When I got the invitation I didn’t know what to expect.
I was even more surprised that I was the only one in the clinic who got one.
When I phoned the association to find out what it was about, I was told:
“We are hosting a summit where there will be a roundtable discussion on what needs to change and what can be done to improve the profession. There will be several other RMT’s and members of the public participating.”
Okay, I’m in.
I walked into the room on Saturday morning and started to see faces I had only ever met online.
More and more people started to look familiar.
I’ll admit, I was a little star struck.
There were between 40-50 people in the room. We were told that the invite was because those in attendance were considered to be thought leaders in the province.
There were no ego’s in the room and everyone was there for one purpose.
Improving the profession.
Massage Therapy In Patient Centered Care
The BC Ministry of Health is setting new priorities for our health system by setting eight new priorities.
While I understand that if you don’t live in British Columbia, it doesn’t really matter to you there are still take-aways from this that can apply to the profession everywhere.
- Provide patient-centered care.
- Implement targeted and effective primary prevention and health promotion through a co-ordinated delivery system.
- Implement a provincial system of primary and community care built around inter-professional teams and functions.
- Strengthen the interface between primary and specialist care and treatment.
- Provide timely access to quality diagnostics.
- Drive evidence-informed access to clinically effective and cost-effective pharmaceuticals.
- Examine the role and functioning of the acute care system, focused on driving inter-professional teams and functions with better linkages to community health care.
- Increase access to an appropriate continuum of residential care services.
I don’t think anyone can argue, these are great priorities (especially the portions that are in bold) and we as Massage Therapists should be involved.
However the sad truth is that we are not.
When we looked at the BC labour market for therapists and talked about the Provincial Priority Health Professions, this is what the list looks like:
- Medical Laboratory Technologist
- Medical Radiation Technologist
- Occupational Therapist
- Physical Therapist
- Registered Nurse
- Registered Nurse-Specialty
- Speech Language Pathologist
We didn’t even make the list as a Priority Health Profession.
When you look at the National Occupation Classification we are under “Major Group 32 Technical occupations in health” and within that grouping are classified as “323 Other technical occupations in health care.” Within that group we are listed along with Opticians, Practitioners of natural healing, Licensed practical nurses, Paramedical occupations and Other technical occupations in therapy and assessment.
Under Major Group 31 Professional occupations in health (except nursing) is the realm and classification given to Occupational Therapists, Physiotherapists, Chiropractors and are called “Therapy and assessment professionals”
RMT’s and Physiotherapists in the BC labour market both are in demand, but RMT’s are listed as having “Some Post Secondary” education and Physiotherapists are listed as having a “Masters Degree”.
The group we are in has significantly less education than we do and with some of those occupations the schooling can be done online. Really!?
In order for us to be recognized as a priority health profession some things need to change.
We need to establish our legitimacy as a profession.
Level of education has been an issue since I became a Massage Therapist and I’m sure it started long before. If we want to be recognized and given increased legitimacy we need to start looking at improvements to our education.
One of the big issues is price of education. For a Physiotherapist or an Occupational Therapist the average tuition is only $13,000 but we know to become a RMT it’s around $30,000.
All because their programs are offered through public universities instead of private schools.
There is a significant decrease in the amount of physical therapists and occupational therapists in the province that are able to fill necessary jobs within the public sector. Most are working in private practice, which creates a substantial need in the public sector working within the health authority.
So where can we start to help fill that gap and be involved?
First off the government needs to fully understand what we do. They are projecting our annual salaries to be in the range of $11,000 – $33,000 a year.
With their stats of 3,200 RMT’s where only 26% are working full time (a total of 832 full time RMT’s in the province?) I think we’d all venture to say those stats aren’t accurate.
Here are the stats from RMTBC on a survey that was done regarding income
It’s time to start lobbying government to educate them on what an RMT does. Show them what our current education consists of and also how effective Massage can be for the patients in hospitals or extended care facilities.
The encouraging side is there are some places where Massage Therapy is being offered in the public sector.
We heard from Liza Dion.
She is a Massage Therapist at the Mayo Clinic. She told us about how surgeons wanted Massage Therapy performed for their cardiac surgery patients. They ran randomized control studies and proved Massage Therapy was effective in helping these patients.
They now have regular Massage Therapy happening in the hospital and is a primary part of the care given. However it’s not just in cardiac patients, they have also done studies with Colorectal surgery, Thoracic surgery, Breast surgery and Cardiology patients. It has even gotten to the point that they have a hospital based Massage Therapy course that is offered twice a year for Massage Therapists to come in and learn how to offer care in the hospital.
Liza also mentioned that she regularly has to educate new nurses and other practitioners in the hospital about what Massage Therapy does.
What if these other practitioners already knew what we did because we all went to university together? At least started out in the same programs and then decided which avenue we were going to pursue.
If we want to join these other therapies in the public sector work, we should also join them in the public sector schools.
Photo by: NEC
Massage Therapy Education, Professionalism, Practice Support and Resources
As part of the summit we were divided into groups to discuss these topics.
I was fortunate to be part of the Education group.
As expected, there was a lot of discussion and passion on the topic.
Everyone there believed more education was crucial to our advancement as a profession. The common belief (as discussed earlier) was that a bachelor’s or master’s degree in massage was the direction we should start looking at.
I’m sure there are just as many people against the idea as there are people for it, but think about what this could do for us.
We have never been able to say that we specialize in something. I’m sure there are a number of therapists out there that focus their practice into something specific or some particular modality. Having more education is one way to lift this type of boundary on the profession. As we start to set up Professional Practice Groups here in the province, why shouldn’t we be able to say that we specialize in something or some area of interest?
Expanded scope of practice. I get frustrated that we are not allowed to use modalities like IMS, Shock Wave, Ultrasound or any other electrical stimulation. I know that in other provinces Massage Therapists are fully licensed and allowed to use these types of modalities. I think it’s time to make these options standard practice in regulated provinces.
Part of the problem with this goes back to lobbying government and making them aware that this should be within our scope (even though I think it already should be). Having a bachelor program in place, would help take away any doubt on their part.
As someone who loves working in sport, I believe there are many things we could do with our curriculum that would support students who have this interest. I spent last year working with some Athletic Therapy students and there are things we could learn from their program.
Those students come out of school with a few different certifications. Since it is a bachelor degree program, they come out with a list of exercise certifications on top of the AT certification. Right now we could start incorporating a CPT (Certified Personal Trainer) certification into the program. It would give students a much better grasp of exercise prescription for their patients and also give them an extra avenue of making money once done school.
For those that are interested they could have a combination Personal Training and Massage Therapy practice. It would also give those students interested in working with athletes or sports teams a better chance of getting involved.
There were so many other topics that were brought up in that discussion, but I’m writing this from memory so I can’t remember it all.
However when each group came back and talked again, every group mentioned that education had come up as a priority.
The Future Of Massage Therapy In Mainstream Healthcare
Dr. Gurdeep Parhar presented to us a new idea on how we could identify what we want from our profession and how we fit into the healthcare system.
He talked about the CanMeds framework that physicians had put into practice to see what is expected of a medical expert. This framework has been adopted around the world, where students and medical professionals are graded on the six branches of the model. But the same model has been adopted in Physiotherapy and Occupational Therapy groups as well.
The public expects a doctor to be a medical professional (obviously) but the above six qualities are expected as well.
Communicators. We are judged by other professions and the public on how we communicate. This includes writing reports in response to doctors and other practitioners that we refer to and from. Dr. Parhar also sat in with the professionalism group and spoke with them on how important it was to implement report or communication writing back to doctors.
It is an area that we are not very good at. During discussions later in the day, the feeling was that most thought a report to a doctor had to be complicated and frequent. Dr. Parhar spoke about how much he as a physician appreciates getting communication from RMT’s, but it just needs to be a report at the beginning of treatment and one at the end. Just a report that informs the doctor in areas of treatment and how treatment progressed, so they know what has been done with the patient.
Collaborators. This works with our communication. How are we interacting with the rest of the healthcare team? We can’t work in isolation, we should be communicating with our patients other practitioners and contributing to their healthcare plan.
Manager. Why can’t we be a case manager on behalf of a patient? We can see a recently injured patient 2-3 times a week for an hour at a time. A doctor will see this person once every 4-6 weeks for maybe half an hour. So why aren’t we a piece of this puzzle, or even the primary case managers?
Health Advocate. Access to care is so crucial, especially in a “patient centred” model of care. There is still a difficulty for doctor’s to explain to their patients why Registered Massage Therapy isn’t approved by their insurance company when it is needed. We need to help advocate for the patients because society trusts us as professionals based on our guidelines and standards of care.
Scholar. This is a difficult area for us. There was plenty of discussion throughout the day on research (in fact a guest speaker Dr. Martha Brown-Menard LMT, spoke to us specifically on research) and how important it is. The problem is that research is done at universities and big companies don’t necessarily want to fund research for massage.
As much as we are pushing for evidence based practice, qualitative studies are just as important. But we need to start doing the research if we want to advocate for more resources to back up our profession.
Professionalism. Is Massage Therapy going to continue to have an artistic side to it, or do we start to present ourselves in a more professional manner? Should there be a standardization so that when someone comes in for treatment a person feels like they are dealing with clinicians?
I’m as guilty of this as anyone, I like just going to work in what I’m comfortable in (which is usually cargo shorts and a t-shirt), but would I be more presentable or respected if I made sure to wear a golf shirt instead? While I don’t think this is something that will ever be mandated, it may just be some food for thought when it comes to your own practice.
Listening to all of those points coming from a doctor was more than rewarding. Knowing there are doctors out there that are also advocates for Massage Therapy says that we are at least on the right track.
When I started this blog, the whole intent was to have other therapists collaborate information on how to improve the profession and share knowledge. I was excited when each one of the coaches agreed to be part of it because they were willing to share.
Sitting in a room of other RMT’s that are passionate about their profession and improving it was impressive. It also showed that we have a ways to go in order for our profession to gain more respect. While it is leaps and bounds ahead of where it was 10, 15 or 20 years ago, we can never stop improving. As the CanMeds model increases throughout the world, Massage Therapists need to continue working on being Professionals, Communicators, Collaborators, Scholars, Managers and Health Advocates. As mainstream healthcare continues to develop we need to make Massage Therapy prominent in patient centred care.
No one is going to this for us, it is only through our efforts that we can prove to government and other practitioners that we belong in the public sector and mainstream healthcare. I realize as I write this post that it seems pretty heavy on the education side of things. There was so much more that came out of the discussions that day, it’s just hard to put it all down in one place. If nothing else, I think the discussion was a step in the right direction.
We were asked to bring the excitement that we were all feeling that day back to our colleagues and share in order to keep the momentum going. I hope I have at least managed to do that, although I know it’s just the beginning.