Exceeding scope of practice is unethical and often dangerous to our clients. It is unethical to represent ourselves as having qualifications we do not possess, such as suggesting we are skilled in handling serious medical conditions. When warranted, we are obligated to refer clients to appropriately trained professionals and, with our clients’ permission, to consult with other professionals who are treating them.
In addition, if a client is ill and currently receiving medical treatment for a serious problem, we should consult with the client’s primary practitioner (with the client’s permission) before beginning work on the client.
Practitioners who exceed scope of practice are a cause of concern for their colleagues because they reflect poorly on the profession. Some bodyworkers claim to work with emotional and psychological issues, but they have had no training or supervision in these areas. Some bodyworkers claim to have the skills to perform a complex manual technique with only limited training in it. One weekend workshop (or even a few) doesn’t make one an expert in anything.
Some therapists cross the line because of another business they’re involved in. Selling nutritional shakes doesn’t make you a nutrition expert any more than selling essential oils makes you a clinical aromatherapist. It’s unethical to advertise ourselves as proficient in a method for which we have only superficial knowledge or training.
Professional Boundaries
We need to respect the time and training it takes to become a psychotherapist, osteopath, medical doctor, chiropractor, physical therapist, and so forth. At the same time, we need to respect the value of our own skills, too. Practitioners of other disciplines often have many more years of training than we do. They may be allowed to diagnose, prescribe, and perform surgery—things we’re not able to do. But we have a skill they are lacking—and we need to stick to it.
Violations of scope of practice happen all the time; diagnosing and prescribing are especially rampant on social media. Frequently, I see posts like, “My client gets frequent ear infections, and I always recommend using oregano oil.” Clients sometimes ask us for advice, and the correct response is, “I’m not qualified to diagnose or prescribe; you’ll need to ask your doctor.” Giving people advice we are not qualified to give, especially when it is the domain of a separately licensed profession, is a gross violation of scope of practice and professional ethics, and is against the law.
Laura Allen is the massage division director of Soothing Touch. A licensed massage therapist, she is an accomplished author and educator. Contact her at educatedheart@gmail.com.
Editor’s Note: In 2017, we are delighted to print excerpts from Nina McIntosh’s The Educated Heart, 4th edition. Nina was a longtime Massage & Bodywork columnist. Prior to her death, she handed her work over to Laura Allen who’s created this new 2016 edition (adapted with permission from Lippincott Williams & Wilkins). Mari Gayatri Stein’s illustrations enrich each edition of the text; she passed away on March 2, 2017.