Am I a carer and do I care? An exploration of the concept of care as applied to osteopathic practice.

A number of dichotomies bedevil the concept of care, among them, the question of whether healthcare is posited on care or cure. On one side the question is whether it is enough to cure without caring (to cure is to care) and on the other whether caring is sufficient without a cure. This has received attention in recent years from feminists, particularly in the nursing profession, and from renewed interest in virtue ethics. This paper describes a study that was undertaken to explore what a group of experienced United Kingdom based osteopaths understand care to be. Following interviews and transcript analysis using Grounded Theory, a number of themes were identified: Care as communication; Care as understanding the patient; Care as the therapeutic relationship; Care as action; Care as most beneficial outcome. The relationships between the various themes were explored and a 'model of osteopathic care' was proposed. Most of the respondents put beneficial outcome of some kind at the heart of their understanding but the process of caring was not regarded as particularly important on its own. In fact the expressed intention of osteopathic care was to facilitate a beneficial outcome. However, beneficial outcome was described in very broad terms and was not confined to the resolution of patients' presenting symptoms. In placing beneficial outcome at the heart of their model of care, respondents did not appear to recognize the dichotomy between care and cure, a finding that contrasts sharply with a number of nursing studies. The paper concludes by suggesting how it may be possible to differentiate between care and good practice.