UK Trained Osteopaths and Evidence-Based Practice: Earning Respect Through Science, Not Sentiment

Healthcare professionals engage in a discussion on advancing evidence-based osteopathic care in the UK.

Introduction to the Divide: Understanding the Gap

The osteopathy profession in the UK is split between those advancing with evidence-based practices and those adhering to outdated methods. One group is moving towards clinical integration, academic rigor, and transparency, while the other relies on philosophies and techniques lacking scientific support.

The UK osteopathic profession is at a turning point. On one side are practitioners who ground their clinical reasoning in research, collaborate within multidisciplinary teams, and deliver measurable outcomes in patient care. On the other side are those who continue to depend on outdated concepts and unverified techniques rooted in tradition rather than science. This divide is not merely philosophical—it is practical, ethical, and regulatory, and it is becoming increasingly apparent to both patients and professionals.

Evidence-Based Practice: Foundation of Modern Osteopathy

Healthcare professional providing patient care in a clinic, highlighting the importance of evidence-based practices for enhanced safety and trust.

According to the General Osteopathic Council (GOsC), osteopaths must “have the knowledge and skills to support their practice as primary healthcare professionals, and must maintain and develop these throughout their careers” (1). These expectations are not optional—they are mandatory professional standards set out in the Osteopathic Practice Standards under Theme B: Knowledge, Skills and Performance (1). Practising without adhering to current evidence-based frameworks not only undermines patient safety but also breaches professional duty.

In fact, the GOsC explicitly states in its Governance Handbook that the overarching objective of the regulator is to “protect, promote and maintain the health, safety and well-being of the public” through proper professional conduct and standards (2). Practitioners are expected to evolve with scientific progress, not cling to 19th-century ideologies.

Education: The Source of Credibility

Modern UK-trained osteopaths typically complete four to five years of university-level education. This includes modules in anatomy, pathology, biomechanics, evidence appraisal, and clinical research. These degrees are regulated and externally audited to ensure they meet the healthcare and educational standards set by national and European bodies (3).

In contrast, many osteopaths who trained in the 1990s entered practice via unregulated diploma pathways that lacked academic rigour or research training. Although many of these practitioners were allowed to register with the GOsC during its early establishment, the regulatory assumption was that they would update their practice through CPD and engagement with new evidence. Unfortunately, some have not (4).

Respect from Healthcare Professionals: Earned Through Rigor

General practitioners, consultants, and surgeons increasingly refer to osteopaths who show academic competence, clinical reasoning, and interprofessional understanding. Respect is not granted merely because of the word “osteopath”—it is earned through how a practitioner conducts themselves, what they know, and how safely they practise (5).

Studies on interprofessional collaboration consistently show that allied health professionals, including osteopaths, earn respect when they demonstrate an understanding of shared care models, evidence-informed decision-making, and patient safety protocols (6). Osteopaths who disregard these foundations are less likely to be trusted or included in multidisciplinary care pathways (7).

Advertising Claims: Backed by Evidence or Not Allowed

The Committee of Advertising Practice (CAP) guidelines make it clear that any healthcare advertising in the UK must be “backed by robust clinical evidence, preferably human trials” (8). Osteopaths who make claims about curing or treating conditions like migraines, arthritis, or digestive issues without substantiation are in direct violation of CAP Code rules 12.1 and 12.2 (8). These rules are legally binding and enforced by the Advertising Standards Authority (ASA).

Furthermore, CAP classifies osteopathy under manipulation therapies (M), meaning claims must be appropriate, responsibly framed, and supported by regulated education and clinical evidence (8). This reinforces why unsubstantiated anecdotal claims do not just undermine trust—they breach legal obligations.

The Divide: Those Who Evolve vs. Those Who Resist

The split in osteopathy: Balancing between evidence-based practice and outdated beliefs.

Unfortunately, research shows a noticeable divide. A 2018 national cross-sectional survey found that while many osteopaths support evidence-based practice, a large subset—mostly older graduates—lack confidence in applying or interpreting research (9). Barriers cited included lack of training, time constraints, and, crucially, philosophical resistance to change (9).

Another UK-based survey highlighted that younger osteopaths and those trained in universities were more likely to align their practices with NICE guidelines, integrate outcome measures, and work in multidisciplinary environments—key indicators of modern, accountable healthcare (10).

Professional Duty: Research Isn’t Optional

Following evidence-based practice is not a matter of opinion. It is embedded in the Osteopaths Act 1993 and all statutory guidance since. The GOsC’s Osteopathic Practice Standards make it explicitly clear that practitioners must “evaluate the impact of your practice” and “respond appropriately to the outcomes of audits, appraisals and clinical governance procedures” (1). Ignoring evidence is not just clinically inappropriate—it may be a breach of fitness to practise.

In a time where misinformation and pseudoscience spread rapidly online, osteopaths must act as beacons of integrity. Promoting unsubstantiated therapies or rejecting clinical research not only risks harm—it damages the credibility of the entire profession.

Interdisciplinary Collaboration: The Future of Healthcare

NHS England’s push for integrated care and community musculoskeletal services is built on one principle: interdisciplinary cooperation based on evidence and shared outcomes (11). Osteopaths have the opportunity to be part of this future—but only if they align with the rest of the healthcare system in language, logic, and legality.

A 2020 review of MSK service models concluded that osteopaths trained in evidence-based protocols were more likely to receive GP referrals and integrate into local care networks (12). In contrast, those practising “alternative” models without scientific foundation were sidelined (12).

Conclusion: A Profession Divided by Choice, Not Circumstance

Healthcare professionals stand united yet distinct, illustrating choices driving divergence within the field.

The divide within UK osteopathy is not generational—it is attitudinal. Every practitioner has access to the same regulatory standards, continuing professional development, and published research. Choosing to ignore that is a choice—and one that jeopardizes the future of the profession.

Osteopaths who wish to be respected by patients, doctors, and regulators must step into the present. Respect is not a relic of the past. It is earned, defended, and maintained through knowledge, accountability, and a commitment to evidence.

References

1. General Osteopathic Council. Osteopathic Practice Standards [Internet]. London: GOsC; 2023 [cited 2025 Apr 14]. Available from: https://standards.osteopathy.org.uk/

2. General Osteopathic Council. Governance Handbook [Internet]. London: GOsC; 2025 [cited 2025 Apr 14].

3. Orrock PJ, Grace S, Vaughan B. The extent and quality of evidence for osteopathic education: A scoping review. Int J Osteopath Med. 2023;49:100107. doi:10.1016/j.ijosm.2023.100107

4.  Plunkett A, Carnes D, Vogel S, Pincus T. Osteopathic practice in the United Kingdom: A retrospective analysis. PLoS One. 2022;17(7):e0270806. doi:10.1371/journal.pone.0270806

5.  ⁠Suter E, Deutschlander S, Mickelson G, Nurani Z, Lait J. Can interprofessional collaboration provide health human resources solutions? J Interprof Care. 2012;26(4):261–8.

6.  Greenstock L, Molloy EK, Fiddes P, Rees CE. Reflections on professional identity formation in health professions education. Adv Health Sci Educ Theory Pract. 2021;26(2):591–605.

7. Reeves S, Lewin S, Espin S, Zwarenstein M. Interprofessional Teamwork for Health and Social Care. Oxford: Wiley-Blackwell; 2010.

8. Committee of Advertising Practice. Health, beauty, slimming and medical conditions: Advertising Guidance (non-broadcast) [Internet]. London: CAP; 2008 [cited 2025 Apr 14]. Available from: https://www.cap.org.uk/Advice-Training-on-the-rules/Help-Notes.aspx

9. Leach MJ, Sundararajan V, Gillham D, May SJ. Attitudes, skills and use of evidence-based practice among UK osteopaths: A national cross-sectional survey. BMC Health Serv Res. 2018;18(953). doi:10.1186/s12913-018-3750-7

10. Carnes D, Plunkett A, Ellard DR. UK trained osteopaths’ relationship to evidence based practice: A national cross-sectional survey. Int J Osteopath Med. 2017;26:14–23. doi:10.1016/j.ijosm.2017.08.002

11. NHS England. Musculoskeletal health: 5 year strategic framework for prevention across the life course [Internet]. London: NHS; 2018. Available from: https://www.england.nhs.uk/

12. CSP & ARMA. MSK Service Mapping Report 2020. London: Arthritis and Musculoskeletal Alliance; 2020.