What is wrong with osteopathy? A response to Thomson and MacMillan

Thomson and MacMillan's paper What's wrong with osteopathy? has understandably caused some consternation within the profession. In this commentary I want to support the intent of their argument, but also suggest they do not go far enough. Western healthcare is entering a post-professional era which will profoundly affect every profession's identity and social purpose. The effects of late capitalism on the atomisation of the body, the unbundling of goodness and expertise, and the transformative effects of digital technologies are not commonly discussed issues in osteopathy, but they are becoming central concerns for any profession looking to adapt to future healthcare. In this essay, I briefly outline the challenges of post-professionalism and explore some of the reactions we have already seen in other professions like physiotherapy. Four response archetypes are identified: watching and waiting, a modern heritage approach, professional renaissance, and hybrid professionalism that, I argue, lies behind Thomson and MacMillan's proposition. All four of these approaches are shown to have significant limitations, so the paper ends with some suggestions for a direction that might be a better way forward for osteopathy.