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Posted by Anita Tandon, Jul 31 2014 3:14PM

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Medical consent

Hi to all therapist,

Please can you help clear up some confusion that I have regarding medical consent and in what format this should be?

I recently had a client who has recently been diagnosed with diabetes and has been prescribed oral medication. He also is suffering from stress and depression.

Whilst I note that diabetes is a Total contraindication requiring medical consent, when I have researched the topic further, I have come across a number of different and conflicting advice ranging from "obtain Medical consent right through to that massage can be given but to adapt it for the client i.e gentler techniques, to avoid working of the injected site, to be aware of the extremes in blood sugar levels of the client and to have a sugary drink nearby.

I have erred on the side of caution & asked the client to get written consent from his GP.

The client has come back to me and stated that his GP is happy for him to proceed with massage, however for The GP to write a letter stating this will cost my client £15.00, which he is reluctant to pay.


1. Is it sufficient & acceptable for me to accept what my client is telling me at face value and get my client to give me informed consent or do I need to get something in writing from the GP?

2. Is it my responsibly to write to the GP and would they give me the information requested bearing in mind Data Protection legislation?

Please can anyone help clear my confusion.

I am wary and whilst I do not want to cause any harm but equally when I have asked previous clients to get medical consent, they often don't come back.

Also considering that problems like diabetes, high blood pressure, arthritis are commonly found in a large number of the populations, especially in the Asian population, is informed consent from my clients adequate for me to give them a treatment.

I look forward to hearing from you all and The CTha views on this.
I thank you for taking time to read and respond to this query.

Have a nice day
Regards
Anita

Angela Wood
Jul 31 2014 3:41PM
In the past I have tried both approaches. I have sent a letter to a GP with a tick box section either giving consent or not that they can send back to me. In this instance I found that I needed to enclose a stamped address envelope in order to receive a reply (it seems GP's do not like paying for stamps0, sometimes I have received a reply sometimes not. Therefore I started taking the clients word that they had received verbal consent from their GP but I write this in their notes (usually in red so it stands out if I need to find the entry quickly) with the date that consent was obtained the name of the GP and get the client to sign and date next to the entry. Whether this would hold up in court if there was ever any problem I do not know.
Anita Tandon
Aug 3 2014 10:43PM
Dear Angela
Thank you for your reply.It was very useful and I think in this case, I will get the client to make a declaration that they have asked and received consent from their GP to have the treatment. Thank you for taking the time and trouble to reply. it is much appreciated.
Best Wishes
Anita.
Henry Watson
Sep 17 2014 7:13AM
I have found that many of the GP's around Surrey are reluctant to put anything into writing to a Complementary Therapist; but they are privately very supportive, and indeed often enthusiastic, for their patients to receive other therapies.
I feel that the problem may lie in there being two, entirely separate, confidential relationships: GP to Patient; and Complementary Therapist to Customer.
On the occasions that I have considered that GP/medical clearance is required, I have asked my customer to speak to their GP and to relay the decision, and any particular cautions, to me. I then write this into my treatment notes and ask the customer to initial the entry. So far (15 years in commercial practise) I have not had the slightest impression that my customers have ever been less than totally truthful to me about such things.
Anita Tandon
Sep 19 2014 9:58PM
Dear Henry

Thank you for your reply. I am finding that I have to rely on the client speaking to their GP and get back to me their response. Like you I too get them to sign their statement. Thank you for taking time out to respond.
Henry Watson
Sep 20 2014 7:09AM
'Tis a pleasure.
I just hope that several other practitioners monitoring this thread also find this a practicable way forward. I am entirely comfortable trusting my customers to be open with me; and the note demonstrates IMHO that I have taken sensible precautions.
Nicki Lee
Oct 14 2014 10:38PM
I'm unclear from your post if this is type 1 or type 2 diabetes, which require somewhat different approaches. Normally neither would be a total contraindication if controlled. I suggest you get the book 'A Massage Therapist's Guide to Pathology' which is an excellent resource on CIs and can help you decide on the appropriate treatment.

Otherwise I agree with those who say if the client has talked to their doctor who indicated no problem with massage to note that on your form and have the doctor sign it.

Best of luck, I'm sure your client will benefit from the treatment.

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