Osteopathy in France
Osteopathy has been recognized in France by a law passed in 2012 (link). Decrees dated 2007 and 2014 regulate practice and education (links). Osteopathy in France is therefore a fully regulated activity.
What is osteopathy in France ?
Patients may visit an osteopath without being referred by a doctor. It is up to the osteopath to decide whether or not his-her patient needs to see another healthcare practitioner. Nevertheless, osteopaths need a certificate from a doctor to be allowed to practice manipulations on babies under 6 months and on cervical spine. However, they may practice mobilizations without such a certificate.
Osteopathy is defined as follow by the health minister (link).
Definition of osteopathy
An osteopath uses a systemic approach, and, after having realized an osteopathic diagnosis, realizes mobilizations and manipulations to fix osteopathic dysfunctions of human body.
The aim of these manipulations and mobilizations is to prevent or treat these dysfunctions in order to maintain or improve persons’ state of health of patients, excepted in cases of organic diseases which need a therapeutic, medical, surgical, drug or physical intervention.
Definition of osteopathic diagnose
Osteopathic diagnosis includes an appropriateness diagnosis and a functional diagnosis:
- Appropriateness diagnosis: osteopath’s procedure consisting in identifying symptoms and warning signs justifying a medical opinion prior to any osteopathic care.
- Functional diagnosis: osteopath’s procedure consisting in identifying and organizing osteopathic dysfunctions and their interactions into a hierarchy in order to decide the most accurate osteopathic treatment likely to improve person’s state of health.
Definition of osteopathic dysfunction
Somatic system components mobility, viscoelasticity or texture deterioration.
It may be accompanied by painful sensitivity.
Definition of osteopathic manipulation and mobilization
A manipulation is a unique, fast and low amplitude movement given directly or indirectly on a dysfunctional somatic system component in order to restore its mobility, viscoelasticity or texture characteristics. Manipulations gets this component beyond its dynamic range as observed during examination, without overtaking the anatomical limits.
Given on a joint or a group of joints, it may be accompanied by a crack noise (cavitation phenomenon) which therefore is not a sign and has no prognosis value.
Mobilization is a passive movement, sometimes repetitive, of various velocity and amplitude, given on a dysfunctional somatic system component.
Who may practice osteopathy in France ?
Only people graduated in osteopathy by a school accredited by French health minister may practice osteopathy after having been registered by local sanitary authorities.
More than 30,000 osteopaths are currently registered in France, among them 22,000 ‘only’ osteopaths, 10,000 physiotherapists/osteopaths, 1,500 physicians/osteopaths.
What curriculum to be graduated ?
A student needs to achieve 4,860 hours of training in osteopathy to become an osteopath.
These hours are divided as follows:
- 760 hours of fundamental sciences
- 632 hours of semiology of health alterations
- 160 hours of human and social sciences, management and legislation
- 160 hours of osteopathic concepts and principles
- 1266 hours of practical training in osteopathy
- 168 hours of academic work methods
- 194 hours of skill development in osteopathy
- 1500 hours of clinical practice, including 150 complete and validated consultations
- 20 hours of thesis guidance
What is needed for a school to be accredited by the health minister ?
24 criteria are required for all training institutions, regardless of the student background (previous health professional qualification or not):
- Training institutions are higher education institutions and contribute to the public service for higher education. They are thus under the joint authority of the Health Ministry and the Higher Education Ministry.
- Their governance must be specifically organized; Scientific Council, Education/Academic Council, Disciplinary Council, and an Examination and Professional Skills Validation Commission.
- The facilities must be exclusively dedicated to the osteopathic training and respect the appropriate regulations. Their surface area must be at least 5 m2 per student.
- The institution must justify a financial capacity sufficient to guarantee at least one year of training.
- The director of the institution must be an osteopath, with a high level of management skills.
- The teachers must have appropriate qualifications. Osteopaths who teach must have at least 5 years of professional osteopathic experience.
- The number of teaching staff must be equivalent to one full-time teacher per 25 students. - In addition, it must include 5 full time education/academic coordinators.
- Clinical training must account for 150 complete and validated consultations per student. - Two thirds of these consultations must be made at the institution’s on-site clinic.
- The institution must undertake a graduate follow-up survey at 18 and 30 months after graduation.
- The student capacity of the institution is calculated based on its adequation with the quantitative criteria.
Is osteopathy popular in France ?
Osteopathy is very popular in France. A survey proceeded in September 2015 by an independent body showed that 27 % of French citizens had received an osteopathic treatment during the last year, 49 % during the last 5 years. 88 % trusted in osteopaths for providing safe treatments.