In WA State, massage therapists are on the list of essential workers who are allowed to work during the coronavirus outbreak.
March 23, 2020 Proclamation 20-25
•Workers providing COVID-19 testing and workers that perform critical clinical research and development needed for COVID-19 response.
•Health care providers and caregivers (e.g., physicians, dentists, psychologists, mid-level practitioners, nurses and assistants, infection control and quality assurance personnel, pharmacists, physical and occupational therapists and assistants, midwives and doulas attending facility-based or home-based births, alternative healthcare providers, social workers, speech pathologists and diagnostic and therapeutic technicians and technologists).
As most other states shut down massage businesses it is difficult to understand why massage therapists are on still on the list of essential workers. Many of us here have tried everything to get us off of the list and to ask why we are on the list – contacting our legislators and the Governor’s office with no results. Many are also using it to justify continuing to work or keep the business open. Some are using it to reopen their business even now.
Why are we on the essential list of workers?
Many are asking: How can we not be on the list of essential workers? Touch is so needed. Pain relief is so needed. Stress is something we can help with.
Being essential in the time of a pandemic is not about touch or stress or pain relief. Being essential has to do with getting down to the basics of what types of services are needed to support the critical infrastructure of combating the virus and supporting the stay at home orders.
It is really complicated and we really don’t know for sure but from what I have been able to figure out is that it is because we are also Health Care Providers AND we are credentialed with health insurance companies under the Every Category Law that allows us to work with injuries and various health conditions and bill health insurance.
The essential worker list from Homeland Security DOES NOT include massage therapists either.
The advisory list identifies workers who conduct a range of operations and services that are typically essential to continued critical infrastructure viability, including staffing operations centers, maintaining and repairing critical infrastructure, operating call centers, working construction, and performing operational functions, among others. It also includes workers who support crucial supply chains and enable functions for critical infrastructure. The industries they support represent, but are not limited to, medical and healthcare, telecommunications, information technology systems, defense, food and agriculture, transportation and logistics, energy, water and wastewater, law enforcement, and public works.
But no one will die without getting a massage.
No they won’t, but massage therapy can keep people out of the hospital and from taking doctors time in serious situations like people who get debilitating migraines, people who wake up and can’t turn their necks or people who just wrenched their back working in the garden or doing home projects. It can help keep people off Opioids which isn’t the main concern here in the time of coronavirus but it is a main concern overall.
Working in the time of Coronavirus
Some massage therapists in WA continue to work either for themselves because they can or work as an employee for a chiropractor or other provider that is considered essential where they risk losing their job if they say they don’t want to work.
Little did we know that we could become part of the frontline of essential workers when we signed up for massage school and got our massage license here in WA State. Being a HCP and being able to bill health insurance meaning we are an integral part of healthcare means extra responsibilities. (What if nurses and doctors said no they won’t work?)
Today WA State Department of Health finally issued more directions on this.
COVID-19 Health Alert for Massage Therapists
Massage therapists should be aware that there is:
Widespread person-to-person transmission of COVID-19 in Washington. People with COVID-19 can spread the illness even when they feel or lookwell.
High risk of severe COVID-19 illness in persons older than 60 years.
High risk of severe COVID-19 illness in persons with underlying health conditions.
No method to completely remove the risk of person-to-person spread of COVID-19in a massage setting. Governor Inslee’s proclamation 20-25allows health care providers to continue essential health services. Many services provided by massage therapists are considered non-essential. No in-person appointment is risk-free, even if the patient and massage therapist appear well. To help control the spread of COVID-19, treatment should be limited to patients with a clear and documented urgent medical need.While the proclamation allows massage therapists to continue providing services, they are not required to do so. Therapists should weigh their own health risk and comfort when deciding whether to continue in-person services.
Only provide massage to patients with urgent medical issues.Examples include, but are not limited to,lymphatic drainage issues, moderate to severe whiplash,and acute pain control.Simply having a prescription for massage is not sufficient to establish urgent care.
Cancel non-urgent massage appointments.
When treatment is medically necessary, screen the patient for symptoms of respiratory illness (e.g., fever, cough, difficulty breathing) before they enter your practice. If a patient has respiratory symptoms,do not provide treatment. Instead, refer the patient to their primary care provider.
When appropriate, consider instructing patients to implement self-care measures such as rest, hydration, light stretching, light or moderate activity,and self-massage to treat aches and pains until the restrictions on non-essential services are lifted.
Make sure patients practice social distancing of six feet in waiting rooms and other areas of the practice.
Closely follow CDC guidelines for hand hygiene and clean equipment and facilities between patients.
Remind sick employees to stay home. Do not require them to work.Allow all employees who are uncomfortable with continuing to work in the clinic to stay home.
Consider wearing a face mask or cloth face covering when providing massage and when within six feet of another person. Provide face covers and request use by clients when close proximity is necessary.
Updated April 6,2020 Background:The virus causing coronavirus disease-2019 (COVID-19), emerged in December 2019 and has since spread around the world causing a global pandemic. Eighty percent of cases are mild, but severe disease and deaths are more common in the elderly (older than 60 years) and in those with underlying health conditions. Health experts are concerned that increasing transmission in our state and an increase in severe disease will limit the ability of our healthcare system to provide urgent care to all who require it.
Additional resources for massage therapists:DOH Workplace Recommendations DOH Coronavirus (COVID-19) Web Page CDC Coronavirus (COVID-19) Web Page CDC Practice Preparedness ResourcesTorequest this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email email@example.com.
The problem though is that many are working as usual and not limiting their care to emergency situations as outlined in the directive. Some of the chiropractors and even massage therapists are inaccurately saying that massage therapy boost the immune system so is essential to fight the virus.
Dual edged sword
While it is great the we have gotten the recognition we deserve here in WA, it comes with the risk of being on the frontline of battling this dreadful virus. Most massage therapists are not trained in the use of PPE let alone have the necessary PPE. Many are saying that they want to be able to work on the nurses/doctors and healthcare workers but that would have the added risk of coming in direct contact with people who have been exposed to the virus meaning that you would need to be able to quarantine yourself away from your family and everyone for two weeks or more to show that you do not have the virus.
Many massage therapists have been trying to get us off the list of essential workers with petitions, emails to the governor and our legislators but with no luck. It is also tricky because if we are saying we want to get off the list, the health insurance carriers might think we are not serious about our work with them and our role as a health care provider.
How do you get on the list of essential workers?
My guess is that you can’t make it happen now but you can work on it after this virus thing is over. You will have to make sure that you are considered to be healthcare providers in your state. That will take legislation if you are not already. Just being licensed by the Board of Health does not make you a HCP. Find the law that says you are a HCP.
After that, consider creating a campaign to get massage therapy covered by health insurance. I have it explained in my book Massage Insurance Billing. Being able to bill insurance is also a great way to sustain your massage business in any economy. People will come in weekly or even twice a week when they are injured and in pain and have someone else paying.