We've Changed

We are not the profession we were 10 or 20 years ago. For better or for worse and it's because we have won. Here's what I mean:

I started massage school in 1998, graduated in 2000. What did we want and dream about then?

• The death of the prostitute/wink wink nudge nudge bullshit.
• Legitimate licensing.
• Greater visibility in the general public.
• Being valued for more than a "vacation/birthday rub down".
• Being noticed (and even being taken seriously) by the medical profession.
• Opportunities to work with other "complementary" health care providers like acupuncturists and chiropractors as peers.
• More multi-therapist practices.
• The ability to bill insurance so more people could get massage therapy.

Simply put, more places to work, greater visibility, and greater legitimacy. While we still want those things, we're dramatically further along than we were 15+ years ago.

But as with everything, there's a price to pay.

As we have gained visibility, we've become a market for non-MTs to make money. Whether it's quickie schools or massage franchises, we are now a legitimate way for those outside our industry to make money from our work.

Along with that, our industry is becoming increasingly "corporatized". How many national school chains and national franchises with a standard business objective -- profit -- are dotting our landscape?

With increased visibility, our customers have higher expectations. They want a great massage experience -- and now often have the experience themselves to have higher standards -- but they want a smooth business operation too. They want the same kind of benefits they get from the local pizza place, hair dresser, and clothing store: credit card processing, long hours of operation, online scheduling, etc. They have higher expectations of us as massage therapy practitioners and massage therapy businesses.

We are actually showing up in hospitals! My business partner / partner in crime Kitty Southworth is training with Healwell this week to provide massage (for pay!) in local hospitals. There is a growing demand for this program locally, enough that the massage therapists who designed and run the program are having some trouble keeping up.

With the growth of that kind of demand, however, is a commensurate rise in expectations: we are expected to be able to function in a clinical setting. We can't even agree on how to define "medical massage"! The standards for what we need to know and what we need to be competent at are rising. "Just" knowing the basics about muscles and massage strokes isn't really enough any more.

Which means rising standards for education and for licensing. Which we are bitching and moaning about as well.

Which leads to a growing segregation between and segmentation into spa, medical, "wellness", sports, etc. specialties. Will there be a time, not so far away, where an MT has to choose their area of specialization early in their career to be competitive?

Will schools need to offer specialized tracks that MTs have to commit to, like declaring a major in college, to be able to graduate?

Now that more than half the states / quasi-governmental-jurisdictions (forgive me, I live in DC, the capitol of quasi-governmental jurisdict'ing) have licensing there's going to be more and deeper legislation. It's just how governments work. We still have to fight the "no, we're not prostitutes / human traffickers / etc." but now we face fights about the value of also having a college education, the need for more classroom hours, continuing education (hands-on, online, etc.), and who governs whom.

Finally, wonder of wonders, more and more of us are able to bill insurance and/or be included in insurance networks! But that also means that insurance companies are getting involved in the licensing decisions because they've got money involved now. What insurance companies ultimately always want to do is control / manage / at least affect how a profession does their work since the insurance companies are helping to pay for it.

How long till we do our work officially in 15-minute segments so we can bill for it?

Now, I want to tell you how we avoid all the bad parts of "winning" the dreams we had.....we don't. These things are the price of success. We won. This is what it looks like and what it will continue to look like.

It means we, individually, need to change too.

• We need to step up our game as business owners.
• We need to push ourselves to be smarter about the body and try to keep up with changes in our knowledge of how the body works.
• We need to find the time and energy to speak for ourselves to legislative bodies and insurance companies.
• We need to broaden our vision about what's possible and gather the knowledge and skill to get there (including learning how to run smart group practices if we don't want to all be working for franchises).

I really wish I could tell you we can all sit back and relax now that we've won many of the fights we had 20 years ago. Just like in the rest of life, it isn't going to work like that. It's like being a parent -- surviving the Terrible Two's doesn't mean you're done, it just means you now get to meet the next challenge.

My simplest piece of advice? Join hands with the other MTs around you whether that's through formal channels like a local AMTA chapter, through an alumni group, through Facebook, or just through a semi-regular happy hour. We grow best when we grow together.