SO WHAT IS A D.O. ANYWAY?
by Dr. Donna Alderman
Doctor of Osteopathic Medicine

"Doctor, I was wondering---what does it mean, the 'D.O.' after your name?"

I have been asked this many times in my practice. I have also been referred to as an "M.D." too, because I am a medical doctor, licensed to practice full general medicine. However to do that is actually a technical error. Recently, I picked up an article I had written and discovered that the editor had made this error in printing my by-line. I want to not only set the record straight, but provide a very interesting chapter in the history of medicine. What you are about to read will almost certainly make you a more informed consumer of medical care in the United States.

Many people do not know that there are two fully licensed types of medical doctors in the United States. One receives an M.D., Medical Doctor, and the other receives a D.O, Doctor of Osteopathic Medicine, however the license to practice medicine for each is equivalent.

First, let's start with definitions. Blue Shield, one of the largest insurance companies in the U.S., states in its "DEFINITIONS" section at the front of each medical insurance policy, this definition:

"DOCTOR OF MEDICINE - a licensed medical doctor (M.D.) or doctor of osteopathic medicine (D.O.)"

The Business and Professions Code for the State of California, Section 2453(a), states: "M.D. and D.O. Degrees - Equal Status - It is the policy of this state that holders of M.D. degrees and D.O. degrees shall be accorded equal professional status and privileges as licensed physicians and surgeons."

Medical school education is equivalent, except that D.O.'s not only receive training in pharmacology (prescribing medication), basic medicine and surgery, but also receive extra training in the musculoskeletal system, which is a most vital component of the human body. A D.O. can specialize, become a dermatologist, surgeon, pediatrician, gynecologist, or just an old fashioned family doctor like me. So what's the difference? Why have two separate degrees for what would appear to be the same thing? To understand this, and also where the name "osteopathic" came from, one has to understand the history of medicine in this country.

150 years ago medicine was barbaric. Blood letting, arsenic and mercury "treatments" were the mainstay of the then medical doctor. Dr. Andrew Still, an M.D. at that time, thought there had to be a better way. "The job of the physician is to find health", he would write. "Any fool can find disease." He believed that if a body was put in correct alignment, given correct nutrition, and circulation was improved, the body could better heal itself. Dr. Still believed the physician was there to assist the patient to a healthier condition, and not as a dictator of prescribed remedies. His philosophy encompassed the School of Osteopathy, now known as Osteopathic Medicine, named after its original emphasis on the musculoskeletal system. Thus, this new breed of medical doctor was born. Dr. Still's osteopathic medical schools were among the first to accept women as well, and the medical school graduates had patients lining up to see them because this was the first school of its kind and, in truth, osteopathic methods of improving overall body health worked. Osteopathic Medicine is the father of physical medicine and rehabilitation, physical therapy, and the western healing arts which involve the use of hands to improve body mobility and function.

As western medicine advanced, however, and the germ theory and antibiotics were discovered in the 1900's, osteopathic medicine also followed in this direction. Both M.D. and D.O. medical school programs have the same hard standards and intense course work in general medicine and surgery, except that the D.O. medical students are required to complete extra hours in musculoskeletal and physical medicine. Medical residency programs these days are mixed with M.D.'s and D.O.'s working along side each other, and medical board exams are even combined in some states. Therefore, the term "osteopathic" has a philosophical origin but for the modern D.O. it is a bit of a misnomer because the D.O. is a complete medical doctor, with the added benefit of this extra training.

Many people in California are not aware of what a D.O. is, in part because of a political event which occurred in the 1960's here. The D.O.'s constructed an agreement with the M.D.'s such that for a $60 trade-in fee, a D.O. could send in his diploma and get an M.D. diploma. While this may have eliminated some of the confusion for the general public about what a D.O. is, it was a step backward for osteopathic medicine in California. Thousands of D.O.'s simply "vanished" behind M.D. degrees, where their special talents and extra training could not be openly appreciated. In other parts of the country, where this political event did not occur, osteopathic medicine is better understood and in fact there are many osteopathic hospitals in the Midwest and Eastern parts of the U.S.

I chose to be a D.O. for a specific reason. I wanted to be the best physician I could, and able to offer my patients as many different treatment options as possible. I am not limited to just writing a prescription, or sending someone for surgery, although I have the background, training and license to do this if needed. I can also use osteopathic techniques to enhance body function if appropriate. I also like the philosophy of osteopathic medicine which aligns with my own concept of healthcare, embracing preventive health care, nutrition, and where the doctor and patient work together toward the common goal of excellent health.