Referrals to Unregulated Health Care Providers

Members have an ethical responsibility to ensure that referrals to healthcare professionals are carried out within the best interest of the client. This responsibility is even greater when making referrals to non-regulated healthcare providers, as there is little to no statutory protection available for clients/ patients of non-regulated healthcare providers.

The following policy has been drafted to assist members and provide additional protection to their clients when referrals are made to non- regulated healthcare providers. There is no prohibition from making such referrals, however, members should be satisfied that the services recommended can reasonably be expected to benefit the client and not cause harm. In addition, it is suggested that members review the following series of questions to also assist in the determination of whom to refer to:

  1. Is there a standard certification for the practice?
  2. What is required for professional certification?
  3. Is there a professional association?
  4. What is the scope of practice and the standards of practice?
  5. Is there someone to notify or inquire about adverse experiences?
  6. Where can one obtain further information?

Policy

It is expected that after members have complied with the applicable Standards of Practice and have determined that a referral to a non-regulated healthcare provider is appropriate member should:

Before a Referral is Made

  • Advise the client of the usual and conventional treatment options, their risks and benefits so that the client has sufficient information to allow them to make informed choice;
  • Ensure that information or an opinion provided to the client is not misrepresented;
  • Ensure that the referral is not made when a member is in a conflict of interest or would otherwise profit from the referral.

After the Referral is Made

  • Document the particulars of the referral to include the name of the non regulated-health provider, the modality, and reason for referral;
  • Document outcomes at next visit, and expected length of treatment. Continue to follow the client through the duration of the treatment.

Rationale

It is clear that a client has inherent protection when receiving care from a regulated health professional. In the event of complaints regarding the competence or professional conduct, the professions governing body will deal with complaints. Where a client is concerned with the services provided by a non-regulated healthcare provider the same protection may not exist. Therefore, it is imperative that members be aware that there exists a professional obligation to ensure their clients will be treated ethically and respectfully, that their safety is not jeopardized and that they have adequate information to make decisions about their care. The above policy will aid members in their decision making process and provide further protection for their clients

Scenario

After 2 weeks of taking muscle relaxants prescribed by her doctor, Tina Brown is referred for Massage Therapy. She takes her medical doctor’s advice and sees Beth Smith, RMT for Massage Therapy. Beth Smith obtains Tina Brown’s medical history, which indicates a soft tissue injury to her low back while picking up her 3 year old child. Tina has no other health conditions and is in good general health.

Beth obtains Tina’s consent to conduct an assessment and reaffirms the doctor’s diagnosis. Beth suggests to Tina that a course of four (1 hour treatments) in the next 4 weeks would be advisable after her initial assessment. Tina agrees to this suggestion and improves with each treatment.

After the 4th week duration has passed, Beth and Tina discus that a 65% improvement has occurred but a lingering discomfort still persists. Beth suggests to Tina that acupuncture may benefit and rid the persistent lingering pain. Beth provides Tina with information relating to Acupuncture and other forms of possible treatments. Beth tells Tina about the positive results of clients that she has referred to Helen Hong, Doctor of Oriental Medicine, Acupuncturist. Helen is a member of the Canadian Acupuncture Association.

Tina wishes to pursue this course of non-regulated treatment and asks for Helen’s phone number and address. Beth gives the information to Tina and requests that she call her after the initial treatment with the Acupuncturist.

Additionally she calls the Canadian Acupuncture Association to confirm that Helen Hong is still a good standing member. Beth Smith, RMT documents in her treatment records all of the above information.

Beth contacts Tina 3 weeks later to determine if there has been a positive improvement in the remaining discomfort. Tina indicates that she feels almost fully recovered.

Beth again documents her follow-up with Tina.

 

Approved: September 20, 2002