D.O. vs. M.D.: What Is a D.O. (Doctor of Osteopathic Medicine)?

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According to the AOA, there are four tenets of osteopathic medicine:

  1. The body is a unit; the person is a unit of body, mind, and spirit.

  2. The body is capable of self-regulation, self-healing, and health maintenance.

  3. Structure and function are reciprocally interrelated.

  4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

In practice, this means that D.O.s generally focus on evaluating different body parts and systems in the context of each other, viewing them all as interconnected, and also considering emotional and mental health as well, Octavia Cannon, D.O., a board-certified ob/gyn in North Carolina and president of the American College of Osteopathic Obstetricians and Gynecologists, tells SELF. “D.O.s are trained to look at the entire patient to determine diagnosis and treatment, not just the specific complaint,” she explains.

That’s not to say M.D.s don’t also focus on the whole patient, though. “M.D.-granting medical schools understand that patient care is often a complex and personal issue. For treatment to be most effective, a holistic approach to a patient’s condition should be followed,” Janis Orlowski, M.D., chief health care officer at the AAMC, tells SELF.

While M.D.-granting medical schools focus on traditional evidence-based medicine, their curricula also include holistic approaches. “Students receive interprofessional training that brings together several different approaches to patient care delivery that can be more comprehensive and can improve the overall health outcomes of a patient,” says Dr. Orlowksi.

As we mentioned, there’s a lot of overlap.

Focus on the Musculoskeletal System

Another important distinction: The D.O. philosophy places a significant emphasis on the musculoskeletal system (your nerves, muscles, and bones) as a cornerstone of health.

Because of this, D.O.s spend at least 200 hours during their medical education getting additional training in a technique called osteopathic manipulative medicine (OMM).

Osteopathic manipulative medicine involves hands-on movement of the musculoskeletal system. Also called osteopathic manipulative treatment (OMT), OMM is a kind of manual therapy some D.O.s use to address mechanical issues in the body, according to the NCCIH. It involves manipulating a person’s muscles and joints with a variety of techniques like stretching and gentle pressure, according to the AOA.

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For instance, a primary care D.O. may use OMM to diagnose and address the root cause of common complaints like lower back pain and headaches, issues that often originate from other parts of the body, Mikhail Varshavski, D.O., a board-certified family medicine physician at the Atlantic Health System’s Overlook Medical Center, tells SELF. “It is not uncommon to find a patient suffering from back pain originating from tight muscles in the hips,” he explains, “or headaches resulting from poor posture leading to muscular dysfunction in the [paraspinal muscles in the back].” In 2017, the Journal of Family Practice reviewed various meta-analyses and found that patients who received OMM for lower back pain reported decreased pain and improved function (compared to patients who received no treatment, other treatments, or “sham” OMM).

However, not all D.O.s employ OMM on a regular basis. Overall, it appears as though the number of D.O.s practicing this method is declining. Although there is not much data on the subject, a 1998 mail-in survey of 955 D.O.s published in the The Journal of the Association of American Medical Colleges found that over 50 percent of the respondents said that they use OMM on less than 5 percent of their patients. A similar survey published in the Journal of the American Osteopathic Association in 1997 found that only 6 percent of the 1,055 respondents reported using OMM on over half their patients.

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