Exploring European Osteopathic Identity: An Analysis of the Professional Websites of European Osteopathic Organizations 

Constanze Wagner, Patrick van Dun¹

Introduction: A sociologically confirmed identity crisis in osteopathy exists in the USA. The crisis stems from the inadequate demarcation of the practical activity of DOs from the allopathic activity of MDs. In Europe differences in terminology and practices exist within the osteopathic professional group, making communication difficult between osteopaths. However, the distinctive identity of European osteopathy is an important precondition for defining a professional profile that would clearly demarcate osteopathy from other medical occupations and that would also set the ultimate goals of an osteopathic degree program having an ensured level of quality and meeting the requirements for state recognition. The result would be improved communication among the osteopaths themselves and with outsiders, to the benefit of the patients as well.

Aim: To study the current status of osteopathic identity in Europe, we considered how the national professional unions and registers as well as the international osteopathic organizations currently present osteopathy.

Methods: We performed a systematic and comparative analysis of the websites of 29 European osteopathic unions and/or registers (from 19 countries) and 3 international osteopathic organizations. We based our analysis on a list of questions arranged according to 11 categories, compiled following a systematic and historical analysis of the literature with the focus on terms referring to identity, identity crisis and professionalization. Our predominantly phenomenological approach highlighted these terms in their osteopathic context.

Results: Identity is a collective notion encompassing personal, collective and professional identity. The term "identity" refers to a state of unity, continuity and coherence. Identity is inconceivable without the setting of boundaries and the formation of oppositions. There exist identity-constituting features of osteopathy that altogether make up its distinctive identity.
The professional unions and registers and international osteopathic organizations do not uniformly characterize osteopathy, however. They agree most (69%) with one another in defining osteopathy as being ‘manual in practice’. 66% of these registers and organizations describe osteopathy as a ‘system of diagnosis and treatment’. In contrast, 33% describe osteopathy as a ‘system of treatment’ (no diagnosis is mentioned). 31% define osteopathy as medicine, and 38% define it as a form of ‘therapeutic method or treatment’. Only 21% see the role of osteopathy to lie in first-line medical care. 24% define osteopathy as complementary and 7% as complementary or alternative. The form of recognition of osteopathy also varies: In some countries osteopathy is an independent profession and in others it represents only further training for other health professions (i.e. physiotherapy).

Conclusions: Significant intra-professional differences exist in the presentation of osteopathy among the European professional unions and registers and international osteopathic organizations. The existence of these differences conflicts with the idea of a collective identity. The criteria for a professionalization of osteopathy as an academic profession are not fulfilled at present. We conclude that osteopathy is undergoing a crisis of identity in Europe that can only be resolved creatively, through a common orientation of professional values.

 1 Commission for Osteopathic Research, Practice and Promotion vzw (CORPP, Belgium)

Osteopathy’s Place in Current Health Care Policy – a Phenomenological View

Karin Drexeler¹ , Patrick van Dun¹

Introduction: Today osteopaths as a professional group are striving for recognition within regular health care. An important part of this endeavor focuses on the scientific underpinning of osteopathic activities, in conformity with the criteria for evidence-based medicine as practiced in our society. Less attention is given to the philosophy of osteopathy, largely broken down into three basic concepts: (1) man as the unity of body, mind and soul, (2) the organism as a self-regulating, self-healing and self-maintaining mechanism and finally (3) the interrelation of structure and function. The philosophical basis of these three notions, that is to say, the underlying ideas about man and health, stirs much less interest. Practice shows that besides the scientific underpinning of the profession, the formulation of a specifically osteopathic identity is also greatly needed.
By neglecting the philosophy of osteopathy or even dismissing it, the professional group cuts itself loose from the foundation for and the legitimization of its actions and even of its specific identity. The envisaged goal of recognition within the regular care framework is then no longer achievable.

Purpose: To answer the question whether the philosophy of osteopathy can be expressed in terms of a contemporary phenomenological approach to sickness and health, and whether this philosophy can contribute to the debate and to the policy regarding recognition of the profession.

Method: A survey of the literature focusing on Still’s works, on the philosophical schools of dualism, Cartesianism, phenomenology, on evidence-based medicine (EBM) and on recent movements within health care policy.

Results:

1. The philosophy of osteopathy is rooted in three basic philosophical concepts that have played an important role in thinking about man and health throughout the history of Western society.
2. Changes in society and the evolution of science in our Western civilization explain the position of osteopathy today.
3. Existential phenomenology opens perspectives for expressing the philosophy of osteopathy in terms of contemporary thought.
4. The lack of clarity concerning the identity of the profession is largely due to the failure of the professional group to express its standards and values unambiguously.

Conclusion: As a philosophy, the philosophy of osteopathy offers a framework for the profession. We can formulate our added social value for health care on the basis of this philosophy, and at the same time point out the limitations of osteopathy. Finally, the philosophy of osteopathy defines the identity of the profession itself. 

1 Commission for Osteopathic Research, Practice and Promotion vzw (CORPP, Belgium)