Different initials, but education and care are the same; osteopaths, or D.O.s, are filling a rural void with 'their thing'

Kevin De Regnier, an osteopathic physician in Winterset, Iowa,
examines Alice Collins. (KFF Health News photo by Tony Leys)

In rural America, you may be more likely to be treated by a "Doctor of Osteopathic Medicine," or D.O., instead of an M.D., but their schooling and boarding tests are alike," reports Tony Leys of KFF Health News. "Osteopathic physicians go to separate medical schools from medical doctors. . . . Their courses include lessons on how to physically manipulate the body to ease discomfort. But their training is otherwise comparable, leaders in both wings of the profession say. . . . Both types of doctors are licensed to practice the full range of medicine, and many patients would find little difference between them aside from the initials listed after their names."

Although currently not as common, D.O. numbers are increasing, especially in rural areas, partly because new osteopathic medical schools have located in places like Pikeville, Ky., and Harrogate, Tenn. "School leaders say their locations and teaching methods help explain why many graduates wind up filling primary care jobs in smaller towns," Leys reports. "U.S. News & World Report ranks medical schools based on the percentage of graduates working in rural areas. Osteopathic schools hold three of the top four spots on the 2023 edition of that list."

"The very nature of osteopathic training emphasizes primary care. That's kind of their thing," Michael Dill, director of workforce studies at the Association of American Medical Colleges, told Leys.

Leys reports, "Data from the University of Iowa shows osteopathic physicians have been filling rural roles previously filled by medical doctors. The university's Office of Statewide Clinical Education Programs tracks the state's health care workforce, and its staff analyzed the data for KFF Health News. The analysis found that, from 2008 to 2022, the number of D.O.s based outside those urban areas [previously filled by M.D.s] increased by 29%. Because of the shift, D.O.s now make up more than a third of rural Iowa physicians, and that proportion is expected to grow."

From 1990 to 2022, "the number of osteopathic doctors more than quadrupled, from fewer than 25,000 to over 110,000, according to the Federation of State Medical Boards. Over half of D.O.s work in primary care, which includes family medicine, internal medicine, and pediatrics. By contrast, more than two-thirds of M.D.s work in other medical specialties," Leys reports.