A global view of osteopathic practice - mirror or echo chamber?

The Osteopathic International Alliance (OIA) released a report in 2013 entitled, 'Osteopathy and osteopathic medicine. A global view of practice, patients, education and the contribution to healthcare delivery'. The report was widely circulated by the statutory regulator in New Zealand. It is said to be a representative document by the OIA. Two osteopathic professional streams were identified - osteopathic physicians (and surgeons) and osteopaths. Other than by ancestry, it is apparent that these two streams are not comparable. The claim of a shared 'core practice' between the streams is not upheld by the data, which also appear to indicate a dichotomy between a claim of evidence-based practice and the nature of practice itself. The response rate to unpublished surveys does not appear to support the notion that the OIA report is representative of global osteopathic practice. The data within the OIA Report identifies the most frequently utilised form of osteopathic manipulative treatment (OMT) as osteopathy in the cranial field (OCF). These issues are explored further by comparing the bibliographies of a systematic review of cranial osteopathy conducted 12 years ago with a current snap-shot summary (2013) published by the UK National Council for Osteopathic Research. OCF appears to be an unfalsifiable practice that has become professionally institutionalised. Far from being marginalised this practice now holds a central position, one inconsistent with a claim of ethical, evidence-based best practice, and one seemingly endorsed by statutory regulators. From these perspectives then, the report appears closer to an echo chamber of belief than an accurate reflection of contemporary osteopathic practice.