Introduction:

I have seen the "health frustration" throughout Steem. Many people have mistrust for the “typical physician" and feeling like there isn’t anyone they can trust with their health. I get it. You experience your body and what works for you. But, do you really understand your body? Do you really know the mechanisms that are occurring in your body to improve your health? People will find any source on the internet to validate their “gut feeling” beliefs.  

Is this bad? Not exactly, but it can be frustrating to the doctor. Let me make a comparison; if you clog up your toilet and need a plumber, do you question the plumbers knowledge because you use the toilet everyday?…I doubt it. I bet you just want the toilet to be unclogged.  

Individual people experience their health, whether good or bad, everyday; however, that does not mean they have the educated knowledge to understand it, or more importantly, to fully manage it. Let’s face it—people (and even myself—about to be a doctor in May, need doctors). From my experience in medical school and in the hospital system, there are good medical doctors and bad ones; but overall, I think doctors really want to help. It is an amazing feeling to save someones life, and it is also meaningful when one dies and you have the role to comfort the loved ones who will bare that suffering. 

My into is long…but an important one. Before I go into the differences between the training of an MD (Medical Doctor—AKA allopath) versus DO (Doctor of Osteopathy—AKA Osteopath) I wanted to set things straight about how doctors care about their patients. Whether individuals here have problems with vaccines, pharmaceutical companies, or just any physician giving them tips about their health, I want the readers here to take a leap of faith. Or, rather, like many on Steem, take a leap into science. Most trained physicians were biology majors (like myself) or chemistry majors before going into the 4-year journey of becoming a physician. Science is the basis we have to give the best management and quality of life to our patients…well that and a big heart. There are good and evil people in every profession. The majority of physicians I have had contact with are not only smart, but they also came into medicine to help others. Most would not endure these long hours that only a medical student can understand, or get into an average of 200,000 dollars of government debt if they did not want to help/make a difference in some way.  

Before speaking about why I love osteopathic medicine, I want to give credit to the “MD". The majority of people I work with at the hospital are MDs. Many are brilliant people, with a heart to help others. They are great at the differential diagnosis, and finding ways to manage patients through consultation or medical management. The one thing that separates us (osteopaths) from any variation you can see physician-to-physician is the study of osteopathic manipulative medicine, which is only taught in osteopathic schools. The philosophy is also slightly different, but again, that philosophy could be shared whether DO or MD. However, osteopathic schools engrain a special philosophy, which will be discussed later.  The philosophy is a personal quality, not one that can be taught by reading a book. I hope to keep the osteopathic philosophy as I start my career as a medical doctor.

Difference in Training: MD VS DO

Undergraduate: 

Almost all MD and DO schools require a 4-year undergraduate degree at some college, with no requirements in a specific major. There are rare exceptions to this rule, in both fields, but to my knowledge, all require many courses in biology, chemistry, psychology, and physics. To express the amount of courses required... after fulfilling all my chemistry requirements, I was one course away from having a minor in chemistry! It is easy to see why most medical professionals major in science before medical school because one gets most of the major requirements just by doing what is required to apply to medical school. 

I really loved history and philosophy too so I decided to major in world religion as well. It didn’t leave me time to study abroad…DANG! but I have no regrets for choosing my two majors.…Basically, you could be a music major and take over 15 science courses and still get into medical school.   

Entrance Exam for Medical School: 

For both MD and DO medical schools, you must take the MCAT, which is a national entrance exam in the US. The test, at least when I took it, consisted of all the science courses you took in college. So sections were broken into physical science (physics), chemistry, and biology. Basically, you had to remember everything you learned in college… I know…WHAT A BLAST (excuse the sarcasm)! 

…So the knowledge going into medical school for DO and MD is the same. 

What is harder to get into: Over the years, they are equalizing more and more. In the continental US, MD schools, are more strict on MCAT scores and typically slightly harder to get into. However, Caribbean medical schools are the easiest to get into and are only MD. So I guess in a way, MD schools are by far the easiest schools to get into (however, I have met very bright physicians from Caribbean based schools, so I would never judge a doctor just because he went somewhere that was easier to get into. It's a simple fact: once a student is into medical school, it's a hard road where the strong survive!) . Osteopathic schools, which are fewer in number and all private, take more consideration on the interview process and grades during college versus MCAT scores. It is not at all easy to get into…competitive scores in DO schools are probably averaging a 3.7- 3.8 GPA in college and an MCAT score of 28-30. Every year, it gets harder and harder to get into medical school. I find this a problem. If you are smart and want to study your butt off, then you deserve to get into medical school, especially since there is much need for more medical professionals.  

Differences in Medical School: MD VS DO 

The medical knowledge training for MD and DO is equivalent. Both fields spend two years studying for ridiculous amounts of time (I would say average over 80-90 hours a week including school) on human anatomy, microbiology, biochemistry, physiology of every organ system, pathology/histology, pharmacology, psychiatry, and much more. At one point, it was like having final college exams every week. 

DOs (osteopathic doctors) also have 200-500 hours of additional training in osteopathic manipulation (I will cover this topic in this post). MDs do not receive training in this form of medicine. 

DOs also are taught a philosophy of “holistic” medicine. In summary, the philosophy is that the body is connected in three ways: mind, body, and spirit. If one in altered in any way, the body is not balanced and can cause medical issues, such as physical manifestations. For instance, if someone has neck pain, you may give ibuprofen to decrease that inflammation. However, if their neck pain is being exacerbated by stress, then it may cause hormones to be released, to again, cause muscle tightness in the neck. So, it is not that ibuprofen is bad or should not be used, but a physician should also consult the patient’s stress before just prescribing medication.  

Bottom Line: 

Doctors of Osteopathy (DO) and Medical Doctors (MD) physicians are equivalent in medical knowledge taught and prerequisites required to attend the school. Osteopathic schools are distinct in that while learning medicine, they teach the philosophy of holistic medicine; it still includes prescribing the correct medication when necessary/appropriate but also treating beyond the body and into the mind and spirit as well. Osteopathic physicians are also trained in "Osteopathic Manipulative Medicine,” which is an additional 200-500 hours of training.   

United States residencies and future medical professions after medical school:

Next year, I will hopefully get my first job as a medical resident. There are DO only residencies or MD residencies (which can be comprised of MDs and DOs). You are officially a doctor after medical school, but typically train in a specific field of medicine. I, like 2-generations before me, will likely be in a family medicine residency, which is a three-year program. You are paid to see your own patients but are still learning from experienced physicians during those three years. DOs and MDs have equivalent rights as physicians. There are no separate restrictions between DOs and MDs. A DO and MD both can prescribe what is legal to prescribe and can become any type of physician (whether family medicine, or a heart surgeon).  

 A Glimpse Into Osteopathic Medicine  

To start off, I would like to first note that I will dedicate an entire post to Osteopathic Manipulative Medicine (OMM) and Osteopathic Manipulative Treatment (OMT) in the future. I want to end this post by discussing the historical foundation of osteopathy, and a brief description of Osteopathic Manipulation. 

The Foundation and Philosophy: 

Dr. Taylor Still is the founder of osteopathic medicine. In 1892 he opened the first school, the American School of Osteopathy in Kirksville, MO. He received the traditional MD degree in the mid-1800s, and was a surgeon during the Civil War. After the war, three of his children died of meningitis, despite medical efforts that the world knew. He became fed up with the lack of healing during the 19th century. At this time “bloodletting and purging” and medicines such as morphine and mercury (for syphilis) were being used often (Ref 1 and 2). 

In the 19th century medicine was not pretty! There were no antibiotics available, and there was not much science backing any of the techniques. Dr. Still was fed up with it, and that is why he made his own field of medicine. He taught people and discovered that the body had the amazing ability to heal itself through homeostasis (Ref 2). 

He taught osteopathic manipulation, in which the physician would move the patients body in ways that could restore function to that area that was dysfunctional. Osteopathic studies, while fewer than many pharmacologic studies, have given signifiant validation to the claims that were discovered during Still’s time. From my own personal experience using these techniques on patients in hospitals, they are very effective. In just 5 minutes, I often can make a very tight muscle in someones back or neck become very relaxed. Dr. Still studied anatomy intensely! He realized that fascia (webbing of tissue) around bone, vascular/neural/lymphatic tissue, and muscle were all connected. By manipulating the patient's body with the physicians hands (moving the structures mentioned through various methods), the fascia can be freed, which speeds up the healing process. The body wants to be in homeostasis, and if a physician can guide that musculoskeletal component to a “normal state,” homeostasis will hopefully be reinstated or, at least, improved.

There have been many amazing accomplishments in osteopathic medicine in the early days, and I would like to highlight one of these....

In 1918, the Great Flu Pandemic wiped out 40 million people world-wide. 650,000 people died in America. If someone just got the viral “flu” there was a 5% chance of death and if someone got bacterial pneumonia (again, before antibiotics were used) there was a 60% chance of dying (Ref 3). 

The flu would often lead to a secondary pneumonia. Under MD care at the time, there was not good medicine, and they would often use pain relief as the main treatment. Under MD care, 5-15 % died from the flu  and 25-60 % died from flu + pneumonia. Osteopathic care at the time, which used more supportive care measures such as hydration and osteopathic manipulative medicine, only had 0.2 % of patients die who had the flu, and only 10 % die who had the flu and pneumonia (Ref 3). 

One thing is for sure--there was a signifiant decrease in mortality when osteopathic physicians treated patients during the Great Flu Pandemic of 1918. 

I hope this brings insight for Steemers to appreciate the osteopathic medical approach. I am proud to be graduating in May, but I also hope to keep this philosophy alive within. I plan to continue using osteopathic manipulation as one tool I have to help patients. 

In the near future, I will discuss in more detail osteopathic manipulation, and maybe perhaps make videos of how the techniques are performed. There is much scientific theory behind these techniques, which I will also be able to provide you. I will also try to validate these techniques with current medical research.

My diabetes posts have met great reception on here. Informing people about health is an important passion of mine, and I will continue blogging about other health topics such as diabetes as well.

Stay tuned, and I appreciate the followers.

Thanks!

and...the classy photo of myself!

*Sources

Ref 1)  American Association of Colleges of Osteopathic Medicine:   http://www.aacom.org/become-a-doctor/about-om/history 

Ref 2)   Foundations of Osteopathic Medicine – 3rd Edition, Chila-Editor, (Lippincott, Williams &  Wilkins), 2010 (VitalSource)  

Ref 3) Historical Foundations of Med Thought, a powerpoint produced by Dr. Kuchera at our Medical University

*All images from Pixabay.com are no source is needed. Photo of myself as a senior in medical school (last photo).