Patient satisfaction Audit 1998


A group comprising 15 principal Osteopathic practitioners had a mutual interest in furthering the process of auditing the results of osteopathic treatment. Discussion resulted in the consensus view that to look at results from the patients' perspective, would be a useful pilot project. Through discussion, a simple questionnaire was developed and piloted to 10 patients. Small changes were made to make the questionnaire more user friendly and the method of administration standardised.


1,200 new patients, commencing from a given date, were sent a questionnaire and letter, along with a stamped addressed envelope so that the questionnaire could be posted by the patient to an independent auditor funded jointly by the practitioners. The practitioners had no contact with the questionnaires until the results had been presented.
The practitioner completed a box containing information about each patient; the practice, the symptom, gender, number of visits, funding and GP referral.


The results were collected by the independent auditor and collated, using Excel.
Results of the Patient Satisfaction questions were encouraging.
  • Satisfaction with waiting time for first appointment? 98% positive
  • Location of Service? Positive responses 82%
  • Courtesy of practice staff? 99% positive responses
  • Standard of premises? 99% positive responses
  • Did treatment help the problem? Either 'completely or 'quite a lot'.82%


  • Gender of patients: 55% female corresponds closely with the Osteopathic Information Service survey of 1998
  • The percentage of spinal pain treated at 80% is higher than the national average, although I cannot think of a reason for this
  • Numbers of visits per patient is lower than other studies (Gilmour & Piper Associates 1996,1999), but the reason for this may be that patients were often questionnaired at less than a month from their initial visit. So some of them would not have completed their episode of care with their osteopath
  • The majority of patients at 90% still fund their own treatment. The extent of GP funding varied considerably with some practitioners not having funding at all. This skews the mean to a low 4%, with other practices having as much as 20% or more funding by GPs


Feedback from Professor Edzard Ernst, Professor of Complementary Health Studies at Exeter University, suggests that the major flaw with this type of study is that it does not account for the opinions of the non-responders. The worst case scenario might be that the non-responders were those least happy with the service.
The way forward might be to devise a prospective audit in which patients agree to be part of the study and complete the questionnaire at, say, six weeks or two months after entering the study. Non-responders would be contacted again, either by second letter or telephone, to seek their views.
At the same time, we would like to see some measurement of outcome and the best way to do this might be to use either SF36 or the shortened SF12.

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