Here’s How You Can Tell the Difference Between MD and DO

Look carefully at the name tag of the physician treating you: Is there DO instead of the usual MD? Here's the difference between MD and DO.

MD vs. DO: What’s the difference?

Ever show up to the emergency room and notice your attending doctor had a DO—rather than an MD— after his or her name? Did it make you wonder: What’s the difference between a DO and an MD? They’re both doctors, but there are some differences. Here’s what you need to know about what the letters mean, their similarities, differences, and when you should choose an MD or DO.

What do all those letters mean?

In the United States, med students have a choice between two main educational paths. They may choose to become an MD (doctor of medicine), by attending an allopathic medical school. Or they may choose to become a DO (doctor of osteopathic medicine), by attending an osteopathic medical school. Each path takes a minimum of four years and each leads to a degree that authorizes the physician to practice medicine.

It’s still more common for potential doctors to choose the MD route but the number of DOs is growing. Enrollments are up 40 percent over the past decade and about one in four medical students now chooses an osteopathic school, according to the American Medical Association (AMA).

Note: A DO is not a chiropractor—this is a common misconception. Chiropractic is an entirely separate field of schooling and practice and generally, chiropractors are not medical doctors.

Portrait of doctorSonja Pacho/Getty Images

MD vs. DO: How they’re similar

Despite the fact that they are different degrees from different types of schools, the criteria to apply and be accepted into each program are virtually the same. Both osteopathic and allopathic programs weigh grade-point average and Medical College Admission Test scores heavily, the AMA says. And once in school, potential MDs and DOs study a similar curriculum, with students spending the majority of their first 12 to 24 months in the classroom, followed by training in a clinical setting. Both then take final exams.

After completing four years of medical school, students choose a residency program. Both MDs and DOs can choose a residency in either program. For instance, Renee Wellenstein, DO, got her doctor of osteopathy degree and was then the first DO to enroll in an MD residency program in obstetrics. Eventually, she became double board-certified in functional medicine and ob-gyn. She also married an MD, so she says this conversation comes up often.

Once graduated, an MD and a DO have the same medical privileges and licensure. They can both see patients, write prescriptions, perform surgeries, order tests, and work in hospitals.

MD vs. DO: How they’re different 

So if they are similar degrees with similar studies from similar schools resulting in nearly identical doctor privileges, why even have two separate degrees? There are some key differences in the approach and the methods the two types of doctors use to practice medicine, Dr. Wellenstein says.

The biggest difference is that in addition to the four years of regular medical school, DOs have to also complete 200 hours of osteopathic training focused on the musculoskeletal system.

“In osteopathic training, there is an additional focus placed on the ‘holistic approach’ and OMT,” says Mikhail Varshavski, DO, a doctor based in New York. A holistic approach refers to the body’s intrinsic ability to heal, treating the whole patient, and the focus on prevention. OMT (short, for osteopathic manipulative treatment) “is a hands-on approach to treating everything from pneumoniasinusitis, and headaches, to lower back pain.”

Another important difference: How the two types of doctors are treated outside the United States. MDs have the advantage of being able to practice in more countries, Dr. Varshavski says. “The American Osteopathic Association and other osteopathic organizations have been making strides in educating foreign governments on U.S.-trained osteopathic doctors,” says Dr. Varshavski. “Currently, around 50 countries allow full-medical practice scope to U.S.-trained doctors of osteopathic medicine with an additional grouping allowing restricted practice.”

Separate specialties

Another difference may be in the type of medicine they choose to specialize in. Both types of doctors can practice any medical specialty, but osteopathic doctors are more likely to specialize in primary care fields, according to the AMA. Nearly 57 percent of DOs practice in primary care specialties: about 31 percent are family physicians, 18 percent are internists, and 7 percent are pediatricians.

By comparison, less than 30 percent of U.S. physicians with MD credentials practice in primary care specialties: 11 percent are family physicians or in general practice, around 11 percent are internists, and 7 percent are pediatricians.

How will your patient experience differ?

You might still be wondering if treatment by a DO will be the same as that of an MD.

You may notice a slight difference during your appointment and in your treatment plan, Dr. Wellenstein says. “DOs often have a better bedside manner than MDs, because we’re taught to focus on listening first and establishing a supportive emotional connection,” she says, something her MD husband seconds. “But that may also be due to individual differences between doctors more than the degree.”

A DO may also be more likely to take a functional or holistic approach. Take, for instance, how they approach asthma. An MD may assess the symptoms and then write a prescription for an inhaler. A DO, on the other hand, will write the prescription for an inhaler, but will also look for problems in the ribs, spine, and neck or for swollen muscles that may be making the asthma worse or causing pain, she says. Both types of doctors may ask questions about issues underlying the asthma symptoms—for instance, known triggers—but a DO is more likely to ask about a patient’s lifestyle, including stress and nutrition, she adds.

But from a patient’s perspective, the difference is minimal, if at all. “Unless my patients specifically notice the DO, like on my business card, they don’t even know,” she says.

And the gap is shrinking rapidly, says Dr. Varshavski. “Unless your osteopathic doctor actively practices OMT (and not all do), you will likely not be able to predict the degree your doctor holds,” he says. “It is true that osteopathic doctors tend to practice with the whole-patient approach. But I believe that’s what leads to the higher percentage of practicing primary care doctors. This is a field where you are actively learning about your patient and using that information not just to relieve symptoms but to prevent problems. This philosophy is instilled in most primary care residencies regardless of DO/MD recognition.”

Should you choose MD or DO?

Are there situations where one type of doctor is better suited to help you? “It is unfair to say one doctor is better than the other based on a degree, especially because we are all trained together during residency,” says Dr. Varshavski. However, you should choose a DO if you want to try OMT.

At the end of the day, both docs say that what really matters is how you interact with your physician. When picking a doctor, focus less on the degree and more on knowledge, bedside manner, communication, and the experiences of other patients. Start with these insider tips for choosing the best primary care doctor for you.

Sources