Long Island Business News
October 16, 2013
Doctors of Osteopathic Medicine on the Rise
By Bernadette Starzee
Featuring: Dr. Lawrence Crafa, Associate Director, Family Practice, Plainview Hospital
As a doctor of osteopathic medicine, Sheldon Yao finds there is often confusion when people notice the initials after his name are D.O., rather than the more familiar M.D.
“They might ask, ‘Are you an eye doctor? A chiropractor?’” he said. “There’s a lack of general knowledge among the public of what a D.O. is.”
Yao himself wasn’t familiar with osteopathic medicine until his junior year at Binghamton University, when he watched an osteopathic doctor treat a car accident victim. The woman hobbled into the room, but after the doctor administered osteopathic manipulation treatment, she hopped off the exam table and left without a trace of a limp, he said.
That encounter inspired Yao to study at the New York Institute of Technology College of Osteopathic Medicine in Old Westbury, where he is currently an assistant professor.
Physicians with D.O. degrees have equal practice rights to those with a Doctor of Medicine, or M.D. While there are about 80,000 D.O.s in the United States, compared to just over a million M.D.s, the number of D.O.s is increasing rapidly. The American Osteopathic Association projects that by 2020, there will be more than 100,000 D.O.s practicing nationwide.
While D.O.s receive comparable training to M.D.s, there are some differences. Osteopathic doctors are taught to consider the whole patient when preventing, diagnosing and treating illness, disease and injury. And in addition to biomedical and clinical education, D.O.s receive training in osteopathic manipulative treatment, in which they use their hands to diagnose and treat injury and illness.
“When a patient comes to me with a headache, I look at him from the feet up to see if there is a structural problem that may be causing the headache,” said Dr. Wolfgang Gilliar, D.O., dean of the NYIT College of Osteopathic Medicine.
Gilliar also applies the holistic philosophy of “treating the body, mind and spirit as a unit.”
“I look at the biological, psychological and social spheres to find the cause of the headache,” he said.
Gilliar said the number of osteopathic doctors is growing in part because there are more osteopathic medical schools than ever before. Currently, there are 29 such colleges with 37 total locations in the United States, including the NYIT College of Osteopathic Medicine, which, with a current enrollment of 1,200 students, is the nation’s second-largest single-site medical school.
Gilliar also believes more students are becoming familiar with the osteopathic option and that they’re increasingly attracted to its holistic philosophy.
“As alternative and complimentary health care has become more obvious, many students are drawn to the hands-on manipulative care they can learn in osteopathic programs,” he said.
About 60 percent of practicing D.O.s focus on primary care, including family medicine, general internal medicine and pediatrics. But many D.O.s have gone on to a broad range of specialties.
Dr. Jason M. Golbin, D.O., is board-certified in internal medicine, pulmonary diseases, critical care medicine and sleep medicine. Recently named chief medical officer at St. Catherine of Siena Medical Center in Smithtown, Golbin takes a holistic approach when treating patients, such as those with chronic obstructive pulmonary disease.
“If a patient is a smoker, I look at the outside influences – if the patient’s wife also smokes, I stress strongly that they need to quit together,” he said. “For patients with a nodule in their lung, I consider the whole patient when determining treatment – whether they are physically strong enough to tolerate surgery, and whether they have a support system to back them up.”
Golbin said most patients don’t notice or care whether a doctor is an M.D. or a D.O.
“Maybe 5 percent are well aware that I’m a D.O. and they’re very happy about it,” he said. “And there’s about 5 percent that have the opposite reaction. Recently, I referred a patient to a superb cardiologist who happens to be a D.O. The patient called my office and was really angry, asking how I could send her to a D.O. – that it’s not even a real doctor.”
So Golbin related that he himself was a D.O.
“There was silence on the phone,” he said.
When hiring and recruiting doctors, Golbin does not consider the initials to be a determining factor.
“We look for good doctors,” he said.
Traditionally, osteopaths have come up against snobbery from physicians and administrators with M.D.s who have considered the D.O. degree to be lesser.
“In the M.D. community, there has been some discrimination against D.O.s,” said Dr. Lawrence Crafa, a North Shore-Long Island Jewish Health System physician based at Plainview Hospital, who noted this has lessened considerably in the last decade.
Among students at Stony Brook University School of Medicine, which is an M.D. program, the M.D. route is generally perceived to be “more prestigious, and offering more flexibility in post-graduate training,” said Dr. William Wertheim, M.D., associate dean for clinical outreach and professor of clinical medicine at the school. While post-graduate programs generally accept both D.O.s and M.D.s, there is a perception among some that M.D. programs are more competitive, Wertheim added.
However, osteopathic programs have become highly competitive, allowing them to turn out high-caliber physicians, according to Gilliar, who pointed to NYIT’s osteopathic program, which received 6,200 applications for 315 spots for fall 2013.
While it has traditionally been difficult for D.O.s to break into elite Manhattan hospitals – many of which have disproportionately high numbers of M.D.s among their ranks – the opposite is true on Long Island.
“D.O.s have made major inroads here,” Crafa said.
Golbin attributes this to the influence of his alma mater, the NYIT College of Osteopathic Medicine, and the fact that many of its graduates have stayed on Long Island and done well.
“We have invaded Long Island and we are popping up everywhere,” he said.