As discussed before on this website, all doctors are not created equal. Like everyone else, doctors have different skill sets, levels of aptitude, training and experience. Doctors are people after all. Many patients do not realize the distinction between a D.O. (doctor of osteopathic medicine) and an M.D. (medical doctor). Patients often say “they’re both doctors.” The truth, however, is that a significant difference exists between the two.
There is a long-standing stigma against doctors with a D.O. While M.D. degrees have existed since at least the early 1700s,[1] D.O. degrees are a recent phenomenon. For example, D.O.s were unable to practice medicine in Nebraska until 1989.[2] Through the 1960s, osteopathic medicine was labeled a cult by the American Medical Association and collaboration by physicians with osteopathic practitioners was considered unethical.[3]
Today, there are far fewer D.O.s than M.D.s. Only 7 percent of practicing physicians have a D.O. degree, compared to 67 percent with an M.D. degree.[4] Of first-year medical students, just 26 percent enroll in D.O. schools, compared to 74 percent for M.D. programs.[5]
It is easier to be accepted to schools awarding a D.O. degree. The standardized test scores and GPAs are lower for D.O. applicants than M.D.s. The average MCAT score for applicants to D.O. schools is 504 compared to 511 for M.D. programs.[6] The average GPA for D.O. applicants is 3.5, compared to an average of 3.7 for M.D. students.[7] D.O. schools are also more likely to accept “non-traditional” students that are older and entering medicine as a second career.[8]
Schools awarding D.O. degrees are less prestigious. There are 36 schools in the country that grant D.O. degrees.[9] There are 144 M.D. schools in the United States.[10] Many D.O. schools have names that are completely unrecognizable to the general population – for example, University of the Incarnate Word School of Osteopathic Medicine.[11] Only a handful of mainstream universities associate with osteopathic schools.
D.O. schools are much less likely to receive funding for academic, peer-reviewed research. D.O. schools rank last out of 17 types of educational institutions in research funding.[12] The Journal of the American Osteopathic Association states research from osteopathic schools amounts to “fewer than 15 publications per year per school, and more than a quarter of these publications have never been cited. Clearly, scholarly contributions from osteopathic medical schools are unacceptably low in both quantity and quality.”[13] Contrastingly, M.D. schools apply for and receive 800 times more funding for scientific and clinical research.[14]
D.O. schools often do not offer the same quality of training as M.D. programs. Generally, D.O. schools operate in rural areas or underserved communities. M.D. programs are typically located near large academic medical centers with clinical rotations.[15]
A much greater percentage of D.O.s serve as primary care physicians than as specialists. 60 percent of D.O.s work in primary care, compared to just 35 percent of M.D.s.[16] The greatest representation of D.O. doctors by specialty is Family Medicine (16.5 percent) and Physical Therapy (13.8 percent).[17] On the whole, M.D.s offer more specialized services requiring a greater amount of technical knowledge and expertise.
Many patients are caught off guard to learn D.O.s may perform the same procedures as M.D.s. A survey in the American Osteopathic Association found 29 percent of adults are unaware D.O.s are licensed to practice medicine and 63 percent do not know D.O.s may perform surgery.[18]
There is some support behind the stigma against D.O. doctors. Some critics go so far as to say the D.O. degree is a workaround for students rejected from M.D. programs.[19] In any event, given the lower standardized test scores, education, training and experience, D.O.s are less-than-ideal candidates to provide complicated procedures. Patients would be well-advised to tread carefully when selecting a D.O.
[1] Comrie, JD. History of Scottish Medicine. Volume 1, pp355-356 (1932).
[2] Gevitz, Norman. The D.O.’s: Osteopathic Medicine in America. Johns Hopkins University Press. ISBN 978-0-8018-7833-6 (2004).
[3] Fauci A., Briggs J., et al.. Complementary, Alternative, and Integrative Health Practices. Harrison’s Principles of Internal Medicine. McGraw-Hill Education (2005). Available at https://accessmedicine.mhmedical.com/content.aspx?bookid=1130§ionid=63652639.
[4] 2016 Physician
Specialty Data Book. Association of American Medical Colleges. Available at https://www.aamc.org/data-reports/workforce/report/physician-specialty-data-report.
[5] Results of the
2016 Medical School Enrollment Survey. Association of American Medical Colleges
(May 2017). Available at https://www.aamc.org/system/files/reports/1/resultsofthe2016medicalschoolenrollmentsurvey.pdf.
[6] Table A-16:
MCAT Scores and GPAs for Applicants and Matriculants to U.S. Medical Schools.
Association of American Medical Colleges (2019). Available at https://www.aamc.org/system/files/2019-10/2019_FACTS_Table_A-16.pdf;
General Admission Requirements. American Association of Colleges of Osteopathic
Medicine. Available at https://www.aacom.org/become-a-doctor/how-to-apply-to-osteopathic-medical-college/general-admission-requirements.
[7] Id.
[8] Park, Madison.
Never Too Late to be a Doctor. CNN
News (June 13, 2011). Available at http://www.cnn.com/2011/HEALTH/06/13/mid.life.doctors/index.html?hpt=hp_t2/.
[9] U.S. Colleges
of Osteopathic Medicine. American Association of Colleges of Osteopathic
Medicine. Available at https://www.aacom.org/become-a-doctor/u-s-colleges-of-osteopathic-medicine.
[10] Medical School
Directory. Liaison Committee on Medical Education. Available at https://archive.is/20131114000754/http://www.lcme.org/directory.htm.
[11] Id.
[12] Results of the 2016 Medical School Enrollment Survey. Association of American Medical Colleges (May 2017). Available at https://www.aamc.org/system/files/reports/1/resultsofthe2016medicalschoolenrollmentsurvey.pdf.; Clark B., Blazyk J. Research in the Osteopathic Medical Profession: Roadmap to Recovery. The Journal of the American Osteopathic Association. 114 (8): 608–614 (2014). Available at https://jaoa.org/article.aspx?articleid=2094616; The Role of International Medical Graduates in the U.S. Physician Workforce. American College of Physicians (May 13, 2008). Available at https://www.acponline.org/acp_policy/policies/role_international_medical_graduates_2008.pdf.
[13] Clark B., Blazyk J. Research in the Osteopathic Medical Profession: Roadmap to Recovery. The Journal of the American Osteopathic Association. 114 (8): 608–614 (2014). Available at https://jaoa.org/article.aspx?articleid=2094616; The Role of International Medical Graduates in the U.S. Physician Workforce. American College of Physicians (May 13, 2008). Available at https://www.acponline.org/acp_policy/policies/role_international_medical_graduates_2008.pdf.
[14] Id.
[15] Chen C., Mullan F. The Separate Osteopathic Medical Education Pathway: Uniquely Addressing National Needs. Acad Med. 84 (6): 695 (2009). Available at https://insights.ovid.com/crossref?an=00001888-200906000-00008.
[16] M.D. vs D.O. –
What are the Differences (And Similarities). Medical School Headquarters. Available at https://medicalschoolhq.net/md-vs-do-what-are-the-differences-and-similarities/#2;
Cohen, Erica, Does Osteopathic Medicine
Have a Future? The Philadelphia Inquirer (Nov. 1, 2012). Available at https://www.inquirer.com/philly/blogs/health-cents/Does-osteopathic-medicine-have-a-future.html.
[17] The Role of
International Medical Graduates in the U.S. Physician Workforce. American
College of Physicians (May 13, 2008). Available
at https://www.acponline.org/acp_policy/policies/role_international_medical_graduates_2008.pdf.
[18] Berger,
Joseph. The D.O. Is In Now. The New
York Times (July 29, 2014). Available at https://www.nytimes.com/2014/08/03/education/edlife/the-osteopathic-branch-of-medicine-is-booming.html.
[19] Id.