Contra indications

[Sooftmoon Ginc.]

Hello - I am a recently qualified holistic therapist, and have been lucky enough to find part-time employment in a spa centre. I would like some advice re: contraindications. When asking which clients would need a doctor's referral letter before treatment, I was told "very few" even when I suggested high blood pressure as an example. This is so different to college situation when a client with high blood pressure would have been re-appointed and asked to come back with doctor's letter. Would be reassuring to hear what you think. Thanks!

 

[alekssebasstrs]

Oh I just love questions like this.

Why did your college say high BP was contraindicated. What was the rationale?

Is there not a possibility that a holistic treatment may actually reduce high blood pressure (if you know anything about physiology)

Do you think any doctor will give a letter re giving consent for treatment (would you do this for a practitioner that you did not know...lets face it, if the client fell off your table who is responsible...you or the doctor who gave consent?). It is most practitioners experience that medics will not reply to any correspondance nor advise patients as to a treatment that they have very little knowledge of, nor have the time or inclination to be bothered with.

I only ask this in order for you to think actively about your practice. Are you happy to go ahead based on what the college has taught you?

Is the teaching they gave you based on evidenc based research or just "what the VTCT/ITEC etc guidelines are (with no rhyme or reasoning).

I bet your college also told you never to massage anyone with cancer either (check SEED institute or Penny Brohn websites for courses in this field)

I am not out to get anyone (colleges that is) just asking why "contraindications" are taught with no specific evidence based research. This is why medics do not take us seriously. We do not take responsibility for what we do, we ask a medic to give us permission. Why? They are not God.

Also, ultimately, it is the client who has total autonomy over their own physical care. I know if a doctor told me I couldn't have massage because I had a physical complaint, it would not stop me having it, if I so chose. I choose self advocacy, so should clients.

Patchouli

(Still having heavy duty massages herself 7 years after cancer)

 

[Nolfet]

Hi there,

I also took ITEC courses and the list of medical contraindications they give is not really applicable to real life working situations, but more as a 'cover my back against anything' on the part of ITEC.

When I started I was asking for GP letters left, right and centre - very few bothered to reply and one even suggested that I was wasting their time and said they wouldn't write a letter to an 'alternative therapist' unless they paid for the privilege !
Don't get me wrong, I'm far from 'anti-GP' but they seldom have the time or inclination to reply to us.

The best you can usually do is ask the client to inform their GP that they are taking an holistic treatment (if they are really contraindiacted they will be having regular medical appointements anyway) and if there are any problems the GP should tell them......

 

[PatriotJays52]

Of course you must also check the terms and conditions of your insurance policy as some seem to be more specific than others.

 

[wiekgufoimxiklexn]

I would ask your client to sigh a piece of paper to say that they are taking responsibility for their own health and well being and their doctor disagrees with the treatment.

The majority of medics take the 'safe' path of non intervention by others. Medical Doctors know better, etc, etc, not always the case but if they cant solve the problem why not let someone else have a go, but of course temper this with a large dose of common sense, get a few opinions, etc, etc, etc,

 

[c: smiley]

I agree with muzone (and others).

The responsibility should be with the client. As practitioners, we cannot go chasing around after doctors trying to get permission, and we should not refuse a client because they can't get permission from their GP.

As long as the disclaimer they sign states that the client has consulted with their GP where they are currently receiving medical attention of any sort, and they accept that they are responsible for their own Physical, Emotional, Mental health and wellbeing, then it is their responsibility to ensure they are happy to receive the treatment. If their GP has advised them not to have a complementary therapy then it's entirely their choice if they do or not. The disclaimer should state that they have been informed by you of what is involved in a treatment and they are happy to proceed with the treatment and will work with the therapist, especially in terms of questioning anything they are unsure about.

Insurance companies will generally be happy as long as the client has signed such a disclaimer.