My PCPs are a husband and wife team. English appears to be their second language (both speak Hindi, in addition to English). He, in particular, calls on long-term care facilities in this area--he's a very caring, responsive provider to the elderly. I've seen him with elderly patients--he's an effective and compassionate communicator.

The premier healthcare systems in the Chicago area have DOs on staff. The PCP of some members of my family is a DO, and his reputation is stellar in our community.

I think you may be ruling out some excellent healthcare providers with your criteria. I'd base my search more on reputation of the care offered.

They would not be my first choice because among those I know in the medical field, they do make a distinction. I always got the sense that it was considered less rigorous or less exclusive to get into a school of osteopathic medicine. YMMV

My primary isa DO, and she is fabulous. Wat other training does your potential doctor have? where did he do his internship and residency? Any Fellowships? My nephew is a DO and is an excellent, caring doctor. He also is an internist.

My DH's lung doctor is a DO and I've never seen a doctor care more about his patients. He's also one of the smartest people I've known. The heart doctor who put in his heart stent is also a DO. Someone who graduates from Harvard is most likely no better at their job than some who graduated from a state school. I'm using that example as medical school vs an osteopathic school. Harvard may be harder to get into and give one bragging rights, but that does not make a difference in quality of education.

Someone who graduates from Harvard is most likely no better at their job than some who graduated from a state school.

No offense, but i think that is just wishful thinking. On average, someone from Harvard or its ilk is likely to be better at their job.

That does not mean that there are not wonderful examples of professionals of all kinds with all sorts of pedigrees.

We have one son that is a DO, a Family Medicine specialist, and another who is an MD, a resident in internal medicine. They agree that their educations were virtually identical, with the addition of manipulation for the DO, who doesn’t practice that part of his education. He opted to take both osteopathic and allopathic (MD) exams, to widen his options after medical school..

On average, without question, people who get into a school like Harvard are more intelligent. That makes them, on average, better in their fields.

That leaves plenty of room for examples of excellence and incompetence from all corners. But just look at how many people want to know what school their doctors went to (something I have never done and never even occurred to me, btw). Are they just being irrational?

I have no axe to grind or bias here but I just think the assertion that it doesn't matter bears commenting on.

I think there is currently very little difference between graduates of either type of degree program, last 20 years or so.

From my colleague in the BIOL department who advises a lot of pre-meds, there is little difference now in the training and quality of practitioner. They all have to do residencies and take their specialty boards. For students, they should go where they can get accepted.

Where there sometimes is a challenge is foreign medical schools, because it can be harder to get accepted to residencies. So, if someone went to a Carribbean medical school, they might have a harder time getting a residency spot.

My H is a DO. He chose the DO program as he was interested in family practice and the holistic approach was especially appealing. Plus it was a state school and cost much less than a private medical school. Then he did a rotation with a Neurologist and decided that is what he wanted. His training did include Osteopathic manipulation which he would describe as much more nuanced than Chiropractic manipulation which is spine-focused.

His residency and fellowship were in an allopathic hospitals (what some of you may describe as "traditional") as they were the only programs instate. He has been certified in Neurology by 4 different neurology boards. Same boards as MDs There are 7 doctors in his private/not conglomerate owned practice. It turns out 3 are DOs and 4 are MDs but I had no idea and had to go to their website to check.

I totally agree that there can be variations in the quality of medical education which is why there are boards. But H always says you can't teach bedside manner and for many of us that is what makes the best doctor.

Okay - I’m going to give the DO family practice doc at my regular clinic a try. We didn’t care for the MDs we tried so nothing to lose.

I also think you are possibly excluding many great physicians when you say only U.S. born and raised. My spouse underwent a 12 hour surgery and both the surgeon who took him apart and the one who put him back together were not born or raised in the U.S. They both were educated in the U.S. and went to well respected med schools and also spoke very fluent english. And we couldn't be more satisfied with the medical care, communication, bedside mannner and outcome.

@lizbeth-gardener I don't rule out foreign born physicians for specialties but for my PCP, who I hope to have a long term relationship with, I want someone that I can clearly understand. For a specialty that requires advanced education and skills I seek out the most qualified individual, regardless of where they're from. So far I have had a more limited relationship with specialists so language difficulties are not as problematic for me personally.

3katz, I would not hesitate based on the letters after their name. Both DH and I see DO's (different ones) as our PCPs. Our adult sons have been seen in both offices. I've seen both of them and feel both of them are among the best doctors I've had. Hope you find the same

I think that many, perhaps most, foreign-born physicians are perfectly easy to understand. However, that is something you would have to find out in a visit.

I see and seeked out specifically a DO instead of an MD as my GP. I see tons of MD/phd specialists who were Yale trained and now teach at the yale medical school through out the year with great knowledge of their specialties but their view of the whole mind and body connection is often limited. Whilst, my yale educated DO is all about my whole health.

I've heard this discussion before and I think there is very little difference between the programs. It is more of a historical perspective than a clinical one. DH's hematology/oncology practice consisted of both MD and DO physicians which is not unusual in the Philadelphia area since both allopathic and osteopathic schools exist here. At one time Philly even had a homeopathic med school at Hahnemann.

DH and I, along with our family members regularly see MDs and DOs without a thought to which initials follow their names. My internist is a MD, my neurosurgeon is a DO and I never even checked to see what my current OB/Gyn is. DH's cardiothoracic surgeon is a DO while his Electrophysiologist is an MD - in the same medical group at a major teaching hospital in Phila.

Several posters mentioned the holistic approach they have experienced with their DO's. From spending the last 50 years surrounded by med schools, med students, and practicing physicians there does seem to be a somewhat greater emphasis traditionally on treating the 'whole patient' in DO teaching. This is just my experience although DH agrees. DH taught AP chemistry before enrolling in med school and he is a natural teacher and loved taking med students, interns and residents on rounds. Over the years he has observed that the focus has changed from his training days and that many of the MD med students are more keenly interested in specializing rather than in family practice or even internal med. Just as there is an elitist attitude about attending an Ivy League university (which is really an athletic designation) there is a similar attitude in med school concerning medical specialties - and unfortunately family practice too often bears the brunt of this thought.

I should add here that DH in general bemoans the current state of medical care - training - insurance - government regulations - etc. In 50 years he has watched what he once considered the 'Art of Medicine' evolve into a rather bizarre system.

Maire

Marie- my son is at a Philly med school - in center city - just wondering if this is the same school your DH attended. They seem to have a very active alumni program.

Given the funding and the access to experts, I suspect those at Harvard/elite schools would have access to a better education than those at other med schools. So the average is probably higher at the better schools. But I also suspect there is a large overlap in the distribution between the 2 kinds of schools and many of the drs at the top of the other schools would exceed many of those at the bottom of the elite schools. And as the old saying goes, the guy who graduated at the bottom of his class is still called dr.

Having both attended/graduated from and taught in an Ivy League doctoral/postdoctoral program at an Ivy League institution in an allied health field, I think the perceived exceptionalism of the graduates of said, over those of many other solid, accredited programs is a myth.

@maire_cate - that was a very informative and helpful perspective - thank you. All of this info reinforced my belief that my concern about DOs was irrational. I do still want an American PCP educated at a US medical school. That may have to change as well as the makeup of physicians in this country continues to evolve.

Yes, I've worked with some Harvard grads who were real duds.

Just because a student has access to a better education doesn't mean a student will learn more.

3 katz - Finding the right physician is not an easy process. I'm more or less in the same position that you are. Since moving to this area in the 1970s we've been using physicians that DH knew or worked with or were recommended. Most are now retiring. We could stay with other members in those groups but we now live about 45 minutes away and it makes sense to look closer to home and physicians who are affiliated with hospitals in my area - especially now that we're older and DH has significant health issues.

We are truly fortunate that there is a wealth of medical practices and facilities nearby. The major Philly hospitals all have local offices and we're still only 30 minutes from Center City. I had my bi-lateral knee replacement done at HSS in NYC and we know many people who have gone to Johns Hopkins or Sloane Kettering for second opinions. I'm now in the process of actively looking for a new primary physician before mine retires....along with several for DH and a GI etc.

@maire_cate - agree we are fortunate to have excellent healthcare facilities in MN as well. I have no problem finding all kinds of great specialists though it can be a bit of a wait to get an appointment. What I find more difficult is finding an excellent PCP. After all the investment in education, I can understand why many might prefer a more lucrative specialty. I did read somewhere that family practice compensation has recently increased considerably - I think the source was reliable.

Timely post. I got a letter Monday from my doctor's office saying he is on "permanent medical leave" as of Jan. 9th. Jan. 9th? and they are now just telling his patients? I never knew he was on temporary medical leave, and I don't have a clue why except I do know he has a wife that has been ill for a very long time and a disabled son. This doctor is a younger man too.

So this is the second time I've had to scramble to find a doctor in order at least for my prescription meds to continue. I have two that have no more refills. I think the office should have warned us sooner than this. There are three other doctors at the practice but the letter states they are unable to accommodate my doctor's patients at this time. ugh.

Schoolhouse - that is awful. Talk about a last minute notice. Even if the other 3 can't take on all of the patients maybe they can at least refill your prescriptions. It's worth a call to the office to ask. DH had a major heart attack, spent 10 days in the hospital and was out of work for nearly 3 months. It required a lot of rescheduling and longer hours for the other 3 doctors in the practice but they somehow managed to see everyone.

Schoolhouse, that is something. i hope there is a PA or NP you can see or who can at least renew your prescriptions.

Tomorrow there is a representative on campus, from one of the DO schools in the region who will be talking to students and one of the things he’ covering is the difference between osteopathic and allopathic medical schools I’d go check it out but I have a training I’m signed up for.

Lynn is right. "The main difference is that those studying for a DO degree need to complete an additional 200 hours of study on the musculoskeletal system." I would never compare them to a chiropractor. I wouldn't even go to a chiropractor for that matter.

I was born at Oklahoma Osteopathic Hospital in Tulsa, and my childhood doctor was a DO. He took my tonsils out too. :) I believe Oklahoma State University now operates the osteopathic medical center/hospital/school in Tulsa.

Mtn, from what I've read over the years is the only difference between Ivy league schools vs state schools, is that ivy league schools are better at research, but not primary care. Harvard probably gets millions in donations for research while a state university can't come close to competing, but their med schools are just as good as ivy league.

Well now. I should have read the letter a third time. Now I see that the other three doctors in the practice will continue to accommodate my doctor's patients, i.e. pressing needs etc. like "they have done during his past medical leaves", and the practice will be adding a new doctor in March.

I didn't realize my prescriptions have been taken care of by others at different times. I just call the pharmacy and order my meds and if there are no refills they contact my doc.office. The extent of my visits to my doctor are six month check ups. As I said, I had no idea he wasn't there much of the time.

But I decided to stop in at the practice this morning and talk to the receptionist. She tells me my prescriptions will be handled with no interruption AND when the new physician comes I'll be grandfathered in, no need to rush out and look for a new doctor or even get on a waiting list. This isn't what happened the last time with my old doctor. So I got all stressed for nothing. Hopefully I'll like the new doctor. They did cancel my May appt. and will reschedule later.

@schoolhouse_gwagain, I would assume that the MD has been out since !/9 on what they thought was a temporary leave and it has just become reality that it is a permanent leave.

I have had an appt scheduled with an eye specialist since September, had heard he was retiring early but hadn't gotten anything. Got a letter last Wednesday that last Friday was his last day. Really?! How about that for notice? (I had already made an appt with another MD)

My field is dominated by Ivy-league graduates, and in my industry we hire "classes" of hundreds of new grads from these schools each year. The need is so high, and the dropout and turnover so large, that all senior managers have a fairly time-consuming interviewing responsibility just to bring these people into the training program. So that is the experience from which I draw conclusions. I have met few, if any "duds" from Ivy league schools. Maybe our processes weeded those few out.

It may also be that age is a factor. A generation, or especially two, ago, these schools were far less selective and competitive. Certainly many legacy people got in who (freely admit) they would never pass muster today.

I am a believer in (relatively) efficient markets. Students (and their parents) expend Herculean efforts, and outsized investment of all manner of resources, on the hopes of Ivy league acceptance. Employers fall over themselves to hire them, and compensate them. These facts alone suggest it is highly improbable that all of these people are simply foolish and obtain no real benefits other than contacts (albeit very valuable).

I have successfully competed against Ivy-league educated peers despite a middling education. I do not believe them to be infallible wizards. I would have thought that saying that Ivy-league graduates are "on average" better than their peers would be damning with faint praise, rather than a point of debate. To imply that there is no quality distinction to me, smacks of the "everybody gets a trophy" movement.

ETA: To swing back to the original question, I myself have never inquired about a physician's education. We have had the good fortune, to date, of good health. I cannot even recall how we came to select our doctors, but we have been happy with them. Our practice sees all ages and has 6 or 7 doctors. Whenever I am there, I overhear people making a big fuss about who they see when they book a follow up. My family makes appointments with whoever is available. I don't understand the fuss. I trust the system. They are all board certified I am sure. If one of us had a serious illness, it might be different but then I think I'd be looking for a particular facility?

@mtnrdredux_gw - we've had some serious health issues and I've observed/experienced suboptimal care so I've become very selective about my health care providers. I guess if my background wasn't in healthcare I probably wouldn't know the difference between optimal and suboptimal care but I have enough knowledge and interest to figure it out when it makes a difference. If you aren't in tip top health I don't think it's a good idea to have blind faith in every licensed, certified physician. They are not all equally knowledgeable or skilled and I find it best to educate myself and take an active role in my care. As long as you have nothing wrong I can see how it doesn't make much difference - as long as whoever you see is capable of quickly detecting problems if they do arise.

I did make an appointment with the DO at my family practice clinic. I predict I will like her much better than the MDs we have seen since the one we loved left.

@mtnrdredux_gw

In the world of corporate and in finance what you Know is pretty much equivalent with what you Do--and it's not quite the same as in the practice of healthcare. Nobody is going to get into an Ivy League allied healthcare doctoral program without being book smart and without good test taking skills. But clinical skills and the ability to sit back and listen to patients and things like that are not really tested at all until you start doing it. And to some extent you may not be applying those clinical skills until halfway through the program or beyond, and it's very rare for someone to actually be dismissed from a doctoral program that far along in it. Everyone will do almost anything to get that student through the program because 1) the student has invested a lot of time and money to get up to this point and has very little prospects for starting to pay back the accumulated debt without the degree after their name, and 2) the school does not want to have empty and Unfillable spots in their program because they are losing tuition.

Absolutely having a degree from a highly ranked school means you have a very Smart Dr., but that's not something that directly translates to how good they are with patients. And some high ranking programs don't really place their emphasis on going out and working in an everyday practice setting, their emphasis is on preparing students further specialization and research.

My family makes appointments with whoever is available. Never, ever do I do this. Actually in our area anyway, this is not common. I want to establish a relationship with a doctor. I don't mind occasionally seeing someone else in the practice. In doing so, at least I am familiar with others in the group. My husband and I have no medical issues either, but I want a doctor who is familiar with us and our history if/when that time comes.

Just this week I saw my gyn. A PA student took my vitals, asked some questions, etc. I was very impressed with the young woman and we had a conversation about her remaining time in clinicals, what she wanted to do once she passed her boards, etc. She had a wonderful manner about her that put me at ease, plus she was very easy to talk to. I made a point to mention to my doctor how impressed I was with the young woman. Sometimes it is so hard to find a physician with that "bedside manner", but I think she will be one of those. As someone who has a bit of "whitecoat nerves", a good and caring manner is important to me.

I agree that being smart does not equal being the best in practice, at anything. But that does not conflict with my primary, modest point.

Ally & Mtn, I'm talking about med school and becoming an MD. They are no better than many state schools in that area. OTOH, they are superb in research.

Other than research, it's mostly prestige. I never hear about an overabundance of medical malpractice against MD's who went to state schools compared to ivy league. I go by reputation, certifications, etc. An ivy league school means nothing to me, unless it's research. :)

Plus, you can find an ivy league graduate who may have graduated last in their medical school.

There's a lot of info on this on the net.

Education and the system of grading and evaluation and such is so complex that I think that to some extent Liking your doctor and feeling like you can talk to your doctor and be heard is one of the more important aspects of being treated.

In my opinion the best student of any particular class is not necessarily the person with the highest grades in the class, and conversely the worst student in the class is not necessarily the one at the very bottom (within reason, of course). Sometimes the person at the very top tests exceedingly well, and knows how to work the system of requirements to their advantage. I have had students who can get 100% on a multiple choice exam when the average grade is 80, but if you ask them any of the information in a clinical setting three days after the exam they don't know it anymore. Conversely a student who is a B student may retain everything they know and apply it well but not test well. And sometimes because of how things are evaluated, a student may meet all requirements at a high standard but not meet them in a particularly timely fashion, and they may have relatively poor grades as a result. At least in the programs I have taught in, if you efficiently produce mediocre but clinically acceptable results in a timely fashion, you may end up with higher evaluations than someone who more slowly produces results at a higher standard.

Personally—-and this comes from a lifetime of going to school with people who became doctors and knowing them socially during school, being married to one and knowing many socially as adults, and having six in our extended family—- I think people place far too much emphasis on the ”bedside manner.” I don’t need to like my physician as a person or friend. I want a competent physician with exceptional skills, a wide fund of knowledge and the experience to be able to diagnose based on their own practice, not just textbook examples or others’ experiences. I want a physician who is respectful and a little distant is okay. And I always find out where they were educated. It doesn’t always make a difference but sometimes I have passed on a physician because of their educational background. I like PA’s and NP’s and see their value as physician extenders, but I will only see one for a wellness check, not for a problem.

I've been around medical people my whole life. Like Kswl, I have them in my family. I don't care about bedside manner. I've been around MDs and medical personnel with great bedside manner with terrible clinical skills. But, for some people that is all important. I understand that. At times, I've wanted to say you're making a massive mistake here? The lines are indeed complicated. People like doctors for their own reasons. I also know that I have more knowledge about medicine, clinical skills, outcomes, etc than most people because of my background. I don't need my clinician to be my friend/pal or whatever. I trust NPs, and PAs probably more than most because I know they work side by side with certain MDs every day so they know who is good. They have nothing financial in this. As to the whole Ivy League? Wow- I know several including family who have passed on it because the clinical offerings were so terrible? If research was what they wanted to do, (including a very close family member) they would have chosen that school? Otherwise. a hard pass. It's publish or perish a lot of the time in the Ivy League.

To be clear, there are first tier, second tier and third tier medical schools. They do not all ”teach the same thing” or even teach the same way. To pass the medical boards the same knowledge is required, but the passing grade is lower than you would expect (across all specialties, including internal medicine— which is a specialty) because of the sheer volume of information covered. Students who attend top tier medical schools have a higher pass rate. Some boards can be taken multiple times. I personally know a physician who took his boards five times. He was personable and everyone liked him. He went to a decent school. His outcomes were not the best, and obviously none of his patients knew he had failed his written boards four times. When people say ”I have confidence in my doctor” they are really saying they like the doctor and that “confidence” is usually based on nothing more than a friend’s recommendation, not any kind of information or evidence.

100% agree KSWL. I always say I am looking for the most competent doctor I can find, not a new best friend. I have crossed paths with at least one sociopath in my life, and she is very friendly and charming (in the beginning). People love her.

I know several sociopaths, and honestly I am as suspect of the judgment the people who interpret their behavior as genuinely nice as I am of the sociopath themselves.

Pal, i am confused by your use of ”their.” You are suspect of the judgment of people who interpret their (own) behavior as genuinely nice, or you are suspect of the people who interpret their (sociopaths’) behavior as genuinely nice?

I would agree with either 😎 but i am curious.

I've been around MDs and medical personnel with great bedside manner with terrible clinical skills. Of course. I don't think there is anyone here who is not looking for the best skilled doctor. BUT, I think you can have both. I'm not looking for a "friend" either, but if it's not someone I am comfortable with, can converse with, etc. then it's not a good fit.

This has turned into quite an interesting discussion. Speaking of making an appointment with whoever is available. DH once fell from a ladder as he was attempting to get on the roof to clear pine needles (he doesn't attempt that any more). He dislocated his shoulder and broke his hand. He received excellent care from a PA at the smaller hospital near our lake cabin. He had to follow up with an orthopod in the city where we live. The second time he went to that clinic he took whoever was available. That MD followed up for tendonitis in his hand, not the fracture noted in his record. DH had no idea as he has no medical background and at that time had blind faith in MDs. I knew something was off when I saw this weird device on his hand when he came home. After that I did some research on the doc and in my opinion he was still in practice well after he should have retired.

I think with my gyn and gp bedside manner is far more important than it is in my specialists. I prefer to like my GP and gyn and did select them based based on how I get on with them on a somewhat personal level. However, my specialists, I researched their backgrounds and only choose Phd/ Mds who are still very involved in research of the particular ailments for which I see them. I have a rare genetic heart defect and blood disease so feel safest with an expert in these issues and bedside manner is a unneeded plus. I am fortunate to live near a very respectable ivy league medical school/ teaching hospital.

@roarah - I've done that too for rare/complex conditions - found someone who is involved in research for the particular condition. That's served me well.

That's a very good idea.

Yes Pal - can you please elaborate on this:

I know several sociopaths, and honestly I am as suspect of the judgment the people who interpret their behavior as genuinely nice as I am of the sociopath themselves.

It surprised me as a comment to my comment and I'm trying to decipher it. I said nothing about whether I thought the woman was "genuinely" nice - I merely said she appeared nice in the beginning.

If I'm splitting hairs and that was your polite way of telling me you think I'm a moron....duly noted.