Objectives: To explore how patients choose individual osteopaths to consult; to test whether patients' preferences for osteopaths depend on gender, the osteopath's qualifications, and the cost of treatment; to explore patients' perspectives.

Design: An explanatory mixed methods design incorporating a quasi-experimental study administered by postal survey and a qualitative interview study.

Setting: One sample of patients at a private-sector complementary therapy clinic in the UK completed a survey; a second sample of patients recruited from osteopathy clinics took part in qualitative interviews.

Main outcome measures: In the survey, male and female respondents (n=176) rated the likelihood of consulting each of 8 fictional osteopaths, representing all possible combinations of 3 factors (practitioner gender, biomedically qualified or not, working in a public sector or private clinic). Semi-structured qualitative interviews (n=19) about patients' experiences of osteopathy were analysed deductively and inductively.

Results: Survey respondents preferred osteopaths who were also biomedical doctors, F(1,174)=67.21, p<0.001, η(2)=0.28. Qualitative data showed that, when choosing an osteopath, patients valued personal recommendations from a trusted source and such recommendations overrode other considerations. First impressions were important and were based on patients' perceptions of an osteopath's competence, interpersonal fit, and immediate treatment effect.

Conclusions: Word of mouth appears to be the primary mechanism by which patients choose individual osteopaths; in the absence of personal recommendations, some patients prefer biomedically qualified practitioners. Trustworthy and appropriate information about practitioners (e.g. from professional regulatory bodies) could empower patients to make confident choices when seeking individual complementary practitioners to consult.