There is a kind of dialog between patient and provider that is often overlooked. A topic not normally discussed, and the source of frustrations caused by boundaries that have already been set.
Well-meaning people seeking to protect themselves and others have found that in order to identify a problem, one needs to perceive it in another. Once we've diagnosed the situation, we seek to determine what kind of remedy will correct the problem. What we've realized about this process is that the perception of a problem is often based upon identification with it; that is, the problem is within the mind of the person who perceives it more significantly than it is in the world.
Whether by written plan, dialog, discussion, or non-verbal communications a patient/provider relationship ought to be a dialog, rather than a dictation - in order to determine what the problem really is, and what exactly would be helpful. While the patient's input is necessary, the treatment itself needs to be limited to the service agreed upon by consent. [i]
Changing a plan can't be accomplished during a session without disrupting the service. Once a service has been established in practice, a practitioner is involved in the delivery of the standard practice. The treatment has been accepted by the society as a remedy that 'works'. There is no further participation by the client other than to receive the treatment consented to in exchange for a fee. Ironically, even witchcraft can be accepted as a standard practice if there is faith in the community that supports it. It is the standards of the community that build confidence in a patient, and a person who has been 'treated', is accepted back into the community by acceptance of the standards of the community and faith in the practice.
With boundaries established by consent (Please see: Medical Model), there is no discussion about the adequacy or inadequacy of an evaluation or treatment. [ii] Everything has either already been determined, or you've agreed to whatever is being done based upon the standards of the community licensure.
The judgement of an injured party, or a provider is irrelevant, and one of very few options for treatment (even the treatment of 'hopeless conditions'), is to appeal to a provider's instructor, superior, or others who can legally advocate for the patient. Licensed practitioners, Courts and/or Judges are equally qualified to determine a person’s competency, or lack of the same by Character reference and/or demonstrations of previous capacity to serve, but ultimately it is our own faith in the practitioner that heals!
When we are dealing with a hopeless condition, if the standards of a service are not known to be successful, then a peson ought to have the opportunity to try out their own ideas. Whether it be the refusal of treatment, and a quality of life decision, or complementary medicine, a practitioner without proven strategy for treatment ought not be involved in making a decision about what should be done. Even a sympathetic relationship ought not interfere with the welfare of the client. A treatment does not become an exchange or intermingling of feelings and interactions even if there is no real financial basis for the exchange. A service provided results in payment to complete the transaction, not to begin an exchange of warm feelings, or feelings of any other sort in kind.
There need be no discussion about the source or value of the payment, or the adequacy of the service if it has been accomplished, just a fee for the service that has been provided. Then, both the provider and the patient can avail themselves of the treatment environment without the interference of unwarranted expectations.
It is only when a complaint is made, where there is a need for advocacy or arbitration, when the need for assessment and alterations may need to be accomplished. If working with a provider is unsuccessful, a referral to a superior, mentor, teacher, or alternative agency to provide a referral, or working on a new treatment plan are two reasonable options.
What we realized about evaluations (Please see Transpositions second column: The Evaluating Mind), is that it is the expectation of the client that is at risk - that no matter how carefully a client is evaluated and treated, the expectations of the patient may never be met. [iii] So, in my opinion, it is best to let go of the analysis of the provider, and simply work on a treatment plan that is useful to the client by fielding input from the client him or herself directly to determine what s/he believes will work. Thereby we may preserve faith in the practice, and good relations with a patient. It is after all 'a hopeless condition' that we usually treat, so why not!
Some patients may become dependent upon treatment, or even evaluations, so to end treatment might not be an easy option for the patient, or without consequence for the provider. We can return to boundaries and treatment plans based upon the clients expectations, and a review of the ideas that have been shared to determine if a satisfactory [iv] treatment can be accomplished without violating our boundaries, or the law.
Then, consent for treatment is on the provider’s conscience, not the patient’s (whose competency is sometimes already in question). If the provider cannot consent to the new plan, then the provider has the right to refuse the role as provider and refer a patient as a last resort. The authority of a teacher, superior, or trade union workers/labor union workers ought to be available to enforce the decision and remove a patient from becoming a threat to the specific practice by referring him or her to another provider.
Please see: Patients Bill of Rights
1. IMID Ltd, Bodywork 2014: Treating a condition at the source of the injury rather than discussing beliefs about it.
2. IMID Ltd, Medical Model 2014: The Medical Model (Describing the hopelessness of treating addictions of any kind)
3. IMID Ltd, Transpositions 2015: Establishing limits on evaluations and dependency.
4. IMID Ltd, Patients Bill of Rights 2014: A patient has the right to seek an alternative provider, a second opinion, or legal advocacy, etc.