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What is a DO?

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Osteopathic Medicine

There are 2 types of physicians that practice the full scope of medicine in the United States, allopathic physicians (M.D) and osteopathic physicians (D.O.). The common question concerning the 2 types is “what is the difference?”.

Osteopathic physicians complete the exact same medical school curriculum as allopathic physicians. They can practice medicine and surgery and prescribe medications as allopaths. The difference is that osteopaths are taught a more holistic approach to medicine and incorporate manual medicine techniques with additional training hours in the curriculum.

In the 19th century, A.T. Still was a trained allopathic physician who noted that most medications given during that time period were more toxic than helpful in eliminating disease. One commonly prescribed drug was mercury. We now know that this is not a drug and its use reproducibly causes toxic side effects. Osteopathic medicine was founded by Dr. A.T. Still (an allopath) because he noted the harm of medications. He subsequently developed a holistic training philosophy. He opened the first osteopathic medical college in Kirksville, Missouri in the mid 1800’s.

Today, with the development of research and tight scrutiny by the FDA, medications are safer and helpful in treating disease. So the gap between osteopaths and allopaths has narrowed. Osteopathic medicine offers subtle differences in training, with an emphasis on incorporating manual medicine techniques. It provides practitioners with the ability to develop keen diagnostic skills in using our hands to help diagnose disease processes. There are many manual treatment modalities that are incorporated into practice.

The real strength is osteopathic medicine is in family practice and orthopedic surgery. Both potentially offer dynamic comprehensive care. The family practitioner has the ability to perform initial evaluations and incorporate a holistic approach to healing using manual medicine and lifestyle changes to promote healing. Prescription medications are also important and utilized in a judicious fashion.

The orthopedic surgeon benefits from osteopathic training by developing a keen diagnostic acumen from the extra training in manual medicine. Palpatory skills are perfected and essential in any orthopedic evaluation. A holistic approach is incorporated by offering therapeutic techniques and/or surgery to eliminate disease. Medications are prescribed when necessary, but used judiciously. Masking pain with analgesics is not a cure for most conditions, but are most definitely utilized for postoperative pain management and other chronic ailments.

There are subtle, yet distinct differences in postgraduate residency training between osteopaths and allopaths. Osteopaths are required to perform a traditional rotating internship that incorporates all facets of medicine and surgery to allow them to be adept at performing family practice. Afterward, they have the choice to pursue any type of specialty training or continue with family medicine. This is crucial in developing an understanding of all disease processes in all specialties as well as developing a bedside manner, no matter what specialty is entered. This is changing and osteopathic internships are becoming more specialized. Fortunately, I had the opportunity to receive the well-balanced curriculum.

An osteopathic orthopedic surgery residency provides a similar curriculum as an allopathic residency. It is a 4 year program (5 including internship) that incorporates techniques mainly developed and perfected by allopathic physicians. Many of the professors training the osteopathic residents are allopaths. It gives the resident exposure to both sides and only gold standard techniques are emphasized. Fellowship training in a subspecialty is dominated by allopathic professors at major university hospitals, but osteopaths are welcomed and effectively train in these programs.

In summary, the osteopathic orthopedic surgeon’s training provides a firm foundation in diagnostic techniques, a holistic approach, and a good bedside manner from an influence of osteopathic and allopathic pre and postgraduate training. Only well studied surgical techniques are performed which are derived from mainly allopathic research. This gives patients the best of both worlds and the opportunity to achieve the best outcome to relevant conditions or diseases.