Dr Paul J Orrock

Objectives: The Research Council of the Australian Osteopathic Association (AOA) identified the need to gather data about the members of the Association as well as ‘who’ and ‘what’ they treat in order to guide strategic planning in research. Methods: A census of two parts was sent to members of the AOA (n ¼ 656). Part 1 focussed on the practitioners and part 2 on the patients. Surveys of specific groups in the osteopathic profession in New Zealand and the United Kingdom as well as earlier Australian surveys were obtained for comparative and temporal analysis. Results: The response rate was 52% of the sample population. The gender was split evenly, and the majority practice was a 32e40 h working week in one (59%) or two (33.8%) locations. They consult an estimated average of 40 patients a week (25% are new patients). In their diagnostic practice, physical examination was considered mostly in the orthopaedic and neurological systems, with a limited consideration of other systems. Referrals for diagnostic investigation were mostly for plain-film radiology. The estimated use of therapeutic modalities had soft tissue, muscle energy, non-high velocity articulation/mobilisation and high velocity manipulation consistently used, with a broad spread of others. Nutritional supplements, exercise and diet/lifestyle changes were all prescribed. Questions about inter-professional relationships revealed that practitioners refer to GPs 68.5% ‘‘occasionally’’ and 19.2% ‘‘frequently’’, masseurs 48.2% ‘‘occasionally’’ and 19.3% ‘‘frequently’’, naturopaths/herbalists 43.4% ‘‘occasionally’’ and 12.0% ‘‘frequently’’, and podiatrists 47.5% ‘‘occasionally’’ and 9.8% ‘‘frequently’’. Referrals were almost exclusively from other patients (96.1% frequently), whilst it was estimated by the respondents that GPs refer occasionally (47.9%) or frequently (17.4%). The sample placed importance on, and attended, continuing education activities, and reported that the most important professional issues were the public and health practitioners’ perception/ignorance of osteopathy followed by the need for evidence into the efficacy of osteopathic management. Conclusions: Part 1 of the survey of a sample of the members of the AOA revealed details of their qualifications and commitment to continuing education. The characteristics of respondents’ practice within a multidisciplinary network, and the utilisation of the diagnostic skills of primary care were revealed. The importance of certain issues facing the Australian osteopathic profession were identified.

Objectives: The Research Council of the Australian Osteopathic Association (AOA) identified the need to gather data about the members of the professional association as well as ‘who' and ‘what' they treat in order to guide strategic planning and research.

Methods: A two part census was sent to members of the AOA (n=656). Part 1 focussed on the practitioners and Part 2 the patients. Surveys of members of osteopathic professional associations in New Zealand, all the registrants in the United Kingdom as well as earlier Australian surveys were obtained for comparative and temporal analysis.

Results: Part 2 had a response rate of 38.9% of the AOA membership. The respondents consulted an average of 8.7 patients on 11 May 2004, 18.9% of them new patients, and 62.5% of them female. Patients were mostly aged 30–49 years (46%), but there was a large range from 0 to 80+ years. They were 89% private paying patients. These people predominantly presented to the practitioners with low back (27.3%) or neck (24.5%) pain and immobility, with symptoms of pain and immobility in thorax (5%) and thoracic spine (7%) somewhat less. Headaches accounted for 10% of presenting symptoms and were also reported in the ‘other’ section as migraines. Only small numbers of patients (4% overall) presented other symptoms (e.g. general illness, paediatric, vertigo). Many of these patients could be classified as chronic, as 51% had 12 or more weeks of history of the presenting symptom(s). They were 66% self-referred, with a mixture of other practitioners referring, including General Practitioners (GPs) at 4.6%.

The practitioners diagnosed these patients with somatic dysfunction (74%), postural dysfunction (46%), trauma (29%) and organic disease (8.9%). Therapeutic techniques employed were soft tissue (71% of patients had this technique used on them), joint articulation (57%), high velocity thrust manipulation (51%), muscle energy (50%), exercise prescription (33%), cranial (23%), functional (21%), counterstrain (17%) and myofascial (16%).

Conclusion: The patients of members of the AOA predominantly present with pain of the lower back and neck, and both spinal immobility and headaches featured as concomitant symptoms. The majority of the patients had chronic conditions, were self-referred and paid for the service without subsidy from a third party. There was also evidence for primary care practice in the diagnostic data. The use of manual treatment modalities was eclectic and interventions also included lifestyle and dietary advice and exercise prescription.