If you're like most people, you've been going to a doctor since you were born and perhaps didn't know if you were seeing a D.O. (osteopathic physician) or an M.D. (allopathic physician). You may not even be aware that there are two types of complete physicians in the United States.

• Applicants to both D.O. and M.D. medical colleges typically have a four-year undergraduate degree with an emphasis on scientific courses.
• Both D.O.s and M.D.s complete four years of basic medical education.
• After medical school, both D.O.s and M.D.s can choose to practice in a specialty area of medicine -- such as surgery, family practice or psychiatry--after completing a residency program (typically two to six years of additional training).
• Both D.O.s and M.D.s must pass comparable state licensing exams.
• D.O.s and M.D.s both practice in fully accredited and licensed health care facilities.

In response, Dr. Still founded a philosophy of medicine based on ideas that date back to Hippocrates, the father of medicine. The philosophy focuses on the unity of all body parts. He identified the musculoskeletal system as a key element of health. He recognized the body’s ability to heal itself and stressed preventive medicine, eating properly and keeping fit.

• Approximately 65% of all osteopathic physicians practice in primary care areas such as pediatrics, family practice, obstetrics/gynecology and internal medicine.
• Many D.O.s fill a critical need for doctors by practicing in rural and medically underserved areas.

• Osteopathic medical schools emphasize training students to be primary care physicians.
• D.O.s practice a "whole person" approach to medicine. Instead of just treating specific symptoms or illnesses, they regard your body as integrated whole.
• Osteopathic physicians focus on preventive health care.
• D.O.s receive extra training in the musculoskeletal system -- your body’s interconnected system of nerves, muscles and bones that make up two-thirds of its body mass. This training provides osteopathic physicians with a better understanding of the ways that an injury or illness in one part of your body can affect another.
• Osteopathic manipulative treatment (OMT) is incorporated in the training and practice of osteopathic physicians. With OMT, osteopathic physicians use their hands to diagnose injury and illness and to encourage your body’s natural tendency toward good health. By combining all available medical procedures with OMT, D.O.s offer their patients the most comprehensive care available in medicine today.

Osteopathic physicians understand how all the body’s systems are interconnected and how each one affects the others. They focus special attention on the musculoskeletal system, which reflects and influences the condition of all other body systems.

This system of bones and muscles makes up about two-thirds of the body’s mass, and a routine part of the osteopathic patient examination is a careful evaluation of these important structures. D.O.s know that the body’s structure plays a critical role in its ability to function. They can use their eyes and hands to identify structural problems and to support the body’s natural tendency toward health and self-healing.

The osteopathic curriculum involves four years of academic study. As a reflection of the osteopathic philosophy, the curriculum emphasizes preventive medicine and comprehensive patient care. Medical students learn to use osteopathic principles and techniques for diagnosis and treatment of disease throughout the curriculum.

After completing osteopathic medical college, D.O.s serve a one-year rotating internship, gaining hands-on experience in internal medicine, obstetrics/gynecology, family practice, and pediatrics. This experience ensures that osteopathic physicians are first trained as primary care physicians. The internship provides every D.O. with the perspective to see and treat every patient as a whole person.

D.O.s practice in all branches of medicine from psychiatry to geriatrics to emergency medicine. However, D.O.s are trained to be generalists first, and specialists second. The majority are family-oriented, primary care physicians. Many D.O.s practice in small towns where they often care for entire families and whole communities.

Some facts about osteopathic physicians:

• The number of D.O.s has increased 67 percent since 1990.
• More than 65% of all D.O.s practice in the primary care areas of family practice, internal medicine, obstetrics/gynecology and pediatrics.
• D.O.s represent 6% of total U.S. physicians and over 8% of all military physicians.
• Each year, more than 100 million patient visits are made to D.O.s.

"Doctors of osteopathic medicine combine the art of healing with the art of caring. They treat each patient with a warm, hands-on approach that’s more about wellness than illness."
John B. Crosby, J.D.
Executive Director, AOA

"We are taking medicine back to where it used to be, and that’s forward thinking."
A. Chris de Laurier, D.O.
Family practitioner, San Diego

"As a physician, I can treat illness, but more important, I can help people to remain healthy."
Anne J. Egan, D.O.
Family practitioner, Philadelphia

The Big Picture

By taking the whole person approach to care, D.O.s don’t just focus on the disease or injury. They look for the underlying causes of disease instead of simply treating the symptoms. Not only do they consider your physical condition, but also they take other factors into account like home, work and family life when making a diagnosis.

Patient, Heal Thyself

D.O.s recognize that the body is inherently capable of healing itself, though it must constantly fight physical, emotional and nutritional "stressors" to maintain a state of wellness. D.O.s believe in educating you about good health and prevention of disease.

The Musculoskeletal System

Diagnosis

Your structural exam will begin with an assessment of your posture, spine and balance. Your D.O. will then use his fingers to palpate your back and extremities. He will also check your joints for restriction and/or pain during motion as well as check your muscles, tendons and ligaments where tenderness can signal a problem. Through extensive osteopathic training in manipulative medicine, D.O.s can detect changes in tissue, however small, that signal injury or impairment.

Once the structural exam is complete, your D.O. will integrate this information with your medical history and a complete physical exam. After that point, a treatment plan can be established.

Treatment

Case 1

Mary visited her D.O. complaining of a sharp pain in her side. The physician asked a series of questions about her pain: its intensity, onset and duration. They also discussed her medical history. The physician then ordered a series of tests to determine whether the pain was caused by disease (i.e. gallbladder or appendix). Tests revealed that it was not. Since the patient indicated that she worked in an office with a "surround style" desk, the D.O. considered that Mary might be suffering from postural/mechanical strain. Based upon his examination, interview with the patient and negative test results, the physician decided to employ OMT to relieve motion restrictions and muscle strain caused by improper sitting and movement. He also recommended changes in the set-up of her workstation to alleviate further pain.

Case 2

Patients were divided into two groups – one treated with standard options like hot/cold packs, physical therapy and anti-inflammatory medication while the other group received OMT and standard care. After a twelve-week period, patients in both groups showed improvement. However, researchers learned that the patients receiving OMT required less medication and physical therapy, resulting in less side effects and lower health care costs.

Another study released on OMT revealed its effectiveness in reducing pain after a hysterectomy. Researchers measured the amount of morphine to treat patients’ pain as well as their perception of their pain levels. Upon the study’s completion, it was determined that administering OMT significantly reduced patients’ needs for pain medication.