Ethics

Comment

Comment by Rachel Sheard, LMT, NCTMB, CIPI on November 4, 2010 at 3:19pm

I didn't expect or mean to imply billing the insurance for her missed appointments, or even the cancellation fees. I guess I just need to toughen up and deal with the situation in person like you said. I will probably let these past ones go, and be very clear with her that if she cancels with less than 24 hours notice again, that it'll be coming from her pocket.

Comment by lee kalpin on November 4, 2010 at 3:14pm

In my experience with insurance companies, they are willing to pay for TREATMENTS so the client will recover from their injuries, they are not willing to pay for missed appointments. This client is probably expecting that the insurance company will just pay for all these missed appointments - and she is wrong! I suggest you speak to her in person and explain to her how it works. Her company will pay for treatment only - If she is not able to make the appointment your usual fee for missed appointments will apply. I would suggest to her that if the insurance company finds out she is not getting her treatments, they may cancell her coverage. You have to be careful how you word this - you don't want it to come over as a threat, but as a "heads-up" for her.

Comment by Rachel Sheard, LMT, NCTMB, CIPI on November 4, 2010 at 3:03pm

Looking for feedback/opinions here... I do insurance billing for clients who've been in a car accident, and am currently treating a 24 year old woman who has cancelled her appt the same day I think 4 times since she started seeing me less than a month ago (appts are 2x/wk). I do have a cancellation policy, but I'm not sure whether or how to enforce that with an insurance client..? Once cancellation was due to pain from ovarian cyst, one was picking dog up from vet hospital after being hit by a car, one was it was too cold/rainy and she didn't have a ride and didn't feel like walking (I live in Oregon...it rains a LOT this time of year!!), today, she had her fiancee cancel for her an hour and a half before her appt because she's not feeling good--thinks she might be getting sick, hasn't felt good since yesterday (both days have been absolutely GORGEOUS outside). I dunno. Yes, some of those seem like actual legitimate reasons to cancel, but I still kinda feel like she's walking all over me, and I do not want that to continue. So...do I enforce the cancellation policy? Mine is $25 if cancelled with less than 24 hours notice, or pay in full if appointment is missed with no notification.

Comment by robbie rogers on September 16, 2010 at 6:03pm

who has good online medical ethics for ceu's?

Comment by lee kalpin on June 6, 2010 at 11:18am

I practice in Ontario and our regulatory body, the CMTO, has the Core Competencies Document which details what a person must know in order to meet minimum standards and qualify for the Registration Exams. For Continuing Education, there is a list of modalities that are considered to be within our Scope of Practice and those that are outside of Scope and do not receive credit for continuing ed.
I believe that as long as massage therapists see themselves as Service providers, like waiters and hairdressers, they will not be accepted as Healthcare Providers. Most massage therapists say that they want to be acknowledged as professionals but that is not likely to happen until they conduct themselves as professionals.

I am offered tips occasionally, and I do turn them down - as politely as possible.

Comment by Gloria Coppola on June 6, 2010 at 10:57am

http://massagecareers.blogspot.com/2010/06/ethetical-issues-with-ou...

Comment by Eve Demey on March 7, 2010 at 11:51am

those places, usually do not treat their therapist very well, big turn over.

Comment by Kevin Green on March 5, 2010 at 11:54am

Lee, sorry for not spelling out the MBOK and I left out the T. Look to the group Massage Therapy Body of Knowledge for the draft. It is part of an effort to define what is and is not massage.
Tips and gifts are hard to turn down and many clients are upset if you refuse. A massage company here advertises a $39 dollar massage but tips are expected and added at 15%. The Therapist relies on the tips as do waiters and other service people. I am in agreement with you on this subject. I can only hope that the more we are healthcare the less we will see this as an issue.
As for products I see Chiros and others therapist selling and it sure would help cover the overhead, I just have not ever felt right about it even when I use and love the product. The exception is the music and oil we use.
More discussion and awareness all around should help. Thanks for the reply.

Comment by lee kalpin on February 28, 2010 at 1:08pm

These are very good points Kevin.
I don't know what the MBOK is, but certainly where I practice, recommending herbs and nutrition is out of our scope of practice. You are right - having the product for sale is an endorsement of that product. And because our clients trust us, they are more likely to buy. For that reason I would not sell these products. If people want information on nutrition (and they often do) I can refer them to articles from legitimate sources and they can make their own educated decisions.
I also do not accept tips. I know this is controversial as therapists in many areas rely on tips as part of their livlihood. However, as a heatlh care professional I do not expect tips any more than a doctor, nurse, chiropractor or any other health professional would expect tips.. There are many ethical issues around tips.
Does the person who tips well get a better massage? Will the person who tips well be favoured when they phone for an appointment and the therapist is busy?
If a person tips well, and wants a favour, such as a letter to their insurance company saying they need time off work - will the therapist comply more readily?

Comment by Kevin Green on February 28, 2010 at 11:29am

Reading the MBOK raises a number of ethical questions. In defining scope of practice a number of things under NOT our scope makes me wonder how other therapist view this. Many therapist sell products including supplements and herbs. This MBOK document states that recommending nutrition and herbs is out side of scope. Just having the product for sale is an endorsement, where do we draw the line.
The subject of tips is also on my mind. I have seen studies that relate touch to hormones that increase trust and generosity. Sales people, and other service staff (waiters, bellmen) and politicians have long known that shaking hands or touching the shoulder increases sales tips and votes.
As health care providers clients trust us and are vulnerable to suggestion after a massage. Is selling anything including things we consider good for them ethical.
What do you think?

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