Referrals – legal requirements and pathway creation

Referrals – legal requirements and pathway creation

The Chinese Medicine Board of Australia’s standard of practice – Code of Conduct section 4, outlines how Chinese medicine practitioners are required to work with other practitioners and colleagues across all medical and health care practices. https://www.chinesemedicineboard.gov.au/Codes-Guidelines/Code-of-conduct.aspx

“Good care is enhanced when there is mutual respect and clear communication between all health professionals involved in the care of the patient or client. Good practice involves:

  1. Communicating clearly, effectively, respectfully and promptly with colleagues and other practitioners care for the patient or client
  2. Acknowledging and respecting the contribution of all practitioners involved in the care of the patient or client, and
  3. Behaving professionally and courteously to colleagues and other practitioners at all times, including when using social media.”

Delegation, referral and handover are also integral parts of being a health professional. Delegation is asking another practitioner to provide care whilst the delegating practitioner retains overall responsibility for the care of the patient or client. Referral involves sending a patient or client to another practitioner for an opinion and or treatment. Referral usually involves the transfer of partial responsibility for the care of the patient or client for a defined time or particular purpose. Handover is where the patient/client is now the responsibility of the next practitioner. Referring, delegating and handing over practitioners have a responsibility to ensure that the person referred to has appropriate qualifications/experience and knowledge and skills to provide the required care, and has the responsibility to provide the next practitioner with sufficient information to provide continued care.

Chinese medicine practitioners that work within a collaborative team of health professionals still have personal accountability for their own professional conduct and any care provided to patients. Good team practice involves:

  • understanding each particular role in the team and any associated responsibilities that that role requires,
  • advocating for clear delineation and communication of roles and responsibilities, including those of team leader or coordinators,
  • communicating effectively with team members and patient/client,
  • acting as a positive role model within the team,
  • understanding the impact of bullying and harassment and seeking to avoid or eliminate such behaviour,
  • supporting supervised or student practitioners and others within the team.

Registered practitioners have a responsibility to work within the greater healthcare system. It is important to utilise government services appropriately according to the needs of the patient/client and are not unnecessary, excessive and are reasonably required. Practitioners should uphold the right of patients/clients to gain necessary healthcare and where possible help them to do so. It is vital and a legal responsibility to delegate, refer or handover patients that require care beyond the capacity of Chinese medicine as allowed in Australian legislation, for example in cases of Red Flags and emergency.

To create a network of local healthcare professionals it may be necessary to reach out and make contact with the local clinics, medical centres, and even public health networks (PHNs). One way of approaching other healthcare professionals is to attend local networking groups and create a dialogue about how Chinese medicine may be able to assist their patients in a delegate role. Rather than taking over care for the patient, you offer a service which is unique to your practice and medicine which will assist the other health professional to assist their client/patient in health care.

Other options to improve networking and referral pathways include:

  • Asking permission from a practice manager and when granted sending information to local General Practitioner clinics regarding the evidence base for Chinese medicine on particular conditions that are commonly seen like lower back pain or osteoarthritis, may be advantageous.
  • Book a lunch or coffee meeting (as one referral pathways educator stated if it is good enough for specialists to buy GP’s lunch why wouldn’t allied health do the same) and have an open and frank discussion about selected topics and how Chinese medicine may be used to improve the options of care offered to patients. Creating a face to face relationship could help to obtain improved referral numbers and increase the health of your local population and could improve business.

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