T. Pincus PhD, Department of Psychology, Royal Holloway, University of London, Egham, Surrey TW20 0EX, UK Complementary Therapies in Medicine (2000), 8, 180–186 © 2000 Harcourt Publishers Ltd INTRODUCTION In Britain, 37% of adults will have experienced back pain that has lasted for more than a day every year. Of these, nearly half will seek treatment from at least one source. Forty-two per cent will visit their GP, 10% will visit a hospital outpatient clinic, and 9% will see a physiotherapist. 1 Most people rely on the NHS for the treatment of back pain; only 5% see an osteopath privately, and only 2% see a chiro- practor. 1 Thus, one in six adults visit the GP for back pain every year. A typical GP practice (five partners and a list size of 10 000 patients) is estimated to spend around £88 000 on back pain per year (adjusted to 1992). 2 In London, 15% of visits to pri- mary care physicians are for back pain. 2 At present, there is no conclusive evidence about the effect of manual treatment on chronic low back pain or about its acceptability to patients. This study compares patients’ self-reported satisfaction when managed by both osteopaths and GPs. The study is unique, as it is the first to assess satisfaction with osteopathic treatment in an NHS general practice setting. OSTEOPATHY WITHIN THE NHS The Osteopath Act 1993 and its implementation by the General Osteopathic Council established ‘state sanctioned self regulation’. This legislation and reports recommending manipulative treatment for acute low back pain 2,3 have contributed to an increase in availability of osteopathy in NHS pri- mary care. This provision has largely been led by fund-holding practices. The formation of primary care groups (budget controlled by groups of practices) shifts the respon- sibility for choice of services offered in general practice to GPs giving them the opportunity to develop osteopathy services if they so choose. The current study will be effective in informing these groups about patient’s response to osteopathy. Why measure satisfaction? Patient satisfaction has become over the last decade an accepted measure of health-care quality. 4,5 This trend is backed both by external authorities and Osteopathic versus GP management of low back pain Patients’ satisfaction with osteopathic and GP management of low back pain in the same surgery T. Pincus, 1 S.Vogel, 2 R. Savage, 3 S. Newman 4 1 Royal Holloway and Bedford New College, University of London, Egham, UK 2 The British School of Osteopathy, London, UK 3 The Stockwell Group Practice, London, UK 4 Department of Psychiatry and Behavioural Sciences, University College London, UK SUMMARY. Chronic low back patients reported their satisfaction with the treatment they received for back pain from GPs and osteopaths practising in the same surgery. Although levels of satisfaction were high for all treatments, patients reported significantly higher scores for satisfaction with the osteopathic treatment.The difference was stronger for aspects of care/communication and competence, and weaker for satisfaction with efficacy.These findings are discussed in reference to patients’ expectations, novelty, time spent with patients, number of visits, and patients’ age. © 2000 Harcourt Publishers Ltd 180