‘We use our brain, our heart and our hands’ — and women now lead osteopathic primary care

For the first time in American Osteopathic Association (AOA) records, women make up the majority of osteopathic physicians (DOs) practicing primary care, at 50.2%. The AOA’s 2026 Osteopathic Medical Profession Report, “Enduring growth of a timeless philosophy,” found 151,240 DOs in active practice, up from 63,121 in 2010, with two-thirds of them younger than 45. Osteopathic medical schools enroll a record 41,001 students, and 55% of DOs practice in a primary care specialty. The number of DOs grew in all 50 states and Washington, D.C.

Those trends arrive as the nation faces a physician shortage and growing attention to the career pressures facing women physicians.

Medical Economics spoke separately with two AOA leaders about the findings. Richard R. Thacker, D.O., MACOI, is the AOA’s president and associate dean of clinical sciences at the Alabama College of Osteopathic Medicine in Dothan, Alabama. He practiced internal medicine for 23 years in Tallahassee, Florida, after starting his career in the National Health Service Corps in rural North Florida. Kathleen S. Creason, MBA, is the AOA’s CEO and secretary of its Board of Trustees, with nearly two decades of leadership experience in the osteopathic profession. Their answers are grouped by topic, and this transcript has been edited for length and clarity.

How has the osteopathic profession changed in recent decades?

Kathleen S. Creason, MBA: The osteopathic profession has changed pretty dramatically over the last few decades. The education and training of osteopathic physicians is more robust than it ever has been. The integration of osteopathic physicians in the medical community has dramatically improved, and the sheer number of osteopathic physicians and osteopathic medical students has increased exponentially in the last two decades.

Which findings in this year’s report stand out to you?

Kathleen S. Creason, MBA: The number we’re really excited about is that there are more than 218,000 osteopathic physicians and osteopathic medical students in the U.S. now. That has increased exponentially in the last 30 years or so, partially due to the growth in the number of osteopathic medical schools and the demand, particularly in rural and underserved areas, for physicians that the osteopathic profession is uniquely poised to meet. More than one quarter of all medical students attend an osteopathic medical school.

Richard R. Thacker, D.O., MACOI: First and foremost is just a record number of graduates. Every year we’re setting a new record in terms of the number of students in an osteopathic program, over 41,000. We had a record match into residency, both in terms of the percentage of our graduates and the overall number. And as osteopathic physicians, we are still very strong in the primary care specialties of family medicine, internal medicine and pediatrics. And one-third of physicians in the military are DOs.

But here’s one statistic in this report that I’m very proud of, and it’s a new thing: For the first time ever, 50.2% of [DOs practicing primary care] are women. And a large percentage of our workforce and students are under the age of 45. So these young people and these women are going to be the ones delivering care to our country and the world for decades to come. We’re very proud of that, and we look forward to seeing that trend continue.

Women now make up the majority of DOs in primary care. What is driving that?

Kathleen S. Creason, MBA: The number and percentage of females in primary care in the osteopathic profession is growing, and it continues to grow. We haven’t done a cause and analysis assessment, but my personal assumption is that females tend to focus more on developing longer-term relationships, as an example, and I think the philosophy of the osteopathic profession resonates with females.

Being able to have that hands-on touch, engaging with the whole patient, learning more about the socioeconomic factors, their background, their experiences, their family lives — all of which has an impact on the patient — I think that resonates with females, and thus the attraction of females to primary care in the osteopathic profession.

Do women physicians still face discrimination at work?

Kathleen S. Creason, MBA: I quite frankly don’t hear a lot about female physicians facing a great deal of discrimination in recent times. I know that certainly has occurred in the past, and I would imagine it still does occur in certain circumstances now. But there are so many physicians, and the number of physicians who are female continues to grow. Females are able to demonstrate their competence, and along with that comes a level of respect.

So my sense is that females generally are viewed in a way that is equal to male physicians, although there are certainly exceptions, and patients will absolutely, in some cases, have their own preferences.

What is drawing so many students to osteopathic medicine?

Richard R. Thacker, D.O., MACOI: First and foremost, and this was true in my day, the osteopathic profession appreciates a more nontraditional student. That’s not to say that our allopathic cousins don’t accept students who had a circuitous route to medical school. But a large percentage of our students had a short career somewhere else. Maybe they were emergency medical technicians or nurses or respiratory techs. They went to junior college and then transferred to a university. Maybe they had a slow start and finished strong. They had atypical majors such as psychology, which was mine.

We absolutely love that someone has worked in the health care field, because now they have a better understanding of the commitment it’s going to take and the sacrifices that are required. There’s a lot of emphasis on professionalism and humanism, the interaction with patients and their families, that whole-person approach.

And the last thing is, be willing to use your hands. Osteopathic medicine is hands-on from the first day, with osteopathic manipulative treatment. Your hands are diagnostic tools, but they’re also therapeutic tools. So we use our brain, our heart and our hands.

Kathleen S. Creason, MBA: The osteopathic profession really is perfectly poised for health care needs at this point in time. It is focused on whole-person care, the integration of mind, body and spirit, and the belief that the body has the innate ability, under the right circumstances, to heal itself. Osteopathic physicians are trained in a manner that is equivalent to allopathic, or M.D., physicians, but they also have additional training in manual manipulation, so they are able to use their hands to diagnose and treat a number of conditions.

Patients are looking for more emphasis on the whole person: how to heal without using medications, if at all possible; how to avoid surgery, if at all possible; how to focus on lifestyle, exercise, nutrition and social factors. Those are all practices and philosophies that align with the osteopathic profession.

What are today’s medical students looking for in a career?

Richard R. Thacker, D.O., MACOI: Almost every health care profession and professional association has to find a way to convey its value to a younger generation that is very interested in work-life balance. That phrase was not present when I trained 30-some years ago, and it should be now. You have to be able to balance work and life. What is the return on investment? Because student loan debt is a real concern.

If you choose to become a physician, that is a long road. That is a huge commitment. You want to choose wisely and make sure that it really is your calling. If you’re going into it because it pays well — and it does — or because of prestige, or because you’re following in the footsteps of a brother, a sister or your parents, that’s the wrong motivation. It really is about making sure that you’re following your path, understanding that it is a long road, and that work-life balance is what’s hopefully going to prevent the burnout that so many folks experience.