From distinct to indistinct, the life cycle of a medical heresy. Is osteopathic distinctiveness an anachronism?

Osteopathy began life as a medical heresy. In the USA, osteopathy embraced medicine and surgery, with an inevitable diminution of distinctiveness. Osteopaths elsewhere practice in much the same way as a century ago. Limited to manual intervention, categorised as ‘allied’, ‘complementary’ or ‘alternative’, distinctiveness is now diminished by similarity with other professional groups. In contrast though to late nineteenth century practice, osteopaths today are the beneficiaries of hitherto unimaginable medical and scientific knowledge, and the target of an omnipresent societal demand for evidence-based practice (EBP), that is requiring of professional and institutional support through explicit policy. There is an urgent need to overcome a cultural torpitude within osteopathy to subject any and all aspects of practice to robust scientific scrutiny, and in particular to relinquish those aspects that have assumed the dimensions of a bloated sacred cow, whose chief requirement for sustenance is faith. To manifest both distinctiveness and professional visibility, determined engagement with science (the evidence), and with other communities whether in clinical practice or in the basic sciences is now imperative. Marginalisation through progressive irrelevance is a poor alternative.