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[jessb2]

This guy has got to be one of the strangest Medical school presidents around. Is it ever appropriate for an educator to say that teachers do not want to teach their students?

http://www.eyedrd.org/2011/03/open-letter-to-dr-ransom-about-his-testimony-that-md-faculty-members-do-not-want-to-teach-his-do-students.html

[torshi]

The topic of the School & College forum is: "What reforms would better prepare students for college?"  And it would be helpful to give some context.

That aside, is he right?   Ransom seems to be saying that many MD faculty do not see DOs as "their" students.  Do the MDs on his faculty prefer not to teach DO students?  Is this generally the case?  And, if they teach them anyway, does it matter?  I'm not involved with medicine or the teaching of medicine, so I don't know the answer.  I would be interested in research on the topic for a class I teach in another area.

As far as I can make out from some quick background reading, the context is a shortage of physicians in Texas and a debate over what to do about it, specifically a proposal for a new medical school in the Fort Worth area for MDs.  (Here is an article about the proposal and here is an editorial discussing the legislative situation).  That is the proposal that Ransom, president of University of North Texas Health Science Center (UNTHSC), argued for in the Texas state legislature.  UNTHSC already has the Texas College of Osteopathic Medicine.  The new MD school would initially share staff and facilities, and would perhaps compete with the existing DO school.  DOs are concerned that the new school would weaken TCOM, whose graduates tend to go into primary care.  Advocates of the proposed MD school say that there is no threat to TCOM. 

Ransom said in his testimony that there are "cultural" reasons for the preference of MDs to train MD students.  He is a DO. If such a culture of preference exists, it could be argued that it is not smart to use it as a funding justification.  But it is not clear that it harmed his efforts to get a new school.


 

[oldfullprof]

The only real difference is that DOs learn chiropractic along with the other specialities.  More DOs than MDs proportionally are primary care practitioners.  MDs do look down on DOs.

[kaysixteen]

I have asked this question here before, regarding what is the real difference between MDs and DOs-- I am not sure I understand the answer any better today, if it is true that MDs look down on DOs, then this presumably means that most MDs do not consider DOs real docs who are their equals, right?

[zharkov]

Perhaps it is human nature for people to play "top-dog, bottom-dog."  MD vs. DO, and among MDs, which school one went to.  Still, there are many joint practices that include both MDs and DOs.   And DOs have "regular" physician licenses.

To correct an earlier comment, DOs lean osteopathy (in addition to "regular" medicine), not chiropractic.

[kaysixteen]

Ok, we are making headway-- I suppose, as a Classicist, I ought to be able to figure this out myself, and I can make etymological stabs at answers, but I would like someone who actually knows real 21st c. English usage to answer:

1) what exactly is 'osteopathy'?

2) MDs practice what is called 'allopathic' medicine-- to what does this term refer?

[madhatter]

Ok, we are making headway-- I suppose, as a Classicist, I ought to be able to figure this out myself, and I can make etymological stabs at answers, but I would like someone who actually knows real 21st c. English usage to answer:

1) what exactly is 'osteopathy'?

2) MDs practice what is called 'allopathic' medicine-- to what does this term refer?

Your answers here:

http://tinyurl.com/2f45ets

http://tinyurl.com/3rzg2gf

[oldfullprof]

Mmmmm...is there a difference between Osteopathy and Chiropractic?

[daniel_von_flanagan]

"Allopathy" is a term invented by homeopaths and is intentionally pejorative.  it was created by the nutcase Samuel Hahnemann as a term with which quacks could try to bring real doctors down to their level. Anyone who uses the term is suspect.

Osteopathy was originally founded on the idea that most disease was caused by spinal misalignment.  As this is patently absurd, the way osteopathy has survived was by accepting an increasing number of classical medical dicta, to the point that the two approaches are nearly indistinguishable today.  There are a few osteopaths who bemoan the loss of the distinction for their field, and thus would oppose creating an MD at schools which were traditionally DO-only.  The person behind this website apparently falls into this group.

I believe the distinctions between osteopathy and chiropracty are (a) historically, the former mistakenly believed that spinal misalignment impeded blood flow, while the latter mistakenly believed that misalignment impeded some kind of neural flow, and (b) the latter never grew to incorporate traditional medicine. 

I would not go to a DO, but only because I would worry that they secretly believe some of the alignment nonsense; other than that I assume that like any other kind of doctor there are good ones and bad ones, and the good ones will give good medical care.  I would not go to a chiropractor either, because I find setting money on fire just as effective a placebo, and cheaper. - DvF

[kaysixteen]

Awright, that makes it clearer.  Etymologically, 'osteopathy' does refer to 'bone suffering', whereas 'allopathy' refers to 'other suffering'.  I would have the same hesitation to use a DO again if I thought he might buy into the spinal stuff-- is that sort of thing still taught at DO schools?

[daniel_von_flanagan]

whereas 'allopathy' refers to 'other suffering'.

Yes, except it is a made-up word. It doesn't come to us from the Greek, it was created by someone holding a Greek dictionary.

  I would have the same hesitation to use a DO again if I thought he might buy into the spinal stuff-- is that sort of thing still taught at DO schools?

I think less than it used to be.  Here's something from the NEJM (though it is 20 years out of date):

Some leading osteopaths say that manual therapy should be part of almost every visit to an osteopathic physician. A recent president of the American Osteopathic Association claimed that he "almost always turned to [osteopathic manipulation] before considering any other modality," and he asserted that 90 percent of his patients got better with osteopathic manipulation alone.  Such claims underscore a raging debate within osteopathy and a disconnection between its theories and its practice. A 1995 survey of 1055 osteopathic family physicians found that they used manual therapy only occasionally; only 6.2 percent used osteopathic manipulation for more than half of their patients, and almost a third used it for fewer than 5 percent.  The more recent their graduation from medical school, the less likely practitioners were to use osteopathic manipulation, a finding consistent with the view that osteopathic practice is moving closer to allopathic practice. A decreasing interest in osteopathic manipulation may also indicate that more physicians enter osteopathic medical school not as a result of a deeply held belief in the osteopathic philosophy but after failing to be admitted to allopathic medical schools.  The osteopathic physicians who are more committed to osteopathic manipulation tend to be more likely than their colleagues to have a fundamentalist religious orientation.

- DvF

[kaysixteen]

1) you are absolutely right about the word being made up, and being no more of classical provenance than the chiro's 'subluxation' is.

2)wrt that quote from NEJM, I was struck by the notion that most younger DOs only go get a DO after they fail to get into an MD program.  If this is true, does it not suggest that the average DO is intellectually, educationally, etc., inferior to the MD?

3)Are the state requirements for licensure and testing the same for DOs and MDs?

[sea_and_ski]

...2)wrt that quote from NEJM, I was struck by the notion that most younger DOs only go get a DO after they fail to get into an MD program.  If this is true, does it not suggest that the average DO is intellectually, educationally, etc., inferior to the MD?

3)Are the state requirements for licensure and testing the same for DOs and MDs?

#2--No it does not suggest that.  Just that they failed to get into an MD program. 

#3--Yes, for the states (~12) I am familiar with.

[daniel_von_flanagan]

2)wrt that quote from NEJM, I was struck by the notion that most younger DOs only go get a DO after they fail to get into an MD program.  If this is true, does it not suggest that the average DO is intellectually, educationally, etc., inferior to the MD?

Elsewhere in the article (which - again - is somewhat out of date):

Osteopathic medical schools have not done as well as allopathic medical schools in recruiting underrepresented minorities and women, and students entering osteopathic medical schools have somewhat lower grade-point averages and lower scores on the Medical College Admission Test. On the other hand, the ratio of applicants to those admitted is higher for osteopathic medical schools, 3.5 applicants for each person admitted, as compared with 2.4 for allopathic medical schools.
Overall, osteopathic medical schools have come to resemble allopathic medical schools in most respects; some students even share classes. Graduates of osteopathic medical schools more often than not go on to residency training in allopathic programs.

An evaluation of performance on the certifying examination of the American Board of Internal Medicine in the 1980s noted that although physicians from osteopathic medical schools did not do as well as those from allopathic programs, overall they "did well" and could be an "untapped reservoir of talented physicians" for internal medicine.

- DvF

[spyzowin]

DO's are only a few stages away from outright quackery. Why would any real MD teach one?