This is an age-old question for premeds trying to decide on the MD vs. DO route. Whether DOs make as much money as MDs depends on some specific factors, like residency, region, specialty and number of hours worked. This post focuses on salary. You can also check out our post on other differences between DOs and MDs.

Are DO vs MD salaries differentiated by degrees?

The simple answer to the question of whether DOs make as much money as MDs is not that simple, nor as obvious as one would assume. All other factors being equal, if a DO and an MD have a comparable residency, work in the same region of the country in the same specialty for a similar DOs make as much money as MDsnumber of hours per week, the pay difference between MD and DO is likely insignificant.

Do osteopathic doctors make less money?

The fact is that most DO schools tend to send out a high percentage of their doctors to work in primary care. In fact, DO training tends to be highly focused on primary care. So, across the board, if you take a doctor of osteopathy vs a medical doctor’s salary, you’ll definitely find a differential. But that’s partly owed to the fact that there is such a high number of DOs who practice in primary care, and the median salary for primary care is significantly lower than in some other specialties.

DO vs MD salaries—tied to residencies?

When calculating osteopathic vs allopathic, one of the top two factors is where the medical student served his or her residency (and fellowship). While it’s true that it can be harder for DOs to get into top residencies for the most competitive specialties, DOs who do whatever it takes to stay at the top of their class are often able to get top residencies. It’s tough to do, since everyone knows that getting into DO school was a tad easier, but all you need to do is prove that you’re a top notch candidate. DOs make as much money as MDs if they are placed in residencies from Radiology to Surgery, ENT to Dermatology, and beyond.

Why does region matter?

The pay difference between MD and DO depends where you practice. After spending six to 10 years or more in medical school, who doesn’t want to land the plum job in the plum city at a plum hospital? We all do. But there are a world of opportunities out there, and lots of need. The jobs in very desirable cities are snapped up by the top candidates, leaving other cities and other hospitals for the second and third-tier candidates. (That’s not to say that lots of top notch residents don’t choose less desirable locations for a whole host of reasons, but typically when they have a choice, they’ll select the best institutions—where their lifestyle matches their hard work.)

Cities and towns all over the U.S., especially rural ones, are often desperate for DO to MD doctors. So, making a move to one of these locations can increase one’s osteopathic doctor salary, and an allopathic MD salary as well. This can distort the salary scale immensely; a family practice physician or ER doc in a tiny town in desperate need of doctors might pull in a higher salary than a specialist like a cardiologist or general surgeon in a large doctor-dense city.

What about insurance company billing codes?

There is no DO MD different salary when insurance companies look at a specific procedure. In fact, that would be illegal. The billing procedure code doesn’t differentiate between degrees, only by the exact procedure offered.

But here’s a weird quirk…a DO may actually get extra pay beyond what an MD is paid. Stay with me here…if the DO offers the same treatment as an MD, using the same billing code, and then adds specialized codes for osteopathic manual therapy during the same office visit, he/she could get extra pay for essentially the same visit by tacking on 5 minutes of OMT at the end.

So…do osteopathic doctors get paid less?

The most important factor in where you’ll land, and hence, your pay, is where you last worked. If you had a stellar residency/fellowship, you’ll do well as either an MD or a DO, and a doctor of osteopathic medicine salary could match an MD’s. Where you went to medical school or DO school is not nearly as significant when determining if DOs make as much money as MDs. Not to mention that hardly anyone will care which initials you have behind your name, but more importantly, what kind of doctor you’ve become.

Check out these other helpful posts as you decide your future medical career:

Choosing a medical school

Will attending a top tier medical school get me a top tier residency match?

How to pay for medical school