What’s Wrong with Osteopathy? (2) Manual Therapy, Plausibility and the Question of Touch

What’s Wrong with Osteopathy? (3) Clinical reasoning, practice & expertise

In this third part of the conversation with Oliver Thomson, we explore how osteopaths think about their practice. Drawing on his doctoral research, Oliver explains how different “conceptions of practice” shape clinical reasoning, therapeutic approaches, and professional identity. We discuss the spectrum between technical rationality and professional artistry — and what this means for how expertise is understood in manual therapy. Rather than reducing expertise to manual skill alone, this episode looks at decision-making, communication, and the complexity of real-world practice. A deeper reflection on how clinicians think, and why variation within the profession may be more structured than it seems. References: * Edwards, I., Jones, M., Carr, J., Braunack-Mayer, A. & Jensen, G. M. Clinical Reasoning Strategies in Physical Therapy. Phys. Ther. 84, 312–330 (2004). * Petty, N. J. Becoming an expert: A Masterclass in developing clinical expertise. Int. J. Osteopat. Med. 18, 207–218 (2015).

What’s Wrong with Osteopathy? (2) Manual Therapy, Plausibility and the Question of Touch

What are we really doing when we put our hands on someone? In this second episode, the conversation moves closer to the clinic. We explore the place of touch in modern manual therapy — not from a defensive position, but from a position of curiosity. If we move beyond outdated structural explanations, does manual therapy still make sense? Does something need to “move” or “change” inside the body for improvement to occur? And how do we think about plausibility without falling into magical thinking — or reducing everything to context? This is not a debate about whether touch works. It’s a conversation about how we understand it. Between biomechanics and experience, between tradition and contemporary thinking, we try to clarify what manual therapy can — and cannot — responsibly claim today. A discussion for clinicians who still use their hands, but want to think carefully about why.

What’s Wrong with Osteopathy? (1) Criticism, Social Media and Professional Culture

Criticism is not new in osteopathy. What is new is the way it unfolds — publicly, instantly, and often emotionally — on social media. In this opening episode, we explore a simple but uncomfortable question: what does criticism reveal about our profession? We discuss: * How online debates shape professional identity * The tension between internal critique and public exposure * The role of social media in amplifying division * Whether controversy signals weakness — or growth * What professional maturity might look like in a fragmented landscape Rather than taking sides, this conversation aims to step back and examine the cultural dynamics at play. Is the problem the criticism itself — or the way we handle it? A reflective discussion for practitioners who care about the future of the profession. References Thomson, O. P. & MacMillan, A. What’s wrong with osteopathy? Int. J. Osteopat. Med. 48, 100659 (2023). Toloui-Wallace, J., Forbes, R., Thomson, O. P. & Costa, N. Fluid professional boundaries: ethnographic observations of co-located chiropractors, osteopaths and physiotherapists. BMC Heal. Serv. Res. 24, 344 (2024).