excerpted from: Mary Anne Dunkin, From
D.O. to P.T.: what do all those letters mean? Finally - an explanation
of those initials you see after your health-care provider's name, 7
Arthritis Today 46-49 (Sept-Oct, 1993).
Finally -- an explanation of those initials you see after your
health-care provider's name.
Looking over a list of doctors specializing in arthritis, you notice
a few have the initials D.O. after their names. You schedule an
appointment to see your family physician, but when you get to her
office, a P.A. examines you and asks about your latest symptoms. When
you describe the problems you've had keeping up with your job and
household chores, he refers you to an O.T.
D.O., P.A., O.T. -- it may sound like a secret code, but actually
these initials can tell us a great deal about the people who handle and
manage our care for arthritis and other medical problems. There are
dozens of professional degrees and designations conferred upon
health-care providers -- many of them are probably familiar by now; some
of them may not be. But even if you know what the initials stand for,
you may still have questions: What's the difference between a D.O. and
and M.D.? Is a P.A. qualified to treat arthritis? What does an O.T. do?
Following is some basic information about the duties and
qualifications of health-care professionals you're likely to encounter.
. . .
D.O. - doctor of osteopathic medicine.
Like medical doctors (M.D.s), D.O.s (or osteopathic physicians) are
complete physicians, which means they are fully trained and licensed to
perform surgery and prescribe medication. The primary difference between
M.D.s and D.O.s is that D.O.s focus on the body as a whole and how
different organ systems function together, rather than on specific
disease symptoms. Teaching prevention by promoting healthy lifestyle
changes is also an important role of the osteopathic physician.
D.O.s practice in all branches of medicine and surgery, but the
majority are family-oriented primary-care physicians, Many D.O.s
practice in small towns and rural areas.
Like M.D.s practice in small towns and rural areas.
Like M.D.s, osteopathic physicians attend a four-year medical school
and complete an approved 12-month intership after graduation. Many then
choose to take a residency program in a specialty area, requiring two to
six years of additional training. To practice, D.O.s must be licensed by
tests and procedures determined by their state. Some states administer
the same tests for M.D.s and D.O.s, while other states adminster
separate licensing exams.
* O.D. - doctor of optometry.
Not to be confused with D.O.s, O.D.s (or optometrists) diagnose,
manage and treat conditions and diseases of the eye and visual system.
Among the services they render are prescription of glasses and contact
lenses, rehabilitation of the visually handicapped and, in most states,
treatment of diseases of the eye.
Unlike ophthalmologists (M.D.s who treat problems of the eye and
visual system), optometrists do not perform surgery. In most states,
however, they can be licensed to prescribe medication.
Most optomertrists complete undergraduate degrees before entering the
required four-year accredited degree program at a school or college of
optometry. After completing optometry school, they must pass a clinical
and written examination administered by the National Board of Examiners
* D.P.M. - doctor of podiatric medicine.
A doctor of podiatric medicine, or podiatric, is concerned with the
diagnosis and treatment of conditions affecting the human foot and
ankle. Podiatrists may perform foot surgery and prescribe medication.
Podiatrists may have solo or group private practices or they may be
affiliated with hospitals, teaching institutions, managed care or other
health-delivery systems and health departments.
D.P.M. degrees are awarded to graduates of the seven four-year
colleges of podiatric medicine in the United States. Most podiatric
physicians complete hospital-based residency programs in specialty areas
such as foot and ankle surgery, orthopaedics and primary podiatric
medicine. To practice, podiatrists must pass licensing tests adminstered
by their states.
* D.C. - doctor of chiropractic.
Doctors of chiropractic, or chiropractors, consider the human body as
a total functioning unit and seek to relieve pain, illness and
disability by utilizing skillful manipulations and adjustments of the
vertebrae and other joints. Chiropractors are concerned in particular
about the spine's relationship to the nervous system, which controls
important body functions. Chiropractors do not prescribe medicine or
perform surgery; they refer patients needing those services to M.D.s or
Educational requirements for doctors of chirpractic are at least two
years of undergraduate study followed by a four-year chiropractic
college. To practice, chiropractors must pass state licensing tests.
Also, most states require national board exams.
* P.A. - physician assistant.
Physician assistants practice medicine with the supervision of
licensed physicians. They are qualified to perform approximately 80
percent of the duties most commonly done by physicians. They may perform
physical examinations, diagnose illnesses, determine treatment plans,
order and interpret lab tests, suture wounds, set fractures and assist
in surgical operations. In most states, P.A.s may also write
If you live in a rural area where physicians are in short supply, a
P.A. may be your primary provider of health care.
Physician assistants are educated in one of 57 specially designed
programs located at medical colleges and universities, teaching
hospitals and through the armed forces. P.A. programs generally require
applicants to have prior healthcare experience and a minimum of two
years of college education. Programs usually last 24 months and consist
of both classroom training and patient contact.
* P.T. - physical therapist.
The role of the physical therapist is to relieve pain and increase
function in people who have suffered illness or injury, helping these
patients reenter the community, home and work environment with as much
independence as possible.
Physical therapists use therapeutic exercise to improve patients'
muscle strength, joint mobility and cardiovascular function. They may
also use heat, cold, electrical stimulation and hydrotherapy to bring
temporary relief of pain and reduce muscle spasms. P.T.s teach people to
do activities safely and efficiently and may recommend a program of pain
management and exercise to perform at home.
Physical therapists are educated in accredited programs offered at
many colleges and universities and must pass a licensing exam
administered by their state. P.T.s practice in a variety of settings,
including hospitals, outpatient clinics, rehabilitation centers, nursing
homes, schools and home health-care agencies. In some states, a
physician referral is required for treatment by a physical therapist.
* O.T. - occupational therapist.
The occupational therapist's role is to improve a person's functional
ability to perform daily living tasks. They help patients adapt to
disruptions is lifestyle and prevent loss of function. O.T.s teach
energy conservation and joint protection as well as stress management.
They also recommend adaptive equipment and teach patients how to use it
to perform tasks related to self-care, job or school, housework or
Registered O.T.s have completed either an undergraduate or master's
degree program as well as a period of supervisedc clinical experience.
To be registered (often designated as O.T.R.), occupational therapists
must complete a national certification exam. Many states require
occupational therapists to be regulated before they can practice. A
physician referral is sometimes necessary for evaluation and treatment
by an O.T.
* B.S.W., M.S.W. - bachelor of science in social work, master of
science in social work.
The role of the social worker is to assess the capacities of
individuals, families and communities to cope with diseases. Social
workers offer a broad range of services from emotional support to
referrals for community resources that can assist patients and their
families in accepting acute and and chronic health conditions.
Social workers may be affiliated with hospitals, rehabilitation
facilities, outpatient clinics, community mental health centers,
schools, family and community service agencies and private practices.
To practice, a social worker must have at least an undergraduate
degree, and most states require social workers to pass to licensing
* R.N., L.V.N., L.P.N., N.P. - registered nurse, licensed
vocational nurse, licensed practical nurse, nurse practitioner .
Nurses can assume a broad range of responsibilities including the
following: evaluation of physical, emotional, psychological and social
needs; diagnosis; treatment; coordination of care given by other
health-care providers; teaching; counseling; collaboration with other
health-care providers; and case management. As the largest group of
health-care professionals, nurses work in a variety of settings
including hospitals, nursing homes, community health centers, home
health agencies and outpatient clinics.
To practice, nurses must be licensed by their state. The difference
between types of licensure is the degree of responsibility based on the
nurse's level of education. Education for R.N. licensure consists of
either a degree from a two-year college, a hospital school diploma, or
an undergraduate degree. For L.P.N. or L.V.N. licensure a 12- to
18-month course is required.
Advanced practice nurses are registered nurses who have
graduate-level education, typically a master's degree. Advanced practice
nurses include nurse practioners (N.P.s), who are qualified to provide
80 percent of health-care services commonly provided by a family
physician. N.P.s conduct physical exams, take medical histories,
diagnose and treat common acute minor illness or injuries, order and
interpret lab tests and X-rays, and counsel and educteate patients. In
at least 43 states, N.P.s can prescribe medications. These are but a few
of the many initials that identify health-care professionals. There are
dozens more. A complete list would more than fill this magazine's pages.
As you try to make sense of this alphabet soup, remember some, such
as R.N., stand for the person's license; some, such as B.S.N. (bachelor
of science in nursing), stand for the academic degree the person holds.
Still others stand for professional organizations of which the person is
a member, such as F.A.C.P. (fellow of the American College of
Physicians). . . .