GP Consent

[Skoder]

Was just going to put what Aromababe put, I also did work with cancer patients - terminal and otherwise - referred by their GPs. Also, some are paid, a friend of mine works at St Thomas's and she is paid to do therapies. These people are out there, they are just quietly battling away and don't get much said about them.[]

 

[Romper Stomper]

i'm reviving this topic because i had some doctor feedback that i thought was quite interesting...

i had a meeting with a doctor at my local hospital. he is in charge of occupational health and the idea is that i go in maybe once a week or whatever to give treatments to nurses and staff... great if it works and gets past HR dept...

anyway, i digress... we got onto CI's and i explained our dilemma in getting the GP's consent. he said, he would imagine that a GP would take it as an *insult* that we want his consent, in other words, we are trying to shift the blame onto the GP. by getting his consent, we are exonerated should there be a claim.

this made sense to me in how a GP could perceive it. i did give my interpretation... that it was a more a curtesy thing to let the GP know that his patient is recieving treatment. this doctor is of the opinion that if someone wants treatment, we should know enough about what we are doing and be professional enough to do what is right. as long as the client has it explained and signs a disclaimer, that should be all. of course, they can mention in passing to the GP that they are having treatments.

hmmm... so why do we ask for the GP's consent, when we know that most GP's know nothing of what we do?

 

[xXDarksideXx]

Hi Rosie

I agree with what the Dr has said and we should be professional enough to know when to treat something and when you really need clarification from a Dr over something that is a proper contra-indication.

Sadly there seems to be an ever enlarging list of so called contra indications which make very little sense to the various therapies being practiced which is I presume causing much merriment in the Gps coffee room, but that is down to the training institutes to sort themselves out and get a better understanding of the therapies they are teaching, I will get off my soapbox now ;-)

 

[kicksd]

ok... so taking it further.

what would you say is a proper CI? i almost get to the point where i dont know anymore! apart from the obvious definites (gangrene, contagious infectious disease, undiagnosed pain) i think thats what i was taught, particularly for reflex, when would YOU ask a GP?

 

[Sue Schpunken]

Well I think I have said before that I have been taught that various problems, such as diabetes, high or low blood pressure and epilepsy are only contraindicated if they are not stablilised. My insurance company (FHT) takes the view that if we treat someone who has what we have been taught as a contraindication (which clearly depends on the tutor concerned), we have to give a very good reason why we though it was OK to treat.

I had a new client yesterday who told me that he had just been to the gym and had his blood pressure taken and it was sky high and was going to call his GP straight after seeing me. He then went on to tell me that he had diabetes which was controlled with tablets, although he was very overweight. Then he told me he was on three other medications (none of which I had heard of), but he didn't know what they were for. At this point, alarm bells started ringing. I told him that I wouldn't be able to treat him until he had seen his doctor and verbally asked him if he thought it would be OK for him to have reflexology (I gave him my leaflet about the treatment). If that was the case, I would, on his next visit, ask him to sign to say that he had his GP's approval for the treatment (this is FHT's advice now rather than for the therapist to write to the GP).

I wonder if anyone would have treated a client in these circumstances.

Lesley

 

[ACexraciexia]

Hi Rosie & Lesley

Most of my patients come with undiagnosed pain and 99% are treatable, it would be silly to treat someone with something you could catch and pass onto others, as for HBP the majority of therapies will effectively reduce the BP during the treatment which has been bourn out time and time again, I think if I was severely overweight and had just done a workout at the gym then I would be very surprised if my BP was low.

Cancer is contra-indicated for all forms of therapy as it is illegal for unqualified medical practitioners to treat it in this country without the Drs consent which they unfortunately very rarely give, diabetics are not contra-indicated as far as my training goes but I usually advise them to watch BS levels but have not so far encountered any problems with it.

Over the sight of recent operations as you do not want to tare it apart but that does not stop you working around the area to help remove the excessive lymph fluid and get the area to flush out.

Over thrombosed varicose veins, this is one I ask the patient to check with their Gps as to if they consider them thrombosed or not, cant think of anything else of the top of my head at the moment.

 

[BMil213_]

i have to say that i think the teaching of CI's is very wooly then. i did ITEC for both massage and reflex and i have a copy of the AoR CI's. however, whenever CI's came up in class, there was never anything really concrete said.

as i said earlier, apart from the three definite CI's (for reflex) the others are sort of treat with care/ GP consent (maybe). so as for what you say, lesley, i should only be treating really healthy people, as most things get a mention as a CI otherwise!

luckily, i dont attract too many folk with loads of health problems. i have some controlled high blood pressures, who benefit greatly, thyroids hmm thats about it.

i did have a lady of 65ish who was booked at the health club for a full body massage. completing the consultation was fun and i do admit, we dont always have the luxury of consultations. she had HBP (meds), diabetes (tablets), angina (meds... result of heart attack some years back), no gall bladder, varicose veins that were quite prominent, iffy cells on forehead that had been lasered a few weeks back.

i ended up doing a soothing back massage and some reiki! i didnt think a full body would have been a good idea.

so anyway, CI's are still a grey area to me and i guess i have to work at my own discretion and intention.

 

[Howenwyth]

I still wasn't sure whether I should treat someone on three different types of medication that they didn't know what it was for. Basically, this tells me that this person has at least one undisclosed medical condition. I know the FHT would have definitiely said not to treat, so I was happy with my decision, but just wondered what everyone else would have done.

Lesley

 

[David C]

i have to say, its a little concerning that someone is taking 3 different meds, as well as other things, and has no idea what they are for? you were right to leave this one until you have more info, i think. one should always know what they are dealing with.

 

[CHRISTINE I]

Going back a bit to Aromababe's point about therapists giving their time for free in a hospital. I suspect that the average GP earns 2-3 times more than your average busy comp therapist (maybe more) so they could afford to do some volunteering themselves surely?

It's OK, I'm joking......

 

[midnight_blue_vampire]

......as if!!

Lesley

 

[Deeplenon]

I think it could be a good move to wite to GP's after succesfully treating clients, telling them they had responded well. With clients permission of course.

We always did this at the Physio I worked for and it brought the practice to the GP's attention.

I would not require permission to treat from GP's for anything as I wouldn't treat anyone with something I thought risky anyway. I recently had to tell a lady, with leg ulcers I couldnt treat her, as risk of thrombosis is a no no as far as I'm concerned. I also am wary of clients who have recently flown.

As to clients undergoing chemo, I was taught that reflexology could help the horrible effects and help the patient relax!! Ann Gillanders firmly states that there are no contra indications to reflexology, although I make my own decisions and go by instinct.
I sometimes say to clients that I will treat conservatively and mostly do very relaxing foot massage. They are more than happy with that.

I've treated someone with last stage terminal cancer, (who was amazingly brave and accepting) but am due to treat someone fairly young with bowel cancer, undergoing chemo at the mo, which I haven't done before and would be very interested to hear anyone elses experience re this. Especially the emotional side, my best friend died of cancer some years ago, and i'm worried I might be a wimp and cry or something.

Perhaps I'll probably put this as a seperate post.

LOL

Iceni