doctors letter please help

mina Si

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I am a student of body massage I have got a client (uncle) that wants a full body massage but he suffers from high blood pressure and sugar I gave him a letter to give to his doctor to sign to say he can have the massage but the doctor read it but wouldnt sign it!!! But the doctor did say as far as he is concerned it is ok!!! What do i do????? Please will someone advise me
 
hello sabs,

difficult one - i had 2 case studiesfor holistic massage that needed doctors letters and it took me a good couple of weeks of persisence from myself and the client to get a letter for one of them.

did the dr give a reason for not signing the letter?

have you spoken to your tutor about it?
 
hi miss alaska
there was no reason given by the doctor and my college is closed for two weeks holiday, so I am really stuck
 
If you are with the VTCT / FHT for your course they have changed their guidelines in their code of conduct (I think cause of liability and doctors unwillingness to pass consent for a therapist they do not know to treat their clients - this islikely what's happened) and it they now suggest, as an alternative, that the client verbally confirms with their doctor that they can have treatments and the client can sign a disclaimer saying they have talked to their doctor and that consent was granted. That way they can phone the surgery and the onus is on them to state what they are told truthfully. This is different to the guidelines I was given a year ago with respect to the same thing. Have a look at your code and if it says that this is ok, go with it.
 
I did VTCT and for in college massages if the client had a condition that warranted permission from their GP then they were asked to talk to the GP and then asked if they had received GP consent and the client signed to say they had. (without it we wouldn't touch them).

Our tutor said it was nigh on impossible to get GP's to consent to anything now, so the responsibility eventually lies with the client, not really ideal for the client, but it seems to be the way of the world now.

Hope this helps

LOL
FBx
 
If the Dr thinks something is ok (probably all right) then that is all you need to know, if the Dr thinks it is a bad idea then leave well alone, it is a lot easier to get your patients/clients to visit the Dr with something that is iffy and talk it over with their Dr and then for them to let you know what the Dr thinks about it :-)
 
Hi Sabs,

In this months "professional Magazine" which comes from membership of the IGPP, there is quite a big article regarding medical consent.

Basically it is saying that in the past, a letter has been produced for the client to request the doctor signs, giving permission for treatment, which would then be held on file by the practitioner.

"However,many doctors feel that this is an additional burden and that the responsibility for treatment lies solely with the practitioner concerned or the client receiving the treatment."


"The General Medical Council provides guidance for doctors and patients. Their website giving advice to medical practitioners states;

'Ensuring voluntary decision making
(15)It is for the patient, not the Dr, to determine what is in the patients own best interests. Nonetheless, you may wish to recommend a treatment or course of action to patients, but you must not put pressure on patients to accept your advice."

They go to suggest that a consent/patient disclaimer form is necessary with wording as follows:

"GP's have been given guidelines with reference to signing documents presented to them, or issuing medicall certificates or reports. In some cases where payments has been made, a doctor may consider signing for patients or practitioners but they are being urged not to do so. Therefore, when a therapist checks your medical history, it is your responsibility to disclose information as requested, and to read thoroughly the form on which it has been recorded. In signing this form you are confirming that the details are correct and that you consent to the therapy you have chosen to receive. You are also confirming that the therapy has been fully explained to you including contraindications and the short and long term effects.

Signature(client)__________________________Date
Signature(therapist)_______________________Date



The article does go into more detail, but I think the long and the short of it is that GP's are not so happy to take the burden of responsibilty any more - we, as professional therapists, must start to take some of the responsibility along with the client.

Hope this helps a little!!!!!

k x
 
Oh dear this does seem like a very grey area now.

I am doing an ITEC course and have been told with regard to my case studies that if i need G.P. consent then i must have it, otherwise i am not permitted to touch my case studies.

However we were told to get the G.P. name and address from the client and write to them ourselves, and only if we are refused permission is the client asked to intervene. They would have to pay any fees incurred though (obviously with prior agreement)
Luckily the G.P. in question was very cooperative........ i posted a consent form to him on a Wednesday morning and received it back in the post Friday morning!
 
It's one thing to have to get GP consent when you are doing a course, but another when you are practicing - depending on the circumstances. To be honest most GPs don't have a CLUE about complementary therapies (I know I have spoken to them and seen the blank stares) and they wouldn't know what the treatment involved.

Personally I would only get GP permission if absolutely necessary. Get the client to sign a consent form to say that they understand about the treatment they are receiving and that they give permissioni to go ahead.

If I do have to do a GP letter then I make sure that it is short, to the point and well presented. Spelling mistakes don't go down well with the medical profession (or anybody to be honest) so make sure you pay attention to detail.

All you have to do is put a section at the bottom to be signed by the GP to say that they see no reason why this person should not receive treatment and enclose an SAE. You don't not have to ask for their permission. I have always had mine returned. GPs are incredibly busy, the last thing they need is to be over-burdened with therapists writing to them when it isn't necessary. There are very few contra-indications to massage, so make sure you know what they truly are and if they don't apply then use your own common sense and don't bother GPs unless you need to.
 
I must agree with you Candie, most GP's are so ignorant of what we have to offer it's unbelievable. I've been doing a charity event at work, 20min IHM. One lady wanted to come but has had thyroid problems (sorted out) and is suffering from leukaemia. She is still healthy enough to work, go on holiday to Canada on a polar bear expedition and on a cross the atlantic cruise. But having her head and shoulders is a no-no! Logic defies me!
Sonia
 
Exactly. And therefore it is up to the therapist to be confident and competent enough to get past this. They will ask you for advice so only you can give it.

You could use the polar bear expedition as a good example in future!
 
This is one area that always worries me and confuses me. I know we studied this at college and was told over and over again but I still wory as to what conditions i need to get GP permission and when I can go ahead without. Please can some tell me I think this may have been posted by someone last year but cannot find it.
 
One thing you could do if you have no reply from the dr. is send a second letter stating that if they think that the client SHOULD NOT recieve treatments, to sign the letter and return it to you (send a SAE)

This is what my tutor told me to do and I heard nothing from the DR. so I proceeded to treat!

I just put both copies of the letters in my case study-it actually made it look EXTREMELY professional!!!

Tx
 
I think you will find that VTCT are much more wobbly about this than ITEC. It would seem that VTCT scare their therapists to death over it to the point that the therapist are scared to treat anybody. I had a VTCT therapist come into the clinic and tell me she couldn't treat her mother with Indian Head Massage as she had high blood pressure.[&:] Er... I thought massage lowered blood pressure?

As said before, exams and case studies are one thing and practice is another. If you have to do what they say then you have to do what they say to pass. I would always ask them only to say if they thought the treatment could not go ahead and get the client to sign a disclaimer.
 
The answer is everything that is on the contra indication list cannot be treated without first receiving a Drs approval, to do otherwise would invalidate your insurance :-)
 
just qualified and been referred to my first client through friend,spoken to client and found out he has several trapped nerves throughout his body so doctors would find it hard to operate.he tells me he has had lots of massage and that it relaxes him,my proffessional body code of ethics states any treatment of known medical conditions must have gp consent first.so im writing a gp consent form for client and also think he should see an osteopath,advice greatful.
peace and calm
 
Donovan - I think you need to clarify this with your organisation, or you are going to spend more time writing letters than treating clients. It is very rare to get a client without something wrong with them. Where do you draw the line? Do you include chronic conditions such as IBS, eczema, asthma, endometriosis....I could go on and on.

There are certain conditions, which, if not stabliised, are sometimes considered to be contraindications (such as diabetes and epilepsy). VTCT recommend that you ask the client to check with their GP (when they have their next check up) that it is OK to receive a treatment and then sign that a verbal consent has been obtained.

Lesley
 
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  35. Sunrise Health Centre:
    ๐Ÿซฆ Yoyo & Noor are her today ๐Ÿ’‹ ๐Ÿ“ž๐Ÿ“ฒ (647) 325-8086 ๐Ÿ’ฆ We have Hot & Sexy Girls Every Day. ๐Ÿ’‹ They all do Extra Services & are Very Open-Minded ~ Drop In Anytime ๐Ÿšถโ€โ™€๏ธ๐Ÿšถโ€โžก๏ธ Walk-Ins Are Always Welcome! Unit 27, 10 East Wilmot Street, Richmond Hill
  36. #203MoMo&Beauty:
    MoonMoon spa/416 887 8801/8131Yonge st #203 open mind Cuban girl (Mimi ) &Asian girl in today
  37. Newspring@:
    โค๏ธโค๏ธโค๏ธsexy hot Singapore ๐ŸŒธJapanese ๐ŸŒธindian girl working at๐Ÿ’“๐Ÿ’“ Nu spring spa โ˜Ž๏ธ416-669-8508โค๏ธโค๏ธโค๏ธ
  38. AliceSpa:
    THURSDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—”, 4915 Steeles Ave. E, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿต๐Ÿด-๐Ÿฌ๐Ÿด๐Ÿต๐Ÿด. 3 girls here today at ALICE SPA. Open to 9pm: *New Girl BELLA: is a cute European lady with blonde hair & blue eyes, busty E Cups, curvy body & sweet slow service. KITTY): is a new Korean girl, super busty, small body, new to the business. Very friendly, no rush, dfk, bbbj, cim, cof, rim, titf*k
  39. wonderspa:
    ๐ŸŒบ๐ŸŒบwelcome to wonder spaโ˜Ž๏ธโ˜Ž๏ธ416-5000-800๏ผŒopen10 to10.we have 4young beautiful girls working everyday,๐Ÿ’„Sunny is very friendly nice girl,providing deep tissue massage and nice body slide ๐Ÿ’„ new girl Judy very good looking,big breasted service queen,girl friend experience,๐Ÿ’„Mina is long hair sexy ,she know what do you need,must try๐Ÿท๐Ÿท๐Ÿฅฐ
  40. Sparkling Spa:
    โšก๏ธ๐ŸŒŸSPARKLING SPAโšก๏ธ๐ŸŒŸ โœ…50 Lockridge Ave Unit 8โœ… ๐Ÿ‘ŒMarkham, ON L3R 8X4๐Ÿ‘Œ โ˜Ž๏ธ (905) 604-8186 Spa Land Lineโ˜Ž๏ธ โ˜Ž๏ธ (437) 446-6688 NEW Spa Cell Phoneโ˜Ž๏ธ (West of Warden & 16th Ave) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅSUPERSTAR SERVICE QUEENS AVAILABLE AT SPARKLING SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅSEXY NEW YOUNG GIRLS ALWAYS WORKING - Todayโ€™s Schedule isโ€ฆ๐Ÿ”ฅ Summer -๐Ÿ”ฅA sexy sultry part time Korean student with a wild and crazy addictive pe
  41. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅTODAYโ€™s ROSTER INCLUDES: Anna๐Ÿ˜˜- A stunning sexy girl from Hong K
  42. Moneylee:
    All season wellness center: Young girl big boobs beautiful face deep massage kasa ,Young girl big breasted beautiful buttocks charming temperament big boobs coco ,young girl pretty face nice figure Thai deep massage Tina ,Student big boobs buttocks Vicky, Enchanting sexy petite deep massage Sherry ,๐Ÿ address: #5-30 Rambler dr Brampton ,Ontario L6W 1E2โ˜Ž๏ธ4376655510 ๐Ÿฆต๐Ÿฆต๐Ÿ‘„๐Ÿ‘„๐Ÿˆต๏ธ๐Ÿˆต๏ธ๐Ÿ‘…๐Ÿ‘…
  43. Annie Spa:
    ๐ŸŽ‰๐Ÿ’ANNIE SPA๐ŸŽ‰๐Ÿ’ โœ…7-1001 SANDHURST CIRCLEโœ… ๐Ÿ‘ŒSCARBOROUGH ON M1V 1Z6๐Ÿ‘Œ โ˜Ž๏ธ (647) 891-9688โ˜Ž๏ธ โ˜Ž๏ธ (416) 291-8879โ˜Ž๏ธ (FINCH & MCCOWAN) OPEN 9:30am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅ๐Ÿ”ฅ ๐Ÿ”ฅGORGEOUS NEW YOUNG ASIAN GIRLS - TODAYโ€™s ROSTER INCLUDES: ๐Ÿ”ฅ Suki๐Ÿ˜is beautiful short petite tiny sexy student from Cambodia. Exotic features and model looks, Suki has a nice bum, slim waist, flat stomach and very good massage skills and has a great playful personality. Suki has a beautiful
  44. Moneylee:
    Full season wellness center: young girl pretty face nice figure Thai deep massage Anika , Student pretty face nice figure Thai deep massage Michelle,Young girl big breasted beautiful buttocks charming temperament big boobs Anjoo ,Young girl Big breasted saucy naughty Ella,Enchanting sexy petite deep massage Mary. 2560 Shepard ave Mississauga unit 1 .โ˜Ž๏ธ4379857899๐Ÿˆต๏ธ๐Ÿˆต๏ธ๐Ÿ‘„๐Ÿ‘„๐Ÿฆต๐Ÿฆต๐Ÿ‘…๐Ÿ‘…
  45. Red Rose Spa:
    ASHA, ๐ŸŒธ We have 5 hot brown girls today ๐ŸŒธ ANAYA, ANGEL, LUCY, NISHA, MEERA, ANGELINA, NUR ๐ŸŒธ 2588 Birchmount ๐ŸŒธ 2 Invergordon ๐ŸŒธ 647-702-8800 ๐ŸŒธ Please visit for a great erotic massage
  46. Golden Sunshine Spa:
    โœจClick on our Username and FOLLOW US for updates and special services ! โœ… Today๐ŸŒธTina๐ŸŒธSusan๐ŸŒธIsabella๐ŸŒธFran๐ŸŒธCassy Call us โ˜Ž 905 - 265 - 2158โ˜Ž๏ธ Your ultimate service awaits! โœจ
  47. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Meet๐ŸŒธLuLu๐ŸŒธLuna๐ŸŒธJazminCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  48. ASPA:
    ๐—ง๐—›๐—จ๐—ฅ๐—ฆ๐——๐—”๐—ฌ ๐—”๐—ง ๐€ ๐’๐๐€: Fox, Coco & ๐—ฏ๐—ฒ๐˜€๐˜ ๐—บ๐—ฎ๐˜€๐˜€๐—ฎ๐—ด๐—ฒ ๐—ฅ๐—ฎ๐—ฐ๐—ต๐—ฒ๐—น[/color] ๐Ÿ…ฐ๏ธ๐€ ๐’๐๐€๐Ÿ…ฐ๏ธ, 28 South Unionville Ave, Unit 5, Markham. ๐Ÿ…ฐ๏ธ๐—–๐—ฎ๐—น๐—น ๐Ÿฒ๐Ÿฐ๐Ÿณ-๐Ÿณ๐Ÿฎ๐Ÿต-๐Ÿฒ๐Ÿฒ๐Ÿฌ๐Ÿฒ ๐—ผ๐—ฟ ๐˜๐—ฒ๐˜…๐˜ ๐Ÿฒ๐Ÿฐ๐Ÿณ-๐Ÿด๐Ÿฏ๐Ÿต-๐Ÿฑ๐Ÿต๐Ÿฒ๐Ÿฒ๐Ÿ…ฐ๏ธ FOX is 26 years old with 34Cโ€™s, stands 164Cm tall and weighs 54Kg. Fox is very friendly and can provide a great girlfriend experience. COCO medium build
  49. ForeverWarden:
    Thursday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ๐Ÿซฆ2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Cindy, Jennifer & Tracy. Anida is a slim Asian babe with a small waist and great bum. Anita has excellent massage, oral and other skills. Cindy is a slim beauty, 5โ€™4โ€, natural C Cups & wonderfully long nipples. Her massage is nice, her bbbj will drive you wild & her cfs finish is a dream come true.
  50. HolidaySpa:
    Thursday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธEMILY, LUCY & CINDY. EMILY is a VERY tiny petite SPINNER superstar of the highest quality. Emily has a pretty face, natural A Cups, slim waist, and a lovely spinner bottom, topped off with the very best of services. LUCY is a beautiful and slim Asian lady with a happy disposition and great services.
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