As our health care ecosystem continues to evolve, I’ve found an increased emphasis being placed on an integrative approach to patient care. As an acupuncturist, you are an essential part of this collaborative system and health care team, cooperating with a range of other professionals including medical doctors, chiropractors, massage therapists, and others.
For these reasons and others outlined below, the World Health Organization included traditional medicine in its ICD 11th revision. The inclusion of the traditional medicine conditions (Module 1) section, or TM, in the International Classification of Diseases (ICD) is a novel element. Its integration into ICD-11 serves the purpose of standardizing international classification, quantification, comparison, and monitoring of TM health services and patient interactions.
This new TM section within ICD-11 fosters continuity and collaboration in health care delivery, thereby endorsing a more integrative, patient-focused approach for those seeking traditional, complementary, and integrative medicine for their primary health care needs.
While I believe this interprofessional collaboration holds immense potential for improving patient care, it simultaneously presents a complex landscape of risk and responsibility that needs to be navigated carefully.
Communication: The Cornerstone of Collaboration
Fundamentally, efficient interprofessional collaboration hinges on clear and understandable communication. As discussed in my previous article [June issue], being able to communicate in a clear and concise manner is not only important for patients, but also important when considering liability exposure and working in a multidisciplinary environment where collaboration is necessary.
Miscommunications can disrupt this harmony, potentially leading to errors in patient care, and compromising both patient safety and care quality.
To counteract this risk, it’s essential for you as an acupuncturist to become comfortable discussing your care and other health care providers’ care when you share a common patient. While you don’t need to become an expert in medical jargon that would be outside your area of expertise, a basic understanding of common terms can bridge any communication gaps you may encounter.
I also believe it’s important to embrace technology, like electronic health records (EHRs), which can streamline information exchange and enhance your interactions with other health care providers.
Scope of Practice and Referrals: Know Your Limits
Every health care professional operates within a defined scope of practice – a boundary of competence determined by their training, skills and licensure. As an acupuncturist, acknowledging this scope and respecting its limits are crucial.
There will be instances in which a patient’s needs exceed your professional capability. In these situations, your licensing board requires that you refer out, allowing you to ensure your patient receives the best possible care.
Yet, implementing referrals introduces a new layer of legal and ethical responsibility. For instance, imagine a situation in which another provider suggests treatments that may contradict your plan. How should you handle this scenario? This requires striking a balance between respecting patient autonomy, upholding your professional obligation, and maintaining open lines of communication with the other provider(s).
Interdisciplinary Teamwork: The Impact of Collective Competency in Health care
In the realm of health care, the saying, “The whole is greater than the sum of its parts,” rings especially true. When you’re a part of an interdisciplinary health care team, you contribute to a collective endeavor that ultimately aims to deliver optimal patient care. However, being a team player also means you’ll have individual responsibility and need to make sure you’re “carrying your weight,” so to speak.
This dynamic of shared responsibility can be complex. It requires clear task delegation and accountability mechanisms to ensure no vital task falls through the cracks. Additionally, this idea of everyone sharing duties shouldn’t turn into a mess whereby tasks are just being thrown around. Instead, it should help create a good working environment; one in which each team member’s special talents and abilities are noticed and used in the best way possible.
Professional Boundaries & Respect: A Necessary Balance
Effective interprofessional collaboration calls for a delicate balance. It requires every team member to play their part, acknowledging and respecting each other’s roles without overstepping professional boundaries.
For instance, you may be treating the same patient as a medical doctor or a physical therapist. In such a scenario, it’s crucial to remember your professional role and avoid overstepping, no matter how well-intentioned you might be. The same holds true for the other medical professionals – they should respect your care, and work to foster a collaborative approach to the patients’ health care journey.
We have seen issues arise when care exceeds what is allowed under the scope of your license and the patient isn’t referred to an appropriate medical provider. An example I share when teaching students: You have a new patient in your waiting room filling out their intake forms. The patient doesn’t appear well; in fact, they appear to be having a stroke.
The acupuncturist’s first course of action should be calling 911 and then working toward assessing the patient’s well-being and providing any support while waiting for emergency medical care to be rendered; and rule out any additional contraindications prior to any care beginning if the patient is cleared.
Liability & Malpractice: The Legal Landscape
Interdisciplinary collaboration inevitably comes with legal implications. Shared patient care sometimes suggests shared liability, particularly in the event of malpractice claims. It’s crucial to familiarize yourself with exposure in your role and evaluate ways to best protect yourself from a lawsuit, board complaints, and the many other exposures acupuncturist face in practice.
Insurance serves as the best tool to protect you and adds a significant safety net in such scenarios. Regularly reviewing your malpractice insurance coverages and ensuring they are adequate and up to date for your current practice environment can provide an additional layer of protection.
Staying informed and prepared can help you mitigate risk and navigate the legal landscape with greater confidence. This especially holds true for acupuncturists who obtain malpractice insurance coverage through their employer or as part of a group plan.
Are you aware of the policy type, limits of liability, and supplemental coverages you’re receiving and have any control of the policy? It’s critical to understand what coverage you carry, any limitations that may exist from a coverage standpoint in a multidisciplinary setting, etc.
Practice Pearls
Interacting with other health care providers represents a balancing act between collaboration, communication, respect, scope of practice, and risk management. This multidisciplinary approach, while posing certain challenges, can amplify the value that acupuncturists bring to patient care.
I hope that with further collaboration and a better understanding of our care, acupuncturists will have better patient outcomes, increased reimbursement, and continued research reinforcing the efficacy of our medicine.
By embracing this collaborative approach and being mindful of additional exposure, you can contribute to improved patient outcomes and experience professional growth in the process. Despite the hurdles, I believe this is a journey worth exploring, and one that ultimately benefits everyone involved – especially the patients we strive to heal.
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