Presidents Report

Following the recent Melbourne seminar I was discussing the pros and cons of various clinical presentations with a colleague. We were both a little despondent about our lack of knowledge in certain areas, especially with regard to the diagnosis and management of sports injuries. We came to the conclusion that it is difficult to remain current in all areas, and hence the role of specialist practitioners in various disciplines.

It also highlighted an important question. Who are the leaders in the diagnosis and management of musculoskeletal disorders? Each profession dealing in this field would claim the mantle. In some ways this is correct, as each discipline has something to offer that the others does not . Some chiropractors and osteopaths, particularly those whose practice life is somewhat insular, may be shocked and upset that there is any question of who leads this field.

Fifteen to twenty years ago the competition was very limited. There was only a handful of medical practitioners and a small group of physiotherapists who had done post-graduate training in this area who could “challenge” the chiropractor or osteopath. Times have definitely changed, with an enormous number of practitioners now working in this field. These include; chiropractors,osteopaths, physiotherapists, (both those with and without post-graduate training in the area of manual therapy), musculoskeletal physicians, myotherapists, massage therapists, Pilates and Alexander practitioners. This list is by no means exhaustive, and raises the point that if manual practitioners of whatever discipline were successful in treating their patients/clients, then why is there such an explosion of other disciplines entering the field of musculoskeletal health-care? What do they offer that is not already on offer?

It could be that we have become complacent. As the evidence supporting manual therapy and in particular manipulation grows, this may confirm our beliefs that chiropractors and osteopaths hold the leadership mantle. Patients who have always associated chiropractors and osteopaths with manipulation will naturally come stampeding our way. However, as the boundaries seemingly blur between the professions people do not always follow the same trends, but are now more influenced by external factors, such as the media and also now the internet (we can all become instant experts from surfing the web).

At present I believe that the average person does see chiropractic and osteopathy as the leader in the field of musculoskeletal health-care, and the others battle the confusion in the public eye that once was our bug-bear…. So what does a myotherapist/Alexander/Pilates practitioner actually do?

It is an important time for both the chiropractic and osteopathic professions in Australia to consolidate our position. We should not lose focus of the big picture nor should we waste energy by focusing on the internal differences within our ranks.

I see COCA’s role as one of leadership. We can play a significant part in keeping the bar high, with respect to ongoing vocational training of our members and to ensure that the clinical standards of practising chiropractors and osteopaths comply with the “best-practice” approach.

Our objective is to provide a clinically sound evidenced-based approach to the available literature. Many of the other established disciplines in this field, such as physiotherapy and musculoskeletal medicine, have embraced this approach for sometime now. In turn they are often the bodies being consulted by governments and regulatory bodies. They are able to divorce themselves from the unsubstantiated claims, dubious practice marketing methods and provide a rational view based upon the evidence – this is what we need to adopt when we deal with such bodies, if we are to maintain our credibility and our leadership mantle.

Peter Werth
National President