Inter-Professional Disagreement

Background

Massage therapists, whether they practice in an independent setting or as part of a multi-disciplinary team, are expected to work in collaboration with other healthcare providers in order to meet the client’s needs.

In most cases, treatment objectives and methodologies will be complementary and all that will be required is communication between the client, therapist and other provider to ensure that the plan of care is co-ordinated.

Occasionally practitioners may disagree about the cause of the client’s problem or the best treatment method to address it. In these circumstances, the Massage Therapist is expected to discuss the situation with the client and other provider to achieve the most suitable outcome for the client.

Position

The Massage Therapist has an ethical obligation to advise the client if he/she has concerns about the treatment methodology or philosophy being used by another clinician. The Massage Therapist will also need to advise the client if instructions are being received from a physician or clinic owner that the Massage Therapist believes should not be followed. The obligation to the client takes precedent over any employment obligations when the two values conflict.

Guidelines

In managing professional disagreements, Massage Therapists should ensure that:

  • The client is not placed in the middle of a disagreement between professional;
  • The client’s consent is obtained prior to speaking with the other provider;
  • The concern is discussed with the other provider and an attempt is made to resolve the disagreement;
  • The client is provided with the most accurate information possible regarding the Massage Therapist’s rationale for his/her treatment decision; and
  • The client’s choice of provider and treatment approach is respected.

Massage therapists should remember that in most cases there are several generally accepted treatment approaches to manage a condition. Discussion of treatment alternatives, should focus on the pros and cons of the methods available, and should avoid any assumptions or judgmental comments by the Massage Therapist about the practice of other professions.

Scenario

Cathy is a Massage Therapist who works in a multi-disciplinary clinic owned by a physician. A client ( Ms. Johnson) arrives at the clinic complaining of leg pain. She is seen by the physician who prescribes medication and refers her for Massage Therapy for her legs.

Cathy conducts an assessment. She believes, that while Ms. Johnson is suffering from leg pain, the source of the problem is her low back. Cathy discusses the case with the physician and asks if x-rays have been taken. The physician advises Cathy that x-rays are not necessary because he is sure that the client is experiencing muscular leg pain resulting from her fitness activities. He advises Cathy that it is her job to treat the client not to diagnose the cause of the problem. Cathy feels caught between meeting the needs of the client and following the direction given by her employer. After much thought, Cathy speaks with the client and suggests that she might want to consider a second opinion.

The client thanks Cathy and does obtain a consultation. Following an assessment and the taking of x-rays, that physician advises Ms. Johnson, that the pain in her legs is referred from her low back. He recommends medication, physiotherapy and Massage Therapy treatment. The client returns to Cathy for her Massage Therapy treatment and receives physiotherapy at another clinic. Within a few weeks, Ms. Johnson’s condition is resolved.

Conclusion

Cathy demonstrated good clinical skills in assessing the client’s condition and identifying the possible cause of her leg pain as a back disorder. When confronted with a professional difference of opinion, Cathy first went to the physician and discussed the case. When resolution was not successful, she elected to meet the client’s needs rather than her own personal employment needs. By providing the information to the client, she helped to ensure that appropriate treatment was received.

 

Approved: November 19, 1999