Two thirds of osteopaths are poorly trained and the Igas denounces this lack of quality. Osteopaths try to clean up. But in the meantime, patients want to understand in order to choose.
Osteopathy is a hit. 20 million French people have already consulted one of these specialists in manual manipulation of bones, joints and muscles. However, this booming profession is going badly. As proof, a report of the General Inspectorate of Social Affairs (Igas) remained under the elbow for two years and which has just been published. Its authors fire red balls on the system of training of osteopaths.
The accreditation procedure for schools is deemed “questionable and falsely binding”. Ten years after recognizing the title of osteopath, the public authorities have approved no less than 74 schools. There are about ten in Great Britain. According to the Igas, the training of osteopaths falls short in terms of quality and quantity. In terms of the number of training hours, for example, France is lagging behind, far behind international recommendations.
Patrick Féval, president of the national union for higher education in osteopathy: “5,000 to 6,000 professionals out of 17,000 are worthy of bearing the title of osteopath”.
Today, 17,000 professionals say they practice osteopathy. 38% are physiotherapists, 8% are doctors, the remaining 64% are neither. Suffice to say that the level of training is very heterogeneous and that for patients, it is difficult to navigate and find a competent professional.
The Igas made 18 proposals to try to see more clearly. The authors of the report proposed in particular to thoroughly review the criteria for accreditation of schools, but also to establish a maximum number of students in the 1st year. But, “two years later, nothing has been done. “We can speak of deception vis-à-vis the patient,” protested Patrick Féval. “I accuse the public authorities of granting an osteopathic status to anyone who claims it, without any regard for the patients,” adds Guy Villemain, president of the register of osteopaths in France.
This is the reason why the national union of higher education in osteopathy, Sneso, decided to take the lead. It has just developed a training reference system which lists the basic skills that all osteopaths must master. Sneso hopes that its business benchmarks will serve as a basis for the Ministry of Health to establish more rigorous legislation.
Patrick Féval : “The osteopath must have medical knowledge, to be able to make an appropriate diagnosis”.
How to navigate?
In the meantime, patients are struggling to sort the wheat from the chaff. Only solution for the moment, check training followed by your osteopath: 4 to 5 years of study are better than 3… and to be a former graduate of a member school of the Sneso constitutes, for example, a guarantee of quality.
Other difficulties for patients, knowing which doors to knock on: osteopath, physiotherapist or even chiropractor? Borders are not always clear. Especially since these professionals often engage in fierce competition. First difference between these three professionals, physiotherapists are the only ones whose care, prescribed in advance by a doctor, can be reimbursed by social security. However, more and more mutuals are offering the management of osteopathy.
Vincent Arin-Stocchetti, osteopath in Albi and author of “Physiotherapist or Osteo, who to consult?”: “The osteopath leads the investigation and considers all the mechanical causes that can disrupt the human body. “
Should we let ourselves manipulate or not the cervical vertebrae for neck pain? This is undoubtedly one of the most recurring questions concerning the practice of osteopaths and chiropractors. The very serious British medical journal recently published an adversarial debate on the subject.
At the center of the debate is a very small, very rare, but very serious risk of stroke. This risk is estimated at 1 to 1.7 / 100,000 person-years. At the end of the debate, the “for” and “against” stand in their position but come together on one point: manipulation of the neck should only be used with a clear objective and not with a preventive objective, and only afterwards. have considered other treatments. Which would not always be the case.
Vincent Arin-Stochetti adds an element to the debate: “The majority of manipulations are useless. Often the necks just adjust to a problem that is lower or higher. “Patrick Féval also believes that” going to manipulate a painful and inflammatory region is not conceivable for an osteopath. You never hit a bump to make it fit, ”he quipped.
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