Letters to the Editor: MD vs DO, AI, Surrogacy – Readers Weigh In

When Abigail MacKenzie and Vijay Rajput urged us to “tear down the wall” between MD and DO training, the reaction was anything but uniform. Some readers cheered the call for equity, while others dug deeper into what really sets osteopathic schools apart.

Robert Cain, representing the American Association of Colleges of Osteopathic Medicine, reminded us that the issue isn’t simply about merging curricula or sharing exam rooms. “We need to preserve the cognitive architecture of osteopathic education,” he wrote, emphasizing the deliberate way DO programs blend biomedical science, health‑systems thinking, biomechanics, and complexity science into a single, patient‑centered worldview. He argued that this integrated lens produces physicians who are as comfortable discussing preventive lifestyle changes as they are performing surgeries.

Cain also pointed out the numbers: roughly thirty percent of U.S. medical students now hail from osteopathic schools, a share that climbs each year. “Those students deserve equal access to residency spots,” he said, noting the FAIR Act as a legislative pathway toward that goal.

Sharon McKelvey, a practicing DO, offered a more grounded take. She recalled that most colleagues never even noticed her title; they cared only about the quality of care she delivered. “The credentialing boards make a lot of money,” she quipped, suggesting that perhaps the whole maintenance‑of‑certification system could be scrapped. “Isn’t passing boards and staying up‑to‑date enough?” she asked, hinting that the looming threat of malpractice suits already keeps most physicians on their toes.

Another voice entered the conversation, focusing less on bureaucracy and more on philosophy. This writer noted that the distinction between MD and DO goes beyond the osteopathic manipulative treatment (OMT) toolbox. “Holism,” they explained, “is a tenet that stresses a global view of the patient, from genetics to community environment, and it starts on day one of osteopathic training.” According to them, DO schools place a heavier emphasis on meticulous history‑taking and physical diagnosis, which often funnels graduates toward primary‑care roles.

Beyond the MD/DO debate, readers also chimed in on two hot‑button topics that surfaced in other First Opinion essays: artificial intelligence and surrogacy. One physician cautioned that while AI can sift through massive datasets faster than any human, it still lacks the empathetic judgment that osteopathic philosophy cherishes. Meanwhile, a reproductive‑health advocate argued that surrogacy policies should be standardized nationally to protect both surrogates and intended parents, echoing the broader call for equity that runs through the MD/DO discussion.

All told, the letters illustrate a vibrant, sometimes messy, conversation about how we train doctors, how we keep them accountable, and how emerging technologies and societal shifts fit into the picture. Whether you lean toward allopathic or osteopathic training, the common thread is clear: patients deserve competent, compassionate physicians—no matter the letters after their names.