Osteopathy is currently regulated in 12 European countries: Cyprus, Denmark, Finland, France, Iceland, Italy, Liechtenstein, Luxembourg, Malta, Portugal, Switzerland, and the UK. Other countries such as Belgium and Norway have not fully regulated it. In Austria, osteopathy is not recognized or regulated. The Osteopathic Practitioners Estimates and RAtes (OPERA) project was developed as a Europe-based survey, whereby an updated profile of osteopaths not only provides new data for Austria but also allows comparisons with other European countries.

A voluntary, online-based, closed-ended survey was distributed across Austria in the period between April and August 2020. The original English OPERA questionnaire, composed of 52 questions in seven sections, was translated into German and adapted to the Austrian situation. Recruitment was performed through social media and an e-based campaign.

The survey was completed by 338 individuals (response rate ~26%), of which 239 (71%) were female. The median age of the responders was 40–49 years. Almost all had preliminary healthcare training, mainly in physiotherapy (72%). The majority of respondents were self-employed (88%) and working as sole practitioners (54%). The median number of consultations per week was 21–25 and the majority of respondents scheduled 46–60 minutes for each consultation (69%).

The most commonly used diagnostic techniques were: palpation of position/structure, palpation of tenderness, and visual inspection. The most commonly used treatment techniques were cranial, visceral, and articulatory/mobilization techniques. The majority of patients estimated by respondents consulted an osteopath for musculoskeletal complaints mainly localized in the lumbar and cervical region. Although the majority of respondents experienced a strong osteopathic identity, only a small proportion (17%) advertise themselves exclusively as osteopaths.

The authors concluded that this study represents the first published document to determine the characteristics of the osteopathic practitioners in Austria using large, national data. It provides new information on where, how, and by whom osteopathic care is delivered. The information provided may contribute to the evidence used by stakeholders and policy makers for the future regulation of the profession in Austria.

This paper reveals several findings that are, I think, noteworthy:

  • Visceral osteopathy was used often or very often by 84% of the osteopaths.
  • Muscle energy techniques were used often or very often by 53% of the osteopaths.
  • Techniques applied to the breasts were used by 59% of the osteopaths.
  • Vaginal techniques were used by 49% of the osteopaths.
  • Rectal techniques were used by 39% of the osteopaths.
  • “Taping/kinesiology tape” was used by 40% of osteopaths.
  • Applied kinesiology was used by 17% of osteopaths and was by far the most-used diagnostic approach.

Perhaps the most worrying finding of the entire paper is summarized in this sentence: “Informed consent for oral techniques was requested only by 10.4% of respondents, and for genital and rectal techniques by 21.0% and 18.3% respectively.”

I am lost for words!

I fail to understand what meaningful medical purpose the fingers of an osteopath are supposed to have in a patient’s vagina or rectum. Surely, putting them there is a gross violation of medical ethics.

Considering these points, I find it impossible not to conclude that far too many Austrian osteopaths practice treatments that are implausible, unproven, potentially harmful, unethical, and illegal. If patients had the courage to take action, many of these charlatans would probably spend some time in jail.

14 Responses to Austrian osteopaths seem to violate legal, ethical and moral rules and conventions

  • Shades, again, of actor Colm Meaney’s role as a charlatan ‘manipulating the womb’ in the film “The Road to Wellville”

  • vaginal touch an example from Austria – sorry its in German



  • Hmmm…my family practice MD has occasionally provided a prostate exam (through the rectum) and examined me for a hernia (through the other side)…and I wasn’t provided informed consent. Something tells me that I’m not the only one.

    Just sayin’…

    • 1) you have chosen an incompetent MD (informed consent is mandatory),
      2) at least GPs have been taught to do the procedure.

    • “and I wasn’t provided informed consent”

      What on earth does that mean? I would expect Dana Ullman, who claims to be both a homeopath and a Master of Public Health, to word such important things correctly.

      • Pete,

        After reading all the contemptuous comments Dana Ullman makes towards MDs and conventional medicine in general, the question at the back of my mind is:

        Why the heck would Dana Ullman see a MD? Is homeopathy not sufficient for his health care needs?

        • After reading all the contemptuous comments Dana Ullman makes towards MDs and conventional medicine in general, the rhetorical question at the back of my mind is:

          Why the heck would an MD see Dana Ullman. (Other than to see if there’s a third ‘research paper’ in the pipeline.)

    • Dana

      Given that you talk out of your arse 99% of the time, two fingers up it would’ve silenced you wouldn’t it?

      • @Lenny
        I don’t think that violating someone’s integrity without informed consent makes good jokes or criticism – regardless how well-deserved any criticism may be otherwise. (Although of course the fact that Mr Ullman apparently consults regular doctors did raise an eyebrow or two, what with him being one of the staunchest proponents of homeopathy worldwide …)

        • Given Dana’s long record of hearing only what he wants to hear in any given conversation I have no doubt that full consent was obtained by the physician.

          I also note Dana’s words “ and I wasn’t provided informed consent”

          Consent is something given by the patient, not the clinician. Does Dana mean he did not consent to the procedure? That he consented without the full nature of the investigation being explained? That the physician went straight ahead with an invasive procedure without first asking Dana’s consent? I find it very difficult to believe that he just said “OK Mr Ullman, drop yer daks and touch yer toes” before ramming a digit up his arse.

          • “Given Dana’s long record of hearing only what he wants to hear in any given conversation I have no doubt that full consent was obtained by the physician.”
            How would a rectal examination without consent even work – or does Dana always take his Y-fronts off when he sees his MD?

  • It reminds me of the days of medicine, before women were allowed to study medicine to become doctors. Middle-class and upper-class women went to the gynecologist for masturbation. They felt to be “in good hands”. It was the time of Charcot and of hysterectomy. Just as homeopathy saved many people from Paracelsus’ heavy metal medicine, which in the history of pharmacy was officially euphemistically described as the age of „chemistry“ thus later manual repositioning of the uterus saved many women from the wave of gynecologists who performed hysterectomies to cure their dissatisfaction. Nowadays, this manual nonsense of manipulating the structures of the prostate or the womb through the anus and vagina, or treating women’s breasts with the laying on of hands for enlargement is an embarrassment. Everybody nowadays knows the case of the American osteopathic sports physician Larry Nasser D.O. who receveid his professional degree in osteopathic medicine from Michigan State University in 1993. He was convicted of sexually abusing hundreds of women. Is this the road that manual osteopathic treatment is taking today? I am afraid that‘s the truth.

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