Roger Kasendorf, DO, discusses What is a D.O.

Roger Kasendorf, DO

August 3, 2023


Imagine for a second that you lived in this makeshift cabin in the woods. It was the only place around for shelter, warmth, and safety. 

Now imagine that it starts raining. Not the drizzle that we call rain where I live in San Diego. I’m talking about monsoon rains, where you hear the whooshing sound against the windows, making you want to curl up in a ball by a warm fireplace.

Then you hear something else—drip…drip..drip…drip. You hear a leak and quickly run to put a bucket down. From the other side of the cabin, you hear drip-drip, drip-drip. You run and put another bucket. The leaks in the roof are evident all over the place and are getting overwhelming and trying to stop them all.    

You use big red buckets for particular drips; you need thin white buckets for the other kind. Next, buckets are down everywhere, and you are simply trying to ride it all out.

As an osteopathic physician, a D.O., you may use a different mentality for the above scenario. The MD will continue putting down all the buckets to prevent flooding. The D.O. mentality would be to find the problem and fix the dang roof!

A  D.O. is a physician who treats the patient as a whole, whereas an M.D. typically targets and treats the patient’s specific ailment or sickness. Though using a different approach to reach the desired result of improving the patient’s physical condition, they are equally qualified. 

It has been said that D.O.’s focus is on a whole-body approach. When this relates to medicine, it means considering the entirety of the problem instead of what I call “bug and drug.”

Bug and drug refers to taking a single problem and giving a pill to fix that problem.  

It is essential to think BIGGER!!!

As a medical community, we must treat people, not just the disease. By looking outward, you may better address the patient’s needs and prevent further problems.  

Unfortunately, so many osteopathic physicians complete their training and forget/don’t use the tools they possess. So many people go to their doctor and never realize they are seeing a D.O. In my case, I am glad to say that osteopathic techniques have become a mainstay in my treatment.

This may also happen when an osteopathic medical student matches into a specialty where finding a way to use their unique skills may be more challenging. For instance, a radiologist sits in a dark room all day reading images on their computer screens. They provide their readings with impressions and, in most cases, don’t interact with their patients. 

The philosophy of osteopathic medicine dates back to 1874, when this A.T. Still recognized the necessity to treat illness within the context of the whole body rather than a single entity. He also pioneered the concept of wellness. Born in 1828, he became a physician like his father graduating from the College of Physicians and Surgeons in Kansas City, Missouri. He later served in the Union Army during the Civil War.  

Following the civil war, he lost three children to spinal meningitis. Due to this, he spent the next decade of his life trying to find the cause of disease within the human body. He found that the body can heal itself and contains all of the elements to do so if properly stimulated. The idea of treating the disease as a whole instead of as a single component was also concluded. It was also said that Dr. Still would get horrendous migraines himself. To treat them, he would put the back of his head against a rope swing and sink.  

Dr. Still opened the first osteopathic medical school in Kirksville, Missouri with a new philosophy. The belief of treating the body as a whole was incorporated. Into the teaching at the school, and osteopathic medicine was born.

It wasn’t always easy for D.O.s in this country. Although well received outside of the U.S., D.O.s in this country often had to compete with an institutional bias of their training. There are currently still a few residency programs that do not take D.O.s despite similar GPAs and USMLE scores.  

There may be no more significant example than the state of California. Osteopathic schools in California started in the early 1900s. The proposition in 1920 created a separate certifying board. However, in 1962, with the passage of Proposition 22, D.O. schools changed to M.D. schools. Additionally,  there a merger agreement for the osteopathic physicians given “MD” status. Although a vast majority of D.O.s agreed to this, there were a few holdouts. These brave physicians took the argument to the California Supreme Court, which ruled that the 1962 agreement was unconstitutional. Later in 1975, anti-discrimination legislation passed which could not discriminate against D.O.  This legislation later strengthened by SB18 and further supported and protected D.O.’s.

I was blessed to have one of the doctors who stood up for D.O.’s patient. On his office visits, for which I would provide osteopathic manipulation to address his neck pain and headaches, we would talk about his struggles to pave a wave for the current generation of D.O.

Even medical students are treated as second-class citizens. Where the path was made much more difficult. I had a recent medical student rotate with me and tell me they were highly interested in turning at a large teaching hospital in Denver. They were told that they would have to pay $3000 to turn at their hospital, as opposed to $300 if they were an M.D. student doing the same role.  

The struggles have not only been in California but not so many years ago. It was only in 2006 that a study found that the American Medical Association (AMA) charged more fees to osteopathic (DO) members than they did for allopathic (MD) students.

Today, D.O.s have no restrictions in 50 states or U.S. territories. We proudly serve people throughout the country, in the military, and overseas. People are becoming more aware of what we do and how strong we are.  

Recently, President Trump contracted COVID-19. His treating physician, Sean Conley, made the news. Because of the very rapid recovery. However, this Philadelphia College of Osteopathic Medicine graduate helped to improve awareness of osteopathic medicine further.