Macfarlane, Christopher (2021) Actions Speak Louder Than Words: Exploring Pragmatism in Osteopathy. PhD thesis, Victoria University.

Abstract

Purpose: To develop a conception of osteopathic practice that assists in defining the profession. Practices by those who comprise a profession are representative of the profession. As such, practices of professional osteopaths were analysed: what they were and how they were conducted, to develop a conception of practice. The key research questions were: What role does clinical reasoning play in defining osteopathic practice? What are the acts that constitute osteopathic clinical practice? How might Pragmatism provide a philosophy that informs the principles and practice of osteopathy? Can Pragmatism provide a bridge to the issues within osteopathy? Method: Pragmatism provided the epistemology with meaning occurring from socially situated acts. Fifteen Australian registered osteopathic practitioners volunteered to have their practice videoed and then respond to a semi-structured interview. The interview addressed questions about the acts that occurred in the consult, with the video recording as a prompt. The transcripts were interpreted, coded and the emergent themes from all transcripts were then pooled and coded to develop knowledge themes. Conclusions: Osteopathic practice is a professional social behaviour that interprets a patient’s concerns with a series of gestures and acts to construct a shared meaning as a basis for ongoing acts that are aligned with establishing meaning relating to the sensitising impulse. Key to these gestures and acts is a structured organised approach that consists of social praxis that supports the conducting of phronesis in the betterment of society. The professional social behaviour contains within it all that is the osteopathic profession and is focused on an individualized experience that occurs within the consult, as the key vehicle of the acts of the profession.

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