New Study Finds DOs and MDs Provide the Same Level of Care in Older Adults

Have you ever been surprised when you looked at the diploma on the wall while waiting for a medical visit and discovered that your provider is a DO (doctor of osteopathic medicine) rather than an MD (doctor of medicine)? Whether that caused you concern about the kind of treatment you might receive, or just made you curious about the differences between these two types of doctors, the findings from a new study published on May 30 in the Annals of Internal Medicine provides insight and reassurance.

Investigators from UCLA Medical School in Los Angeles examined the medical records of over 300,000 people and found that patient death rates, readmission to hospitals, length of stay, and healthcare spending were nearly identical for people 65 and older who were hospitalized and treated by physicians with an MD or DO degree.

“We found that any distinctions between allopathic [MD] and osteopathic medical schools, in terms of training or student demographics, aren’t associated with differences in costs or quality of hospital care,” says lead author Yusuke Tsugawa, PhD, MD, associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and an associate professor of health policy and management at the UCLA Fielding School of Public Health.

The Number of DO Physicians Has Increased 72 Percent Since 2010

The research was prompted by a lack of evidence as to whether quality and costs of care differ between allopathic and osteopathic physicians, says Dr. Tsugawa. “With the rapid growth of osteopathic medical schools and the increasing number of patients treated by osteopathic physicians, we thought that it is important to assess whether outcomes of patients treated by allopathic and osteopathic physicians differ,” he says.

About 9 out of 10 of practicing physicians hold MD degrees compared with only 1 in 10 with DO degrees, according to a paper published in July 2021 in the Journal of Medical Regulation. But in the past decade, that ratio is beginning to shift — the number of DOs increased by 72 percent between 2010 to 2020, from 58,329 to 100,379, compared with only a 16 percent increase in the number of MDs during the same period, according to the authors of that study.

In addition, osteopathic physicians are more likely than their MD counterparts to serve patients in rural and underserved areas, according to Health Affairs.

Patient Outcomes and Costs Nearly Identical for MDs and DOs

Patient participants came from a 20 percent sample of Medicare fee-for-service beneficiaries, amounting to nearly 3233,000 people aged 65 years and older who were hospitalized between January 1, 2016, and December 31, 2019. Physician information came from the Medicare Data on Provider Practice and Specialty and a Doximity physician database.

A total of 77 percent of participants were treated by MDs and 23 percent were treated by DOs.

Key findings from the analysis included:

• Patient mortality rates were 9.4 percent among people receiving care from an MD versus 9.5 percent among those cared for by a DO.
• Patient readmission rates were 15.7 percent for MDs vs. 15.6 percent for DOs.
• Healthcare spending was $1,004 for MDs and $1,003 for DOs.
• The average lengths of hospital stay were 4.5 days for both.

“These findings 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,” says Tsugawa.

The authors acknowledge a few limitations to the study, primarily that they focused on elderly Medicare beneficiaries who were hospitalized with medical conditions, so the results may not apply to other population groups.

What’s the Difference Between an MD and a DO?

No matter what state you live in, there’s a chance you could be cared for by either type of doctor. MDs and DOs are licensed to practice medicine in every state.

The two degrees reflect different types of medical school training. MD-granting institutions are often called allopathic medical schools, while DOs attend osteopathic medical schools.

The application requirements and curriculum are largely the same, with students typically spending much of the first year or two in the classroom, and then moving to clinics or hospitals to continue their training. In general, more DOs go into primary care specialities, including family medicine, internal medicine, and pediatrics, according to the University of Medicine and Health Sciences.

DOs May Offer More Holistic Care Compared With MDs

Both allopathic and osteopathic physicians practice evidence- and science-based clinical medicine, and both types of doctors can diagnose, treat, and prescribe medications along with lifestyle or nonpharmaceutical interventions.

Historically, DO programs have described their methods as more holistic than those taught in traditional medical school, according to the American Medical Association (AMA). The overall philosophy of osteopathic medicine places more emphasis on preventive healthcare and using methods to encourage the body to heal itself, according to Cleveland Clinic.

However, in practice, the differences between the professions have become increasingly difficult to identify, according to an editorial published along with the study. For example, many MDs and other types of healthcare providers practice preventive or integrative medicine, which have many similarities to the tenets of osteopathy.

One of the most obvious differences is osteopathic manipulative treatment (OMT), a practice in which the DO moves a patient’s muscles and joints using techniques including stretching, gentle pressure, and resistance. But research shows recent surveys indicate most DOs don’t use OMT in their practice.

When asked what people should know when considering which type of provider to choose, Tsugawa says, “Patients should be reassured that both allopathic and osteopathic hospitalists provide high-quality care.”