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Posted by: Sandra Mary Smith, 28 Jan 2011 10:07AM
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GP referal/contraindications

Hello, Im fairly new here and to complementary therapys. If a contraindication is established and relevant paper work is sent or taken to a clients gp but they dont respond, how do you proceed ? I think this is a confusing area , refuse the treatment or sign a disclaimer ? Also Im just preparing an information sheet for such occasions, how much detail should I include ? are gps familiar with massage terms ? Any help would be appreciated. Thank you Sandra


Amanda Clegg
28 Jan 2011 10:40AM

It is really up to the client to chase up their GP as the GP cannot talk to you without the client's permission. In the past (it doesn't happen very often) I ask the client to ask their own GP themselves, and then they sign a disclaimer on my form to say that they have consulted their GP. I've not spoken to a GP directly yet - apart from one case where I rang my own GP and discussed the condition as a hypothetical case study, which was very useful. I do work with a local physio and a podiatrist - we have cross-referred in the past, and also, where my clients are seeing physios, chiros or osteopaths, I encourage them to ask the other therapists what they would like me to do particularly to support their treatment of that client - eg a client yesterday relayed from her chiro that she needed specific releases into piriformis and glutes, and another client who is needing stretches to certain leg muscles to support the work the podiatrist is doing with shaped insoles, to correct a hip misaligment due to uneven leg length. (it gets really interesting as you gain experience and confidence and contacts!) Remember that we are all COMPLEMENTARY therapists - ie we should all work together and our treatments should support eash other's for the benefit of that client. Best of luck - keep us posted of your progress!
Barbara Lewis
28 Jan 2011 3:12PM

it is my understanding that gp' s cannot currently recommend any complementary therapy unless it is carried out by someone with a medical qualification - this is a grey area i have found it is best if writing to a gp/ surgeon etc to state what you propose to do and why you wnat them to know, for instance i have treated patients with knee or hip replacemetns and i have said i am not going to use any movements that will compromise the joint and that the treatent is to aid relaxation and thereby improve healing this has elicited a positive response from the doctors You cannot assume that the doctor has any knowledge of any complementary therapy or the fact that you may see a condition as contra indication so you have to explain what you intend to do what is likely outcome in my experience many patients do not want to ask their gp for approval as they have come because they are not totally happy with the conventional treatment- i also have had difficulty with some regular patients in actually getting them to go to their gp when i have thought they needed tests etc best one was somone who came for a massage and presented symptoms which i thought indicated she had pneumonia - i needless to say did not do the massage but convinced her i needed to ring nhs direct - she did have pneumonia i am not conventionally medically trained but i do study extensively so i can communicate with the medics on their terms
Angela Rawlins
28 Jan 2011 4:29PM

Hi Amanda you have a good thing going there:)) GP referrals, if you're not a nurse, forget it, they won't. If you want a reply from a GP, make sure you use headed paper with your qualifications, associations on the top. AND MOST IMPORTANTLY - a self addressed envelope - this has always worked for me:)) Angela
Sandra Mary Smith
7 Feb 2011 6:56PM

Thank you to all of you above for posting your comments and advice. It really is an area where there is no real solution. Grey indeed . Thanks again
Caz Sayles
21 Apr 2011 2:50PM

I tend to send a letter to my GP stating the issue with the patient, and if they are unhappy with me treating their patient they are to respond to me before a certain date (the date that I intend to commence treatment) I also state that if I receive no response from them I will assume consent. This puts the ball in their court and also covers you as the therapist.
Angela Rawlins
21 Apr 2011 5:50PM

Caz, Thanks for that information, very good idea:)
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