DOs and MDs are licensed physicians. DOs are guided by the principles of osteopathy. MDs are guided by those of allopathic medicine. The difference between MDs and DOs is that in addition to four years of medical school, DOs receive additional training in osteopathic manipulative medicine (OMM).

Chiropractors are not fully licensed medical doctors, and are not required to have completed residency training in a hospital. Chiropractors and DOs practicing hands-on osteopathy differ in many ways—level of training, scope of practice, and approach to treatment. While chiropractors focus exclusively on spinal alignment, DOs are concerned with systemic movement and restoration of health.