At the Institute of Osteopathy annual convention, recently, one of the speakers used the term ‘sustainable healthcare’ in relation to Osteopathy and the NHS. When looking at NHS funding, the historical figures show that the more money you pump in to increase resources, the more demand you create. On the surface, that doesn’t make sense: surely, the amount of sickness is an independent fact – people are either sick or they aren’t – so if you increase resources you improve the speed and quality of the service?
In reality it doesn’t work like that. If you increase the resources of the NHS, you enable it to things it couldn’t do before, so it starts investigating and treating people who, previously, it hadn’t, so you bring more patients into the system, creating more demand. This is unsustainable – healthcare demand will expand to fill the resources available.
In addition, orthodox medicine allocates patients to particular populations. This is often a ‘diagnosis’ based on categorizing the symptoms, such as ‘mechanical low back pain’, the principle being that everyone in that population should receive the same treatment – you ‘treat the diagnosis’. A further characteristic of much of the treatment is that it is directed towards controlling symptoms rather than solving the underlying problem, and many patients are put onto ‘rest of life’ treatment. All of these factors tend to make treatment expensive and unsustainable.
What makes Osteopathy sustainable – what are the differences? For a start it looks at the individual rather than allocating patients to populations who then are all subjected to the same treatment. You get ‘personalised’ treatment – the Osteopath monitors your response to treatment while it is being given, so you only get as much treatment as is necessary for your body – not ‘the average patient’. Next, Osteopaths look for the underlying cause of the complaint, rather than just controlling the symptoms, aiming to allow the patient’s body to return to health. That means no need for on-going treatment.
‘Mechanical Low Back Pain’ is a good example of the difference between Orthodox medical treatment and Osteopathy. Your GP will prescribe painkillers and anti-inflammatories and tell you to come back if it doesn’t get better – treat the symptoms and hope! For some patients that may be enough – by controlling the pain you enable the patient to move normally and that allows your body, eventually, to recover. But the GP has no way of determining whether you are one of those patients or not – everyone is put into the same ‘Low Back Pain’ category and treated the same regardless of the cause of their pain.
The Osteopath asks: ‘What and why?’ What is causing the pain – muscle, ligament, disc etc? What is the mechanism – inflammation, infection, nerve damage or irritation, etc? And then why have you got Low Back Pain? If you have tissue damage in the Low Back (disc, ligament or muscle), why? The Low Back usually gets overloaded and injured because it has to compensate for other things that are not working properly. We can treat the Low back as much as we want, but the Low Back Pain will recur because the problem that is causing it is elsewhere. It could be a problem with the mid-foot, the ankle, knee hip or pelvis. It could be the neck, upper back and rib-cage or a shoulder problem. Any of these, and many more, can end up overloading the Low Back.
If you want to stop the Low Back Pain, you need to deal with the underlying cause in that individual patient, and that is what Osteopathy is about. And that means Osteopathy is rather good at treating patients more cheaply and avoiding ‘rest of life’ treatment. A sustainable approach to healthcare.