Résumé
Objectives The aim of this study was to describe
osteopathic activity and scope of practice to understand
the current and future role of osteopathy in the Swiss
healthcare system.
Design A questionnaire survey that included a patient
record-based retrospective clinical audit.
Setting/population Osteopaths with a national diploma
(n=1086) were invited by mail to participate in an online
survey. Osteopathic assistants (n=84) were identified
through their national association.
Questionnaire The survey was constructed from
previous surveys and tested for face validity with experts,
osteopaths and patient representatives. The questionnaires
were completed online in English, German and French
between April and August 2017. Osteopaths anonymously
reported information about themselves, their practice, and
the treatment and care for four randomly selected patients
they managed in 2016.
Results The response rate from the survey was 44.5%
(521/1171). Data on osteopathic care were collected for
1144 patients and 3449 consultations. In 2016, osteopaths
saw approximately 6.8% of the Swiss population for
1700 000 consultations and an overall estimated cost
of 200 million Swiss francs. 76% of patients sought care
directly without a referral from another care provider. Few
osteopaths (<1%) work in a hospital setting and 46%
work in isolation in private practice. Infants (under 2 years
old) made up 10% of all patients and 9% of patients were
≥65 years. Patients most commonly sought treatment for
musculoskeletal conditions (81%) with the spine being the
most frequent location (66%). Treatments also included
exercise advice (34.2%) and lifestyle management
(35.4%). Fewer than 1 patient out of 10 were referred to
another health profession or provider.
Conclusions In Switzerland, osteopathic care represents
an important first line management for musculoskeletal
conditions that alleviates some of the burden of care in the
Swiss primary healthcare system.