The Biopsychosocial model: Redefining osteopathic philosophy?

The Biopsychosocial model (BPS), first proposed by Engel in 1980, can be considered as both a philosophy of clinical care, and a practical guide to individual patient management. The BPS model also has the benefit of extensive supportive literature. Osteopathic philosophy, however, remains poorly defined and suffers from both a lack of published corroborating evidence of effectiveness, and a universally accepted definition of practice. This potentially leaves the osteopathic profession drifting against the tide of evidence-based practice clinging to the ‘life raft’ of what it perceives to be a distinctive philosophy, but without the evidence to support or justify swimming against the tide. As the osteopathic profession reviews its underpinning philosophy and its relevance in a fast changing evidence-based care environment, the BPS model potentially provides the answers to a number of the issues surrounding the current and future practice of osteopathy. In reviewing the accepted tenets of osteopathic philosophy in light of the BPS model, it is necessary to briefly consider aspects of science and evidence as well as the art of clinical care which all contribute to evidence-based ‘best practice’.