Steps Into Practice

Scope of Practice

It is important you understand the consequence of acting outside your scope of practice. Generally, scope is based on what you have been trained to do in university; or the additional skills and training you can demonstrate that are aligned with what you learnt in university. The further a topic is away from that area of scope, the more likely you are to be acting ‘outside of scope’. Just because you can undertake some training does not mean the regulator will accept you can practice within that area.

Potential complications associated with ‘scope of practice’

• What is considered appropriate levels of training and how you keep that current?

• Whether your insurance covers you to practice in a new area or with a specific technique?

• The regulator does not specifically define scope; therefore, you have to judge if the regulator would consider something outside osteopathic scope. The OBA does give some guidance (for example, any vaccination advice is considered outside of osteopathic scope).

• The multitude of rules associated with any third-party funder, such as Medicare, private health insurance or other schemes and what they consider they are paying for via rebates. Failure to follow these rules can result in rulings to reimburse significant funds.

• The recent specific government exclusion of a range of treatments from private health insurance rebates such as Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi and yoga.

If you are going to work in other areas of practice, under the name (or billing) of osteopathy, Osteopathy Australia strongly advises you should seek additional advice before proceeding.

The Osteopathy Australia Statement of Scope of Practice can be viewed on the Osteopathy Australia website at www.osteopathy.org.au/article/osteopathy-scope-of-practice

Registration

National Registration

As of 1 July 2010, the Health Practitioner Regulation National Law came into force in each state and territory. This law means that, in Australia, 15 health professions, including osteopathy, are regulated by nationally consistent legislation under the National Registration and Accreditation Scheme.

Australian Health Practitioner Regulation Agency (AHPRA) supports the 15 National Boards that are responsible for regulating the health professions. The Osteopathy Board of Australia (OBA) is the national registration board.

The primary purpose of the National Law is to protect the health and safety of the public, not the reputation of osteopaths.

The OBA’s registration standards, codes and guidelines have direct bearing on your practice, and it is therefore important to ensure you are aware of and understand your obligations. Any breach of those standards, codes or guidelines could result in complaints, being called before a tribunal or even deregistration.

The functions of the OBA include:

• Registering osteopaths and students

• Developing standards, codes and guidelines for the osteopathy profession

• Handling notifications, complaints, investigations and disciplinary hearings

• Assessing overseas trained practitioners who wish to practice in Australia

• Approving accreditation standards and accredited courses of study

Registration Standards

Registration standards define the requirements that applicants, registrants or students need to meet to be registered. The OBA has developed the following registration standards, available at: www.osteopathyboard.gov.au/Registration-Standards.aspx

• Osteopathy Continuing Professional Development Registration

• Standard Osteopathy Criminal History Registration Standard

• Osteopathy English Language Skills Registration Standard

• Osteopathy Professional Indemnity Insurance Registration Standard

• Osteopathy Recency of Practice Registration Standard

General AHPRA Codes and Guidelines

With the national registration of osteopaths come a range of codes and guidelines by which all osteopaths must abide. These are available online on the OBA website at www.osteopathyboard.gov.au/codes-guidelines.aspx

NOTE: READING THESE DOCUMENTS COUNTS TOWARDS YOUR MANDATORY CPD HOURS. You must read and understand each of the following codes or guidelines. In particular, it is important to develop your soft skills, such as appropriate communication with patients and thorough note taking, while understanding the nuances of risk management and the complaints procedures.

• Continuing Professional Development – your requirements to meet the 25 hours of CPD per year. Applicants who are registered part-way through a registration period must complete the first aid requirements, and six hours of CPD for every three months of registration remaining in the registration period. Find out more at https://bit.ly/3NnxMeQ

• Mandatory reporting – what you need to do when you find out about inappropriate behaviour by another practitioner

• Code of Conduct – the rules according to the OBA, which, if breached, can lead to a Regulation Board tribunal

• Clinical Records guidelines

• Guidelines for Infection Control

• Advertising – what you can and can’t do in advertising regulated health services

• Professional Indemnity Insurance – the minimum requirements needed to practice

• Informed consent – guidelines on obtaining a patient’s informed consent

• Professional boundaries – specific guidance on professional boundaries in the osteopath-patient relationship

COVID-19 Specific Codes and Guidelines

COVID-19 raised the need for infection control approaches in practice specific to COVID-19, its modes of transmission and contamination risks. Various states and federal departments have released advice and additional guidance for health professionals. For more information, visit our dedicated web page at www.osteopathy.org.au/help-resources/ practice-resources/covid-resources

Use of the Title ‘Dr’

Under National Registration, AHPRA uses the title ‘Dr’ in the register*. However, osteopaths must make it clear, including in their advertising, that they are not registered as medical practitioners by including a reference to their health profession whenever the title is used. E.g. Dr David Smythe (Osteopath).

*Osteopaths who wish to change their title back to Mr/Mrs/Ms etc can do so by lodging a change of details form with AHPRA.

Needling Techniques in Osteopathy

Dry needling and other acupuncture related techniques are increasingly common in osteopathic practice. Osteopathy Australia advises members to undertake a formal course of training in these techniques and only use them to the extent of the competence the training provides. At present, there are no agreed minimum training requirements to practice needling-related techniques and these are not restricted practices under the Health Practitioner Regulation National Law.

The title Acupuncturist is, however, a title protected under the National Law and only those registered with the Chinese Medicine Board of Australia may use it. In the same way, only those registered with the Osteopathy Board of Australia may lawfully refer to themselves as an osteopath. You must avoid any advertising, written or verbal claims that could mislead patients and other parties that you are an Acupuncturist or carrying out acupuncture.

This is known as holding out which is a legal concept that means to present yourself in a way that suggests to others that you are something or someone that you are not. AHPRA may investigate and, where appropriate, seek to bring prosecutions. This is a complex area and it is the courts that will decide the merits of the case.

Registration Board

Contact the Osteopathy Board of Australia (OBA)

Website: www.osteopathyboard.gov.au

Phone: 1300 419 495 (AHPRA)

The maximum fine for holding out by an individual is $30,000 and an incorporated entity $60,000 (per offence). So be sure to describe your proposed treatment in such a way that it clearly establishes that the needling techniques are within the context of osteopathic practice and that you are not a practitioner of Chinese medicine or an Acupuncturist.

Guild Insurance – Osteopathy Australia’s partner that provides professional indemnity cover for members – will insure osteopaths that use needling techniques. This is included in the general cover where an osteopath has undertaken a course of training which was at least 16 hours in duration and had practical component.

If you choose not to meet this minimum requirement Guild may include needling in your cover for an additional premium. If you intend to use needling techniques and you have not had the minimum training specified, Osteopathy Australia strongly recommends that the cover is noted on your policy schedule. Without such cover, you may not be adequately insured and may be personally liable for civil claims.

Osteopathy Australia is currently developing a Clinical Practice Group for Needling in Osteopathic Practice to support this area of members’ practice. Check our website for developments.

Online Enquiry Form: www.ahpra.gov.au/About-AHPRA/Contact-Us/Make-an-Enquiry.aspx

Postal address: Chair

Osteopathy Board of Australia

GPO Box 9958

Melbourne VIC 3001