DOs as Good as MDs in Clinical Outcomes, Patient Experience

May 31, 2023 - A new study out of the UCLA David Geffen School of Medicine found that doctors of osteopathy (DOs) perform just as well as medical doctors (MDs) in various measures of clinical outcomes and patient experience.

DOs are physicians who study osteopathic medicine, which “sees an interrelated unity in all systems of the body, with each working with the other to heal in times of illness,” according to the American Osteopathic Association, which was not a part of this study. Because of this philosophy, DOs often practice patient-centered and holistic care, AOA said. DOs account for around 11 percent of all physicians in the US, the organization added.

The study, published in the Annals of Internal Medicine, showed that DOs could be a good option for patient care access. This is particularly salient in areas experiencing MD shortages, according to Dr. Yusuke Tsugawa, the senior study author and associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

“These findings offer reassurance to patients by demonstrating that they can expect high-quality care regardless of whether their physicians received their training from allopathic or osteopathic medical schools,” Tsugawa, also an associate professor of health policy and management at the UCLA Fielding School of Public Health, said in a statement.

The researchers looked at a handful of data sources, including a sample of 329,500 Medicare fee-for-service beneficiaries, Medicare Data on Provider Practice and Specialty, a Doximity physician database, and the American Hospital Association’s annual survey of hospital characteristics.

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They then compared the outcomes for the 23 percent of patients accessing care from a DO and the 77 percent who accessed care from an MD. Overall, there was no difference in outcomes, the team found.

Patient mortality rates were 9.4 percent for MDs compared to 9.5 percent among DOs. Meanwhile, patient readmission rates were 15.7 percent for MDs versus 15.6 percent for DOs, while hospital length of stay was 4.5 days for both types of physicians. Additionally, there was only a dollar difference in healthcare spending across either type of physician; for MDs, healthcare spending was $1,004 compared to $1,003 for DOs.

The researchers emphasized that these comparable outcomes are the result of the similar academic rigor that characterizes both osteopathic and allopathic medical school programs. The study results “should be reassuring for policymakers, medical educators, and patients because they suggest that any differences between allopathic and osteopathic medical schools, either in terms of educational approach or students who enroll, are not associated with differences in quality or costs of care, at least in the inpatient setting,” the researchers wrote in the study.

DO Field Grows During Provider Shortage

This study is good news for patients who are staring down care access problems caused by a clinician shortage. Understanding the comparable outcomes among MDs and DOs could open up avenues for patients in terms of whom they see as a provider.

These results come in the background of a burgeoning DO field, the researchers added. More people are considering osteopathic medical education, they said, with the number of enrollees increasing by 72 percent between 2010 and 2020; this compares to a 16 percent increase in the number of MD program enrollees, the researchers pointed out.

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What’s more, DO programs have outlined specific efforts toward increasing medical workforce diversity, a key goal as the healthcare industry works toward health equity. To be clear, MD programs have similarly outlined goals to broaden the demographic makeup of the medical field.

But in a 2023 episode of Xtelligent Healthcare Media’s podcast, Healthcare Strategies, leaders in the DO field outlined specific action steps for supporting more diversity in osteopathic medical programs.

Through marketing, messaging, and recruitment, the American Association of Colleges of Osteopathic Medicine (AACOM) and its medical schools are working to change the understanding of what constitutes the typical medical student.

There is more than one way to become a doctor, according to Helene Cameron, PhD, AACOM VP for Undergraduate Medical Education and Recruitment, and that can include becoming a doctor of osteopathy or coming from an underrepresented background.

“It starts early. You do not decide, most people don't decide, to become a physician their senior year in college when they're two weeks away from graduation and trying to figure out what their next move is,” Cameron pointed out in the podcast. “And so, we are trying to find ways to strategically introduce the profession to young students, so that they can have time to make decisions about what direction they want to go in.”