Allopathic, osteopathic physicians provide similar quality and cost of care

Despite often being regarded as distinct medical philosophies, allopathic and osteopathic medicine have much in common in training and treatment techniques. Now a new study shows the two groups also differ little in the quality and cost of care they provide.

A team of researchers at UCLA’s David Geffen School of Medicine and the University of Tokyo analyzed costs and outcomes for 329,510 hospitalized Medicare beneficiaries and treated by about 18,000 hospitalists during the period 2016-2019. Approximately 79% of the treating physicians were graduates of allopathic medical schools, while the rest graduated from osteopathic schools.

The researchers reported finding no clinically important differences between the allopathic and osteopathic hospitalists in any of the categories they examined, which included mortality, readmission rates, length of stay and per-admission spending. Their findings, they say, “were consistent across a wide range of medical conditions and…severity of patient’s illness, indicating that any differences between allopathic and osteopathic medical schools…are not associated with differences in costs or quality of care in the inpatient setting.”

The authors offer several possible explanations for their findings, including:

• Both allopathic and osteopathic medical schools provide standardized, accredited medical education systems, and while their accrediting bodies are different, both types of programs comply with similar accreditation standards;
• Since the 1990s, most osteopathic physicians have trained alongside allopathic physicians in residency programs accredited by the Accreditation Council for Graduate Medical Education; and
• Osteopathic manipulative treatment is becoming increasingly rare due to lack of time, institutional support, and reimbursement

An accompanying editorial notes that despite the similarities between allopathic and osteopathic practices created by workplace and educational standardization, the medical field has been reluctant to accept osteopathic medical students into their preferred specialties, causing increasingly pronounced disparities in competitive programs.

The study,

“Comparison of Hospital Outcomes for Patients Treated by Allopathic Versus Osteopathic Hospitalists” appears in the May 30, 2023 issue of Annals of Internal Medicine.