A preliminary investigation into the attitudes and practices of New Zealand osteopaths in relation to the health care system: Does the future hold a greater degree of integration into the biomedical system?

Background: Complementary and alternative medicine (CAM) is said to be currently integrated in an ad hoc fashion in New Zealand, with patients choosing CAM as part of their health care and practitioners referring patients to each other. In New Zealand, the Ministerial Advisory Committee of Complementary and Alternative Health (MACCAH) recommended that if specific CAM modalities can contribute to New Zealand’s health strategies, are cost effective and have proof of efficacy, further integration should be encouraged. Osteopaths in New Zealand come under the umbrella of CAM. However, little is known of the practices, attitudes and opinions of New Zealand osteopaths in relation to the general health care system. This study investigates the phenomenon of further integration of osteopaths into the biomedical system. Methods: A qualitative interpretive descriptive study was undertaken. Two focus groups of six purposively selected osteopaths provided the data. The inductive analysis approach identified core statements that described practitioners’ experiences, practices and opinions of the biomedical system. Results: Three key themes were identified ‘Interactions in the biomedical system’, ‘Integrity: being true to yourself’ and ‘Integration’. For each theme three subthemes emerged respectively: ‘The role of osteopaths’, ‘Relationship with the other health care professionals’, ‘Promoting osteopaths’; ‘Defining osteopathy’, ‘Fitting into the biomedical system’ and ‘Securing a place in the biomedical system’; ‘Opinions on models of integration’; ‘Expanding the role of osteopathy’ and ‘Concluding thoughts’. The overarching theme, ‘towards integration’, reveals osteopaths’ opinions on prerequisites for further integration which emerged from the data. Conclusions: Osteopathy has the potential to expand its role in the general health care system and contribute to New Zealand health strategies. However, osteopaths do not appear to be well integrated in the current ad hoc model of integration, which may also diminish their ability to practice in accordance with the osteopathic philosophy of holism. Not being well distinguished from other physical therapies and known in the general health care system is a major issue for osteopathy and seems to be an important factor for the lack of integration. Defining osteopathy, a strategic marketing plan and research into efficacy, safety and expansion of the role of osteopathy, are required to support further integration in the general health care system