GP Consent

[Strawberry Milk]

I was reading the thread about therapists on the NHS Directory with interest, and it got me wondering ..... It seems that some of us struggle to get consent to treat a contra indication or a chronic condition from GP's. I'd be interested to see if we could do a 'straw poll' to find out what the result is for majority of us therapists, and whether being on the NHS directory (or anything like it) actualy has any effect or benefit at all?

Health & happiness

Waywood

 

[BossResurfacing]

I recieved my letter today from NHS directory still wondering if its worth the £50 joining fee. hmmm??
I work for the NHS ,and i just cant imagine Drs saying you need to see a complimentary therapist let me look on the computer for you. I think if they did recomend they would let the patient find a therapist for themselves.
Im not saying its a bad idea but its rather pricey.

 

[ParDelaaoe]

I agree I think that the docs who would look on a database to recommend a therapist are rare gems indeed. As for contraindications you hear about so many docs don't bother replying or say they can't give permission because they don't know enough about the therapy I wouldn't contact them.
I believe that adults should take responsibility for themselves and if a client has a contra-indication I would ask them to get their doctors written permission. I say on my consultation form after I have asked all the usual questions related to contra-indicators lifestyle etc..that it is your responsibility to tell me if you have a health problem/concern and your responsibility to get your doctors agreement to treatment if necessary I talk people through exactly what this means and so far I haven't had a problem. But then my clients all seem to come for relaxtion stress relief .

 

[vlocity]

Oh I am with you Soar!

I feel just like you do and can't be doing with all this faffing about. Personally I have had consent from doctors for:

Diabetes
Heart conditions
Triple By-pass
Heart attack
High/low bp

and goodness knows what - can't really remember.

If you can't get the GP to consent you are probably wasting your time as it is an attitude problem on the part of the GP. Get the client to take responsibility. I have treated people with cancer, under-going chemo and radiotherapy, in wheelchairs, without certain body bits etc etc and not one of them has felt worse afterwards. I even treated a lady who died and I visited her at home as she approached her death and gave her foot massages.

As for the NHS register. I think it will eventually be a good thing, but personally think that at the moment the money is better spent elsewhere as so many GPs won't use it. The enlightened ones already have therapists attached to their surgeries.

Seriously, have been to an event recently where GPs were present and only one showed a real interest in what we did, a couple were open and the rest had no intention of ever being interested.

On we slog.
[]

 

[Shorty]

Should add about the lady who died.....it wasn't anything I did.[:-]

 

[loyatafloadia]

LOL - not having any doubts about that are you Candie? [sm=rollaugh.gif]

 

[nudangler]

interesting, isnt it... that we as therapists are wiling to work alongside GP's but they (generally speaking <w&gt have no interest in even finding out a little. yes, i know they are busy, but they also have a responsibilty to their patients to let them know of alternatives.

GP's are worried about litigation (so they say) and hardly ever recommend a named therapist. it would be up to the patient to find their own. i would be more than happy to give GP's a free treatment so that, not only would they see what a treatment is all about and how good it can be, but so that they would then know me personally.

i play tennis regularly with a GP and whilst i have managed to wangle her taking some leaflets for the ante natal clinic (probably binned them!), i have offered her a go and she has never taken me up on it. maybe its an embarrassment thing ( i suppose they can get like that).

the NHS register would be a good thing if the genral public knew about it... sheesh, not many of us do! but maybe to get on it, apart from paying, grrr, one should show qualifications also.

i dunno, its a big uphill and as candie says, those in the know have attached therapists already (how did they though? i never see "GP needs reflexologist to work at surgery"!)

GP consent... so far i have never realy had any acute contras but i generally tell borderliners to tell their GP's that they are having reflex (in particular), not that the GP could say no, dont... that would be admitting therapy "does" something!

 

[qfgkdgih]

I agree with candie on this. It's very unlikely that a GP will reccomend a patient to see any therapist that isn't statutorily registered, so at the moment that equates to osteopaths and chiropractors only.

Also when you dont hear back from a GP after asking for their consent its probably becuase they are worried about giving it. They are worried because they are unsure who would then be medico-legally responsible for the patients treatment, ( a treatment that they often know nothing about) so the safest option for them is not to give it.

best wishes, Tony

 

[OsbMarauiu]

That sums what I think about GP consent. Most of them would say "go ahead" probably thinking "anyway, it doesn't do anythimng...". If a GP knows nothing about the therapy we are practicing, how can we expect them to give an "informed consent"? Let's look at facts here: they have trained in medicine, but WE have trained in aromatherapy, reflexology, massage, etc...
Having said this, I can see how GP consent can be good in some cases to "cover us up" in case we get accused of something we are not even responsible for.

Artemis

 

[KingPineApple]

I have been told that many drugs companies fund (in part, at least) the training for Dr's. If this is true, then these comapnies have a vested financial interest to ensure the medical profession (generally) do not learn about, look to or support alternative therapies.

I agree with Candie's practice of allowing the client to be responsible for getting their GP's consent, but here's another thought,
if their Dr declines, or ignores their patient's request for alternative treatment, would that then leave the GP open to the accusation from their patient of not acting in the best interest of their client/patient? In the current and increasing climate of the threat of legal litigation if it came to such an open conflict who would benefit?

 

[? ? ? ???? ????? ???]

Back again with a few points.

Tony, my business partner is an osteopath and he finds that most GPs don't follow the guidelines laid down for back pain - ie they don't recommend osteopathy![] Soooooo..... don't worry all of you - we are not alone! It is a struggle even when you are regulated.[]

Re the GPs with therapists: my surgery provides (sit down now) refelexology, aroma, REIKI!!!! acupuncture and indian head massage. Bloomin' eck! It is the practice nurse who provides it - so there is your answer for job description.

Onto GPs not giving consent and the client wanting to have treatment anyway (how dare they decide such things themselves!) I would just get them to sign a disclaimer and that is that.

I am treating a lady currently with reflexology who was referred by her physio (good enough for me) and she has a shed load of problems. I just give her a very glorified foot massage. It means a huge amount to her and she doesn't have much time for the medical profession anyhow. If it helps her and she enjoys it and benefits, then I'll do it.

 

[dceweuariquiulehz]

This is all interesting. I have just massaged a friend who is in remission from breast cancer. She is also now diabetic. The cancer centre she attends offer massage, reflexology, healing etc (voluntary therapists) They are allowed 5 of each therapy as there is a waiting list which just goes to show how popular complimentary therapies are.

She told me that doctors recommend it to keep them relaxed. She has massage every 2-3 weeks and loves it and says it helps relax her. The treatments at the hospital are free but when she has had her 5 sessions she pays privately.

I am sure if GP's looked into complimentary therapies more that their surgeries would be less full ( I do realise that GP's are very busy and have to keep to a tight budget) . A lot of people visit their GP's due to stress. While we as therapists cannot get rid of their stress we can help them recognise what is causing it and what steps they can take to relieve it as well as relax them. GP's can only give out tablets as they do not have the time or resources to sit and councel them.

I work in a hospital as a secretary and am sure that many patients would love to have a hand massage and and someone to talk to. Oh I would love that job but don't think the NHS would pay somehow!

Best wishes everyone

 

[natural horse]

Rose, I would go as far as to say that complimentary therapies can get rid of their stress - some temporarily and some permanent. So there, yar boo sucks to GP's!!!!

Did you know they call such patients 'heart sink patients'?

 

[Natie]

i find it interesting, and i was talking to some medical professionals today, that therapists are allowed to be let loose on cancer patients and mental health patients... is that because doctors feel we cant do much harm to these people??? how come we are not allowed near "well" patients?

 

[Emmanuel]

we are allowed near 'well' patients. Aren't we?[&:]

 

[Inc.2wks ago]

If it's the same NHS directory that I suspect that it is, then it is a scam. How they have managed to get away with using the NHS name beggars belief, as it is a private company that is just trying to cash in on the increasing popularity of complimentary therapies. []

The so called 'Dr Foster' is another one. Through self publicity they are trying to hoodwink the medical profession into assuming credibility - not that difficult if you have a shed load of cash - take the drug companies as an example!

Most alternative/complementary therpaies have their own bonefide regulatory bodies & registers and some have even gained mandatory status in latter years, which has been largely due to public demand & it's likely that the BMA fought it all the way. [sm=banghead.gif]

Progress is painfully slow & I only hope that I will see all therapies of benefit & good intent recognised by the time I let go of life, but I'm not holding my breath on that one.

A few things that may help put things into perspective:

So called modern medicine is less then a hundred years old. [sm=scratchchin.gif]

The NHS was set up just after the 2nd world war on the wave of euphoria generated by thediscovery of pennicillin ( a natural antibiotic ) & on th premise that they would soon have a cure for all disease & that they would soon be able to focus on preventive medicine.

An infamous study in the '90's that showed that Dr's acquire most of there prescribing information from adverts in journals, rather than the articles. []

A recent admission in the press by a director of one of the big five drug companies, that in general - drugs don't work. I treated a health insurance exec recently & they said - oh yeah, it's been the best kept medical secret for the last 20 years. []

A study in '98 showed that less than 15% of accepted medical procedures is based on evidence & less than that on good evidence. [:'(]

Not to mention - that you are bot legally dead until a doctor says you are & signs a death certificate. Forgive me, but when the time comes I may not actually wait around for that. [sm=rollaugh.gif]


The point is - is that it's the individuals choice. Medics are there to inform, advise & support, if asked. We, supposedly live in a free country - Your life is your life, just don't try & end it , cos if you fail you'll end up in court. [sm=idea.gif]

So if you have done your best & explain to those that have a known higher risk, then it is their responsibility. If you consider that they are of high risk, but they would like to be treated by you anyway, then I would advise that sshould sign a consent form or disclaimer. In such cases it's rarely the client that's the problem, but members of their family.

 

[ItsPossibleButNotLogical]

The Idea that we are going to be 'let loose' on mental health and cancer patients just goes to show how short sighted the BMA is. Are they going to ensure that the therapist is qualified in councelling for a deppression case? In my experience, mental illness is one of the most difficult to give treatment for - mainly due to the clients state of mind, and the negative energy I have to break through before sessions become productive.

Cancer patients - we're talking contra indications here!!!! or are we talking about 'well they're going to snuff it anyway, so it can't hurt...' either way, it shows utter contempt by the BMA more to their patients, than to us therapists.

 

[Gary C]

i doubt it in a hospital... even if voluntary.

it just seems that you only ever hear about therapists on cancer wards when no more medically can be offered (and as waywood says, cancer can be a CI). or in any situation where the illness is terminal (again as waywood says).

maybe if GP's were a little more forthcoming to patients about the benefits of therapies, even on a stress level, let alone anything else, then at least the patients would get a more positive vibe from the GP, rather than have the scepticism washed off onto them.

interesting comment further up (candie)... so thats how the therapy gets into a surgery without advertising for therapists! talk about being in the right place!

 

[Zallen]

yes, thats what i was getting at.

 

[zpirffah]

Not strictly true. I do know of cancer and leukaemia patients (my mum included) being treated with reflexology and aromatherapy, when their disease isn't necessarily terminal and a long remission is expected.

However, what always puzzles me is that holistic therapists are not paid in hospitals and only work on a voluntary basis. I know that the NHS is strapped for cash, but there would be a big outcry if it was suggested that doctors volunteer their services to save the NHS money. After all we're all professionals here....aren't we??

Lesley