Do you have other physicians to ask (dentist, ENT doc, etc.)?

If you are considering a certain doctor, type his/her name in the search box, and sometimes reviews come up; I've even seen such reviews on yelp.

Also, check any doctor you are considering as to where they were educated. The info is usually available online if you search around. I like doctors from the medical school near me.

Also, if you are near a university which has a medical school, check with that school for referrals.

Good luck.

What university teaching hospital system is closest to you? Find a doctor there. Part of the PCP's role is to quarterback your care and be able to direct you to great specialists if they are needed. You want a PCP and specialists associated with a hospital that has the most up to date research and care. Doctors at university research hospitals adopt new reseach and evidence based medical practice often years before it a community level hospital does. (It can take 7 years for new medical research to make it from discovery down to the level of community practice.)

Use their online directory to look up PCPs who are accepting new patients. Check out where they went to med school, if they did research in their field, and for how long they have been practicing.

Young new PCPs can be fantastic. But you want someone who has been around your hospital system for at least a few years so they will have developed relationships with specialists and be able to direct you to good people.

I think most online reviews of docs are pretty bogus. Plus, most people just want a doc who is nice. I want a hell of a lot more from my doc.

Am I the only one who first thought you were trying to score a hallucinogenic? I missed seeing the A.

If you have other specialists ask them, or more important, ask their nurses. I often find the nurses know better than the drs. do. Also do check their backgrounds. Look for board certification. If you have an insurance network make sure they are included. Make sure they take new patients. If you have a favorite or nearby hospital, make sure they are associated with it. Our state has a magazine that annually runs a "top doc" issue where other doctors recommend colleagues in all sorts of specialties.

You are in a rich university area. UMass, Tufts and Harvard have medical schools and many new interns want to stay near their Alma mater. I agree that asking nurses, PTs, OTs and neighbors is the best way to get suggestions. Just be aware that some practices aren’t taking new patients. Young doctors have advantages sometimes (newer information was taught, ethics and communication skills are in many med school’s curriculum now, etc) and the medical community as a whole is helpful to each other. I think personality is another important factor when choosing a PCP.

Massachusetts has some of the best medical care in the US. Take your time to find the right fit.

Finding a physician who is free to practice medicine as they see fit is increasingly difficult.

Find out who owns the medical group before making an appointment. If they are owned by a for profit corporation who has to answer to stock holders first, they are being pushed to increase profits.

https://www.webmd.com/a-to-z-guides/features/health-care-corporate-takeover

Look at the physicians in the group and how long they have been in the group. Do they have a revolving door where the majority of the doctors stay 5 years or less and move on to some other group?

Ask your trusted specialists if they like their PCP and who it is. Ask other medical professionals who they go to and why they like them. I tend not to listen to non-medical professionals - they may not have the expertise to recognize good medicine vs a nice personality.

I wish you the best of luck. I am anxiously awaiting retirement and Medicare so I can go to the one group in my small town that is still an independent group.

" I often find the nurses know better than the drs. do. "

There ought to be a recognized term along the lines of "nurse syndrome". That's to describe the phenomenon often encountered, that nurses have a tendency to think they know and understand far more than they actually do.

Doctors aren't always a good source either because their views can be based on a variety of things that are not related to the patient's experience nor the true competence offered by another doc.

I was going to say something similar to what Annie said. Elmer is not wrong but neither is Annie. If looking for a particular specialist, an ER nurse can sometimes be a great resource. There are numerous examples I could list here, but think along the lines of heart, ortho, urology, ob/gyn, and other specialties where a doctor’s skills, patient care and communication and the way they treat others is on full display. You don’t usually see a lot of PCPs there. In general, word does get around the community and it isn’t a bad way to find out, but not all nurses are wired into the community as a whole.

Somebody needs to stay in their own lane. I worked with many physicians at a university hospital in the CA bay area for my whole career (a long one!). Most physicians and nurses would tell you they ask the nurses who the best physician is; they don't depend on MD referrals. Nurses are the ones who see the results of physicians' care from beginning to end. Many, if not most, MD referrals by MDs are made on the basis of friendships, practice referrals, etc. At the very least, I would get nurse referrals, also.

Well, maddie, I have a family member who's a specialist physician (in a medicine fellowship trained specialty, not a resident) at the hospital of a Top 20 medical school not in the Bay Area. Just last week, they called me when driving home and I could tell they were agitated. I asked what was wrong and what I heard, to this effect but these are not exact words, "today was another day that but for my nosing around when told everything was fine and nothing required my attention , I happened upon a situation in which a nurse practitioner nearly killed a patient. What was given to the particular patient caused a serious problem that neither the NP or the RN knew anything about. It happens too often". I asked if the same with a physician's assistant, and the answer was "Yes"

I asked what the problem was - the answer was " our system doesn't graduate and train enough docs and nurses and others who get another year or two of training are given too much responsibility for which they don't have the knowledge to carry out competently."

I expect the cat calls again challenging the wide breadth of people I know and am in contact with will start. That's fine. Unlike many of you whose fabrications are easy to spot, I make nothing up. I happen to know a lot of people in wide ranging occupations - family members, friends and their families, and other acquaintances. Those who don't are welcome to doubt me. Do so without name calling, please.

Edit to add - my mother was an RN at a time when medicine was even more hierarchical than now and nurses had a lot of responsibility. Like most people who are competent, she was much more aware of what she didn't know than what she did, and she always called docs promptly.

Carry on and on and on and on........ With anecdotes and your google searches.

Sorry to disappoint you - this was tip of the tongue stuff, it happened just a few days ago.

Elmer, please. "Do so without name calling, please." After you call us all a bunch of liars with: "Unlike many of you whose fabrications are easy to spot". I know you don't think we understand words with more than 4 letters, but we do, no prevarication.

Many moons ago, my boss who was a very big wig at a very large corporation, made the comment with which I agree: the underling knows their manager much better than the manager knows them. Or I always used to say, if you want to really know someone, marry them or work for them. The reason why I suggest nurses is because they see a dr. and their work intimately. They know how they treat others, how they act, what they know and don't know and what screw ups they've made, how much compassion, bedside manner, etc. One friend of mine switched specialists just because of how she witnessed the nurses' behavior change when he walked into the room.

While it is still de rigueur for the medical profession to cover for the less competent and not say anything negative about any doctors, I've often found nurses will provide more enthusiastic support for the ones they think are best and recommend them highly.

“Make sure he’s a good bit younger than the two you, lol! I am sort of kidding, but when our former PCP retired a while back, I said i wanted a younger doctor so I didn’t have to worry about them retiring and us having to find another one.”

Some young docs are pretty competent too, and no kidding but you can’t have it both ways as age usually comes with more skills and experience. When my dentist finally retired I had to look for another but none yet compared to my favorite who then passed away shortly after!

Once you get referrals from specialists, nurses, friends you can then look up their online profiles to make sure their qualifications fit your treatment objectives.

Elmer, please. "Do so without name calling, please." After you call us all a bunch of liars with: "Unlike many of you whose fabrications are easy to spot". I know you don't think we understand words with more than 4 letters, but we do, no prevarication.

Pffff. Such hypocrisy I have seen it time and time again from the same person.

How to find a good PCP? Darned if I know. Pray maybe? HA!!!

I've had FOUR PCP's in the last 6 years. My original primary care doctor was fabulous, I saw him for decades - he actually knew who I was, recognized me outside of his office, etc..

Since he retired it's been a revolving door. I liked his replacement but she left, then I didn't like the replacement for the replacement and was looking for someone else when replacement #2 left and made my dissatisfaction moot.

I'm now on the 3rd replacement and I am hoping this one stays because she seems fabulous. She assures me she has no intentions of leaving so hope springs eternal.

I grew up in a medical family, with doctor's, nurses, laboratory techs, pharmacists, EMTs . . .

The doctors work with each other, cover each other, and generally know the ones who are good docs, the one they would trust to care for themselves or their family, as do most of the nurses, who work with the physicians on a daily basis and get to see the physicians interact with their patients.

Both are qualified to give you a good recommendation for a Primary Care Physician.

There may be some confusion on Elmer's part. I think that everyone answering the question was saying ask a nurse for a recommendation for who to choose as your Primary Care Physician. The official CMS definition for PCP changed about 15 years ago. A PCP was a Primary Care Physician, but then was changed to Primary Care Provider and included both Physicians, Nurse Practitioners and Physician Assistants.

More and more insurance groups and for profit centers are pushing people into seeing a PA or NP as their PCP (Primary Care Provider) and PA and NP are gaining more an more autonomy to practice medicine independently vs under the supervision of a physician. The training to become a PA or NP is far less than what it takes to be a physician (6-8 years vs 11-15 years), they are paid far less than a physician and in my personal opinion, nurses (RNs, PAs, NPs) may be quite knowledgeable, but they do not have the same level of expertise and training as a physician and I would not want a PCP that was not a Physician.

I think @Elmer J Fudd was discussing the difference between having a PCP that is a PA or NP vs a physician, where @Annie Deighnaugh was saying to ask the nurses for a recommendation for a PCP(Physician). when she said "I often find the nurses know better than the drs. do." She was not saying the nurses make better PCP(Providers) than a physician.

It looks like my state (Pennsylvania) will be the 28th state to buckle under pressure from the for profit medical system:

https://www.pamedsoc.org/home/news-resources/news-and-resources/articles/press-release-pennsylvania-medical-society-reacts-to-governor-shapiro-s-move-to-allow-nurse-practitioners-to-practice-independently.

For more than a decade many endocrinology clinics such as diabetes management clinics have been run mostly by NPs who write scripts, give counsels and recommendations directly to their clients. Of course NPs are under supervision of a physician and they follow a set of protocols signed off by the physician in charge. In a large teaching hospital, PAs often take place of a physician as pcp because the older more experienced doctors are involved in research and teaching. So for primary care, a new patient can often opt for a PA or a newer/younger doc who still accepts new patients.

I'm not sure why, maybe it's because of the medical insurance mess and the difficulty of dealing with insurance companies, but as the years pass, more and more docs are affiliating with larger medical groups. That seems to be good in some respects but not always so.

The retirement of my old school primary care doc 25 years ago led us to use the faculty clinical practices of the local medical school. Wow, what a huge difference that has been. There have been a few doc changes over the years, caused by out of the area moves, but the pick of a replacement is always at our option and we've been very happy with the attention and thoughtful care we've received.

There's a range of ages in each of the few practice locations that have exclusively clinical faculty. Most have 10 years or more of experience post-residency. A good primary care doc is supposed to be the team quarterback, knowing a little about a lot, able to spot warning signs and telltale issues requiring follow-up by them or by referral to others, and with practical experience of what to do and what not to do with different issues. Knowledgeable and confident enough to stray from the "party line" when they think other approaches are more appropriate.

It's not like an HMO, there's never a reluctance to recommend going to another doc, whether within the medical school practice or elsewhere (I've gotten a few "elsewhere" recommendations for specialties my doc thought the school was weak in). There are no para-medical types - meaning, no PAs or NPs are involved where I go. Sorry, but for me, they have neither the training nor the background for me to rely on them to be my quarterback. If I were 30 and completely free of health issues, different story. If the situation were such that I could not rely on having timely access each and every time the need arose to an MD, I would go elsewhere.

Massachusetts General has 15 PCPs in Waltham, which you could research, if that is close enough for you. One of them got her medical degree at Harvard Medical School, as did this one, and this one at Columbia University, but they all went to prestigious medical schools.

Good luck with your search - mine has been extremely difficult after moving to Coachella Valley from L.A., where I saw doctors associated with UCLA. I've switched from three PCPs in the past year. The first one was assigned to me by the insurance company, and he described himself as a Christian missionary, and I did not want that, and so I switched before I even saw them.

The second one was in the same medical group (Optima, I believe), and most doctors there had gotten their medical degrees at American University of the Caribbean, which is one of the easiest medical schools to get into and is private and for profit, which I especially do not like. The second doctor left Optima a couple of months ago, and then the insurance immediately assigned me to another doctor in that group, whose credentials I did not like, and so I found another doctor in the Desert Oasis group who is almost as close to me, but now all of my referrals to specialists are no longer valid, and I have to get new referrals for four offices, of which I have only received two so far.

I don't like switching doctors of any kind because I like for my medical records to stay in one place. All the doctors at UCLA could see all of my records, but none of the doctors here seem to be able to import my old records into their systems, even though they use MyChart - the same portal used by UCLA. I did request my records to be sent from my doctor's office in Pacific Palisades (which burned to the ground in January) to Desert Oasis, but I do not see that they have imported my information - I believe they will have to do it by hand, since they do not use MyChart.

You should have a much better experience in the Boston area than I have had in the desert, but it still might be a bit daunting.

Why is it that state governments don't allow paralegals to provide legal advice, but will allow a nurse practitioner to provide medical advice?

The corporatization of our medical system is leading to higher costs and lower quality of care.

Hospitals and medical groups, pharmacies and nursing homes have gone from independently owned or run by faith based non-profits to being owned by corporations who are beholden to their stockholders.

How do you feel about companies like United Health Group or Aetna (CVS) selling you insurance, owning the pharmacy, owning the medical practice and determining what care you receive and how much it is going to cost you?

CVS Health

CVS Health supports more than 40,000 physicians, pharmacists, nurses and nurse practitioners. The company has 1,100 MinuteClinic locations in 36 states and Washington, D.C., and through its deal with Oak Street Health, CVS Health has more than 130 primary care clinics.

HCA Healthcare

HCA Healthcare supports 38,000 physicians. The healthcare giant consists of 184 hospitals and about 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom.

Optum

With 90,000 physicians in its portfolio, UnitedHealth Group’s Optum is the largest employer of physicians in the U.S. Optum has 2,200 primary and specialty care offices in 16 states.

“Why is it that state governments don't allow paralegals to provide legal advice, but will allow a nurse practitioner to provide medical advice?”

The State Medical Board can petition the State legislature for approval of NP’s additional scope of practices. The Board of Medicine or the State Medical Board regulates the scopes of practices for physicians (MD, DO), PA, NP, and other healthcare professionals in a State, except for pharmacists who have their own State Board of Pharmacies. The Board of Pharmacies, after several years of advocating for pharmacists to have prescribing authority have become a reality in all 50 States, and DC although in some limited prescribing capacities such as contraceptives, HIV pre/post, opioid overdose, uti, etc. On the other hand the paralegals who don’t have a state or national board to advocate for them to take on more responsibilities thru additional training/certification they remain limited legally in their practices.

palisades, I understand the laws - I don't understand the logic, except that it is self serving.

Most politicians are lawyers - they don't want paralegals to have autonomy or provide low cost alternatives to hiring an attorney. Our justice system is incredibly financially motivated and financially biased. Have enough money and you can hire the dream team and get away with murder. If your poor, you get stuck with a public defender and either plead out or go to jail.

I think the medical system was much better when it was mostly regulated by physicians, when it was not for profit and only those who were fully trained as physicians were allowed to practice with autonomy. BTW, most state have a Medical Board that regulates physicians and a Nursing board that regulates nurses and Lawyer politicians who decide if nurses are allowed to practice with autonomy. They will make the medical system as financially biased as the legal system, but leave the poor with even less qualified care than a public defender.

The rich will have concierge physician groups and the rest will be left to deal with the lowest cost care possible while satisfying the corporate doners who support their campaigns.

" Why is it that state governments don't allow paralegals to provide legal advice, but will allow a nurse practitioner to provide medical advice? "

I have an observation about what I think one difference is. But I won't speculate whether what I suggest is or isn't a reason that addresses your question.

Most physicians have at least an iota of compassion and concern for patient wellbeing. Not all, but most. As I mentioned above, the growth of training slots and the production of new docs has not kept pace with population growth and medical care needs. To serve the public's needs for health care, if a portion of a patient load can safely and effectively hived off to another type of practitioner for which the supply can be increased, any care is better than no care. If adequate boundaries are set restricting what can be seen and what can be done, it should be possible to do so mostly safely. Treating more patients without requiring more time of docs.

But, as one of my clients told me early in my career when as a junior staff member I asked if he had any concerns or issues needing attention not covered in our meeting, he said :" I don't know what I don't know. So my answer is, I don't know. Should I have some?" Para-medical (meaning non-doctor) practioners in hospitals and clinics don't always have their work checked if it's generally within bounds of the what they've been told what to do. But, they don't know what they don't know, they don't always recognize signs or indications that someone with more training would see. If they ask no questions of their technical supervisors, they're working autonomously. Should that happen? I don't think so, and I don't want that to happen if I'm the patient.

Contrast that with paralegals, junior staff members at various types of financial and service firms, and the like. They're supervised more directly. Their work always has review and oversight. They do what they're told to do, and the end result theoretically has been reviewed by the responsible professional. Whether it is or not, that person is responsible.

Not so to the same extent with the sub-doctoral providers giving medical advice, diagnoses and treatments.

JH, so there you see, our system is inherently corrupted from the start with donors and campaign donations, but that is a hot topic not to be dissected here. Self serving sure when the upper echelon (lawyers) do not provide an opportunity for the lower class so they can continue to rake in, but this is not to say there are not lawyers out there fighting for the underprivileged every day.

I’ve seen this over the medical side where older physicians retired but there are few young guns take their place as most would want to be specialized to make more $$$. The situation is especially dire in rural areas, not to mention many hospitals there end up closing. So to make do with less the medical board looked into PAs and RNs to cover the physician shortage and save on operating costs. Then there is the spiderweb of insurance businesses in play in all this.

" So to make do with less the medical board looked into PAs and RNs to cover the physician shortage and save on operating costs. "

Huh.

Among some of the other apparently misinformed comments is this one.

According to an internet search, the concept of Nurse Practioners was developed and a program began by a nursing educator and a medical doctor at the University of Colorado.

And the first physician assistant program was started by a professor at Duke.

Comparing our medical system to those of other industrialized countries we have the highest spending per capita and the worst outcomes. We have also seen fewer of our best and brightest wanting to spend ridiculous amounts of money and more than a decade of their lives to become an employee of some corporate entity who will tell them how to practice medicine and drive them see more patients and increase profits. .

Why do we have such a shortage of PCPs? Why aren't other industrialized countries suffering the same type of shortages? What are we doing wrong?

Profit driven healthcare is never going to provide the best care.

https://www.kff.org/global-health-policy/health-policy-101-international-comparison-of-health-systems/?entry=table-of-contents-how-do-health-insurance-systems-and-coverage-in-the-u-s-compare-to-other-countries

elmer, your internet searches were irrelevant to the reason the board decided to take advantage of available PAs and NPs because of the physian shortage. It’s just common sense. No one has said the board started those programs for PAs or NPs.

JH: it’d be a start if every member of Congress read your link and think better - but then again campaign donations…..

" We have also seen fewer of our best and brightest wanting to spend ridiculous amounts of money and more than a decade of their lives to become an employee of some corporate entity "

I believe the trend is otherwise. To stretch an expression to illustrate a point, my information is that younger generation healthcare doctors do not aspire to practice in independent practices to the extent their fathers/mothers in earlier generations did. They want to practice their professions. They don't want to hire and fire employees, find and sign leases for office space, nor manage a back office that has to figure out how to present and collect from insurance companies. That's why the local yocal offices have declined so much and group practices have grown as they have.

By the way, you've cited an article from the Kaiser Family Foundation. Are you familiar with its history of tripe? If we were to follow the not so subtle advice and suggestions in its position papers and other biased bits of written garbage, all of us would be patients of a Kaiser Foundation practice. It's the only structure in the US that meets its standards and criteria. Unfortunately, it's record of poor care and disaster event stories falls short of meeting what most people want to expect from their medical providers.

“Why do we have such a shortage of PCPs?”

One reason for physician shortage from the article:

“Because primary care generally comes with a lower salary, some new physicians pursue a higher-paid specialty, even if they would rather work in primary care.”

Just as what I’ve seen as mentioned in earlier post.

“The corporatization of our medical system is leading to higher costs and lower quality of care.”

This is not the whole picture. The other side of the coin is very high obesity rate which is probably the biggest contributing factor to higher healthcare costs for all Americans as obesity progresses to diabetes and congestive heart failure, and the US is leading those far ahead of other countries. Japan is a good example where total spending and out-of-pocket spending are the lowest because of the fact their population is one of the healthiest in the world. You can refer to the kff link for more details.

A good doctor is hard to find. I had a great one for 20 years, and although he was a little younger than me, he got cancer but recovered and moved out of the area. Next doc was a very good friend of my daughter and son-in-law and I loved him. I knew him outside of the practice but he got fed up with the bureaucracy and left and started a Boutique practice, which is doing very well. So well, he had to add another doctor. I think he has 400 patients now and is available anytime of the day. I think it's $3500 or $4000 a year. He was my doctor for ten years and then my husband stupidly chose the current one we've had for over ten years because he's two miles from our house. We're with UPMC and everything changed a few years ago. I see this guy every six months and he does a blood check at each visit. I do it a week before my visit. Previously once a year I had a physical where I'd get on the exam table and and he'd do a minimal checkup. Now he sits over across the office, tapping his device. , checking my blood results, reminds me of mammograms. Then he slides his chair over , wants me to take deep breaths, listens to my heart and I'm done. I have zero rapport with him, but he's methodical and answers any question that I ask on my portal. He's a couple of decades younger but so were the other two, and they left.

I provided a link, but you are all capable of google searches and there are hundreds upon hundreds of articles that show that medical outcomes keep dropping while costs keep increasing and the number of PCPs keep dropping and that job satisfaction for physicians keeps dropping and that there are huge concerns with corporatization of medicine.

Many of the people who responded to the OP have noticed the same difficulty in finding a PCP that they feel good about having as their Primary Care Provider.

@Jen Hogan, I agree, and offer up a couple of other thoughts. In our experience people in the US have become more mobile in the last several years. Our regional area has had tremendous growth in the past 5 years and doctors have been in short supply along with many other services. We’re beginning to catch up because there has been an aggressive attempt to get them here, and with the lower cost of living, it is very attractive.

Another example…An old friend and her husband recently moved to a retirement community in a small town about 40 miles outside of Atlanta. They formerly lived for many years in the Florida panhandle but so many of their physicians left the area with the rising costs of insurance, etc there. They found several doctors in their new community they really like plus have the ability to get to Atlanta hospitals and specialists should it be needed.

We do love our PCP and it was worth the terrible parking at his former location. He moved to a new place about 18 months ago. The doctor he had partnered with for many years has semi-retired and works out of the new office a couple of days a week doing flight physicals. Plus he will sub for our doctor in an emergency. We like him too, so a win-win in our book.

a few of my thoughts and observations. Finding PCP's in my area is not that hard, but they are all "family practitioners " Not internal medicine MD's that cater to senior citizens that often need a finely tuned medicinal regime. Those that were here, have retired. The few clinics here probably can't offer enough $ to make it worthwhile to leave the city. I get that, I cant say I blame them. Also, those MD's see geriatric patients on medicare and med advantage plans that have very poor reimbursements. Plus, many internists now are employed by hospitals as hospitalists; which is a great thing, but alas, takes them out of private practice. I once asked a FP for a presc. for diflucan. (for female yeast infections) He didn't know what it was for. I said I need some every year in the summer. He prescribed thirty. (typical dose is just one.) Hmmm. I went elsewhere.

Concierge medicine is an interesting emerging issue. Like so many things in life, it seems those who are able to afford extra expenses are likely to get better care.

Different areas and different practices are doing the "concierge" approach in their own way, but the gist is that patients have to pay an extra (monthly/yearly) fee to be a patient. In return, one gets (presumably) better access to the physician, quicker/longer appointments, and it's allegedly providing much better personalized care.

I have not gone this route. However I know several people who have and they all love it and feel the high fees are worth it.

I won't try to talk about some of the muddled misinformation higher up the thread but I'll mention something that acts as a chokepoint preventing an increase of new doctors entering the profession annually.

I believe that but for a few limited exceptions, obtaining a medical license usually requires completion of a US residency training program. These are fixed in number and have not increased in recent years in step with the increases in our population.

A financial aspect of medical residencies that most people are unaware of is that the overwhelming majority of them are funded by the US Medicare agency. For sponsoring community hospitals, medical school hospitals, and other practices that have residency programs, it's a "you help us, we help you" arrangement. The hospital or medical system that hosts residents agrees to competently train them (following specified curriculum requirements set by the various boards of each specialty) and in return, they receive money to cover the direct and indirect costs of "employing" the trainees. Free labor in return for providing training. Win-win - but the program sizes are limited and funding increases to provide more slots have been slow in coming.

Most graduates of US allopathic (ie, MD) medical schools are successful in the competitive residency match programs and some graduates of foreign medical schools who do well with Board exams do too. Also, a few DOs get slots but they're viewed as less competitive applicants. Graduates DOs most often do their residency training in DO-oriented programs. Interestingly enough, and a difference between MD and DO education, allopathic (MD) schools have more rigorous requirements for being accredited and one of those is that they have to operate a hospital in which medical students can begin learning about patient contact. As of the last time I looked, such is not the case for a DO school to be accredited. Though, they usually make arrangements will local community hospitals but a difference remains in terms of the scope of medicine students get to observe and experience.