Ecological
Osteopaths recognize the importance of how the individual inter-relates with his/her environment. The modern osteopath therefore recognizes the importance of environmental factors in the maintenance of health. Hygiene and clean water have had a profound influence on public health. The role that nutrition plays in maintaining health is being increasingly accepted. The ecological perspective is acknowledged with emphasis on the holistic approach.
Holistic
Smuts coined the word holism to describe a philosophical way of looking at how living things functioned, both in their interactions with each other and with their environment. It also applied to the individual organism in the terms that health depended upon the healthy structure of the whole person and not just to an isolated part. Irwin Korr, a physiologist who devoted his life to putting osteopathy on a scientific basis, summed up the osteopathic perspective by suggesting that the person was not ill because he had an ulcer but that he had an ulcer because he was ill. A holistic perspective is essentially ecological in that it postulates that the whole is greater than the sum of its individual parts.
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Psycho-social
The osteopath acknowledges that an understanding of life-styles and the influence that these have on health outcomes is necessary. Psycho-social factors and their role in producing a negative or positive health outcome in patients are discussed. In considering psycho-social factors much has been written about the role of happiness in being healthy. I was reminded of this when I read in the BMJ recently, 23rd Dec, 2000, to quote Hugh Downs `A happy person is not a person in a certain set of circumstances, but rather a person with a certain set of attitudes’. It could be suggested that exchanging the word `happy’ for `healthy’, in this context, is appropriate when exploring issues of health and illness.
Health promotion
A White Paper in 1992, The Health of the Nation, was possibly the first government health document to suggest that individuals and communities had influence over their own health status. Alternative medicine has always recognised the importance of the patient at the centre in the attempt to attain health. Health promotion differs from preventative health or public health in that while the latter’s strategies are imposed from above such as chlorinating water supplies or vaccination, the former seeks to empower the individual to have control over their own health. Osteopaths recognize the perceptions of the patient in assessing what may be wrong. Health belief models are important in this regard. Empowering the patient to have knowledge and control over their own health is often crucial in producing a positive outcome. The unhealthy patient is often disempowered with feelings of helplessness and a seeming inability to have any control over one’s destiny. An osteopath is trained to offer support and guidance in promoting health for the individual patient. Issues of sex and gender, culture and ethnicity may have influences here.
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