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Osteopathic Docs as Mainstream as M.D.s

These physicians combine hands-on body manipulation with traditional medicine

SATURDAY, Oct. 12, 2002 (HealthDayNews) -- What does it mean when your doctor has a D.O. after her name instead of an M.D.? Is she a "real" doctor?

The answer is an unqualified yes. A doctor of osteopathy has the same four-year medical school training as a medical doctor -- although at different medical schools -- as well as a year of internship and a year of residency.

While the basics are the same, there are subtle differences in the ways the two groups of physicians practice medicine.

And Oct. 6-12, National Osteopathic Medicine Week, is designed to highlight the continuing growth of this branch of medical care in the United States.

"When people ask me, I use the analogy of the Democrats and the Republicans. They are both writing laws, but are coming at them with different philosophies," says Dr. Tyler Cymet, a doctor of osteopathy and a professor at Johns Hopkins Medical School in Baltimore. "M.D.s and D.O.s are both in the business of healing, but they have different philosophies and a different orientation."

Adds Dr. J. Edward Hill, chairman of the American Medical Association: "The position of the American Medical Association is that M.D.s and D.O.s are perfectly comparable. There are no significant differences between the two. We are very supportive of each other, and it's been a good arrangement."

D.O.s, Cymet says, are trained in a "whole person" idea, so they focus on personal history in addition to medical history when diagnosing an illness. They also receive extra training in the musculoskeletal system, the way the body's nerves, tissues, muscles and bones are interconnected, with the idea of understanding how an injury or illness in one part of your body affects other parts. The training includes osteopathic manipulative treatment (OMT), which is a therapeutic application of force to help patients maintain a full range of motion.

"Sixty percent of D.O.s are primary-care specialists," Cymet says. "We are not just looking at the disease. We try to develop a relationship with the patient, understanding the social aspects of their lives as well as the biomechanical problems they may have."

He adds, "Our philosophy is to use the body to heal itself, to use medical knowledge to free up motion to allow the person to be active, to help a person stay healthier."

Cymet says a typical initial visit with a patient takes an hour. First, there is a physical examination, and then he spends time getting to know the patient.

"I ask him how he spends his day, what time he wakes up, what he eats for breakfast…," he says. "Then I ask about the problem, whether it is new or old, and how it has changed his life. The discussion itself can be therapeutic to the patient."

The treatment can be a standard medical treatment, such as a drug prescription, or can include manipulative treatment to help the patient with his pain or range of motion. Because of time constraints, however, Cymet says he often has to have the patient return for osteopathic manipulative treatment.

Though an OMT sounds like standard chiropractic treatment, Cymet says it's more than that.

"We have more medical training," he says. "We know more about the organs and soft tissues than chiropractors, and are much better prepared to know if there is a problem with a prostate or gall bladder or other organs."

Dr. Patrick Alguire, the director of education and career development at the American College of Physicians in Philadelphia, used to teach a training program in internal medicine at Michigan State University, which has both a D.O. and M.D. program. He agrees the training for both specialties is very similar.

"Many of the courses were the same, and there was no difference in the baseline knowledge or skills with patients," he says, except that the D.O.s took courses in manipulative medicine.

Alguire, an M.D., adds he continues to see little difference in the ways the two groups practice medicine.

"Holistic care is not unique to D.O.s," he says. "Starting about 20 or 30 years ago, there has been a push toward generalization, to developing specialized training tracks for primary-care physicians."

There are far more M.D.s than D.O.s, says Cymet, but the ranks of D.O.s are growing.

According to the American Osteopathic Association, there were more than 44,000 osteopathic doctors in 2000, the latest year with available figures.

"The number of schools has increased, from six in the 1980s to 19 schools now, and there are two-and-a-half applicants for every spot," Cymet says.

What To Do

For an explanation of osteopathic manipulative treatment, you can visit the American Osteopathic Association. And the American Cancer Society has an informative explanation of doctors of osteopathy.

SOURCES: Tyler Cymet, D.O., assistant professor, internal medicine, Johns Hopkins School of Medicine, and section head, family medicine, Sinai Hospital, Baltimore, Md.; Patrick Alguire, M.D., director, education and career development, American College of Physicians, Philadelphia; J. Edward Hill, M.D., chairman, American Medical Association, Chicago
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