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Ten years on: What does the future hold for massage therapy care?

While no one can know for sure what the future holds for the profession, forecasting based on the best available information – and a little intuition – can yield a look-see for what is to come. Forecasting can guide practitioners to fortify against risk, design their practices to remain relevant and identify new opportunities. Forecasting is essential for regulators, professional associations, training colleges and other stakeholders for resource allocation and planning for contingencies in addressing the needs of their members/students.

Here’s my speculation for the next ten years in the massage therapy profession in Canada.

Advent of health technology
The fields of bio-technology, robotics and artificial intelligence impact all aspects of our lives. While current massage devices may appear crude, advances in sensate machines that detect pressure progress. Robotics are incorporated in a variety of sophisticated applications like surgery and, linked with artificial intelligence, will foray into the bodywork and movement space.

Mechanized touch providing pressure and stretch to a stiff body can be applied daily cost-effectively and will increasingly be employed in rehabilitation and assisted movement. This won’t replace the personalized human touch provided by skilled practitioners but augment it. Watch for DIY (do-it-yourself) applications in bodywork and movement to expand.

Technology will be incorporated in patient safety, security and quality of outcomes. Virtual reality (VR) will expand the cognitive and sensory experience of massage applications. VR can enhance massage experience but may also modulate pain in the brain. People will adopt more sophisticated bio-sensors in all their activities, measuring heart rate, blood pressure, and stress response. I believe we’ll see increasingly sophisticated data generated on physiologic effects of massage therapy in real-time.

Personalized and convenient care
More and more providers offer convenient, on-demand massage services in a growing list of Canadian cities. Patrons use a phone app to arrange appointments at home or alternative locations, choose from a variety of healthcare services, and pay for and the rate their experience. Technology verifies patron identity for the security of the practitioner. I expect technological improvements to lighten and strengthen portable massage tables, and make hydro/electro-therapies more portable to augment client experience.

Antithetical to the always-on, technology-saturated social and work environments we occupy, expect the values of embodiment and mindfulness to drive some massage experience. In addition to virtual reality integration, I expect massage practitioners to work in tandem with practitioners of psychotherapy (perhaps incorporating legalized psychedelic drugs) to address deep-seated trauma, promote higher consciousness and a sense of embodiment.

More populations served
Massage therapy already serves a number of market sectors: rehabilitation, spa/wellness, holistic/integrated care, palliative care, athletics and work performance on-site. Adopting a bio-psycho-social model of care, greater research literacy and capacity, and (if) the profession can galvanize on government/insurer/media advocacy, we may see massage therapists incorporated in mental health, public health, home care and intensive rehabilitation programs. Massage therapy may prove especially helpful in socially marginalized populations – the poor, indigenous, victims of domestic violence, refugees, the elderly and disabled.

Government funding and efficiencies may drive individual disciplines to work collaboratively together – for example in home care, a physiotherapist or nurse, massage therapist, personal support worker and social worker. Massage therapy will continue to be valued as an antithesis to the felt effects of aggression, violence, workplace stress, sensory overload and trauma.

Tighter structure in working with third-party payers
Insurers want accountability in claims. They want customers to use benefits judiciously and expect health practitioners to work efficiently within financial constraints and demonstrate efficacy in outcomes. Increasingly insurers may only fund services that are evidence-backed. Insurers have the ear of employers regarding cost-savings and efficiency in purchasing employee benefit plans. We may see massage therapy services positioned in add-on/higher premium insurance products, potentially reducing the number of employers signing on.

A shift to an employee spending account with a suite of options puts the user in charge of spending, hence greater scrutiny and accountability by the user for how benefit dollars are invested. Insurers may look to WSIB and auto-insurance service fee schedules and apply downward pressure on practitioner compensation for all their insurance products.

Watch for insurers to incorporate user reviews to determine preferred providers to work with, insurer control over spending and citizens actively engaged in sourcing their best health and wellness options.

Corporations and capitalization
The wellness industry is valued at $4.2 trillion globally. Massage therapy will continue to be popular, and corporations will continue to capitalize on market demand. Watch for growth in corporate employers of practitioners, high profile locations in commercial real estate hubs, strong branding and messaging, and vigorous recruiting of practitioners. Also watch for branded methods/customized protocols designed and promoted towards marketplace pain-points – similar to the many types of yoga and fitness products now available.

Wildcards
A 2018 report from the Associated Bodywork & Massage Professionals (ABMP) reports a drop of 15% in persons graduating from massage therapy training programs in the USA since 2016, and a reduction in the number of training programs. This follows at 22% drop in the 2014 report. What can we expect for Canadian training programs and the number of graduates?

The CMTCA reported in March 2019 only Ontario, New Brunswick and Newfoundland/Labrador have signed agreements for school accreditation. The funding model appears in contention for the remaining provinces. Accreditation is sought, in part, to ensure public confidence in the quality of massage therapy education and its graduates.

Centralized government – the health care system in Ontario has reduced management levels to become more centralized in decision-making and administration. Massage therapy advocates have long knocked at the door for inclusion in the health care system…we will see what happens.

Media are increasingly critical of whether health professions should be allowed to maintain self-regulation. It remains to be seen if massage therapists lose the amenable working relationship with a regulatory body and face generalized regulations under a centralized health authority.

Immigration, inflation and economic health – Refugees fleeing oppression and unemployed college/university graduates not finding work in their field may look to rapid-entry fields for employment and may be willing to work for less compensation, affecting supply and cost-constraints on MT services in general. Economic impact on worker salaries, discretionary income and employee benefit plans all affect the market for massage therapy care.

What do you see happening in the next 10 years of the profession?

Donald Quinn Dillon, RMT is a practitioner, lecturer and practice coach. He co-produces the podcast On The Table.