Study finds similar quality and cost of care for patients treated by an allopathic (M.D.) or osteopathic (D.O.) physician

Abstract: https://www.acpjournals.org/doi/10.7326/M22-3723

Editorial: https://www.acpjournals.org/doi/10.7326/M23-1165

URL goes live when the embargo lifts

An observational study of more than 329,000 Medicare admissions found that older persons receiving hospital care from an allopathic (M.D.) or an osteopathic (D.O.) physician experience similar quality and cost of care. The findings are published in Annals of Internal Medicine.

Medical education in the United States falls under two types of programs—allopathic medical schools that award a Doctor of Medicine, or M.D. degree, and osteopathic schools that award a Doctor of Osteopathic Medicine, or D.O. degree.  Approximately 90 and 10 percent of practicing physicians in the United States have M.D. and D.O. degrees, respectively. Education requirements between programs are very similar, but osteopathic programs focus on holistic care and physical manipulation of the body. Osteopathic physicians are also more likely to more likely to practice in rural and underserved areas and pursue careers in primary care compared with allopathic physicians, contributing to narrowing the gaps in disparities in access to health care in the United States.

Researchers from the David Geffen School of Medicine at UCLA and the University of Tokyo studied 329,510 Medicare admissions between 2016 and 2019 to determine whether quality and costs of care differ between hospitalized patients treated by allopathic or osteopathic physicians. Of these admissions, 253,670 (77.0%) and 75,840 (23.0%) received care from allopathic and osteopathic physicians, respectively. The data showed no clinically important differences in mortality, readmission, length of stay, and healthcare spending between the two groups. The findings were consistent across a range of medical conditions and across severity of patient’s illness, suggesting that any differences between allopathic and osteopathic medical schools, either in training or the types of students who enroll, are not associated with differences in costs or quality of care in the inpatient setting. According to the authors, these findings should be reassuring for policymakers, medical educators, and patients.

An accompanying editorial from authors at University of California San Francisco and Eastern Virginia Medical School highlights the similarities between allopathic and osteopathic practices because of workplace and educational standardization. However, the authors also highlight that despite these similarities, the medical field has been reluctant to accept osteopathic medical students into their preferred specialties, causing increasingly pronounced disparities in competitive programs.

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with corresponding author Atsushi Miyawaki, M.D., PhD, please email [email protected].