MagnouatDelphine - British School of Osteopathy

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Individual Enquiry



Research Paper 200
8





Title: A description of the profile of osteopathic
practitioners in France





Author: Delphine Magnouat





Supervisor: Roberta Herrick











The British School of Osteopathy

275, Borough High Street
, London SE1 1JE


2

AC
KNOWLEDGEMENTS


I would like to thank my supervi
sor Roberta Herrick for her

time and advice.
















































3

Background:
Since the recent statutory regulation of osteopathy in France in 2002, there is no
up
-
to
-
date research that has explored the profile of practitioners.


Purpose:
The objectives of this study were to identify the personal characteristics of
osteopathic practitioners in France.


Methods:
A questionnaire was sent to 200 members of the French re
gistrar “Registre des
Ostéopathes

de France (ROF)”.

A systematic selection of the participants was performed and
every fifth osteopath on the registrar’s list was drawn.


Results:

A response rate of 56% (N=112) was obtained, of which 53.5% (N=107) were use
d
for statistical analysis. The average age was 40.58 and males (67.3%)
outnumber

females
(32.7%). The average time in practice was 10.835 years. They report working 35.28 hours per
week, seeing 14.77 new patients and 27.68 follow up patients.
They spend

o
n average 47.99
minutes for a new patient and 27.68 minutes for a follow up patient.
On average, 6.66% see
patients on the same day they contact the practice, 13.33% see patients the next day and
35.24% see patients within a week
. Many have prior medical q
ualification (43.92
%) and most
were physiotherapists

(37.4%).
Most osteopaths (
71.7%
)

report working alone,
few as part of a
team (
1.9%
)

and
some alone and as part of a team (
26.4%
)
. The average number of practices
they work in is 1.34. Osteopaths charg
e 5
3.85 Euros for a new patient

and 53.4
1 Euros for a
follow up patient
. The most common therapeutic adjunctions were counselling and
psychotherapy (23.36%), homeopathy (17.76%), herbal medicine (7.48%), nutritherapy
(7.48%), naturopathy (6.54%), acupuncture
(3.74%).
The majority of practitioners received
their education in France (71%).


Conclusions:

This study is unique because
no previous research has

describ
ed

t
he
profile of
French osteopaths
since
statutory
regulation of the profession

in 2002
.

This resea
rch provides
up
-
to
-
date information and a first insight into the characteristic of practitioners in France.

The
results can be used

as a
baseline for future research and

for comparison with other countries.
This study

may encourage further research
.
It als
o provides

information for os
teopaths who
may want to practis
e in France.

















4

INTRODUCTION


Statutory reg
ulation of osteopathy in France


Osteopathy was legalised in France on the 4
th

March 2002 and became

a professional academic
institution

(
Bo
utin, 2008
). A
rticle 75 of

the law provides the basic framework within which
osteopaths pra
ctis
e
. Practitioners can use the title “Osteopath” if they receive a professional
education from establishments selected by the Health Office and if they prove conti
nued
professional development. Without any prior medical qualification, osteopaths must complete a
full time training of six years to obtain the Diploma of Osteopathy
(
D.O.
)
, at the end of which
they

must pass a clinical exam and present a dissert
ation
. Fi
nally,

they must register with

a
b
ody recognised and approved by

the State representative. The main French Registrar
“Registre des
Ostéopathes

de France (ROF)” sets standards of osteopathic training and
practice, sets codes of conduct, promotes osteopathic

care, develops the profession and protects
the patient (
Boutin, 2008
).


Historical account


The time it took for osteopathy in France to obtain statutory regulation confirms the desire it
had to become a legal independent and autonomous profession.

Oste
opathy ha
s

been

practised in France since 1925 and was introduced by Doctor Lavezarri
(Leboursier, 1
993). In 1950, Paul Geny created

the first French school, “
l’Ecole Française
d’Ostéopathie
” (EFO). In 1965, the school wa
s exported to England

and later bec
ame

the
European School of Osteopathy (ESO). In 1973, students from the ESO create
d


l’Association
Française de Défense de l’Ostéopathie

(AFDO)” to protect and regulate the profession. The

Registre des Ostéopathes de France
” (ROF), created in 1981, organi
ses and controls the
profession. The “Federation
Française d’Ostéopathie

(FFO)” wa
s created in 1976 to protect
osteopathy, later known as the “Union
Fédérale des Ostéopathes

de France (UFOF)” in 1987.
The Union

wished for

statutory regulation, a change in
law against illegal practice and
recognition of schools (UFOF, 1988). In 1987, the “
Collégiale Académique

(CA)” regrouped
and controlled

osteopathic colleges in France. On the 19
th

May 1997
, the European Parliament
adopted

the resolution of Paul Lannoye to

promote non
-
conventional medicines. On the 26
th

September 1998, a council “Conseil National
Représentatif des Ostéopathes

de France
(CNROF)” wa
s formed and represented by the ROF, the CA, the AFDO, the UFOF and a

5

French Academy. The

Health Ministry and th
e ROF me
t in 2001 to evaluate a regulation of the
profession. The GOsC chairman Simon Fielding

met

the ROF to help with this matter (
Boutin,
2008
).

All this effort led to statutory regulation in 2002.


Challenges faced by the profession


Since osteopathy
existed in France, it has been accused of illegal practice.

Penalties were
augmented
,

setting back the recognition of the profession (Leboursier, 1993). In 1962, a
decree stated that forced mobilisation from osteopathic or chiropractic treatment should on
ly
be practised by qualified doctors (ROF, 2007). In 1987, the Ministry only allowed practitioners
with full medical studies to make a diagnosis and choose the ap
propriate therapy. Those
practis
ing vertebral manipulation ran the risk of being prosecuted fo
r illegal practice (ROF,
2007).

Because osteopathy in France has only been legally recognised

since 2002
, its role

and its
boundaries within the healthcare system are constantly

changing (CEESO, 2007).

T
he Code of
Conduct is regularly updated upon changes

within the profession and the healthcare system
(ROF, 2007 and

CEESO, 2007).
Despite the legalisation and

the increase in demand
f
or

osteopathic treatment, osteopathy is criticised by the medical establishment. Recently, in
March 2007,
the conditions and

rights of osteopaths were reviewed (ROF, 2007). The decree
stated that practitioners cannot treat the pelvic region and gynaecological or obstetric
disturbances (ROF, 2007). A doctor must make a diagnosis before the osteopath can
manipulate the cranium, th
e face, babies under six months and the cervical spine (ROF, 2007).
In October 2007, a decree was published and showed a significant drop in the number of
establishments in France entitled to deliver the diploma of osteopathy (ROF, 2007). The
medical estab
lishment in France is compared to an

almighty citadel of medical power


(Leboursier, 1993
, p.86
).
It has been argued that t
h
e m
onopoly reje
cts osteopathy because they
do no
t appreciate it, because they are misinformed or because of their desire to rule al
l medical
professions (Leboursier, 1993).

Knowledge, collaboration and good communication between
healthcare professionals

enhances standards of care and continued professional development
(Langworthy and Smink, 2000

and Brussee
et al.
, 2001
).

It could be

argued that the separation
of osteopathy from mainstream medicine in France may have adverse consequences for patient
care.




6

Increase in demand
f
or

osteopa
ths


Chronic pain from musculoskeletal problems has dramatically increased in Europe and is a
major

health care problem placing more demand on manual therapists (Breivik
et al.
, 2005).
There has been a significant rise in the demand of non
-
conventional therapies in France in the
last twenty years (
Boutin, 2008
). In 1995, a study done by COFREMCA, a surv
ey institute in
Paris, shows this shift in demand with 38% of French people seeking non
-
conventional
medicine and 19% seeking osteopathy compared to 5% in 1983 (
Boutin, 2008
). Of those asked,
66% were willing to try osteopathy (
Boutin, 2008
). Most patients

are female, sports

people or
sedentary people. A r
esearch department in health CREDES (Centre de Recherche, d’Etudes et
de Documentation en Economie de la
Santé
) published data in December 2002 on the
popularity of osteopathic and chiropractic treatment a
mongst the general public. 8.5% of
French (5.5 million) had received treatment in the last year. More than 70% were treated by
osteopaths exclusively. A study by the “Academie d’Osteopathie” showed 46% (270000) of

babies born in 2005
have received treatmen
t (
CEESO, 2007).


The profile of French o
steopat
hs


In France
, osteopathy i
s
now
an official
legal health practice but

its

s
cope of practice remains
unclear

(CEESO, 2007).

E
-
O Renard published data in 2006 on the professional background of
osteopaths in F
rance

(CEESO, 2007)
. Six hundred doctors practis
e osteopathy.
Four to five
thousand physiotherapists have taken a c
omplementary training to practis
e osteopathy
,

of

which two thousand only practis
e osteopathy
. Three thousand osteopaths only received
osteo
pa
thic training and only practis
e osteopathy (
CEESO, 2007).
There were one thousand
registered on the ROF in 2006
,

of which 40% have a doctor or physiotherapy background.
Today, there are 961 registered osteopaths on the ROF (ROF, 2008).


The last study on d
emographics of osteopaths in France was done by E
-
O Messeguer in 2001.
He analysed the osteopathic population from 1988 to 2001
registered on the ROF
and looked at
the number of registered osteopaths on the ROF, gender, the number of practices osteopaths
w
ork in and age distribution.
The number of registered osteopaths steadily increased every year
from 193 members in 1988 to 635 in 2001.
In 2001, the survey provided information on
pr
actitioner
s gender (females: 23%, male: 77%), age (20
-
30: 11%, 30
-
40: 20%,

40
-
50: 34%,
50
-
60: 31%, over 60: 4%), number of practices (one: 543, two: 81, abroad: 6).

More than 65%

7

were between 40 and 60 years of age. Between 1988 and 2001, there was a rise in the number
of practitioners in the 20 to 30 age group because of the in
crease in full time training
programmes (Messeguer, 2001).

Today, there are 961 registered osteopaths working in France
(females: 35.3%, males: 64.7%) (ROF, 2008).


The profile of osteopaths in other countries


Osteopathy is spreading worldwide and every c
ountry has different standards of training and
pr
actice, which makes it

difficult to define a scope of activity (WOHO, 2007). In March 2004,
the World Osteopathic Health Organization aimed to define “educational requirements,
licensure and registration” (W
OHO, 2007).

I
n America, osteopaths are part of the medical mainstream and are licensed physicians (Baer,
1984). Their scope of practice is similar to medical doctors’ with less emphasis on the manual
aspect of the profession (WOHO, 2007). Over the last ten

years, osteopathy has become
increasingly popular in Europe with different training and practice (OSEAN, 2007). In
England, osteopathy was a marginal profession (Baer, 1984) before being legall
y recognised
with the Osteopaths

Act in 1993 and moving from b
eing an alternative therapy to
a mode of

primary health care (GOsC, 2007
). Within the primary health care system, the profession is
constantly trying to define its scope of practice and its role remains un
clear (Vogel and
Grundy, 2003). The General Osteopa
thic Council carried out three snapshot surveys in 1994,
1997 and 2001 to gather information about osteopathic practice. The information was on
patients’ characteristics (age, gender, symptoms patients present with, osteopathic evaluation,
and treatment te
chniques), osteopaths’ characteristics (age, gender, time in practice, fees) and
practitioners’ lifestyle.
In 2001, the survey provided more information on the profile of
practitioners.

There were

a fairly

equal proportion of female (48%) practitioners and

male
practitioners (52%). The majority of osteopaths were aged 36 to 45 (40%)
or

over 45 (30%).
37% had been in practice for 3 to 10 years and 34% for 11 to 20 years. Many osteopaths
reported working as part of a team (44%).
The average number of patients

seen by practitioners
per day decreased from 1997 to 2001. It was 9.07 in 1994, 9.31 in 1997 and 8.3 in 2001. It
would be interesting to see whether this number has changed since 2001.

Fees for

consultations
ranged from £20 to over £40.

45% of practitione
rs reported charging between £25
-
30

for an
initial consultation and

57% of practitioners reported charging £25
-
30 for subsequent
consultations.
Information on funding showed a decrease in payment by patient from 1997
(payment by patient: 89.5%, NHS funded:

3.4%, Private Health Insurance: 7.1%) to 2001

8

(payment by patient: 86.2%, NHS funded: 2.3%, Private Health Insurance: 10.4%).

Today,
there are 3987 registered osteopaths with the GOsC (53.1% males and 46.9% females) (GOsC,
2008).



In France, there is cur
rently no funding for osteopathic treatment; all payments are made by the
patient (ROF, 2007). This is also the case in other European countries such as Belgium,
Switzerland and Sweden (
Blanchard
et al.
,
2006).


In Australia
, an unpublished dissertation

pr
ovided data on the profile of 63 osteopaths (Hepke,
2004).

The study provided information on gender (female: 69%, male: 31%), age (up to 25:
25%, 26
-
35: 41%, 36
-
45: 15%, over 45: 19%), years in practice (up to 2: 24%, 3
-
10: 44%, 11
-
20: 16%, over 20: 16%),
type of work (teamwork: 62%, alone: 38%), funding (payment by
patient: 53%, payment by State Health Authority: 5%, payment by Private Health Insurance:
33%, payment by Accident Compensation Fund: 9%) (Hepke, 2004).


There has only been one published study
describing the profile of osteopathic practitioners in
France (Messeguer, 2001). Since statutory regulation of the profession, there is little data
available describing the osteopathic profile (ROF, 2007; osteopathie
-
france, 2007).
Despite the
increase in
demand
f
or

osteopathy in France, osteopathic practice and training is criticised and
ruled by the powerful medical establishment.
Collaboration and knowledge between healthcare
professio
nals enhances standards of care and

allows them to cooperate to delive
r optimal care.

This manual therapy has not been investigated recently and lacks recognition. It

is useful to
up
date data on demographics

of osteopaths. The aim of this project was to investigate the
profile of osteopaths in France. The objectives were to
identify the personal characteristics of
osteopathic practitioners. The study may encourage further study and the results will provide a
baseline for future research and future comparison. This research will
also
provide valuable
information for those who
may want to practi
s
e in France.










9

METHOD


Questionnaire development:

This research was based on a questionnaire to access a greater number of subjects. Parts of an
unpublished questionnaire presently under development by the British School of Osteopa
thy
(BSO) have been
translated into French and proof
-
read by an independent French teacher (See
appendix

3 and
6
). The questions focused on variables of age, years in practice, school of
training, other therapies used, number of practices, number of hours
of work a week, number of
patients a week, number of days to get an appointment, time for treatment and consultation fee.


Ethics:

Ethical approval was given by the BSO Research Ethics Committee BSOREC.


Participant
s:

Participants (72 males and 35 females
) were
recruited from a French Registe
r: the “Registre
des
Ostéopathes

de France (ROF)” and
they
work in France.
The ROF registers qualified
practitioners from an approved training establishment and sets standards of conduct and
practice in F
rance (ROF, 20
07). This registe
r was chosen

because it is the main registe
r in
France and the largest (AO, 2007 and GOsC, 2007). The ROF was contacted to obtain
permission to use their data base for this study and permission was obtained.
There are 961
registered osteop
aths on the ROF (ROF, 2008). To select a sample, a systematic selection of
the participants was performed and starting on the first page, every fifth osteopath on the
registrar’s list was drawn. 200 participants were drawn providing a sample of 18.57%.


P
rocedure:

A survey pack in French was sent to each subject at their postal address and included: a

letter
of introduction
explaining the purpose of the study and inviting them to participate in the
study, a
n information sheet, the questionnaire and a stamp
ed self
-
addressed envelope. See
appendices 1 to 6

for copies of the survey pack in
English

and in
French
. Survey packs were
sent at the end of September 2007. Participants were asked to return the completed
questionnaire by the 30
th

November 2007
. Data col
lection was done from October until the 30
th

November 2007.




10

Data analysis:

The data obtained from osteopaths practising in France was entered manually into SPSS
database. Statistical analyses were performed using SPSS 15.0 for Windows. It was analysed
u
sing simple quantitative descriptive statistics. Correlations and independent sample t
-
tests
were used to explore the data. The data was explored for normality of the distributions.































11

RESULTS


200 questionnaires were sent out. Th
ere were one hundred and twelve responses
-

a response
rate of 56%. Five recipients did not complete the questionnaire and expressed personal
disapproval of the study (2.5%). There were one hundred and seven questionnaires used for
statistical analysis (53
.5%). Please see table 1 and 2 for a summary of the answers to the
questionnaire.


Table

1

Participants


responses (N=107)


Questionnaire item

Mean

(SD)

N

Age of participants (years)

40.6

11.1

106

Time in practice (years)

10.8

7.8

106

Number of practic
es

1.34

0.5

107

Number of hours per week working

As an osteopath

Including treating patients using

other
types of therapy (e.g. physiotherapy)

35.3

37.8

14.2

13
.6



107

107



Average number of patients seen

per week as an osteopath

New patients

Follow
-
up

patients



14.8

27.7



11.7

20



95

96

Appointment time (in minutes) for a

New

patient

Follow
-
up patient


48

41


11.4

10.1


107

106

Consultation fee (in Euros) for a

New patient

Follow
-
up patient



53.8

53.4



7.6

7.1



104

104













12

Table
2

Parti
cipants


responses (N=107)

Questionnaire item

Number

%

N

Gender


Male


Female


72

35


67.3

32.7


107

107

Prior medical qualification


Physiotherapy


Other

No prior medical qualification

47

40

7

60

43.9

37.4

6.5

56.
1

107

107

107

107

Work


Alone


As part
of a team


Alone and as part of a team


76

2

28


71.7

1.9

26.4


107

107

107

Average time between contacting the

practice and osteopathic treatment


Same day


Next day


Two to seven days


Eight to fourteen days


More than two weeks


Variable



7

14

37

14

17

16



6.7

13.3

35.2

13.3

16.2

15.
2



105

105

105

105

105

105

Country of training


France


England



France and England


Canada


76

23

7

1


71

21.5

6.5

0.9


107

107

107

107

Other type of therapy used

Counselling/psychotherapy

Homeopathy

Herbal medicine

Nutrition therapy

Naturopathy

Acupuncture

Hydrotherapy, Medicine, Applied

Kinesiology, Interferential (E.g. lasers,
ultrasound, articulation machines)


25

19

8

8

7

4



1

23.4

17.8

7.5

7.5

6.5

3.7



0.9

107

107

107

107

107

107



107












13

Pearson’s pr
oduct
-
moment correlation coefficient test was used to test for any correlations

-

please see Table 3 for significant correlations. Further testing was performed where relevant
(e.g. analysis by age, years of practice).

R values lower
than 0.2 were excluded

from further
analysis.


Table
3

Pearson’s correlation



Age

Years in
practice

Number
of New
Patients
per
week

Number
of
Follow
-
up
patients
per
week

Osteopathy
hours only
per
week

Total
Hours
of work
per
week

Fee for
a New
Patient

Fee for
a
follow
up
patie
nt

Number
of d
ays
before
treatment

Age

1

0.876**

0.135

0.251*

0.267**

Years in
practice

0.876**

1

0.211*

0.381**

0.424**

Number of
New
Patients
per week

0.135

0.211*

1

0.339**

0.496**

0.433**

-
0.16

0.047

0.258*

Number of
Follow
-
up
patients
per week

0.339**

1

0.720**

0.678**

0.185

0.178

0.248*

Osteopathy
hours per
week

0.496**

0.720**

1

0.859**

0.191

0.176

0.293**

Total hours
of work
per week

0.
433**

0.678**

0.859**

1

0.279**

0.278**

0.289**

Fee for a
New
Patient

0.251*

0.381**

-
0.16

0.185

0.191

0.279**

1

0.948**

0.210*

Fee for a
Follow up
patient

0.267**

0.424**

0.047

0.178

0.176

0.278**

0.948**

1

0.167

Days
before
treatment

0.
258*

0.248*

0.293**

0.289**

0.210*

0.167

1

*. Correlation is significant at the 0.05 level (2
-
tailed)

**. Correlation is significant at the 0.01 level (2
-
tailed)


Strong positive correlations were found between the following variables: the more hours
oste
opaths work on an average week, the more patients they see, the more they charge and the
more number of days patients wait before treatment.

The main two variables were examined: age and years in practice. Age was coded into two
groups (25
-
37 and 38
-
64) u
sing a median split (Mdn=37). More than two groups would have

14

provided small groups for analysis. One outlier, a participant with the age of 71 was excluded.
The Kolmogorov
-
Smirnov test was used to check for the distribution of the scores.

All data
was nor
mally distributed. Independent sample t
-
test revealed statistical significant differences
between the two age groups for the following variables. The older group (38
-
64) treat more
follow
-
up patients (F
93
=2.403,

p<0.001), work more hours a week (F
104
=0.047
,

p<0.001), work
more hours as an osteopath a week (F
104
=0.309,

p<0.001) and has a longer waiting list
(F
102
=1.645, p<0.001) than the younger age group (25
-
37). Table 4 shows the mean differences
between the two groups.


Table
4

Mean values by age group


A
ge Group 1

Mean (SD)

Age Group 2

Mean (SD)

Mean
difference

Number of Follow
-
up
patients

20.8 (15.7
)

35.7 (21.6
)

14.9

Osteopathy hours a
week

30
.7 (11.7
)

40.3 (14.7
)

9.
6

Total hours of work a
week

33 (12
)

43.1 (13.2
)

10.1

Days before treatment

3.2 (1.4
)

4.1 (1.4
)

0.9


Number of “Years in Practice” was split into two groups (1
-
8.5 and 8.6
-
36) using a median
split (Mdn=8.5).
Independent sample t
-
test revealed statistical
ly

significant differences
between the two groups for the follow
ing variables. Those w
ho practis
ed longer (8.6
-
36) have
more follow
-
up patients (F
93
=1.624,

p<0.05), work more hours as an osteopath a week
(F
104
=0.063,

p<0.05), work more hours a week (F
104
=1.66,

p<0.05) and have a longer waiting
list (F
102
=0.15,

p<0.05). Table 5 shows the mea
n values and mean differences between the two
groups.



Table
5

Mean values by Years in Practice group


Mean for
Years
in Practice

Group 1

Mean for Years in
Practice

Group 2

Mean
difference

Number of Follow
-
up
patients

21.7 (16.2
)

34.3 (21.
6)

12.
6

Osteop
athy hours a
week

32.2 (13.3
)

38.7 (14.3
)

6.
5

Total hours of work a
week

34.2 (13.7
)

41.4 (12.8
)

7.2

Days before treatment

3.3 (1.5
)

4.1

(1.3)

0.
8


Due to the scope of this project, no further analyses were performed.


15

D
ISCUSSION


The purpose of this stu
dy was to explore the profile of French osteopaths. Since regulation of
the profession, no previous research has described osteopaths in France. This study provides a
first description of

some of

the characteristics of French practitioners.


The results
o
f

the questionnaire indicate that osteopaths work fairly long hours. Findings of the
present study show a wide variation in the number of patients tre
ated per week by osteopaths.
On

average, osteopaths treat a

large proportion of patients a
week (14.8 new
patients and 27.7

follow up patients). Results are comparable to those in the UK, which show practitioners
treated an average of 8.3 patients a day in 2001 (GOsC, 2001). The older population

work
10.1
more hours a week

and treat
14.9
more follow
-
up patient
s

than the younger population
.
According to Cartmell (1993), number of patients seen per week varies widely between
practices, and osteopaths tend to regulate the number of patients seen per week to suit their
own circumstances (In North
et al.
, 1998). The

numbers of years in practice show similar
results: the lon
ger osteopaths have been practis
ing, the more patients they have and the more
hours they work. The reasons for such variations were not established but may be related to
experience and reputation o
f the osteopath. The average time in pra
ctice was just over ten
years,

which is similar to Australia (Hepke, 2004) and less than in the UK (GOsC, 2001). Half
the practitioners in the UK have worked for more than 10 years (GOsC, 2001). This could be
explain
ed by the fact osteopathy in the UK was regulated ten years before it was in France.
More than half of practitioners can see a patient who consults the practice within a week.
Patients that consult older practitioners or those with more years in practice t
end to wait longer
between contacting the practice and osteopathic treatment. Once again, those that work more
and see more patients will have a longer waiting list.



The results
o
f

this survey (N=107) represent 11.34% of the French Registrar “Registre de
s
Ostéopathes

de France (ROF)”. The findings of this study regarding the personal
characteristics of osteopaths support previous findings

by Messeguer in 2001
. Messeguer
(2001) analysed
the profile

of French osteopaths

from the ROF

from 1988 to 2001 and al
so
showed male osteopaths outnumber females. The ratio is representative of the ROF that
consists of 35.3% females and 64.7% males (ROF, 2008). The average age of osteopaths is
40.58. This correlates with Messeguer’s (2001) results who found most osteopath
s were aged
between 40 and 50.

These findings suggest that osteopathy is a relatively young profession.

16

Messeguer (2001) explains that the increase in full time programmes in France since legal
regulation of the profession accounts for these findings. Howe
ver, this has caused the Health
Office to review the professional education of all establishments which has led to many
colleges not
being
entitled to deliver the diploma of osteopathy (ROF, 2007).



The professional background of osteopaths in this study
showed that 43.92% have a prior
medical qualification. The majority are physiotherapists
. Other

qualification
s

in
cluded

general
medicine, midwifery, nursing
, psychology, acupuncture, veterinary

medicine

and podiatry
. In

2006, E
-
O Renard
found that fo
ur to
five thousand physiotherapists had taken a
complementary training to practi
s
e osteopathy (
CEESO, 2007). The ROF counted

40%
of its
registered osteopaths in 2006 with

a
background in general medicine or physiotherapy (ROF,
2008).

It seems popular amongst ph
ysiotherapists to train as osteopaths. Six year part
-
time
programmes are available to the following health care professionals: doctors, mid
-
wives,
physiotherapists, veterinaries and dentists (
Boutin, 2008
).


The present study suggests that
most osteopaths
work in one practice and most work on their
own (71.7%). The majority of practitioners also had one practice in 2001 (Messeguer). The last
Snapshot survey in the UK in 2001 showed more osteopaths work as part of a team (44%).
Osteopathy in the UK was legal
ly recognised many years before it was in France and this may
have allowed the profession to develop more in the UK and encouraged osteopaths to work in
teams.

This is also the case in Australia, where there is a larger proportion of osteopaths
working in
teams than alone (Hepke, 2004).

French osteopaths are still trying to become more
accepted by the medical establishment, which may account for their autonomous style of work.


Another finding of this survey

was the price osteopaths charge for a consultatio
n in France. No
previous study has investigated this before. The average fee is 47.99 Euros for a new patient
and 40.85 Euros for a follow up patient. This proves to be more expensive in France than in
England according to the Snapshot survey in 2001 (GOsC
, 2001). All payments are made by
the patient in France (ROF, 2007). The lack of funding in France could be explained by the fact
osteopathy is a relatively new profession in France and it is still challenged by the medical
establishment. In countries such

as the UK, Australia and New Zealand, where the profession
has been regulated for
longer and is more accepted
, there is s
ome funding available (
Hepke,
2004

and GOsC, 2007
).



17

The survey result
s indicate
that
most osteopaths trained in
France

(71%)
.

Some tr
ained
overseas with a majority in the UK (21.5%) and one in Canada (0.9%). The remaining 6.5%
trained both in England and in France. There is a study programme where students spend two
years in St
-
Etienne in France at the “Centre International d’
Ostéopathi
e
” CIDO and two years
at the ESO in Maidstone (CIDO, 2008

and ESO, 2008
). These results show that the UK is a
popular country of training for the French population. This could be because the profession is
more accepted in the UK and the schools have a good

reputation.
With the

rise in demand
f
or

manual therapy, healthcare professionals need to work collaboratively and not competitively.


This study provided information on some types of therapy used by osteopaths. The most
popular therapeutic interventions w
ere counselling and psychotherapy (23.36%), homeopathy
(17.76%), herbal medicine (7.48%), nutrition therapy (7.48%), naturopathy (6.54%) and
acupuncture (3.74%). Alternative therapies have been expanding at great speed in Europe.
Despite the power of the m
edical establishment, patients seem to

be attracted more and more to

non
-
conventional medicines (WOHO, 2007).


Statutory regulation is recent in France and it is important to improve knowledge about the
practice of osteopathy. There is little published wo
rk of recent origin on osteopathy in France.
This study only provides a brief description of the profile of osteopaths. A more detailed and
thorough description is needed.

This study only describes the profile of 107 practitione
rs. A
larger sample is requi
red.
Future research should

be aimed at describing the profile of patients

(age, gender…), their presenting symptoms, the evaluation

of the patient, the activity of the
patient when they injured themselves and

the techniques used by practiti
oners. Because
osteopaths are trying to become
accepted by the medical establishment, it would be interesting
to explore their views on the situation
. It would be interesting to see whether they have any
contact or relationship with doctors or other health care practitio
ners and

to
describe the
different patterns of referrals

of patients.

These results could be used for comparison with other
countries.


This study provided data on the characteristics of osteopaths in France. The osteopathic
profession

in France is

young i
n comparison to other countries (GOsC, 2008). There are more
male practitioners than female. The older population or those longer in practice work more.
The majority of practitioners work autonomously. Most osteopaths received their education in
France and

England was the second most popular country of training. Many physiotherapists

18

have trained as osteopaths. There is no funding available in France and osteopathy treatment
appears to be more expensive in comparison to other countries.

















































19

REFERENCES


Baer, H.A. (1984) The drive for professionalization in British osteopathy.
Sociology Scientific
Medicine.

19
, pp. 717
-
725.


Blanchard, N., Fagnani, F. and Gadenne, S. (2006)
Etude documentaire sur les professions
d’
os
téopathe

en Europe

: Belgique, Royaume Uni,
Suède
, Suisse
.
HAS Haute
Autorité

de
Santé
, CEMKA EVAL.


Breivik, H., Collett, B., Ventafridda, V., Cohen, R. and Gallacher, D. (2006) Survey of chronic
pain in Europe: prevalence, impact on daily life, and treat
ment.
European Journal of Pain.

10
.
pp. 287
-
333.


Brussee, W.J., Assendelft, W.J. and Breen, A.C. (2001) Communication between general
practitioners and chiropractors.
Journal of Manipulation physiology therapy.

24
. pp.12
-
16


Cartmell, L. (1993) Practice P
rofile (Unpublished).
Cited i
n: North, N.H., Madas, E., Legg,
S.J., Goddard, R.W., Carruthers, R., Cartmell, L. and Gollan, C. (1998) Variation in the
clinical practice of Osteopathy in the Central Region of New Zealand.
J
ournal of Osteopathic
Education an
d Clinical Practice
,
8
, p. 19
-
27.


Hepke, A.S. (2004)
A comparison of clinical practice between Australian & UK osteopaths.

Degree

dissertation.
T
he
British School of Osteopathy.


General Osteopathic Council GOsC

(
1997
)

Snapshot Survey 1997
.
Copy available

at the
British School of Osteopathy library.


General Osteopathic Council GOsC

(199
4)

Snapshot Survey 1994
.
Copy available at the
British School of Osteopathy library.


Grundy, M. and Vogel, S. (2005) Attitudes towards prescribing rights: a qualitative fo
cus
group study with UK osteopaths.
International Journal of Osteopathic Medicine.

8
. pp.12
-
21.


Langworthy, J.M. and Smink, R.D. (2000) Chiropractic through the eyes of physiotherapists,
manual therapists, and osteopaths in The Netherlands.
Journal of Alt
ernative Complementary
Medicine.
6
, pp.437
-
443.


Leboursier, T. (1993)
Les
Ostéopathes

dans le
système

de
santé

français
.
Diploma of
Osteopathy

Thesis
. Unknown publication place. Unknown awarding institution. Copy available
at the British School of Osteopa
thy library.


North, N.H., Madas, E., Legg, S.J., Goddard, R.W., Carruthers, R., Cartmell, L. and Gollan, C.
(1998) Variation in the clinical practice of Osteopathy in the Central Region of New Zealand.
J
ournal of Osteopathic Education and Clinical Practic
e
,
8
, p. 19
-
27.


Renard

E
-
O

(2006)

Note de synthèse sur la

situation de l'ostéopathie en F
rance des
tinée au
Ministère de la Santé e
t des solidarités
. Cited in

:

Centre Européen d’Enseignement Supérieur
de l’Ostéopathie CEESO
[Internet]

Available from:
htt
p://www.ceeso.com/ukosedef.htm

[Accessed on: 24 January, 2007]



20

Académie

d’
Ostéopathie

de France AO

[Internet]

Available from

:
http://www.academie
-
osteopathie.org/

[Accessed on: 24 January, 2007]


Bout
in
, J
-
L.

(2008)

[Internet]

2001
-
2008

Jean
-
Louis Boutin et le Site de l'Ostéopathie.
Available from:
http://www.osteopathie
-
france.net

[Accessed on: 24 January, 2007]


Centre Européen d’Enseignement Supérie
ur de l’Ostéopathie CEESO
[Internet]

Available
from:
http://www.ceeso.com/ukosedef.htm

[
Accessed on: 24 January, 2007]


Centre International d’Ostéopathie St
-
Etienne CIDO
[Internet]


Available from

:
http://www.ecole
-
formation
-
osteopathie.com/vie
-
etudiante.htm

[Accessed on: 5 January, 2008]


European School of Osteopathy ESO

[Internet]


Available from:
http://www.eso.ac.uk/home.html

[Accessed on: 5 January, 2008]


General Osteopathic Council GOsC

(2007
) [Internet] Available from:
http://www.osteopathy.org.uk

[Accessed on: 24 January, 2007]


General Osteopathic Council GOsC

(2001
)

Snapshot
Survey 2001.
[Internet] Available from:
http://www.osteopathy.org.uk

[Accessed on: 5 January
, 2007]


Messeguer L. (2001)
Les ostéopathes DO MROF
dans le paysage ostéopathique français en
2001.

In
Registre des O
stéopathes de France ROF

(2007) Available from:
http://www.osteopathie.org/infos
-
juridiques/

[Accessed on: 8 January, 2007]


Osteopathic European Academic Network OSEAN
(2004) [Internet] Ben Bro
wn Online
Ministries. Available from:
http://www.osean.com/joomla/

[Accessed on: 24 January, 2007]


Registre des Ostéopathes de France ROF

(2007) Available from:
http://www.osteopathie.org/infos
-
juridiques/

[Accessed on: 8 January, 2007]


Union Fédérale des Ostéopathes de France UFOF

[Internet] Available from:

http://www.osteofrance.org/

[Accessed on: 24 Ja
nuary, 2007]


World Osteopathic Health Organization

WOHO [Internet] Available from:
http://www.woho.org/

[Accessed on: 24 January, 2007]
















21

BIBLIOGRAPHY


Baer, H.A. (1984) The drive for professionalization i
n British osteopathy.
Sociology Scientific
Medicine.

19
, pp. 717
-
725.


Blanchard, N., Fagnani, F. and Gadenne, S. (2006)
Etude documentaire sur les professions
d’
ostéopathe

en Europe

: Belgique, Royaume Uni
,
Suède
, Suisse
.
HAS Haute
Autorité

de
Santé
, CEMK
A EVAL.


Breivik, H., Collett, B., Ventafridda, V., Cohen, R. and Gallacher, D. (2006) Survey of chronic
pain in Europe: prevalence, impact on daily life, and treatment.
European Journal of Pain.

10
.
pp. 287
-
333.


Brussee, W.J., Assendelft, W.J. and Breen,

A.C. (2001) Communication between general
practitioners and chiropractors.
Journal of Manipulation physiology therapy.

24
. pp.12
-
16


Hepke, A.S. (2004)
A comparison of clinical practice between Australian & UK osteopaths
.
Degree dissertation. The
British
School of Osteopathy
.


General Osteopathic Council GOsC

(
1997
)

Snapshot Survey 1997
.

Copy available at the
British School of Osteopathy library.


General Osteopathic Council GOsC

(199
4)

Snapshot Survey 1994
.

Copy available at the
British School of Osteopat
hy library.


Grundy, M. and Vogel, S. (2005) Attitudes towards prescribing rights: a qualitative focus
group study with UK osteopaths.
International Journal of Osteopathic Medicine.

8
. pp.12
-
21.


Langworthy, J.M. and Smink, R.D. (2000) Chiropractic through

the eyes of physiotherapists,
manual therapists, and osteopaths in The Netherlands.
Journal of Alternative Complementary
Medicine.
6
, pp.437
-
443.


Leboursier, T. (1993)
Les
Ostéopathes

dans le
système

de
santé

français
.
Diploma of
Osteopathy

Thesis
. Unkno
wn publication place. Unknown awarding institution. Copy available
at the British School of Osteopathy library.


North, N.H., Madas, E., Legg, S.J., Goddard, R.W., Carruthers, R., Cartmell, L. and Gollan, C.
(1998) Variation in the clinical practice of Ost
eopathy in the Central Region of New Zealand.
J
ournal of Osteopathic Education and Clinical Practice
,
8
, p. 19
-
27.


Renard

E
-
O

(2006)

Note de synthèse sur la

situation de l'ostéopathie en F
rance des
tinée au
Ministère de la Santé e
t des solidarités
. In

Cent
re
Européen

d’Enseignement
Supérieur

de
l’
Ostéopathie

CEESO
[Internet]

Available from:
http://www.ceeso.com/ukosedef.htm

[Accessed on: 24 January, 2007]


Shadday, G.J., Papadeas, G.G. and Smith, L.L. (1988) The progression of osteopathic medicine
internati
onally

:

A survey of America
-
trained DOs practicing abroad.
Journal of the American
Osteopathic Association
.
88
, p.1095
-
1098



22

Académie

d’
Ostéopathie

de France AO

[Internet]

Available from

:
http://www.ac
ademie
-
osteopathie.org/

[Accessed on: 24 January, 2007]


Boutin
, J
-
L.

(2008)

[Internet]

2001
-
2008

Jean
-
Louis Boutin et le Site de l'Ostéopathie.
Available from:
http://www.osteopathie
-
france.net

[Accessed

on: 24 January, 2007]


Centre Européen d’Enseignement Supérieur de l’Ostéopathie CEESO
[Internet]

Available
from:
http://www.ceeso.com/ukosedef.htm

[Accessed on: 24 January, 2007]


Centre International d’
Ostéopathie

St
-
Etienne CIDO
[Internet]


Available f
rom

:
http://www.ecole
-
formation
-
osteopathie.com

[Accessed on: 5 January, 2008]


European School of Osteopathy ESO

[Internet]


Available from:
http://www.eso.ac.uk/home.html

[Accessed on: 5 January, 2008]


Ge
neral Osteopathic Council GOsC

(2007
) [Internet] Available from:
http://www.osteopathy.org.uk

[Accessed on: 24 January, 2007]


General Osteopathic Council GOsC

(2001
)

Snapshot Survey 2001.
[Internet] Available
from:
http://www.osteopathy.org.uk

[Accessed on: 5 January
, 2007]


Messeguer L. (2001)
Les ostéopathes DO MROF
dans le paysage ostéopathique français en
2001.

In
Registre des Ostéopathes de France ROF

(2007) Av
ailable from:
http://www.osteopathie.org/infos
-
juridiques/

[Accessed on: 8 January, 2007]


Osteopathic European Academic Network OSEAN
(2004) [Internet] Ben Brown Online
Ministries. Available fr
om:
http://www.osean.com/joomla/

[Accessed on: 24 January, 2007]


Registre des Ostéopathes de France

ROF

(2007) Available from:
http://www.osteopathi
e.org/infos
-
juridiques/

[Accessed on: 8 January, 2007]


Union Fédérale des Ostéopathes de France UFOF

[Internet] Available from:

http://wwwosteofrance.org/

[Accessed on: 24 January, 2007]


World Osteopathic Heal
th Organization

WOHO [Internet] Available from:
http://www.woho.org/

[Accessed on: 24 January, 2007]
















23

APPENDICES




1
-

Letter in English


2
-

Information sheet in English


3
-

Questionnaire in English


4
-

Letter in Fren
ch


5
-

Information sheet in French


6
-

Questionnaire in French


24










Delphine Magnouat

18 priory avenue








Chiswick W41TY








London England

Dear Colleague,


I am a fourth year student at the British School of Osteopathy (BSO) in London. As part of my

course, I must write a dissertation on a topic of interest to me. Because I am French and I may
want to practise osteopathy when I graduate, I would like to investigate the practice of
osteopathy in France and compare it with the UK.


In 2001, the Genera
l Osteopathic Council (GOsC) conducted a Snapshot Survey to describe the
nature of the practice of osteopathy in the UK. I am using the same survey to investigate the
practice of osteopathy in France and compare it with the UK.

I would greatly appreciate y
our participation in my study. I am sending you a copy of the
GOsC Snapshot Survey. It includes a patient
-
based and a practitioner
-
based questionnaire.
Please use a separate column for each patient and enter the corresponding number. Please
return the surv
ey in the stamped addressed envelope by the (?). All information received will
remain strictly confidential and anonymous.


I would be very grateful if you would participate in my study. Because osteopathy in France
has only been legally recognised since 2
002, its role within the healthcare system is changing
and it is striving towards greater acceptance. This study will provide valuable information on
how osteopathy is practised and developing internationally. If you are unable to participate,
could you pl
ease fill in the tear
-
off slip provided.


Thank you for your time,


Yours sincerely,


Delphine Magnouat.




I am unable to participate in your survey due to:……………………………………….


a. lack of time


b.


c. other (please specify)…………………………………………………………


1. Age


Up
to 25yrs

26
-
35yrs

36
-
45yrs

over 45yrs


2. Gender

Male

Female


3. Time in practice

Up to 2yrs

3
-
10yrs

11
-
20yrs

over20yrs


25

Information Sheet



1.

Study Title

A quantitative investigation into the clinical practice of osteopathy in France


2.

Invitation para
graph

You are invited to take part in a research study. Before you decide, it is important for you to understand why the research i
s being
done and what it will involve. Please take time to read the following information carefully and discuss it with other
s if you wish. Ask
us if there is anything that is not clear or if you would like further information. Take time to decide whether or not you wi
sh to take
part.

This study is about the working practice of osteopathy in France. Thank you for reading this.


3.

What is the purpose of the study?

Because osteopathy has only been recently legalised in France, very little research has been carried out to investigate the w
ork of
osteopaths. The profession is struggling to be accepted within the healthcare and this
study aims to provide a better understanding of
osteopathy. The study will provide an up to date account of osteopathic working practice in France. It will draw a profile of

osteopathic clinical practice and it will give an indicator of the growth of osteo
pathy internationally. Results could then be used as a
baseline for future research and comparison. The study will be carried from the 1
st

of August 2007 till the 31
st

of March 2008.
Participants will have to return their completed questionnaire by the 30t
h of November 2007 so that the researcher can interpret the
results.


4.

Why have I been chosen?

Participants are randomly chosen from the French Registrar of Osteopaths (ROF).


5.

What does it involve?

If you take part in this study, you are asked to answ
er the questionnaire provided. It is up to you to decide whether or not to take part.
If you do decide to take part you will be given this information sheet to keep. If you decide to take part you are still free

to withdraw
at any time without giving any r
eason
.
If you do not want to take part, you may express this decision by filling in and returning the
tear
-
off slip provided. By returning the completed questionnaire, I assume you consent to participate. If you wish to receive a co
py of
the results of the

study, you may express this.


6.

What do I have to do?

You are asked to complete the questionnaire provided and return it in the stamped addressed envelope by the 30
th

of November 2007.


7.

Will my taking part in the study remain confidential?

Confidenti
ality will be insured throughout the study. The identity of the subjects will be protected throughout the study. Names of the

osteopaths that wish to participate will not be asked and will therefore not be mentionned in the study. No subject will be f
orced

to
participate. They may express their decision not to participate by filling in and returning a ‘tear
-
off slip’. The data will be used by the
researcher to be analysed. Only
the researcher, the supervisor and the research department from the BSO will hav
e access to the data.

It will not be available to anyone else. The data will be securely stored and retained for six years following completion of
the study by
the research department at the BSO. It will then be disposed of.


8.

What will happen to the re
sults from the study?

Participants may express their wish to receive a copy of the results when they return the questionnaire. A copy of the publis
hed results
will be available from the BSO library. Participants will not be identified in any report or publ
ication.


9.

Who is organising the research?

I am a final year student at the BSO in London. This project is part of the undergraduate course for a Bachelor of Osteopathy

at the
BSO. This project is being supervised by Roberta Herrick, from the research de
partment at the BSO.


Thank you for taking the time to read the information sheet. Our contact details are given below should you have any question
s or
want further information.


My Name and contact details.




My Supervisor’s Name and contact details.

De
lphine Magnouat





Roberta Herrick

British School of Osteopathy




Research Centre

275 Borough High Street





British School of Osteopathy

London SE1 1JE






275 Borough High Street

Tel: 02074070222





London SE1 1JE

Email:
research@bso.ac.uk




Tel: 02074070222








Email:r.herrick@bso.ac.uk

App
endix 3


25

1.

Age:







2.

Gender:


Male
Female

3.

When did you qualify as a healthcare practitioner?






4.

When did yo
u qualify as an osteopath?






5.

How many years have you been practicing explicitly using the title of osteopath?






6.

What was the name of the institution that gave you your final qualification as an
osteopath?






7.

As part of your work as an osteopath do you practice or incorporate other therapeutic
methods?

No



Yes, Please specify below:

Please indicate whether you practice the following:

Discipline




Homeopathy

Yes

No

Acupuncture

Yes

No

Dry needling

Yes

No

Herbal medicine

Yes

No

Nutrition therapy

Yes

No

Naturopathy

Yes


No

Hydrotherapy

Yes

No

Counselling
/psychotherapy

Yes

No

Medicine

Yes


No

Applied kinesiology

Yes

No

Clinical kinesiology

Yes

No

Electrotherapy

Yes

No

Steroid injections

Yes

No

Sclerosant

injections

Yes

No

Int
erferentials (e.g. lasers, ultrasound, articulation
machines)

Yes

No

Others


please
specify








Work
/practice

profile

8.

Do you currently provide any care that is reimbursed/funded by your statutory healthcare
system?

Yes

No

9.

How many different practices do you work explicitly as an osteopath in?






10.

In an average week how many hours do you work treating patients (including all types of
interventions you may use)?








App
endix 3


26

11.

In an average week how many hours do you work exclusively as an osteopath?







12.

Do you
p
rimarily

work alone or
primarily

as part of a team?




Primarily alone






Primarily as part of a team



Both (e.g. 50% alone 50% team)




13. In an average week how ma
ny patients do you see when you are working
as an osteopath
:


-

Private:



New patients/new episode of care:









Follow up patients:










-

reimbursed/funded by your statutory healthcare system?: (D: word for NHS here)


New patients/new episode of care:









Follow up patients:











B. On average how long
does it take for a
new patient

contacting your practice
for osteopathic
treatment

to be seen?

-

Private:



Same day,

Next working day,

2
-
7 working days,

8
-
14 working days,

more than 2 weeks


-

Funded by the NHS:



Same day,

Next working day,

2
-
7 working days,

8
-
14 working days,

more than 2 weeks


C. How long do you

usually allocate for a patient appointment (in minutes)?

New patients:









Follow up patients:








D. How much do you usually charge for a patient consultation?

-

Private:



New patients:









Foll
ow up patients:







-

Insurance funded:







-

Funded by the NHS (Please estimate based on contractual arrangement)


New patients:









Follow up patients:







App
endix 3


27

Delphine Magnouat








29/09/2007

Etudiante en ostéopathie à la BSO

British School of Osteopathy

275 Borough High Street

London SE1 1JE

Angleterre

d.magnouat@bso.ac.uk


Objet

: Sujet de mémoire


Cher(e) Collègue,


Je m’appelle Delphine Magnouat et je suis étudiante en quatrième
année en école
d’ostéopathie à Londres, en Angleterre, à la British School of Osteopathy (BSO). Cette année, je
dois rédiger un mémoire. Comme je suis française et que je souhaiterais pratiquer un jour
l’ostéopathie en France, il m’importe de savoir préci
sément comment elle y est exercée.


Dix minutes suffisent pour répondre aux questions. Je vous serai très reconnaissante si
vous acceptez de collaborer à ce travail de recherche
.
Toutes les informations que je recevrai
seront traitées avec la plus grande c
onfidentialité et resteront anonymes. Veuillez me renvoyer le
questionnaire
dûment

complété avant le 30 novembre 2007 dans l’enveloppe timbrée qui est
jointe à ce courrier. Vous trouverez également une fiche d’information dont vous pouvez prendre
connaissa
nce. Si vous ne voulez pas participer pour une raison quelconque, veuillez remplir le
talon ci
-
joint et me le renvoyer dans l’enveloppe timbrée.



Je vous remercie par avance Madame, Monsieur de l’attention que vous porterez à cette
lettre et j’ose esperer

que vous trouverez le temps de remplir au plus vite ce questionnaire.


Je vous prie Madame, Monsieur de recevoir l’expression de mes meilleurs
sentiments.





................................................................................................
..........................................


Je ne peux pas participer parce que :……………………………………….


a. manque de temps


b. autre:…………………………………………………………


1. Age

:


2. Sexe

:

Masculin

Feminin


3. Temps dans l’emploi

:






Appendix 5


28



Fiche d’information



1.

Titre d
u mémoire

Une recherche sur l’exercice de l’ost
é
opathie en France


2.

Qui est responsable de cette recherche

?

Je suis étudiante en quatrième année en école d’ostéopathie à Londres, en Angleterre, à la BSO. Pour mon diplôme
d’ostéopathie (Bachelor of Oste
opathy), je dois rédiger un mémoire cette année sous la direction de Roberta Herrick, du
service de la recherch
e à la BSO. Etant de nationalité

francaise, je me pose des questions sur l’exercice de la profession en
France.


3.

Q
uels sont les objectifs de m
on
étu
de

?

Souhaitant connaitre le m
ieux possible la maniè
re dont se pratique en France ma future profession, j’ai besoin de votre
participation. Veuillez donc prendre le temps de lire ces informations et de r
é
pondre aux questions. Les résultats pourraient

ensuite servir de référence et de point de comparaison pour des recherches futures.


4.

Pourquoi ce questionnaire vous est
-
il adress
é
?

Parce que vous
e
xercez l’ostéopathie en France et que vous appartenez au Registre des Ostéopathes de France (ROF).


5.

Qu’est
-
ce que cette
é
tude implique?

Si vous vous engagez, vous devez répondre au questionnaire ci
-
joint. C’est a vous de décider si vous voulez participer. Si
vous vous engagez, vous pouvez garder cette fiche d’information. Vous restez libre de vous retire
r à tout moment sans avoir
à fournir de raisons. Si vous ne désirez pas participer à cette recherche, faites
-
le savoir en découpant et en renvoyant le talon
préalablement rempli. En me renvoyant le questionnaire

dûment

complété, vous vous engagez à partici
per à ce projet. Si
vous souhaitez recevoir les résultats de ma recherche, vous pouvez me le demander par mail (d.magnouat@bso.ac.uk).


6.

Que devez
-
vous faire?

Vous êtes priés de compléter le questionnaire ci
-
joint

et de le renvoyer dans l’enveloppe fourn
ie avant le 30 novembre 2007.


7.

La confidentialité est
-
elle garantie
?

La confidentialit
é

de vos informations sera garantie pendant toute la dur
é
e de ce travail de recherche. L’identit
é

des
participants sera proteg
é
e.

Aucun nom d’ost
é
opathes ne sera deman
d
é

ou mentionn
é
. Les donn
é
es seront utilis
é
es et
analys
é
es seulement par l’auteur de la recherche. Seuls l’auteur de la recherche,

le directeur de la recherche et les
responsables des m
é
moires de la
British School of Osteopathy (BSO) y

auront accès
. Elles
ne seront communiqu
é
es
à

personne d’autre, elles seront enferm
é
es en lieux surs et conservées pendant six ans apr
è
s la fin de la recherche et seront
ensuite
d
étruites.


8.

Qu’ advientra
-
t
-
il des résultats de l’étude?

Les participants peuvent demander à re
cevoir une photocopie des données de la recherche. Un exemplaire des résultats une
fois publiés sera disponible à la bibliothèque de la BSO. Aucun nom des participants ne sera mentionné. Si vous souhaitez
re
çevoir un ré
sum
é

de la recherche, vous pouvez me

le demander par mail (d.magnouat@bso.ac.uk).


Merci d’avoir pris le temps de lire cette fiche d’information. N’hésitez pas à me contacter pour tout autre renseignement.



Coordonnées de l’auteur de la recherche

:



Les coordonnées de mon directeur de rech
erche

:

Delphine Magnouat






Roberta Herrick

British School of Osteopathy





Research Centre

275 Borough High Street





British School of Osteopathy

London SE1 1JE






275 Borough High Street

Tel: 02074070222






London SE1 1JE

Email:
d.magnouat@bso.ac.uk





Tel: 0207 089 5331









Email: r.herrick@bso.ac.uk
Appendix 5


28



Questionnaire


13.

Age:

…………

14.

Sexe:


Masculin

Feminin

15.

Avez
-
vous une autre qualification
médicale

et quand l’av
ez
-
vous obtenu? …………………...

16.

Quand avez
-
vous obtenu votre qualification d’ost
é
opathie? …………………………………..

17.

Depuis combien
d’années

exercez
-
vous

votre metier
d’ostéopathe
? ………………………….

18.

Dans quelle
é
cole avez
-
vous obtenu votre
diplôme
? …………………………………………..

19.

Dans votre

métier
d’ostéopathe
, utilisez
-
vous d’autres pratiques
thérapeutiques
?

Non



Oui

Indiquez si vous utilisez ces pratiques suivantes:

Discipline


Hom
é
opathie

Oui


Non

Acupuncture

Oui

Non

Autre utilisation

d’aiguilles
=
Oui

Non

Herboristerie

Oui


Non

Nutrithé
rapie

Oui

Non

Naturopathie

Oui

Non

Hydroth
é
rapie

Oui

Non

Soutien psychologique/psychot
é
rapie

Oui

Non

Médecine

Oui

Non


Kinesiologie

Oui

Non

El
ectrothé
rapie

Oui

Non

Injections

Oui


Non

Utilisations de lasers, ultrasons,
machines)

Oui

Non

Autres




thodes de travail

20.

Est
-
ce qu’une part des soins est
remboursée

par la
Sécurité

Sociale?

Oui

Non

21.

Dans combien de cabinets travaillez
-
vous en tant qu’ostéopathe
déclaré
? ……………………

22.

Combien d’heures en moyenne par semaine travaillez
-
vous (incluant tout type d’interventions)?

………………...........................
.........................................................

23.

Combien d’heures en moyenne par semaine travaillez
-
vous exclusivement en tant
qu’ostéopathe
?
…………………………………………………………………………


Appendix 5


29

24.

Travaillez
-
vous majoritairement seul ou au sein d’une
équipe
?




Majoritairement seul





Majoritairement au sein d’une équipe


Seul et en
équipe





13. Combien de patients en moyenne par se
maine voyez
-
vous en tant qu’osté
opathe?:


-

Pat
ients
priv
é
s
:


Nouveaux patients:………………………………………….

Patients réguliers:…………………………………………...

-

Patients dont les soins sont
r
emboursés

par la
Sécurité

Sociale?:


Nouveaux patients:………………………………………….

Patients reguliers: …………………………………………..


14. Combien de temps
faut
-
il pour qu’un nouveau patient soit
traité
?

-

Patients p
riv
és
:



Le meme jour,

Le jour suivant,

2 a 7 jours,

8 a 14 jours,

plus de 2 semaines


-

Patients do
nt les soins sont
r
emboursés

par la
Sécurité

Sociale
:



Le meme jour,

Le jour suivant,

2 a 7 jours,

8 a 14 jours,

plus de 2 semaines


15. Quelle est la
duré
e

d’une consultation?

Nouveau patient:……………………………………………………………………………

Patient


gulier:……………………………………………………………………………..


16. Quel est le prix d’une consultation?

-

Patient
privé
:


Nouveaux patients:………………………………………….

Patients


guliers:…………………………………………...

-


Patient couvert par une mutuelle:………………………………………………………...

-

Patient dont les soins sont r
emboursé
s par la Sécurité Sociale:

Nouveaux patients:
………………………………………….

Patients ré
guliers:
…………………………………………...