A model for improving generalist physician output: the osteopathic experience.

Osteopathic medicine is identified closely with primary care. Approximately one-half of all doctors of osteopathy (DOs) are family practitioners. The educational model responsible for producing such a high percentage of generalist physicians should be better understood for its achievements. Colleges of osteopathic medicine are unique in sharing a common mission of producing primary care physicians, and their methodologies reflect a similarly shared educational emphasis. Compared to allopathic medical schools, colleges of osteopathic medicine are the highest producers of generalist physicians because of several common features. This article evaluates colleges of osteopathic medicine by profiling each institution according to characteristics that have a potential impact on the output of generalist physicians: (1) institutional ownership; (2) age; (3) class size; (4) leadership; (5) educational focus; (6) whole-time as opposed to adjunct clinical faculty; (7) clinical educational settings; (8) clinical training sites; and (9) reliance on MD rather than DO clinical faculty. Comparisons between colleges of osteopathic medicine according to these characteristics yield mixed results but also highlight many differences from allopathic educational models. Factors separating the highest from lowest producers of generalist physicians vary at colleges of osteopathic medicine, and other characteristics or circumstances beyond their control may affect the number of graduates pursuing careers in primary care.