TCM Week 13
Forum Discussion Questions:
Further to reading the CMBA code of ethics (Reading two); discuss why you think it is so important for practitioners to follow the guidelines for completing and storage of patient records.
Record Keeping
The Chinese Medicine Board of Australia (CMBA) states: ‘By law, practitioners must keep accurate, up-to-date, factual, objective and legible records that report relevant details of clinical history, clinical findings, investigations, information given to patients or clients, medication and other management in a form that can be understood by other health practitioners’ (CMBA, 2021).
CMBA also states that keeping good records can be done by: ‘Ensuring that records are held securely and are not subject to unauthorised access, regardless of whether they are held electronically and/or in hard copy; Ensuring that records show respect for patients or clients and do not include demeaning or derogatory remarks; Ensuring that records are sufficient to facilitate continuity of care, Making records at the time of events or as soon as possible afterwards; Recognising the right of patients or clients to access information contained in their health records and facilitating that access, and promptly facilitating the transfer of health information when requested by patients or clients’ (CMBA, 2021). Good communication with the client, research, record keeping, and reporting will help the practitioner meet their Duty of Care to the Client
Registration and Duty of Care
All Chinese Medicine and Acupuncture Practitioners Must be Registered with AHPRA in Australia from 2012. This requires them to follow a Code of Ethics regulated by the Chinese Medicine Board of Australia (CMBA). The Code of Conduct is monitored under Section 39 of the National Law (CMBA, 2021).
Practitioners have a duty of care to Clients and they must practice safely, effectively, and ethically. They must also maintain a high level of professional competence and conduct which is essential for good care (CMBA, 2021).
Health Practitioner Laws
There are many laws that guide a Medical Practitioners conduct – ‘Acts’ provide guidelines on practice to, for example, The Privacy and Confidentiality Act, The Anti-Discrimination Act, The Health Practitioner Regulation Act, The Fair Work Act, The Aged Care Act, The Children and Young Persons Act, The Therapeutic Goods and Services Act, The Workplace Health and Safety Act, and the Medical Indemnity Act.
Standards for practitioner behaviour in the CMBA 11 points of conduct
These are: ‘Providing good care; including shared decision making; Working with patients or clients; Working with other practitioners; Working within the healthcare system; Minimising risk; Maintaining professional performance; Professional behaviour and ethical conduct; Ensuring practitioner health; Teaching, supervising and assessing; and Undertaking and contributing to research’ (CMBA, 2021).
Evaluating Professional Conduct / Record Keeping
The Code of Conduct assists National Boards in evaluating the professional conduct of practitioners, and if it varies significantly from the code, practitioners must explain and justify their actions. Repeated failures have consequences for Registration. The code doesn’t include provisions for the Law’s a Professional Registered Practitioner is required to follow, It’s the practitioner’s responsibility to know and follow the laws relevant to their practice (CMBA, 2021).
Further to the reading, “Guidelines for Advertising Regulated Health Services”, section 6.2.3 states that the National law has a ban on the use of testimonials in advertising. Why do you think this law has been made and why is it so important?
Laws about Testimonials in Professional Practice
AHPRA states: ‘The public is entitled to accurate and honest information about healthcare services. Any person or business that advertises a regulated health service has an obligation to make sure their advertising complies with the National Law.’ The National Law has rules about how businesses can collect feedback from their customers, and for how they advertise their goods and services, for example, confidential information about a client’s health progression, or misleading claims about the products sold at the clinic is unprofessional. It can be misleading and inaccurate if testimonials are selectively published, edited, or untrue (AHPRA, 2021).
Feedback on Treatment and Services is allowed by Clients, however there are guidelines – AHPRA states: ‘The advertising guidelines define a testimonial as recommendations or positive statements about the medical aspects(results) of a regulated health service used in advertising’. Furthermore -’They are often personal opinions and may have no objective basis for recommending a registered health practitioner or health service; The outcomes experienced by one patient do not necessarily reflect the outcome, or likely outcome available to all patients; They can be misleading as they are not usually a balanced source of information (they often include a selection of positive comments about experiences and do not tell the whole story), and/or the public may not have expert knowledge to assess if the information is accurate (AHPRA, 2021)
Clients are allowed to leave reviews at the place of business commenting on things such as, Customer Service, Clinic Facilities, Communication Style of the Staff, Parking Spaces, Ease of Access, and Overall Experiences without the feedback being considered a Testimonial. Due to technology, Clients often now leave reviews on Third Party websites. AHPRA advises the Practitioner not to respond to statements made there, unless they’re to clarify a matter, as this may be seen as promotion of their services. There are further guidelines about these types of interactions at ‘AHPRA – Testimonials Understand The Requirements’ (AHPRA, 2021).AHPRA Advertising hub
https://www.ahpra.gov.au/Publications/Advertising-hub/Resources-for-advertisers/Titles.aspx
AHPRA – Testimonials Understand The Requirements
Chinese Medicine Board Australia
https://www.chinesemedicineboard.gov.au/codes-guidelines/code-of-conduct.aspx
Student Feedback
Hey Heather, this is a great summary of the CMBA code of ethics, however you haven’t mentioned why you think these guidelines are so important. Personally, I believe that although the principles of TCM and Acupuncture did not have these guidelines centuries ago, they reflect the minimum expectation of patients seeking health care no matter what modality is chosen. I’d love to hear your reasons too.
Reply
Hi, thanks I missed that! I feel that it’s great for TCM to be given the recognition it deserves under AHPRA. I do think however there are limitations under this registration such as legal implications of not referring on with diseases like cancer, where the client may chose TCM Alone. I think it just takes more paperwork and informed consent along with communication between TCM practitioners and other specialists to work through.
Interestingly another student posted a link to the AMA’s stance on Complementary Medicine which is really good, it’s encourages doctors to integrate this into practice. I’ll find the link and post it.. Here’s the AMA link about Comp Med 🙂
https://www.ama.com.au/position-statement/ama-position-statement-complementary-medicine-2018
Student
Thanks Heather! Agree there, if the conventional and complementary medicine fields could put aside ego and history and instead put first the preferences and wishes of an informed patient then perhaps a more holistic approach and beneficial partnership would arise. I think that both could learn a lot from each other.