Introduction to Ethico -legal Considerations in Practice

1. Introduction to Ethico-legal Considerations in Practice and Workplace Relationships

2. Preparing to Practice Setting up your practice Providing care to clients Documentation and Reporting Effective Workplace Relationships

3. Preparing to Practice

4. Mandatory association membership is required to obtain a TGA Advertising Exemption Certificate that recognises you as a health professional who can buy and sell therapeutic goods. Association membership is also required to obtain professional indemnity insurance (PII) that is mandatory for practise. Skill and knowledge development Personal work goals

5. The associations the AoCH are accredited with are: • Association of Massage Therapists (AMT): • Certificate IV Massage Therapy • Diploma of Remedial Massage • Australian Natural Therapists Association (ANTA): • Advanced Diploma of Naturopathy • Advanced Diploma of Herbal Medicine • Advanced Diploma of Nutritional Medicine • Advanced Diploma of Homoeopathy • Diploma of Remedial Massage

6. Australian Naturopathic Practitioners Association (ANPA): • Advanced Diploma of Naturopathy • Australian Traditional Medicine Association (ATMS): • Advanced Diploma of Herbal Medicine • Advanced Diploma of Nutritional Medicine • Advanced Diploma of Homoeopathy • Diploma of Remedial Massage

7. National Herbalists Association of Australia (NHAA): • Advanced Diploma of Naturopathy • ASQA: • Advanced Diploma of Naturopathy • Advanced Diploma of Herbal Medicine • Advanced Diploma of Nutritional Medicine • Advanced Diploma of Homoeopathy • Diploma of Remedial Massage • Certificate IV in Massage Therapy

8. Setting Up Your Practice

9. Satisfying Government Regulations: • Clinic must be in an appropriately zoned location • Complies with local ordinances (fire, health, and skin penetration etc.) • Parking and bathroom facilities

10. Comply with other licenses: • Music license if planning to play music in your clinic: • APRA  Australian Performing Right Association ($50 - $100) • PPCA  Phonograghic Performance Company of Australia ($50 – $60) • Premises and contents insurance • Income protection

12. Legislation: • Work through the handout and highlight the legislations that apply to your industry. (Aldred, E (2007), A guide to starting your own Complementary Therapy practice, Churchill Livingstone)

13. Public liability insurance • Protection from damages brought against you from a member of public being injured on your premises. • Cost will be relative to the amount of cover you need.

14. Providing Care to Clients

15. Entering a contract • Consent • Duty of care • Treatable and non-treatable complaints • Claims to cure • Health Care Complaints Commission (HCCC) code of conduct and client complaints process • Notification requirements

16. Entering a contract A contract for the health worker to provide care is usually considered valid when an appointment is made and kept by the client. It is firmed once an agreement to the extent of treatment is agreed upon and payment made. The contract remains in force until both client and practitioner agree that treatment is completed.

17. Consent Informed consent must be obtained from a client before any treatment or procedure is commenced. Consent may be implied, verbal, or written. Consent for children under 18 must be obtained from a parent, though children between 14-18 who can understand an explanation of the care to be delivered, may give consent on some occasions. The failure to obtain the appropriate consent from a client can result in the charge of assault and battery.

18. Duty of Care Having entered into a contract to provide care to your client you now owe a “duty of care” to that client. Duty of care implies the provision of treatment in such a manner that the best interests of the client are maintained and that no harm will come to a client as a result of care given. Failure to adhere to the principles of “duty of care” may result in charges of negligence being brought against the practitioner.

19. Treatable and Non-treatable Complaints Legally, a non-medical practitioner is unable to treat cancer, AIDS, epilepsy, diabetes, hepatitis, leukaemia, MS, TB, and any communicable diseases without the overseeing care of a person with the appropriate medical qualifications. You may play a supporting role in the treatment of the above conditions while informing the concurrently treating medical officer of your role

20. A written or signed waiver obtained from the client may not protect you from the consequences of ignoring this regulation. You must advise them of the necessity of maintaining their care under the appropriate medical officer and document that you have done so.

21. Claims to Cure You cannot lay claims to being able to cure most conditions. You may be able to claim to be able to aid recovery. If you make such claims and fail to achieve them you become liable to a breach of contract. Should such claims be seen as causing harm to the client you then may also be charged with negligence.

22. HCCC In 2008 the HCCC drafted a code of conduct that outlined a complaints process that all complementary practitioners must comply with. This includes providing your clients with the HCCC code of conduct document (see their website) and clients rights, either by clearly displaying them in your clinic or by directly proving them.

23. The website clearly outlines what your clients rights are in term of your care of them, and the complaints process via the HCCC that they may pursue if they feel those rights have been breeched. Now refer to the Australian Charter of Healthcare Rights poster and checkout the website for more information.

24. Notification requirements • As a registered practitioner, you are required to notify the authorities of client information: • In the case of certain infectious diseases • In cases of suspected or known child abuse • If the information is deemed to be in the public’s best interest

25. Documentation

26. Your client interview and notes are a legal document. Interviews / case notes need to be complete and must include treatment provided, copies of any results received, referrals, allied health letters, and be dated. Subsequent notes must be dated, include response to previous treatment, and any changes made to treatment.

27. Any changes made in case notes must be signed and dated by the practitioner. Notes should be made in blue or black pen, never use liquid paper, and never scribble out errors. Must be kept for a minimum of 7 years. They can be called on at any time during that period.

28. Dispensary / labelling requirements • The label must be fixed to the bottle permanently • Be written in English at not less than 1.5mm ht. • State the nature of the contents • Dose instructions • Batch number • Expiry date • Practitioner details (name, address, phone, provider number etc)

29. Ethical Considerations

30. Confidentiality and privacy. Treat people with integrity, respect and empathy. Maintenance of education and currency of information. Be prepared to acknowledge when referral to another practitioner will be necessary, taking into account your understanding and knowledge of the situation. Maintenance of honest business practice.

31. Providing the client with full and complete information with regards to their treatment plan. Maintenance of a professional relationship with the client. Be prepared and able to recognise, avoid and/or address any conflict of interest between practitioner and client. Information regarding costs of consultations and treatments are given up front.

32. Respect and care taken of the client in view of the perceived power that the client may feel you have in relation to their care. Maintain the client’s rights to access information held about them including medical records. Maintain hygiene and safe practice where indicated. Avoid discrimination in any form.

33. Regularly review workplace outcomes to identify and resolve issues and implement improvements. Ensure you are physically fit to safely practice. Support your colleagues. Avoid criticising fellow health professionals. Any complaint against a colleague should be referred to the appropriate association to avoid bringing the profession into disrepute.

34. Workplace Relationships

35. Gain and maintain the trust and confidence of your colleagues, clients, suppliers through your demonstration of your knowledge and understanding of the requirements and needs of the workplace. Identify and utilise workplace networks in the process of building relationships. Develop networks to help support workplace relationships, develop policies, build business strength and work through conflicts and personal difficulties.

36. Strategies for coping with the demands on you while you are developing your clinic. (Aldred, E (2007), A guide to starting your own Complementary Therapy practice, Churchill Livingstone) • Work through the document and highlight the strategies that you can relate to in your specific modality. • Compare which ones each modality feel are specific to them and discuss.

37. Other Resources for Further Information

38. Medhurst, R. 2003, The business of Healing, self-published, Adelaide Australian Competition and Consumer Commission- www.accc.gov.au Complementary Healthcare Council – 02 6260 4022 Therapeutic Goods Administration – www.health.gov.au/tga

39. Department of Fair Trading- www.fairtrading.nsw.gov.au Department of Health and Aging – www.health.gov.au National Herbalists Association of Australia (NHAA)- www.nhaa.org.au

40. References: • Aiken, T,D (2002), Legal and Ethical Issues in health Occupations, Saunders) • Aldred, E (2007), A guide to starting your own Complementary Therapy practice, Churchill Livingstone • Medhurst, R (2003), The Business of Healing, Robert Medhurst publishing • Staunton (1989)