Holistic treatments in G.p practices

kjbl1977

Just wondering if any doctors / consultants would be interested in discussing with me the possibility of having a holistic therapist ie reflexology , deep tissue massage / muscle injury in their practice , this is not a hard sell what i am looking for are doctors/ general public feed back as to what they would need to see to be open to the possibility of a holistic therapist treating their patients / how public would feel ( IF OPEN TO THE IDEA ) when medical treatments are not working ie stress , migraines and any other condictions where the g.p would recommend alternative methods as reflexology is being mentioned by midwives and also cystic fibrosis consultants as benifical to the patients through out their pregnancy / illness this information comes from heads of mid wifery training and also c.f consultants .

I am well aware of the lack of offical medical proof of the benifits of alternative therapies but as a therapist myself the amount of people across the country and also in the u.k that state that it does work for them makes me wonder if this concept could work in ireland.I would like to ask if only people whom have a genuine question or input into my thread would post as all to common mentioning alternative therapies tends to attract alot of negative comments from people whom do not know what training or understand what the therapies actualy involve

Looking foward to hearing feedback .

Eoin

thread moved - not an employment issue.

Ayla

OP - good luck getting positive responses in this thread either - IME posters here tend to be pretty anti-alternative treatment methods.

That said, as a just-normal (i.e.: non medically-trained) person, I would welcome any development of my own GP to include alternative treatment options. I agree there is a lot of benefit to be acheived through appropriate use of these methods and I wish my GP had an "alternative" business partner.

Having said that, having this type of situation could raise some logistical questions - for one: who/how would the payment work (i.e.: if the patient has a medical card, would your treatments be covered as it's through a GP?).

Good luck on your endeavour - I think it's a great one but likely to be a very rough uphill battle here in Ireland.

bill buchanan

Ayla wrote: »

OP - good luck getting positive responses in this thread either - IME posters here tend to be pretty anti-alternative treatment methods.

That said, as a just-normal (i.e.: non medically-trained) person, I would welcome any development of my own GP to include alternative treatment options. I agree there is a lot of benefit to be acheived through appropriate use of these methods and I wish my GP had an "alternative" business partner.

Having said that, having this type of situation could raise some logistical questions - for one: who/how would the payment work (i.e.: if the patient has a medical card, would your treatments be covered as it's through a GP?).

Good luck on your endeavour - I think it's a great one but likely to be a very rough uphill battle here in Ireland.

As a doctor who certainly believes in some "complementary" (rather than your phrase "alternative") therapies, I think you're being a bit harsh.

There wold be huge logistic issues for a GP to assimilate a therapy unit into their practice. If I were a GP (which I'm not) I'd be more interested in having a physio, or psychologist or someone else that could provide an evidence based service if I was gonig to undertake something like that (I'm also aware of the lack of evidence for some physio interventions).

To be fair to the GPs, there's nothing stopping any therapist setting up next door to a GP surgery. The problem is that the situation as described above would probably be a relationship whereby the therapist expects the GP to make referrals to him/her. It would also have the appearance of an endoresement by the GP. BUt it would take a long time for the GP to know of the therapist was very good or a total shyster.

I wouldn't be opposed to the idea. But I'm not sure the GPs will think they should be the ones who take all of the risk in a scenario like this.

Ayla

bill buchanan wrote: »

As a doctor who certainly believes in some "complementary" (rather than your phrase "alternative") therapies, I think you're being a bit harsh.

In my defence, the reason I said this is because - time & time again - when the idea of complimentary/alternative treatments are discussed on this forum they are shot down by many frequent posters as being quack medicine. I can see by the number of posts you have that you may be new(ish) here, but you'll see what I say if anyone dares mention the words chiropractic care, kinesiology, reflexology, etc.

Unless you were thinking I was being harsh toward the general Irish GP system? I'm not really sure, honestly, but knowing the reaction of many people here when I've mentioned alternative/complimentary methods I've used, I would think there would be a great deal of resistance to a GP adopting this practice.

Otherwise I completely agree with your other comments

opinion guy

Are there not plenty of GP's that do this kind of thing already ?

locum-motion

kjbl1977 wrote: »

...I would like to ask if only people whom have a genuine question or input into my thread would post ...

I can see you're new to boards.ie, so you might not be aware that the usual etiqette round here is that the person who starts a thread has to be prepared for the fact that some other posters will disagree with them. If somebody is opposed to your point of view, they are entitled to post that oposition as long as they don't breach other forum rules while they do so. You can't just say "Please don't reply if you disagree with me."

echo beach

Ayla wrote: »

Having said that, having this type of situation could raise some logistical questions - for one: who/how would the payment work (i.e.: if the patient has a medical card, would your treatments be covered as it's through a GP?).

Treatments would not be covered by the medical card, which only entitles you to services provided directly by the HSE (e.g public health nurses), or by persons (like a GP) who have a contract with the HSE to provide certain services on their behalf.

The person availing of the service would have to pay for it themselves regardless of the fact they had a medical card and it was recommended by a GP.

opinion guy

echo beach wrote: »

Treatments would not be covered by the medical card, which only entitles you to services provided directly by the HSE (e.g public health nurses), or by persons (like a GP) who have a contract with the HSE to provide certain services on their behalf.

The person availing of the service would have to pay for it themselves regardless of the fact they had a medical card and it was recommended by a GP.

Actually, some insurance premiums cover certain CAM treatments

MrCreosote

Ayla wrote: »

In my defence, the reason I said this is because - time & time again - when the idea of complimentary/alternative treatments are discussed on this forum they are shot down by many frequent posters as being quack medicine. .

That's because in general they are quack medicine.

I believe there is no place for treatments that have time and time again been shown to be no better than placebo anywhere near a medical practice. It is unethical for a GP practice to be benefitting from having them onsite and would lend them a certain prestige by associating with them.

It's like the homeopathic rubbish on sale in pharmacies. Totally unethical.

hidinginthebush

Just because they've been setup in a gp practice it doesn't mean they will suddenly work, and that would be the main issue I'd have: people would generally trust their gp, but when that doctor starts referring them onto the homeopathy / reiki (sp?) / reflexology / accupuncture place next door, it gives those places a credibility they do not deserve.

kjbl1977

Thanks to everyone whom gave their feedback , just to reply to some of the comments .

As regards to medical card payment this would not be the case it would be a cash based payment and i personaly would not be looking for it to become medical card at any stage , also i would not be looking for my G.P to endorse the treatments a waver would be signed by the patient stating this .
My idea maybe would be better explained through pehaps an example of when /where and why complimentary/alternative ( whichever suits ) would come into play in a G.P practice as i feel their is a time and place for everything .

A patient who suffers from migraines badly comes to their G.P and after exhaustive test , bloods , consultants , scans nothing comes up , their comes a point very often that the G.P can no longer offer anything else as treatment . Once this situation has arose the G.P ( if open to and comfortable ) would state that while their is no other treatment bar more bloods & painkillers which do not work , that they are free to follow other avenues of treatment and that their are these alternatives in house IF the client under the own free will and interest would like to try them .
It is totaly up to the patient to choose what they want to do may it be nothing and suffer , continue with more tests if they can be done or this alternative / complimentary treatment if they choose to do so . It pretty much about having a choice inhouse in a G.P practice .
I for one am not stating that its the be all and end all to solving health issues but i do fully think that their is a time and place for these therapies .
Any patient records would not be needed the only information needed would be the reason why they are their from the G.P as all therapist fill their own consultation forms which are very detailed and client / patient specific , having had talks to senior leactures in mid wifery and also cystic fibrosis consultants and c.f doctors in ireland one therapy is becoming fast tracked into being a possible day to day treatment in cystic fibrosis wards and clinics as recently as earlier this year and also as part of pregancy as a complimentary treatment during the full term is reflexology .
I have spoke to many vastly experience mid wives who recommend reflexology to most their patients during term and even in some cases where their are complications ie high blood pressure , acute back pain as most mothers refuse and are not allowed heavy medication so close to labour . Again i state these treatments are only for people who willingly choose to use them not and never to be forced on people as with everything their are different points of view and some as above i have read would have no issues with the concept bar the legal / logistic side of it .

As for these therapies being QUACK i can fully understand how like alot of medication in modern times ie antibiotics simply do not work along with alot of painkillers in alot of people and concidering that point paint a very bleak and " dodgy " image of alternative treatments .
If no sector of heathcare anywhere in the world considered these treatments as anything but QUACK then i would be not putting up this post but its clear to see that if c.f consultants / doctors are starting to recommend it along with senior figures in mid wifery in ireland then their must be a consences that these treatments are of value in the right envoirment and in certain situations .

Sorry for such a long post but their seemed to be a good few points to cover from the feedback i read and also to go more into detail about what i am trying to do .

Regards

locum-motion

kjbl1977 wrote: »

... complimentary/alternative ( whichever suits ) would come into play in a G.P practice as i feel their is a time and place for everything ...

THERE may be a time and a place for most things, but most of these so-called complementary or alternative therapies have no place anywhere. Most especially not in a GP's surgery or in a pharmacy.

MrCreosote

kjbl1977 wrote: »

As for these therapies being QUACK i can fully understand how like alot of medication in modern times ie antibiotics simply do not work along with alot of painkillers in alot of people and concidering that point paint a very bleak and " dodgy " image of alternative treatments .

I think you'll find that when prescribed appropriately antibiotics simply DO work. There might be problems with resistant organisms becoming more common, but for the most part they are still supremely effective medications.

The problem with alternative medicine is that at best it's no better than placebo, and it's unethical to knowingly prescibe a placebo. At worst they are actively harmful by diverting people away from appropriate investigation and treatment.

opinion guy

MrCreosote wrote: »

The problem with alternative medicine is that at best it's no better than placebo, and it's unethical to knowingly prescibe a placebo. At worst they are actively harmful by diverting people away from appropriate investigation and treatment.

Gotta pick you up on this. At best some of it does actually work. Some of course is plainly ridiculous but for alot of it there simply isn't evidence either way on what works and what doesn't. At worst it is actually directly harmful.

SleepDoc

kjbl1977 wrote: »

I have spoke to many vastly experience mid wives who recommend reflexology to most their patients during term and even in some cases where their are complications ie high blood pressure , acute back pain as most mothers refuse and are not allowed heavy medication so close to labour .

Most "vastly experienced" midwives also recommend a cup of tea and a sit down at all stages of pregnancy and in the post partum period.

El_Dangeroso

It is a real shame that a lot of what I would term adjuvant therapies that have evidence bases get lumped in with things that don't at all. It makes the term complementary care a dirty word.

CBT, physio, medical herbalism, certain nutritional supplements, meditation, massage are all largely outside the medical mainstream, but have clear evidence in their favour.

But you end up having them lumped in with quackology such as reiki and kinesiology and other such crap.

Reality_Check1

I may be misunderstanding the OP but from subsequent posts this seems to be the line of thinking (questioning) please correct me if Im wrong

Patient comes in with problem
All medically tested diagnostics and treatments fail to solve problem
GP doesn't bring up anything about alternative that has to be the patient
GP doesn't endorse it because you can't endorse something there is no evidence for
but doesn't discourage it

OP is your whole point about the bit in bold? As in if this came up in practice the GP simply wouldnt discourage it?

My stance would be (and Im not a GP) "well it's hasn't been proven to work and may be harmful but if you want to waste spend the money its up to you"

candlegrease

El_Dangeroso wrote: »

It is a real shame that a lot of what I would term adjuvant therapies that have evidence bases get lumped in with things that don't at all. It makes the term complementary care a dirty word.

CBT, physio, medical herbalism, certain nutritional supplements, meditation, massage are all largely outside the medical mainstream, but have clear evidence in their favour.

But you end up having them lumped in with quackology such as reiki and kinesiology and other such crap.

Medical herbalism? Evidence?

El_Dangeroso

candlegrease wrote: »

Medical herbalism? Evidence?

Many herbs are pharmacologically active compounds. It's totally plausible that some do indeed do what they say on the tin. Some have no evidence, some do. Yet I have never ever once heard of a GP prescribing St. John's Wort, have you?

http://www.bmj.com/content/321/7258/395

Single studies are unlikely to convince sceptics, but an increasing body of evidence is now emerging from systematic reviews and meta-analyses of randomised clinical trials. These suggest that some herbal medicines are efficacious. The increased demand for St John's wort, for instance, was triggered by press reports of a meta-analysis of 23 randomised trials of 1757 patients with mild or moderate depression. The authors concluded that extracts of hypericum were significantly more effective than placebo (odds ratio 2.67; 95% confidence interval 1.78 to 4.01) and as effective as conventional antidepressants (odds ratio 1.10; 93 to 1.31) in alleviating the symptoms of mild to moderate depression.2 Since this article was published, at least …

newmug

http://www.youtube.com/watch?v=YMvMb90hem8

candlegrease

El_Dangeroso wrote: »

Many herbs are pharmacologically active compounds. It's totally plausible that some do indeed do what they say on the tin. Some have no evidence, some do. Yet I have never ever once heard of a GP prescribing St. John's Wort, have you?

http://www.bmj.com/content/321/7258/395

I think St. John's wort is overlooked because of its many drug interactions

El_Dangeroso

candlegrease wrote: »

I think St. John's wort is overlooked because of its many drug interactions

Fair point, don't want to narrow my point too much with that example.

Just be aware that there are actually other efficacious treatment options that may not in fact come in the form of a prescription.

Although, I just remembered my GP did prescribe evening primrose oil once (like an actual prescription), I looked up the evidence and found there really wasn't any solid evidence for what she was prescribing it for. I mentioned it to her (I am the type of patient that brings in papers for my GP to read ) and she was like 'Oh don't mind that, it's always worked in my experience.:D

RobFowl

El_Dangeroso wrote: »

Yet I have never ever once heard of a GP prescribing St. John's Wort, have you?

http://www.bmj.com/content/321/7258/395

I know of one at least who prescribes it......

El_Dangeroso

RobFowl wrote: »

I know of one at least who prescribes it......

Cool, although after seeing the interaction list that candlegrease referred to, I can now see why some don't!

magicherbs

There is a hypnotherapist in {the local} GP practice one day a week. I've never attended his services but it's there anyway.

locum-motion

magicherbs wrote: »

There is a hypnotherapist in my GP practice one day a week. I've never attended his services but it's there anyway.

When you say "my GP practice", do you mean that you're the GP, and it's your practice, or do you mean that the hypnotherapist is in the practice of the GP you attend?

magicherbs

sorry I meant my gp as in the one i pay money to

in the same way i say there is a guy that changes tires in my garage. i do not work at this garage.

in the same vein if i say my busdriver wears a suit. he's not my personal bus driver not am i an owner of a bus.