2019 United States Osteopathic Medical Regulatory Summit: Consensus, Recommendations, and Next Steps in Defining Osteopathic Distinctiveness

A Thematic Analysis of Osteopathic Physicians' Identities and Experiences in North American Professional Sports

Objective

This interview-based thematic analysis examines the evolving professional identities and practices of osteopathic physicians (DOs) in North American professional sports (baseball, basketball, football, hockey, and soccer) to understand the extent to which DOs employ osteopathic-specific skill sets in their work with player-patients. In addition, the study sought to understand the prevalence of professional bias, interprofessional dynamics between DOs and other health professionals, and other factors such as management.

Methods

This qualitative, interview-based study is grounded in twelve semi-structured interviews with 41% of DOs (all nonsurgical, primary care sports medicine trained) working with North American professional sports teams. Interviews were transcribed and coded to identify key themes and representative quotes.

Results

Findings suggest that DOs believe their training and philosophical orientation positions them well to make important contributions to serving the medical needs of professional sports teams. At the same time, DOs are careful about championing an osteopathically-specific approach to patient care, such as evoking osteopathic principles of care or techniques such as Osteopathic Manipulative Medicine. This is the case for several reasons, the most important of which is a strong drive toward collaboration and collegiality within professional sports medicine teams.

Conclusion

This study finds that in navigating the complexities of osteopathic identity, DOs working in professional sports are proud of their osteopathic orientation and report experiencing little discrimination, but also downplay what has historically distinguished their practice from that of other healthcare professionals. These findings have consequences for how scholars think about emerging professional identities in sports medicine, generally, as well as the fast-growing profession of osteopathic medicine specifically.

Beliefs and Use of Palpatory Findings in Osteopathic Clinical Practice: A Qualitative Descriptive Study among Italian Osteopaths

The Italian government has started the regulatory process of osteopathy to include it among the healthcare professions mentioning terms, such as “perceptual palpation” and “somatic dysfunction” within the professional profile. ‘Palpatory findings’ are one of the multidimensional aspects that can inform osteopathic clinical reasoning. The non-regulated educational system has led to heterogenic professionals working in Italy, thus, the aim of this study was to investigate how Italian experts use palpatory findings in their clinical practice. A total of 12 experts were selected to participate in four virtual focus groups. A qualitative inductive approach with a constructivist paradigm was chosen to describe the results. The themes that emerged were: osteopathic identity; evaluation; osteopathic diagnosis; and sharing with different recipients. Participants agreed on the peculiarity and distinctiveness of osteopathic palpation, but there was some disagreement on the clinical significance of the findings, highlighting a complex multidimensional approach to diagnosis and treatment. The results seem to reflect the history of the profession in Italy, which has evolved quickly, leading professionals to seek new paradigms blending tradition and scientific evidence. The authors suggest further investigation to verify the state of art among osteopaths not involved in research or a broader consensus of the results.