Most people know the letters “M.D.” identify someone as a medical doctor. But if you were in the hospital and the person treating you wore a lab coat with the letters “D.O.” on it, you would probably wonder what those letters stood for. And once you learned they designate the person as a doctor of osteopathy, your next few questions would be logical: What is a doctor of osteopathy? And is there a difference between a D.O. and an M.D.?
According to the American Osteopathic Association (AOA), D.O.s, like M.D.s, are fully qualified physicians licensed to prescribe medication and perform surgery. Their training is quite similar: Both complete four years of basic medical education after earning an undergraduate degree; both pursue graduate medical education by taking internships, residencies and fellowships after med school; and both must pass state exams to obtain their licenses.
“We have to know everything the M.D. student knows,” said Rob Brandenburg, D.O., who is currently at the University of Kentucky Medical Center on a gastroenterology fellowship.
D.O.s must graduate from an osteopathic medical school accredited by the AOA’s Commission on Osteopathic College Accreditation. The curriculum emphasizes preventive medicine and comprehensive patient care. Like M.D.s, D.O.s can choose to practice in a medical specialty such as pediatrics, family medicine, psychiatry or ophthalmology. D.O.s are found in all the same hospital and health-care venues as M.D.s. However, osteopathic medicine has a distinct approach to care that incorporates a healing touch.
Osteopathy began in this country in 1874. It was founded on a philosophy of treating people, not just symptoms. The term “osteopathy,” which means “bone disease,” was coined by Dr. Andrew Taylor Still. D.O.s practice a “whole person” approach to health care, according to the AOA. This approach appealed to Brandenburg.
“When I was a dietitian seeing patients, I felt they needed more than what they were getting from their physicians, and it was very frustrating,” Brandenburg said. “The way we were taught in osteopathy school, when talking with patients, you listen to everything. Just because they come in with a cough, you just don’t focus in on the lungs; it may be something else is going on. I think that’s beneficial.”
The AOA says D.O.s are trained to identify and correct structural problems. They also understand how all the body’s systems are interconnected and how each one affects the others, especially the musculoskeletal system.
D.O.s use osteopathic manipulative treatment, or OMT, to help diagnose illnesses and treat patients. OMT encourages the body to heal itself. OMT can be used to treat asthma, musculoskeletal abnormalities, back pain, carpal tunnel syndrome, menstrual pain, sinus disorders and migraines. OMT can complement and sometimes even replace drugs or surgery.
“OMT encompasses everything from what’s called mild facial release, which is really just kind of gentle movements, to muscle energy where you use opposing muscles,” Brandenburg said.
Although some D.O.s stop using OMT after they leave medical school, Brandenburg continues to incorporate it in his treatment plans.
“I always used manipulation throughout my residency and on my patients, and I actually had a following of patients who would only come see me because of that,” he said.
As a GI fellow, Brandenburg often sees people who come in with abdominal pain. A nurse practitioner or family physician who was not able to figure out what to do for them might have sent the patient to Brandenburg.
“I did osteopathic exams and I noticed this is [a] muscular skeletal problem; this is not a gastric or intestinal problem,” Brandenburg said. “I told them [they] just needed stretching, or more manipulation would be beneficial.”
Brandenburg started out as a dietician, having earned a bachelor’s degree in dietetics from Morehead State University and a master’s degree in clinical nutrition from Marshall University. While working with a chiropractor, he became intrigued by that field. He thought about going to chiropractic school, but his colleague talked him out of it.
“He said, ‘If you want to do manipulation, go to an osteopathic school. That way you are a physician and you are treated with respect and you can also do manipulation,’” Brandenburg said. “I talked to some D.O.s. They seemed more open to new ideas.”
Brandenburg, a licensed internist, completed his internal medicine residency at UK and earned his D.O. at the University of Pikeville Kentucky College of Osteopathic Medicine. After completing his fellowship – which will be the culmination of 10 years of study – he plans to return to his hometown of Ashland to be in a practice at Our Lady of Bellefonte Hospital.
Brandenburg sees himself as an ambassador for osteopathy. He takes D.O. students at UKMC under his wing and works to educate the public about osteopathy and D.O.s.
“People should know a D.O. is the equivalent of an MD,” Brandenburg said. “There’s nothing an M.D. can do that a D.O. can’t do. Jokingly, we say we have rivalries, but as long you’re a good doctor, you’re a good doctor.”
According to the American Osteopathic Association (www.osteopathic.org):
• Approximately 60 percent of practicing osteopathic physicians (D.O.s) practice in the primary care specialties of family medicine, general internal medicine, pediatrics and obstetrics and gynecology.
• Many D.O.s fill a critical need for physicians in rural and other medically underserved communities.
• D.O.s can become certified through one of the AOA’s 18 certifying boards.
• In the 2014-15 academic year, there will be 30 osteopathic medical colleges in 40 locations throughout the United States.
• Most insurance plans cover D.O.s.
• Currently, there are more than 80,000 D.O.s in the United States.
By Tanya J. Tyler, Staff Writer