In June, 2024 I posted an article titled “Will Your Next Family Doctor Be An Osteopath?” The article stated that allopathic (MD) medical schools’ emphasis had shifted toward preparing graduates for training in a specialty, or sub specialty, rather than for primary care, ie. Family Medicine. Actually “shifted” is the wrong verb because medical schools have always had that emphasis, even back in the 1960’s when I was a med student. There was never a shifting. It was a pursuing of the same course toward specialization. Now, it’s more in the public consciousness.
Schools educating MD’s reported that only 9% of their graduates planned a career in Family Medicine, while 23% of DO grads went into primary care. In 2021, doctors choosing a Family Medicine residency were 47.1% MD’s, 41.7% DO’s, and 11.1% foreign medical graduates. The Family Medicine residency at Franciscan Health (formerly St. Francis Hospital) in Indianapolis has 27 residents, or 9 each year of the three-year program. Of the 27 residents, twenty are osteopathic physicians (DO) and 7 are MD’s. That’s 74% osteopathic or three-fourths are non Medical Doctors. That trend says there will soon be a sharp increase in osteopathic family physicians.
We also must not forget the flood of Advanced Practice Providers (APP’s) into every corner of the medical profession. These are the increasingly ubiquitous Physician’s Assistants and Nurse Practitioners (NP’s) who patients are constrained to see in place of their doctor. These ancillary practitioners (non-MD’s) all pose a perceived threat to Family Physicians and the status we worked so hard to attain.
Kenny Lin MD, a practitioner, associate director of Lancaster (PA) General Hospital family medicine residency, and editor of American Family Physician, the journal of the AAFP, American Academy of Family Physicians, thinks this is an acceptable shift; one that will better populate the profession with well-trained professionals possessing broader knowledge and experience. He feels his “specialty’s future will benefit from an influx of young osteopathic physicians,” and physicians who are over-worked and fighting burnout will get some relief from the stresses they encounter.
It is likely that primary care physicians (MD’s) will decline in numbers and influence as osteopathic medical schools and family medicine residencies graduate more DO’s and fewer MD’s. A disturbing trend, in my thinking, is the proliferation of PA’s and NP’s into the role of primary care providers. The responsibility they are given and the latitude they are shown is worrisome because a well-trained, experienced MD has the inherent ability to know what’s wrong with a patient by sensing it. A good FP recognizes things about patients that less experienced providers will miss. They develop a “sixth sense” that gives them a diagnostic and therapeutic advantage PA’s and NP’s don’t possess. One word from the patient, one exam finding, one lab result is all the Family physician needs to pursue the right path to better health for the patient. This is an inbred talent that experience instills, and PA’s and NP’s, I fear, never develop.
While my preference is that all primary care practitioners be MD’s, I’m willing to concede that the primary doctor shortage can be reduced by DO’s. I think that’s a good thing. I would much rather see that than an army of advanced practice providers in every office or running their own practice.
Reference: Lin KW. DO ‘s are quietly becoming the backbone of American Family Medicine. Medscape 2025 November 20.
Gilkison WM. Will your next family doctor be an osteopath? www.drgopines.com 2024 June 20.
