Osteopathic Medicine Continues to Grow in Popularity

Osteopathic medicine is one of the fastest growing segments in healthcare, according to the American Osteopathic Association’s (AOA) Osteopathic Medical Profession Report. The number of osteopathic medical students has grown by 77 percent in the last ten years, which has led to an 81 percent increase in the total number of DOs (including practicing physicians, residents, and medical students). Today, there are an estimated 122,236 in the physician workforce, just over one in four medical students are currently pursuing a Doctor of Osteopathic Medicine (DO) degree, and an estimated 36,500 medical students are expected to matriculate into a DO program this school year (up 2,700 from last year). 

Demographic highlights:

• Practicing DOs predominantly fall within a younger cohort. Just over two-thirds of practicing physicians are under 45 (35 percent are under 35, and 32 percent are between 35 and 44). 

• In 2022, 43 percent of the practicing DOs were female, an upward trend that has continued over time (40 percent in 2015, and 32 percent in 2010). Almost half of practicing physicians (47 percent) are female and under 45. 

• Most DOs tend to practice near where they completed their education, and DO programs are typically located in medically underserved regions. The states with the largest number of DOs include: California (8.3 percent), Pennsylvania (8.1 percent), Florida (7.9 percent), Michigan (6.6 percent), New York (6.4 percent), and Texas (6.1 percent).

• Since 2020, the Accreditation Council on Graduate Medical Education (ACGME) has overseen the accreditation of all graduate medical education (allopathic and osteopathic). DO graduates also participate in the National Resident Matching Program (NRMP). The report notes that 2022 brought a new record level of placement for participating DOs, with 7,049 graduates placing into residency programs in 41 specialties. This is up 7 percent from the previous year. 

• DOs predominantly work in primary care specialties. The top fields include family medicine, internal medicine, and pediatrics. Among the remaining 43 percent who opt into other specialties, the top fields include: Emergency medicine, Anesthesiology, Obstetrics and Gynecology, General surgery, and psychiatry. 

Related: Alternatives to Allopathic Medical Programs in the United States

Implicit Bias Training Could Be a Starting Point for Improving Health Equity

In 2020 Maryland’s state legislature passed a law requiring all health care providers in perinatal units to receive implicit bias training once every two years. Delegate Joseline Peña-Melnyk, the law’s sponsor, cited the striking disparity in maternal mortality rates (four times as high for black women than white women in Maryland) as the initial reasoning. However, in 2021, after seeing the pandemic’s devastation concentrated in minority zip codes, she introduced and the legislature passed an expanded bill. Implicit bias training was mandated as a licensing requirement for all healthcare professionals. 

Implicit bias training is predicated on the belief that most people hold unconscious biases related to race, gender, socioeconomic status, or weight. For many, the hidden biases directly contradict their conscious or stated views. And these latent stereotypes can take hold in times of multi-tasking, stress, or fatigue, which, in a healthcare environment, can impact care. “Health care providers, like everyone else … have an active way of processing information that is very conscious, but then we have these unconscious or implicit ways of processing information,” said Dr. Lisa Cooper, a researcher on racial health disparities at Johns Hopkins University. “There are things we’ve been exposed to throughout our lives that lead us to think and behave in certain ways. We think certain things but aren’t aware that we are thinking them.” The training seeks to bring awareness and acknowledgement of those hidden stereotypes so that a provider can notice when they’re occurring and proactively work against biases. 

Since 2019, five states—including Maryland—have adopted policies requiring implicit bias training for at least some segment of health care workers. And, more recently, eight additional states have had lawmakers introduce bills. It doesn’t stop there. Medical schools, including leading programs like Harvard, Icahn School of Medicine at Mt. Sinai, and Ohio State, have incorporated the training into their curriculum.

Research substantiates that implicit bias plays a role in provider care and patient interactions, and research will likely continue. Michelle van Ryn, a researcher on implicit bias in health care and owner of a company providing diversity and inclusion consulting services, wants to know more about how implicit biases impact health disparities and the efficacy of training. “Lots of people are doing interventions,” she said, “but there’s not a huge body of evidence of what works.”