Issue link: https://www.massageandbodyworkdigital.com/i/1488451
Standard of Care The legal definition for the term standard of care is a diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. Obviously massage therapists don't diagnose, but as clinicians we are also obliged to deliver an acceptable standard of care. The expectation is that a practitioner will make clinical decisions that an average, prudent provider in a given community would practice. For instance, if a massage therapist chooses to do intrusive work deep in the pelvis knowing the client had been diagnosed with an ovarian cyst, that would not be delivering an appropriate standard of care. By contrast, if a person with appropriate credentials performs lymph drainage technique for a client with a sprained ankle, that is an appropriate standard of care. Scope of Practice The term scope of practice is an important concept, and it is essential that massage therapists be familiar with what it means. Fortunately, it's not difficult. For virtually every helping profession, scope of practice means two things: competency and permission. Massage therapists who work within their scope of practice provide skills they are competent to offer, and they limit those interventions to what is permitted by both the client/patient and by local laws and regulations. Competency Every jurisdiction that regulates massage therapy imposes some baseline of professional skills and knowledge to maintain public safety. This is usually achieved through completion of an approved massage therapy school or apprenticeship program. Some locations have no regulation of the practice of massage, however. In these areas, anyone can call themselves a massage therapist, even with no education in the field at all, so a baseline level of competence cannot necessarily be assumed. It's important to highlight the term baseline. Massage therapy regulation is usually put in place to preserve public safety, not to support or improve the skills of local massage therapists. Consequently, educational requirements allow the local regulating agency to expect safe practice (competence), but they don't include advanced skills. Specialty fields go far beyond a baseline level of education. So even if a person has a massage license, they are not competent to practice a specialty skill like oncology massage therapy, manual lymph drainage, or others without advanced education. If they did so, they would be practicing outside their scope. Permission The permission for massage therapists to work comes from two sources: their jurisdiction and their client. All massage must begin with the client's informed consent. If a massage therapist incorporates some technique or intervention for which they did not obtain their client's consent (for instance, breast massage or using a percussion tool), they are working outside of their scope of practice. Also, scope of practice is defined and limited by local laws and regulations. These vary from place to place, and it is incumbent on massage therapists to be familiar with their local rules. Some states allow breast massage if the therapist is appropriately educated and obtains informed consent; others permit massage therapists to work intraorally if they have had appropriate training. Recommending stretches or exercises is allowed in some states, but not others. But in every instance, the practitioner must be adequately educated to provide the intervention. So even if someone lives in a state that allows massage inside the mouth, if a licensed massage therapist with no specialized education does this, they are working outside their scope of practice. And if a client suffers an injury because of this uninformed work, the therapist is fully at fault. Safe, effective, ethical practice demands that massage therapists observe both their scope of practice and standards of care in every interaction with every client. Resources American Medical Association. "What is Scope of Practice?" www.ama-assn.org/ practice-management/scope-practice/ what-scope-practice. LawInsider.com. "Scope of Practice Definition." www.lawinsider.com/ dictionary/scope-of-practice. LegalDictionary.net. "Standard of Care." March 20, 2019. www.legaldictionary.net/ standard-of-care. MedicineNet.com. "Medical Definition of Standard of Care." www.medicinenet.com/ standard_of_care/definition.htm. NursingWorld.org. "Scope of Practice." www. nursingworld.org/practice-policy/scope-of- practice. Standard of Care, Scope of Practice L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 57