Power in Collaboration

Communicate Across Disciplines for Your Client’s Benefit

By Cal Cates
[Critical Thinking]

Key Point

• Networking with providers outside your field can benefit your client treatment process and add to your repertoire of valuable resources and referrals.

Health care often happens in a vacuum, but excellent health care happens in collaboration, with a view beyond our treatment rooms and discipline-specific care plans. As massage therapists, we are not generally taught about the importance of collaboration with other providers or the skills of interdisciplinary communication. 

The initial steps to begin this relationship with other providers are simple and can have a lasting effect on your own practice as well as on the outcomes your clients enjoy. You are well within your right as a fellow health-care provider to take the initiative to connect with other providers. At the same time, it’s reasonable to feel a bit daunted or even jaded by what have felt like failed attempts in the past or the fear that your outreach won’t be well received. Don’t let that stop you. Take a deep breath and think of your clients.

Pulling Out the Focus

The first thing to remember is that it’s not about you. You may reach out to other providers and never hear back. You may reach out and feel that the information you receive is not as helpful as you had hoped. Any number of other scenarios may play out when you try to connect with other health-care providers in the service of your clients. It’s important to remember that much of what we do to open doors to relationships with more mainstream health care can be equated with planting seeds for trees under which we won’t have the opportunity to sit. We are clearing the path for those who come after us. It’s also important to remember that just because you didn’t get the response you wanted, or any response at all, doesn’t mean your outreach did not have an impact. 

Most humans suffer from fundamental attribution error. In its most basic sense, fundamental attribution error is when we decide that other people do bad things because they are bad people with malicious intent or poor character. It’s considered an error because, as one of my favorite teachers once said, “Nobody thinks about you as much as you think about you.” The doctor, physical therapist, or chiropractor who didn’t get back to you is likely just busy. Maybe they sprained their ankle, or maybe they already think massage therapists are great and they were just glad to hear that their patient was seeing you. I could list any number of other benign, real, and human reasons for a nonresponse. The bottom line: Don’t take it personally. 

Making the Connection

If you decide you’d like to reach out to a fellow provider on behalf of a client, the first step is to get consent from your client to talk with their other provider about the work you’re doing together. There are a variety of ways to obtain consent, but in this case, you want to get what’s called informed consent, and you want to get it in writing so all three people (you, your client, and the other provider) have a clear record of the decision and agreement to share what is called protected health information (PHI). Anything related to your work with a client is considered PHI, and that information is protected by the Health Insurance Portability and Accountability Act (HIPAA). While the application of HIPAA to the practice of massage therapy varies by state and practice setting, it’s good practice to adhere to its dictates. If you assume you are bound by HIPAA, any information you collect about your clients is covered by HIPAA. Breaking the rules of HIPAA comes with fines and jail time. (Check out www.massageandbodyworkdigital.com/i/1128556-july-august-2019/74 to familiarize yourself with HIPAA.)

To obtain informed consent, you can use a simple form, such as the Permission to Communicate form I use (scan the QR code on this page), or you can download a more specific template from any number of HIPAA-compliant sites for free or a small fee. You do not need to use an official HIPAA Authorization Form because you are not requesting access to clients’ medical records or results from diagnostic or other testing; you are requesting permission to speak with, write with, or meet with your clients’ other provider(s), so a simple Permission to Communicate form will suffice. You can make the form a standard part of your intake process, or you can wait until you have built trust and rapport with your clients and then employ the form after discussing it with them. 

Also, remember that you need to make this outreach by snail mail if you don’t have a HIPAA-compliant email platform or encryption software. A handwritten letter in a hand-addressed envelope is also more likely to stand out than an email, so I recommend beginning your outreach on paper even if you have email encryption capabilities.

At the end of the day, it’s important to know why you’re reaching out to another provider and to be clear about your goal when you conduct that outreach. Your goals don’t have to be purely clinical or to seek out the answer to a specific question about a client’s concern. One of your goals can always be to build relationships with fellow providers and to share perspectives. You don’t have to wait until you’re “stuck” in your treatment plan to reach out to a client’s other providers. It’s always the right choice to connect with a network of folks who share the same goal as you: to help people live better, more functional lives. 

Introductory Letter to Other Health-Care Providers

Dear [OTHER PROVIDER’S NAME], 

My name is [YOUR NAME]. I am a licensed massage therapist in [JURISDICTION/STATE/CITY]. I practice at [NAME OF PRACTICE] in [CITY]. One of your patients, [CLIENT NAME], sought out my care on [DATE] to address [REASON CLIENT IS SEEING YOU]. 

I have been working with [CLIENT NAME] on a [FREQUENCY] basis since [MONTH AND YEAR] providing [DESCRIPTION OF CARE WITH AS LITTLE JARGON AS POSSIBLE] with a focus on [LOCATION and/or OUTCOME] (for example, “right knee and lower leg, but also incorporating full-body massage with a broad goal of relaxation”).

[CLIENT NAME] has shared that they are feeling notable benefits from our sessions together. I have noted [BRIEF DESCRIPTION OF WHAT YOU WANT TO SHARE]. (You might say something like, “I have noted improvement in their pain and increased mobility. They have shared with me that they are sleeping better and are able to enjoy riding their bike without pain again.”)

I am grateful to participate in [CLIENT NAME]’s care and would welcome the opportunity to collaborate with you to achieve the best possible outcome for them now and in the future. Please feel free to reach out by phone or email to discuss this patient or to talk about how we can collaborate in the future. 

Thank you for all you do. 

In service, 

[Your signed name here]

[YOUR NAME, CREDENTIAL, AND CONTACT INFO]

Cal Cates is an educator, writer, and speaker on topics ranging from massage therapy in the hospital setting to end-of-life care and massage therapy policy and regulation. A founding director of the Society for Oncology Massage from 2007–2014 and current executive director and founder of Healwell, Cates works within and beyond the massage therapy community to elevate the level of practice and integration of massage overall and in health care specifically. Cates also is the co-creator of the podcasts Massage Therapy Without Borders and Interdisciplinary.