Medical Malpractice

During my work as a lecturer in adult Further and Higher education and also in my private practitioner work in a variety of settings, I have come to realise just how difficult it can be to obtain written consent from a G.P for a therapist to provide a treatment.

Students often struggle to be taken seriously by the medical profession, which seems to remain a difficulty for many practising complementary therapist's years down the line. I am always disappointed to learn just how little attention to detail is given by the awarding bodies to the subjects of ethics and the law in relation to Complementary therapy training leaving students and practitioners vulnerable.

Given that the government is currently striving for statutory legislation and the regulation of Complementary medicine, training providers need to be aware of the ethical considerations and implications of working with client's, especially those who are contra-indicated for treatment or who have potential to be given their medical history.

We all need to be made aware of how to work in a 'collaborative way' with all health care professionals, if we truly believe in working in a 'holistic way' and this must be an integrative part of the training process. Using a 'multi-disciplinary' approach is an essential element of working holistically requiring excellent communication skills by all concerned. Often time's students or even experienced therapists tell me that they send the 'standard' (college format) doctor's letter, but fail to get any kind of response making it either impossible for them to proceed with the treatment affecting morale and livelihood or worse; being placed in a difficult position by the client who may exert pressure on the therapist to carry out the treatment anyway.

As we live in a litigious society those therapists should not be surprised if they find themselves being taken to court. We are all aware of the increase in the litigation trend in respect of trippers and slippers, but there also appears to be a significant increase in litigation in respect of malpractice according to a variety of surveys and reports carried out by leading newspapers and insurance companies.

Outlined below are a few simple tips to help therapists in the process of obtaining consent.

A FEW SIMPLE DO'S

• It is always advisable to create your own letter, requesting that your client takes the letter in person to obtain signatures. This can be empowering for the client as they are involved in the process. It also engages the doctor with the collaborative process.
• In situations where this is not possible or practical speak with the doctor concerned over the phone making notes of the conversation and outcome of the discussion.
• Feed this back to the doctor by providing a written letter confirming the content of the telecommunication. This will then cover you because it is up to the doctor to respond if he disagrees with anything you have written or if anything has been misunderstood in the communication process.
• Be positive and proactive tell the doctor what you intend to do and keep him up to date with reports of how the treatment is going.
• Be a reflective practitioner, let the doctor know the outcome of the treatment, which is good ethical practice and enables the doctor to understand the efficacy of the treatment.

A FEW SIMPLE DON'TS

• Never ask for a doctor's permission because you will not get it. This in many ways would compromise the doctor's position in terms of insurance. Instead seek advice and agreement.
• Don't be defensive the doctor is acting in the best interests of your client as you are. Try to negotiate a therapeutic intervention that you both agree on.
• Never assume anything. Remember the three C's

• check
• clarify
• confirm

ALWAYS REMEMBER TO OBTAIN YOUR CLIENTS PERMISSION TO WRITE TO OR COMMUNICATE WITH THE DOCTOR IN THE FIRST PLACE, which takes into consideration the data protection issues involved and ensures you are working within the law.

Finally, often times doctors need educating about Complementary treatments and what a complementary therapists can provide. Take this as being part of your remit; GO ON EDUCATE.