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32 m a s s a g e & b o d y wo r k j a n u a r y/ fe b r u a r y 2 0 2 1 Equity in Massage Therapy Taking Massage from Luxury to Accessible Health Care for All By Cal Cates best practices | MASSAGE THERAPY AS HEALTH CARE As health-care providers, one of the most important ways we can show up in this moment is to work toward ending inequity and racism in massage therapy, but this is a concept most of us have yet to fully grasp. Every white provider has played a part in holding up systems that perpetuate inequity (after all, massage therapy is a pretty white profession), and the time has come to set down our proud declarations of "color blindness" or claims that we "treat everyone the same." We must engage in unflinching self-examination, embrace the truth of unconscious bias, and move straight on through our self-indulgent fragility and defensiveness, so we can directly access the truth of how we got here. This is our work to do. Every single one of us. Humans see difference. All humans. That's how we're wired. Even kind humans who are trained and called to care for other humans. So, we will not untangle this centuries-old mess in one column in one magazine. We can, however, peek at a recent editorial published in the International Journal of Therapeutic Massage & Bodywork titled "Equity, Diversity, and Inclusion in the Massage Therapy Profession," where the authors offer some key observations and questions. For example, the authors posit that "[since George Floyd's murder] . . . people are beginning to wake up to the reality that Black and Brown people are treated differently in the United States." 1 Health-care disparities in the US are well documented and corroborated by the lived experience of pretty much every person of color in this country. The editorial's authors invite "the profession—from a fallacy. It suggests that a certain course of action is undesirable because it leads to an unwanted conclusion. It is based on a series of tenuously connected, unproven, and unsubstantiated premises. And, in this case, there is no consideration of our privilege as mostly white providers or the likelihood of desirable outcomes for others. Therapists say, "I don't want the insurance companies telling me what to do," or "If I take insurance, I'm going to spend my life on paperwork and get paid $30 per session." And the unintentionally classist claim that, "My whole practice will become workers' comp cases, and people who 'don't really get massage,' but who have been told they have to." These fears are bolstered by horror stories we have heard from providers in other disciplines who work within the insurance system, and they are not entirely unfounded but are also not well-researched. Additionally, they fail to account for the possibilities that lie in a future that includes researchers, to educators, practitioners, and associations—[to work to] improve the landscape." That's all of us, and the landscape is in need of much more than improvement. I'm talking brush fire, friends. The editorial's authors point to a variety of possible factors for disproportionate representation among consumers as well as providers, including white-centric media representation, economics, access, and education. We can't tackle all of those here, so let's look at one in particular: access. THE INSURANCE DISCUSSION Massage therapy can no longer exist solely as a "luxury," available to those with disposable income or who can find a program where massage therapists are serving "the underserved" by working for free. We have to get on board with insurance reimbursement—not just philosophically, but actually. The insurance "discussion" typically devolves quickly into a slippery slope. The slippery slope is a common default, but it's

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