Sometimes people may get better when visiting a health care practitioner, but the reasons why people get better are sometimes overlooked. There are many reasons why but mainly, as said by A.T. Still, the body has an innate capacity of self healing. This means that the body will do its best to get better and return to a state of ease. This defines dis-ease as an abnormal state of health; therefore, as osteopaths (and also other types of health care practitioners) we may be only facilitators of health.

Having a look at Steve Hartman’s paper on ‘Why do ineffective treatments seem helpful? A brief review‘ one can get insights on why people get better. In summary (unless misunderstood) Hartman, S. (2009) considers that symptoms may improve for several reasons other than treatment -such as the self healing mechanism of mammals, return to the mean, a clinic coat, nurse’s smile, placebo effect, attitude, etc. Second he considers that patients and practitioners tend to fall in confirmation biases wanting to believe, or expect, treatments to be effective; looking for success rather than questioning outcomes. He argues that practitioners, after previous efficacy, expect success in following treatments and guide post-treatment patients answers to confirm this success; self nourishing a misconception of effectiveness based on expectations. Finally he states that randomized controlled trials, with sham treatments, are the only way of controlling treatment outcome; concluding that ‘alternative’ or ‘complementary’ medicine, based on trial-error and patient-practitioner experience, has no place in modern medicine against randomized control trials.

Hartman’s statements are clear and strait forward raising the question in many cases of where should health care practitioners stand. One point to stand could be a place where some patients may just come because they need someone to talk to, or in other cases, someone to reassure them and tell them that they will get better. If the practitioner is aware of these points, takes them into account in treatment and is honest with his results; he is less likely to fall into the mistake of believing that his ineffective treatment has had an effect.

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