COVID-19 Response — The Portland Clinic is open and equipped to provide safe, quality care for the community. Learn more >>  

MD or DO: What’s the difference?

Those two letters after our doctors' names, explained

By Thomas Starbard, DO, a doctor specializing in manual medicine and osteopathy at The Portland Clinic.

Dr. Starbard

The Portland Clinic has several DOs on our team, practicing in a variety of specialties, and we’re often asked about those two letters that follow our names. What’s the difference between a DO and an MD? I’m happy to explain.

In the United States, there are two types of medical schools that train doctors. The type that most people are familiar with grants “medical doctor” (MD) degrees. The other type, called an osteopathic medical school, grants “doctor of osteopathy” (DO) degrees. Today, about one in four medical students chooses an osteopathic medical school. 

The osteopathic difference

All DOs and MDs are fully licensed physicians with the certification and training to prescribe medications and to perform surgical procedures. The training for both is exactly the same, with one exception. Both MDs and DOs study anatomy, physiology, pharmacology, microbiology, and all the other specialty courses, and both do residency training after they graduate. The only difference is that, in addition to all the other topics, osteopathic training also includes courses in hands-on techniques, called osteopathic manipulative treatments, as another way to assist in healing.

Many feel that there is a philosophical difference in DO training, as well. It’s a bias that leans toward approaching patients more holistically, rather than treating individual ailments or parts. That may have something to do with the extra training in the musculoskeletal system, where DOs learn about the intricate interconnections between bones, muscles, nerves and the rest of the body. As I’ve seen many times in my own practice, for example, back pain isn’t always a back problem: sometimes it’s a sign of a related problem somewhere else.

Like MDs, DOs can pursue any medical specialty, from primary care to cardiology, gastroenterology, urology, etc. That’s why, at The Portland Clinic, you’ll find an ophthalmologist, several family practice physicians and a gynecologist — who also happens to be our chief medical officer — who have DO degrees. In addition, because all osteopathic students study osteopathic manipulative medicine, they also have the option of specializing in that, specifically — as I do.

Are DOs the same as chiropractors?

The osteopathic manipulative treatments used by many (but not all) DOs include the fundamental “joint popping” style used by chiropractors, as well as several gentler techniques for improving soft tissue function. Because of that, some people confuse DOs with chiropractors, or even with naturopaths — but only DOs and MDs are licensed and trained as physicians.

MD or DO: which should you choose?

When you’re choosing a doctor, should you seek an MD or a DO? Unless you’re specifically looking for a doctor who performs osteopathic manipulative medicine, it doesn’t make a big difference. Your confidence and comfort level in an individual provider are much more important than which two letters follow his or her name.