“No problem can be solved from the same level of consciousness that created it.” This quote, sometimes attributed to Albert Einstein, perfectly exposes the truth that underlies our frustration as we look at how and where massage therapists fit into health care.
When I say massage therapists are health-care providers, I’m afraid we may already be starting at a deficit. If I say, “You’re a hippo,” to 300,000 people and invite them to draw a hippo, there’s a solid chance most of those people will create similar images. Even being amateur artists at best, we’d come up with a lot of similar features. If I say to those same people, “You’re a health-care provider,” no such similarity in perspective will be enjoyed. I’d get responses along an entire spectrum, from downright aversion to a sense of recognition and pride.
This is hard. Even if we weren’t trying to hop onto a moving train, it would be hard, but this train is very much moving even though its destination is unclear. If we’re being honest, the “system” we call health care has always had major challenges in terms of access, bureaucracy, affordability, efficiency, and more. Finding a means of integration into a system that is poorly constructed is no easy task.
As a starting place, let’s agree to set down our stories of what it has “always meant” to be in health care. When I suggest it’s time to consider ourselves health-care providers, it’s not an invitation to the lamest party ever. It’s an invitation to blow up this joint, so to speak. Health care, as it currently exists, doesn’t work. It never has, and that’s no single person’s fault. The people who have been called health-care providers for decades without question will not defend this “system.” It has depleted them and prevented them from accessing and practicing their true passion. It’s not working for providers, and it’s not working for patients.
This is the perfect time to build something new. Something with less hierarchy, less gatekeeping, more equity, and more humanity. Maybe it’s a thing we don’t even insult by calling it a “system.” I’m talking about a “collaborative.” A community of humans who work together, mobilizing the best of technology, finance, communication, access, and humanity to deliver meaningful outcomes at lower costs. Better lives. Less pain. More health.
Massage therapists can fit perfectly into the emerging paradigm, nudged by both COVID-19 and forces that were already in motion. Community-based, collaborative care is the future we will be working in. This is the future of health care, even if massage therapists do nothing. So, let’s get involved.
It’s challenging to be asked to move in the direction of a thing that has not yet formed or even been fully imagined. Or is it? Isn’t that what we do every time a person gets on our table? Massage therapists are famous for relying on intuition. We say things like, “I’m not sure why I spent extra time there. It just felt like it would be useful.” We live and work in this space of watching creation unfold before us. We lead and follow simultaneously. We trust our hands. Why should this be any different? It’s possible we’re even better at what’s needed here than any of our fellow collaborators. We add value to this equation of creation.
This new way of providing care will make use of per diem reimbursement structures, Medicaid waivers, bundled payments,1 and other opportunities yet to be imagined. These are opportunities that will magnify the imperative for us to become integrated providers. Collaborating with other providers of care will augment the ability of massage therapists to improve outcomes. It will also mean that individual providers, in many cases, will be saved from having to personally “take” insurance.
Participating in and being at the table as these new models are created requires that we up our game. We have to learn about and understand these models. We need to use our personal experience as health-care consumers and our passion as providers to support creative new avenues to bring our value to real people.
As we keep talking, let’s also keep breathing deeply. If you love the handful (or armload) of clients you see each week, and they can afford your rates and will continue to benefit from your care, what I am proposing here will not endanger your ability to continue to do that. The ability for patients to access care through insurance mechanisms will never require providers to engage with that system if they’d prefer to continue to work outside of that system. That said, these collaborations and partnerships and previously unexplored ideas that challenge the status quo will benefit all of us—not only as practitioners but also as people who will, ourselves, need health care and as people who love people who will need it too. We can continue to see our clients as we have been while we open our minds to a future that’s bigger than any of our individual practices.

Note

1. Terry Shih, Lena M. Chen, and Brahmajee K. Nallamothu, “Will Bundled Payments Change Health Care? Examining the Evidence Thus Far in Cardiovascular Care,” Circulation 131, no. 24 (June 16, 2015): 2,155–58, https://doi.org/10.1161/CIRCULATIONAHA.114.010393; NEJM Catalyst Staff, “What Are Bundled Payments?,” NEJM Catalyst (February 28, 2018), https://catalyst.nejm.org/doi/full/10.1056/CAT.18.0247.