The Future of the Massage Profession

In order to start planning for the future of the massage profession, it is important to learn where we have come and where we are currently at.

Right now we need more younger massage therapists to step up and become leaders in the profession to direct our future.  Most of what happens in the massage profession happens because of the many volunteers for AMTA Chapters.  Yes that’s right – volunteers are really the one’s who direct our future. If you want to make something happen – volunteer.  Step up and run for a board member position or at least start attending your AMTA Chapter Board meetings.  Most of the local volunteers really have a good heart, but AMTA National is not much help in directing where each state should go.  I only recently learned that the Government relations volunteers in each chapter do not really network with each other.  Instead they are just fighting fire in their own states rather than sitting down and figuring out what they want for the STATE and National Therapist – not themselves.  I always thought that AMTA National had more influence and was leading the volunteers.  (Correct me if I am wrong).

When you volunteer with AMTA you will see some of the politics outright. Many volunteers have been previously ‘fired’ and accused of insubordination and can’t even talk about it because of agreements they signed.  I would love to write a whole book on that someday and call it “As the AMTA Turns”.

Currently, the main issues are:

• Lack of a unified definition of massage therapy, deep tissue massage and other terms that make it confusing for consumers to figure out what to ask for and what they need.  We have a Massage therapy Body of Knowledge that was trying to do that but the last update was 2011.
• Lack of standards in education.  The Alliance for Massage Therapy Education is working on it.  The AMTA and ABMP also have a schools division but not sure if they are working on it.  The Entry Level Analysis Project (ELAP – www.elapmassage.org) is the closest thing we have that should be implemented in all schools but that was done in 2012 and is starting to be outdated.
• Low pay in many of the franchises and other financial factors have led to a shortage of massage therapists in the US.  Not enough people are choosing massage therapy as a career.  Franchises and other massage businesses are struggling to find therapists to work and rent rooms.  For as long as I can remember, massage therapists have talked about unions for jobs yet no one is stepping up to form them.  As far as I know, there would have to be a union for every franchise which is independently owned but not really sure on that one.   It won’t work for massage therapists who own their own business.  How many massage therapists are employees is really unknown.
• There was also a time a few years ago when many massage schools were closing because they were schools that did not meet the requirements and were telling potential students inaccurate salary data when entering schools.
• There are currently two main massage therapy associations – ABMP and AMTA.  ABMP is a for profit business meaning they are all about the money while AMTA is a non-profit membership organization (501 C6) where they are obligated to provide for their members.  To be a 501c6 organization, they must ” (from the IRS) the organization’s activities, must be meaningful. For this purpose, membership support includes the following items:
  • Amounts derived from performing the organization’s exempt functions or from substantially related activities
  • Contributions or gifts from the general public
    The activities that generate the income must contribute importantly to accomplishing the organization’s exempt purposes to be substantially related.”

  They also have to make their financial reports public so that people can see what they are doing.   AMTA was started first and then ABMP was started in about 1992 by a disgruntled massage therapist.  At the time I thought it was a good idea, but now looking through the last 30 years or so I see how it has split up the profession and also made it so we have limited influence over anything in politics and policies. (Just think if massage therapy were covered by insurance in every state like it has been for over 20 years here in WA – would there be an Opioid epidemic?)

• We also have two associations fighting over who will manage the CE requirements.  NCBTMB and the FSMTB are at an all out battle over this.  FSMTB even publicly stated that they would let the NCBTMB handle the CE approval process (as they had been since their inception) but then somewhere along the line changed their minds and now are working to take over the CE approval process.
• The NCBTMB created Board Certifications and in the beginning it was called the National Certification Exam but nothing about it was National.  It never meant that anyone could practice in any state and that confused many.  Currently they are a struggling organization and a few years ago even had to sell the furniture and find new office space.  AMTA now funds the NCBTMB which could be seen as a conflict of interest.  The NCBTMB was originally meant to be an entry exam for AMTA and AMTA funded it to start and then stopped to make it stand on it’s own.  At sometime AMTA actually withdrew their support of the exam.  Currently the NCBTMB is playing around with something called specialty certifications but to me it is taking us 10 years or more backwards.  The specialty exams are for specific schools.  What we really need are true Board Certifications in things like spa therapies, rehabilitation massage, hospital massage, cancer massage and sports massage…and that is it really.
• While we have been able to bill health insurance here in WA for over 20 years, we are now being hit by allowable fees being lowered significantly, by massage therapy benefits being reduced and other problems working with health insurance.  It started about 7 years ago when the first one dropped their allowable fee from $120 something to under $60 per session.  I went to AMTA WA and started asking around about what could be done and what is being done and the answer I got from volunteers there was that there isn’t anything that could be done or if there was they would be doing it. The problem is that no one has been at the table with the carriers and providing them with data they need to set their fees accordingly.   I helped start a new organization in WA State – the WA State Massage Therapy Association to start getting to the table with carriers and start standing up for the profession.
• As I learned more and more about what was going on politically in WA State, I also came to realize that the Political Action Committee was something that needed to be revived and built into at least a $100k business like the WA State chiropractors and Physical Therapists have.  WA State is the only state that I know of that even has a PAC.  This past spring I watched a bill that the PT’s and Chiropractors initiated that also included massage therapists regarding prior authorizations that were being done by a few major insurance companies to try to cut down on the number of sessions being done.  I watched all the hearings on the bills and was actually amazed that the legislators were asking the right questions to the insurance companies who were of course fighting it all.  The bill passed although with a compromise but I never in a million years even thought it would pass.  It passed because of the many many years of lobbying, contributions to political campaigns and educating legislators about what is going on.  (AMTA and ABMP are no where to be found in the arena – maybe AMTA in some states are now getting involved but they are mostly on their own.)  I am now the secretary of the PAC – the WA Massage Alliance for Health (www.wamah.org). It was started in 2003 or so by some past AMTA members.
• There is also NO National Political Action Committee.  If there was, I imagine that massage would be covered by health insurance in every state to help combat the Opioid epidemic…or maybe there would not have been such a problem if massage therapy were covered – image that.
• Sex scandals where massage therapists are attacking clients, and where clients are attacking therapists is becoming all too common.  What is up with that?
• Human trafficking is getting more attention but not really from the national associations that I have seen.
• Discrimination is still a really big issue in the massage profession with men being discriminated against as well as minorities.
• There is a split in the profession where spa/wellness/relaxation massage is looked upon as being less than or less qualified than medical massage therapists (which also needs a definition.)  ALL massage therapy is healthcare.

So what can you do to get more involved?

• Start paying attention.  Read everything you can on reports of associations.
• Attend conferences to network and learn from others.
• First start with your local AMTA chapter to see what is going on.
• Run for a board position in your state AMTA Chapter.
• Run for a National AMTA Board Position.
• Get involved with the NCBTMB and figure out what the heck they are doing/thinking.  I have emailed them a few times but no replies.
• Consider starting your own state massage association if you don’t get anywhere with AMTA. That is what happened in WA State – www.mywsmta.org was created after struggling with AMTA National for years and years over getting the support we needed here in dealing with insurance companies. (Many other professions also have their own state organizations that are not connected to a national organization.)  I also am concerned about splitting the profession up more so more thought is needed.
• Start a political action committee in your State!
• Start a National PAC – I hope to do that after I learn more about running the state PAC.
• Start your own massage school that teaches a new way of being a massage therapist that focuses on practice building and have a support team in place to help graduates do just that.
• Start saying NO to low paying jobs with no benefits.
• Start having meetups in your area with other local therapists and start brainstorming the answers together.  Start a grassroots efforts to make changes in your area and teach others how to do that too.

We need more people under 45 doing these things.  Now.

Most of what we have now in the massage profession has been created by the older generation of massage therapists – people like me over 60 years old.  When you look at the list of volunteers in AMTA and other organizations, it is usually the same names over and over stepping up.  The future really lies in the people younger than 45 – what do you really want for OUR profession?

Getting involved and learning what is going on is just the beginning really.  What we need is a plan for our future and people with the guts to stand up for the profession.  I see so many creative and inspiring stories of people creating things, community and even political action in other fields but nothing is really new in the massage profession. Here are some of the things I have thought about that need further research.

• One National association that brings us together.
• TV commercials on various topics like massage for headaches, fibromyalgia, pain issues (back, neck, knee, hand etc), carpal tunnel syndrome, stress etc. etc.
• Ads in major magazines like Oprah, Prevention, Time, Newsweek, etc
• Massage therapy covered in all states by health insurance that pay at least your cash rate if not more for rehab and medically necessary conditions.
• Massage therapy covered by health insurance for stress/wellness options for massage sessions done once a week or as needed.
• One universal definition of massage therapy that is adopted by all states in their laws that clearly states our scope of practice.
• One standard number of hours of education for entry level therapists and one standard number of hours of required education hours for advanced care (rehab, hospital massage, cancer care) in all states.
• TV commercials and ads that show massage is not a ‘happy ending’.
• TV commercials and ads that create awareness about the problems with illegal massage businesses, human trafficking.
• TV commercials showing people of color and black people getting and giving massage therapy.
• Anatomy and basic massage taught in grade school or high school.
• More higher paying jobs that pay over $30 an hour and you get paid that whether or not you have a client or not. (Yes I know that would seem nearly impossible financially.)
• A union for franchise workers, spa workers and other employers.  (Unions have been talked about since I have been a massage therapist in 1987, yet nothing has been done.)
• Community clinics where massage therapy is offered for free or low cost for those in need.
•  Your idea here __________________________________.
• Create paid activist positions or do things that make you money to help pay for volunteers time/energy.  Too many volunteers and not enough paid positions.
• Have AMTA State chapters hire an executive director, admin and others as needed to get away from volunteers having to do everything.
• ALL massage therapy is healthcare.

Overcoming objections.

Getting people involved in this profession is often likened to “herding cats”.

Stepping up and making a difference takes time and energy.  Most massage therapists are barely getting by enough to want to make time to do these things.  It is difficult to get involved in AMTA as they are all volunteers at the local level and they are busy doing their work.  This is a very well known place for non profit organizations, but I expect more support from AMTA National in this area.   If you are not an AMTA member, it is also difficult to get involved as they try to keep it to members only but I got involved in WA without being a member.  It depends on your local chapter and their leaders.

Getting involved has helped me come out of my own introverted shell and share my .02 and be a part of something greater than myself. I have met some great people and have learned more on how to deal with difficult people and situations. I will continue my ‘herding cats’ as someone once said “and Julie turns the massage therapists eastward and begins herding”.  Massage therapy has been a great profession for me even with it’s ups and downs.  As I think about retiring in the next 5-7 years, I feel sadness for the future of the profession and am concerned on what it will be if no one else starts standing up.  Will it just be cheap massage done by poorly trained massage therapists who answer their phones in a session and say things like ” I am so bored doing massage and with all that free time in a session – what do I do?”

What will it take for you to make the time and step up and deal with the politics and such to start making a difference in creating the future of the massage profession instead of what is happening now which is that the future is happening without any input on where we would like it to go.

Where do you want the massage profession to go or not go for that matter?

My Vision:

I envision a massage therapy profession with one unified voice of the profession, that advocates ALL massage therapy is healthcare.  Wellness/relaxation massage and medical/hospital massage are all as important and compensation for therapists should all be the same.  All massage therapists should be able to make a living wage that will allow them to work 25-30 hour work weeks in a job or whatever it takes in private practice to own a house or live where they want, take vacations, save for retirement etc.  I picture massage therapy offices in every hospital, cancer center, healthcare center/office.  I picture every person in the US getting a massage once a week no matter their ability to pay.

I picture a community where we can all come together to support each other despite our difference of opinion and beliefs.

I would love to see schools that cater to people with business degrees/experience to learn the art and science of massage therapy to create more massage businesses where massage therapists can be fairly paid and respected.  I hope schools can attract the students they need without having to give into the franchises and teaching the minimum and that schools would more carefully screen out felons and others who are giving our profession a bad name.

I see a profession that is no longer being confused by the public by illegal massage businesses offering ‘other types of so called massage’.

More associate and bachelors degrees in massage therapy are needed.  Heck – what about a doctorate?

Full Disclosure: Just so you know… I was only an AMTA member for probably a year or two in the very beginning of my career.  I was also a supporting member for a few years just so I could access their Fact sheets and attend the state convention at a discounted rate.  I have been watching AMTA for over 30 years and never was a big supporter of them, but the fact is that they have the power and ability to hire lobbyists to help each state chapter.  I helped set up the WA State chapter website in 2015.  I later went on to help start the new WA State association – WA State Massage Therapy Association (www.mywsmta.org) and was the secretary of that organization for 2 years.  I am currently the secretary for the WA Massage Alliance for Health – the PAC for massage therapists in WA State (www.wamah.org).  I also am on the board of a new organization trying to find it’s way – The National Alliance of Medical Massage and Bodywork (www.nammb.net) that was started in CO and working on CO legislation first to get massage therapy covered by health insurance.