Talk:Comparison of MD and DO in the United States/Archive 3

Mention that both M.D. and D.O. are medical doctors.

Both M.D. and D.O. are medical doctors. Medical doctors=physicians and M.D. and D.O. are both physicians. Remember M.D. stands for Medicinae Doctor or "Doctor of Medicine", it does not stand for medical doctor, which is a profession not a degree. D.O. are medical doctors but D.O cannot call themselves M.D. — Preceding unsigned comment added by 68.232.117.59 (talk) 04:12, 11 February 2016 (UTC)

Am I the first non-DO to read this page?

The page provides a lot of "DOs are just as good as MDs" tone, which becomes noisome long before the end of the article. I also question it's NPOV. There are no areas where there are clearly differences, e.g. I can list the number of major research DO schools on, um, how many fingers? How many DO neurosurgery residencies are there? This isn't meant to denigrate DOs (some of my best friends are DOs--men and women I trained with--and they are very good physicians) but there are a lot of differences NOT mentioned.

I also think that the basic curriculum is comparable (we all buy the same $10K/200kg of books for the first two years), but there is a big difference in major medical schools (by which I mean those in the top N/X% of NIH funding--mine was #7 when I was there) and smaller school (which most DO schools fit into) when it comes to opportunity to participate and learn hands-on in how the business of biomedical research is carried out. I.e. how things end up in that giant pile of dead tree matter I have replaced w/ an iPad and Amazon Kindle. I am not sure I would be too jazzed to enroll my kid in a pediatric cancer clinical trial in too many cities (and that excludes a bunch of MD medical schools). I did residency and became medical school faculty at very large (student wise, but not research wise) primary care focused medical school and the differences were clear. While the very well regarded pediatric hospital would have one or two specialists in most of the pediatric sub-specialties, where I trained would have a department with 6-10 faculty and 3-6 fellows. This is really more a difference in academic centers v. those medical schools where research is more of a faculty hobby--but all the osteopathic schools fall in this category. So some discussion would be useful to investigate this.

Also, what isn't reported is comparison of the students enrolled in each medical school (grades, MCATs, etc.) and the eventual outcome (distribution into different specialties).

This page of comparisons reads like feel-good propaganda.

Also, there are MDs who do manipulative therapy (mostly PMR, but some orthopods and family medicine). It just isn't a required part of our curriculum (thanks, but 38 credit-hours per semester was just plenty, thank you), and they typically pick it up during residency (you can still learn a lot even after getting resident work hours slashed to 80h/week) or hang out with a physical therapist or PMR who already does it.

Finally, some discussion about what movement is afoot to get rid of having separate MD and DO boards. Makes no sense. — Preceding unsigned comment added by 75.73.1.89 (talk) 00:36, 23 June 2016 (UTC)

On of the major problems with this article is that almost all information comparing MDs and DOs comes from DO sources. MD-associated sources don't concern themselves with trying to convince everyone that they are equivalent to DOs, because they have no reason to care. DOs, on the other hand, put a lot of effort into self-promoting and trying to get people to think they aren't the red-headed step-child of the medical family. It's like the Ivy League university and the community college a few blocks away. None of the Ivy League students spend a minute of their day thinking about their neighbor, because the whole city already revolves around them. Natureium (talk) 21:15, 7 December 2017 (UTC)

Appears to be an unbalanced comparison

The second sentence in this article lays out the tone of the rest of the article: "the medical training for MDs and DOs is indistinguishable"

According to the NRMP match data, 93.8% of allopathic seniors matched at a PGY-1 residency, whereas 80.3% (2396 out of 2982) of DO students matched. Moreover, 25.9% (1108 out of 4278) of all DO students who began the match process withdrew from the match, compared to 2.1% of allopathic students. This means of all DO students who intended on matching, only 56% of students matched.

Although you can argue that this shows a bias against DO students, this metric is arguably more important to showing how residency programs who have interviewed these students regard their medical training.

This article seems to be an advertisement for DO programs, without adequate discussion of the differences between the programs. Instead of trying to prove that a DO degree can compare with an MD degree and both doctors are the same, the article should focus on the reality that people attend DO programs when their MCAT, GPA, or extracurriculars are not competitive enough for an MD program, and that the osteopathic manipulative medicine that it started from lacks any significant evidence based medicine. No one is entering a DO program for the OMM education. — Preceding unsigned comment added by 2602:304:6EAC:B720:3845:634E:6854:7867 (talk) 00:59, 8 December 2016 (UTC)

Much of this due to the second match; there is currently an independent osteopathic match. However, the data that you mention only looks at the NMRP match. The vast majority of DO students (much like MD students), match into a residency. However, DO students withdrawal from the NRMP match if they match a residency in the osteopathic match. These two residency match programs are in the process of merging.

The term "indistinguishable" was used because it was referenced from Harrison's Principles of Internal Medicine, a respected medical textbook. I think the article is clear on the admission statistics; do you disagree?

If you have data supporting your claims, I strongly urge you to include it in the article. However, speculation on why medical students choose their schools should not be included in a high quality encyclopedia. It sounds like you may have bias against the osteopathic profession. Keep in mind, unbalanced does not mean that the artile must potray the point of you that you hold.

As it stands, the article compares and contrasts geographic distribution of MD/DO physicians, specialty selection, and demographics. What do you feel should be included in comparing/contrasting the two degree pathways?

Rytyho usa (talk) 17:35, 8 December 2016 (UTC)

Edit warring

Natureium, this is where the discussion should be held. In this edit [1], you reverted removal of the disputed tag which has received no significant discussion on the talk page for over six months (as I said in my edit summary quite clearly) and the few points that were raised were addressed/rebutted on the talk page without further discussion. Therefore, it's quite reasonable to consider that conversation closed. I've seen disputed tags removed for far less. Second, you reverted reversion of this edit [2], in which you have a very POV edit summary displaying your opinion and introduced content changes that do not accurately reflect the cited Harrison's Principles of Internal Medicine source. This falls afoul of WP:STICKTOSOURCE. My disagreement is primarily with these changes and the removal of the well-sourced exam statistics that come straight from the USMLE. Your opinion about the comparison is an insufficient reason for removal. We reflect the sources. I don't particularly care that much about the Cohen source although I will say I can't access it and verify what it says and it would be better if it were subject to proper vetting before it's included to ensure its accuracy. TylerDurden8823 (talk) 21:40, 29 June 2017 (UTC)

Looking at the talk page, the same issues that existed then still exist. Just because it's been 6 months and no one has fixed it doesn't mean that it's not true. I'll concede on the Harrison's quote, but although it's in a textbook, that doesn't mean that it's NPOV. My edit summary reflected the sentiments of others on the talk page and described the changes I was making to attempt to begin to remedy the disputed tag. And while USMLE may have published the statistics, they are extremely misleading, because they are comparing 20 people and 16,000 people. Natureium (talk) 01:54, 30 June 2017 (UTC)

As I said before, Harrison's is widely regarded as a very high-quality source. Your sole opinion won't overturn that. Six months with zero discussion after a tag has been placed and one person's concerns have been addressed (they were answered on the talk page which did not provoke any further discussion from anyone) is insufficient grounds for a persistent tag. If you have a specific proposal/suggestion to make the page more neutral, then present it here. Natureium, you say the statistics are misleading but explicitly mentioning that the sample sizes are so different makes the unbalanced comparison obvious. I would agree that it's misleading if the n statistics went unmentioned. Looking over the edit history again, you also wholesale removed the entire comparison paragraph even though the figures for USMLE Steps 1 and 2 were not so imbalanced in terms of the sample sizes (not thousands compared to 20). I don't have a strong objection to solely removing the Step 3 comparison since that's what you find so objectionable. Lastly, do you have access to the Cohen source? I would like to vet it but do not have access. TylerDurden8823 (talk) 09:22, 30 June 2017 (UTC)

Yes I have access to the Cohen article, and it turns out the quote at the beginning of the page was incorrect. It's fixed now. In regard to making the page more neutral, having a balance of information between MD and DO would be a start. As it is, much of the article is about DOs. Natureium (talk) 14:17, 30 June 2017 (UTC)

I have no objection to more information about MDs on the page. In fact, I think that would be a nice addition though I will be making some edits to your most recent proposed edits with which I don't entirely agree. I have no objection to the tweak you made to the Cohen edit. Will you please email me a copy of the Cohen piece so I can look it over? That would be very helpful. The difficult part to adding some of the content you mention will be to avoid significant overlap with other pages that already discuss this topic quite a bit to avoid significant redundancy. TylerDurden8823 (talk) 18:14, 30 June 2017 (UTC)

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Balanced tag

As mentioned by 3 prior topics on this talk page, this article is focused far more on DOs than it is a balanced comparison between DOs and MDs. I've tried to remove or rephrase some of the information that does not contribute to the comparison, but I've tagged it because there is more work necessary. Natureium (talk) 19:23, 6 September 2017 (UTC)

Regarding this diff [3], I see where the 65.1% figure comes from though Natureium is correct that it is not explicitly stated in the document. On page 7 of the document, a pie graph is shown with the total number of osteopathic physicians in residency. If the proportion in ACGME or dually-accredited programs is calculated, then you get the 65.1% figure though this likely amounts to synthesis since it requires the reader to do the math and this mathematical figure isn't explicitly stated in any of the captions. TylerDurden8823 (talk) 00:15, 8 September 2017 (UTC)

I've also reworked the lead quite a bit and added some references for previously unreferenced material as well. TylerDurden8823 (talk) 00:59, 8 September 2017 (UTC)

Lack of research

Just removed some content that described "lack of research" at osteopathic medical schools. This statement was included in the lead only, and referenced an opinion piece from the Journal of the American Osteopathic Association. There may be some content worthy of mention here, but far from as it was described. Could offer a comparison on research dollars at US MD schools vs DO schools, the number of NIH grants, etc. I've removed it for now. Will work on it, if I have time. Rytyho usa (talk) 21:56, 18 February 2018 (UTC)

It's not in the lead only. There's a whole section on it, which even includes the number of NIH grants. Natureium (talk) 15:20, 19 February 2018 (UTC)

The reference is only attributed to the content in the lead. Yes, it's an opinion article, and an encyclopedia should not rely on references to opinion articles. I move that we eliminate the reference from the article, because I do not believe it adds anything of worth the article. This topic discussed thoroughly in the relevant section. If you feel the content in the body of the article could be better summarized in the lead, I urge you to do so. Rytyho usa (talk) 13:23, 22 February 2018 (UTC)

What do you mean that the reference is only attributed to the content in the lead? There is a section on research, which states that there is a discrepancy between the research done at DO schools and MD schools, with 4 references cited. Natureium (talk) 15:38, 22 February 2018 (UTC)

I will say that some of those references used to support that content are rather dated (some are ~18-30 years old). TylerDurden8823 (talk) 00:46, 23 February 2018 (UTC)

POV & Pharmaceuticals

I've never seen allopathic as a derogatory term, although I have noted derisive dismissals of DOs as not 'real' doctors even though they are every bit as licensed. Where there is a POV in this article with 'citation needed' I provided an inline citation to allopathic medicine to support the pharmaceutical basis of 'western medicine' - it's just a fact, not a slam. Another citation for the pharma heavy MD emphasis on Pharma is "Allopathic or mainstream medicine, practised by the medical profession relies heavily on pharmaceutical drugs. Drugs produce an effect on the body that directly opposes and alleviates symptoms of the disease" in https://www.sciencedirect.com/topics/medicine-and-dentistry/allopathic-medicine - This is not pejorative or a POV, it is simply fact that mainstream Western medicine relies very heavily on use of drugs to treat symptoms. However, my edit was immediately undone.

I also suggest the following definition is also an improvement over the Wiki entry https://medicalschoolhq.net/md-vs-do-what-are-the-differences-and-similarities/

MD’s practice allopathic medicine, the classical form of medicine, focused on the diagnosis and treatment of human diseases.

DO’s practice osteopathic medicine which is centered around a more holistic view of medicine in which the focus is on seeing the patient as a “whole person” to reach a diagnosis, rather than treating the symptoms alone.

On the other hand, although I didn't try to edit it, I suggest the line about DO's lack of science that references one article written by an author who discloses his conflict of interest as being he's in pharmaceuticals is pejorative. Seabreezes1 (talk) 14:51, 16 July 2018 (UTC)

The edit you made on the history of allopathic medicine:

"Historically, MDs and DOs significantly differed in their approach to medical treatment. Allopathic medicine was primarily based on the use of pharmaceuticals."

is untrue. That is why I reverted it, not immediately, but an hour later when I was reviewing my watchlist. Natureium (talk) 14:57, 16 July 2018 (UTC)

Saying it is 'untrue' isn't proof of anything. I pointed to actual references, and the only citation you have for what you claim is a lack scientific foundation for DO's (who by the way have rights in US hospitals the equivalent of MDs) is an opinion piece whose author reveals the following as a conflict of interest: "Financial Disclosure: Dr Clark has received consulting fees from Regeneron Pharmaceuticals, Inc, and Abbott Laboratories."

What I wrote was not perforative - it was factual and documented.Seabreezes1 (talk) 19:26, 25 July 2018 (UTC)

historically allopathic medicine - primarily based on scientific practices?

The lead describes allopathic medicine as being "primarily based on scientific practices" in the late 1800s. I think that's clearly untrue. The culture of medicine was not centrally rooted in science. There were countless practices in common use that were neither effective or evidence based, such as bloodletting, use of leaches, arsenic, mercury for STDs, etc. Many of these practices were harmful. I'm going to adjust the wording here to more accurately reflect the differences between allopathic and osteopathic medicine. Any additional thoughts are welcomed! Rytyho usa (talk) 20:28, 30 June 2019 (UTC)