‘It's all connected, so it all matters' - the fallacy of osteopathic anatomical possibilism

The global health and wellness industry has an estimated value of $4 trillion USD, of which traditional and complementary medicine (osteopathy included) represent $359.7 billion USD (almost 9 %). While some European countries are gradually recognizing osteopathy as an independent health profession and regulating it in a timely manner, in Spain, osteopathy characterized by a lack of consensus within the professional community itself and the lack of regulation. In February 2019, the Government of Spain launched a campaign (#coNprueba) that was part of the "Plan against pseudotherapies and pseudosciences". In Spain, there is a serious possibility that it will be banned or that osteopathy will be classified as a subspecialization of other health professions (despite this contravening existing national laws). This could set a dangerous precedent for those countries where osteopathy is in the process of being recognized, as it could paralyze such implementation. The aim is to understand how it might be possible to change this trend to promote the education of new osteopaths, foster a culture of research, and obtain regulated status. A narrative report based on the literature addresses current issues, including sources of debate and controversy. The hand of osteopathy is outstretched to define a collaborative strategy in defence of a freely accessed, plural, safe, and regulated profession in Spain. Spain's own efforts could help the international osteopathy community define its niche and identity and determine the most flexible way to combine tradition and modernity. 

The Importance of Constructing an Osteopathic Profession Around Modern Common Academic Values and Avoiding Pseudoscience; the Spanish Experience

In diesem Kommentar werden die grundlegenden Annahmen, Praktiken und die behaupteten Besonderheiten, auf denen die Osteopathie basiert, kritisch untersucht. 5 Bereiche werden als höchst problematisch für die Osteopathie angesehen: die schwache theoretische Basis, die inhärente Biomedikalisierung, der Monointerventionismus, die standardmäßige Zentrierung auf die Therapeutin resp. den Therapeuten und die Vorliebe für nicht plausible Mechanismen. Wir argumentieren, dass diese Bereiche überdacht und Maßnahmen ergriffen werden müssen, um die Entwicklung, Einheit und Legitimität des osteopathischen Berufs nicht zu gefährden. Die zugrunde liegenden Theorien, Annahmen und daraus abgeleiteten Fähigkeiten müssen auf der Grundlage aktueller Erkenntnisse und des Wissens aus nicht-osteopathischen Disziplinen neukonzipiert werden. Implikationen für die Praxis: Die schwache theoretische Basis der Osteopathie, die Biomedikalisierung, der Monointerventionismus, die Praxiszentriertheit und die nicht plausiblen Mechanismen sind problematisch und stellen eine große Gefahr für die Entwicklung, Einheit und Legitimität der Osteopathie dar. Ständige kritische Reflexion, Neukonzipierung der Praxis und Forschung sind für die osteopathische Professionalität erforderlich. Osteopath*innen sollten sich auf Theorien und Erkenntnisse aus nicht-osteopathischen Fachbereichen stützen. This commentary critically examines the foundational assumptions, practices and claimed distinctiveness upon which osteopathy was built and continues to be structured. Five areas which are considered to be highly problematic for osteopathy, namely its weak theoretical basis, inherent biomedicalism, monointerventionism, default practitioner-centredness and predilection for implausible mechanisms. It is argued that these areas require considerable reflection and action as if not remedied, they constitute a major threat to the development, unity and legitimacy of the osteopathic profession. Ongoing reconceptualisation of underpinning theories, assumptions and associated skills informed by current evidence and knowledge from disciplines outside of the osteopathic domain is necessary for professional maturation. Implications for practice: Osteopathy’s weak theoretical basis, biomedicalism, monointerventionism, practitionercentredness and implausible mechanisms are problematic. These constitute a major threat to the development, unity and legitimacy of osteopathy. Ongoing critical reflection, practice reconceptualisation and research are needed for professional maturation. Osteopaths should draw on theory and evidence from outside the osteopathic domain. 

Was stimmt nicht mit der Osteopathie?

This interview-based thematic analysis examines the evolving professional identities and practices of osteopathic physicians (DOs) in North American professional sports (baseball, basketball, football, hockey, and soccer) to understand the extent to which DOs employ osteopathic-specific skill sets in their work with player-patients. In addition, the study sought to understand the prevalence of professional bias, interprofessional dynamics between DOs and other health professionals, and other factors such as management.This qualitative, interview-based study is grounded in twelve semi-structured interviews with 41% of DOs (all nonsurgical, primary care sports medicine trained) working with North American professional sports teams. Interviews were transcribed and coded to identify key themes and representative quotes.Findings suggest that DOs believe their training and philosophical orientation positions them well to make important contributions to serving the medical needs of professional sports teams. At the same time, DOs are careful about championing an osteopathically-specific approach to patient care, such as evoking osteopathic principles of care or techniques such as Osteopathic Manipulative Medicine. This is the case for several reasons, the most important of which is a strong drive toward collaboration and collegiality within professional sports medicine teams.This study finds that in navigating the complexities of osteopathic identity, DOs working in professional sports are proud of their osteopathic orientation and report experiencing little discrimination, but also downplay what has historically distinguished their practice from that of other healthcare professionals. These findings have consequences for how scholars think about emerging professional identities in sports medicine, generally, as well as the fast-growing profession of osteopathic medicine specifically. 

A Thematic Analysis of Osteopathic Physicians’ Identities and Experiences in North American Professional Sports

Objective This interview-based thematic analysis examines the evolving professional identities and practices of osteopathic physicians (DOs) in North American professional sports (baseball, basketball, football, hockey, and soccer) to understand the extent to which DOs employ osteopathic-specific skill sets in their work with player-patients. In addition, the study sought to understand the prevalence of professional bias, interprofessional dynamics between DOs and other health professionals, and other factors such as management. Methods This qualitative, interview-based study is grounded in twelve semi-structured interviews with 41% of DOs (all nonsurgical, primary care sports medicine trained) working with North American professional sports teams. Interviews were transcribed and coded to identify key themes and representative quotes. Results Findings suggest that DOs believe their training and philosophical orientation positions them well to make important contributions to serving the medical needs of professional sports teams. At the same time, DOs are careful about championing an osteopathically-specific approach to patient care, such as evoking osteopathic principles of care or techniques such as Osteopathic Manipulative Medicine. This is the case for several reasons, the most important of which is a strong drive toward collaboration and collegiality within professional sports medicine teams. Conclusion This study finds that in navigating the complexities of osteopathic identity, DOs working in professional sports are proud of their osteopathic orientation and report experiencing little discrimination, but also downplay what has historically distinguished their practice from that of other healthcare professionals. These findings have consequences for how scholars think about emerging professional identities in sports medicine, generally, as well as the fast-growing profession of osteopathic medicine specifically.

https://www.dovepress.com/getfile.php?fileID=83957

Evocations of Osteopathy's founder and questions for contemporary osteopathic professional identity: A thematic analysis

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Evocations of Osteopathy's founder and questions for contemporary osteopathic professional identity: A thematic analysis