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Relative contraindications for the use of lymphatic pump treatments include fractures, abscesses or localized infections, and severe bacterial infections with body temperature elevated higher than 102 °F (39 °C).

The American Medical Association listed D.O.s as « cultists » and deemed M.D. consultation of D.O.s unethical from 1923 until 1962.

In 1988, Petr Skrabanek classified osteopathy as one of the « paranormal » forms of alternative medicine, commenting that it has a view of disease which had no meaning outside its own closed system.

In a 1995 conference address, the president of the Association of American Medical Colleges, Jordan J. Cohen, pinpointed OMT as a defining difference between M.D.s and D.O.s; while he saw there was no quarrel in the appropriateness of manipulation for musculoskeletal treatment, the difficulty centered on « applying manipulative therapy to treat other systemic diseases » – at that point, Cohen maintained, « we enter the realm of skepticism on the part of the allopathic world. »

In 1999, Joel D. Howell noted that osteopathy and medicine as practiced by M.D.s were becoming increasingly convergent. He suggested that this raised a paradox: « if osteopathy has become the functional equivalent of allopathy, what is the justification for its continued existence? And if there is value in therapy that is uniquely osteopathic – that is, based on osteopathic manipulation or other techniques – why should its use be limited to osteopaths? »

In 2004, the osteopathic physician Bryan E. Bledsoe, a professor of emergency medicine, wrote disparagingly of the « pseudoscience » at the foundation of OMT. In his view, « OMT will and should follow homeopathy, magnetic healing, chiropractic, and other outdated practices into the pages of medical history. »

In 2010, Steven Salzberg wrote that OMT was promoted as a special distinguishing element of DO training, but that it amounted to no more than « ‘extra’ training in pseudoscientific practices. »

Retired MD and U.S. Air Force flight surgeon Harriet Hall stated that DOs trained in the U.S. are doctors of osteopathic medicine and are legally equivalent to MDs. « They must be distinguished from ‘osteopaths’, members of a less regulated or unregulated profession that is practiced in many countries. Osteopaths get inferior training that can’t be compared to that of DOs. »

Several international and national organizations exist relating to osteopathic education and political advocacy. Similarly, there is also an international organization of organizations for national osteopathic and osteopathic medical associations, statutory regulators, and universities/medical schools offering osteopathic and osteopathic medical education, known as the Osteopathic International Alliance (OIA).

A majority of osteopaths work in private practice, with osteopaths working within aged care, traffic and workers compensation schemes or co-located with medical practitioners. The majority of private health insurance providers cover treatment performed by osteopaths, as do many government based schemes such as veteran’s affairs under the Chronic Disease Management plan.

Osteopathy Australia

The Osteopathy Board of Australia

Students training to be an osteopath in Australia must study in an approved program in an accredited university. The capabilities are based on the CanMEDS competency framework that was developed by the Royal College of Physicians and Surgeons of Canada.

A 2018 large scale study, representing a response rate of 49.1% of the profession indicated the average age of the participants was 38.0 years, with 58.1% being female and the majority holding a Bachelor or higher degree qualification for osteopathy. The study also estimated a total of 3.9 million patients consulted osteopaths every year in Australia. Most osteopaths work in referral relationships with a range of other health services, managing patients primarily with musculoskeletal disorders.

In Canada, the titles « osteopath » and « osteopathic physician » are protected in some provinces by the medical regulatory college for physicians and surgeons.

There is no European regulatory authority for the practice of osteopathy or osteopathic medicine within the European Union; each country has its own rules. The UK’s General Osteopathic Council, a regulatory body set up under the country’s Osteopaths Act 1993, issued a position paper on European regulation of osteopathy in 2005.

Osteopathy is a governmentally recognized profession and has title protection, autorisation d’utiliser le titre d’ostéopathe.

Germany has both osteopathy and osteopathic medicine. There is a difference in the osteopathic education between non-physician osteopaths, physiotherapists, and medical physicians.

Osteopathy is a governmentally recognized health profession and the title of Osteopath is protected by Law (Act 45/2003, of 22 October, and Act 71/2013, of 2 September). Currently there are three faculties that teach the four-year degree course of osteopathy (BSc Hon in Osteopathy).

In New Zealand a course is offered at Unitec. Australasian courses consist of a bachelor’s degree in clinical science (osteopathy) followed by a master’s degree. The Unitec double degree programme is the OCNZ prescribed qualification for registration in the scope of practice: Osteopath, Australian qualifications accredited by the Australian and New Zealand Osteopathic Council are also prescribed qualifications.

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