Describe what counselling is
www.skillsyouneed.com/general/counselling.html
A professional counsellor is a highly trained individual who is able to use a different range of counselling approaches with their clients.Lis 2 main legal and ethical issues that relate to practitioner-client relationships, including any regulations that relate to these issues
I recently had some dental surgery and the periodontist got ready to give me a shot of pain killer without saying anything to me about it. I told him that I did not want it. He got upset, so I explained that I had been using self-hypnosis successfully for years for dealing with pain during dental procedures. He finally agreed to go ahead, and since I showed no signs of pain during the procedure, he finally admitted that it was as much for his own comfort as that of the patient that he routinely, without informing the patient, used a pain killer. His needs versus those of the client seemed to take a priority. It is useful to remember that we all develop habits as practitioners and not all of them are for the benefit of all clients. Due care to what a practitioner does or does not do with each indiv
http://www.resourcenter.net/images/AAPB/Files/Biofeedback/2005/BIOF3301_08-13.pdf
What is the importance of Client Confidentially?
Security of customer information very important just to keep the trust of the customers just keep confidence in the profession. Moreover, giving guests the best care practice. Information should be kept confidential. Security is an issue of professionalism and in laws enacted to protect consumers.
http://vista.engines4ed.org/nutrition/docs/NA_ConfidentialityFAQ.htm
https://www.reference.com/.../important-maintain-confidentiality-283218aa66320641
Identify three ways in which practitioner can safeguard themselves against neglience?
- Honest and open communication is the best approach; that’s why it’s often referred to as “disclosure".
- informed consent
- stay up-to-date on standards and training
- adequate follow-up of diagnostic tests and specialist referrals
- Variations in policies and procedures
- Compassionate gestures count
- understanding of the mechanisms and causes of patient harm and provide this information to physicians so they can reduce risk and promote patient safety.
Six ways physicians can prevent patient injury and avoid lawsuits
When a patient or family sues, the emotional wound takes a toll on the physician, undermining confidence and trust. “We doctors tend to be really hard on ourselves,” says Richard G. Roberts, MD, JD, past president of the American Academy of Family Physicians and a professor at the University of Wisconsin’s primary care clinic in Belleville, Wisconsin. “We see every wart in the process of care.”
But risks surround physicians every day, from alleged diagnostic errors to inadequate follow-up. By recognizing what poses the greatest risk, physicians can create and implement formal policies and procedures to protect their practices.
“Risk management,” Roberts explains, “is a series of strategies designed to reduce the likelihood of injury to the patient, and when injury occurs, to reduce the likelihood that a suit results.”
PIAA—formerly known as Physician Insurers Association of America—reports that 70% of the claims closed within its Data Sharing Project (DSP) database have no indemnity payment. Among the 30% that close with an indemnity payment, the majority of risk surrounds claims alleging diagnostic errors, says P. Divya Parikh, director of research and loss management in PIAA’s Rockville, Maryland, headquarters.
The association’s database contains nearly 290,000 medical professional liability claims and lawsuits closed since 1985. PIAA’s most recent report is based on 2013 comparative data on claims closed between 2003 and 2012.
“Obstetrics still is a top medical specialty that has claims reported, but others include internal medicine, orthopedic surgery and general surgery,” Parikh says. “Within the DSP, the majority of claims reported are by the patients themselves, except in the pediatric cases and in cases of patient death or long-term injury.”
To identify the most overlooked risks to physicians, Medical Economics asked several thought leaders to share their insight into strategies for protecting office-based practices. Here, we present six common risks that you can mitigate.
1. Faulty communication
Honest and open communication is the best approach; that’s why it’s often referred to as “disclosure.” When patients feel that healthcare providers genuinely care and have their best interests in mind, they tend to be more forgiving of errors, says Graham Billingham, MD, FACEP, FAAEM, chief medical officer of The Medical Protective Company, a national professional liability insurer based in Fort Wayne, Indiana.
The number of medical malpractice claims has declined significantly in the last decade. Billingham suspects the decline is due at least in part to physicians offering the explanations that patients need when faced with unanticipated outcomes of their care.
“A bad outcome is not always synonymous with malpractice. However, a bad outcome and poor communication are usually the driving force when a patient or family considers litigation,” Billingham says. “The importance of communicating effectively with patients and their families cannot be emphasized enough—it is one of the best ways to mitigate risk.
“Listening carefully, offering clear answers and instructions, addressing complaints, setting realistic expectations, including family members (as appropriate), and documenting thoroughly are all good techniques to improve communication and avoid risk exposure,” he suggests.
It’s also important to inform the patient and loved ones that the physician’s practice will learn from the error so as to eliminate or minimize harm to others in the future.
Some circumstances may call for a formal apology, Billingham says, but in all cases, it never hurts to express empathy to the patient and family.
Certain populations may require special consideration, such as patients with language barriers, and those who are elderly or noncompliant—leaving the hospital against medical advice or acting in a violent or disruptive manner.
2. Lack of informed consent
“Patient consent is a big area where claims can come into play,” says Rob O’Connor, CPCU, senior vice president at People’s United Insurance Agency Inc., a general carrier headquartered in Hartford, Connecticut that underwrites liability policies for physicians and healthcare facilities.
“You want to make sure that the patient has consented to whatever procedure the doctor is doing,” he adds. For instance, the patient should have “a full understanding of the risks—that surgery may lead to death or paralysis.”
It’s essential to verbally communicate the risks before a procedure, not after—and to include this information in a written consent form that the patient signs. The patient must receive a proper explanation of the form’s purpose that clearly spells out the risks inherent in the procedure.
“This should be standard practice,” O’Connor says, “but there are still problems in this area with claims.”
3. Failure to stay up-to-date on standards and training
Physicians also need to be aware of new and revised developments in their areas of practice and specialties, says Kenneth N. Rashbaum, a healthcare compliance lawyer in New York, New York. This includes changes in disease management for acute and chronic conditions, technological innovations, recently published research and practice standards.
“Often, medical liability issues focus on the question of whether the doctor followed current standards of practice,” Rashbaum says, “or was he or she treating the patient based on an older standard that has been revised in recent years?”
While this advice may sound obvious, he adds that busy practitioners “may not feel they have the time to read up on everything that is current,” or to participate in conferences and other continuing medical education opportunities.
The transition to electronic health records is among the most significant risk management concerns, Rashbaum says.
“Clinicians should make sure they are current in training on their organization’s systems and familiar with the issues regarding use of templates and clinical support systems in computer-based pharmaceutical ordering,” he says, “and that they are aware of the need for retention of communications relevant to treatment.”
4. Inadequate follow-up of diagnostic tests and specialist referrals
Some of the most frequent problems resulting in litigation involve physician orders for tests and the corresponding lab or X-ray results, says Darrell Ranum, JD, CPHRM, vice president of patient safety at The Doctors Company, a medical malpractice insurer headquartered in Napa, California.
There are instances when tests results aren’t received by the ordering physician. On other occasions, patients don’t follow through with tests as directed; or the results come in, are filed away before the physician reviews them, and the patient isn’t briefed about the findings.
“If test results that indicate patients need further testing or treatments are lost or not addressed, patients may not receive necessary treatment,” Ranum says. “It is essential that physicians and their staffs be able to track the status of these orders to make sure that none are overlooked or forgotten.”
Another aspect of care needing better follow-up involves referrals to specialists. The referring physician’s office often makes appointments with specialists for patients and documents when a specialist’s report is anticipated.
“The referring office should set a reminder as to when to expect the report,” Ranum suggests.
If the report isn’t received within a specified time from the appointment date, the referring office should contact the consulting practice and note its follow-up efforts in the patient’s medical record.
“Generally, the consultant will contact the referring physician if the patient is a no-show,” he says. “The referring physician should then contact the patient.”
5. Variations in policies and procedures
“In well-run practices, there is one set of rules that all staff understands and follows,” says Karen B. Everitt, regional vice president of risk management at ProAssurance Companies, a professional liability carrier based in Birmingham, Alabama. “The alternative is risky, where there are numerous competing procedures that vary from physician-to-physician or between staff members, making it easy for errors or omissions to occur.”
Policies and procedures should be specific and readily available to all staff members. They can be kept in a notebook or manual or in an electronic format that is easy for the office staff to access. The physician or a committee should review policies and procedures on an annual basis to ensure that they reflect preferences and requirements, Everitt says.
In addition to follow-ups on diagnostic tests and specialist referrals, these policies would detail the protocols for calling in new or refill prescriptions and dealing with cancellations and no-show appointments. They would also provide clear guidance in addressing patient or family complaints, security, retention, storage, destruction, maintenance, and release of medical information under Health Insurance Portability and Accountability Act rules.
Other issues include fire safety and emergency or disaster response, social media, and employee competency and conduct.
6. Avoidance behavior
Compassionate gestures count. If a hospitalized patient has a bad outcome, some physicians may avoid making rounds in the presence of relatives.
“Look at it through the family’s eyes,” says Roberts, the University of Wisconsin family medicine practitioner. “That’s exactly when they really need you.”
Don’t be afraid to face them. It’s important to let them know you understand how they feel. Make eye contact with whomever you’re addressing and put a comforting hand on the individual’s arm.
“That’s a key part of doctoring,” he says. And be sure to listen; don’t do all the talking. In other words: “Just shut up and be there. Show that you care.”
Remember, however, that risk management remains “a moving target,” cautions Billingham of The Medical Protective Company. “As new technologies and treatments emerge, so too will new risks. It’s important to constantly reassess and measure both quality and safety,” he says.
The causes of malpractice suits and patient injury
The Doctors Company has one of the nation’s largest databases of medical malpractice claims and suits. The company studies the clinical information captured in the data to gain understanding of the mechanisms and causes of patient harm and provide this information to physicians so they can reduce risk and promote patient safety.
The following are some key findings for the studies:
Surgical treatment is the most common allegation in claims. Some 25 percent of all claims involve surgical treatment.
Missed or delayed diagnosis is the second most common allegation. Some 21 percent of all claims involve missed or delayed diagnosis.
The top factors that actually contributed to patient injury, based on expert reviews of the data, are:
- Problems with clinical judgment (38%)
- Technical skills (23%)
- Communication (22%)
- Patient behaviors (20%)
- System failures (14%)
- Documentation (13%)
Source: The Doctors Company
Xem them: Negligence - A person is negligent if he fails to exercise ordinary care to avoid injury to other persons or their property. In other words, he failed to do something a reasonably careful person would do or he did something a reasonably careful person would not do under the same or similar circumstances. For example, if a person causes an auto accident because he was driving faster than was safe for the existing conditions, the resulting lawsuit will likely include a negligence claim. For a negligence claim, a plaintiff must establish four elements:
- Duty of care
- Breach of duty
- Causal connection; and
- Actual loss or harm
http://www.inc.com/articles/1999/11/15373.html
5. What is the Code of Ethics intended to provide?
Code of Ethics is a summary statement of the standards of conduct that define ethical behavior for the massage therapist. Adherence to the Code is a prerequisite for admission to and continued membership in the American Massage Therapy Association (AMTA). Principles of Ethics.
https://www.amtamassage.org/About-AMTA/Core-Documents/Code-of-Ethics.html
http://www.sagemassage.edu.au/blog/professional-ethics-your-responsibility-as-a-massage-therapist/
therapist. You’ve got a job, a certificate on the wall, and paying clients queueing up to see you. Woo-hoo! And, have you noticed? People now want to listen to what you have to say! They respect you, and with this, your professional ethics kick into play. It is your responsibility to give only ethical and sound health advice.
Hmm. Scary stuff. Well, not that scary, just as long as you stick to a couple of sensible rules. Read on…
Your “personal code of ethics”: why is it that what you say matters?
Now that you are certified in the health industry, people will listen to you about matters regarding health. This means both healthy people and more vulnerable, unhealthy people. In other words, people with serious diseases – even cancer – may ask for your health advice. But, of course, if you are a small business or work in one, it is unlikely that you have a code of ethics written up and available for all to see. You need to develop your own personal code of ethics. One of the fundamental principles of this code of ethics is that, you should only give health advice on areas where you are qualified to do so.
During or after your session with a client, it’s totally reasonable that you may give your clients health advice on issues such as, for example:
- when is the right or wrong time to receive a massage,
- exercises and stretches to perform to help with your clients’ posture or health conditions, and
- tips on taking care of their bodies, muscles and joints.
The above health information is “in keeping” with your line of work – areas where you have gained professional expertise. Sage has educated you with the latest evidence-based content and research, and of course that great 120 hours of hands on practical experience in the student massage clinic, so graduates are well equipped to give professional health advice in this line of work.
On the other hand, it’s important not to give healthcare advice on areas that you are not an expert in, such as serious medical illnesses, medications or vaccinations. These are outside the boundaries of your experience, and your professional ethics. If your client has queries around these issues, it’s essential that you refer them to a GP or qualified health practitioner who can respond appropriately in keeping with their areas of expertise and their code of ethics.
Personal beliefs versus facts
Your professional session times should never be used as an excuse to push your personal beliefs in things such as health or spiritual practices that are not scientifically based, in other words, pseudoscience. Start talking about such opinion based material to your clients and your professional reputation will walk out the door. At the same time, you’ll do the whole massage industry a discredit. Need examples?
- Talking about a client’s “auras”
- Suggesting their pain comes from ‘metaphysical causations’, e.g. “I think you’re stiff back comes from ‘financial problems’
- Talking a client out of taking prescription medication
- Recommending practices with no scientific validation, e.g. homeopathy, juice fasting, the latest fad diet, etc.
Social media (remember your professional ethics)
A Facebook page is a great way of attracting new clients, engaging with them and having some fun. But remember, you have a professional obligation to act responsibly and apply your personal code of ethics. It’s essential that you don’t pass on incorrect or unethical memes or content, as health information just because you think they will get likes and shares.
Here’s an example:
Just because someone on Facebook posts a meme that suggests rosemary oil will improve your memory by 75% or doctors are evil tricksters, it doesn’t mean that you should share it on your Facebook page to get more “Likes”. As a health professional, you have a responsibility to check facts before sharing.
Just because someone on Facebook posts a meme that suggests rosemary oil will improve your memory by 75% or doctors are evil tricksters, it doesn’t mean that you should share it on your Facebook page to get more “Likes”. As a health professional, you have a responsibility to check facts before sharing.
What’s the big deal? There’s a lot of misinformation and pseudoscience on the web. Some of it may look harmless enough or even like a ‘good news story’ but ultimately, sharing ill-founded material perpetuates the problem and can reflect poorly on your professional reputation. Think carefully about what you share and from which sites.
Here’s another example:
If you are trying to sell products, such as essential oils, focus on the positives, but don’t scare people into false negatives. In other words, suggesting that “medicines are toxic” or “chemotherapy kills” is simply fear mongering for profit.
If you are trying to sell products, such as essential oils, focus on the positives, but don’t scare people into false negatives. In other words, suggesting that “medicines are toxic” or “chemotherapy kills” is simply fear mongering for profit.
Bottom line: If you want to post anything on health, it’s recommended that you back your information with valid references. Remember that it’s up to you to ensure that you apply your own personal code of ethics and avoid giving health advice that is outside your area of expertise.
Massage therapy – a valid complementary health practice
Choosing a career as a massage therapist is a smart choice. Along with its many benefits and joys, it is recognised as a successful complementary therapy and a respectable career. Just make sure you uphold your professional reputation – and the reputation of the industry – by developing and applying a sound set of professional ethics. Then, you’ll reap the benefits of the respect and gratitude you deserve.
Sage Institute of Massage – it’s more than a job, it’s a rewarding career.
6. Identify three breaches in "duty of care"?
study.com/academy/lesson/what-is-duty-of-care-definition-examples.html
7. Describe the meaning of informed consent
permission granted in full knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with knowledge of the possible risks and benefits. "written informed consent was obtained from each patient"
8. What are the professional boundaries?
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