Talk:Comparison of MD and DO in the United States/Archive 1

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Importance

This is an unimportant article in medicine, so I'm changing the rating to reflect that. Also, this article does not explain what it considers to be "allopathic and osteopathic medicine". It seems that it's actually contrasting the educational systems and the beliefs of people at osteopathic and allopathic schools, not the actual practice of medicine itself. Antelan ^talk 04:42, 9 July 2007 (UTC)

This is an very important article. Commonly misunderstood topic with many misconceptions OsteopathicFreak ^{T ?} 06:03, 9 July 2007 (UTC)

I validate that this is important to you, but there are actually guidelines for this type of thing. This isn't internationally important - only important in one country. Also, I have placed the dubious tag on one of your statements, for reasons that I have elaborated on in the Allo talk page. Antelan ^talk 12:02, 9 July 2007 (UTC)

I agree, in relation to medicine this is very unimportant and this page also reads like it was written by Osteopathy public relations staff. —Preceding unsigned comment added by 123.2.184.152 (talk) 15:08, 10 September 2008 (UTC)

Seconded. This article doesn't appear to have been edited at any time by a MD or actual medical professional --Numist (talk) 16:27, 7 July 2011 (UTC)

Actually, I think this article is relevant. Here in the UK we have osteopaths, who practice the traditional osteopathic medicine (manual therapy etc.) However people with this qualification are not Doctors, nor can they cannot prescribe medications or perform surgery or work in hospitals. The case is very different over in the states, where they study the same topics and eventually work in hospitals and can prescribe medicine, become surgeons and all other responsibilities undertaken by a 'proper' doctor here in the UK and this article helped clear a lot of confusion for me.

78.148.120.210 (talk) 00:28, 20 November 2011 (UTC) Saloom

Homoeopathic, Naturopathic and Allopathic Osteopaths

Much of the effort that has gone into the osteopathic pages seems to be aimed at showing that American doctors of osteopathy (or osteopathic medicine) are virtually the same as American doctors of medicine, despite their origins in a school of thought that rejected much of what regular physicians did and believed in. In the UK, the first osteopathic school (the British School of Osteopathy) was founded and run by an American homeopathic graduate. Subsequent schools (e.g. the British College of Osteopaths) taught naturopathy alongside osteopathy. There is (or was) also a London College of Osteopathy, later the London College of Osteopathic Medicine, which provided courses for registered medical practitioners. Can one then distinguish between homoeopathic osteopaths, naturopathic osteopaths (possibly the majority outside the USA) and allopathic osteopaths, and include modern American D.O.s among the allopathic osteopaths? NRPanikker 17:49, 4 November 2007 (UTC)

Your question is an extremely important one. One issue, D.O.s in the U.S. are officially no longer called osteopaths - this is an attempt by AOA to address this confusion. The D.O. degree in the U.S. is no longer "Doctor of osteopathy" but "Doctor of osteopathic medicine." Likewise the practitioners are called "osteopathic physicians" to distinguish them from their European counterparts, "osteopaths." IMO, this is all very silly, but the whole thing is confusing as hell. This is discussed in a few places:

• Doctor_of_Osteopathic_Medicine#International_practice_rights
• International_practice_rights_of_U.S.-trained_D.O.s#International variations in the D.O. degree

IMO, there is almost no relationship between the training of American D.O.s & European/Canadian D.O.s, they have diverged so much that they seem to only share the name and the history. If we could get some sources together that discuss this more precisely and make these comparisons directly, I think that would be great. User:Hopping ^T 19:55, 4 November 2007 (UTC)

All of which are good reasons to use "M.D." and "D.O." when you are referring to these groups, and not "allopathic" and "osteopathic", which are ambiguous terms. Antelan ^talk 23:14, 4 November 2007 (UTC)

I'd say they both have their problems, in some situations saying M.D. and D.O. can be more ambiguous, especially since sometimes U.S.-D.O.s are labeled (incorrectly) as M.D.s. (here) User:Hopping ^T 23:23, 4 November 2007 (UTC)

If they had labeled the D.O. as a D.O., there would have been no problem. There's no ambiguity - just error. Antelan ^talk 23:26, 4 November 2007 (UTC)

I don't know if it was an error. People commonly associate the post-nominal letters "MD" with physician. The title is a vernacular way of saying "Hero, physician." Let's face it, if they had said "Hero, DO" it just wouldn't have the same instant recognition impact. I think they got their point across perfectly. [1] User:Hopping ^T 23:32, 4 November 2007 (UTC)

OK. There's still no ambiguity - just a lack of recognition leading to a decision to make an intentionally incorrect label. Antelan ^talk 23:42, 4 November 2007 (UTC)

Well, that's show business! (or in this case, infotainment). NRPanikker 17:22, 5 November 2007 (UTC)

Article title is inaccurate; should be renamed

Among other problems with the title of this article, the most obvious is that it inaccurately lumps all non-DO physicians, including foreign-trained physicians practicing in the United States. Instead of renaming this to "comparison of DOs with MDs, MBBSs, and MBChBs," this could be simplified as "Unique features of osteopathic culture" or something thereabouts. Antelan^talk 05:29, 27 March 2008 (UTC)

That's not a bad idea, although the obvious thing to do with that concept is to merge it all back into Osteopathic medicine in the United States (which links to this article no less than three times for "further information"). WhatamIdoing (talk) 00:47, 29 April 2008 (UTC)

Yep, your idea makes even more sense. I'd support it. Antelan^talk 03:38, 29 April 2008 (UTC)

Whatever you do, please try to find a sustainable solution. Osteopathic medicine in the United States already has 60 KB, and it's natural and normal for an article of that size to have subarticles. User:Hopping, who is currently not able to participate in this discussion, will no doubt disagree with the merger, and I am not sure it won't be mainly for advocacy reasons. But it would also be wrong to merge the articles for the opposite advocacy reasons. By the way, I could find only two links "for further information". There is another link from the infobox "Osteopathic medicine in the United States", but I don't think that should be counted. --Hans Adler (talk) 06:53, 29 April 2008 (UTC)

From my viewpoint, the name of this article is not that critical, as long as we don't use allopathy to describe physicians. I wonder if this article should be deleted anyways. It's an odd POV fork. OrangeMarlin ^{Talk• Contributions} 07:05, 29 April 2008 (UTC)

I think it's a bit unfair to call it a POV fork. I am sure for DOs it's an extremely important topic, even though for almost everybody else it seems completely irrelevant. But Wikipedia has room for such specialised articles. One thing I just noticed is that there is also a (slightly underdeveloped) article Doctor of Osteopathic Medicine. In a sense that's almost the same topic, because minorities generally define themselves foremost by comparison with the majority. --Hans Adler (talk) 07:31, 29 April 2008 (UTC)

I agree that some stable change must be made. Based on (1) the fact that Hopping created this article, and (2) his prior behavior towards me, whatever we do here will likely be resisted by Hopping when he returns. Because of that, and in an effort to make stable changes, this process will need to involve as many as possible. I agree with both OM and Hans Adler - that this has a D.O. advocacy slant, while at the same time being an important topic to DOs. I do think that some sort of merger would make sense, and I'll look into the Doctor of Osteopathic Medicine option more closely. Since the MD is the "conventional" degree, it does make sense that the D of OM article could be the right place for all of this "comparison" information, anyway. Antelan^talk 10:52, 29 April 2008 (UTC)

(Undent) Hans, the three that I found were not inside infoboxes. They are in these sections:

==Demographics== {{further|[[Comparison_of_osteopathic_and_allopathic_medicine#Demographics|Comparison of osteopathic and allopathic demographics]]}}{{-}}

===Significance=== {{further|[[Comparison_of_osteopathic_and_allopathic_medicine#Cultural_differences|Allopathic & osteopathic: Cultural differences]]}}

==Current Status== === Education and training === ====Graduate Medical Education==== {{further|[[Comparison of allopathic and osteopathic medicine]]}} Hope this helps, WhatamIdoing (talk) 18:19, 29 April 2008 (UTC)

You are right, sorry. I didn't see the one called "cultural differences". --Hans Adler (talk) 19:57, 29 April 2008 (UTC)

If people feel strongly that the "further info" link should be removed, I have no problem with that. However, I do feel that the "Osteo med in the US" article is already quite large, adding more content comparing DOs and MDs seems inappropriate. Bryan Hopping ^T 21:34, 1 May 2008 (UTC)

Legal cases related to MD/DO

I thought this were interesting sources for additional (if somewhat tangential) information about this article. Perhaps a section on the legal aspects of this topic would be appropriate? Law is very outside of my area of expertise.

• BRANDWEIN v CALIFORNIA BOARD OF OSTEOPATHIC EXAMINERS; The California Board of Medical Quality Assurance; The California Department of Consumer Affairs United States Court of Appeals, Ninth Circuit.
• EATOUGH v New Jersey State Board of Medical Examiners United States Court of Appeals, Third Circuit.

Bryan Hopping ^T 21:31, 1 May 2008 (UTC)

M.D., D.O. and dermatology

Interesting source, discusses many of the issues touched upon in this article.

• John Jesitus M.D.,D.O. disparity, Differences blurring for state licensing bodies, medical societies, patients. Dermatology Times. 1 Dec 2007.

"Although the training of osteopathic (D.O.) dermatologists and their allopathic (M.D.) counterparts differs somewhat, these paths are converging — to the point that both are equally rigorous, many sources say.And, while pockets of resistance remain, acceptance of D.O. dermatologists in the M.D. community is increasing, some say. "D.O. dermatology training is much better now than it's been in the past," says David M. Pariser, M.D., American Academy of Dermatology (AAD) president-elect. "Some allopathic dermatologists may not realize the improvements that have been made in D.O. dermatology programs, though there's still more work to do for some programs.""

Bryan Hopping ^T 03:57, 3 May 2008 (UTC)

You have already posted this elsewhere. Antelan^talk 03:52, 3 May 2008 (UTC)

Image

Can we get the scale on the demographics image changed so it isn't so vertical? I don't see any particular reason why the space between each Y-axis tick mark needs to be a full inch on my screen. WhatamIdoing (talk) 01:04, 1 June 2008 (UTC)

Is this image even useful? It needs changing if it isn't just removed. ~~----SesquipedalianVerbiage (talk) 18:24, 13 June 2008 (UTC)

the graph is vertical because the scale of the two graphs is so different. The MD students are in the 16,000 range, the DO students is in the 3-5,000 range. The graph compares the two, as per the articles title. Bryan Hopping ^T 16:09, 14 June 2008 (UTC)

The difference in the size of the two groups explains why there is a large space between the red line and the blue line. It does not explain why the scale of the Y-axis was set to "4,000 students = one inch" instead of "4,000 students = one centimeter." You could have the Y-axis be half as tall and it would still convey the same information. WhatamIdoing (talk) 04:20, 16 June 2008 (UTC)

July 2008

Hopping was absolutely right to correct that inappropriate use of MD: This is a reference, not text in the article, and the reference should be identified by the exact, verbatim title given by the authors, without editing it to reflect our preferred terminology. WhatamIdoing (talk) 06:43, 24 July 2008 (UTC)

I changed the term back to MD, in square brackets to show that it is a rephrasing of the quote. This is to follow consistent naming throughtout the article. In this case it really isn't a big deal, but allopathic is not a well understood term, especially in the way it's used by American DOs to the rest of the world. I intended my edit to improve and clarify, and I have no argument if you feel strongly the other way. --Verbal (talk) 18:43, 24 July 2008 (UTC)

I do, in fact, feel quite strongly about this. I dislike the term allopathic and steadily oppose its inappropriate use. However, we must not change the title as given by the author. WhatamIdoing (talk) 18:52, 24 July 2008 (UTC)

I disagree. If the author gives a title that I hard to understand, possibly as it uses obscure, insulting, or culturally sensitive terminology, we are certainly within our rights and wp policy to paraphrase or clarify. However, this is only a reference, and, although it's incongruous with the rest of the section (a reader might ask "why is there an article about allopathy in a section about MDs only"), it's very trivial. --Verbal (talk) 19:13, 24 July 2008 (UTC)

I agree with WhatamIdoing in this instance. The title of a source is the title of the source. Changing authors or titles obscures the provenance of our information. I can imagine a few words that might be so offensive that we would avoid using sources whose titles employ the terms. I find the word "allopathic" offensive, but not to the degree that I would exclude a source on those grounds. Now, having said all of that, I am removing the extraneous information from that reference. Specifically, the title of the source itself does not actually contain the term "allopathic", and the table to which this information is sourced can easily be identified by its number (Table 16). Antelan 13:58, 27 July 2008 (UTC)

Referring to simply "Table 16" seems like a perfectly reasonable solution. I also feel strongly that we should not change titles. But, as Antelan correctly points out, the title of the article doesn't use the term. Next question: The "Princeton Review" source (which is no longer called "allopathic medicine" so should be changed) has this to say about professional advantages for MDs: "[P]rospective DOs should be prepared to be a part of the minority in the medical community. Because they comprise only a small percent of American doctors, osteopathic physicians must often explain—and sometimes defend—their educational background." I don't think the current wording reflects this source very well. Bryan Hopping ^T 20:44, 27 July 2008 (UTC)

Yep, agreed. I've changed the statement; something along these lines is truer to the source. Antelan 21:00, 27 July 2008 (UTC)

Overseas

Antelan (and others): I thought that there were a few countries that simply didn't accept a DO at all. Is that no longer true? WhatamIdoing (talk) 00:59, 28 July 2008 (UTC)

You're quite right. Hopping has a nice image of this, which is displayed in the international practice rights of DOs article: Image:DOworld.PNG Antelan 01:09, 28 July 2008 (UTC)

One point to consider, in many countries, the requirements for both US-MDs and DOs are extensive, especially in industrialized nations. In many cases, regardless of one's degree, a physician license is granted based on completion of a series of exams (the local version of USMLE) and training requirements (residency). The details of these requirements are complex and vary widely by country; its difficult to summarize them in a few words, and difficult to "compare" a DO to MD succinctly. Bryan Hopping ^T 14:19, 29 July 2008 (UTC)

Professional advantages for MD qualified physicians

The following is copied from my talk page, and we would like this discussion to continue here. -- Fyslee / talk 03:17, 28 July 2008 (UTC)

• Discussion about Professional advantages for MD qualified physicians

Hi there,

I wanted to respond to your edit summary. "Please reserve such tags for highly controversial wordings, not for "the sky is blue" & "humans usually have two legs" types of obvious facts."

I wasn't tagging the statements as controversial. As I said in my edit summary, I noticed the citation given does not exist. Hence the "citation needed" tags.

Also, you seem to feel those statement as obvious as "the sky is blue." I don't think that applies in this case. The statements are questionable at best. You'd be hard pressed to find a source for them. Again, in US, DO and MD are legal equivalents. Bryan Hopping ^T 23:38, 26 July 2008 (UTC)

Hi Bryan. ??? Those statements have been there for some time and I had always believed it was you who had written it! I guess I should have checked the edit history. Who did write it? My edit summary wasn't concerned with the existing citation's status (I don't know if it applies at all to the words at the end of the sentence), but that I didn't see any reason for citations for the two points where the tags were located. Do you really think anyone would really know so little about medical history as to challenge those two obvious statements? I guess if they do, they can challenge them. BTW, I'm not questioning the current legal status of the DO degree, or the fact that it is legally - and more and more so generally - considered equal to the MD degree. It just hasn't gotten there yet. When that finally happens in reality, then there will finally be no more justification for keeping the DO degree at all. It's very existence is living proof that there is a difference, and history shows that difference has been huge, but now is getting smaller. -- Fyslee / talk 00:25, 27 July 2008 (UTC)

Hi Fyslee. I did write some of this paragraph, and overall I don't have a problem with it. It's really just these two sentences. "It gives the option to practice in any of the medical specialties, and, unlike the DO (Doctorate of Osteopathic Medicine), the MD is universally recognized as a medical degree. When practicing overseas, the MD is far easier to negotiate with than is the DO.' " The first clause is misleading, as DOs certainly practice in all specialties. As far as the universal recognition part, I don't mind the idea, but its the weasel words that I have trouble with, i.e. "far" easier and "universally recognized". These are overly subjective, sweeping statements. I think this all should be discussed, but it needs to be sourced, and toned down a notch. Bryan Hopping ^T 04:13, 27 July 2008 (UTC)

Okay. That makes sense. Here's the original:

• MD qualification training is by far the most widely available and recognized type of medical training. It gives the option to practice in any of the medical specialties, and, unlike the DO (Doctorate of Osteopathic Medicine), the MD is universally recognized as a medical degree. When practicing overseas, the MD is far easier to negotiate with than is the DO.

Here's an attempt to improve it:

• MD qualification training is the most widely available and recognized type of medical training. Like the DO, it gives the option to practice in any of the medical specialties, but unlike the DO, the MD is internationally recognized as a medical degree. Thus, when practicing overseas, the MD is easier to negotiate with than is the DO, where the DO degree isn't always understood or recognized.

Does that deal with your concerns adequately? -- Fyslee / talk 05:43, 27 July 2008 (UTC)

Yes! This is much better. I think saying that MD is "more widely available & recognized" would be better than "most widely available." I know other countries use degrees other than MD (MBBS, etc). Perhaps we could also refer people to the section of Osteopathic Medicine in the US that discusses Int'l practice rights of US-trained DOs? Since it already exists and is well-sourced.

Osteopathic medicine: International Practice Rights

-- Bryan Hopping ^T 20:54, 27 July 2008 (UTC)

Sounds good to me. Before doing this, I think we should seek consensus by copying this to the article's talk page and getting more input. I'll do it now. -- Fyslee / talk 03:08, 28 July 2008 (UTC)

Hi, I'd just like to point out that the article talk page might be a better place for this discussion, as then we can all get involved - I only found this by accident. Looks like a good discussion about improving the article, and that's good, so put it where we can all see :) I hope I'm not speaking out of turn here, thanks. Verbal chat 21:04, 27 July 2008 (UTC)

Right on. Going to do it now. -- Fyslee / talk 03:08, 28 July 2008 (UTC)

i agree w/ fyslee and bryan hopping and i will make the change suggested because the current wording seems to imply that DOs cannot practice in all specialties. thats just not true. Brendan19 (talk) 21:26, 4 December 2008 (UTC)

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