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{{Wikipedia|Osteopathy|Osteopathy|19.9.18}}

'''Osteopathy''' is an approach to health care that emphasizes the role of the musculoskeletal system in health and disease. In most countries osteopathy is a form of complementary medicine, emphasizing a holistic approach and the skilled use of a range of manual and physical treatment interventions (osteopathic manipulative medicine, or OMM in the United States) in the prevention and treatment of disease. In practice, this most commonly relates to musculoskeletal problems such as back and neck pain. Many osteopaths see their role as facilitating the body's own recuperative powers by treating musculoskeletal or somatic dysfunction. According to the American Osteopathic Association, the difference between an osteopath and an osteopathic physician is often confused. In the United States, Doctors of Osteopathic Medicine (D.O.s) are fully licensed medical physicians and surgeons, practicing in all clinical specialties along with their M.D. colleagues. Just like M.D.s, D.O.s practice the full scope of medicine.

The government policy and legal framework in which practitioners operate vary greatly from country to country, with some having both non-physician "osteopaths" and medically trained "osteopathic physicians".

== History ==

{{See also|Osteopathic medicine in the United States#History|l1=Osteopathic medicine in the United States: History}} The practice of osteopathy began in the United States in 1874. The term "osteopathy" was coined by Andrew Taylor Still, MD, DO. Still was a physician and surgeon,<ref>{{cite web|url=http://cdm.sos.mo.gov/cdm4/document.php?CISOROOT=/atsu&CISOPTR=693&REC=1|title='&#39;Medical Registration for Macon County, MO as of March 27, 1874,'&#39; Missouri Digital Heritage, Secretary of State of Missouri|accessdate=13 November 2011}}</ref>{{#tag:ref|{{cite web |url=http://cdm.sos.mo.gov/cdm4/item_viewer.php?CISOROOT=/atsu&CISOPTR=759&CISOBOX=1&REC=2 |title=Medical registration for Adair County, MO dated 28 July 1883 |publisher=Missouri Digital Heritage, Secretary of State of Missouri}}}} a Kansas state and territorial legislator,<ref>{{cite web|url=http://cdm.sos.mo.gov/cdm4/document.php?CISOROOT=/atsu&CISOPTR=685&REC=2|title='&#39;Six Survivors of First Free State Legislature in Kansas, Topeka Daily Capital'&#39;, Missouri's Digital Heritage, Secretary of State of Missouri|publisher=Cdm.sos.mo.gov|accessdate=13 November 2011}}</ref> a free state leader,<ref>{{cite web|url=http://cdm.sos.mo.gov/cdm4/document.php?CISOROOT=/atsu&CISOPTR=670&REC=1|title=Charles E. Still (son) – Letters to Edith Mellor, DO. Missouri's Digital Heritage, Secretary of State of Missouri|publisher=Cdm.sos.mo.gov|accessdate=13 November 2011}}</ref> and one of the founders of Baker University.<ref>Autobiography of A.T. Still, A.T. Still, Kirksville, Missouri, 1908, p. 97–8.</ref> He lived near Baldwin City, Kansas at the time of the American Civil War and it was there that he founded the practice of osteopathy.<ref>{{cite web|url=http://www.lasr.net/pages/city.php?Baldwin%20City&Kansas&City_ID=KS0301001&VA=Y&Attraction_ID=KS0301001a017|title=Baldwin City, Kansas|quote=Among Free State leaders was Andrew T. Still, founder of osteopathy, whose theory of healing developed here.}}</ref>

Andrew Still held a view common to early 19th century proponents of [[Alternative_medicine|alternative medicine]], supporting the idea that the body's natural state tends toward health and inherently contains the capacity to battle any harmful threats to health in the body.<ref name=":0">{{Cite book|url=https://link.springer.com/chapter/10.1007/978-1-4899-3067-5_1|title=Osteopathic Athletic Health Care|last=McKone|first=W. Llewellyn|date=1997-01-01|publisher=Springer US|isbn=978-0-412-59090-0|pages=1–9|language=en|doi=10.1007/978-1-4899-3067-5_1|chapter=History of osteopathy}}</ref> This view was opposed to that of the orthodox practitioner, which held that intervention by the physician was necessary to restore health in the patient. The division between irregular medicine, also known as unorthodox medicine, and regular medicine that resulted because of these differing views was a major conflict for decades before Still established the basis for osteopathy.<ref>{{Cite book|title=Nature Cures: The History of Alternative Medicine in America|last=Whorton|first=James C.|publisher=Oxford University Press, Inc|year=2002|isbn=978-0-19-514071-2|location=New York|pages=8}}</ref> The foundations of this divergence may be traced back to the mid-18th century when specificity in physiology became the central study that pointed to the cause and nature of disease. Diseases began to be localized to organs and tissues, and doctors began shifting their focus from the patient to the internal state of the body, resulting in an issue labeled as the problem of the "vanishing patient".<ref name=":1">{{Cite book|title=Nature Cures: The History of Alternative Medicine in America|last=Whorton|first=James C.|publisher=Oxford University Press|year=2002|isbn=978-0-19-514071-2|location=New York|pages=15}}</ref> A stronger movement towards experimental and scientific medicine was then developed. In the perspective of the unorthodox physicians, the sympathy and holism that was integral to medicine in the past were left behind. Heroic medicine became the convention for treating patients, with aggressive practices like bloodletting and prescribing chemicals such as mercury, becoming the forefront in therapeutics.<ref>{{Cite book|title=Nature Cures: The History of Alternative Medicine in America|last=Whorton|first=James C|publisher=Oxford University Press|year=2002|isbn=978-0-19-514071-2|location=New York|pages=4}}</ref> Alternative medicine had its beginnings in the early 19th century, when gentler practices in comparison to Heroic medicine began to emerge. [[Homeopathy|Homeopaths]], Thomsonians, and hydropaths practiced unconventional forms of healing that may have had strong appeal to patients due to their more attenuated practices.<ref name=":1" /> As alternative medicine grew to include more followers, orthodox medicine continued to rebuke and seek to invalidate the "irregulars," as termed by the orthodox practitioners in Heroic medicine. As each side sought to defend its practice, a schism was presented itself in the medical marketplace, with both the irregular and regular practitioners attempting to discredit the other. The irregulars—those that are now referred to as Alternative Medicine practitioners—argued that the regulars practiced an overly mechanistic approach to treating patients, treated the symptoms of disease instead of the original causes, and were blind to the harm they were causing their patients. Regular practitioners had a similar argument, labeling unorthodox medicine as unfounded, passive, and dangerous to a disease-afflicted patient.<ref>{{Cite book|title=Natures Cures:The History of Alternative Medicine in America|last=Whorton|first=James C|publisher=Oxford University Press|year=2002|isbn=978-0-19-514071-2|location=New York|pages=18}}</ref> This is the medical environment that pervaded throughout the 19th century, and this is the setting that Still entered when he began developing his idea of osteopathy.

After experiencing the loss of his wife and three daughters to spinal meningitis and noting that the current orthodox medical system could not save them, Still may have been prompted to shape his reformist attitudes towards the conventional medicine.<ref name=":2">{{Cite journal|last=Gevitz|first=Norman|date=2014-01-01|title=A Degree of Difference: The Origins of Osteopathy and First Use of the </ref> Still set out to reform the orthodox medical scene and establish a practice that did not so readily resort to drugs, purgatives, and harshly invasive therapeutics to treat a person suffering from ailment,<ref name=":0" /> similar to the mindset of the irregulars in the early 19th century. Thought to have been influenced by spiritualist figures such as Andrew Jackson Davis and ideas of magnetic and electrical healing, Still began practicing manipulative procedures that were intended to restore harmony in the body.<ref name=":2" /> Over the course of the next twenty five years, Still attracted support for his medical philosophy that disapproved of orthodox medicine, and shaped his philosophy for osteopathy. Components of this philosophy included the idea that structure and function are interrelated and the importance of each piece of the body in the harmonious function of its whole.

Still sought to establish a new medical school that could produce physicians trained under this philosophy, and be prepared to compete against the orthodox, or allopathic physicians. The American School of Osteopathy was established on 20 May 1892, in Kirksville, Missouri. Twenty-one students made up this first class.<ref>{{Cite journal|last=Peter|first=Wagner,|date=2011-04-11|title=History of Osteopathy|url=http://thescholarship.ecu.edu/handle/10342/3694|language=en-US}}</ref> Still explains the science of osteopathy in his book "The philosophy and mechanical principles of osteopathy" in 1892.<ref>{{Cite book|url=http://www.anatomy4beginners.com/resources/The%20Philosophy%20and%20Mechanical%20Principles%20of%20Osteopathy%20AT%20Still%201902.pdf|title=The philosophy and mechanical principles of osteopathy (full text)|author=Andrew Taylor Still, Discoverer of the Science of Osteopathy; Founder and President of the American School of Osteopathy|place= KANSAS CITY, Mo.|publisher=HUDSON-KIMBERLY PUB. CO.|year=1892}} This edition 1902; copyright 1892. Chapters: Preface; Introduction; I. Important Studies; II. Some Substances of the Body; III. Divisions of the Body; IV. Head, Face, and Scalp; Chapter V. The Neck; VI. The Thorax; VII. The Diaphragm; VIII. The Abdomen; IX. The Pelvis; X. Fevers; XI. Biogen; XII. Smallpox; XIII. Obesity; XIV. Ear-Wax and Its Uses; XV. Convulsions; XVI. Obstetrics.</ref>

Still named his new school of medicine "osteopathy", reasoning that "the bone, osteon, was the starting point from which [he] was to ascertain the cause of pathological conditions".<ref>{{cite web|url=http://www.meridianinstitute.com/eamt/files/webster1/webcont.html#HOW%20I%20CAME%20TO%20ORIGINATE%20OSTEOPATHY|archiveurl=https://web.archive.org/web/20101205145639/http://meridianinstitute.com/eamt/files/webster1/webcont.html#HOW%20I%20CAME%20TO%20ORIGINATE%20OSTEOPATHY|archivedate=5 December 2010|website=Early American Manual Therapy|title=Concerning Osteopathy|first=George V. | last=Webster, D.O.|date=1919|deadurl=yes|df=dmy-all}}</ref> While the state of Missouri granted the right to award the MD degree,<ref>{{cite web |url=http://www.nj.gov/highereducation/AGMEC/osteopathic_med_school_accreditation_standards.pdf |title=Commission on Osteopathic College Accreditation |publisher=State of New Jersey |deadurl=yes |archiveurl=https://web.archive.org/web/20080908041004/http://www.nj.gov/highereducation/AGMEC/osteopathic_med_school_accreditation_standards.pdf |archivedate=8 September 2008 |df=dmy-all }}</ref> he remained dissatisfied with the limitations of conventional medicine and instead chose to retain the distinction of the DO degree.<ref>{{cite web |url=http://history.osteopathic.org/educate.shtml |title=Osteopathic Virtual Museum |accessdate=13 November 2011 |deadurl=yes |archiveurl=https://web.archive.org/web/20120316164329/http://history.osteopathic.org/educate.shtml |archivedate=16 March 2012 |df=dmy-all }}</ref> In the early 20th century, osteopaths across the United States sought to establish law that would legitimize their medical degree to the standard of the allopathic medic.<ref name="Booth">{{Cite book|url=https://books.google.com/?id=tO8yAQAAMAAJ&pg=PR9&dq=history+of+ostepathy#v=snippet&q=legislature&f=false|title=History of Osteopathy: And Twentieth-century Medical Practice|last=Booth|first=Emmons Rutledge|date=1905-01-01|publisher=Press of Jennings and Graham|language=en}}</ref> The processes were arduous, and not without conflict. In some states, it took years for the bills to be passed. Osteopaths were often ridiculed and in some cases arrested,<ref name="Booth" /> but in each state, osteopaths managed to achieve the legal acknowledgement and action they set out to pursue.

In 1898 the American Institute of Osteopathy started the ''Journal of Osteopathy'' and by that time four states recognized osteopathy as a profession.<ref>{{cite journal|title=General Notices|journal=Popular Science Monthly|date=Mar 1898|page=710|url=https://www.biodiversitylibrary.org/page/20879097|accessdate=14 May 2013}}</ref>

== Worldwide ==

The osteopathic profession has evolved into two branches, non-physician manual medicine osteopaths and full scope of medical practice osteopathic physicians. These groups are so distinct that in practice they function as separate professions. The regulation of non-physician manual medicine osteopaths varies greatly between jurisdictions. In Australia, the UK, and New Zealand the non-physician manual medicine osteopaths are regulated by statute and practice requires registration with the relevant regulatory authority. The Osteopathic International Alliance has a country guide with details of registration and practice rights and the International Osteopathic Association has a list of all accredited osteopathic colleges.<ref>{{cite web|title=Directories|url=http://www.oialliance.org/directories.htm|publisher=Osteopathic International Alliance|accessdate=27 July 2012}}</ref>

Several international and national organizations exist relating to osteopathic education and political advocacy. Similarly, there is also an international organization of organizations for national osteopathic and osteopathic medical associations, statutory regulators, and universities/medical schools offering osteopathic and osteopathic medical education, known as the Osteopathic International Alliance (OIA).<ref>{{cite web |url=http://www.oialliance.org/ |title=Osteopathic International Alliance |accessdate=13 November 2011}}</ref>

The following sections describe the legal status of ''osteopathy'' and ''osteopathic medicine'' in each country listed.

=== Australia ===

Osteopaths work in private practice, and the majority of private health insurance providers cover treatment performed by osteopaths.<ref>{{cite web|url=http://www.oialliance.org/pdf/australia_osteopathy.pdf|title=''Osteopathy in Australia'', Osteopathic International Alliance. Retrieved 26 February 2011.|publisher=|deadurl=yes|archiveurl=https://web.archive.org/web/20120324124423/http://www.oialliance.org/pdf/australia_osteopathy.pdf|archivedate=24 March 2012|df=dmy-all}}</ref> In addition, treatment performed by osteopaths is covered by the public healthcare system in Australia ([[Medicare_(Australia)|Medicare]])<ref name="Medicare Australia">{{cite web|title=Chronic Disease Management - Individual Allied Health Services under Medicare - Provider Information|url=http://www.health.gov.au/internet/main/publishing.nsf/Content/health-medicare-health_pro-gp-pdf-allied-cnt.htm|publisher=Medicare Australia}}</ref> under the Chronic Disease Management plan.

Osteopaths in Australia undertake a minimum of five years' university training in anatomy, physiology, pathology, general medical diagnosis and osteopathic techniques to be eligible to practice.<ref name="ahpra.gov.au" />

Osteopathy Australia<ref>{{cite web|title=Osteopathy Australia|url=http://www.osteopathy.org.au|publisher=Osteopathy Australia|accessdate=10 July 2014}}</ref> (formerly the Australian Osteopathic Association) is a national organization representing the interests of Australian osteopaths, osteopathy as a profession in Australia, and consumers' right to access osteopathic services. Founded in 1955 in Victoria, the Australian Osteopathic Association became a national body in 1991 and became Osteopathy Australia in 2014.<ref>{{cite web|title=Allied Health Professions Australia (AHPA)|url=http://www.ahpa.com.au/|publisher=Allied Health Professions Australia (AHPA)|accessdate=10 July 2014}}</ref> and is a member of the Osteopathic International Alliance.<ref>{{cite web|title=Osteopathic International Alliance|url=http://wp.oialliance.org/|publisher=Osteopathic International Alliance|accessdate=10 July 2014}}</ref>

The Osteopathy Board of Australia<ref>{{cite web|url=http://www.osteopathyboard.gov.au/Codes-and-Guidelines.aspx|title=Board of Australia Codes & Guidelines of the Profession|website=www.osteopathyboard.gov.au|deadurl=yes|archiveurl=https://web.archive.org/web/20110219150950/http://www.osteopathyboard.gov.au/Codes-and-Guidelines.aspx|archivedate=19 February 2011|df=dmy-all}}</ref> is part of the Australian Health Practitioner Regulation Agency which is the regulatory body for all recognized health care professions in Australia.<ref name="ahpra.gov.au">{{cite web|url=http://www.ahpra.gov.au/ |title=Australia Health Professions Regulatory Agency |accessdate=13 November 2011}}</ref> The Osteopathic Board of Australia is separate from the Medical Board of Australia which is the governing body that regulates medical practitioners. Osteopaths trained internationally may be eligible for registration in Australia, dependent on their level of training and following relevant competency assessment.<ref name="ahpra.gov.au" />

=== Canada ===

In Canada, the titles "osteopath" and "osteopathic physician" are protected in some provinces by the medical regulatory college for physicians and surgeons.<ref>{{cite web|url=http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91m30_e.htm |title=Ontario Medicine Act – Restricted Titles, Section 9 |publisher=Province of Ontario, Canada |accessdate=13 November 2011}}</ref><ref>{{cite web|url=http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/19_416_2008 |title='&#39;British Columbia Medical Practitioners Act,'&#39; Section 40 Registration of Osteopaths |date=1 June 2009 |accessdate=13 November 2011}}</ref><ref>{{cite web|url=http://www.canlii.org/ab/laws/sta/m-11/20060310/whole.html |title='&#39;Alberta Medical Profession Act,'&#39; Sections 3 and 18 |accessdate=13 November 2011}}</ref> As of 2011, there were approximately 20 U.S.-trained osteopathic physicians, all of which held a Doctor of Osteopathic Medicine degree, practicing in all of Canada.<ref>{{cite web|url=http://thedo.osteopathic.org/?p=80661 |title=MSUCOM pilot program targets Canadian students for training |publisher=The DO |accessdate=3 May 2014}}</ref> As of 2014, no training programs have been established for osteopathic physicians in Canada.<ref name="Who Provides Osteopathy">{{cite web|url=http://osteopathyontario.org/about-osteopathy/who-provides-osteopathy/|title=Who Provides Osteopathy? |publisher=Ontario Association of Osteopathic Manual Practitioners |accessdate=28 April 2014}}</ref>

The non-physician manual practice of osteopathy is practiced in most Canadian provinces.<ref>{{cite web|url=http://www.osteopathy.ca/provinces.html |title=Who is an Osteopath in Canada? |publisher=Canadian Federation of Osteopaths |accessdate=3 May 2014}}</ref> As of 2014, manual osteopathic practice is not a government-regulated health profession in any province,<ref>{{cite web|url=http://osteopathyontario.org/our-association/regulation/|title=Regulation|publisher=Ontario Association of Osteopathic Manual Practitioners |accessdate=28 April 2014}}</ref> and those interested in pursuing osteopathic studies must register in private osteopathy schools.<ref name="Allard_2011" /> It is estimated that there are over 1,300 osteopathic manual practitioners in Canada, most of whom practice in Quebec and Ontario.<ref name="Who Provides Osteopathy" /> Some sources indicate that there are between 1,000 and 1,200 osteopaths practicing in the province of Quebec, and although this number might seem quite elevated, many osteopathy clinics are adding patients on waiting lists due to a shortage of osteopaths in the province.<ref name="Allard_2011" />

==== Quebec ====

Beginning in 2009, [[Université_Laval|Université Laval]] in [[Quebec_City|Quebec City]] was working with the ''[[Collège_d'études_ostéopathiques|Collège d'études ostéopathiques]]'' in [[Montreal|Montreal]] on a project to implement a professional osteopathy program consisting of a [[Bachelor's_degree|bachelor's degree]] followed by a professional [[Master's_degree|master's degree]] in osteopathy as manual therapy.<ref name="Allard_2011" /> However, due to the many doubts concerning the scientific credibility of osteopathy from the university's [[Université_Laval_Faculté_de_médecine|faculty of medicine]], the program developers decided to abandon the project in 2011, after {{fract|2|1|2}} years of discussion, planning, and preparation for the program implementation.<ref name="Allard_2011">{{cite news|last1=Allard|first1=Marc|title=L'Université Laval ferme la porte à l'ostéopathie|url=http://www.lapresse.ca/le-soleil/actualites/education/201110/02/01-4453561-luniversite-laval-ferme-la-porte-a-losteopathie.php|accessdate=12 May 2015|agency=Le Soleil|publisher=La Presse|date=3 October 2011|language=French}}</ref> There was some controversy with the final decision of the university's committee regarding the continuous undergraduate and professional graduate program in osteopathy because the Commission of studies, which is in charge of evaluating new training programs offered by the university, had judged that the program had its place at Université Laval before receiving the unfavourable support decision from the faculty of medicine.<ref name="Allard_2011" /> Had the program been implemented, Université Laval would have been the first university institution in Quebec to offer a professional program in osteopathy as a manual therapy.<ref name="Allard_2011" />

=== European Union ===

There is no universal regulatory authority for the practice of ''osteopathy'' or ''osteopathic medicine'' within the European Union; it is on a country-by-country basis. The UK's [[General_Osteopathic_Council|General Osteopathic Council]], a regulatory body set up under the country's [[Osteopaths_Act_1993|Osteopaths Act 1993]], has issued a position paper on European regulation of osteopathy.<ref>European Public Health Alliance [http://www.epha.org/a/1673 UK GOsC Position paper on pan-European regulation]. Retrieved 2 August 2006</ref>

=== France ===

''Osteopathy'' is a governmentally recognized profession and has title protection, ''autorisation d'utiliser le titre d'ostéopathe''.<ref>{{cite web|url=http://www.legifrance.gouv.fr/affichTexte.do;jsessionid=E2C6AF0F427389ECA418BB4307239596.tpdjo08v_3?cidTexte=JORFTEXT000000227015&idArticle=&dateTexte=20090604 |title=Article 75, Public Health Law(2002) |language=fr |accessdate=13 November 2011}}</ref> The most recent decree regarding osteopathy was enacted in 2014.<ref>{{cite web|url=http://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000029449275|title=Legifrance|publisher=}}</ref><ref>{{cite web|url=http://www.legifrance.gouv.fr/eli/decret/2014/12/12/2014-1505/jo/texte|title=Décret n° 2014-1505 du 12 décembre 2014 relatif à la formation en ostéopathie - Legifrance|website=www.legifrance.gouv.fr}}</ref><ref>{{cite web|url=http://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000029574545&dateTexte=&categorieLien=id|title=Legifrance|publisher=}}</ref><ref>{{cite web|url=http://www.legifrance.gouv.fr/eli/arrete/2014/12/12/AFSH1426478A/jo/texte|title=Arrêté du 12 décembre 2014 relatif à la formation en ostéopathie - Legifrance|website=www.legifrance.gouv.fr}}</ref><ref>{{cite web|url=http://www.legifrance.gouv.fr/eli/arrete/2014/12/12/AFSH1426479A/jo/texte|title=Arrêté du 12 décembre 2014 relatif aux dispenses d'enseignement susceptibles d'être accordées en vue de la préparation au diplôme permettant d'user du titre d'ostéopathe - Legifrance|website=www.legifrance.gouv.fr}}</ref><ref>{{cite web|url=http://www.sante.gouv.fr/fichiers/bo/2014/14-11/ste_20140011_0000_0098.pdf|title=Legifrance|publisher=}}</ref>

=== Belgium ===

For 40 years (since the early 70s) osteopaths have been practicing in Belgium, during which time several attempts have been made to obtain an official status of health care profession. In 1999, a law was passed (the 'Colla-Law'<ref>{{cite web|title=Pratiques non conventionnelles|url=https://www.health.belgium.be/fr/sante/professions-de-sante/pratiques-non-conventionnelles|website=Service Public Fédéral - Santé publique}}</ref>) providing a legal framework for osteopathy, amongst three other non-conventional medical professions, to develop into an independent medical profession in its own right. In 2011, the Belgian Minister Onkelinx created and established the Chambers for Non-Conventional Medicines and the Joint Commission provided for in the "Colla-law" (1999). The Chamber for Osteopathy has been active since then. Their goal is to discuss and reach an agreement between the various medical bodies to rule on these practices. In February 2014, only one practice, homeopathy, received its recognition. The others, including osteopathy, remain unresolved.<ref>{{cite web|title=Développement de l’Ostéopathie en Belgique {{!}} Osteopathie.be|url=http://osteopathie.be/fr/osteopathie-je-suis-patient/organisation-belgique/|website=osteopathie.be|access-date=2017-11-11}}</ref> Since 2014, the majority of the professional osteopathic associations have joined together under the name UPOB - BVBO (Union Professionelle des Osteopathes de Belgique - Belgische Vereniging van Belgische Osteopaten - Professional Union of Belgian Osteopaths) in order to consolidate the image and united vision of osteopathy (± 900 osteopaths). This merger also resulted in the creation of a website<ref>[http://www.osteopathie.be osteopathie.be]</ref> which represents all aspects of osteopathy in Belgium. Its aim is to offer Belgians a base of information about osteopathy, to provide access to a national emergency care service as well as to osteopathic care facilities for the less fortunate. It also serves as a directory for osteopaths who practice osteopathy exclusively. Lastly, the website serves as a platform to support actions working towards the recognition of osteopathy.

=== Germany ===

Germany has both ''osteopathy'' and ''osteopathic medicine''. There is a difference in the osteopathic education between non-physician osteopaths, physiotherapists, and medical physicians.

Physiotherapists are a recognized health profession and can achieve a degree of "Diploma in Osteopathic Therapy (D.O.T.)". Non-physician ''osteopaths'' are not medically licensed. They have an average total of 1200 hours of training, roughly half being in manual therapy and osteopathy, with no medical specialization before they attain their degree. Non-physician osteopaths in Germany officially work under the "[[Heilpraktiker|Heilpraktiker]]" law. Heilpraktiker is a separate profession within the health care system. There are many schools of osteopathy in Germany; most are moving toward national recognition although such recognition does not currently exist.<ref>{{cite web|url=http://www.oialliance.org/pdf/germany_osteopathy.pdf|title=''Osteopathy in Germany'', Osteopathic International Alliance. Retrieved 26 February 2011.|publisher=|deadurl=yes|archiveurl=https://web.archive.org/web/20130602132251/http://www.oialliance.org/pdf/germany_osteopathy.pdf|archivedate=2 June 2013|df=dmy-all}}</ref> In Germany, there are rules (at the country level) under which persons (non-physicians) may call themselves osteopaths.<ref>Verordnung einer Weiterbildungs- und Prüfungsordnung im Bereich der Osteopathie- Hessen, [http://www.rv.hessenrecht.hessen.de/jportal/portal/page/bshesprod.psml?pid=Dokumentanzeige&showdoccase=1&js_peid=Trefferliste&documentnumber=1&numberofresults=37&fromdoctodoc=yes&doc.id=jlr-OsteoWeitBiPrOHErahmen%3Ajuris-lr00&doc.part=X&doc.price=0.0&doc.hl=1 hier online]</ref>

=== New Zealand ===

The practice of ''osteopathy'' is regulated by law, under the terms of the [[Health_Practitioners_Competence_Assurance_Act_2003|Health Practitioners Competence Assurance Act 2003]]<ref>{{cite web |url= http://www.legislation.govt.nz/act/public/2003/0048/latest/whole.html |title=Health Practitioners Competence Assurance Act 2003 No 48 (as at 01 August 2011), Public Act – New Zealand Legislation |year=2011 |accessdate=18 November 2011}}</ref> which came into effect on 18 September 2004. Under the Act, it is a legal requirement to be registered with the Osteopathic Council of New Zealand (OCNZ),<ref>{{cite web|url=http://www.osteopathiccouncil.org.nz/|title=Home|website=www.osteopathiccouncil.org.nz}}</ref> and to hold an annual practicing certificate issued by them, in order to practice as an osteopath. Each of the fifteen health professions regulated by the HPCA Act work within the "Scope of Practice" determined and published by its professional Board or Council. Osteopaths in New Zealand are not fully licensed physicians. In New Zealand, in addition to the general scope of practice, osteopaths may also hold the Scope of Practice for Osteopaths using Western Medical Acupuncture and Related Needling Techniques.<ref>{{cite web|url=http://online.gazette.govt.nz/MSOS118/On-Line/NZGazette.nsf/6cee7698a9bbc7cfcc256d510059ed0b/56863e2945a2e287cc25763c004d1a9b?OpenDocument |title=The Department of Internal Affairs: New Zealand Gazette – The New Zealand Gazette|accessdate=13 November 2011}}</ref>

In New Zealand a course is offered at [[Unitec_Institute_of_Technology|Unitec]].<ref>{{cite web| url = http://www.unitec.ac.nz/?C7B4901F-385F-44F0-B37B-609CE4CC0E1E| title = Master of Osteopathy courses, postgraduate study for a masters degree |accessdate =26 January 2009| publisher = Unitec| quote = The Master of Osteopathy is the only New Zealand-based programme that enables you to register with the Osteopathic Council of New Zealand, and to enter practice as an osteopath in New Zealand.}}</ref> Australasian courses consist of a bachelor's degree in clinical science (osteopathy) followed by a master's degree. The Unitec double degree programme is the OCNZ prescribed qualification for registration in the scope of practice: Osteopath, Australian qualifications accredited by the Australian and New Zealand Osteopathic Council are also prescribed qualifications.

Osteopaths registered and in good standing with the Australian Health Practitioner Regulation Agency – Osteopathy Board of Australian are eligible to register in New Zealand under the mutual recognition system operating between the two countries. Graduates from programs in every other country are required to complete an assessment procedure.<ref>{{cite web|url=http://www.oialliance.org/pdf/newzealand_osteopathy.pdf|title=''Osteopathy in New Zealand'', Osteopathic International Alliance. Retrieved 26 February 2011.|publisher=|deadurl=yes|archiveurl=https://web.archive.org/web/20130602130203/http://www.oialliance.org/pdf/newzealand_osteopathy.pdf|archivedate=2 June 2013|df=dmy-all}}</ref>

The scope of practice for US-trained ''osteopathic physicians'' is unlimited on an ''exceptions'' basis. Full licensure to practice medicine is awarded on an exceptions basis following a hearing before the licensing authorities in New Zealand. Both the Medical Council of New Zealand<ref>{{cite web|author=Medical Council of New Zealand |url=http://www.mcnz.org.nz/ |title=Medical Council of New Zealand |accessdate=13 November 2011}}</ref> and the Osteopathic Council of New Zealand [OCNZ]<ref>{{cite web|url=http://www.osteopathiccouncil.org.nz/ |title=Osteopathic Council of New Zealand |date=19 February 2009 |accessdate=13 November 2011}}</ref> regulate osteopathic physicians in New Zealand. Currently, the country has no recognized osteopathic medical schools.<ref>{{cite web|url=http://www.oialliance.org/pdf/newzealand_om.pdf|title=''Osteopathic Medicine in New Zealand'', Osteopathic International Alliance. Retrieved 26 February 2011.|publisher=|deadurl=yes|archiveurl=https://web.archive.org/web/20130602130524/http://www.oialliance.org/pdf/newzealand_om.pdf|archivedate=2 June 2013|df=dmy-all}}</ref>

=== Portugal ===

''Osteopathy'' is a governmentally recognized health profession and the title of Osteopath is protected by Law (Act 45/2003, of 22 October, and Act 71/2013, of 2 September). Currently there are three faculties that teach the four-year degree course of osteopathy (BSc Hon in Osteopathy).<ref>{{cite web|url=http://www.parlamento.pt/ActividadeParlamentar/Paginas/DetalheIniciativa.aspx?BID=40568|title=Iniciativa - Atividade Parlamentar e Processo Legislativo|website=www.parlamento.pt}}</ref>

=== United Kingdom ===

The practice of ''osteopathy'' has a long history in the [[United_Kingdom|United Kingdom]]. The first school of osteopathy was established in London in 1917 by John Martin Littlejohn, a pupil of A.T. Still, who had been Dean of the [[Chicago_College_of_Osteopathic_Medicine|Chicago College of Osteopathic Medicine]]. After many years of existing outside the mainstream of health care provision, the osteopathic profession in the UK was accorded formal recognition by Parliament in 1993 by the Osteopaths Act.<ref>{{cite web|url=http://www.legislation.hmso.gov.uk/acts/acts1993/Ukpga_19930021_en_1.htm |title=Osteopaths Act 1993 |date=27 May 2011 |accessdate=13 November 2011}}</ref> This legislation now provides the profession of osteopathy the same legal framework of statutory self-regulation as other healthcare professions such as medicine and dentistry.

The [[General_Osteopathic_Council|General Osteopathic Council]] (GOsC) regulates the practice of osteopathy under the terms of the Osteopaths Act 1993. Under British law, an osteopath must be registered with the GOsC to practice in the United Kingdom.<ref>{{cite web |url=http://www.osteopathy.org.uk/information/about-osteopathy/ |title=About osteopathy |author= |work= |publisher=General Osteopathic Council |accessdate=7 March 2013}}</ref> The General Osteopathic Council has a statutory duty to promote, develop and regulate the profession of osteopathy in the UK. It fulfills its duty to protect the interests of the public by ensuring that all osteopaths maintain high standards of safety, competence and professional conduct throughout their professional lives. In order to be registered with the General Osteopathic Council an osteopath must hold a recognized qualification that meets the standards as set out by law in the GOsC's Standard of Practice.<ref name="osteopathy.org.uk">{{cite web|url=http://www.osteopathy.org.uk/about_gosc/about_standards.php|title=Standards of Osteopathic Training & Practice, General Osteopathic Council|publisher=|deadurl=yes|archiveurl=https://web.archive.org/web/20090412122741/http://www.osteopathy.org.uk/about_gosc/about_standards.php|archivedate=12 April 2009|df=dmy-all}}</ref> This Act provides for "protection of title" A person who, whether expressly or implicitly describes him- or herself as an osteopath, osteopathic practitioner, osteopathic physician, osteopathist, osteotherapist, or any kind of osteopath is guilty of an offence unless they are registered as an osteopath. There are currently more than five thousand osteopaths registered in the UK.<ref>{{cite web |url=http://www.osteopathy.org.uk/training-and-registration/ |title=United Kingdom |author= |work=Osteopathy |publisher=General Osteopathic Council |accessdate=26 October 2015}}</ref>

''Osteopathic medicine'' is regulated by the General Osteopathic Council, (GOsC) under the terms of the Osteopaths Act 1993 and statement from the GMC. Practising osteopaths will usually have a B.S. or M.Sc. in osteopathy. Accelerated courses leading to accreditation are available for those with a medical degree and physiotherapists.<ref>{{Cite web|url=http://www.osteopathy.org.uk/training-and-registration/becoming-an-osteopath/|title=Becoming an osteopath - General Osteopathic Council|website=www.osteopathy.org.uk|access-date=2016-09-25}}</ref> The London College of Osteopathic Medicine,<ref>{{cite web|url=http://www.lcom.org.uk/ |title='&#39;London College of Osteopathic Medicine'&#39; |accessdate=13 November 2011}}</ref> teaches osteopathy only to those who are already physicians.

=== United States ===

{{Main|Osteopathic medicine in the United States}}

Those trained only in manual osteopathic treatment, generally to relieve muscular and skeletal conditions, are referred to as osteopaths.<ref>{{cite web|title=</ref> These non-physician practitioners are not permitted to use the title D.O. in the United States.{{citation needed|date = March 2017}} This is to avoid confusion with [[Doctor_of_Osteopathic_Medicine|osteopathic physicians]] who are [[Physician|medical doctors]] trained and certified to practice in the branch of [[Medicine|scientific medicine]] called [[Osteopathic_medicine_in_the_United_States|osteopathic medicine]].<ref name="SBM" />

The [[American_Osteopathic_Association|American Osteopathic Association]] and the [[American_Association_of_Colleges_of_Osteopathic_Medicine|American Association of Colleges of Osteopathic Medicine]] recommend using the terms ''[[Doctor_of_Osteopathic_Medicine|osteopathic physician]]'' (U.S.-trained only) and ''osteopathic medicine'' in reference to osteopathic medicine as practiced in the United States.<ref>{{cite web |url=http://www.osteopathic.org/inside-aoa/about/leadership/aoa-policy-search/Documents/H315-A2015-OSTEOPATH-AND-OSTEOPATHY-USE-OF-THE-TERM.pdf |title=H315-A/15 Osteopath and Osteopathy - Use of the Term |year=2015 |author=Staff writer |website=American Osteopathic Association}}</ref> Osteopathic physicians earn the degree of [[Doctor_of_Osteopathic_Medicine|Doctor of Osteopathic Medicine]] (D.O.).<ref>{{cite web |url=http://www.ama-assn.org/ama1/pub/upload/mm/40/physician.pdf |title=Medicine |author= |work= |publisher=American Medical Association |accessdate=20 March 2013}}</ref><ref name="Harrisons">Dennis L. Kasper, Eugene Braunwald, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Kurt J. Isselbacher, Eds. ''[http://accessmedicine.com/content.aspx?aID=9106846 Chapter 10. Complementary and Alternative Medicine]'' Harrison's Principles of Internal Medicine, 16th Ed. 2005. McGraw Hill.</ref><ref>{{cite web |url=http://www.ncmedboard.org/faqs/list/category/consumer_info#what_is_a_doctor_of_osteopathic_medicine_do |title=Consumer Info FAQs |author= |work= |publisher=North Carolina Medical Board |accessdate=20 March 2013}}</ref><ref>{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/002020.htm |title=Doctor of Osteopathic medicine |author=MedlinePlus |year=2012 |work= |publisher=U.S. National Library of Medicine |accessdate=25 October 2012}}</ref>

''Osteopathic medicine'' in the United States has always meant a physician trained in and entitled to the full scope of medical practice. ''Osteopathy'' or ''osteopath'' as written in some U.S. state and federal laws refers only to ''osteopathic medicine'' or ''osteopathic physicians'', respectively.{{citation needed|date=April 2018}} With the increased internationalization of the profession, these older terms have fallen out of favor as generally accepted use due to the confusion they may cause.<ref>{{cite web|url=http://www.do-online.org/TheDO/?p=24181 |title=AOA House reasserts preferred terms ''osteopathic physician'', ''osteopathic medicine'' |date=August 4, 2010 |last=Schierhorn |first=Carolyn |website=The DO |archive-url=https://web.archive.org/web/20131006043533/http://www.do-online.org/TheDO/?p=24181 |archive-date=October 6, 2014 |dead-url=yes}}</ref><ref>{{cite web|url=http://www.do-online.org/TheDO/?p=26191 |title=Promoting DOs: Words, medium change, but message stays the same |date=3 September 2010 |last=Croby |first=John B. Crosby |website=The DO |archive-url=https://web.archive.org/web/20131012035325/http://www.do-online.org/TheDO/?p=26191 |archive-date=12 October 2013 |dead-url=yes}}</ref>

=== Egypt and the Middle East ===

Hesham Khalil introduced osteopathy in the Middle East at a local physical therapy conference in Cairo, Egypt in 2005 with a lecture titled "The global Osteopathic Concept / Holistic approach in Somatic Dysfunction". Since then he has toured the Middle East to introduce osteopathy in other Middle Eastern and North African countries, including Sudan, Jordan, Saudi Arabia, Qatar, UAE, Kuwait and Oman. In December 2007 the first Workshop on Global osteopathic approach was held at the Nasser Institute Hospital for Research and Treatment, sponsored by the Faculty of Physical Therapy, University of Cairo, Egypt.<ref>{{cite web |url= http://egyptianpt.blogspot.com/2007/10/26-osteopathy.html |title= Osteopathy |first=Mohamed | last=Rizk |year= 2007 |work= |publisher= Physical Therapists Of Egypt Blog |accessdate= 30 July 2014}}</ref> On 6 August 2010, the Egyptian Osteopathic Society (OsteoEgypt) was founded. OsteoEgypt promotes a two-tier model of osteopathy in Egypt and the Middle East. The event was timed to coincide with the birthday of A.T. Still.<ref>{{cite web |url= http://osteoegypt.org/about-us/history/ |title= The History of the Egyptian Osteopathic Society |first=Hesham | last=Khalil |year= 2014 |work= |publisher= OsteoEgypt |accessdate= 26 July 2014}}</ref><ref>{{cite web |url= http://digital.ahram.org.eg/Community.aspx?Serial=1515679 |title= هشام خليل: الاستيوباثي علاج يستهدف العرض وليس المرض |author= |year= 2014 |work= |publisher= alahram newspaper |accessdate= 30 July 2014}}</ref>{{Primary source inline|date=July 2014}}

=== India ===

[[Sri_Sri_University|Sri Sri University]] is the first university in India to offer M.Sc in Osteopathy programme by following the benchmarks defined by the World Health Organisation for training in Osteopathy.<ref>{{cite web|url=http://srisriuniversity.edu.in/program/m-sc-osteopathy|title=M.Sc - Osteopathy - Sri Sri University|website=www.srisriuniversity.edu.in}}</ref>

== References ==

== Further reading ==

*{{cite book |last=Collins |first=Martin |title=Osteopathy in Britain: The First Hundred Years |year=2005 |publisher=Martin Collins |location=London |isbn=978-1-4196-0784-4}} 
*{{cite book |last1=DiGiovanna |first1=Eileen |author2=Schiowitz, S |author3=Dowling, DD |year=2005 |title=An Osteopathic Approach to Diagnosis and Treatment |edition=3rd |publisher=Lippincott, Williams and Wilkins |location=Philadelphia |isbn=978-0-7817-4293-1}} 
*{{cite book |last=Stone |first=Caroline |title=Science in the Art of Osteopathy: Osteopathic Principles and Practice |year=2002 |publisher=Nelson Thornes |location=Cheltenham, UK |isbn=978-0-7487-3328-6}} 

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