"Navy doctor, Conley, is a DO, not an MD, and with a specialty of
emergency medicine. This prompted me to look up osteopathic training."

It remains difficult to get into allopathic (traditional MD) schools. The application process is somewhat self-selecting (meaning, candidates with less than sterling academic records and test scores compared to their peers know that applying may be a waste of money and time). For the majority of schools, acceptance rates overall are in the single digits (less than 10%).

DO schools by comparison are much less selective, much less competitive, easier to get into. From what I observed of family members, few physician wanna-be's have DO schools as their first choice. It's a second choice used by those failing to gain traditional MD school admittance. A way to think of it is that DO schools produce Second Team players, less academically accomplished and arguably less qualified. DO residencies are also considered a second, inferior pathway compared to what traditional allopathic grads go through.

DO trained individuals can become good doctors and MD grads can be poor ones, everything has a bell curve. But when trying to choose a care provider, a DO credential is an inferior one. Also note that while DOs are licensed to practice medicine in all the same ways that MDs are (true now, not true historically as chisue notes), you find very few DO degreed faculty members at medical schools.

If I was given hope of recovering, I'd do traditional medicine. If I was given 3 months to live, I'm NOT spending it sick on chemo.

A DO isn't really considered "alternative medicine."

DO vs. MD

https://www.ama-assn.org/residents-students/preparing-medical-school/do-vs-md-how-much-does-medical-school-degree-type

Side note regarding DT: Your primary care doc should NOT be an emergency medicine physician! A primary care doc should be internal medicine, family medicine/practice, or if a child- pediatrics.

I'm with you Nicole. I just had this talk with my daughter a week or so ago. She thinks I would be crazy to just "give up and die" if I were to be given a terminal diagnosis. I've known too many people who've lingered, and for what? For ZERO quality of life! No thank you.

We are fortunate to live close to Boston with world class teaching and research hospitals. I had advanced breast cancer and was treated through the Cape Cod Healthcare system but years later became very weak and ill over the course of about 7 months. The MD's on Cape Cod came close to figuring it out, but my excellent primary care doctor referred me to see a gastroenterologist at Beth Israel Deaconess Medical Center in Boston, affiliated with Harvard Medical School. I was near death with a very rare blood disease. One in about 750,00 people have it. Their team saved my life. I'll stick with the MD's.

She thinks I would be crazy to just "give up and die" if I were to be given a terminal diagnosis. I've known too many people who've lingered, and for what? For ZERO quality of life! No thank you.

My father, a doctor (who spent most of his life doing cancer research) would occasionally tell me about some of his patients.

He never used a name of course, I think it was more a way to get me thinking about important issues in life and death. He was talking one day about an 'elderly' patient who had a more advanced stage of breast cancer, and how she decided to not have it treated because she did not want to go through all the misery that such treatment can entail, and instead wanted to spend as much quality time as she had left with friends and family. He said that made perfect sense to him.

Conventional medicine for me, while there is any hope of recovery. If recovery isn't possible, I'd want palliative care instead of life-extending care. But again as "traditional", that is, "tried and true" as possible. Marijuana would fit in that category now, I think.

The Mayo Clinic makes it sound like there is not much difference between a DO and an MD, except that a DO might do some extra things that an MD typically doesn't.

What kind of doctor is a D.O.? Does a D.O. have the same training as an M.D.?

Answer From Brent A. Bauer, M.D.

A doctor of osteopathic medicine (D.O.) is a fully trained and licensed doctor who has attended and graduated from a U.S. osteopathic medical school. A doctor of medicine (M.D.) has attended and graduated from a conventional medical school.

The major difference between osteopathic and allopathic doctors is that some osteopathic doctors provide manual medicine therapies, such as spinal manipulation or massage therapy, as part of their treatment.

After medical school, both M.D.s and D.O.s must complete residency training in their chosen specialties. They must also pass the same licensing examination before they can treat people and prescribe medications.

https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/osteopathic-medicine/faq-20058168

Conventional medicine as long I was willing to fight. For end of life anything goes for palliative care.

I forgot to answer, but I choose to have my medical health taken care of by an MD, though I'd be open to alternative medicine, if a condition was not responding to traditional treatment.

I would do a combination of tradtitional medicine and alternative, here's why:

Twenty years ago, my SIL was diagnosed with stage 4 inflammatory breast cancer and given 6 weeks to live. She opted for aggressive traditional treatment and alternative supplements. She is still alive and relatively healthy.

Two years ago my daughter at the age of 27 was diagnosed with stage 2 aggressive triple negative breast cancer. She chose the same path of treatment as my SIL. Her blood counts never went so low that she had to stop chemo which given the type of treatment is rare. Her oncologists at Beth Israel and Dana Farber encouraged her to keep taking the alternatives. Though the 5 year survival rate for her type of cancer is only 50%, so far she is cancer free. If she makes 5 years then the odds go way up to 95%. Needless to say I am planning a HUGE party for summer 2023.

Rightly or wrongly, with no other info to go on and without a knowledgeable referral, my first screen for choosing a physician is the pedigree of their educational accomplishment. Given alternatives, I'd rather have one whose undergrad degree is from a UW-like school, a UC, a Stanford, etc., rather than Cal State East Bay. Whose medical school was any of the same mentioned before rather than South Dakota or University of New Mexico Schools of Medicine. Similarly for their training years. Similarly as regards schools in other parts of the country, quite common for docs to move around cross the country to get their education and training done. Half the medical students hailing from California go to medical school out of state (more qualified students than available in-state spots), and most commonly at private university schools. Plenty of those though too.

Admitted students at DO schools on average have lower undergrad GPAs and lower MCAT (Medical College Admission Test) scores than students admitted to allopathic (MD) schools. This is easily found public information, not speculation.

Does academic achievement mean that what comes out the pipeline is a great doctor? No, of course not. Personality screening is still not what it should be too. But through the years of education and training there's a lot of material to know and be familiar with and that continues through their years of actively practicing. I want docs with a demonstrated track record and aptitude for learning. The second and third string players play when the game's almost over, the score and result are set, and all that's left is for the time to run out. For my health, that's never until a competent doc tells me so and at that point, I will accept it.

I was diagnosed with a deadly disease. At a very tender age. Western medicine wasn't sure how to treat it. Would I have gone another route? Nope. I made the best of it. I survived. Lucky? Great medicine? Dunno. I did what I could. They did what they could. I guess I had it all invested in Western. But I'm so grateful, I switched careers. Went from a brokerage firm to Research Administration. I'm not sure what that says, but it's my journey.

I worked for 15 years in a residency program FHC. We had both MD and DOs. The MD concentrated mostly on the present problem . The DO not only addressed the present problem but how it affects the person as a whole both physically, socially and mentally. Generally they spent more time with their patients and the patients loved them.

Personally I never tried alternative medicine, but I wouldn't rule it out if conventional medicine was not producing results.

What does FHC stand for? What institution was the resident training at?

Are you suggesting that the attending physicians/teaching docs directed one set of behaviors from one group of residents and something different from others?

It's true that DO grads can do allopathic rather than DO residencies. They have to take the allopathic boards and produce competitive scores. Some can, some can't. Not all programs are competitive. Depending on the specialties involved, I was once told many allopathic program directors (the docs who run the programs) don't want DO grads.

Elmer I can not answer your question but I do know that the hospitals in this area including KU Med have residents of both DO and MD. Two of the times when my husband was in a hospital, Catholic and Adventist, the groups that came through had name tags that showed both. If your doctor has admitting privileges you might have them for your care but many do not vs. years ago when a doctor could admit and treat at several hospitals. You can ask for a different doctor if one is available but should no longer expect your doctor to treat you.

FHC = Family Health Center

FHC = family heath center. The training was at UPMC hospital heath system.

No, the preceptors at the FHC and the directing docs for the program did not change the style of teaching from the DO to the MD residents. In fact the DOs enhanced the program and the MDs implemented some of DOs whole approach to patients.

My primary is a MD, but he did his residency where I worked. I can see some of the osteopathic approach when I have a encounter with him compared to seeing one of his MD associates. With his associates it is strictly problem focused.

Maifleur, there are many DO schools in the Midwest and so more DOs in practice. Including, In Kansas City. A childhood friend of one of my kids wanted to become a physician. He tried and failed in three different cycles (over 3 years) to apply and received no nibbles for his apps at all. After the first time, the guy did a masters degree in biology for better grades and a better record and for each time, studied with intensity to improve his MCAT score. After 3 strikeouts, he applied and was accepted to Still in the megalopolis of Kirksville, MO, population 18,000.

How can there be a "medical school" in such a small town, when most are in city centers for access to patients for their hospitals and staffing for their research divisions? Well, because DO schools aren't required to operate their own teaching hospitals as MD schools are, as part of the requirement for accreditation. So none do. Also, they're not required to do research and have PhD programs as MD schools are, so none do.

I've had melanoma and breast cancer. I did the conventional treatment for both and would again if I had to. Also, I would try an alternative if conventional failed.

My mom saw an osteopathic cardiologist. Mom didn’t know she was a DO at the time, she didn’t “believe” in osteopaths. But, this turned out to be the best doctor she had. When she did realize it was a DO, she brushed it off.

Anyway, for a life-threatening illness? For me? While I still have one in college and the other just embarking on his career and life? That’s a tough one.

Angela Id - I would definitely get a second (or 3rd) opinion besides Dr. Gloom and Doom about treatment options before I decided to check out. I've been through years of lifesaving but debilitating surgeries, chemo, radiation and drug therapies but I still have my life. Id'd do it again to still be here with my dog on my lap and my husband and family to love.

With his associates it is strictly problem focused.

This is what I like in a doctor.

We keep an open mind here in our family. We have been helped by conventional and alternative (traditional) medicine.

I don’t have an opinion on homeopathy. I never looked into that much.

Euthanasia for me. I think it is absolutely ludicrous that we can put down a suffering pet, and not make that decision for ourselves when the time comes!

this really hits home for me. i am in complete agreement. i watched my husband suffer through 21 months of kidney cancer, diagnosed at stage 4 and hopeless. when he was home with hospice care, i had enough morphine on my kitchen counter to kill 10 men. i was always thankful that he never asked me to do it. i'm not sure i could have said no to him.

Zalco - that's the exact opposite of what I'd want. I want a doctor that's aware of the whole body, not just one portion.

For example, that same doctor that diagnosed "mild heartburn" offered me a prescription. I asked if the medication would be contraindicated with hypothyroidism. The docs answer was "of course not", so after I got home I looked it up in the PDR. It clearly said at the top "Do Not Take with hypothyroidism". The doc had no idea because he only focused on his one area, not the whole body.

MM is incurable, but the treatment for it has been tolerable, and I've been living quite normally for a late-seventies woman -- not just 'clinically alive' -- since diagnosis in June 2018. Prior to diagnosis, I was borderline Multiple Myeloma (not treated), as determined by blood tests.

One of the first things I learned upon diagnosis was that today's 'chemo' is seldom what we remember from the movies -- the nearly transparent, bald, skeletal woman with her head in a bucket. I usually have two or three days of fatigue after an infusion; nothing more. My first med was an injection in the upper arm, weekly, then bi-monthly, then monthly. This one follows the same pattern, but is via IV. As long as some med is effective, I'll continue until the disease, age, and other ailments become overwhelming.

My father was on dialysis for ten years. In his early eighties he'd 'had enough', and he stopped treatments to die.

My BFF grew up riding, fishing and hunting in Wyoming. She became a highly regarded stained glass artist. She developed a gioblastoma (teeny survival rates) in her early seventies; had several brain surgeries and chemo; and was a shell by the time the disease won. In our last telephone conversation she deeply regretted going along with doctors 'who always had one more thing to *try*'. She cried, saying, "I hate that this *wreck* is how my grandchildren will remember me."

Illness is relative. Our reactions are hard to predict.

Raye Smith, Knowing what medicines are indicated and contraindicated from the patient's whole medical history is just a bare minimum of competence.

I expect my doctors to be able to keep my whole medical history in mind when treating me. I don't need them thinking much about how I feel about anything, aside from basic human decency, of course.

I agree with Zalco. A competent physician in a primary care practice looks at patients' health and treatments comprehensively. Very few osteopaths practice core osteopathic treatments - which, by the way, are complete quackery, elements of which came from the imagination of the founder, AT Still, and are without foundation in science.

I've asked my primary care doc about drug interactions, side effects, etc, alternatives, many times. The questions have always been answered in seconds from the PCs in every exam room. If your doc missed something or gave the wrong info, that's a crappy doc. Find a better one.

I don't want to be treated by someone who couldn't get in to medical school. DO schools are a back door for those of lesser capabilities, not something different. There are some American doctors in practice with MD degrees from Caribbean medical schools. I don't want to be treated by any of them either, for the same reason.

Recently found out an acquaintance passed from the cancer she had battled for several years. Conventional treatments initially worked, but early this year docs told her there was nothing more they could do. So she traveled to Mexico for alternative treatments and stayed there for months, off and on. Obviously it did not do any good, but she was convinced she was going to recover and, psychologically, that made her feel better til almost the end.

Add to this mix of possibilities the influence of insurance companies, and what they will and will not cover. Sometimes they will not cover because of the alternative or experimental nature of the proposed treatment, many times the bottom line for their refusal, whatever the reason given, is cost.

Those who are treating you whether they are mainstream or alternative providers, have the option, difficult though it may be, of helping to push back against a refusal to cover and hopefully win for you a reprieve and payment for a previously refused treatment.

Exactly what Nicole said.

Conventional medicine unless I was terminal and poor prognosis. In that case, hospice. As a friend of mine said after one round of chemo, "I'd rather die once than feel like I am dying every day because I feel so sick."

This has become quite philosophical.

My first wife was diagnosed with melanoma when she was 24. At that time it was a death sentence. The source was identified as a mole on her left upper back. The mole along with a couple square feet of underlying tissue and all the lymph glands in her left arm pit were removed. She took chemo in the form of a big black bolus for several weeks. She lost all her hair of course, but was only sick for a couple days each treatment, which was administered out patient. During the course of two years she underwent several more surgeries as tumors popped up, always recovering rapidly due to her age and general good health. She took experimental therapy at Yale-New Haven.

My FIL wanted to look into non traditional treatment. He found someone in Mexico and was ready to take her there when symptoms of stroke occurred, paralyzing her left side and confining her to bed. The cancer had spread to her brain, a favored location for metastasis. I cleared out the dinning room and set up everything she needed and hired a nurse during the day so I could work. I took care of her nights and weekends. I slept on the couch. She was taking increasing doses of Methadone for pain, which surprisingly controlled it well. Despite the paralysis she was comfortable for a month. One morning just before the nurse came the pain became intractable. She was taken to hospital where she lapsed into coma and died that evening. She lived two years after diagnosis, most of which was good.

My feeling has been that I wouldn't want a slow, miserable end. I've told everyone that would listen, including my kids and stepkids, that if it came to a terminal diagnosis I would somehow end it myself. Maybe someday the building with the purple roof will make it easy...

KennsWoods, I am so sorry for your loss. My father spent his life doing cancer research, I hope that someday it will not be the cause of death for so many.

Sorry to hear of these unfortunate experiences, kennswoods. Many of us, maybe most of us, will die from terminal illnesses or conditions and we will suffer some kind of decline beforehand. I'm not sure what's better and what's worse, certainly it's a personal decision everyone will think about but about which a choice can't always be made.

I'm convinced that many cancers would not occur in the first place were we to DO something about pollution.

My DM's long dying due to leukemia forty years ago couldn't be relieved by hospice. It was almost unknown in the US then, but now services can help and comfort many patients and their families. Before planning suicide, please contact a hospice to discuss what's offered.

Discuss orders to cease hydration. Ask about pain remediation. Hospice also offers emotional support to patient and family, including grief support groups for children (sorely lacking until recent years).

As a friend of mine said after one round of chemo, "I'd rather die once than feel like I am dying every day because I feel so sick."

Exactly! My loved ones will eventually get on with their lives and move on if I die in my sleep. 10 ( or 1, or 3 ...) years of pain, suffering, treatments, caretaking, and medical bills, haunts you for a lifetime!

For about one thousand years of western medicine our Humors were balanced. That involved purges, bleedings, scarifications, and blisterings. All in the name of balancing Blood, black and yellow bile and my favorite Phlegm. It was mainstream medicine but not science based. It did not work but it didn't keep the medical community from keep on keeping on though it was not based in science. There had never been any tests or record keeping. Traditional medicine of which this was one is the same. I for one am going with science based medicine. It has to be proven to be effective. It isn't always right and it doesnt always work but it beats being blistered or given some tea with a bunch of chemicals in it that could do anything. Natural is just as lethal and potentially wrong as science based. I prefer to go with something that has been shown to be effective for others.

Patriciae - yes, that's what medicine was for centuries but that's not what alternative & holistic medicine is. Alternative & holistic medicine do use natural vs synthetic, but don't we do that with our diets already? They do use evidence based treatments. The big difference is they consider how the treatment will effect the entire body not just their one area of specialty. Western medicine is all about pushing a pill that treats symptoms because if you only give the patient a pill and they must take it for life then you have a guaranteed income source patient.

I've seen if myself. Friend had a lump on their ankle. Western medicine doctor just said take an anti-inflammatory can't be fixed. Tried it for a year and that didn't solve the problem. After going to my chiropractor the lump is going away. Because he looked at the whole patient and diagnosed that the insertion point of the too short calf muscle was the issue and is stretching the muscle to return it to normal function. That's was alternative medicine can do.

Do realize that in the future our medical techniques will be just as antiquated. Future generations will look in horror at western medicine. Just think about how we feel about physicians in the 50's that prescribed smoking to patients or gave nitrogen mustard to cancer patients.

Traditional forms of healing have been around thousands of years. That is why I avoid newer forms of “alternative medicine”. Ayurvedic healing methods have helped us greatly as well as traditional herbs and remedies.

My primary doctor knows my way of living. She knows I prefer to not take medications, if there are other options.

Any time I have any appointment anywhere, the assistants that check me in are always amazed I’m not on any daily medications.

We don’t have to choose our sides here. Don’t close the door on different methods that may help.

Very often a simple change in diet and exercise can set things straight.

"Alternative & holistic medicine do use natural vs synthetic, but
don't we do that with our diets already? They do use evidence based
treatments."

Other than acupuncture, which has been studied on an after the fact basis, can you name other non-traditional systems of alternative treatments that are based on scientific evidence? I believe most of them aren't, chiropractics included (other than the placebo effect and massage benefits).

Placebos work just fine for many people. You have to recognize the power of suggestion -- for good and for ill -- especially when the suggestion comes from someone who commands authority. Plenty of OTC 'supplements' consist of nothing other than the consumer's belief in them.

To: bob_cville about homeopathy: Well said! Homeopathy fluids are similar to having a chicken wade trough a pan of water and calling it chicken soup.

If I were diagnosed with a life threatening illness, I'd make sure that my will was up to date. Also, I continue working with the Doc who diagnosed the disease since he knew how to recognize it, and probably had experience with it. If he did not, then he should refer me to a specialist who is an expert at treating the disease.

It's a good idea for everyone to keep their wills up to date - even better yet to have Living Trusts instead - no matter what one's current health status is.

I thought I had made the point that Balancing Humors was a traditional medical practice that was used for hundreds of years. It was bogus and fraudulent and yet many people were cured and lived to die of advance old age. In fact if you had no treatment at all most people who havent gotten some sort of cancer, bacteria or lethal virus and started in reasonable health (not half starved) would survive most things. That is why wrapping a potato peeling wrapped in linen around your wart and then burying it under a rock during the right time of the moon cures warts. Warts are self limiting so anything tended to cure warts. There are hundreds of cures for warts. We want what we have been treated with to be cures but most of the time we would have gotten better anyway. Living as we do in a world of good food and clean water most of us are destined to live to fairly old age. I did not figure amongst that most as I had a terminal cancer that was successfully treated. Was it the surgery or that plus the hocus pocus Chemotherapy and radiation I had? I dont know. But I do know that that cancer(ovarian cancer) is now much more curable than it was when I was diagnosed. Something changed and it wasn't the improved surgical techniques. That is science and I am sticking with it.

I light of all modern medicine has given us, I have a very hard time understanding the desire for a more down to earth, touchy-feely approach.

Better yet to have living trust AND wills.

Yes, donna, you're right. I wrote too quickly. I was responding to jemdandy - what needs to be updated periodically is one's living trust and that's where the disposition of property should be handled. The accompanying will, which often just says "anything not obviously in the trust, consider it in the trust and the omission of the formality to do so as an oversight during my lifetime" or something like that. With that and the other perfunctory things, wills usually don't need to be updated.