L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 29
Chronic, unmanaged stress is a major
but unquantified factor in these deaths.
CLOSING THE GAP
Massage therapy is screening. Massage
therapy is behavior modification. We hardly
have to open our mouths as practitioners
for this to be true. We touch our clients
regularly. We see how they walk into
our treatment spaces. We notice changes
in their skin and muscles. We notice
decreases in energy. They tell us about their
sleep habits and what they eat and other
important indicators of health—and disease.
We take it all in, but we have nowhere
to go with it once they leave our table.
We can ask open-ended, nondiagnostic
questions of clients, inviting them to
consider choices that they express as
challenging to their health. We can touch
them in a way that invites them to notice
areas of pain or dysfunction, but there's
no continuity between our care and the
observations and guidance they receive
from other clinicians. When our clients
see their primary care physician (PCP) or
psychotherapist, we don't exist and neither
do our observations. And when they don't
have to see their PCP or another health
professional because some regular stress
maintenance and soft-tissue tune-up keeps
them functioning, we are truly invisible.
This is a huge gap, and this gap will persist
unless we close it.
Health-care providers of all stripes—
including massage therapists—need to foster
care that is patient-centered, comprehensive,
and interdisciplinary; and financing,
referrals, records management, and other
systems need to support this flexibility. This
will be yet another overlapping and heavy
lift, but we need to make ourselves hard to
miss in this conversation.
As massage therapists who are
invested in an inclusive and integrative
future, we need to start following the
work of organizations like the Coalition
to Transform Advanced Care (C-TAC),
Integrative Health Policy Consortium
(IHPC), Centers for Medicare &
Medicaid Services (CMS), and America's
Health Insurance Plans (AHIP). The
US Department of Veteran's Affairs
is also leading the way in looking at
how massage therapy fits into a picture
of whole community health. You
and I need to do this. These are our
relationships to build and solutions to
create. We can't expect others to take up
this mantle on our behalf. This is our
work (yours and mine) to do.
Notes
1. U.S. Bureau of Labor Statistics, "Massage
Therapists," updated September 1, 2020,
accessed January 2021, www.bls.gov/ooh/
healthcare/massage-therapists.htm; Center
for Health Workforce Studies, "Who's In the
Health Workforce?" accessed January 2021,
www.chwsny.org/the-health-workforce/whos-
in-the-health-workforce; Jaclyn Chadbourne,
"What is an Allied Healthcare Professional?"
March 20, 2018, www.medfitnetwork.org/
public/all-mfn/allied-healthcare-professional.
2. Shirley Musich et al., "The Impact of Personalized
Preventive Care on Health Care Quality,
Utilization, and Expenditures," Population
Health Management 19, no. 6 (December 2016):
389–97, https://doi.org/10.1089/pop.2015.0171.
3. Shirley Musich et al., "The Impact of
Personalized Preventive Care on Health Care
Quality, Utilization, and Expenditures."
4. Committee on Advancing Pain Research Care
and Education, Board on Health Sciences Policy,
and Institute of Medicine, "A Call For Cultural
Transformation of Attitudes Toward Pain and
Its Prevention and Management," Journal of
Pain and Palliative Care Pharmacotherapy
25, no. 4 (November 2011): 365–69, https://
doi.org/10.3109/15360288.2011.621516.
FOR MORE INFORMATION
Listen to Cal Cates's and Cathy
Ryan's podcasts Massage
Therapy Without Borders and
Interdisciplinary on Apple Podcasts,
Google Play, Spotify, or healwell.org.
5. Institute of Medicine Committee on Advancing
Pain Research, Care, and Education,
Relieving Pain in America: A Blueprint for
Transforming Prevention, Care, Education,
and Research (Book summary, Washington:
National Academies Press, 2011), accessed
January 2021, www.ncbi.nlm.nih.gov/books/
NBK92510/#summary.s2; Drew DeSilver, "10
Facts About American Workers," Pew Research,
August 29, 2019, www.pewresearch.org/fact-
tank/2019/08/29/facts-about-american-workers.
6. Will Evans, "Ruthless Quotas at Amazon Are
Maiming Employees," The Atlantic, updated
December 5, 2019, www.theatlantic.com/
technology/archive/2019/11/amazon-warehouse-
reports-show-worker-injuries/602530.
7. American Heart Association, "Stress and Heart
Health," reviewed June 17, 2014, www.heart.
org/en/healthy-living/healthy-lifestyle/stress-
management/stress-and-heart-health.
8. World Health Organization, "Diabetes,"
June 8, 2020, www.who.int/news-room/
fact-sheets/detail/diabetes; Centers for
Disease Control and Prevention, "Heart
Disease Facts," reviewed September 8, 2020,
www.cdc.gov/heartdisease/facts.htm.
Cal Cates is an educator, writer, and
speaker on topics ranging from massage
therapy in the hospital setting to end-
of-life care and massage therapy policy
and regulation. A founding director of the
Society for Oncology Massage from 2007
to 2014 and current executive director
and founder of Healwell, Cates works
within and beyond the massage therapy
community to elevate the level of practice
and integration of massage overall and in
health care specifically. Catesªalso isªthe co-
creator of the podcasts Massage Therapy
Without Borders and Interdisciplinary.
