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Do we have the "Right of Refusal"?
This came out of another topic and Susan Salvo rightly pointed out that right of refusal is an excellent topic all on it's own. So, do you have the right to refuse doing a massage when you work for someone else? If so, under what conditions can you refuse? This discussion came up because a therapist wasn't comfortable with their knowledge level when a client undergoing chemo arrived for an appointment. Her employer did not agree with the decision not to do the massage because of the therapist's comfort level.
My feeling is that you can only refuse if there is a medical or ethical reason for doing so.
My feeling is that you can only refuse if there is a medical or ethical reason for doing so.
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Replies to This Discussion
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Permalink Reply by Lisa on
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i will go as far to say that we should have the right to refuse anyone just based on our intuition. and as an individual in practice i can make that choice. the real dilemma is when you are working for someone else.
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Permalink Reply by Darcy Neibaur on
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Well I can say this. I work for Massage Envy as everyone knows. I had a client 2 weeks ago wo asked me to complete remove his draping. I refused. I did complete the massage and he did not remove his draping. I said something to the house manager on duty about the situation and she told me I was not to say anything about these types of situations in front of the front end staff as they will not re-book the client. Interesting concept. Also, I was rear-ended on Friday for the third time in 2 1/2 years and am under doctor's care. I am off work for a week at the moment. When I asked yesterday if I could receive a massage that I pay for, I was told,"NO WORK NO MASSAGE ONLY WORKING TERAPISTS RECEIVE MASSAGE". Now what is wrong with this idiot comcept from the owner of the clinic I work for. All the advertising we do is for pain relef. Besides, I pay for my massages they are not free. I felt like he was trying to set me up to fail. All therapists who have had any kind of issues have been fired. So will see what happens with me. I have followed the law of Massage Envy to the T.
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Permalink Reply by Susan G. Salvo on
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I can’t speak to situations when a therapist works for a chain industry such as Massage Envy (sorry Darcy and Lisa – no experience here).
But in the realm of professional responsibility…
…if a therapist is going to refuse to work on a client under ANY certain circumstances, those circumstances need to be disclosed up-front – such as during the informed consent process.
Then, a client can make informed decisions whether or not to enter into the therapeutic relationship with that particular therapist.
I tell students frequently, “I can play the game, if I know the rules.”
Example: If I knew in advance that therapist John Doe would refuse massage if I had two beers, then I could make the informed decision to NOT have the two beers that day of my schedule appointment.
Yes, we use this example as a case study in class to discuss right of refusal. It provides lots of great discussion.
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Permalink Reply by Travis Alligood on
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Hi I know where this started, and this will be an interesting subject, and as a new Therapist (1 1/2 yrs.) Im very excited to not ever have to worry about turning down no more clients than I have to, however, when there is a right of refusal to be made I would be more conscience of hurting someone. Reading certain Code of ethics from different organizations tell me that there is a pretty good reason to not start the session if there is a question in my mind as to wether Im educated enough to give client the benefit of a good session.
CODE OF ETHICS:
NCBTMB,Represent their qualifications honestly, including education and professional affiliations, and provide only those services that they are qualified to perform.
AMTA,Demonstrate commitment to provide the highest quality massage therapy/bodywork to those who seek their professional service.
ABMP I shall acknowledge the limitations of my skills and, when necessary, refer clients to the appropriate qualified health care professional.
I work on my own happily and I do not run into this often and there is usually a contra-indication involved for me not to start and I explain why, and they are quite understanding. Now if I were working for someone and there was a contraindication involved even if there is a script from the doctor, then there is a good possibility that I may not be there as in the case where this forum started, because my manager/superior may not accept my reasoning. From a consciouse level I can sleep better knowing that I got fired because the decision that I made was what I felt the safest one for my client rather than putting a dollar in my pocket. Peace Travis
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No contract signed. Just a regular employee like any other place being employed.
Ty Capuano said:Hi Rick -
Never having worked for a franchise I am unclear if the therapist signs a contract and ,if so, is "right of refusal" addressed in the contract? If not, perhaps, discussions like this one will bring this issue to the forefront.
Being in private practice I have total discretion as to who is on my table. I do have the right to refuse for medical considerations, but have only done so when someone arrives who is sick (coughing/fever) and did not think it was important to let me know. Usually medical conditions are discussed when setting the appointment, not when they arrive at my office. As to ethics...again, any concerns I have are addressed when scheduling.
If I am an employee - I agree with you...if there are no medical or an ethical concerns - give the massage to the best of your ability. And if you can't do that...better to be in private practice. Getting out of our comfort zone (while doing no harm) can be an amazing learning opportunity.
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Permalink Reply by Monica Reno, LMT, NCTMB on
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ok well I guess I'll weigh in on this. If the massage therapist is an employee, which I believe is the case. He or she is acting as an agent of the business. So it reverts back to the labor laws governing the state or municipality where the work is being performed. It might seem logical that the employer would not want the therapist to work on a client if the therapist feels that their skills are insufficient. Conversely, the employer has every reason to assume that the therapist is competent to handle any routine condition, that is not in general a contraindication. Therefore, if the therapist during the hiring phase gave the impression that they were skilled enough to perform the job, then they in fact refused work as assigned, and that in most places would be grounds for termination. In addition, in states like Florida, "right to work states", no reason need be given to terminate an employee.
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I can say that there has been a few cases at the Massage Envy that I work at that LMT's have been scheduled to do Pre-Natal and have not been trained. They have refused and have not been fired. it was the fault of the booking staff. Massage Envy is now certifing their LMT's in Pre-Natal .
Monica you are correct about the laws in Florida. I live here also.
Monica Reno, LMT, NCTMB said:ok well I guess I'll weigh in on this. If the massage therapist is an employee, which I believe is the case. He or she is acting as an agent of the business. So it reverts back to the labor laws governing the state or municipality where the work is being performed. It might seem logical that the employer would not want the therapist to work on a client if the therapist feels that their skills are insufficient. Conversely, the employer has every reason to assume that the therapist is competent to handle any routine condition, that is not in general a contraindication. Therefore, if the therapist during the hiring phase gave the impression that they were skilled enough to perform the job, then they in fact refused work as assigned, and that in most places would be grounds for termination. In addition, in states like Florida, "right to work states", no reason need be given to terminate an employee.
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Permalink Reply by Julie Onofrio on
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I would think that anyone who is an employee has to abide by the employers rules and they don't have much of a right in the way of refusal of service. That is why it is important to interview your employer too and know what you are getting into.
If you have your own business you set the rules and have more freedom to refuse service and set your boundaries around every aspect- working on clients who are hygiene challenged, have conditions that you are not trained to deal with, etc.
Julie
www.thebodyworker.com
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what does this mean?
Allan J Jones said:Whatever....as that annoying sayin goes.Rick...!!@ its imperative that if you think you're dealling outside....of what you know....
Lisa said:i will go as far to say that we should have the right to refuse anyone just based on our intuition. and as an individual in practice i can make that choice. the real dilemma is when you are working for someone else.
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Hey Rick...i'm glad you picked up on this. :) Most everyone here is talking in the realm of the therapist that works for someone. but we also have the same decisions to make when we work for ourselves. so i'll bite. :)
you're right...it is a slippery slope we will find ourselves in if we refuse service to someone discriminatorially. For the record I would say, I would never refuse someone based on their weight, gender, age, color, etc. But let's talk about the "creepy". Aren't we taught as therapists to listen to our intuition? My school did. They empowered us to listen. One colleague's experience keeps playin in my head so I'll share.
A friend/colleague of mine asked my thoughts. She had already had a session with this client. She said that it went well and not only did he enjoy the massage but that they had a decent rapport. The only thing that felt "odd" was his little joke comment through text after the session about how she "rubbed his ass well". She thought nothing of it. 24 hrs later he texted her wanting to book another appointment at 9:30 at night. She explained that she didn't do late hours but would be able to see him tomorrow afternoon. He then proceeded to correspond with her that he wanted her to work on her groin because he was having issues with tightness. she mentioned that she could incorporate various stretches in the session that could help him. however he insisted that she needed to work his groin area and was not open to the stretches. they went back and forth until finally she refused the session and politely told him that she could refer him out to someone else. she told him that she felt he was looking for something she didn't offer. he responded asking her what was wrong and did he do anything wrong. and he didn't do anything wrong. but their correspondence created a "creepy" feeling with her and she ultimately got to the point where she didn't want to do the session. she struggled with the decision which was why she was asking my feedback. her intuition went from normal to red flag. yet nothing was blatantly inappropriate.
should she be required to give this client a session because medically and ethically there was nothing there to refuse the session by?
and, perhaps it's my inexperience, but if i as the MT am uncomfortable with a client (no matter what the reasons are - even if they are discriminatorially) am I really going to give a good massage? am i doing that client justice by going through with something my spirit is not fully committed to? or is it better for the client that i refuse and allow that client to find someone that will give them a 100% session? We as MTs still work with the parameters of our own personal experiences. just hypothetically...if i am an MT that was raped in my past and have continually struggled with the opposite sex both on and off my table, do i quit the practice because I can't comfortably work on the opposite sex? or do i work with the clients i can?
i can't help but go back to the fact that our practice is a very intimate setting. it's an intimate relationship. there is MAJOR trust that has to occur for one to feel at ease being undressed and massaged by another individual. how can we turn our backs on that aspect?
to me if we work on anyone and everyone without regard to the relationship between client and therapist, than we are limiting our practice to cookie-cutter franchises only out to make a buck.
Rick Morgan said:Hi Lisa, As therapists-health care providers, ethically, can we just arbitrarily decide who we want to see? If a person seeks us out to help them and it's in our scope of practice, can we decide not to just because they might seem a bit creepy, or too big, wrong gender etc. How much of your personal feelings should you put aside? Does a client have the right to say you are discriminating against them if you refuse treatment based on your personal intuition? (not judging your comment- just bringing out the topic a bit)
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Permalink Reply by Allan J Jones on
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Simply that you dont treat what you're not comfortable with....... the individual or the dysfunction.
Lisa said:what does this mean?
Allan J Jones said:Whatever....as that annoying sayin goes.Rick...!!@ its imperative that if you think you're dealling outside....of what you know....
Lisa said:i will go as far to say that we should have the right to refuse anyone just based on our intuition. and as an individual in practice i can make that choice. the real dilemma is when you are working for someone else.
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Permalink Reply by Emmanuel Bistas on
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According to NCBTMB code of ethics, "certificants and applicants will ....exercise the right to refuse to treat any person or part of the body for just and reasonable cause."
Similar references can be found in other codes of ethics an literature, for example, AOBTA's code of ethics states "...do not unjustly discriminate against clients and colleagues". One of AMTA's principles of ethics states "Accept responsibility to do no harm to the physical, mental and emotional well-being of self, clients, and associates.", which I take it to imply that you could refuse service to someone if by working on them you were to going to do harm (to you, the client, or associates)
Refusal of service does not necessarily mean discrimination in the bad sense of the word, but certainly if a therapist cannot help a client (or worse, if the therapist can do harm to self or client by working on them) then the therapist should not be working on that client.
Reasonable cause is open to interpretation but I don't think it is meant to be used capriciously. If a person has an issue working with certain groups/people/conditions, the boundaries should be known to an employer ahead of time to avoid misunderstandings.
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