What Distinguishes a DO from an MD?
Both Doctors of Osteopathic Medicine (DOs) and Doctors of Medicine (MDs) are fully licensed physicians in all 50 U.S. states. They can prescribe medication, perform surgery, and pursue any specialty. While their paths converge significantly during residency, the core difference lies in their medical philosophies, rooted in different foundational educational approaches. MDs practice allopathic medicine, which traditionally focuses on diagnosing and treating diseases and specific symptoms with medicine, surgery, or other interventions. DOs are trained in osteopathic medicine, which is centered on a holistic, 'whole person' approach.
The Foundational Philosophy: Holistic vs. Allopathic
- The Allopathic (MD) Approach: The conventional allopathic model trains physicians to focus primarily on the diagnosis and treatment of specific conditions and diseases. This model uses a scientific, evidence-based approach to identify the cause of symptoms and determine the most effective treatment, often relying on targeted interventions like medication or surgery.
- The Osteopathic (DO) Approach: Osteopathic philosophy views the body as an interconnected system of mind, body, and spirit. DOs are taught to look beyond a patient's symptoms to understand how lifestyle, environment, and the body's various systems influence overall well-being. This perspective emphasizes preventative care and supporting the body's natural tendency toward health and self-healing.
The Hands-On Distinction: Osteopathic Manipulative Treatment (OMT)
A significant distinction in a DO's training is the additional 200+ hours spent on Osteopathic Manipulative Treatment (OMT). OMT is a set of hands-on techniques used by DOs to diagnose, treat, and prevent illness or injury by moving a patient's muscles and joints. OMT can help with a variety of conditions by:
- Easing musculoskeletal pain, such as chronic back or neck pain.
- Improving range of motion and mobility.
- Supporting the body's ability to heal and promoting overall wellness.
Education, Licensing, and Specialization
The educational path for MDs and DOs is strikingly similar, involving a four-year undergraduate degree, four years of medical school, and a residency program.
The Training Pathway
- Undergraduate Studies: Both MD and DO candidates complete pre-med coursework and take the Medical College Admission Test (MCAT).
- Medical School: Both attend four years of accredited medical school, studying similar foundational science and participating in clinical rotations. The key difference is the extra OMT training for DO students.
- Residency: As of July 2020, the residency accreditation systems merged, allowing both MDs and DOs to apply for the same residency programs. Residency programs typically last three to seven years depending on the chosen specialty.
- Licensing: MDs take the USMLE, while DOs take the COMLEX, though many DOs take both to expand their residency options. Both are then licensed to practice medicine.
Career Trends
While DOs can pursue any specialty, a higher percentage of DOs choose primary care fields like family medicine, internal medicine, and pediatrics compared to MDs. This trend is often attributed to the alignment of primary care with the osteopathic philosophy of wellness and prevention.
Comparison: DO vs. MD at a Glance
| Feature | Doctor of Osteopathic Medicine (DO) | Doctor of Medicine (MD) |
|---|---|---|
| Medical Philosophy | Holistic, 'whole person' approach; emphasizes the body's interconnected systems. | Allopathic, conventional approach; focuses on diagnosing and treating specific diseases. |
| Hands-On Treatment | Includes Osteopathic Manipulative Treatment (OMT) for diagnosis and treatment. | Typically does not include hands-on manipulation, unless specially trained. |
| Licensing Exam | Comprehensive Osteopathic Medical Licensing Examination (COMLEX). | U.S. Medical Licensing Examination (USMLE). |
| Specialization | Can specialize in any field, but more likely to choose primary care. | Can specialize in any field, with a higher rate entering non-primary care specialties. |
How to Choose the Right Physician for You
When deciding between a DO and an MD, consider what aspects of healthcare are most important to you. The letter after a doctor's name is less important than their individual communication style, experience, and the rapport you build with them.
- If you prioritize a collaborative, patient-centered approach that considers your lifestyle, environment, and emotions, and are interested in hands-on treatment options like OMT, a DO may be an ideal fit.
- If you are seeking highly competitive, specialized care in a field like neurosurgery or cardiology, an MD may have more residency experience in that specific area, though DOs are fully capable of specializing in these fields as well.
- Regardless of the degree, many physicians today incorporate elements of both philosophies. It is essential to interview a potential doctor and ask about their approach to care. Tools like the American Osteopathic Association's 'Find Your DO' search can help locate qualified osteopathic physicians in your area.
Conclusion
Ultimately, the choice between a DO and an MD comes down to personal preference for healthcare philosophy and approach. Both are highly-trained, fully licensed physicians who provide quality medical care. For those who value a holistic, whole-person perspective and may benefit from hands-on therapies, an osteopathic physician offers a unique and comprehensive path to wellness. The key is to find a doctor who you trust and with whom you can partner to achieve your health goals, whether they have a DO or an MD behind their name.
The DO Difference
To learn more about the osteopathic philosophy and find a qualified DO in your area, visit the American Osteopathic Association (AOA) website at osteopathic.org.
