Making a living as a massage therapist is an uphill battle. It is unrealistic, and unsafe, to attempt to bring in a full eight hours of paid work in a day. Spas, gyms, and wellness centers often expect therapists to see too many clients, which leads them to develop injuries. In private practice, the overhead means that most of the fees we charge (which clients complain are too high) are devoted to paying for rent, supplies, insurance, and taxes, leaving many of us struggling from month to month.
Trying to work anywhere in or near the healthcare system is nearly impossible. It is only through the generosity of donors that a handful of hospital and hospice jobs exist for massage therapists. I am one of the fortunate few who have managed to obtain one of those privately-funded jobs.
How did that happen? Over the course of several years I built a professional network and kept in touch with people who support the kind of work that I do. The first stepping stone I laid on this path was to volunteer at a hospital-based palliative care program seven years ago.
At the time I was looking to develop a referral base for private clients. I was starting a specialty practice in geriatric massage and reaching out to physicians who were involved in caring for my first client, an elderly woman suffering from advanced Parkinson’s Disease. One of those physicians just happened to be affiliated with a palliative care program that had a volunteer massage therapy program, and she invited me to participate.
Volunteering was not exactly what I had in mind; I was looking to get paid for my work. But I figured that I would gain valuable experience and training, and maybe some referrals would come from it, so I signed up. I stuck with it for about a year and a half, until it was financially impossible for me to continue.
During my time as a volunteer I did learn a great deal. I came into contact with some very sick patients who expressed a profound appreciation of my work. I massaged people who were in their last days and weeks of life, or who were undergoing painful cancer treatments, who received some measure of relief from my hands.
I also felt resentful at times. When the head physician told me she felt that “sometimes massage is the best thing we can offer our patients” I wanted to ask, “why then, if this is so valuable, is our work not compensated?”
Now, all these years later, I find myself in the enviable, yet conflicted, position of running a volunteer massage therapy program at a hospice. When I took the job I agreed, on the one hand, to perpetuate an unequal system whereby massage therapists are the only healthcare professionals who are asked to donate their time and talents. On the other hand, I committed myself to providing the best training and mentorship possible to my volunteers so that someday they would be prepared to step into a paid healthcare job, should one materialize down the road.
Right now I am knee deep in researching foundations that might wish to support my hospice massage program. Because massage is not reimbursable through Medicare or private insurance, we need private funding so that I can keep my job. However, I am looking at this challenge as an opportunity: if I am successful in seeking funding for our program, perhaps I will be able to obtain enough support not only to keep my job, but to create jobs for other hardworking massage therapists.
In the ideal scenario, massage therapy would be reimbursable by Medicare and insurance. That ideal scenario, of course, is impossible, given the fact that healthcare in the U.S. is on the brink of utter disaster. So for now, I will keep on with researching foundations and applying for funds, and working my hardest to provide a quality service for our patients and volunteers.
Yes, your are right. I know lots of massage training students at my school brings their guests at no cost, and trainee gets valuable training at the same time.
We would love to connect with you as we share a mission-serving the special population of those in later life stages. Please visit our site at http://www.compassionate-touch.org and drop me an email!
Also-please try the Massage Therapy Foundation
http://www.massagetherapyfoundation.org/
Your comments reflect the experience of many. As a leader in massage in eldercare and hospice, I’ve seen the doors open for paid positions over the last five years especially. I’ve posed the question about Medicare reimbursement on my blog and invite your comments. I wish you well in your endeavors and want to say thank you for your diligence in serving the hospice community. Here is a link to the blog post.
http://massagemag.com/massage-blog/stillness-motion/2010/02/19/medicare-reimbursment/
Be well,
Ann
There is much interest and education developing in the hospice industry around formal complementary therapy programming that recognizes the special role that massage and bodywork therapy plays in stress support and emotional nurturing. Interesting fact is that hospice programs are reimbursed in a way (via medicare) that puts the choice of hiring and utilizing therapists in the hands of the hospice program. A hospice is reimbursed x amount of money per day per patient for the hospice program to provide services, including medications, equipment, supplies, bereavement and volunteer support, inpatient respite stays, etc.. Reimbursement rates are low.. and hospice programs struggle to document and consistently get paid for the services they do provide under the medicare conditions of participation regulations. Justifying a prognosis of 6 months or less is often a challenge and requires much energy and time dedicated to keeping staff educated and accurate in hospice care provision. With that understood, a hospice with a high census could potentially decide to create hired positions for massage therapists, create guidelines and supervisory positions to oversee a formal program, have suppliers for products, etc… To initiate that takes much time and money. Time to develop guidelines and training. Money that is in competition with other program growth (like the volunteer program and the bereavement program, that do not bring in money from insurance either..but are mandated to be a part of a hospice program’s provision of services). .. not to mention the growing costs required of a hospice for advertising in order to get the census built up and sustained in order to grow the ‘extra’ services / programs that end of life care deserves for enhancing quality. Phew… exhausting just to write it.. and it is exhausting to live it everyday in healthcare. Massage and bodywork therapy needs to be a routine offering for non pharmacological symptom support. NEEDS to be, for so many reasons that Eva writes about here in this blog. Barriers are breaking down and hospice administrators are recognizing the value and want programs with consistent access to the use of therapy for priority cases. And ideally, we will need hired therapists with complementary therapy leadership who want to be that committed and paid for providing services, as well as strong volunteer based programs for those who want to give back without the pressures of documentation and workload.. and we need to teach hospice team members how to use comforting forms of touch in the work they do everyday. It is a process, and if there is a break into that vision at any point, it will allow for growth into the other areas – hired, volunteer, and teaching touch to staff. Willingness and sacrifice has to happen on all Team levels, including (perhaps, especially) administrative levels. There is sacrifice entering into this field, and it is important to understand in doing so, that the entire hospice team sacrifices as professional staff as well. There is no “I” in Team – as we hospice professionals say. And part of what makes hospice care so unique in our healthcare system is the way in which we all practice as an interdisciplinary team. We all have a shared experience. ..and opening up to a strong complementary therapy program that targets the effects of fear and grief.. is worth an entire hospice program, sacrificing for. Bringing it into the fold benefits everybody.