Defending DOs

I am a DO: Facing the skeptics

Matthew Tilton, DO, explains his experience with confusion about the osteopathic profession. He also points out reasons for optimism and how DOs can tell the story of a distinct approach to patient care.

Editor’s note: This is an opinion piece; the views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

It has happened to me on several occasions. I have seen and heard the DO skepticism more often than I care to admit. At the very beginning of residency, I was listening to a patient’s heart sounds on a weekend ER shift when the patient inquisitively asked, “What is a DO?” My eyes reflexively flashed down to my badge, and I replied, “Doctor of Osteopathic Medicine.” The conversation continued with me inadequately explaining osteopathic medicine.

Maybe the question caught me off guard, maybe it was intern jitters, but either way, I completely fumbled through my first opportunity to represent the osteopathic community. I completed medical school in Kirksville, Missouri, where DOs are plenty and MDs are few. To this day I couldn’t tell you why I was hesitant; I am a proud osteopathic physician.

I am proud of my medical school, my training and who I am as a physician. I just wasn’t prepared for the question. Luckily this patient became more interested in my ability to help them rather than my training. This same patient established care with me at the residency clinic and I have now had several opportunities to discuss osteopathic particulars.

Many of us have similar experiences where we are hesitant to share who we are and why we are different. In our search for a residency position, many of us asked the question, “Is this program DO-friendly?”

How many exceptions does it take for something to no longer be the exception, but become the rule? This is a large enough problem that last year, the AOA and the American Medical Association released a joint statement to stand against the misrepresentation of osteopathic physicians. This is a step in the right direction.

Matthew Tilton, DO

DO advocacy

The AOA has established an advocacy page to help spread the word and curb professional discrimination against DOs. When I first came to residency, I was the only DO in my program and HR initially put MD after my name. I wasn’t at all irritated, it could happen to anyone.

That was the first time I had seen MD behind my name, but it was certainly not the last. I eventually became an expert at conversations explaining how I was the same as my MD co-residents, but also different. Is this an example of groundbreaking advocacy? It is a start, but it isn’t enough.

There continues to be a stigma associated with the osteopathic profession even while we continue to move forward. Our postgraduate residency training is now unified into a single accrediting body under the ACGME. Many said this could never happen. But the problem is not with our progress or achievements. We as osteopathic physicians have achieved an unprecedented level of representation and support in recent years.

We are now part of NASA, the CDC, every branch of the United States Armed Forces and countless hospitals, clinics and organizations throughout the United States. Let’s not forget the innumerable contribution our profession has made while fighting the COVID-19 pandemic. We also treat presidents and Olympians.

I personally have found my interactions with patients, MD counterparts and other health care professionals to be overwhelmingly positive. However, time and time again our training is mischaracterized by prominent organizations and news outlets.

At best, this ongoing misrepresentation is sheer elitist ignorance; at worst this is untainted professional discrimination shrouded with the ever-redundant excuse of, “I just wasn’t aware.” The fact that this inexplicably occurs at seemingly regular intervals does raise a red flag.

Are osteopathic physicians purposely targeted? Even if the answer is yes, surely, a few poorly informed rogue individuals wouldn’t intentionally alienate 160,000 DO-trained physicians and medical students during a worldwide pandemic that has already brought the entire world to a screeching halt and threatens to do so yet again.

Hopefully, those who describe our profession as “quackery” would not choose to perpetuate misleading information that may result in further strain on an already taxed health care system. That would be especially irresponsible of those professing to care about the spread of medical misinformation.

Rising to the challenge

I am optimistic that those who discredit our profession are willing to have an open discussion, and I challenge them to use this opportunity for further education. I am only requesting that they have enough insight to ask the questions, before believing they have an answer. I am thankful that our community has representation and has risen to the challenge each and every time we see this misinformation occur.

As for our role in all of this, the osteopathic pledge of commitment states: “Live each day as an example of what an osteopathic physician should be.” The answer lies with us. If we want to be heard, then we need to have the courage to say something.

If we want to make a change, then we need the audacity to do something. It is not enough to agree that there needs to be change. We need to BE that change. The opportunity for advocacy is anywhere that you want to find that opportunity. There is no such thing as small advocacy. Pick your stage and own that stage. Discover that on-fire passion and help show the world who you are.

There are so many opportunities to get involved, including international, federal and state advocacy. Whether you participate in DO Day on Capitol Hill or just take a little extra time to explain to a patient or a coworker what it means to be a DO, that is how we show the world who we are. Our story will be told by someone. It can be the naysayers, elitists and the ill-informed. Or it can be told by those who live it day to day. It is not just me. It is us and we are DO proud. We are DO strong.

Related reading:

Osteopathic medical profession fights back after CNN, MSNBC mischaracterize DOs

Recent advocacy wins combat professional discrimination against DO trainees

8 comments

  1. Amen Dr Matthew Tilton! Exactly what I always teach my medical students in my office and my alma mater PCOM.

  2. Well said. I am sure that most of us have had similar experiences in our professional life – I know that that I have. Thank you for bringing it to our attention the way that you have.

  3. Very glad Dr Tilton you have taken up the task of addressing a common challenge in our profession. Great job! If you wish to see how I handled in a lecture at UC Davis, Google “Introduction to Osteopathic Medicine” and there is a YouTube video that the University had streamed. Please dig on. Gratefully, RMH

  4. I regret that so few DO’s actually use or incorporate OMT as part of their practice – it’s a great modality – not one I use in psychiatry but my own pcp is a DO (also has DC credentials) and 30% of his practice is manual medicine.

  5. I practiced in Michigan for 46 years I delivered infants,did surgery worked the ER,did office, made house calls I very rarely was asked what is a DO I guess because I was a complete physician and treated everything and all types of patients which today is missing. By the way did you see in the college bowl none of the three Uof M students knew what a DO is I am sure a Michigan State student knows

  6. Having been a Kirksville graduate as well and doing rotations at a DO hospital in central Missouri it was very common to get the question from patients who just want care. When I started my first Air Force post-grad assignment I was the token DO and no one before me did OMT really. I changed that quickly and made a name for myself and when I left we had a switch with one token MD in the clinic. We are out there and you will find that some patients are aware of who we are and what we can do. When you do, it makes it special.

  7. Well said. The profession has changed dramatically since I graduated from PCOM in 1980. I completed residency in an allopathic hospital in North Carolina, with over 1000 beds. I was the first DO resident in that facility and I dealt with my share of questionable remarks from some of my MD cohorts. This only served to motivate me harder and today I look at our profession’s North Carolina presence with great pride. “The journey of a 1000 miles begins with a single step”. Sometimes, it’s a single resident.

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