curricula, and complete accredited residency training programs. Overall the training is very similar. There are some subtle differences in the approach to medical care, but the most noticeable difference is the hands on approach to patient care.

Osteopathic medicine was founded in 1892 by Andrew Taylor Still, MD. Dr. Still was a practicing allopathic physician who lost his wife and children to meningitis. After their deaths, he grew dissatisfied with the medical practices of the day, which were frequently ineffective and often caused more harm than good. The common medical practices during that time period included the use of arsenic, opium, castor oil, and whiskey. Dr. Still’s distrust in the medical practices of his day, prompted him to develop a new theory of medicine that would promote the body’s innate ability to heal itself.

Osteopathic medicine was founded on 3 key principals: 1) the body is a unit and health is related to the mind, body, and spirit of the individual; 2) the human body has an inherent ability to heal itself given the optimal conditions; and 3) that structure influences function and proper alignment of the musculoskeletal system is key to proper function.

The first 2 principals are not novel concepts; they date back to Hippocrates who said, “It is far more important to know what person the disease has than what disease the person has.” DOs are trained to use a holistic approach to patient care, which means they see each person as more than just a collection of organ systems, body parts, or disease. Today most physicians, MD and DO, have adopted this holistic approach to patient care.

The most notable difference between an MD and DO, however, is the hands on aspect. A key concept in osteopathic medicine is that structure influences function. Thus, if there is a problem in the body’s structure, function in that area, and possibly other areas, can be affected. Osteopathic physicians use this knowledge to aid in making diagnosis and in some instances to treat. This concept is generally applied through osteopathic manipulative medicine (OMM). A DO receives about 200 extra hours in OMM training during medical school. OMM is most often used by a DO in primary care fields such as family medicine, sports medicine, pediatrics, and internal medicine. It can be used to diagnose and treat a variety of medical conditions, including, but not limited to: low back pain, joint pain, neck pain, headaches, gastrointestinal conditions, and respiratory problems.

Currently there are about 141 medical and 33 osteopathic schools in the US. Each year around 80% of medical students enter MD programs and 20% enter DO programs. The prerequisites for acceptance into either program are the same, as well as the pathway for board certification and maintaining continuing medical education (CME). There are currently over 100,000 practicing DOs that make up about 7% of the medical physicians in the US.

In all 50 states, licensing agencies, hospitals, and residency programs recognize MD and DO degrees as equivalent. Recent studies comparing both disciplines have revealed that there are few remaining differences. While the pathways to becoming either an MD or DO are becoming indistinguishable, a blend of both the allopathic and osteopathic approaches to treating patients may offer patients the most comprehensive form of treatment.

Author: M. Canaan Prater, DO, and David Coffey, DO, FAAO, FCA

Reprinted with permission from the Hughston Health Alert, Volume 29, Number 3, Summer 2017.