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Legal implications when treating a patient who refuses to register with a GP

Q:  What are the legal implications and requirements for an acupuncturist when treating a patient who refuses to register with a GP?

A:  There are no legal requirements of which we are aware about treating patients who are not registered with a GP. Registration with a GP through the NHS is entirely a matter of choice for a patient, and if someone exercises their choice not to register it does not mean that we cannot treat them or are not legally allowed to treat them.
 
However, there are circumstances where it may be essential to refer a patient on to orthodox or conventional medical services. Indeed, this is taken seriously by many regulatory bodies, and the Advertising Standards Authority has a long and very exhaustive list of named conditions which it believes put a patient at risk if someone who is not suitably medically qualified promotes their treatment instead of referring to orthodox care or fails to ensure that someone is receiving orthodox care. 
 
This might present something of an ethical dilemma for a BAcC member. If the practitioner believes that the patient should consult an orthodox medical practitioner and the patient refuses, the question would be whether offering some treatment 'blind', so to speak, is better than refusing to treat and running the risk that the patient will have no treatment of any kind. In circumstances like this our members would almost certainly seek advice from our experts in the field of insurance, conventional medicine and law.
 
The BAcC has all of these expert facilities in place, and if there is any perceived risk to either patent or practitioner, we advise and encourage our members to contact us.
 
This will always remain a troublesome area, however. Even if someone is registered with a GP they may refuse consent for a practitioner to contact the GP or may listen to the practitioner's advice and ignore it. Breaching confidentiality by disclosing details to a third party, even in the patient's best interests, is also a minefield, and the legal advice we have been given is that only in exceptional circumstances can disclosures without consent be made, and only where there is a real risk to the general public.
 
Essentially we would deal with each case on its own merits, given that some medical needs are more pressing than other. It would be true to say, though, that such instances are quite rare, and we hear of very few people who opt out of registration with a GP.
 
 

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