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| Ten years ago. |
I am working on textbook revisions. The reason publishers have textbooks on
revision schedules are to assure that content remains current. My revision schedule for Fundamentals of Therapeutic
Massage and Essential Sciences for Therapeutic Massage is at minimum every 5
years. That means every 3 years I begin a revision cycle. Truth is that I am always revising textbooks
because Mosby’s Massage Therapy Review for licensing exam preparations and
Sports and Exercise Massage plus other books are also on revision
schedules. I am always looking for what
has changed and what is the same in the world of massage.
This commitment to textbook revisions places me in a unique
situation. I have to stay current with
all developments that impact massage therapy education and practice and I have
to be a visionary able to project into the next 5 years to assure that content remains
viable between revision cycles. I have
been writing textbooks for a long time – since 1995. Wow 20 years!
And I have been a massage therapy school owner and instructor since 1985.
Wow 30 years! I have been a massage therapist since 1979. Wow 36 years! Let me tell you, a lot has changed! And I have had to change too. I am 61 and expect to be active in the
massage world another 30 years. I will
have to continue to embrace change. My
next 30 years is devoted to developing the next generation of massage
therapist, teachers and leaders. Over the years of professional practice I have
a good track record for being accurate with future events and will share a few
of major future events I expect. But
first, a reflection on just the events of the past year.
It has been quite a year.
Major events include:
·
Release of the Entry Level Analysis Project (Dec
2013 technically but close enough to 2014)
·
Release of the Federation of State Massage Board’s
Model Practice Act.
·
National Certification Board for Therapeutic
Massage and Bodywork moving beyond licensure and putting full support to the
advanced credential Board Certification
·
Movement by Commission on Massage Training and
Accreditation to provide a programmatic approval outside of institutional accreditation.
It was rough going but all four of these events are
necessary for advancement of massage therapy.
Other important events include:
The Joint Commission, the accrediting body for health care
released the Clarification of the Pain Management Standard November 5, 2014.
The implications are huge for massage becoming part of integrated health care. http://www.jointcommission.org/assets/1/18/Clarification_of_the_Pain_Management__Standard.pdf
Effective January 1, 2015, for
Ambulatory Care, Critical Access
Hospital,
Home Care, Hospital, Nursing Care Centers,
and
Office-Based Surgery Practice Programs
Standard PC.01.02.07: The
[organization] assesses and
manages
the [patient’s] pain.
Revised Rationale for PC.01.02.07 (New for Ambulatory
Care and Office-Based Surgery Practice)
The
identification and management of pain is an important
component
of [patient]-centered care. [Patients] can expect
that
their health care providers will involve them in their assessment
and
management of pain. Both pharmacologic and
nonpharmacologic
strategies have a role in the management
of pain.
The following examples are not exhaustive, but strategies
may
include the following:
l Nonpharmacologic strategies: physical modalities (for
example,
acupuncture therapy, chiropractic therapy,
osteopathic
manipulative treatment, massage therapy, and
physical
therapy), relaxation therapy, and cognitive behavioral
therapy
l Pharmacologic strategies: nonopioid, opioid, and adjuvant
analgesics
C
EP 4 : The
[organization] either treats the [patient’s] pain or
refers
the [patient] for treatment. M
New Note for EP 4 (Additional Note for Nursing Care
Centers)
Note: Treatment
strategies for pain may include pharmacologic
and nonpharmacologic approaches. Strategies
should reflect a [patient]-centered approach and consider the
patient’s current presentation, the health care providers’
clinical
judgment, and the risks and benefits associated with the
strategies, including potential risk of dependency, addiction,
and abuse
Education
Education was shook up with the collapse of the corporate
financial aid based school sector and increased regulation and oversight of private
post-secondary education accepting financial aid as well as limits on amount of
federal aid available based on projected income upon graduation (gainful
employment). This development is going to need to be watched closely.
http://www2.ed.gov/policy/highered/reg/hearulemaking/2012/gainful-employment-fact-sheet-10302014.pdf
Massage Franchises
The increase in massage therapy and spa focused franchises
will continue. Massage Envy is not the
only player. There are multiple franchise
options these days. Like it or not, the
franchise model is successful. Stomp and
spit and get your fascia in a twist, pay rates and yearly income amounts in the
franchise structure are reasonable based on a 625 contact hour entry level
vocational education and comparable to other health professionals with similar
education. Ongoing confusion on income perpetuates because the misunderstanding
of what is charged for massage is not what is actually made. In past blogs I have discussed this topic often. If a
massage therapist works full time and doing 5-6 massage sessions per 8 hour day
5 days per week (which is reasonable) should make between $25000 and $30000 per
year and payroll taxes will be deducted from that. A massage therapist with more education and
experience should make more. This is
employment in the real world and massage is a health service.
Yes this is change from when I first came into the
profession or is it? I charged $20 per
hour massage, work all hours of the day and night, did between 20 and 30
massage sessions per week and made about $30,000. Calculate all the time actually spent and I
made about $12 per hour. You would think the economy would be better today but
it is not. The median wage for 2014 in
the U.S. per person is $26,695 and median household income is at $50,500(
multiple people working).
Today the franchise fee for basic massage ranges from $40-$60. As an employee you should get ¼ of that fee
per massage. You walk in, provide excellent massage, be a great employee and
walk out. The business owner takes all the risk, pays the overhead and expects
to make a profit. Overhead is 50% of
gross sales. Wages are 25% of gross sales. It just is and doesn’t matter if you are your
own boss and self-employed or an employee where the owner has to pay the
overhead and take the risk. And all, heads up.
Pay rates in health care establishments will not be any better. The business owner needs to make a profit and
that should be 25 % of gross sales. Here
is the kick. The owner gets paid last.
Overhead and employees have to be paid first.
Education has to prepare graduates for success and realistic
expectations. I think those that do not achieve success 2 years post-graduation
from massage school should not have become a massage therapist in the first
place. Schools need to better inform
potential students about income and work expectations and do a much better job
screening potential students. This is a service profession. There must be a
passion for massage therapy independent of income potential. Not everyone
should be a massage therapist.
Graduates must be
able to provide a beneficial therapeutic massage clients are willing to pay $50
(average) for and they have to be able to do 20-30 massage sessions per week. Somebody
has to step up and do a for real ergonomics analysis to prevent burnout. Educators
at entry level needs to get real and provide a curriculum that does reflects
the job market for graduates today and tomorrow. Massage therapist have opportunity to advance
and increase income with continuing education and experience reflected by Board
Certification.
Continuing education needs to be practical and actually
provide skills instead of fluff. Too
much of the continuing education available does not translate to practical
skills in the actual massage practice.
I am excited about the next 5 years. Ongoing research will
continue to validate the biologically plausible benefits of massage. I think by 2020 most of the confusion about
massage therapy education and practice will sort itself out.
One of the biggest shifts I think will be employment out
pacing self-employment for massage therapists at entry level. Franchises, spas and healthcare establishments
will be the major employers. I think
that major employers for massage will make adjustments to support income and
advancement for top performing massage therapists.
Tuitions need to come down to a more realistic level. Student should pay per classroom hour what is
a typical hourly wage for massage practitioners $10-$15. This means entry level
tuition at the 625 ELAP recommendations should be between $7000 and $10,000.
I think massage therapy will sort into a tier system based
on licensing at entry level and then Board Certification and Specialty
Certification. I do not see massage education routinely becoming an associate’s
degree entry point into the job market. I believe entry level education is best
provided at a diploma level. I do think more community colleges will begin to
provide massage education.
I hope and believe
the small vocational school will become again the major avenue for massage education
as corporate schools continue to be under pressure. I think the financial aid system will be
completely revamped and I recommend that massage educators avoid getting into
the financial aid trap. I expect COMTA
will provide a programmatic approval process for small schools that do not participate
in financial aid. Truth is COMTA has to
do this for it’s own survival. I do hope that massage educators will be
required to achieve specific certification and be encouraged to achieve at
least associates degree to bachelor’s degree academic education.
So change is inevitable.
Fighting to stop change is a waste of time. Working to guide change for the best outcome
is an important commitment. Let’s get over the past, learn from it and move
forward.
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| Now ! |
