To the Editor.—We share Dr. Melnick's awareness of the potential error in grouping all osteopathic physicians into a general category of osteopathic practice. Neither ignorance nor bias was operative in our action. Osteopathic physicians are not broken down by specialty in the National Disease and Therapeutic Index (NDTI) for the same reasons that medical and surgical subspecialists (MD) are not. Seventy-five percent of the approximately 10,000 office-based private-practicing DOs are generalists; thus, a 1% sample of the one fourth who are specialists would comprise only 23 physicians scattered among the specialties and census regions, permitting undue influence of a single, possibly atypical, practice. As the number of DO specialists increases, NDTI will need to consider sampling their practices as separate specialties or together with their MD counterparts.
As Dr. Melnick describes the specialist DO, it is likely that his or her practice is as represented in the NDTI specialty