We believe that the Scope of Practice should be determined by the profession and that it should be a simple, clear statement of the fundamental osteopathic concept to which all osteopaths can subscribe. The essential question is can you practise ‘your’ osteopathy freely under this description?

We have been in discussions with the GOsC and have shared the document with the osteopathic undergraduate colleges. We wish now to involve the profession in the debate and are seeking your views. Once we have your views and comments we plan to meet further with all the osteopathic stakeholders to agree appropriate next steps. Your feedback will help to determine how it is best for all of us to move forward.

We urge you to contribute to this process, which will help to shape the future of the osteopathic profession. You can read and comment on the document online at scope.shapingosteopathy.org where you will also find a link to a short online survey which we hope you will complete. The survey is password protected for security. BOA members will find the password in the email accompanying June’s digital edition of Osteopathy Today. Alternatively, you can e-mail us at consultation@apdc.org.uk and we will provide you with the details.

We look forward to hearing what you think.

Nick Handoll

Coordinator for APDC (Association of Professional Development Colleges)

The APDC is constituted of the following organisations:

Osteopathic Centre for Children

Sutherland Cranial College

Osteopathic Pelvic, Respiratory & Abdominal Association

Institute of Classical Osteopathy

Sutherland Society

Society of Osteopaths in Animal Practice

Osteopathic Sports Care Association

Rollin E Becker Institute

British Osteopathic Association

A definition should be attempted only in the wider context of care. It is invidious to try to define osteopathy without a definition of medicine. If medicine is defined then perhaps a definition of osteopathy could be achieved. Osteopathy is not an “alternative” to medicine. It was not Dr Still’s intention to found a new profession. He wished to reform the existing system (Korr 1995). After a slow start in the UK with the challenges of the war and the formation of the NHS free at the point of delivery, osteopathy is now beginning to take its rightful place in the delivery of health care to the nation. In the early days, osteopaths had no choice but to restrict practice to neuromusculoskeletal conditions. There were far too few osteopaths even to attempt treating conditions beyond this narrow range. Not surprisingly, the profession developed a name for this, not because it summarised osteopathic care but because neuromusculoskeletal conditions are so extremely common and are poorly served by allopathic medicine. However, to restrict osteopathy to this narrow practice now, poorly serves public choice.

The osteopathic concept can be described simply. Dr Still recognised in the 19th century that the body is a self-healing, self-regulating, self-adjusting organism. This is conventional wisdom today. In disease, therefore, should the issue be to control the disease or should it be to find out what has impaired or compromised the self-healing, self-regulating and self-adjusting mechanisms (the health) to have allowed the disease to occur in the first place and not to have resolved on its own? There are two clear differences in philosophy here. Allopathic medicine is concerned with the control of disease, while osteopathic medicine is concerned with that which has compromised the health. Dr Still himself said “To find health should be the object of the osteopath. Anyone can find disease”.

This may be achieved many different ways. The osteopath will do what is necessary to assist the health mechanisms to resolve the disease naturally. It is not technique centred, neither is it restricted to a system of the body, a part of the body, a group of conditions, nor an age group.

The model proposed in the Consultative Document is technique centred and divisive. Osteopathy is not technique centred. What sound evidence is there for the claim that there is a typically encountered practice? This is described in Clause 35 as “the features of the typical experience most likely to be had by patients when seeing the majority of osteopaths”.
Which patients see the “the majority of osteopaths”?
How many patients are there who see “the majority of osteopaths”?

The typically encountered osteopathic practice is that which is typically performed in each individual practice. My patients and many other osteopaths’ patients would be highly alarmed if they were given the “typical approach” as described in Clause 39.

This GOsC Consultative Document should be scrapped and consultations begun not just with the BOA and Regional Societies, but with some of the groups who are driving this profession forward, such as the Foundation for Paediatric Osteopathy, the Osteopathic Sports Care Association, the visceral osteopaths, veterinary osteopaths, the Sutherland Society and the Sutherland Cranial College. There is no “lack of clarity around what constitutes osteopathic practice” (GOsC p2). The philosophical basis of osteopathy is clear.

Nicholas Handoll, DO
April 2009

This proposal is endorsed by Stuart Korth D.O., on behalf of the Foundation for Paediatric Osteopathy, Peter Armitage D.O. on behalf of the Sutherland Cranial College, Nicholas Woodhead D.O. on behalf of Post Graduate Cranial Faculty, Stephen Sandler, Ph.D., D.O. on behalf of Post Graduate Obstetric Training, and Christian Sullivan D.O. on behalf of the Sutherland Society.

Please take the time to engage the consultation process as fully as possible.