Importance of Clear and Effective Communication in the Osteopath/Patient Relationship

Osteopaths, like any health professionals, must take care to clearly and effectively communicate throughout the treatment process in order to avoid misunderstandings which may threaten the osteopath patient professional relationship.

An osteopath must ensure that a patient consents to each part of the treatment process, and it is important to be highly sensitive to signs that the patient is uncomfortable or has potentially withdrawn consent.

While an osteopath may be accustomed to treating patients who are in a state of undress, an individual patient may not be comfortable or understand why they are required to be in a state of undress in the presence of their health practitioner. Osteopaths have a professional responsibility to provide each patient with appropriate covering, and respond sensitively and respectfully to each patient’s needs.

Practitioners are reminded to keep discussions with patients professional at all times. Be wary about discussing personal matters. Casual comments about a patient, even where intended to make the patient feel at ease, may be misinterpreted. Conversation should be limited to topics that are appropriate in the clinical setting.

Case Scenario:

A female patient attended for the treatment of a left knee injury sustained from running. The practitioner requested the patient remove her jeans. The purpose was to allow the practitioner to examine how the patella tracked and also to assess how the tissues surrounding the patella were moving. Towels were available but not offered. The patient felt uncomfortable and could not recall the practitioner explaining why she needed to undress. The patient complained to the Australian Health Practitioner Regulation Agency (AHPRA).

The Likely Finding:

The request to remove clothing was clinically justified. The practitioner acted inappropriately by not offering some sort of covering. The practitioner also acted inappropriately by not clearly communicating the need for the patient to remove her jeans, before making the request. In all of the circumstances, the practitioner’s performance is likely to be regarded as below the standard reasonably expected of an osteopath of a similar level of training and experience.

Common Errors



The practitioner gives a special status to a patient

The giving of special status to a patient, even where there is a familial or friendly connection, is a warning sign of potentially crossing professional boundaries.

The practitioner does not ‘offer’ a towel or robe to a patient who is in a state of undress

Where a patient is asked to disrobe/partially disrobe, the practitioner should provide suitable covering during an examination. Clean gowns or towels should always be offered and freely available for all patients. It is important to actively offer towels or robes to a patient who is requested to undress.

Where towels or robes are clearly available, the Board still requires the practitioner to actively ‘offer’ them to the patient, and a failure to do so may amount to unsatisfactory professional performance.

The practitioner requests the removal of clothing without explanation

Practitioners must communicate the clinical need for the patient to remove any part of their clothing.

This requirement is clearly set out in the Osteopathy Guidelines – Sexual & Professional Boundaries.

The practitioner stays in the room while the patient dresses or undresses

Practitioners should not remain in the room while a patient undresses, even if the patient raises no objection and dismisses the need for the practitioner to step out of the room. A space must be provided for patients to undress in private, and there should be an increased degree of care and skill in communicating with patients when they are in a state of undress.


Effective communication is the key to avoiding any misunderstandings on the part of patients regarding the nature and need for all aspects of their clinical care.

This article was written by Principal, Kellie Dell’Oro and Graduate Lawyer, Marianna Kirchmann. Please contact Kellie Dell’Oro if you have any questions or would like further information.

Kellie Dell’Oro

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