What’s Wrong with Osteopathy? (3) Clinical reasoning, practice & expertise

In this third part of the conversation with Oliver Thomson, we explore how osteopaths think about their practice.Drawing on his doctoral research, Oliver explains how different “conceptions of practice” shape clinical reasoning, therapeutic approaches, and professional identity. We discuss the spectrum between technical rationality and professional artistry — and what this means for how expertise is understood in manual therapy.Rather than reducing expertise to manual skill alone, this episode looks at decision-making, communication, and the complexity of real-world practice.A deeper reflection on how clinicians think, and why variation within the profession may be more structured than it seems.References:Edwards, I., Jones, M., Carr, J., Braunack-Mayer, A. & Jensen, G. M. Clinical Reasoning Strategies in Physical Therapy. Phys. Ther. 84, 312–330 (2004).Petty, N. J. Becoming an expert: A Masterclass in developing clinical expertise. Int. J. Osteopat. Med. 18, 207–218 (2015).