Osteopathy around the world

There are two main schools of thought within the osteopathic world. They are so different in practice as to be separate professions, but there have been attempts in the last few years to enhance exchange and dialogue between them.

Osteopathic physicians in the United States are licensed medical practitioners. In other countries, osteopaths continue to rely on non-surgical, non-pharmaceutical approaches, and see themselves as a complete school of manual medicine or NeuroMusculoSkeletal specialists, complementary to most mainstream medical practices. Commonwealth osteopathic students may spend up to ten times as many hours training in osteopathic diagnosis and technique as their American counterparts. Because of this specialization, they have traditionally remained as an alternative to mainstream healthcare alongside naturopaths and chiropractors. In Commonwealth countries, osteopaths have also had to compete with physiotherapists, many of whom have integrated manipulative therapy into their practice. Nevertheless, osteopathic medicine is growing in size and mainstream acceptance in many countries of the Commonwealth and Europe. Osteopathic and allopathic physicians now work side by side in academic, hospital, and clinical settings, and osteopathic medical departments are now well-established in many public universities.

Osteopathy in the United States
See also: Doctor of Osteopathic Medicine and Medical school in the United States
In the United States, osteopathy is only practiced by medical doctors. Graduates of osteopathic medical schools are awarded the Doctor of Osteopathic Medicine degree, and can become licensed to practice medicine as a physician or surgeon.

Osteopathy in the United Kingdom
In the United Kingdom osteopathy developed as a distinct profession. The first osteopathic college was established in the UK in 1917 by Littlejohn, a Scot who had studied under Dr Andrew Taylor Still. Littlejohn altered the osteopathic curriculum to include the study of physiology. The UK school he founded, the British School of Osteopathy, was the first osteopathic education institution outside the USA, and it still exists today. British osteopaths use manipulative techniques based on the philosophy of Dr Andrew Taylor Still, but are not medical doctors. Some medical doctors do undertake osteopathic training as a postgraduate interest. The profession is subject to statutory regulation following the passing of the Osteopathy Act in 1993. The General Osteopathic Council (GOsC) was established by the act to regulate the profession. There are currently seven approved training institutions in the UK. There are approximately 5000 registered osteopaths in the UK, a small but growing profession. For the sake of comparison there are approximately 36,000 physiotherapists. Most medical services in the UK are delivered through the state funded National Health Service, osteopathy is largely excluded from this with most osteopaths working in private practice. Several large studies in the UK have produced evidence of the cost-effectiveness and clinical effectiveness of manipulation in the management of low back pain, the latest being the UK Back pain Exercise And Manipulation (UK BEAM) trial.

There is an increasing interest in osteopathic medicine amongst patients, but barriers remain to osteopathic provision within the state system, among them opposition from the allopathic medical profession and physiotherapists.[citation needed] Many UK osteopaths are also naturopaths, with one osteopathic college offering a dual training in osteopathy & naturopathy (the British College of Osteopathic Medicine) and another offering a post-graduate programme (the College of Osteopaths).

In 2005 the General Medical Council of Great Britain announced that U.S.-trained D.O.s would be accepted for full medical practice rights in the United Kingdom. This decision was an important departure from the United Kingdom’s long-standing tradition of exclusively manual, or “traditional” osteopathy.

Osteopathy in Australia and New Zealand
In Australia and New Zealand the profession has developed along the same lines, and until recently neither country trained its own practitioners and relied on UK graduates. Likewise, each country maintains a government-approved list of practitioners and private health insurance reimbursement is available for osteopathic treatment. Three publicly-funded Universities now offer osteopathic medical courses in Australia. Courses consist of a bachelor’s degree in clinical science (osteopathy) followed by a master’s degree. Integration into the university system has given Australian osteopaths the opportunity to access public research funding, raised the credibility of the profession, and focused attention on refining the scope of practice through clinical trials and basic research.

Osteopathic Medicine in Canada
In Canada osteopathic physicians are trained along similar lines to those in Britain and other Commonwealth countries. Canadian Osteopaths hold the designation D.O. (M.P.) meaning Doctor of  Osteopathy (manual practice) and only practice using manual procedures. However, when US-trained osteopathic physicians visit or relocate to Canada or Great Britain, their parity with allopathic physicians is recognized and they have an unlimited scope of medical practice.

In some countries, osteopathic medicine straddles the boundary between Allopathic medicine and alternative medicine, with a variety of approaches and philosophies being brought to the practice. Osteopathic physicians are trained in standard medical differential diagnosis and have diagnostic competences similar to primary care physicians, but with a scope of practice focused mainly on musculoskeletal conditions and treatment of some other conditions by manual means. Osteopathic physicians in these countries, except Canada, do not have prescribing rights, although the British Government has included osteopathic medicine in the list of Allied health professions that may be granted prescribing rights in the future.[12].This is the way in which Osteopathic Physicians currently practice in Estonia.

Osteopathic Medicine in the European Union
Within the EU there is no standardized training or regulatory framework for osteopaths but attempts are being made to coordinate the profession within the union. There is a conflict between the principle of free movement of labour – a cornerstone of the EU – and the right to practice osteopathic medicine in different member states as there is cross-border equivalence in training and regulation of the profession. In the UK, since the Osteopaths Act, osteopathy has been a recognised profession. The UK’s General Osteopathic Council, a regulatory body set up under the country’s 1993 Osteopaths Act has issued a position paper on European regulation of osteopathy. The teaching of osteopathy in the UK, France and (European Economic Area member) Switzerland is well established – but not all European nations have yet embraced this form of medicine.

Osteopathic Medicine in Estonia:
 In Estonia, Osteopathic Medicine is strictly practiced as a form of manual medicine much in the same way as in Canada and the U.K. and is regulated by EMMKS. Osteopathic Physicians in Estonia  simply use the designation of  D.O.

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