One of the most common questions new patients ask me: "What's the difference between a DO and an MD?"
It's a fair question, and the answer is more interesting than most people expect.
The Short Answer
A Doctor of Osteopathic Medicine (DO) and a Doctor of Medicine (MD) are both fully licensed physicians in the United States. Both complete four years of medical school, residency training, board examinations, and state licensing requirements. Both can prescribe medications, perform surgeries, and practice in any specialty.
The difference is the educational philosophy — and one additional clinical tool.
The Longer Answer: Osteopathic Philosophy
Osteopathic medicine was founded in 1874 by Dr. Andrew Taylor Still, who believed that the body has an inherent capacity to heal itself — and that structural alignment of the musculoskeletal system affects overall health and the body's ability to function.
In practical terms, osteopathic medical education includes everything MD education does plus approximately 200 additional hours of training in Osteopathic Manipulative Medicine (OMM) — the hands-on diagnosis and treatment of musculoskeletal dysfunction.
The philosophical principles of osteopathic medicine include:
- The body is a unit — physical, mental, and spiritual components are interconnected
- The body has self-healing mechanisms — our job is to remove barriers to those mechanisms
- Structure and function are interrelated — dysfunction in the musculoskeletal system affects overall health
- Rational treatment is based on understanding these principles
Osteopathic Manipulative Therapy (OMT): What It Actually Is
OMT is the hands-on clinical skill that differentiates DOs from MDs. It involves using the hands to diagnose and treat musculoskeletal dysfunction, with effects on pain, mobility, circulation, and nervous system function.
Common OMT techniques include:
High-Velocity Low-Amplitude (HVLA) — the adjustment most people associate with chiropractic care (the "crack"). A precise, quick thrust that restores normal joint motion.
Muscle Energy Technique (MET) — the patient actively contracts a muscle against a counterforce held by the physician. Used to lengthen shortened muscles and restore joint mechanics.
Counterstrain — placing the body in a position of comfort to relieve spasmed muscles. Gentle and effective for acute pain.
Myofascial Release — sustained pressure into connective tissue restrictions. Useful for chronic tension patterns.
Craniosacral Therapy — gentle techniques applied to the skull and sacrum, based on the theory of cerebrospinal fluid rhythm.
What I Use OMT For in Practice
As a family medicine physician, I use OMT regularly for:
- Acute and chronic back and neck pain
- Headaches — especially tension and cervicogenic
- Rib dysfunction and chest wall pain (including post-COVID breathing complaints)
- Shoulder and hip girdle pain
- Sports injuries, particularly when acute
- Post-partum back and pelvic pain
OMT is not appropriate for fractures, infections, metastatic cancer in bone, or acute inflammatory arthritis flares. But for musculoskeletal pain in appropriate patients, it's an effective tool that I'm glad to have.
Do All DOs Use OMT?
No. Many DOs practice without using OMT in their daily work, particularly those in surgical specialties or in certain hospital-based practice environments. I chose family medicine and sports medicine in part because OMT is particularly valuable in these settings.
If you're interested in OMT as part of your care, mention it when you book your appointment — I'll make sure we have time for it.
Questions? Call us at 408-266-3100 or book online at parikhhealth.com.