Why are you in practice?

ARCHIVED POST N.B. This post is based on the 2012 Osteopathic Practice Standards and therefore may not reflect current legislation or current Mint procedures.

It is a wonderful reward when a patient gets up off the couch with an exclamation of ‘that feels much better’ or when they return for follow-up treatment and report a great improvement in their symptoms.  That is the ultimate in job satisfaction.

‘I didn’t know I could feel this good’

‘I wish I’d come sooner’

‘It’s easy to put my shoes on now’

‘I feel taller’

These are all phrases that are music to any practitioner’s ears.  We all know that treatment is not a dramatic success every time and there are those complex cases that we struggle with but remembering the benefits of treatment helps to motivate us and remember why we wanted to do the job.

It is good to remind ourselves from time-to-time why we entered our profession and what we enjoy about it.

For me, there are three primary motivations:

  • The desire to help people to better health
  • The process of making a diagnosis and unravelling the underlying causative factors
  • The enjoyment of participating in a small part of life’s journey with patients – people are so interesting and I have learnt so much from my patients

The reason I am encouraging you to think about the motivations behind your work is because we often need to remind ourselves of these.

Research from doctors (Bourne et al, 2015) has shown that 75-80% practice defensively i.e. they have changed the way they practice not in the interest of patients but in order to protect themselves professional from complaints and litigation.  This is something we are seeing more and more in private practice.  Healthcare practitioners are changing the way they practice in order to protect themselves.  Practitioners can feel restricted, lacking freedom in the way they practice and experience increasing levels of anxiety or stress and depression.

Whilst it is a good thing to hold practitioners accountable for bad practice and no practitioner wants their profession tainted by poor practice, the increase in complaints against practitioners is changing practice and not necessarily for the better.  In physical therapy practitioners have become increasingly wary of using some techniques such as cervical manipulation and may avoid asking patients to undress but these are not necessarily improvements in practice.  It is disappointing that practice is heading in this direction but practitioners feel the pressure of professional responsibility and react accordingly.

It will be interesting to see how the future develops regarding accountability and seeming restrictions on practice.  In the current climate the belt seems to be ever tightening and it seems hard to perceive how there could be any slackening.  If you have good clinical compliance procedures in place then should trouble arise you are likely to have a robust defence.

I encourage you however that if you are becoming discouraged and finding yourself practising in an increasingly defensive way think back to your motivations for taking up your profession and be encouraged by the daily rewards that you receive in your practice.


Bourne, T., Wyants, L., Peters, P., Van Audenhove, C., Timmerman, D., Van Calster, B. and Jalmbrant, M. (2015) The impact of complaitns procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey Accessed at: BMJ Open 2015;5:e006687 doi:10.1136/bmjopen-2014-006687


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