An osteopathic doctor, known as a DO, is a fully licensed physician who can diagnose illness, prescribe medication, perform surgery, and practice in every medical specialty. There are more than 167,000 DOs practicing in the United States as of 2025, making osteopathic medicine one of the fastest-growing segments of the healthcare workforce. What sets DOs apart from MDs is additional training in hands-on musculoskeletal techniques and a medical philosophy that emphasizes treating the whole person rather than isolated symptoms.
How DO Training Compares to MD Training
DOs and MDs follow nearly identical educational paths. Both complete four years of medical school, followed by residency training in their chosen specialty. The first one to two years are spent in the classroom studying anatomy, pharmacology, pathology, and clinical sciences. The remaining years focus on clinical rotations in hospitals and outpatient settings. DOs can enter any residency program, and since 2020, all residency training in the U.S. falls under a single accreditation system shared by both MD and DO graduates.
The key curricular difference is that DO students receive additional coursework in the musculoskeletal system and learn osteopathic manipulative treatment, or OMT. This is a set of hands-on techniques for diagnosing and treating problems with muscles, joints, and connective tissue. That extra training gives DOs a manual diagnostic skill set that most MDs don’t carry into practice.
To become licensed, DOs must pass the COMLEX-USA, a three-level national licensing exam. Level 1 is typically taken during the second year of medical school, Level 2 during the third or fourth year, and Level 3 during residency. Each level must be passed before moving to the next. Many DO students also take the same USMLE exams that MD students sit for, giving them flexibility in residency placement.
The Philosophy Behind Osteopathic Medicine
Osteopathic medicine is built on four principles that shape how DOs approach patient care. First, the body is a unit of body, mind, and spirit, meaning a DO considers psychological and social factors alongside physical symptoms. Second, the body is capable of self-regulation and self-healing, so treatment often aims to remove barriers to the body’s own recovery processes rather than simply overriding symptoms. Third, structure and function are interrelated: how your bones, muscles, and tissues are aligned directly affects how your organs and systems perform. Fourth, effective treatment follows from understanding all three of those ideas together.
In practice, this means a DO treating chronic headaches might examine your neck alignment and shoulder tension in addition to reviewing your medications and stress levels. It doesn’t replace conventional medicine. It layers a structural and whole-person perspective on top of it.
What Osteopathic Manipulative Treatment Involves
OMT is the most distinctive tool in a DO’s practice. During a session, the doctor uses their hands to move your muscles and joints through stretching, gentle pressure, and resistance. Most people seek OMT for lower back pain, neck pain, or migraines, but it’s used for a surprisingly wide range of conditions: breathing problems like asthma and sinus infections, bowel issues like IBS and constipation, chronic pain conditions including fibromyalgia and arthritis, carpal tunnel syndrome, sports injuries, and repetitive stress injuries. For pregnant patients, OMT can improve sleep and relieve sciatica and swelling.
Several specific techniques fall under the OMT umbrella:
- High-velocity, low-amplitude (HVLA): A quick, targeted thrust applied to a restricted joint to restore normal range of motion. This is the technique that often produces an audible “pop,” similar to what you might hear during a chiropractic adjustment. The goal is to stretch contracted muscles and trigger a reflex relaxation response through the nervous system.
- Myofascial release: Slow, gentle pressure applied to tight muscles and the connective tissue surrounding them. This loosens restricted areas and promotes blood flow.
- Muscle energy: The patient actively contracts specific muscles against the doctor’s resistance. This relaxes and lengthens tight muscles, improving range of motion and circulation.
- Lymphatic pump: Rhythmic compression that encourages lymph fluid drainage, reducing swelling and easing symptoms of respiratory and digestive infections.
- Cranial osteopathy: Very light touch applied to the head and neck to address TMJ disorders, headaches, and neck pain.
During HVLA treatment, you stay passive while the doctor positions and applies force. Other techniques are more collaborative, requiring you to push or breathe in specific ways. A single visit often combines multiple approaches. DOs sometimes use myofascial release first to relax muscle groups before applying a more targeted joint technique.
Where DOs Practice and What They Specialize In
About 57% of DOs work in primary care fields, including family medicine, internal medicine, and pediatrics. The remaining 43% practice in other specialties, from orthopedic surgery and cardiology to psychiatry and emergency medicine. A DO holds the same legal practice rights as an MD in all 50 states. They can prescribe controlled substances, perform complex surgeries, deliver babies, and admit patients to hospitals.
The primary care concentration is partly historical. Osteopathic medical schools were originally founded to address physician shortages in rural and underserved communities, and that emphasis on community-based primary care persists in how many DO programs train their students. But the profession has expanded significantly. The total number of DOs has grown by more than 1,700% since the American Osteopathic Association began tracking in 1935, and when you include current osteopathic medical students, the profession now exceeds 200,000 people.
How a Visit With a DO Differs in Practice
If you see a DO for a routine checkup or a specific complaint, much of the visit will feel identical to seeing an MD. You’ll go through the same intake process, the same physical exam, and receive the same evidence-based treatments, prescriptions, or referrals. The difference tends to show up in two ways.
First, DOs are trained to use their hands as a diagnostic tool. A DO examining you for lower back pain is more likely to palpate your spine, hips, and surrounding muscles to identify areas of restricted motion or tissue tension. That hands-on assessment can reveal structural contributors to pain that imaging alone might not explain. Second, if OMT is appropriate, treatment can happen right in the office. A session typically takes 15 to 30 minutes and can be combined with other treatments like medication or physical therapy referrals.
Not every DO uses OMT regularly. A DO working as a hospitalist or an emergency physician may rarely perform manual treatment. Others, particularly those in family medicine, sports medicine, or pain management, integrate it into nearly every patient encounter. The extent to which OMT plays a role depends on the doctor’s specialty and the patient’s needs.
Conditions Commonly Treated by DOs
Because DOs practice across every specialty, the list of conditions they treat is the same as any physician. But the conditions where osteopathic training adds a distinct advantage tend to involve musculoskeletal components or chronic pain. Joint pain, sciatica, tension headaches, postural problems, and sports injuries are common reasons patients specifically seek out a DO. OMT has also been used for conditions you might not immediately associate with manual therapy: chronic pelvic pain, recurrent ear infections in infants, colic, and difficulty breastfeeding.
Diaphragm techniques, where a DO works on the muscles involved in breathing, can help patients with asthma or chronic obstructive conditions breathe more easily. Rib-raising techniques gently stretch the fascia around the ribcage to allow the lungs to expand more fully. These approaches don’t replace inhalers or other standard treatments, but they can complement them by addressing the structural side of a breathing problem.