Osteopathy in Germany

Osteopathy in Germany is not yet regulated, neither in terms of education or practice. Osteopathy is performed by different medical professions: Physicians, Physiotherapists and Heilpraktiker (alternative practitioners). Due to different interests within those professions there is no uniform, official definition of osteopathy.

The Bundesarbeitsgemeinschaft Osteopathie (BAO), an umbrella organisation of schools and associations, describes osteopathy as follows1:
“Osteopathy is a medicine with an intrinsic concept. It is a part of complementary and alternative medicine (CAM). Osteopathy aims at restoring health and sustaining it. To this effect osteopathy adopts a holistic approach.
 To achieve this the osteopath uses a particular osteopathic diagnostic method in order to perceive the patient in his or her entity and individuality.
 The osteopath senses changes in vitality, function or structural integrity. Diagnosis includes all parts of the body. Including medical differential diagnosis the osteopath also focuses on osteopathic medical history and examination.
Osteopathic diagnosis leads to an individualised treatment concept, that is mainly manually performed and based upon the osteopathic therapeutic principles.
 Osteopaths act autonomously and under his or her own authority in primary contact.
 Osteopaths need great knowledge of Anatomy, Pathophysiology, medical Semiology, clinical reasoning/examination, differential diagnosis as well as the ability to transfer of this knowledge into practical treatment of patients in order to take the responsibility towards their patients and grant safety.
 Profound manual skills and a deep understanding of osteopathic philosophy are the basis for performing safe and differentiated osteopathic diagnosis and treatment.”

Osteopathic physicians use the terms „Osteopathic medicine“ instead of „osteopathy“.
definition of osteopathic medicine is given by the European Register for Osteopathic Physicians (EROP):

„Osteopathic medicine is a branch of medical science which is  performed by Osteopathic Physicians and Osteopaths.

 OM is based on the  philosophy and principles of Dr. A.T. Still. OM combines these principles with the general accepted standards in medicine.

 OM emphasizes the interrelationship between structure and  function in the body and has an appreciation of the body’s capacity of salutogenetic resources in restoring and maintaining health.

 OM includes a comprehensive manual assessment, diagnosis and therapy as well as prevention of somatic dysfunctions in the muscular-skeletal system (parietal), the inner organs (visceral) and the peripheral and central nervous system (cranio-sacral).

 OM is an extension and completion of the regular medical system in the context of an integrated patient care which is focused upon both evidence based and patient centred medicine.“

In legal terms osteopathy is regarded as a medicine, as stated by the administrative court Düsseldorf (December 8, 2008):

„Osteopathic treatment by the plaintiff is subject to authorisation pursuant to § 1 para. 1 HeilprG. Under that provision the authorisation is needed by anyone who wants to perform medicine without being a physician. Medicine is pursuant to §1 para. 2 HeilprG any professionally or commercially performed activity that aims to determine, cure or relief diseases, suffering or physical injury of human beings even if performed at the service of others. (...) On the basis of these legal standards the osteopathic treatments of the plaintiff are regarded as practice of medicine. (...)“

The legal right to practice medicine is only granted to physicians and Heilpraktiker.

1 Scope of practice, 2012

Berufsvereinigung fr heilkundlich praktizierte Osteopathie, hpO.