Decoding the Difference: MD vs DO

When searching for a physician, you may have noticed two common but confusing sets of credentials next to providers‘ names: MD and DO. While both signify that someone is a licensed doctor, these letters actually mean different things that can impact the type of care you receive. Read on to understand the distinction between medical doctors (MD) and doctors of osteopathic medicine (DO).

Origins of Osteopathic Medicine

To start, let‘s look further back at the origins of osteopathic medicine and how it came to be its own recognized medical profession.

The foundation of osteopathy dates back to 1874. That‘s when Andrew Taylor Still, a Kansas physician, established the field after feeling dissatisfaction with orthodox medicine‘s limitations. Still emphasized disease prevention, the unified nature of the body, and the body‘s unique ability to heal itself when properly cared for.

He went on to open the first college of osteopathic medicine a few decades later in 1892. This laid the groundwork for a steady growth in osteopathic physicians over the next century. Today, about 7% of all U.S. physicians are doctors of osteopathic medicine.

A Look at the Meaning Behind MD and DO

To clarify what these commonly used abbreviations stand for when you visit a physician‘s office or hospital:

• MD: Doctor of Medicine. An MD has trained in traditional allopathic medicine, which relies on science-based treatment like medication, surgery, radiation, etc. The term comes from “allopathy," coined in the 1800s to contrast this type of medicine with homeopathy.
• DO: Doctor of Osteopathic Medicine. A DO practices osteopathic medicine, which takes a whole-body approach focused on disease prevention by facilitating the body‘s natural healing abilities. The word osteopathy comes from the Greek words for bone (osteo) and suffering (pathos).

So in short, MDs and DOs start from slightly different philosophical standpoints in their approach to medicine, but there is significant overlap in their training and credentials.

Education and Qualifications: MD vs DO

Though their names and underlying philosophies differ, MDs and DOs share extensive common ground when it comes to medical education and qualifications:

• Undergraduate education: Before entering med school, both MD and DO students typically must complete bachelor‘s degrees with rigorous premedical coursework including biology, chemistry, physics, etc.

• Medical College Admission Test (MCAT): All aspiring U.S. MD and DO physicians must take and submit competitive MCAT exam scores, averaging around a 505-510.

• Licensing exams: Both MD and DO graduates must pass a series of national board exams including the STEP exams and practice rotations before earning full licenses.

However, DO students receive some distinctly different training as well:

• Osteopathic Manipulative Medicine: DOs take 200–300 additional hours of study in Osteopathic Manipulative Treatment (OMT). Here they learn hands-on techniques focused on muscles, joints, connective tissues and the spine.

So in a nutshell, MDs and DOs undergo extensive overlapping medical preparation, but DOs also study an additional therapeutic specialty.

Growth in Osteopathic Schools and Graduates

Since Andrew Still established the nation’s first osteopathic medical school in 1892, the number of these programs and graduates has steadily risen. As of 2022, there are 37 accredited osteopathic medical schools across the U.S.

And today, new DOs represent about 25% of all incoming U.S. medical residents and fellows. So while an MDstill remains the majority physician type, osteopathic medicine continues to expand as an complementarily medical profession.

National Licensing Exam Performance

Given their similar curriculums but differing extra osteopathic training, how do MD and DO graduates compare when taking the same national board licensing tests?

On the difficult STEP 1 exam, first-time test takers pass at similar rates:

• MD candidates: 94%
• DO candidates: 93%

And on STEP 2 clinical skills assessments, DO students actually demonstrate slightly higher pass rates:

• MD candidates: 97%
• DO candidates: 98%

So the data shows osteopathic medical students are equally equipped to pass these milestone exams on the path to full physician licensing.

How Do MD and DO Physicians Typically Practice?

When it comes to practicing medicine, MDs and DOs can work in any specialty or care environment. However, they often gravitate toward different areas:

• MD specialties: Tend to practice specialized medicine like cardiothoracic surgery, neurology, gastroenterology and perform complex procedures.

• DO tendencies: Commonly enter primary care fields like family medicine, internal medicine, pediatrics, OB/GYN. Osteopathic techniques naturally lend themselves to these areas of whole-patient medicine.

For example, 39% of actively practicing DOs work in primary care roles, compared to just 14% of MDs. And MDs are more heavily concentrated in specialized fields like surgery that may require less hands-on manipulation.

That said, there are many exceptions – some MDs have very holistic approaches similar to DOs philosophy, while some DOs prefer to sub-specialize. But in general, these practice tendencies reflect the differing core approaches of each path.

Residency Match Rates: MD vs DO Grads

Gaining entrance into competitive medical residency programs is the next major stepping stone after graduating from either MD or DO medical schools.

Success rates in matching with an accredited residency program are high but skew slightly in MD graduates’ favor:

• MD graduate match rate: 94%
• DO graduate match rate: 89%

The difference primarily lies in matching with very competitive specialties like orthopedic surgery, dermatology, or ophthalmology. This likely reflects MD focus on specialization as well as bias at some traditional MD institutions.

However, when it comes to primary care residencies, MD and DO match rates are equivalent. So there is near equal opportunity for clinical placement in family medicine, general internal medicine, and pediatrics.

Income Prospects: MD vs. DO

Once graduated, licensed, and practicing in their medical specialty, how do DO and MD salary prospects compare?

On average, we see a modest pay gap that again favors the MD route:

• Average MD salary: $250,000 per year
• Average DO salary: $230,000 per year

This ~8% difference amounts to about $20,000 less annual pay for DOs. Research shows a couple factors that contribute to this MD earning premium:

• MDs are more heavily concentrated in higher paying specialized fields
• In the same specialties, MDs may earn slightly higher salaries at traditional MD institutions

However, DO incomes are rapidly rising too. And for primary care fields like general internal medicine and family medicine, MD and DO pay is nearly equivalent.

Number of MD and DO Physicians

As we‘ve discussed, DOs currently make up about 7% of all actively practicing physicians in America – though this percentage has risen rapidly since the profession‘s origins. So in terms of sheer numbers:

• MD practicing physicians: 985,000
• DO practicing physicians: 77,000

So while vastly outnumbered, the over 70,000 DOs across the U.S. still deliver a substantial share of healthcare alongside their MD counterparts.

The distribution also varies greatly by state and region. For instance, DOs make up 15% of all physicians in Oklahoma – more than double the national percentage. So in pockets like these centered around osteopathic schools, their presence is quite prominent.

Which is Better: MD or DO?

When it comes down to it, both MD and DO physicians complete rigorous medical training to accurately diagnose and treat a broad range of health conditions. They also demonstrate very similar board exam pass and residency match rates. So from an credentials perspective, neither type of doctor objectively outweighs the other.

Ultimately the decision between seeing an MD or DO depends on your personal preferences and priorities around your care, such as:

• Comfort level: Look for a doctor you feel at ease talking to openly. This facilitates sharing important details about symptoms, family history, lifestyle context etc.

• Bedside manner: Prioritize a physician who listens attentively without rushing you, welcoming all questions without judgement.

• Treatment approach: Consider differences like hands-on osteopathic adjustment techniques versus more targeted prescription medication approaches.

I‘ve had positive individual experiences with both MDs and DOs. For instance, after my car accident last year, I really appreciated my DO physician taking the time to gently realign my back and neck areas that had muscle tension after whiplash. This provided gradual pain relief alongside the pain medication prescribed.

Later on dealing with chronic migraines, I’ve trusted my MD neurologist’s expertise honing in on effective prescription preventative treatment. Her breadth of knowledge on the latest studies and specialty drugs gave me confidence we could identify an optimal regimen.

These were just personal snapshots. But in general, realize you have access to highly qualified physicians whether they hold an MD or DO credential. Both receive intensive medical education and demonstrate competence applying it.

Why Osteopathic Medicine Matters

While 7% seems like a small percentage, if the over 70,000 DOs in America went on strike, our healthcare system would greatly suffer. They provide invaluable patient care, often for underserved populations.

For instance, DOs are more likely than MDs to practice rurally and in low-income communities. A full 25% of DOs work in rural, underserved areas – nearly triple the percentage for MDs. This expanded primary care access offers medical homes for 20 million Americans who would otherwise need to travel long distances to see a physician.

And in today‘s healthcare landscape, DOs also deliver care in a more financially sensible way – directing more attention to preventative approaches that cost far less than reactive medication or surgery. This mirrors the general direction policymakers want medical practice to shift.

Plus, the very philosophies driving osteopathic medicine offer useful reminders for all physicians aiming to practice patient-centered care. DOs set an example emphasizing holistic treatment not just of symptoms, but facilitating the body and mind‘s own healing wisdom through adjuvant therapies like manipulation. Translating more of this preventative, hands-on emphasis could improve conventional medicine too.

Key Takeaways: Decoding MD and DO Distinctions

In closing, while subtle differences exist between these two types of physicians, the key takeaways are:

• Both MDs and DOs receive rigorous medical education and qualify as fully licensed doctors and surgeons.
• MDs focus more narrowly on treatment of specific illnesses and symptoms while DOs emphasize understanding root causes and leveraging the body‘s self-healing tendencies.
• MDs typically specialize while DOs more commonly work in primary care, but there is significant variability on an individual basis.
• Metrics like board scores, earnings, and career paths show great success for both physician training paths.
• When choosing a personal doctor, factor in bedside manner, communication style, and therapeutic approaches over letters behind the name.

Rather than viewing MD and DO distinctions as some rigid divide, recognize the strengths each bring. Appreciate osteopathic medicine‘s specialist perspective while understanding conventional MDs‘ value too. The two nicely complement one another – combining targeted treatment plans as needed with holistic facilitation of the body‘s own healing powers.