{"id":7050398,"date":"2026-08-28T22:40:56","date_gmt":"2026-08-28T22:40:56","guid":{"rendered":"https:\/\/peraltafinancing.com\/alternative-medicine\/mary-monro-on-the-future-of-osteopathy-in-the-uk\/"},"modified":"2026-08-28T22:40:56","modified_gmt":"2026-08-28T22:40:56","slug":"mary-monro-on-the-future-of-osteopathy-in-the-uk","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=7050398","title":{"rendered":"Mary Monro on The Future of Osteopathy in the UK"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div>\n<p class=\"wp-block-paragraph\">OK I have finally got round to my second ever youtube interview, this time with Mary Monro.<\/p>\n<p class=\"wp-block-paragraph\">Mary has written an article on issues facing the profession. It is reproduced below the video, complete with references.<\/p>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<p>\n<span class=\"embed-youtube\" style=\"text-align:center; display: block;\"><iframe loading=\"lazy\" title=\"The Future of Osteopathy in the UK - with Mary Monro\" width=\"840\" height=\"473\" src=\"https:\/\/www.youtube.com\/embed\/L6Zya9I6QU0?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/span>\n<\/p>\n<\/figure>\n<h2 class=\"wp-block-heading\"><strong>The Future of Osteopathy in the UK<\/strong> by Mary Monro<\/h2>\n<h2 class=\"wp-block-heading\">Introduction\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/h2>\n<p class=\"wp-block-paragraph\">We are at a moment of seismic change in osteopathy and the wider healthcare ecosystem in the UK. Whilst change is a constant and the profession has always had to adapt, Brexit, the COVID pandemic, Social Media and the use of Artificial Intelligence (AI) are all having significant impact on both higher education and consumer health-seeking behaviour, that affect osteopathic schools and the profession. We must consider whether and how osteopathy can remain relevant to the contemporary student and client. This article discusses key issues facing the UK profession, but these changes in the health-scape have international implications for regulation, education, research and professional practice.<\/p>\n<p class=\"wp-block-paragraph\">Currently, 5,597 UK osteopaths (General Osteopathic Council (GOsC), 2025 data) treat an average of 31 patients per week [2], equating to 9 million patient consultations per year (compared to 353 million GP consultations in the National Health Service (NHS) in England [3]). There is a growing tension between demands for tighter regulation in healthcare and an explosion of unregulated actors (including on Social Media platforms) servicing health-seeking consumers [4,5]. Does the osteopathic regulatory system adequately meet the changing needs of patients, students and practitioners?<\/p>\n<p class=\"wp-block-paragraph\">With the entire UK university sector facing financial meltdown (an estimated 15,000 jobs were lost in 2025 [6]), how can osteopathic schools survive? Do we need a different model of osteopathic education that is attractive to students, meets the needs of the profession and is cost effective?<\/p>\n<p class=\"wp-block-paragraph\">Within the profession, a tolerant pluralism regarding modes of treatment has shifted to an unhelpful sectarianism [7], yet our patients have a high regard for their osteopathic experience [8]. Their perspective is often backgrounded in research, with the unfortunate impacts of silencing patient views on osteopathy and losing their contribution to legitimating the profession[9]. How can we demonstrate the full value of the osteopathic therapeutic encounter in a way that meets the demand for evidence-informed care?<\/p>\n<h2 class=\"wp-block-heading\">1.\u00a0\u00a0\u00a0 The Changing Health-scape<\/h2>\n<h3 class=\"wp-block-heading\">1.1\u00a0 Overview<\/h3>\n<p class=\"wp-block-paragraph\">The World Health Organisation (WHO) strategy for Traditional Medicine 2025-2034 \u201cenvisions universal access to safe, effective and people-centred Traditional, Complementary and Integrative Medicine (TCIM) for the health and well-being of all. It was developed based on nine guiding principles: evidence-based; holism and health; sustainability and One Health; the right to health and autonomy; Indigenous Peoples\u2019 rights; culture and health; people-centred care and community engagement; integrated health services; and health equity\u201d[10]. This strategy implies a closer integration between orthodox medicine and TCIM, recognises the role of political, social and environmental determinants of health and the right of every person to proper healthcare. The strategy has had a mixed response from the medical profession, with defence of the status quo, using well-rehearsed tropes about lack of evidence and risk of harm from TCIM [11], meeting robust responses about colonialism, epistemicide and reductionism in orthodox medicine. This argument indicates that a paradigm shift is occurring, driven by consumers changing attitudes and an increasing acceptance of the need for a more person-centred approach to healthcare.<\/p>\n<p class=\"wp-block-paragraph\">The doctor is no longer at the centre \u2013 that is now occupied by the patient, who is an \u2018active patient\u2019 and healthcare consumer, as shown in Figure 1. This is a growing trend that was accelerated by the COVID pandemic, with changing attitudes in the UK about accessing healthcare and a shift towards \u2018self-care\u2019 [5]. The patient may be described as a \u2018pragmatic pluralist,\u2019 using both credentialed and experiential knowledge in their health-seeking behaviour [9], seeing \u2018health\u2019 as a spectrum from serious illness through to physical, psycho-emotional, environmental and social wellness. Figure 1 should be partially obscured to represent the lack of access to healthcare suffered by some patients due to inequalities such as poverty, pollution, poor education and discrimination.<\/p>\n<p class=\"wp-block-paragraph\"><strong>Figure 1: The UK healthcare ecosystem, showing regulated sectors in blue and unregulated sectors in green.<\/strong> Some examples are given for each, but the list is not exhaustive. Unequal access to healthcare is not depicted.<\/p>\n<p class=\"wp-block-paragraph\">Children de-centre when they begin to realise that others have different, and sometimes conflicting, perspectives and priorities [12]. The \u201cde-centring\u201d of the healthcare professions is both liberating for patients and a developmental shift for practitioners. If we are to be empathetic practitioners, we must de-centre and truly be therapists \u2013 the word therapy comes from Greek, meaning \u2018attendance\u2019 or \u2018service.\u2019<\/p>\n<p class=\"wp-block-paragraph\">To understand what is happening in this ecosystem, we need to view it through political and sociological lenses. Politically, we are in late-stage capitalism, characterised by globalisation, consumerism and wealth inequality, where new markets are created by turning inward and finding endless niches to exploit [13]. Widespread adoption of wearable monitoring devices and apps is an example. Eager therapists claiming to transform your life with a gadget, exercise regime or supplement is another. But this is also a democratic shift, with consumers becoming \u201cco-creators of health services and co-creators of value\u201d[14]. In an unregulated marketplace, anyone can improvise as an infant sleep consultant, a fitness guru, or write a book on how to manage your menopause.<\/p>\n<p class=\"wp-block-paragraph\">From a sociological perspective, we can see the power arc of orthodox medicine passing its peak, with implications for osteopathy and the wider healthcare ecosystem, as discussed below.<\/p>\n<h3 class=\"wp-block-heading\">1.2 Challenges faced by orthodox medicine<\/h3>\n<p class=\"wp-block-paragraph\">Until the late 19<sup>th<\/sup> century, doctors were often seen as quacks with limited efficacy. The period from 1870 to 1920 saw a flowering of alternatives to medicine in response, including osteopathy, seeking to provide better healthcare and, at the same time, saw orthodox medicine start to improve. Developments such as X-rays, ECGs, antibiotics, antiseptic surgery and the discovery of insulin began to transform medicine into an effective, technocratic force. This increased the social capital (elite status) and cultural capital (schools, institutions) of the medical profession and these were readily exchanged for economic capital [13,15]. These types of capital, and the power they confer, are not a given, however, and medicine is now under threat, for at least three reasons:<\/p>\n<p class=\"wp-block-paragraph\">First, the biomedical model does not fit well with modern and projected health needs. The major public health concerns are obesity, diabetes, cardiovascular disease, cancers, chronic illness, substance abuse and mental health [16,17]. These, to some extent, respond to technocratic interventions when they are past the point of no return, but they arise from health inequalities, environmental and lifestyle factors and the ageing population. By 2030 one in six people on the planet will be 60 or older. By 2035 it is estimated that 36% of people over 50 will have at least one chronic condition [18]. Recent research shows a persistent rise in \u2018deaths of despair\u2019 (from suicide, and drug and alcohol abuse) [19].\u00a0 Medicine is trying to shift from its biomedical model to the P4 model \u2013 Personalised, Preventive, Predictive and Participatory Medicine [18]. One initiative from NHS England is to introduce a \u2018neighbourhood health service,\u2019 a collaborative approach intended to reduce pressure on GP and hospital services [20]. P4 medicine remains within the reductive biomedical model, however [21], unable to affect the social and environmental determinants of health and with \u201csocial prescribing\u201d presenting issues for demonstrating efficacy, as neither the problem nor the solution fit the randomised controlled trial model [22].<\/p>\n<p class=\"wp-block-paragraph\">Secondly, medicine is eroding its own capital through a dissonance between its ideals and its practices. Modern medicine is founded on scientific, evidence-based interventions, sometimes endorsed by National Institute for Healthcare Excellence (NICE) guidelines but, in reality, patients experience poor access to care, systematic bias against minorities (race, sexual orientation, gender, disability, religion) and sometimes poor outcomes [23]. Scientific and technological excellence seems to have come at the cost of caring excellence. The medical scandals of recent years (e.g. in Bristol, Shrewsbury, North Staffs, East Kent, Nottingham, maternity and neonatal care England [24]) have revealed how a combination of top-down hierarchies with \u201chubristic leaders,\u201d and a culture of coerced silence and denial have led to catastrophic consequences [25,26].<\/p>\n<p class=\"wp-block-paragraph\">Thirdly, the NHS\u2019s status is being undermined by long-term underinvestment in staff and infrastructure, with millions of patients now facing intolerable waiting times for elective and emergency treatment [16] and 65% of maternity units deemed unsafe [27]. This is both driving patients toward private medicine and forcing the NHS to pay for private care [28]. It\u2019s estimated that 40% of treatments do not follow known best practice, at the best of times, let alone in an understaffed, exhausted and demoralised NHS [29,30]. According to the British Social Attitudes survey 2024, satisfaction with the NHS was down to 21%, its lowest since the survey began in 1983, from a peak of 70% in 2010 [31] and with a sharp decline from 2019. Among osteopathic patients, confidence in osteopaths exceeds confidence in GPs and physios [32].<\/p>\n<p class=\"wp-block-paragraph\">The NHS recognises the need to change in its 10 year plan, published in a policy paper in July 2025: \u201cthe choice for the NHS is stark: reform or die\u201d [33]. The paper proposes a shrinking role for the NHS, with greater use of technology (including AI) and a shift towards prevention, helping to reduce patient dependence on medical care. The NHS currently has little to offer people with social care needs and is overwhelmed by the prime causes of workdays lost in the UK: musculoskeletal problems (49%) and mental health (23%) [34].<\/p>\n<h3 class=\"wp-block-heading\">1.3\u00a0\u00a0\u00a0\u00a0\u00a0 Osteopathy\u2019s position<\/h3>\n<p class=\"wp-block-paragraph\">Osteopathy sits at mid-level in the social and cultural hierarchy, with its power constrained by restrictions imposed by medicine, above it, such that osteopaths may not prescribe drugs or treat cancer, for example. Osteopathy regards itself as superior (i.e. more like medicine) to voluntarily regulated and unregulated healthcare providers, from a practitioner-centric perspective. Gaining status (in England) as Allied Health Practitioners (AHP) in 2017 has led to more osteopaths working in the NHS, currently 6% of the whole profession and this rises to 18% in the under 35 age group [2]. Medical profession acceptance of osteopathy, however, remains patchy both geographically and across NHS services. Examples include osteopathic practices that used to work with the NHS being subjected to changes in policy, such as the termination of Any Qualified Practitioner contracts; and AHP status not being extended to the rest of the UK [35].<\/p>\n<p class=\"wp-block-paragraph\">Osteopathy shares the same biases as medicine, with practitioners and patients being overwhelmingly white, heterosexual, financially secure and non-disabled. Osteopathic principles have been criticised as ableist, as they assume that disability is a flaw to be overcome [36]. Osteopaths, like doctors, can confuse patients by using medical\/scientific terminology and work with patients who may feel vulnerable, due to pain or anxiety about their health, compounding the power imbalance [15]. As largely private practitioners, the profit motive risks influencing patient management decisions. The biomedical model is used in osteopathy, but with a focus on the biophysical (mechanics, fluid and energy interactions, systems behaviour, etc.) rather than the biochemical.<\/p>\n<p class=\"wp-block-paragraph\">However, osteopathy has always taken a hybrid and person-centred approach, using both the scientific biomedical model and other epistemologies to arrive at an holistic assessment. Results from UK osteopathic Patient Reported Outcome Measures (PROMs) show that patients give high satisfaction ratings for good communications, empathy, the opportunity to ask questions, competence and effectiveness [8]. The patient experience of osteopathy is not only about the hands-on techniques employed. Equally important is the relationship, the agency given to the patient and the sense-making involved [37,38]. The osteopathic self-management plan agreed with patients through a shared decision making process is thought to be key to the softer positive outcomes, such as social integration, reduced anxiety and better coping mechanisms [32].<\/p>\n<h3 class=\"wp-block-heading\">1.4\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Unregulated healthcare<\/h3>\n<p class=\"wp-block-paragraph\">Outside the regulated sectors of the healthcare ecosystem a \u2018wild west\u2019 is developing, fuelled by Social Media platforms. Osteopaths are sometimes tempted into this arena, adding the \u2018Mummy MOT,\u2019 Shockwave therapy [39] or other packaged protocols or technologies to their osteopathic toolkit. Some of these have evidence of efficacy, some are just well marketed and have created a demand among patients to which osteopaths respond. Osteopaths (and other professionals) may be inadvertently contributing to the spawning of unqualified practitioners by demonstrating techniques online, on YouTube or TikTok, for example. At a wedding reception in 2024, I saw a man manipulate the occipito-atlantal joints of his neighbours at the table, a skill he later told me he\u2019d learned from a video. He is not a healthcare practitioner, has no knowledge of anatomy and did not conduct a risk assessment. There is no regulator for an untrained operator inappropriately using an osteopathic technique.<\/p>\n<p class=\"wp-block-paragraph\">According to a UNESCO survey reported in 2026 [40], an average of 67% of the UK population (compared to 83% Norway, 61% Germany, 56% France, 74% Canada, 37% New Zealand) now seek health information online. As the report states, \u201cPeople with limited health literacy, language barriers, or desperate health situations may be more susceptible to misinformation. Online health information seeking can exacerbate health inequalities if reliable information is less accessible to disadvantaged populations.\u201d Responsible healthcare providers are contributing to democratisation and patient agency by sharing diagnostic, preventive and health promoting information, whereas others are misinforming and fleecing the health-seeking public [4,41]. Use of AI Chatbots for health information (and sometimes diagnosis and treatment) is also increasing, though trustworthiness issues are inhibiting faster growth [42].<\/p>\n<p class=\"wp-block-paragraph\">The current administration in the USA is encouraging deregulation, delimiting AI development, leaving the WHO and cutting funding to the National Institutes of Health. This opens the door even wider for irresponsible and malign actors with global reach, as well as undermining health research and monitoring.<\/p>\n<h2 class=\"wp-block-heading\">2.\u00a0\u00a0\u00a0 Regulation<\/h2>\n<p class=\"wp-block-paragraph\">Healthcare regulation is a multi-layered phenomenon, that includes statutory regulation of some healthcare professions (e.g. osteopathy, medicine), some medical devices and some harmful substances (e.g. sugar, alcohol), as well as voluntary regulation (e.g. psychotherapy, acupuncture) and, at the frontline, of self-regulation by practitioners. In turn, the statutory healthcare regulators (including the GOsC) are regulated by the Professional Standards Authority (PSA), whose remit is to oversee and improve their work.<\/p>\n<h3 class=\"wp-block-heading\">2.1 \u00a0\u00a0\u00a0\u00a0 Patient Safety<\/h3>\n<p class=\"wp-block-paragraph\">Historically, the driving principle of regulation in \u2018high-hazard industries\u2019 such as healthcare has been to reduce or eliminate harm, termed Safety-I by Hollnagel [43]. However, recent thinking argues that in a system as complex as healthcare, with a great propensity for things to go wrong, this is a misguided and unachievable aim. A better regulatory approach is to focus on <em>how<\/em> things go well, termed Safety-II. Hollnagel argues that achieving resilient performance is feasible if four potentials are pursued: the potential to respond; to monitor; to learn; and to anticipate. These potentials can only be achieved with closer connection between the regulator, the profession and the public.<\/p>\n<p class=\"wp-block-paragraph\">The data on cause for complaint against osteopaths indicate room for improvement in basic clinical skills (case history taking, examination and assessment, avoidance of forceful techniques), patient communication, and boundary awareness and management [44]. The solutions lie upstream, in the fields of undergraduate education and continuing professional development (CPD). The regulator could respond to this challenge by shaping the \u2018graduate outcomes\u2019 competencies and the requirements of the CPD scheme, to meet the first three of Hollnagel\u2019s \u2018potentials.\u2019 Strategic assessment and inclusion of our patients\u2019 changing needs must also feed into this, meeting the \u2018potential to anticipate.\u2019 A 2022 paper on boundary issues in osteopathy, written for the GOsC, recognises that this is a systemic problem requiring a systemic solution, rather than individual punishment [45].<\/p>\n<p class=\"wp-block-paragraph\">In 2024 the GOsC spent just over \u00a31million (a third of its budget) on managing a tiny number of \u2018fitness to practise\u2019 complaints. By comparison, NHS Resolution (a public body in England that handles clinical negligence claims) received 15,236 new negligence claims in 2025-26 (up from 14,428 in 2024-25), costing \u00a33.2billion in payments to claimants and legal costs. \u201cMuch of this \u00a33.2bn could have gone to frontline NHS care to give the service the staff and resources it needs to minimise harm\u201d [46]. The same could be said of the GOsC\u2019s fitness to practise spend, using it instead to invest in Hollnagel\u2019s four potentials and adopting a \u2018right touch\u2019 approach [47]. According to the PSA, the General Optical Council (GOC) has run a mediation service since 2014 that has handled a 259% increase in the volume of complaints, while delivering a 60% reduction in unit cost per complaint [48]. There is no such option for handling osteopathic complaints.<\/p>\n<p class=\"wp-block-paragraph\">Another emerging theme is the need for cross-profession regulation [47]. The patient journey does not occur within a single silo but often across a series of actors \u2013 perhaps seeing a GP for neck pain and being prescribed paracetamol, then attending an Accident &amp; Emergency department when symptoms worsen, being discharged, going to see an osteopath and having a neck manipulation that results in injury. Which of the actors is responsible? Who should handle the complaint?<\/p>\n<h3 class=\"wp-block-heading\">2.2\u00a0\u00a0\u00a0\u00a0\u00a0 Standards in Osteopathic Education and Professional Development<\/h3>\n<p class=\"wp-block-paragraph\">The GOsC sets the guide to the curriculum that osteopathic schools must follow, known as the Graduate Outcomes and Standards for Education and Training (GOSET) document [49]. According to the GOSET document, this does not require the input of the profession, the employers of the graduates. How can schools adapt to the changing demands of practice without close connection between practising osteopaths and the curriculum taught to students? This is not controversial: most regulators (including for the utilities, financial industry and, in the realm of healthcare, the GOC [50]) explicitly include employers and create cross-stakeholder structures in curriculum design, school governance and performance assessment.<\/p>\n<h3 class=\"wp-block-heading\">2.3\u00a0\u00a0\u00a0\u00a0\u00a0 Other Regulatory Issues<\/h3>\n<p class=\"wp-block-paragraph\">The strategic aims of the GOsC, 2024-2030, include \u201cchampioning inclusivity\u201d in the organisation and \u201cstrengthening trust\u201d with the profession [51]. Such aims are welcome, given that recent research showed that 46% of osteopaths have no trust in the regulator. A key priority for improvement identified by the research was \u201clistening to the views and needs of osteopaths and students\u201d [52]. These aims, however, are not expressed in a way that is meaningful to osteopathic schools or the profession. How well are osteopaths navigating Equity, Diversity, Inclusion and Belonging (EDIB) issues, for instance? What proportion of practices are wheelchair accessible? How can osteopathic schools support applicants who are financially or geographically disadvantaged, disabled or who fear discrimination?<\/p>\n<p class=\"wp-block-paragraph\">Misleading claims made by osteopaths are only discovered if a complaint is made to the regulator or to the Advertising Standards Authority (ASA). This fails to adequately protect the public, a key role of the regulator. The ASA has recently introduced an Active Ad Monitoring system, using AI to monitor online advertising [53]. In 2025, the system monitored over 60 million adverts, prioritising problematic areas (such as cryptocurrency, age restricted products and healthcare) but with the potential for wider use, thereby improving intelligence, enforcement and monitoring compliance [54,55]. A recent study used AI to trawl websites of members of the Complementary and Natural Healthcare Council, searching for misleading claims [56]. They found a large number that met their criteria and, though flawed and needing careful human input, AI has the potential to provide a more efficient way for regulators and the ASA to systematically monitor registrants\u2019 websites.<\/p>\n<h2 class=\"wp-block-heading\">3.\u00a0\u00a0\u00a0 Education &amp; Research<\/h2>\n<h3 class=\"wp-block-heading\">3.1 \u00a0\u00a0\u00a0\u00a0 Education Challenges<\/h3>\n<p class=\"wp-block-paragraph\">The university sector in England is struggling with cuts in government funding (the funding freeze and high inflation mean that, in 2011\/12 prices (when fees were set at \u00a39000\/year), fees per student are now below \u00a36000\/year [57]), loss of fees from overseas students due to Brexit and visa issues (foreign students represented 5% of university funding in the mid-1990s rising to 23% in 2022 [58]) and lower than expected growth in British students. Overall, it is estimated that UK government policies will lead to a net reduction in university funding of \u00a32.5bn between 2024\/5 and 2026\/27 compared to 2023\/24 [59]. The university regulator, the Office for Students (OfS), expects 72% of universities to be in deficit by the end of 2026 [60].<\/p>\n<p class=\"wp-block-paragraph\">Long term financial sustainability is under threat, even for the most successful universities, where high cost courses (science, engineering, medicine) and research focus (now only covering 68% of its total costs) predominate [57]. Mitigating actions may include cutting staff and courses and seeking collaboration with other providers [61]. Meanwhile there is increasing pressure to be more student-centred, offering improved access to disadvantaged groups, lifelong learning, distance learning, part-time learning, interdisciplinary experiences and connections with employers [57].<\/p>\n<p class=\"wp-block-paragraph\">This situation affects the osteopathic schools, with responses including the recent merger of the University College of Osteopathy (UCO) with a chiropractic college, the merger of the European School of Osteopathy (ESO) and the British College of Osteopathic Medicine (BCOM), the closure of the College of Osteopaths and the closure of the ESO\/BCOM undergraduate masters programme. Student applications to study osteopathy have plummeted and this is forecast to continue [62]. This is likely due to a mix of factors \u2013 student funding difficulties (43% are mature students for whom there may be little financial support [2]), the cost-of-living crisis, location of schools, lack of student accommodation, post-Brexit impacts on overseas students, single subject schools that don\u2019t offer a broad social mix for students, accessibility issues and, perhaps, a curriculum and profession that are not sufficiently attractive and distinctive. 65% of UK osteopaths are 45 or older [2] so, unless young students are recruited, osteopathy has a limited lifetime ahead of it, regardless of its value to health.<\/p>\n<p class=\"wp-block-paragraph\">Another perceived barrier to entry is the limited awareness of osteopathy as either a potential career or as a patient. Across Europe, only 5.2% of the population surveyed had seen an osteopath in the previous year [63], though this percentage may be higher in the UK. Even if it\u2019s 10%, that is still a small fraction of the population who are familiar with osteopathy. The Institute of Osteopathy has run campaigns to promote osteopathy, as a career and for patients, but has a limited budget in a disseminated and intensely competitive communications landscape. Osteopaths themselves contribute to raising awareness of the profession (locally and online) but there is room for expansion.<\/p>\n<p class=\"wp-block-paragraph\">According to the OfS, the biggest influences on a successful student experience are\u00a0academic support\u00a0(54%),\u00a0high quality curriculum and teaching\u00a0(48%) and\u00a0financial support\u00a0(40%).\u00a0Long term student concerns revolve around career preparation and progression, developing skills for future employment, and building social networks [64]. As mentioned in the previous section, the disconnect between schools and the osteopathic profession may interfere with students\u2019 career preparation and developing skills for employment, as noted by the Osteopathic Alliance [65].<\/p>\n<h3 class=\"wp-block-heading\">3.2\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Research Priorities<\/h3>\n<p class=\"wp-block-paragraph\">Detractors of osteopathy, from without and within, point to a weak evidence base for both osteopathic conceptual models and the efficacy of specific techniques. Should osteopathy cease to exist, then, if it doesn\u2019t make sense or add any value? Overall, osteopathy is under-researched and most of the research that has been done adheres to the reductive biomedical model and shows modest benefits. Over 1700 osteopathic patients\u2019 PROMs show exceptionally positive outcomes [8], however, at odds with the reductive research evidence.<\/p>\n<p class=\"wp-block-paragraph\">Asking AI chatbot ChatGPT, \u201cWhat research has been done on osteopathy?\u201d reveals the reductive bias of research to date. Then asking, \u201cIs osteopathy holistic?\u201d produces a positive response that includes headings for: whole body focus, patient centred care, prevention and wellness, osteopathic manipulative treatment (\u201caddresses not just specific symptoms but the underlying imbalances in the body\u2019s structure and function\u201d), mind-body connection and collaborative care.<\/p>\n<p class=\"wp-block-paragraph\">Osteopathic principles \u2013 the body is a unit, structure and function are interrelated, the body has the capacity for self-healing [66] \u2013 are couched in biomedical terms but indicate the importance of considering the whole body. Beyond that, AT Still said that \u201cthe object of the doctor is to find health. Anyone can find disease.\u201d He argued that \u201cMan is triune when complete. First the material body, second the spiritual being, third a being of mind which is far superior to all vital motions and material forms, whose duty is to wisely manage this great engine of life\u201d [67]. His archaic choice of words should not obscure his wisdom, and future research must seek to capture the entirety of these osteopathic concepts, [68].<\/p>\n<p class=\"wp-block-paragraph\">A recent European-wide survey [69] has helped to shift the research agenda for the future, not least by including patients and practitioners, rather than only questioning the education, research and policy community. Interest in studying hands-on techniques continues to be important, but there is a gratifying recognition of broader aspects of osteopathic care, as shown in Table 1.<\/p>\n<p class=\"wp-block-paragraph\"><strong>Table 1: Top 10 Research Priorities Identified in the PROCare Survey, 2025.<\/strong><\/p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td><strong>Domain<\/strong><\/td>\n<td><strong>Subdomain<\/strong><\/td>\n<td><strong>Topic<\/strong><\/td>\n<td><strong>Score<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Process of Care<\/td>\n<td>Effectiveness and efficacy<\/td>\n<td>Hands on techniques<\/td>\n<td>54.7%<\/td>\n<\/tr>\n<tr>\n<td>Population Health<\/td>\n<td>Physical activities and mobility<\/td>\n<td>Sedentary lifestyle prevention<\/td>\n<td>51.0%<\/td>\n<\/tr>\n<tr>\n<td>Basic Sciences<\/td>\n<td>Osteopathic manual treatment (OMT) mechanisms<\/td>\n<td>Neurophysiological effects of OMT \u00a0<\/td>\n<td>50.0%<\/td>\n<\/tr>\n<tr>\n<td>Education Research<\/td>\n<td>Continuing education<\/td>\n<td>Quality of training and education<\/td>\n<td>39.7%<\/td>\n<\/tr>\n<tr>\n<td><a>Education Research<\/a><\/td>\n<td>Knowledge transfer<\/td>\n<td>Critical thinking<\/td>\n<td>38.6%<\/td>\n<\/tr>\n<tr>\n<td>Education Research<\/td>\n<td>Knowledge transfer<\/td>\n<td>Best practice integration into clinical routine<\/td>\n<td>37.8%<\/td>\n<\/tr>\n<tr>\n<td>Population Health<\/td>\n<td>Public awareness and education<\/td>\n<td>Health promotion<\/td>\n<td>37.5%<\/td>\n<\/tr>\n<tr>\n<td>Methodology Research<\/td>\n<td>Methodology improvement<\/td>\n<td>Innovative methods and research framework for Non-Pharmaceutical Interventions<\/td>\n<td>37.4%<\/td>\n<\/tr>\n<tr>\n<td>Basic Sciences<\/td>\n<td>Osteopathic Manual Treatment mechanisms<\/td>\n<td>Neuroendocrine and immunological responses to OMT<\/td>\n<td>35.8%<\/td>\n<\/tr>\n<tr>\n<td>Population Health<\/td>\n<td>Physical activities and mobility<\/td>\n<td>Behavioural change in physical activities<\/td>\n<td>35.4%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n<p class=\"wp-block-paragraph\">Banton [70] goes further, demanding that \u2018contextual factors\u2019 in osteopathy, e.g. relationship, patient expectations, the healing environment, patients\u2019 health beliefs, communication effectiveness etc., should be explicitly stated when planning a research study, to better understand and evaluate the mechanisms that generate osteopathic outcomes. This is most obviously important for chronic conditions (which can vary over time) and instances when ongoing stresses on a patient (e.g. caring for others, poverty, mental health issues) can affect the effectiveness of treatment.<\/p>\n<p class=\"wp-block-paragraph\">Research needs to bring the patient experience into the foreground. Legitimating the profession is an ongoing process in a dynamic environment where the patient\/consumer is increasingly important [9]. Patient-centred research is imperative to understand how we might remain relevant, to shape our education and professional development and to show our various publics and peers what the osteopathic therapeutic encounter actually delivers.<\/p>\n<p class=\"wp-block-paragraph\">Patients have their own ways of forming opinions and making choices. Most patients don\u2019t (or can\u2019t \u2013 due to the specialised vocabulary used) read scientific research papers, preferring to read online customer reviews [71]. TikTok is a key source of health information for younger generations, in preference to asking healthcare professionals, despite known issues with misinformation [72]. Osteopathy needs to respond to these changes, using PROMs, Google reviews and social media, as well as research, to generate trust in the profession.<\/p>\n<h2 class=\"wp-block-heading\">4.\u00a0\u00a0\u00a0 The Future of Osteopathy<\/h2>\n<p class=\"wp-block-paragraph\">Are we entering a post-professional world where the healthcare professions will lose power and prestige as players in the healthcare ecosystem [13]? Will winners and losers be decided by empowered, well-informed consumers, and the term \u2018evidence-informed\u2019 broaden to mean patient preference, clinician experience and qualitative, whole person research as well as quantitative research?<\/p>\n<p class=\"wp-block-paragraph\">Rather than centralised but fragmentary and disconnected records, will patients each have an app\/chip\/device that holds their entire health record, including real time monitoring of heart rate variability and hormonal shifts, alerts for regular check-ups, air pollution\/pollen counts, and such like? Will patients take control of access to their data by physicians and public health agencies? Privacy, data security, ethical and technological questions must be answered, but there is already a template for this in the banking and financial system [73].<\/p>\n<p class=\"wp-block-paragraph\">Will students choose modules from different providers and in different formats (face-to-face, online, clinical) to build a portfolio of skills and knowledge that meets their own needs as well as professional standards? This kind of\u00a0 apprenticeship model is already established among other AHPs, such as physiotherapy and occupational therapy [74].<\/p>\n<p class=\"wp-block-paragraph\">Will osteopathy better mirror local priorities, beliefs and attitudes, such that an osteopath in Scotland practises differently to an osteopath in Nova Scotia? Which aspects of the local osteopath\u2019s role can be better done by AI, a psychotherapist, a personal trainer, a community garden project or a remotely located but specialist online osteopath? How will osteopathy overcome barriers facing disadvantaged people, enabling them to access care?<\/p>\n<p class=\"wp-block-paragraph\">For all the changes that are swirling around us, people have forever sought therapeutic touch and someone to talk to about their troubles. Osteopaths know, from their experience in practice, the transformative potential of osteopathic care. Our embodied, enactive, relational selves must deal with dynamic and diverse situations throughout life, and osteopaths can help patients to potentise some of that complexity, possibility and ambiguity. Nicholls argues that \u201cfalling back on standardised assessments, evidence-based \u2018best practice\u2019 mandates, pre-formulated care plans, and even rules of professional conduct, can have the perverse effect of <em>reducing<\/em> the ethical conduct of practitioners. As the anxieties of undecidability are substituted with formulaic ways of thinking and acting, we increasingly \u2018evacuate ethical decision making [75]\u2019 and substitute complexity for systems and structures that are de-contextual and reductive\u201d [13].<\/p>\n<p class=\"wp-block-paragraph\">Osteopaths have confidence in their profession, with 69% agreeing that its strength comes from breadth and diversity of practice, 73% believing it can successfully evolve to respond to changing healthcare needs, and 77% believing that it takes a whole-person, individual approach to meeting patient needs [2]. If that\u2019s true, osteopaths (and their institutions) should be open to change, humble and creative in their response to shifting patient priorities.<\/p>\n<p class=\"wp-block-paragraph\">Osteopaths can revisit their roots for inspiration. As AT Still said, \u201cto obtain good results, we must blend ourselves with, and travel in harmony with nature\u2019s truths\u201d [67]. A more recent expression of this concept says, \u201cThe osteopathic profession has a unique opportunity for the future, namely, promoting integrative care through its Body-Mind-Spirit tenet and incorporating manual approaches for symptom and non-symptom-based treatments\u201d [76]. Stephen Tyreman wrote movingly, in his last editorial, about becoming a person-centred practitioner: \u201cThe practitioner\u2019s task is not merely to explain and treat, but to provide support and insight into the meaning of illness experiences in order to enable a patient to develop a better, life-enhancing narrative and become a more whole person\u201d [77]. The missing part, perhaps, is a sense of equality between osteopaths and patients and between osteopaths and other professionals. As Deborah Smith said, \u201cProcess-based approaches are the theme of new models alongside multi-dimensional, multi-modal, individualised treatment programmes focussed on goal-directed outcomes including the expertise of other professions\u201d [78].<\/p>\n<p class=\"wp-block-paragraph\">We need to embrace osteopathy in its wholeness to appreciate its value, fulfil its true potential and to clarify our professional identity [79]. Only then will we be able to communicate our profession effectively to both potential patients and potential students.<\/p>\n<p class=\"wp-block-paragraph\">To summarise, this paper signposts potential avenues for change, including:<\/p>\n<h3 class=\"wp-block-heading\">Navigating The Changing Healthscape<\/h3>\n<ul class=\"wp-block-list\">\n<li>Consider how osteopathy might remain relevant, focusing on the profession\u2019s distinctive and popular appeal in a person-centred healthcare ecosystem, while addressing weaknesses with regard to unconscious biases and the need for more collaboration with other healthcare providers.<\/li>\n<li>Utilise PROM findings and the value of statutory regulation (trust is a key decision making factor among health consumers [5]) in promotional messages, targeting both health consumers and prospective students.<\/li>\n<li>Encourage all 5,597 osteopaths to share health and wellbeing promoting ideas with the public and encourage their patients to post reviews and talk about their osteopathic experiences on social media.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Regulation<\/h3>\n<ul class=\"wp-block-list\">\n<li>Consider how to bring the osteopathic profession, the schools and the regulator closer together to achieve more effective (Safety II) regulation and increase trust with the public.<\/li>\n<li>Explore a mediation-based conflict resolution model to help secure a patient-centric outcome and preserve financial resources.<\/li>\n<li>Shape the GOSET document and CPD scheme in consultation with the profession, to protect the public and to minimise complaints.<\/li>\n<li>Increase engagement between the GOsC and the profession to evaluate EDIB situations already being faced and develop a framework for handling current and anticipated issues.<\/li>\n<li>Encourage dialogue between GOsC and other healthcare regulators to consider cross-profession regulation, a need acknowledged by the Health and Care Professions Council [80].<\/li>\n<li>Explore the use of AI by the GOsC to monitor misleading advertising claims and non-osteopaths claiming to be osteopaths, or who use osteopathic techniques.<\/li>\n<li>\u00a0Consider the use of AI for cost-effectively auditing registrants\u2019 CPD activities.<\/li>\n<li>Establish a clearer connection between the arbitrary-seeming demands of the CPD scheme and the nature of patient complaints received.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Education &amp; Research<\/h3>\n<ul class=\"wp-block-list\">\n<li>Use the \u2018marketing mix\u2019 or the four Ps (Product, Price, Promotion, Place) [81], that are within our control to change, to create a more attractive educational offering in a competitive marketplace. An osteopathic school in Northern England or Scotland would overcome \u2018place\u2019 issues, for instance.<\/li>\n<li>Explore collaboration opportunities with other education providers to help students create a skills portfolio that fits the needs of the profession and meets their own interests.<\/li>\n<li>Encourage greater involvement of the profession with the OEIs to match the content of undergraduate courses (the \u2018product\u2019 offering) to the osteopathic therapeutic encounter, ensuring that graduates are fit to practise and that the course is distinctive and inspiring to prospective students.<\/li>\n<li>Explore how to reduce barriers to entry to osteopathic schools.<\/li>\n<li>Review student needs and how these could be better met, through different educational models and wider collaboration with other educational providers.<\/li>\n<li>Review research strategy to reflect the full scope of osteopathic practice and foreground the patient experience, building on the National Council for Osteopathic Research (NCOR) initiative on practice based research networks [82] and the findings of the PROCare survey [69].<\/li>\n<li>Existing osteopathic patients are willing and able to help us, if they can be given a voice in our research. 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International Journal of Osteopathic Medicine 2022;45:25\u201337. <a href=\"https:\/\/doi.org\/10.1016\/J.IJOSM.2022.06.005\" rel=\"nofollow\">https:\/\/doi.org\/10.1016\/J.IJOSM.2022.06.005<\/a>.<\/p>\n<p class=\"wp-block-paragraph\">[80]\u00a0\u00a0\u00a0\u00a0 HCPC. A new era for health and care: why regulation must evolve to protect the public | The HCPC 2025. <a href=\"https:\/\/www.hcpc-uk.org\/news-and-events\/blog\/2025\/a-new-era-for-health-and-care-why-regulation-must-evolve-to-protect-the-public\/\" rel=\"nofollow\">https:\/\/www.hcpc-uk.org\/news-and-events\/blog\/2025\/a-new-era-for-health-and-care-why-regulation-must-evolve-to-protect-the-public\/<\/a> (accessed September 30, 2025).<\/p>\n<p class=\"wp-block-paragraph\">[81]\u00a0\u00a0\u00a0\u00a0 Mojtaba Hosseini S, Etesaminia S, Jafari M, Jafari M. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL. Materia Socio-Medica 2016;28:366. <a href=\"https:\/\/doi.org\/10.5455\/MSM.2016.28.366-369\" rel=\"nofollow\">https:\/\/doi.org\/10.5455\/MSM.2016.28.366-369<\/a>.<\/p>\n<p class=\"wp-block-paragraph\">[82]\u00a0\u00a0\u00a0\u00a0 Draper-Rodi J, Fawkes C, Bailey D. Development of a national osteopathic Practice-Based Research Network\u00a0(PBRN): the NCOR Research Network. Scientific Reports 2025 15:1 2025;15:1\u201313. <a href=\"https:\/\/doi.org\/10.1038\/s41598-025-11527-4\" rel=\"nofollow\">https:\/\/doi.org\/10.1038\/s41598-025-11527-4<\/a>.<\/p>\n<p class=\"wp-block-paragraph\">Thanks everyone for reading and for watching the video, more should be coming soonish<\/p>\n<p class=\"wp-block-paragraph\">Penny<\/p>\n<p><span id=\"wordads-inline-marker\" style=\"display: none;\"\/>\t\t\t<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>OK I have finally got round to my second ever youtube interview, this time with Mary Monro. Mary has written an article on issues facing the profession. It is reproduced below the video, complete with references. The Future of Osteopathy in the UK by Mary Monro Introduction\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We are at a moment of seismic change [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":7050399,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11764],"tags":[2481,5239,212951,15042],"dealstore":[],"offerexpiration":[],"class_list":["post-7050398","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-alternative-medicine","tag-future","tag-mary","tag-monro","tag-osteopathy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Mary Monro on The Future of Osteopathy in the UK - Som2ny Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fivemor.com\/?p=7050398\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Mary Monro on The Future of Osteopathy in the UK - Som2ny Network\" \/>\n<meta property=\"og:description\" content=\"OK I have finally got round to my second ever youtube interview, this time with Mary Monro. Mary has written an article on issues facing the profession. It is reproduced below the video, complete with references. 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