It was a tremendously interesting time. In fact, it was the first time in a long while that I had observed a qualified osteopath in action. Some of my thoughts on how it went were clearly more to do with the cultural situation than the difference with the osteopathy from my own, but there were other parts which were more immediately relevant to my own forthcoming practice.
Initial impressions of the clinic were much like any other doctor I had visited in Japan, with the same metal desks I remember from my time in schools and offices. The lead practitioner was the only person in the office, but there were curtained areas to create four treatment rooms.
Not long after I arrived, the first treatment began. It was a very efficient system. Whilst the osteopath was treating, he would nod to the new patient and invite them to go into the treatment space opposite from the one he was using and get changed. He would then finish up with the current patient, and leave them to change whilst preparing their bill. After they had paid, he was ready to start the new one.
This meant there was very little in the way of talk before putting his hands on the patients. However, in contrast to our strict line between talking before and treating in underwear, I don't think that there would have been an issue in discussing things with the patient, as nobody was exposed. This was because every patient changed into a pair of pyjamas which were supplied by the clinic, before the osteopath came in to speak to them. In fact, as it was extremely hot when I visited, at least two of the patients were more exposed when they walked in than when they were being treated.
This came as quite a shock to me; we spend so much time talking about how we may be the only people who see the patients backs, and hence need to be sure to report any potential pathologies, and how important the skin-to-skin contact is. I spoke to the osteopath about this, and he said that in his time training (at the BSO) the constant time in underwear had been a great embarrassment to him, both his own and his colleagues, and that Japanese people were more comfortable being clothed in a clinical environment.
I was somewhat shocked, especially in comparison with the onsen (hot spring) culture where group nudity is all the rage! However, I did see him moving the clothes for palpation when he required, so perhaps there is not as much contrast as I thought at first. After all, when I massage clients, I cover them liberally with towels, and many osteopaths I have spoken with have said that they keep towels in their private practices for comfort purpose.
The next surprise came when I realised that there was very little discussion between the patients and osteopath. He walked straight in and got on with treatment, examining as he went. I didn't observe any new patients, and I assumed that there would be a lot more talking in that situation, but with those I did see, with the exception of one man who described a recent accident exacerbating his existing symptoms, pretty much said, "yes, more of the same".
The treatment was interesting. There was a range of soft tissue and articulation approaches, cranial used when required, but the most interesting part was that every single patient received HVT to the cervical, thoracic and lumbar spine. I observed treatments on a boy of about ten up to a lady who was seventy or so, and each one had manipulations at each section. When I asked the osteopath about this, he said that his approach was to treat every part of the problem on each visit, and that if any part was left untreated, it would prevent recovery and draw the rest of the problem back together.
I met his father, the head of the practice and initial principal of the Japanese College of Osteopathy. Later, I went and had a tour of the college, and received a quick treatment from one of the technique tutors. It seemed largely functional and was fun and effective. I also learnt a lot about the schools philosophy and the origin of their favoured techniques (eg. Fryette for HVT, Lawrence H. Jones for Strain Counterstrain and Fred Mitchell Jr. for MET). So far I haven't been able to read the recommended texts, but they are on my list for the future.
So, would I be able to practice osteopathy in Japan? My current spoken Japanese would be an obvious area for improvement, but not a hard one. The necessity for notes in Japanese however would require some serious study. The technical skills involved are not, I think, beyond me, although the move to a fully clothed patient would require some adjustment. Adjusting to patient expectations would probably be a larger leap, and one that would require some investigation! However, I think my biggest handicap would be that by being a foreigner, I would immediately alienate a large proportion of potential patients.
One to explore with Japanese friends in the future!