Doctor's Note?

Beach Blondie

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I occasionally send clients to get a doctor's permission before giving them a massage. I have heard that "it's hard to get a doctor to fill out anything." This was from an obese, elderly woman who had been previously been diagnosed with Osteoporosis. She says she's normal now. I asked her if that meant normal or normal for her age. She doesn't know. She wants me to perform traction on her neck. Her PT does. I won't. She continues to come to me; and, continues to ask for traction! The second situation isn't as clear-cut. I gave my doctor's form to a woman with RA and a family history of diabetes. She says she needs to lose about 100 lbs. I think that's a high estimate; but, I don't weigh my clients! ย I overheard her tell someone that she takes at least sixteen pills in the morning. I wanted to err on the side of caution so I gave her the paper, before the day of her appointment . She threw the paper back at me and said "I don't need this. I never had to do that before." A couple of other therapists think I'm overly cautious. Am I? And, what contraindications do you get notes for? Opinions, please.
 
The overweight diabetic RA client wouldn't fill out your client intake form??? ย I NEVER work on any client without them filling out an intake form, personal friends included! ย You need to do what makes YOU feel comfortable and confident in this situation. ย Some therapists never have their clients fill out any forms and they are fine with that. ย I am not. ย I like to be a bit more cautious. ย It is for the health and safety of the client, as well as for my own protection against potential legal action, should anything happen. ย 
 
I've had a similar situation where a woman came in and had a stroke two months before she came in. ย She was on a bloodthinner so I let her know she would need doc's permission and I would need a signed note and/or call from the doctor. ย I could tell she was upset but better safe than sorry.I rarely have to ask for doctors permission for things but I have when there is unexplained edema, or client is taking lasix. ย I think you are doing the right thing. ย It's way better to not get involved with a client who could possibly become a lawsuit and/or other problem that could weigh on your conscious.If someone doesn't fill out your form, then don't accept them as a client.
 
To clarify, they didn't have a problem with the client intake form. ุขย They had a problem with asking the doctor to fill out the Physician's Permission form. It's one page and would probably only take a minute of the Doctor's time. jujubean, I got my form from the Successful Business Handbook from ABMP. They send you one when you purchase insurance from them.I'm wondering what the norm is as well. Do any of you not have them fill out an Intake Form? ุขย For the ones that do, under what conditions do you have them get Dr's permission?Thanks for your opinion ย and support, kathryn. Still not sure if I should "lighten up."
 
I'm still in school, studying Pathology this semester. ย Our school strongly promotes getting doctor's permission when there is a question of risk. With a client who has had a stroke recently, I would think the doctor would want to have input into whatever treatment the client was getting that might impact their condition.On the other hand, I have often wondered how receptive a doctor would be to signing off on any responsibility. I have not had to deal with situations like yours yet, but I would agree with Kathryn. It's better that you are covered. The client who comes in saying don't worry about it ends up being the one with 3 lawyers as soon as anything happens.
 
I think if you feel it necessary to have an MD sign a release for massage, continue that practice. Don't ever let it give you peace of mind that you have the MD standing behind you. They'll be the first to deny any wrong doing and find the best lawyer to question you and your massage intake form, charting session notes, and your massage expertise/ethics. I would recommend you get the MD release, explain why you need this to the client{generally for client safety} and ย then only work what you feel comfortable with each client and their condition. Example: I refused to work on a pregnant mom ย who passed out every time she got out of bed. She was hospitalized her last trimester. They wanted her to have massage on the pregnancy table and an RN had to be present in case she lost consciousness. MD gave approval but I refused because I felt there were too many unknowns. Bottom line is it's my license I worked hard for and I want massage to be given in the best way for everyone. I've been in practice for 5 years and have had to refuse 3 people. :)
 
From a clients standpoint, my massage therapist wants the doctors ok before he does deep tissue work on some cancer patients. ย I have melanoma and I had to get the ok from my oncologist die to lymph work involved.
 
I agree with BJB-LMP. ย When conditions affect circulation is when I'm most concerned about getting a note: ย kidney conditions, heart, especially. ย But, as you've encountered, most doctor's either won't give a note, or give a note that won't cover my okole anyway. ย Bottom line is being able to offer Reiki, and gentle stretching or specific work. ย If someone comes to me with a kink in his neck, I'll do treatment work, stretching, etc on that particularl area. ย As I understand it, it's full body circulatory massage that's the concern. ย And, I've wondered, as we've discussed in previous subjects, how dangerous it actually is. ย 
 
By the way, ย I don't believe diabetes is contraindicated except on extremeties with numbness (concern over working deeply when client has no feeling to monitor pressure).
 
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    ๐Ÿ’•๐Ÿ’•Beautiful Korean girl working at 382 Wilson Ave ๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-840-0071โค๏ธโค๏ธ
  39. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  40. Spa in Markham:
    GOLDEN FS โ€“ 8380 Kennedy Rd ๐Ÿ“ž 905-258-0777 / 416-688-6886 ๐Ÿ‡ป๐Ÿ‡ณ AMY, ๐Ÿ‡ป๐Ÿ‡ณ JULIE, ๐Ÿ‡ญ๐Ÿ‡ฐ JOJO (9PMโ€“2AM), ๐Ÿ‡ธ๐Ÿ‡ฌ CANDY, ๐Ÿ‡จ๐Ÿ‡ด MEGAN ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookinggoldenlove
  41. FLOWER Spa - BLUEXADO | Thornhill | VAUGHAN:
    BLUEXADO FS โ€“ #06-1102 Centre St ๐Ÿ“ž 416-357-9797 / 416-678-8668 ๐Ÿ‡ต๐Ÿ‡ญ๐Ÿ‡ป๐Ÿ‡ณ LUXY, ๐Ÿ‡ป๐Ÿ‡ณ๐Ÿ‡ญ๐Ÿ‡ฐ CICI, ๐Ÿ‡ป๐Ÿ‡ณ SHERRY ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingbluexadolove
  42. FLOWER Spa โ€“ PINK | Scarborough | TORONTO:
    PINK FS โ€“ 3300 McNicoll Ave ๐Ÿ“ž 416-299-5515 / 416-817-3839 ๐Ÿ‡ฎ๐Ÿ‡ท ELINA (Iran), ๐Ÿ‡ญ๐Ÿ‡บ VANESSA (Hungary), ๐Ÿ‡ญ๐Ÿ‡ฐ JOJO (Hong Kong), ๐Ÿ‡จ๐Ÿ‡ด MEGAN (Colombia) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingpinklove
  43. Annie Spa:
    ๐ŸŽ‰๐Ÿ’ANNIE SPA๐ŸŽ‰๐Ÿ’ โœ…7-1001 SANDHURST CIRCLEโœ… ๐Ÿ‘ŒSCARBOROUGH ON M1V 1Z6๐Ÿ‘Œ โ˜Ž๏ธ (647) 891-9688โ˜Ž๏ธ โ˜Ž๏ธ (416) 291-8879โ˜Ž๏ธ (FINCH & MCCOWAN) OPEN 9:30am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅ๐Ÿ”ฅ ๐Ÿ”ฅGORGEOUS NEW YOUNG ASIAN GIRLS - TODAYโ€™s ROSTER INCLUDES: ๐Ÿ”ฅ Feifei๐Ÿ˜˜Our new Japanese beauty Feifei specializes in creating an intimate and deeply relaxing massage experience tailored to your desires. Her soft, skilled hands glide effortlessly, easing tension and awakening your senses
  44. AliceSpa:
    WEDNESDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—” 416-298-0898, 4915 Steeles Ave. E, Scarborough 3 very nice girls here today. Open 10am to 9pm: APPLE (11am-9pm): from Hong Kong, very small body, 5' 100Lbs, petite with natural C Cups, small waist, pretty baby face, smooth skin, very clean. Shaved tight Pu**y, strong professional massage. Available FS bbbj cim cof rim. CLOUDIA (10am-9pm): is Vietnamese, young
  45. HolidaySpa:
    Wednesday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: FIONA, KIKI & CINDY. FIONA is a slim hottie with long dark hair, great melons and ass, and nice services. Kiki is very attractive, young, about 5โ€™4โ€ and 110 Lbs., slim with a banging body. Kiki is very popular for her great attitude and services. CINDY is slim & incredibly sexy
  46. SugarLoveSpa:
    Wednesday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: ELLA, NANCY, SUSAN & TIFFANY. 1270 Finch Ave W (at Keele St), Unit 18. North York, ON โ˜Ž ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฏ๐Ÿฒ๐Ÿฑ-๐Ÿฎ๐Ÿฒ๐Ÿด๐Ÿด โ˜Ž ELLA is a lovely Thai sweetheart, 5โ€™1โ€ with C Cups, smooth skin and a very pleasing attitude. NANCY is a curvy and very friendly Spanish girl, who has all the versatile skills you need. SUSAN is a small, slim & sexy Latina girl
  47. bnwellness_wilson:
    We have 4 young girls are working today, young sweet Mia 25โ€™s with curve body and sexy Coco, pretty Ella and flirty GFE Lina are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  48. luckywellness:
    Lucky Wellness Center 4379721888 295 Eglinton Ave E,Unit 7,Mississauga We had two girls working today. Niko and Kiki. They are both young, pretty and cute. The massage and back walking were very good.
  49. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน2 girls ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ5124 Dundas St W Etobicokeโ˜Ž๏ธ416-817-3366๐Ÿ‘ Table Shower Sea Salt Bath Body Scrub๐Ÿ˜˜ Japanese girl Nina โค๏ธ Natural Big Boobs 38 DD ๐Ÿ˜˜Pink Mini Nipples Hot body slide, super enjoyable๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ very provocative service๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜, professional super Luna deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธYou are welcome to make an appoint
  50. Lulu_Villa_Spa:
    Sami is a gorgeous model type Vietnamese Girl Aiko Mixed Chinese/Japanese Girl Sasa friendly Vietnamese girl Bella She is Mexican Gorgeous face Natalie she is CBC/filipina mixed Petite girl โ˜Ž๏ธ647- 446-0886
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