| There are two main schools of thought | | | | being the UK Back pain Exercise And |
| within the osteopathic world. They are | | | | Manipulation (UK BEAM) trial, There is |
| so different in practice as to be | | | | an increasing interest in osteopathy |
| separate professions, but there have | | | | amongst patients, but barriers remain to |
| been attempts in the last few years to | | | | osteopathic provision within the state |
| enhance exchange and dialogue between | | | | system; not the least being hostility |
| them.[7] | | | | from the orthodox medical profession and |
| Osteopathic physicians in the United | | | | physiotherapists. Many UK osteopaths are |
| States are medical practitioners; see | | | | also naturopaths, with one osteopathic |
| Osteopathic medicine for further | | | | college offering a dual training in |
| details. | | | | osteopathy & naturopathy (the British |
| The international model of osteopathic | | | | College of Osteopathic Medicine) and |
| medicine is significantly different to | | | | another offering a post-graduate program |
| that in the U.S. Osteopaths continue to | | | | (the College of Osteopaths). |
| rely on non-surgical, non-pharmaceutical | | | | In 2005 the General Medical Council of |
| approaches, and see themselves as a | | | | Great Britain announced that |
| complete school of manual medicine or | | | | U.S.-trained D.O.s would be accepted for |
| NMS specialists, complementary to most | | | | full medical practice rights in the |
| mainstream medical practices. | | | | United Kingdom. This decision was an |
| Commonwealth osteopathic students may | | | | important departure from the United |
| spend up to ten times as many hours | | | | Kingdom's long-standing tradition of |
| training in osteopathic diagnosis and | | | | exclusively manual, or "traditional" |
| technique as their American | | | | osteopathy. |
| counterparts. Because of this | | | | Australia and New Zealand |
| specialization, they have traditionally | | | | In Australia and New Zealand the |
| remained relegated to the fringe of | | | | profession has developed along the same |
| healthcare alongside naturopaths, | | | | lines, and until recently neither |
| chiropractors and others. In | | | | country trained its own practitioners |
| Commonwealth countries, osteopaths have | | | | and relied on UK graduates. Likewise, |
| also had to compete with | | | | each country maintains a |
| physiotherapists, many of whom have | | | | government-approved list of |
| integrated manipulative therapy into | | | | practitioners and private health |
| their practice. Nevertheless, osteopathy | | | | insurance reimbursement is available for |
| is growing in size and mainstream | | | | osteopathic treatment. Three |
| acceptance in many countries of the | | | | publicly-funded Universities now offer |
| Commonwealth and Europe. More and more | | | | osteopathic medical courses in |
| osteopaths are now working alongside the | | | | Australia. Courses consist of a |
| mainstream in interdisciplinary | | | | bachelor's degree in clinical science |
| settings, and osteopathic departments | | | | (osteopathy) followed by a master's |
| are now well-established in many public | | | | degree. Integration into the university |
| universities. | | | | system has given Australian osteopaths |
| Osteopathic medicine in the UK, | | | | the opportunity to access public |
| Australia, Canada , New Zealand and | | | | research funding, raised the credibility |
| India. | | | | of the profession, and focused attention |
| The United Kingdom | | | | on refining the scope of practice |
| In the United Kingdom osteopathy | | | | through clinical trials and basic |
| developed as a distinct profession. The | | | | research. |
| first osteopathic college was | | | | Canada |
| established in the UK in 1917 by | | | | In Canada osteopaths are trained along |
| Littlejohn, a Scot who had studied under | | | | similar lines to those in Britain and |
| Dr Andrew Taylor Still. Littlejohn | | | | other Commonwealth countries. However, |
| altered the osteopathic curriculum to | | | | when US-trained osteopathic physicians |
| include the study of physiology. The UK | | | | visit or relocate to Canada or Great |
| school he founded, the British School of | | | | Britain, they have an unlimited scope of |
| Osteopathy, was the first osteopathic | | | | medical practice. |
| education institution outside the USA, | | | | In all four countries osteopathy |
| and it still exists today. British | | | | straddles the boundary between orthodox |
| osteopaths use manipulative techniques | | | | and complementary or alternative |
| based on the philosophy of Dr Andrew | | | | medicine, with a variety of approaches |
| Taylor Still, but are not medical | | | | and philosophies being brought to the |
| doctors. Some medical doctors do | | | | practice. The model of osteopathy |
| undertake osteopathic training as a | | | | employed is essentially a drug-free |
| postgraduate interest. The profession is | | | | system of manual therapy. Osteopaths are |
| subject to statutory regulation | | | | trained in standard medical differential |
| following the passing of the Osteopathy | | | | diagnosis and have diagnostic |
| Act in 1993. The General Osteopathic | | | | competences similar to primary care |
| Council (GOsC) was established by the | | | | physicians, but with a scope of practice |
| act to regulate the profession, to | | | | focused mainly on musculoskeletal |
| protect the public by maintaining a | | | | conditions and treatment of some other |
| register of practitioners, to | | | | conditions by manual means. Osteopaths |
| investigate allegations of professional | | | | in these countries,except Canada, do not |
| misconduct, and to ensure the quality of | | | | have prescribing rights, although the |
| training. Since 2001, there has been | | | | British Government has included |
| graduate only entry to the register. | | | | osteopathy in the list of professions |
| There are currently seven approved | | | | allied to medicine that may be granted |
| training institutions in the UK. There | | | | prescribing rights in the future, Health |
| are approximately 5000 registered | | | | & Social Care Act 2001. Unless |
| osteopaths in the UK, a small but | | | | separately qualified as a medical doctor |
| growing profession. For the sake of | | | | or holder of a doctorate degree, |
| comparison there are approximately | | | | osteopaths in New Zealand or the UK do |
| 36,000 physiotherapists. Most medical | | | | not use the honorific title of Doctor. |
| services in the UK are delivered through | | | | Contested by some osteopaths, there is a |
| the state funded National Health | | | | campaign to use the title Doctor anyway. |
| Service, osteopathy is largely excluded | | | | Australian osteopaths routinely call |
| from this with most osteopaths working | | | | themselves Doctor. There is a debate on |
| in private practice. Several large | | | | what differentiates an osteopath from a |
| studies in the UK have produced evidence | | | | chiropractor from a physiotherapist in |
| of the cost-effectiveness and clinical | | | | these countries, rather than the D.O. |
| effectiveness of manipulation in the | | | | M.D. debate in the USA. |
| management of low back pain, the latest | | | | |