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Communicating About Osteopathic Medicine: An Analysis of Osteopathic Residents’ Responses to the Question “What’s the Difference Between a DO and an MD?”

Journal: The Journal of the American Osteopathic Association Date: 2012/08, 112(8):Pages: 559-560. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2012.112.8.529/html)

Keywords:

cross sectional study [880]
distinctiveness [16]
medical students [679]
osteopathic medicine [2080]
residency [335]
USA [1734]

Abstract:

Background: As the number of practicing osteopathic physicians (ie, DOs) increases, more patients will find themselves being treated by physicians who wear the letters DO on their white coats. Many will have had no prior experience with osteopathic medicine. Our challenge in osteopathic medical education is to enable our students and residents to communicate effectively about osteopathic medicine, ensuring that they can professionally present and accurately promote their profession. Objective: To generate themes from osteopathic residents' descriptions of the difference between DOs and allopathic physicians (ie, MDs) and to compare the generated themes and responses to a statement on the Web site of the American Osteopathic Association (AOA). Methods: During the 2010 and 2011 Nova Southeastern University College of Osteopathic Medicine Resident Objective Structured Clinical Examinations (ROSCE), the following question was asked by the standardized patient: “I see you have DO behind your name. What's the difference between a DO and an MD?” Resident responses were digitally recorded, transcribed, and distributed to residency program directors as part of their core competency assessment. After the ROSCE reporting was completed and upon approval from the institutional review board, the 362 archived resident responses were deidentified and qualitatively analyzed. Results: The following 7 themes emerged: (1) DOs use osteopathic manipulative treatment, (2) DOs and MDs have similar licensing, prescribing rights, and practice opportunities, (3) DOs have a more holistic philosophy, (4) DOs have additional musculoskeletal training, (5) DO and MD medical schooling is the same, (6) DOs have an “extra tool in their bag,” and (7) DOs focus on the body's interconnectedness. Six of these themes closely match concepts in the AOA statement. However, 1 theme (DO and MD medical schooling is the same) is not in the AOA statement. Further review revealed that 2 concepts in the AOA statement—”preventing illness through healthy lifestyle” and “help the body heal itself”—were only mentioned by 1% and 7% of the residents, respectively. Conclusion: Given that only 2 generated themes were mentioned by more than 50% of the residents, the resident responses were incomplete. Although the ROSCE time limit may have impacted some residents' ability to fully answer the question, the author recommends examining curricula to determine whether current instruction and assessment is this type of patient communication is adequate and whether the concepts of prevention, wellness, and helping the body heal itself are being sufficiently taught.


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