Gathering place for osteopaths
What are the reasons for our patients choosing osteopathy?
Our practice comprised of three osteopaths (MRO's) in 1994 when we conducted our first survey on the subject of patient choice. The questionnaire was simple and consisted of a few questions which helped us focus on our patients' own reasons for attending their GP or other primary healthcare practitioner. We have conducted several similar surveys subsequently with similar responses each time.
According to our own patient population here are the primary reasons for them choosing osteopathy over conventional (allopathic) medicine, or other alternative medical practitioners. These are conveyed in the patients own terms and perception of what osteopathy could/might offer them....
1. Osteopathy might improve my health without relying completely on medicines or drugs.
2. Osteopaths are holistic and look at the whole patient which is important.
3. I have had a bad experience with medicines which my GP prescribed and they either didn't provide relief, didn't relieve for sufficiently long periods or had unpleasant side-effects.
4. I was recommended by my GP as he/she thought you could help.
5. A friend/relative recommended me
6. I read an article in a magazine about osteopathic medicine and wanted a second opinion on my health problem.
7. I have an interest in finding out what's causing my problems and osteopathy may help get to what these causes might be rather than covering it up with drugs.
8. I've never had any kind of manual/physical treatment before and I'd like to see for myself what it can do!
In addition to these principal reasons there were a minority of other reasons for attending. When auditing this miscellaneous group we found that they rarely attended for more than their initial consultation. What was also interesting was that patients who had attended for more than four or five appointments were much less reticent about providing their personal rational, nor reluctant about expanding on their opinions when offered the opportunity.
For those interested in statistics the patient demographic was male/female 50:50, all age groups covered between 20-70 years of age; only musculoskeletal patients included (defined by the examining osteopath); n=190
Approximately 5% declined to take part within the new patients canvassed. There was 100% uptake on existing patients who had attended for more than four treatments.
I should say that we have also employed Alexander Teachers, Reflexologists, Physiotherapists, Psychotherapists and Podiatrists to try to indicate that we wish to offer what the patient wants, rather than what we'd like them to request.
This is patient-centred holistic medicine?
According to our own patient population here are the primary reasons for them choosing osteopathy over conventional (allopathic) medicine, or other alternative medical practitioners. These are conveyed in the patients own terms and perception of what osteopathy could/might offer them....
1. Osteopathy might improve my health without relying completely on medicines or drugs.
2. Osteopaths are holistic and look at the whole patient which is important.
3. I have had a bad experience with medicines which my GP prescribed and they either didn't provide relief, didn't relieve for sufficiently long periods or had unpleasant side-effects.
4. I was recommended by my GP as he/she thought you could help.
5. A friend/relative recommended me
6. I read an article in a magazine about osteopathic medicine and wanted a second opinion on my health problem.
7. I have an interest in finding out what's causing my problems and osteopathy may help get to what these causes might be rather than covering it up with drugs.
8. I've never had any kind of manual/physical treatment before and I'd like to see for myself what it can do!
In addition to these principal reasons there were a minority of other reasons for attending. When auditing this miscellaneous group we found that they rarely attended for more than their initial consultation. What was also interesting was that patients who had attended for more than four or five appointments were much less reticent about providing their personal rational, nor reluctant about expanding on their opinions when offered the opportunity.
For those interested in statistics the patient demographic was male/female 50:50, all age groups covered between 20-70 years of age; only musculoskeletal patients included (defined by the examining osteopath); n=190
Approximately 5% declined to take part within the new patients canvassed. There was 100% uptake on existing patients who had attended for more than four treatments.
I should say that we have also employed Alexander Teachers, Reflexologists, Physiotherapists, Psychotherapists and Podiatrists to try to indicate that we wish to offer what the patient wants, rather than what we'd like them to request.
This is patient-centred holistic medicine?
Tags: evidence based medicine, holistic medicine, patient centred, patient choice
Replies to This Discussion
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Permalink Reply by Hume O'Rous on -
‘Feeling is all, the name (meaning conception or thought) but sound and smoke’.
Goethe, Faust
Why are people so fascinated by 'speed'? i understand that Jeremy Clarkson has an obsession with speed, but it doesn't appeal to me....
Have you listened to this podcast, Paul?
http://julianbaggini.blogspot.com/
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Permalink Reply by Hume O'Rous on
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I went to Baggini's discussion on philosophy at last year's 'Aye Write Festival' and found him a personable and lucid speaker. I'd read several of his books including 'The Duck that won the Lottery', 'The Pig that wants to be Eaten' and 'Complaint'. He looks remarkably like David Cameron in the looks department but was clearly having to compete as an author by having a 'style' to help his accessibility factor to the public. There are so many people writing mountains of blogs, posts and books nowadays that, much like in the music industry, you have to become an itinerant creative vagrant, homeless and detached and obliged to dedicate your life to the publishing business.
What would Bertrand Russell do to get into print in today's marketplace, I wonder?
All Julian's podcasts are worth listening to...
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Permalink Reply by Hume O'Rous on
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Dear Paul,
What a truly wonderful question you pose. I would never have guessed this question could ever have arisen!
Ever...
I will need to think about this after the New Year.... but my initial reaction would be that they would not have gelled as Still was never an intellectual thinker, and Russell would have treated him with distain. He did that with most people, so Still need not have been perturbed by this behaviour.
We cannot all be geniuses after all!
Best wishes for a Happy Hogmanay to you and yours...
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Permalink Reply by Steve on -
Still was a Vitalist, which Russell would have despised. Still was also a Christian, which Russell would have despised even more.
How could Still have entered into a dialogue with a guy whose stated worldview was:
"That man is the product of causes which had no prevision of the end they were achieving; that his origin, his growth, his hopes and fears, his loves and his beliefs are but the outcome of accidental collocations of atoms; that no fire, no heroism, no intensity of thought and feeling, can preserve an individual life beyond the grave; that all the labors of the ages, all the devotion, all the inspiration, all the noonday brightness of human genius, are destined to extinction in the vast death of the solar system, and that the whole temple of man's achievements must inevitably be buried beneath the debris of a universe in ruins - all these things, if not quite beyond dispute, are yet so nearly certain that no philosophy which rejects them can hope to stand. Only within the scaffolding of these truths, only on the firm foundation of unyielding despair, can the soul's habitation henceforth by safely built."
Blimey! Let's all slit our wrists right now and be done with it!
P.S. Despite our lives being intrinsically meaningless, Godless and pointless, and despite our worthless and pathetic existences being doomed to perish for all eternity in the entropic heat-death of the universe -
Happy New Year!
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Permalink Reply by Steve on
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Paul, Thou dissembling codpiece-sniffing barnacle!
That Russell quotation reminds me of a nice quip about the positivist philosopher Sir Alfred Ayer, who was even more dogmatic in his beliefs than Russell. One of his colleagues was heard to say "I wish I was as certain about anything as Alfred is about everything!"
May your contemplation likewise be fetterless in 2010, thou pribbling sheep-biting pumpion!
Steve
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Permalink Reply by Hume O'Rous on
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Is the rate of suicide higher in mathematical scholars (some consider Russell as much a mathematician as a philosopher), than average, and are they more inclined to be attracted to agnosticism or atheism as a result of their left hemisphere dominance?
While were on the topic of imagining the dialogue between different personalities, what would Andy Still think about Wilhelm Reich's concept of 'orgiastic potency' or Ida Rolf's theories on 'body armouring' I wonder?
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Permalink Reply by Hume O'Rous on
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I still believe that Russell would have nothing but distain for Still, who was a primitive, God fearing frontiersman who sort of reminds me of Blake and Whitman in as much as they saw God in everything... and this reflected in their everyday lives.
What did they have in common?
They were both supporters of an individuals freedom, with Still fighting the Yankees to abolish slavery and Russell fighting Big Brother, which at that time was represented by American Imperialism. They may well have been able to understand each others darker side. It is well documented by biographers such as Ray Monk that Russell suffered severe bouts of depression (like Wittgenstein his contemporary) throughout his life, and though it is not documented in any of the texts about Andrew Still I would imagine the loss of his wife and children must have brought him enormous suffering, though his spiritual convictions m,ay have been a source of comfort.
Russell wouldn't have understood his religious beliefs as he was aetheistic from an early age...
Three passions, simple but overwhelmingly strong, have governed my life: the longing for love, the search for knowledge, and unbearable pity for the suffering of mankind.
These passions, like great winds, have blown me hither and thither, in a wayward course, over a deep ocean of anguish, reaching to the very verge of despair. I have sought love, first, because it brings ecstasy—ecstasy so great that I would often have sacrificed all the rest of life for a few hours of this joy. I have sought it, next, because it relieves loneliness—that terrible loneliness in which one shivering consciousness looks over the rim of the world into the cold unfathomable lifeless abyss.
I have sought it, finally, because in the union of love I have seen, in a mystic miniature, the prefiguring vision of the heaven that saints and poets have imagined. This is what I sought, and though it might seem too good for human life, this is what—at last—I have found. With equal passion I have sought knowledge. I have wished to understand the hearts of men. I have wished to know why the stars shine. And I have tried to apprehend the Pythagorean power by which number holds sway above the flux. A little of this, but not much, I have achieved.
Love and knowledge, so far as they were possible, led upward toward the heavens. But always pity brought me back to earth. Echoes of cries of pain reverberate in my heart. Children in famine, victims tortured by oppressors, helpless old people a hated burden to their sons, and the whole world of loneliness, poverty, and pain make a mockery of what human life should be. I long to alleviate the evil, but I cannot, and I too suffer.
This has been my life. I have found it worth living, and would gladly live it again if the chance were offered to me'.
This passage reveals the problem of maintaining hope in a God-less world inhabited by those individuals who cannot sense a divine presence and believe that their human capacity to comprehend the universe is all there is.
Maybe it's Karma but I reckon Russell for all his writing and touches of genius
was essentially isolated and unable to contact others at an emotional level. His daughters biography details this aspect of the private persona which entirely refutes much of the public behaviour Russell showed.
Ironically he wrote:
"The good life is one inspired by love and guided by knowledge".
‘What I believe’ by Bertrand Russell 1925
He also wrote about death in the following passage...
I believe that when I die I shall rot, and nothing of my ego will survive. I am not young and I love life. But I should scorn to shiver with terror at the thought of annihilation.
Happiness is nonetheless true happiness because it must come to an end, nor do thought and love lose their value because they are not everlasting. Many a man has borne himself proudly on the scaffold; surely the same pride should teach us to think truly about man's place in the world.
Even if the open windows of science at first make us shiver after the cosy indoor warmth of traditional humanizing myths, in the end the fresh air brings vigor, and the great spaces have a splendor of their own.
This was quoted in The God Delusion, Richard Dawkins, 2006
I just wonder if Still's ability to get through to someone so intellectually disconnected from his physical body would have been sufficiently powerful... who can say?
I doubt it.
Also I'm not sure that Still would have had the capacity to grasp particle physics at a molecular level that Russell was learning about from Einstein and Bohr...?
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Permalink Reply by Steve on
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"Only on the bedrock of despair can Man's habitation be built......Life is merely an accidental co-location of atoms...."
No wonder Russell had bouts of depression!
Dawkins' quotation of Russell's "the fresh air brings vigour" is a neat summary of the (currently very hip, very trendy, very Western middle-class intellectual) New Atheism. The inference being that there is a certain stoic nobility in facing up to the ultimate pointlessness of existence - and maybe there is.
That is, of course, if existence is pointless. The late Freddie Ayer, committed atheist and positivist philosopher, had a near-death experience towards the end of his life, after choking on a piece of smoked salmon! Dr. Jeremy George, the medic in charge of Ayer's case, reported that Ayer (who was, according to George, completely lucid at the time) told him: "I saw a Divine Being. I'm afraid I'm going to have to revise all my books and opinions."
Ayer "toned down" his experience considerably when he wrote about it later, and even managed to put a quasi-atheist slant on his account. But who could blame him? Admitting to his doctor that he'd been mistaken about the nature of existence is one thing; admitting the same to his philosophical colleagues and fellow atheists quite another.
Donald, returning to Russell and his opinions of Still, Rolf and Reich: yes, he certainly would have despised Still's religion, and his vitalist ideas. He might, however, have accepted the practice of osteopathy as a simple mechanical treatment.
Russell might have had more time for Ida Rolf's "body armouring", as that is a psychosomatic link which - in Russell's or other materialists' opinion - is ultimately reducible to physics. (The Mind is explained by biology, biology is explained by chemistry, chemistry is explained by physics, hence the Mind is explained by physics.)
Wilhelm Reich's "orgiastic potency" might have appealed to Russell - if you've only got one life, why not discharge one's orgiastic potential as often as possible? Ultimately, however, Russell would have despised Reich for his theories on "orgone energy" which are pure vitalism - total heresy to a committed materialist.
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Permalink Reply by Steve on
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Donald, I've just realised I've answered a question you didn't ask - it was Still's attitude to Rolf and Reich that you were discussing.
I think Still might have appreciated Rolf's structural work, and would have empathised with Reich's vitalist views. However, as a 19th-century Bible-thumping Christian, he would no doubt have been horrified at Reich's concept of "orgiastic potency". Had they been contemporaries, Still might have recommended that Reich should take a large dose of bromide and a lot of cold showers!
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Permalink Reply by Hume O'Rous on
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Paul,
Is there a vaccine to stop this Anglo-Saxon "thou speckled fc*k-wit*ed aspic coated camel" s**t etc.. etc from spreading from OFA web domain into the relatively safe haven of SM...? Who started it anyway...?
If a thimerosal-free jab can be found to stop it infecting me also, may I have it please?
Any chance of returning to the subject of what patient's want from us, as opposed to other healthcare providers in the market?
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Permalink Reply by Steve on
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Patients seek us for manipulation for back pain. They've heard this hands-on stuff does some good, as opposed to ultrasound + exercise from the physio and painkillers/NSAIDs from the GP -both of which most patients have usually tried.
I don't think we should kid ourselves that patients (a) consider us as the first port of call - in most cases - or (b) have any knowledge or interest whatsoever in the so-called "philosophy" of osteopathy. They've just had a recommendation from a friend, relative or workmate that this muscle-rubbing and joint-twiddling is worth a shot, if the GP and physio have already tried and failed.
What we can offer them is more than they expect - as Paul has said, we can provide a therapeutic environment in which patients can unburden themselves. We have time to discuss not only the mechanics and physiology of their pain, but the effect of factors such as stress, suppressed emotion, diet and dehydration - most of which comes as a total surprise to most patients. ("What - you mean that eating mainly crisps and chips, drinking mainly Red Bull, Diet Coke, triple-sugared strong coffee and Lager, smoking 30 a day and hating my bloody boss has got something to do with my backache? I thought it was just a trapped nerve, that's what the Doc said!")
I often say that the most difficult thing about running an osteopathic practice is getting people through the front door. Once they've been and had treatment, they're usually happy to come back.
Sorry, Donald, about the Shakespearian banter between Paul and myself. But the Bard's insults were so rich and fruity that it's a shame not to revel in them. And they're intended affectionately, as Paul has said.
And so Paul, thou wart-necked malmsey-nosed blindworm, I loved your suggestion that Wm. Reich would have advised A. T. Still to have a jolly good Jodrell Bank. I imagine that if that had happened (in some weird alternate reality), Reich would have found himself on the receiving end of Still's fist and some dire warnings of hellfire!
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Permalink Reply by Hume O'Rous on
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The reasoning to justify a number of skilled therapists working together under the one roof, is to put the patient at the centre of the healthcare issue.
The consult if conducted in the most creative way, can often open up several issues, some of which will undoubtably be responsive to osteopathy. The problem is that each practitioner will only be able to provide a lasting solution to some of their patients, for a whole variety of legitimate reasons.
As a matter of fact I currently practice as a solitary osteopath, without any other associates as the massage therapist we employed moved on, and most others including the physiotherapists, Alexander Therapist, podiatrist and counsellors couldn't make a living working in private practice.
This situation is likely to remain the norm for the foreseeable future, unfortunately.
I used to find a homeopathic or Reiki input shone some light on the complex patient, (aren't they all?) complimenting my own understanding of the patient's perception of their health. It also helps with patients who need many hours of treatment to progress. Stops burn out...
Phil Latey's latest work explores much of this area, without the psycho-babble undertones.
'Job's Body: A Handbook for Bodywork' by Deane Juhan also explores the essence of the holistic approach... where the soma interfaces with the psyche. Not everyone gets this. Not everyone wants to, either.
I don't get Shakespeare, except maybe his sonnets. And MacBeth.
Do you intend to assist NCOR in their latest attempt to understand 'What patients want from Osteopathy'?
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