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There’s an ad for that

The drive to ramp up political support for enhanced massage therapy regulations marches on, and, in still unregulated jurisdictions, proponents are taking their case public.

“This is an important issue whose time has come in our profession,” says Sheila Molloy, executive director of the Winnipeg-based Massage Therapy Association of Manitoba (MTAM).

Describing the movement in her province towards a more regulatory environment as more like rubbing sticks together over time rather than an instant spark, Molloy emphasizes the MTAM has been advocating pro-regulations for decades.

“There have been presentations to the province for 30 years,” she says. “It was in 2004, however, when the province started public consultation on the idea of a Regulated Health Professions Act. In 2009, it was approved, and in 2011 part of the Act was proclaimed that enabled applicants for regulation. In 2012, after consulting with members, the MTAM applied.”

To bolster general awareness on the matter, the MTAM, which represents about 85 per cent of Manitoba’s professional massage therapists, has allocated a budget for a vigorous communications outreach.

“Our campaign over 2012 and 2013 was focused on a full newspaper feature during Massage Therapy Week,” Molloy explains. That initiative has expanded to include articles published in rural newspapers, TV commercials, magazines, advertising on digital signs in health clinics, and displays on bus panels. Brochures and decals are being handed out to members and at public events where MTAM has a presence, such as the Challenge for Life fundraiser for CancerCare Manitoba and The Manitoba Marathon.

“In the coming months, we will re-ignite the public awareness side of our quest, specifically during Massage Therapy Awareness Week (Oct. 20 to 26, 2014),” notes Molloy. The Association’s goal: to join the ranks of other provinces which have opted for regulations, currently Newfoundland and Labrador, New Brunswick, Ontario and British Columbia.

Molloy, whose background is in marketing as a consultant to the technology, manufacturing and not-for-profit sectors, points out that the MTAM’s message will be spread through a stream of media releases, newspaper supplements and TV commercials, as well as via social media portals Facebook and Twitter.

“These will also be tied to a number of changes to our website,” she says. Those changes will include a refresh on the association’s landing page to make navigating the site easier, an improved “Find a Massage Therapist” referral link, and distinct sections for members, the public and future RMTs, highlighting advancements in research and updates on the regulation quest.

“These changes will help us better determine if we are reaching people,” she adds.

At the time of writing, the MTAM’s application process, including stakeholder feedback, is now in the hands of the Health Professions Advisory Council (HPAC). The council will make its recommendation to the Health Minister who has the option to accept them. To date, the Manitoba government, led by NDP Premier Greg Selinger, has not expressed an opinion on the subject of regulating the province’s massage therapists – but it is anticipated that a decision may be forthcoming soon.

“Certainly, the work we have done over the last few years has built a base of understanding and awareness and, overall, our feedback is that people understand why it is beneficial to the public,” says Molloy. “However, making regulation for any profession top of mind in the public takes a lot of time, money and patience. It comes in peaks and valleys. Momentum is a product of awareness, understanding, relevance and enthusiasm. With regulation, so much time may go by between key actions or meaningful moments that keeping your mission in the public conversation is a challenge.”

Winnipeg RMT, Susan Kos-Whicher, has her own perspective on how regulations could forever change her practice and the overall delivery of health-care services in the province.

“Manitobans are increasingly using massage therapy regularly for their health care,” she says. “Other health-care providers such as physiotherapists, chiropractors and athletic therapists are working with massage therapists. We have the ability to take the pressure off of our over-extended emergency rooms… it would simply and soundly offer Manitobans another cost-efficient way of seeking health care.”

In Manitoba, people can wait weeks or months to access the service of other medical care providers. Longer waits, with poor immediate first aid care results in longer healing times, poorer resolution, thus further taxing the province’s health-care system.

Given the multi-faceted communications campaign being waged by the MTAM, the public perception of massage therapy is becoming ever more positive. Third-party insurance usage is on the upswing. People are using their health-care spending accounts for massage therapy more often.

“Therefore, I would say that the public is becoming more confident in ‘where to and how to’ find a legitimate therapist, people are talking,” asserts Kos-Whicher, a Winnipegger who trained in Toronto and started her practice in 1988 before deciding to move back to Winnipeg. She admits she was uncomfortable in the beginning to say she was a massage therapist.

“Public perception was different for Manitobans back then. The regulated environment in Ontario made a palpable difference. At that time, there were only three of us in the province of Manitoba that had the 2,200-hour education that is now the current standard. Today, there are over 1,000.”

“On my return to Winnipeg in 1988, I phoned the city to acquire a business licence. When I explained I was a massage therapist there was one answer. I would have to pay $3,000 for a business licence. When I questioned how that could be, the answer was, ‘to operate a massage parlour, it is $3,000.’ There was no other category at that time for ‘massage.’ There were several columns in the phone book for escort services under the heading of massage, but nothing in the therapeutic health-care realm. Needless to say I operated my business without a licence for several years. Eventually, the city of Winnipeg managed to position massage in three categories: massage parlours (adult entertainment), massagists (less than 2,200 hours of training), and massage therapists (more than 2,200 hours of training). It was confusing for everyone to have these categories, and it didn’t include the rural communities.”

Do her patients really even care about regulations? “Yes, they do,” retorts Kos-Whicher, who is also the current president of the MTAM. “Regulation is important to them for safety and affordability. While many think we are already regulated because we are in the public eye and more sought out than ever before, they don’t experience the same advantages that they might with other health-care providers. For example, the disadvantage of having GST added to their invoice. Patients come in asking me if they can claim massage therapy as a health-care expense. Answer: ‘No, not until we are regulated.’ The province of origin must recognize the profession in order for this to happen. It’s a grave disadvantage in my view, especially to our senior citizens and individuals with ongoing pain issues. This change will begin when there are five regulated provinces. We could be next.”

Meanwhile, next door
Saskatchewan MTs are also in hot pursuit of that goal with their Manitoba colleagues.

The Massage Therapists Association of Manitoba and the Massage Therapists Association of Saskatchewan engaged in a series of public awareness campaigns in recent years aimed at improving the public perception of massage therapy as a health-care service, as well as reinforcing their efforts to push for massage therapy regulation in their respective provinces.

“Saskatchewan has been working very hard for many years to seek regulation and we rely fairly heavily on the CMTA (Canadian Massage Therapist Alliance),” says Lori Green, executive director of the Massage Therapy Association of Saskatchewan (MTAS), from her Saskatoon office.

The CMTA has been a vital resource for associations in non-regulated provinces that may not necessarily have the expertise or experience to move forward with the regulatory agenda. “However, the CMTA only comes in to lend help when the provincial association asks for it, so as not to step on anybody’s toes,” Green points out. CMTA is an alliance of massage therapy professional associations from various provinces, including the MTAS.

Pointing out that the momentum to bring in a regulatory environment to the profession was set in motion 15 years ago, Green says the past five years have been particularly active.

“Though we continue to consult with the Saskatchewan government, and those talks are going quite well, there are more serious cases of professional and sexual misconduct being dealt with through our complaints and discipline committee and through the Court of Queen’s Bench. Our unregulated association can remove an offending member, however we cannot publicly publish their name. The removed member is then free to join another massage therapy association and continue practicing.”

To counter what some refer to as the “seamy” side of massage, the MTAS’s media blitz to raise public awareness of the profession is accelerating. But it’s on a frugal budget, according to Green. The campaign has largely consisted of billboard advertisements and marketing the MTAS logo. The key message: if you don’t see a member of the MTAS, you don’t know what you’re getting.

“We believe we’ve done a pretty good job of getting the word out,” stresses Green.

As part of its legislation marketing strategy, the MTAS is planning to participate in a series of hour-long radio shows later this year on talk radio stations in an educational program called “Talk to the Experts.” In addition to interviews with MT practitioners on topics of anatomy and health, the program’s Q&A component has a massage therapist fielding questions, explaining what a registered massage therapist does, why people should see a massage therapist, and the kinds of medical conditions MTs can help alleviate.

“We tell people why we are different from the nice lady down the road who gives you a nice back massage,” says Green. “This affords us an opportunity to dispel misconceptions about the profession. It’s a learning curve for many people.”

In his Regina practice, Garret Woynarski often hears about the public’s confusion over massage therapy. “A lot of patients find it hard to believe that we are not regulated already, especially when a medical doctor refers them to me. I receive weekly referrals from dentists and dental surgeons for TMJ (problems with the jaw, jaw joint, and surrounding facial muscles that control chewing and moving the jaw). The general public also has elevated respect for RMTs when their treatments are part of a rehabilitation program from a workplace or motor vehicle accident.”

 Running his full-time massage therapy practice since 2001 after his graduation from the Western College of Remedial Massage Therapies in Regina, Woynarski has seen what he calls major strides made in the legislative process toward a regulatory milieu in Saskatchewan.

“The MTAS has a specific board of directors chair position being dedicated to our legislation goal,” says Woynarski, who is also president of the MTAS. “Regulation of massage therapy in Saskatchewan will not only benefit the people of Saskatchewan, it will also support the profession on a national level.”

The MTAS also has a dedicated research board of directors position and is allocating funds for innovative research projects. “In recent years, the amount of published research-based material has significantly increased which validates the effectiveness of massage therapy,” lauds Woynarski.

Asked what he believes Saskatchewan massage therapists can do in their own practices to propel the movement for regulations and to enhance public perceptions of the profession, Woynarski states, “We have had RMTs get petitions signed by their patients supporting regulation. A recent poll of the over 800 RMTs that belong to MTAS produced a result of over 80 per cent in favour of regulation.”

“Members can speak to their local MLAs (members of the legislative assembly) and government officials. RMTs can also help spread positive messages through social media and local volunteer opportunities. In addition, RMTs can establish positive long-term working and referral relationships with other health-care providers. RMTs that are active in their community will help to further boost the public’s perception of massage therapists.”

The future of regulated health professions is all about developing safer, more effective and cost-efficient health care for all Canadians. In that context, Woynarski is optimistic that regulations will one day become a reality in the massage therapy profession across Canada.

“I predict only positive outcomes for my practice and the profession of massage therapy at the provincial and national levels. I don’t foresee any negative issues.”

Jack Kohane is a Toronto-based freelance journalist writing for several national health-care magazines and the National Post.

Related articles in the Regional Focus series:

Western Canada (Spring 2014)
The regulation debate

Ontario (Summer 2014)
Onward and upward

Eastern Canada (Winter 2015)
To have and have not