Welcome to the last issue of the Osteopathy Board of Australia’s newsletter for 2018. Osteopaths have been regulated in Australia for 40 years. Here we talk to some osteopaths who applied for registration in those early years and I hope you find their recollections very interesting, as it shows how much regulation has changed.
Our early adoption of osteopathy regulation in Australia is significant, as many developed countries are still striving for regulation of osteopathy and other professions in Australia have come to regulation relatively recently. The United Kingdom introduced osteopathy regulation in 1993 and New Zealand in 2004.1 In Australia we now have a National Registration and Accreditation Scheme (the National Scheme) that is widely recognised as one of the best in the world. As a Board we acknowledge the work of our predecessors over the past 40 years, and we continue to strive for improvements in our regulatory work.
In November 2018, Australian Health Ministers announced new appointments and reappointments to the Board. We welcome our four new members, Dr Patricia Thomas (practitioner member from Queensland), Dr Kate Locke (practitioner member from Victoria), Ms Julia Duffy (community member), and Mr Joshua Hatten (community member).
I also thank the retiring Board members, Ms Liza Newby and Mr Robert McGregor AM, for their contribution and unwavering commitment to protecting the public during their terms. A full list of appointments for the National Boards is available in the Ministerial Council communique.
I am also pleased to announce that as part of the Board’s commitment to communication, we will be holding a series of forums with registered osteopaths and stakeholders. We usually hold our monthly meetings in Melbourne, but in 2019 and 2020 we plan to hold meetings in other capital cities. This will give us an opportunity to host forums to meet state AHPRA staff, professional representatives and local practitioners. We will publish meeting dates and further details in the newsletter closer to the time.
Season's Greetings to you all.
Dr Nikole Grbin
Chair, Osteopathy Board of Australia
1Osteopathy and Osteopathic Medicine, OIA, 2014, p.15.
back to top
With more than 2,300 registered osteopaths in Australia today, this year marks 40 years since regulation began in 1978. We talk to some of those practitioners who applied for state-based registration in the early days, and find out how far regulation has come in the national model.
Victoria and New South Wales were the first states to begin regulating osteopaths, both passing legislative acts in 1978. Queensland passed their legislative act the following year, the Australian Capital Territory in 1983, South Australia in 1991, the Northern Territory in 1996, and Tasmania and Western Australia in 1997.
Before the Osteopathy Board of Australia began in 2010 with the National Scheme, registration differed markedly across the states and territories.
Longstanding regulator and former Board member Adjunct Associate Professor Philip Tehan recalls that in Victoria, a small number of osteopaths who had either UK qualifications recognised by the General Council and Register of Osteopaths (GCRO) or qualifications from US-accredited Osteopathic Colleges were accepted for registration without any form of assessment.
‘In 1978 there were no university-based programs in osteopathy and none of the Australian private college osteopathic qualifications were included in the list of approved degrees and diplomas for the purposes of registration in Victoria,’ Philip said.
But, Philip reflects, a number of these osteopaths were still granted registration under a grandparenting provision: ‘Osteopaths who did not have these approved qualifications but who had practised in Victoria for a long time were offered personal interviews and a number of these osteopaths were granted registration, under a grandfather provision, on the basis they had practised solely as an osteopath for a satisfactory period of time and they were deemed safe to practice.
‘Many of these practitioners were self-taught, learned about the practice of manipulation through informal apprenticeship arrangements, or were trained in a variety of privately run colleges,’ he said. ‘Graduates from these colleges commonly had qualifications in both chiropractic and osteopathy, as well as in a range of natural or alternative therapies’.
Fewer than 20 osteopaths were registered in Victoria with the initial registrations in 1978. Even rarer were joint titles. Marcus Try, an osteopath who had practised for many years in Victoria, obtained registration as both a chiropractor and an osteopath – and was the only practitioner in Victoria at that time to have joint titles. All other practitioners registered either as a chiropractor or an osteopath.
Osteopaths who did not have the approved UK or US qualifications, and who had practised for a shorter time, were required to pass written and practical exams to be considered eligible for registration. Philip recalls that only one osteopath successfully completed these exams and was registered via this mechanism.
New South Wales beginnings
When the Chiropractors Act 1978 was introduced, New South Wales registration of osteopaths was managed by the NSW Chiropractors and Osteopaths Registration Board. The state board comprised mostly chiropractors, some community members (such as lawyers) and a single osteopath.
Like Victoria, New South Wales also had a grandparenting clause which enabled registration without needing to sit a new exam.
New South Wales practitioners sat their first registration exam in early 1981. The University of NSW held the written exams and Sydney College of Chiropractic and Osteopathy ran the clinical exams. Dr David Moor (osteopath) recalls: ‘It was very divisive. The NSW Board stated that the standard expected was a pass standard for BSc with anatomy major, but no study guidelines were given, no sample papers, and no real indication of the depth of knowledge you would need in any of the subject areas.’
The NSW Board eventually put together a bridging course and provided more detailed outlines of expected knowledge levels in the various domains, so over the next couple of years quite a number of osteopaths registered by exam, although there remained a high failure rate.
David sums up the experience, saying, ‘In those early transition days the deck did seem to be a little stacked against us. You had to be very determined to get through’.
Dr Louise Adam, another registered osteopath applying to register in NSW in the early 1980s, recalls there was ‘a great deal of uncertainty within the student body about how registration would affect our ability to practise after having invested four years of full-time study and payment of fees, which were in those days paid by the students’.
Louise recalls the exams included interpretation of imaging and a long case. ‘We provided our own "patients" to demonstrate examination and manipulative techniques on. I and some of my fellow students spent weeks together studying for these examinations. They were extremely tough because the two weeks of examinations covered all the content of a clinical undergraduate degree − from biochemistry and histology to pathology and differential diagnosis. My recollection is that of the students who had successfully passed their four-year courses, only one-third passed this set of exams. Many left the profession and found alternative careers’.
Dr Paul Orrock (PhD) points to the lack of mobility in the 1980s because of the differing requirements for grandparenting, qualifications and exams. ‘As a graduate from NSW I passed the exams and was registered in 1988, but I couldn’t register in Victoria!’
Reflections on the national model
The benefits of the national model that Philip sees decades later are consistency of regulation no matter where you live, and an ability to practise anywhere in Australia by paying just one annual registration fee. There is greater multi-profession cooperation, with the challenge being to not take a one-size-fits-all approach to regulation and accreditation of all professions in the National Scheme.
David sums up the journey to where we are now with a national model: ‘I think it’s fair to say that statutory regulation of osteopathy, since initial legislation in 1978, has been the most important driver of standards in osteopathic education and clinical practice. It took years before statutory regulation was in place in all states and territories, and when that did happen, the legislation was anything but uniform. An osteopath registered in one state may have been ineligible to practise in another and for many years some states used conjoint osteopathic and chiropractic registration boards, which produced its own set of challenges. There’s no doubt that the evolution of the national regulatory model, although it may not be perfect, provides a framework for greater consistency in education and practice standards, sensible portability of qualifications and is good for the public as well as the profession.’
Thank you to our contributors who all became formally involved in osteopathy regulation over the past 40 years.
Now let’s fast forward to 2018 …
Congratulations to the newest members of the profession who recently graduated with their osteopathy qualifications and are applying for registration as an osteopath this year. Today you can start and manage your application online and your registration application will be managed the same way no matter where you live in Australia (glad it’s not 1978?!).
As a graduate you might ask, why is it important for osteopaths to be registered? Registration and regulation ensure that practitioners providing care as an osteopath and using the title ‘osteopath’ are appropriately skilled, trained and qualified to practise the profession. The public must have the confidence that a registered osteopath meets the national standard for practice in the profession and registration aims to achieve this objective.
To assist your transition from student to registered osteopath the Board has published a graduate video and PowerPoint presentation that outlines what graduates need to do before they register and start to practise as an osteopath, and what they need to do to renew their registration each year once they are registered.
Registered osteopaths must meet the Board’s standards and expectations of the profession throughout the course of their career, not just upon initial registration.
Obligations of all health practitioners registered under the National Scheme include carrying out and recording continuing professional development (CPD), maintaining recency of practice to stay registered, and ensuring that their professional indemnity insurance is current.
There are also mandatory requirements under the National Law (see below), such as notifying the Board of another practitioner’s conduct if you believe the public may be at risk.
Obligations of a registered osteopath
Osteopaths have until 31 December 2018 to renew their registration during the late period. The quickest and easiest way to renew is online.
If your application is received during the one-month late period, you can continue practising while your application is processed. However, applications received in December will incur a late payment fee in addition to the annual renewal fee.
If you do not apply to renew your registration by 31 December 2018 you will have lapsed registration. You will be removed from the national register and will not be able to practise in Australia.
More information about registration renewal is available on the Board’s website.
The Annual Report for the Australian Health Practitioner Regulation Agency (AHPRA) and the National Boards for the year to 30 June 2018 is now available to view and download.
The report provides a nationwide snapshot and highlights our multi-profession approach to risk-based regulation across the work of the National Scheme. Our mission is to make sure that Australians have access to a safe and competent registered health workforce.
In the coming months, AHPRA and the National Boards will publish profession-specific summaries and these will also be available for download from the AHPRA website.
In early 2019, AHPRA will conduct a pilot audit to check health practitioner compliance with advertising requirements.
The pilot audit has been modelled on the well-established approach to auditing compliance with core registration standards and involves adding an extra declaration about advertising compliance for two professions when applying for renewal of registration in 2018. (The National Law2 enables a National Board to require any other reasonable information3 to be included with a renewal application.)
Random audits of advertising compliance will advance a risk-based approach to enforcing the National Law’s advertising requirements and facilitate compliance by all registered health practitioners who advertise their services.
AHPRA Regulatory Operations Executive Director Kym Ayscough said the audit for advertising compliance would provide opportunities to extend the current action under the Advertising compliance and enforcement strategy launched in April 2017.
‘This pilot audit will potentially improve compliance with advertising obligations across the entire registrant population, not just those who have had an advertising complaint,’ Ms Ayscough said.
‘It will also provide opportunites to become more proactive in preventing non-compliant advertising by registered health practitioners’.
The National Boards for chiropractic and dental are taking part in the pilot audit.
The audit will be carried out by AHPRA’s Advertising Compliance Team from January 2019 and will involve a random sample of chiropractors and dental practitioners who renewed their registration in 2018.
‘One of the audit’s main objectives is to analyse the rate of advertising compliance for those practitioners who advertise and who have not been the subject of an advertising complaint in the past 12 months,’ Ms Ayscough said.
Other objectives of the audit are:
A pilot audit report addressing the above objectives and including data analysis and recommendations will be prepared for National Boards to consider the pilot outcomes and implications for future compliance work.
For information about your advertising obligations see AHPRA’s Advertising resources page.
2 The Health Practitioner Regulation National Law, as in force in each state and territory.
3 Section 107(4)(e) of the National Law.
AHPRA and National Boards have welcomed the publication of the Independent Accreditation Systems Review final report.
The Independent Accreditation Systems Review’s (the Review) final report makes significant, far reaching recommendations to reform the accreditation system for regulated health professions in Australia. It proposes recommendations which range from relatively uncontentious and which the National Scheme bodies generally support, to those which are significantly more complex and contentious.
Health Ministers commissioned the Review following a review of the National Scheme as a whole.
For more information read the statement on the AHPRA website.