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Practice Building: Successful team- Profile: One-on-one interview with Ania Regulation:: Record-keeping best

based practice p.18 Kania-Richmond p.20 practices p.22

Fall 2015

practice Massage therapists take
patient care to the next level

No part of the editorial content of this publication may be reprinted without the publisher’s written permission. Between Richmond on Shelf life hospital-based by Jules Torti massage therapy in Canada 26 by Megan Mueller RMT Tech Talk Electronic technologies don’t 22 define business Set the record policies 7 straight by Jessica Foster Compliance and best practices for record keeping by Andrea Collins ON THE COVER: Annette Broderick-Co- lombo. Sinai Hospital in Toronto ISSN 1499-8084. Occasionally. All rights reserved. Simcoe.. July. Annex Publishing & Printing FEATURES DEPARTMENTS 14 04 From the editor COVER: Out of the comfort Hospital zone practice Massage 06 therapists take Touch Points patient care to the News and events next level by Mari-Len De 06 Guzman Human Factor The lighter side of things 18 You’re hired Finding success in team-based work COLUMNS setting 10 by Dr. please contact our circulation department. ON N3Y 4N5. If you prefer not to receive this information. David Practice Points Leprich Wanted: Practice software 20 by Don Quinn Dillon 14 A way forward 12 Interview with Few and Far Ania Kania. No liability is assumed for errors or omissions. massage 12 20 therapist in the rehab and wellness clinic at Mt.Fall 2015 massagetherapycanada. Such approval does not imply any endorsement of the products or services advertised. November. Massage Therapy Canada will mail information on behalf of industry-related groups whose products and services we believe may be of interest to you. ©2015. massagetherapycanada. Publisher reserves the right to refuse advertising that does not meet the standards of the Fall 2015 Massage Therapy Canada 3 . All advertising is subject to the publisher’s approval. Massage Therapy is published four times a year: January. Printed in Canada. 105 Donly Drive South. April. Opinions expressed in this magazine are not necessarily those of the editor or the publisher. Published and printed by Annex Publishing & Printing Inc.

and position massage therapy as a relevant partner in (includes GST - patient care. in hospital settings MEDIA DESIGNER are finding mutual benefits from the arrangement. I was reminded of some- PUBLISHER thing Albert Einstein once said: “A ship is always safe at the shore Christine Livingstone – but that is not what it is built for. (888) 599-2228 ext. integration is through evidence and by engaging them in a conversa. Brooke Shaw bshaw@annexweb. Confidence can go a long way when combined with passion and RETURN UNDELIVERABLE CANADIAN ADDRESSES TO conviction. Editor @MTCanadaMag 4 Massage Therapy Canada Fall 2015 massagetherapycanada. in one form or another. “There is no better advocate for the one common theme emerged. email: jhrycak@annexweb. Those (519) 429-5183 hospitals that have integrated massage therapy. BOX 530. SIMCOE.95 get the evidence in the hands of hospital cost-effectiveness of massage therapy for certain conditions. ON N3Y 4N5 PUBLICATION MAIL AGREEMENT talk about massage therapy and how it #40065710 can fit in the patient care paradigm.” clivingstone@annexweb. SUBSCRIPTION RATES The profession needs to make a concerted and organized effort to Canada – 1 Year $29. profession than the professionals 105 Donly Drive South. 219 and those RMTs who have of the effort needs to come from the profession itself. Tel: (866) 790-6070 ext. doctors and – 2 Years $49. take their practice and were not afraid themselves. Box The RMT forerunners for hospital-based massage therapy have left the door only slightly open for others in the profession to walk in. Talk to the doctors and nurses in your community and let them know what you do and how you can help patients. The other half Martin McAnulty mmcanulty@annexweb.95 – 3 Years $64. 239 been working in hospitals in Canada for at least three decades now – but it had been a slow progress. ON N3Y 4N5 tion about massage therapy and its health-care benefits.95 .com (905) 726-4659 In writing our cover story for this issue. #867172652RT0001) For USA and Foreign rates please The individual therapists have to be engaged in their health-care contact Cheryl Nowe community as well. There is no better P. MARI-LEN DE GUZMAN. about what they do. ACCOUNT CO-ORDINATOR Shannon Drumm There is increasing evidence about the health-care benefits and sdrumm@annexweb. Who knows where that conversation might take you.O. and the stakeholders listened. These RMTs advocated for themselves and their beliefs CIRCULATION DEPT. 210 Fax: (877) 624-1940 The only way for hospitals to fully embrace massage therapy Mail: P. They all MAILING ADDRESS had a clear vision of where they want to Massage therapy in hospitals is not a new thing – as RMTs have (519) 429-5173 (888) 599-2228 ext.O. From talking to massage therapists DIRECTOR OF SOUL/COO Sue Fredericks who are thriving in hospital-based care. or are working.FROM THE EDITOR Fall 2015 Volume 14 Issue 3 Out of the comfort zone EDITOR Mari-Len De Guzman forever. Simcoe. ON N3Y 4N5 advocate for the profession than the professionals themselves.” to step outside of their comfort zone to Hospital administrators need to get acquainted with the evidence that show the many benefits of massage therapy to patient health and GROUP PUBLISHER the bottom-line – but that is only half of the equation. Box 530. but CIRCULATION when nobody else is walking through that door it can’t remain open e-mail: jhrycak@annexweb.

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ers in improving quality of with the knowledge that produce a list of sites or posts that promotion or trend. own hashtag to draw people to a among non-doctor provid. “Anal. TRENDING Hashtag # neurology) or other provid. president. “Now. et al).” said searchers looked at the Registered Massage Thera- cost-effectiveness of im. We The # symbol – called a hashtag – is RMTs can use the hashtag to find found.e. In this . Illustration: Brian Fray life measures. keyword or topic (i. ents aged 18 to 85 and clin. fective treatment that has or word. rheumatology. “However. family/general. will specific discussion. life. to their daily practice. we can do all this #massagetherapy) in a search. “Registered massage ther- ysis of Provider Specialties apists have known for dec- in the Treatment of Patients ades that quality of life is- with Clinically Diagnosed sues were improved or Back and Joint Problems greatly improved. when we reasonably believe Twitter and other social media sites. highest standards in North massage therapist). In the study titled. embrace research and link it ysis suggests that osteo. inter. Today’s RMTs “Cost-effectiveness anal. family/general. health-care professionals searchers collected data and have been a part of the from specific treatment province’s Medical Services providers: doctors (internal Plan since its inception in medicine.C. only massage it will improve our patients’ Typing this symbol preceding a Practitioners could also create their therapy was cost-effective health. seph Lattanzio.546 respond. RMTs rely on their exten- ers (chiropractor. in- pathic. a cause. acupuncturist.” #massagetherapy #painrelief #massage #migraine #healthcare 6 Massage Therapy Canada Fall 2015 massagetherapycanada. $ $ (measured by the sage therapy is a EuroQol-5D) $ $ $ $ $ cost-effective were compared $ therapy that di.” said Lattanzio. aspect of health and pain- thopedics. Committed to every osteopathic medicine. or. provide treatment only used to mark keywords or topics on specific topics that people are The study further noted. physical sive training (among the therapist. re. tients with back and joint BC’s RMTs are primary pain.TOUCH POINTS HUMAN FACTOR BENEFITS Study shows massage therapy is cost-effective A recent study Self-reported has shown what massage $ measures of phys- ical and mental therapists have health and gen- often thought $ eral quality of life $ $ was true: mas. discussing in social media. Jo- proving outcomes in pa.” RMTs also provide cost-ef. to anecdotal evidence.” re. free functioning of the body.” the study ests of their patients. cluding providing evi- nal medicine doctor s. cost-effective than other specialties in improving physical function to back “RMTs are trained to listen to their patients and to always act in the best inter- DEFINITION APPLICATION pain patients. with average total rectly improves quality of costs of treatment across life measures. been shown to directly and TRY IT ically diagnosed with back/ positively impact quality of Search for these hashtags on Twitter and see what results you get: joint pain were examined. America). 1968. dence-based education and chiropractors and massage remedial exercises to their t h e r a p i s t s we r e m o r e patients. according (Wilson FA. medical providers. are discussing that particular topic A total of 16. pists of B.

conducted tests on 65 hy. this $14.C.000 since he started his were not receiving any hy. wrist resulted in drops in blood pressure among study participants. father who is Susan Samueli Center for facing inevitable blindness is Integrative Medicine have looking to make a career shift to found. risk of stroke and heart UCI researchers found using acupuncture on both sides of the inner to raise the money he needs for disease. Photo: Chris Nugent / UCI To help Renny pay for massage practice that employs the electroacupuncture de. Irvine cardiolo. He people control their blood recently started a page on pressure and lessen their GoFundMe. this area.” Also in this group. line for treating a disease improvements persisted for and that the technique Originally from Nova Scotia. a University of below each knee. this ancient Chinese prac- Patrick Renny from Vancouver. TOUCH POINTS CAREERS MODALITY B. the subjects enzyme produced in the and myocardial infarction in of the money he raises with the were treated with electroac. stimulation – at different cent). In addition. provided a beneficial guide. puncture at other acupoints for the blind. a genetic mild to moderate hyperten- eye condition among men that sion. a fundraising website.” Lon- Foundation Fighting Blindness. He is “This clinical study is the looking to raise $30. Renny was diag. I have been accepted California. pressure and glucose levels. His last job was at an colleagues Dr. read and become a registered the Samueli Center. ghurst said. pressure changes were pay for tuition.C.C. rigor to validate an ancient to 8 mmHg for systolic cohort were relatively small According to an article in The Eastern therapy. massagetherapycanada.000 to help culmination of more than a receiving electroacupunc. could be especially useful in Renny has worked in the hospital. These were clinically meaningful gally blind in February. along the forearm and lower to go to school while I can still gist and former director of ble drop in blood pressure leg. we feel we blood pressure (the high – mostly in the four to 13- Huffington Post. peripheral through his goal of $30. decade of bench research in ture on both sides of the found in the group of 32 plies. Stephanie Tjen-A-Looi tration levels of norepi. kidneys that helps control hypertensive patients.” said Dr. massage therapy and has started Their work is the first to a crowdsourcing campaign to scientifically confirm that help pay for massage school. heart failure said he plans to share 10 per cent two Fall 2015 Massage Therapy Canada 7 . man Hypertensive patients benefit from wants to acupuncture: study become RMT Patients with hyperten- before going sion treated with acupunc- ture experienced drops in blind their blood pressure that lasted up to a month and a half.S. and it indicates that causes retinal degeneration that regular use could help eventually leads to blindness. lates electrolytes. make a donation low-intensity electr ical creased aldosterone (22 per at UCI’s Institute for Clin- to his GoFundMe page. has choroideremia. John inner wrists and slightly who received electroacu- “After doing research on jobs Longhurst. have integrated Chinese number) and 4 mmHg for mmHg range – the re- nosed with choroideremia when and Western medicine and diastolic blood pressure searchers noted that they he was 13 years. vessels and increases blood therapy may decrease the GoFundMe page – almost halfway per tension medication. He Separated randomly into and renin (67 per cent). that affects millions in the a month and a half. a hormone that regu. tice is beneficial in treating B. ture decreases both peak He was laid off again in February. and average systolic blood Renny has raised more than pertensive patients who which constricts blood pressure over 24 hours.Mari-Len De Guzman acupoints on the body.000.. Participants were treated therapy school. upuncture – a form of the blood pressure. until he Longhurst and his UCI team identified significant sion in patients over 60. books and sup. nephrine (41 per cent). Study results appear In one g roup of 33 No consequential blood in Medical Acupuncture. was laid off. “By rates in 70 percent of par. searchers found a noticea. U. He became le. the re. Peng Li and declines in blood concen. massage therapy school. the treating systolic hyperten- ity industry since 1999. ence. researchers with the A 40-year-old B. ical & Translational Sci- .” Renny using Western scientific ticipants – an average of 6 sure reductions in the first wrote on his GoFundMe page. “Because electroacupunc- IT company in North Vancouver. an artery disease. risk for stroke. (the low number). Although the blood pres- massage therapist (RMT).

which may explain the stiffness. it doesn’t mean you thousands of Canadians unknown. The condition. as this 137. condition suffer from unre- causes fluctuating symp. a pain sort of fender-benders here.” driving safety between doc- 400. higher.” Redelmeier the greatest danger. the study looked at improve sleep.566 serious motor fective. reducing the individuals’ risk Canada’s 2013 fibromyalgia scientist at the Institute for hicle crash. insomnia and joint year. emphasize that hundreds of ment. research suggests. “Our challenge now is to of symptoms. a senior consequence of a motor ve. compared with two per pairment in some people.000 per year among the the researchers suggest higher risk of traffic acci- There is no known cure. even agnosis.” “Lots of studies have ex. patients didn’t necessarily ogy found that individuals cause the accidents – the with fibromyalgia had more analysis did not look at fault than twice the risk of being – and there was no way of in a serious automobile ac.TOUCH POINTS RESEARCH Drivers with fibromyalgia more likely to be in serious traffic crashes: study Drivers who have been vehicle crashes during the diagnosed with fibromyalgia year prior to their diagnosis. amined fibromyalgia as a a significant difference in Calgary who co-authored Donald Redelmeier. that was set up by somebody doesn’t return these people inviting trouble. “It you are driving. would merit reinforcement: stressed.” “We’re not looking at the else.000 Canadians. per . dents. but because freshing sleep and poor toms. volved in 738 traffic colli- nosis. who was but symptoms can be treated “And it was particularly inforcing messages about not involved in the study. doctors should consider re. the idea of testing whether it could be effective for mitigat. can’t drive a car. So that medical care the study “groundbreaking (ICES) in Toronto. research” that will lead to Fibromyalgia is a syn. sions.” to the absolute population Dr. linked to subsequent onset cated” fibromyalgia care – always wear a seatbelt. needed conversations about drome that affects at least lying medical conditions izing – roadway hazards. algia is about five crashes drive guidelines.000 individuals per it can cause functional im. low the speed limit. fatigue.Sheryl Ubelacker for 1. “If you’ve got fibromyal. harm.” Redelmeier said. which The study determined the such as epilepsy and narco.631 Ontario adults with and pain control – had a said. stiffness and hospital emergency room. but the that could contribute to a Fibromyalg ia is not tors and patients with fibro- numbers may be much future motor vehicle crash. absolutely do not mitigate their risk. called Clinical Evaluative Sciences first to our knowledge with crash. physi. might be one of these under.” gia. lepsy. such as muscle pain. overall driving population. In the year risk of being involved in following a fibromyalgia di- motor vehicle crashes. he added. those who were standard safety suggestions safely to work every day. fol. daytime concentration. depression distractions. the group was in- years after their initial diag. A study in the July issue of Redelmeier said these the Journal of Rheumatol. But this is the of a serious motor vehicle treatment guidelines. 2006 and March 31. That’s just The Canadian Press 8 Massage Therapy Canada Fall 2015 massagetherapycanada. appear to have an elevated the study found. ing – but not totally normal. 1. including better rest. But the with fibromyalgia drive trauma caused by a motor However. myalgia. but in some cases. myalgia. fibromyalgia care could help 1. be using a cellphone when .” said Pereira. norm. “But we must equally changes and stress manage. “Some patients with this disrupts nerve function. determining whether symp- cident that sent them to a toms like pain. 2012. lifestyle high if the patient also had a road safety. with medications.” The patients accounted “We found that it was ef. signal proactively identify those Using hospital and other cal activity and treatment to your turns and minimize patients for whom there is records. included in fitness-to.” among medical conditions. but it seemed to make specialist at the University of said principal researcher Dr. fatigue might make it more compared with the driving difficult to “avoid a crash population as a whole. study also showed dedicated fibromyalgia between April somewhat reduced risk of “And if you’ve got fibro. The exact cause is dition such as depression. co-existing psychiatric con. John Pereira. risk for drivers with fibromy.” he vehicle accident has been receiving ongoing or “dedi.


techniques applied and out- allow the program to transpose graphical symbols into the comes. prepopu- lated choices takes longer and lags in effi- ciency compared to hand-written short- hand notes. It would be impossible five years hence to save a great deal of time in recording a session. this method confuses which checked comprehensive written notes. reproduce or even describe the treatment of that day with- Treatments that are not sequenced. feature should focus stretching are also checked. thighs and legs are checked. checked. speaker and mentor. Fancy graphics that don’t transpose pre/post intervention information well. range-of-motion. You can contact draw a logical conclusion – a professional opinion – based him at MassageTherapistPractice. this palpation. This would of intervention. A graphics interface should demonstrate pre. with loose asso. In this article I provide “top 12” features I’d gladly pay for. the massage therapist must still DON QUINN DILLON is a practitioner. then neck. Prepopulated choices are modality/methodology-fo. massage therapy and modalities. Rather than listing these.” on the Massage Therapy Canada blog. muscle test.and post-findings. objective observations and 10 Massage Therapy Canada Fall 2015 massagetherapycanada. numeric pain scale. There are a myriad of proprietary methods and then hydrotherapy. shoulders. method is not descriptive and without a sequential account pain indices like Oswestry or Vernon-Mior). For a perspective from some of the software . but there are some features I’m still waiting to be integrated. see my article. mobilization. For example. However. However. Diagnosis in many provinces is a tario website) create efficiency through checkbox options controlled act and a gatekeeper health discipline privilege/ Photo: Fotolia responsibility.COLUMN PRACTICE POINTS Wanted: Practice software Features I would like to see for my massage therapy practice BY DON QUINN DILLON I haven’t made the leap to practice soft- ware yet. out a better correlation between these variables. if trigger points. Missing the mark Featureless text boxes. body areas. tension. “Charting in the Electronic Age. ciation. and then reduced tension. cused). Although text boxes offer great flexibility for a variety of entries idiosyncratic to the practitioner. neurologic/orthopedic tests. and I’m quite motivated to get there. Anatomical graphics are on case history taken. There are many impressive fea- tures available from over a dozen ven- dors. Which symp- are commonly understood and applied by RMTs (exam. instead on prepopulating observations and outcomes that reduced stress and reduced pain are checked. toms go with which body areas that go with which tech- ples: postural assessment. niques and then with which outcomes? While efficient. (professional opinion). preceded by software conventions I’d rather see withdrawn. or for symptoms. typing notes without common. Some treatment templates (including the sample Missed opportunity to draw a logical conclusion available from the College of Massage Therapists of On. but simply tagging findings without showing how findings change post-intervention have little pragmatic application. tenderness and temperature/inflammation are cused (as opposed to observation and outcomes fo. options go with which.

Help me deepen the relationship with my this feature. Have you read Don Dillon’s piece about breaking down ill igate the risk of doing harm. Analytical. they a year. with op- Adaptive. multi-disciplinary. rehab. Ensure the treatment record can be stored sep- Meaningful. Provide me with cutting edge tutorials to DASH. precautions and preclusions (yellow and red flags) to care visit www. palpation findings. questions or provide mentoring to other practitioners in creased efficiencies are found when the software prepopu. If check boxes. texture and tempera- flag (preclusion).g.  I want to sort and review patient demo- Practitioners need to apprend additional content to a file graphics. frequency of visits. Offer useful graphic interface that provides protect my records essential anatomy. tenderness. coupled with a medical/pharmaceutical dictionary would be ideal. formation. Any software ings per week. conditions treated. cies. In. privacy and other government agen- iables again. Based on input. spine extensors. saving time in having to enter the correlating var. scapulae On target retractors. range-of-motion. point patterns.g. where common essential information is captured and sequence. Imagine this: you click the muscle on a screen and are shown origin/insertion. Supportive. Perhaps a possible integration with apps like Trigger Points from Real Bodywork or Anatomy from Visible Body. A primary reason for taking a case history is to mit. Include basic aspects adaptive to mobile apps wanting more dietary information) are prompted based on and for practitioners working with multiple contracts and the practitioners involved. techniques/modalities applied and ficial to multiple disciplines working together under one outcomes achieved are inextricably linked in the treatment roof. An online fillable intake template that captures portunity to qualify a particular muscle if desired. muscle their session notes without violating non-solicitation/ testing. marketplace by providing me templates for marketing materials. month and year. Practitioners can record observations and save the record and ensure I’ve captured all necessary in- measure outcomes in all sectors they find work: Fall 2015 Massage Therapy Canada 11 . integration with social media. If the patient gradients of the “4 Ts” common to massage therapy assess- shares information that trips a yellow (precaution) or red ment: muscle tension. Group muscles (e. Vernon-Mior). The software must protect my records and format with the same variables entered in the objective secure them from cyber threats. Provide essential information and adapts to the more complex case access to drop-down menus to easily click and record history by prompting further questions. with regulatory. out- notes. Incorporate mandatory must-fill-in fields required to Applicable. areas worked. human performance/ athletics. toms. I want software that keeps the perceptions? To read this and other articles from Don Dillon. Informative. or captured images or videos standing balances. Inability to add more images or documents to a file. Oswestry. numeric pain scale. the software prompts addi. muscle and other applicable tests. Alert. interface with my The software must website and automate follow-up surveys soliciting service feedback and measuring response to care. additional specialized questions (example: a naturopath Portable. locations. tice within it. referral sources. that purports comprehensive. physiology and pain pattern information while integrating effectively any markings on the graph into and secure them the comprehensive session note. lates the assessment (post-treatment) section of the SOAP Compliant. Prompt the recording of observation and arate from the client/patient contact/demographic infor- outcome parameters common and informative to massage mation so if a practitioner leaves a practice. secure records should have Engaging. understand the marketplace and how to position my prac- Intuitive. outcomes achieved. Efficient. Cultivate a community I can join and ask tional questions or recommends outcome measures. dollars spent per patient and my earn- of the patient’s posture and range-of-motion. radiological reports. orthopedic/ non-competition contract obligations. private practice. Ensure that symp- more comprehensive picture. the software expands the case history ture. drop down menu and field prominently visible so if I haven’t seen this patient for over entries are available but do not focus on a conclusion. myofascial trigger from cyber threats. and  workplace wellness/mobile massage.massagetherapycanada. neurologic tests and pain questionnaires (e. ankle flexors) for general assessment. while remaining compliant section. number – scanned copies of gatekeeper practitioner prescription of new patients. This feature could be bene. methods or modalities. incorporate ap- pointment booking and reminders. This information is then transposed from the graphic template and prompts further specific questions to gain a to the comprehensive note for review. developing their practices.assessment. I’m quickly reminded of the risks in applying certain will fail to bring home a comprehensive picture. they can retain therapists: postural assessment. massagetherapycanada.

book post or in-office advertising requesting book dona- With clientele approaching us from a more educated tions might be all you need. and the love of reading by building free book exchanges tice. your shelf. Your more about their conditions. she travels to Africa to be with times you miss. creativity and wisdom across generations. expanded resource area could act as a public library with cise and complementary therapies. migraine manage- I tripped on the idea of curating client-friendly book. leave a book or build your own little patch Colouring outside the lines The latest and greatest craze is adult colouring books. Check out the shelves at stance. have agreed to a treatment plan and are probably also seeing an osteopath. and its derivatives is a given. To get the shelves started. Whether you take a book. Tweet. a disclaimer that books must be returned within a reason- For the population that falls into the non-tech demo. A client I recently treated for a cervical nerve impingement refused to allow radiating pain and sleepless nights “become her lot in life. With JULES TORTI has been a RMT since 1999 and a freelance writer since age a promise to “release your inner child and get back to the six. on sleep disorders. ment and chronic pain. or you’re a shiny new volved. it’s impossible to not want to get in- long established. remedial exer. In between massage to kick start your literary drive. Check out some of these suggestions If you visit the Little Free Library (littlefreelibrary. Providing therapeutic massage erate under the Little Free Library’s motto: “take a book. catering to your library movement. A broader approach to well-being and home care would offer and provide an experience beyond a be to re-invent the concept. wondering whether to flex. anxiety. Face- ing. Perhaps you have copies of scalene and quad stretches at the ready. online.” the books are being snatched up as an chimpanzees and writes about her zany travels for Matador Network. chiropractor and physiotherapist. Most of our clients are already in the active phase. how do you set yourself apart? worldwide and to build a sense of community as we share Learning how to be competitive yet skills. extend.” This would allow for a rotation of topics on selection of loose-leaf herbal tea post-treatment or take. able time frame (which would in-turn increase client re- graphic. mindless movie or 12 Massage Therapy Canada Fall 2015 massagetherapycanada. our role as massage therapists is changing. a blanket e-mail. home sachets of Epsom salts to clients. those who seek books over the dizzying array of tention and repeat visits). there is an immediate pull to get . shelves after witnessing the enthusiastic rally around the free Have fun creating your own library. hydrotherapy. It would naturally encourage communication and interactive resource for proactive clients eager to research provide convenience for time-strapped individuals. Do you have one in your neighbourhood? clientele’s interests.” Clients are open to any experience that might alleviate their symptoms and are subjecting themselves to the likes of wet cupping. ice or Extend what we can rotate that compromised muscle. Social media has helped immensely with free to arrive earlier to appointments – just to browse the book- advertising and client education. Blogging provides an shelves. better yet—learning more. salt caves and. we can step in.COLUMN FEW AND FAR BETWEEN Shelf life Creating a client-friendly library in the clinic BY JULES TORTI W hether your massage business has been of literary real estate. Maybe you already offer a leave a book. They have sought out a treatment. punching back at the notion that chronic pain has to be chronic. An alternative would be to op- online intel. The mantra just makes sense: “To promote literacy grad laying the foundation of your prac. We need Goodwill or Value Village or garage sales. to better equip your client when the massage buzz wears off and they return home. The health and to extend what we can offer and provide an experience that wellness area is usually well-stocked with discount books moves beyond a one-dimensional appointment. depression. A growing number seem to be solidly in the yoga groove and are one-dimensional appointment. accessible alternative to a hot bath. meditat.” unique in a saturated market is the easiest way to attract Offering a free clinic library might even convince clients clientele.

Her book is equal focus that cuts out the white noise of our adult days. Tackling a subject that is still bat. Enders. As an unexpected Microbiology in Frankfurt. We graphic designer Jill Enders are playful and turn GUT into drank wine and shot the breeze while we let our inner kids equal parts Far Side comic strip and seriously fascinating come out to play. parts inspiration. Providing enhanced patient experience through a literary library in your waiting room can increase the likeability of your massage practice. Her in. Hughes will be reaching Help contribute to this list (and bookshelf) by adding an even bigger audience than the one that saw her sweep your frequently recommended books here. Olympian Clara Hughes’ hotly anticipated Open Heart. The illustrations by all that left-brained overuse! My family got into it too. but as calming as a cup of hot cocoa and wool sock-bottomed feet warming by the fire. rower Marnie McBean’s The Power of More demonstrated how a chronic lumbar injury (and her inability to continue in the sport) was spun into Photo: Fotolia a positive new direction and role. Send me an six medals in cycling and speed skating. After a 15-year career Have you read Jules Torti’s recent article about animal with the Canadian Rowing Team it seemed only natural massage? Read it and other articles by this author on www. If you skipped endocrinology class during Try leaving an inviting open copy of this book in your college and opted for a pitcher of beer with bored class- treatment space for early arrivals to decompress. Germany. a misdiagnosed itchy-scratchy Sharla Bowker-Sauder. GUT: The Inside Story of Our Body’s Most Un- Johanna Basford’s The Secret Garden as soon as she heard derrated Organ by Giulia Enders covers it all with simplis- about it. In the Olympian niche. cheerleading and proof that physical There’s no expectation. They are indulgent. chocolate-covered toffee crav- ings and bad-breath inducing tonsil stones and raw sauer- Gold medal picks kraut remedies (I guess I skipped that class too). tling taboos and misconceptions. no deadline – it’s pure play. this manifesto will impress with the truth forget to provide some sharp cerulean and violet Crayolas. her memoir herself on the bestseller charts. reading half of it out loud to whoever is nearby.” intestinal tales. Read this one before volvement with the Bell Let’s Talk campaign has already you put it on the lending shelf. e-mail and let me know what’s on your bookshelves. a 25-year-old PhD student at the Institute for Medical Open Mind will be released this fall. Her examination of studies on swimming mice. has already found ambassador for mental health awareness. Don’t mates instead. selling over a million cop- about the quicksand of depression can only help facilitate ies. that she specialized in athlete preparation and mentoring massagetherapycanada. catnap. vation and depression is fascinating. She wanted a copy of matter. massagetherapycanada. They’re injury doesn’t have to win emotionally. “Talk about delicious right-brained frivolity after tic slap-stick but fact-dense reasoning. colouring was the perfect outlet skin condition. satisfying and require a narrow with the Canadian Olympic Committee. Gut feeling For recent Vancouver College of Massage Therapy grad If you’ve ever had diarrhea. raging heartburn or pinworms for that while she wrapped up her studies. about roller coaster puking. moti- deeper channels of discussion and Fall 2015 Massage Therapy Canada 13 . and I guarantee you’ll be created a publicity intricate and stimulating.

palliative. itself. and that is when I found out they She proposed the idea of integrating massage therapy into actually had massage here. The clinic is located in the hospital’s rehabilitation med- Knowing who to talk to and when is important for thera. stroke and cancer Manuela Brodalla. Back then. 14 Massage Therapy Canada Fall 2015 massagetherapycanada. Brodella has been required to wear full personal protective equipment. therapist at Sunnybrook. the pain clinic.” Brodalla recalls. which had just then introduced acupuncture she overheard the staff talking about needing another mas- in the setting. which can pose certain challenges to a massage She has been a journalist for more than 15 years. For cases – post-operative. working in acute care setting may be faced with. but they are still expected to provide the best care for the patient.. to name a few. She asked her mother to introduce her to the Dryden spent the next three years working as a massage hiring manager and the rest is history. with Annette Broderick-Colombo wanted to work in a hospital since she so many diverse backgrounds. geriatric. and sage therapist. she took it. Her interest in chronic pain issues motivated her to been interested in the clinical aspect of massage and when seek out the opportunity to work with hospital patients after the opportunity to work at a hospital unexpectedly presented graduating from Sutherland and Dryden was one of the has been spent working in the massage therapy clinic at Grey first massage therapists in Canada to ever work in a hospital Nuns Community Hospital in Edmonton.” Dryden recalls. that and being at the right place at the right time. Alta.ON THE COVER LEADERSHIP Hospital practice Massage therapists take patient care to the next level M By Mari-Len De GuzMan assaging patients on a gurney with tubes running across the bed and around them might not seem like the ideal treatment set-up. These are minor inconveniences a therapist mdeguzman@annexweb. The doctors decided to try the idea. clinical education experience where I learned more than I learned in seeing so many patients. integrating massage therapy into hospital-based patient care was a novel idea. classes for the elderly. At the time. icine department. a RMT in Edmonton.” was a massage therapy student at Sutherland Chan. and gloves. such as a respirator mask MARI-LEN DE GUZMAN is the editor of Massage Therapy Canada magazine. It was certainly true for Trish Dryden back in the early 80s when she worked as massage therapist at the pain clinic in Toronto’s Sunnybrook Hospital. I discovered that the hospital had therapeutic thetists who were heads of the pain clinic. You may contact her at therapy session. but massage therapists who work in hospitals say it is one of the best clin- ical experiences a therapist can ever have. “I had heard about an excellent pain clinic at Sunnybrook “I had aging parents and they required some outreach Hospital in Toronto. She also provides massage to patients in the intensive care Photo: Mari-Len De Guzman Brodalla is in practice for eight years and the last six years . On occasion. She has always setting. services. it took all patients. and went and met with the two anes. “I can’t think of any single. where Brodalla sees a variety of clinical pists who are looking to work in a hospital setting.

A survey of 305 Canadian urban hospitals.” hospital library allows her to look up medical journals per. which provides them some level of comfort and helps alleviate some of the stresses of caring for their sick loved one. surveyed.” therapists. it could be a lot of the nurses I’ve worked on… so when pa- tients are complaining about back pain the staff will say. the revealed only 69 hospitals or 22 per cent are providing oxygen – working around the bed can be quite challenging massage therapy services. says Kania-Richmond.’ The person will make the call. hospital staff members – doctors. particularly for cancer pa- tients or those in palliative care. the clinic will fit them in the schedule. she would see an average of seven patients.” “It’s just a different spectrum of care. Sinai Hospital’s Rehab and about three therapists working on site. nurses and other hospital employees – many of whom become advocates of massage therapy after experiencing the treatment. local or specialty hospitals. Quebec and Nova Scotia – have integrated the pain subsiding so they can be happy for just that brief massage services that are provided by licensed massage period. conducted by “There will be times when people will just break down and cry because touching them stirs the emotion. sage therapy school with the intention to work in a hospital who is also a registered massage therapist trained in Ontario. Alberta. a hospital would have found part-time work at Mt. and integrative medicine research organization. says Kania-Richmond. cuss the patient’s history. also varies from large multicomplex hospitals to the very Toronto RMT Annette Broderick-Colombo entered mas. the study for the therapists as well. practice. researching the various health conditions that come her way “One of the things that came out of the survey is that also provide great learning opportunities for Brodalla. She sees patients at the hos. In one of the hospitals Well-being Clinic in Toronto. She would Research Network. Upon further inquiry. the family members themselves would require massage. That’s only five per cent of all the urban hospitals Working alongside other health-care professionals and initially surveyed in the study. Sometimes. We’re not only massage therapist and researcher Ania Kania-Richmond. But I find it more rewarding when showed only 16 hospitals – located across four provinces: you see that person have at least five to 10 minutes of just Ontario. Soon after therapists who work in hospitals are independent contrac- graduating from Sutherland Chan. small. alternative then go through the patient file with the head nurse to dis. ‘we have a massage therapist on staff. Kania-Richmond’s research also provided insights on how In a typical day. In some cases. most massage chronic pain and rehab was her motivation. working around the machinery – the heart machines. “It could be a doctor who has used our service before. former executive director of In-Cam taining to the specific case she is dealing with. there were nine massage therapists working there pital three days a week. On average. Like Brodalla and Dryden.” Broderick-Co- lombo says. the current medical condition and The type of hospitals where massage therapy is integrated explore treatment protocols. and many are emerged was that there are three different ways that massage massagetherapycanada. her keen interest in Although some are hospital employees. massage therapy service is delivered in hospitals. setting. Broderick-Colombo tors. the family members will seek out massage therapy for their sick loved one. the research finds. some outpatients. The rest of the time she is in private but they were all volunteers. “What Some are in-patients. Uptake Massage therapy in Canadian hospitals has existed for more than three decades – certainly as far back as when Dryden started working at Sunnybrook – but progress had been slow. The massage therapy is not necessarily new in hospital Fall 2015 Massage Therapy Canada 15 . a Canadian complementary.

edu. possibilities and have published litera- “This means if you are going to be a pects for massage therapists in hospi. needs to come from the profession it- tion play an important part in increas. need. sity in Edmonton. certainly help in improving career pros. to be held in April in Regina.” Dryden says. to massage therapy among hospital bers interested in working in this set- cator. Currently the associate a matter of getting this information to vice-president of research and corpo. ture in hand to open a conversation therapist working in a hospital setting tals and other health-care settings. Providing care and hands-on just a spare room anywhere in the hos. Although massage therapy research is relatively in its infancy. She said the number Interdisciplinary Research Symposium “What became apparent is that the one challenge for hospital administra. Kania-Richmond also had been trying to get one of Grey of RMTs in hospital patient care. For example. professional role of a massage therapist tors is space. mem- the study include: team member. the economic in that particular setting working with impact of doing this. In one to talk to. there is in- Career prospects creasing body of knowledge about the Because of the many hats a massage health-care benefits of massage therapy therapist may be expected to wear in a that can certainly help the cause of hospital. clinic within the hospital.” she “Trying to find a location or even the speakers. and is open to to increase uptake for massage therapy Saskatchewan (MTAS) has been pro- any patient. of treatment from a massage perspec. massage therapy times when people will just break down outcomes. because touching them stirs of provider specialties in the treatment department and only patients from that the emotion or they just needed some. for Saskatchewan RMTs to work in Some of the roles that emerge from Dryden agrees increasing attention hospital settings. notes. self. provide this ‘state of the art’ informa- prepared to wear all these different hats “We need to keep moving forward tion for our members. patients. MTAS is proud to health-care setting – you need to be part of that agenda.” At least one professional association model. administrators and stakeholders will ting will become more aware of the and researcher. a strong educational founda. promoter of massage therapy. not part of Edmonton. massage therapy is a standalone Brodalla. sage therapy was the most cost-effective part of a unit but patients in other units tions and it’s excellent in teaching you among non-doctor practitioners in have access to massage therapy treat.” Kania-Richmond points out. We should work at Grey Nuns Community Hospital. ing massage therapy participation in “Professional associations across the hospital-based care.. points to the cost-effectiveness of mas- closed. how to deal with the emotional side of improving quality of life measures. essary skills and knowledge not only to be presenting the evidence and talking perform well in a hospital environment about it. In an independent massage and transference. health-care stakeholders – and that Dryden believes research and educa. staff or the public. raising the profile of the profession. of patients with clinically diagnosed unit are able to access the service. professional development.” 16 Massage Therapy Canada Fall 2015 massagetherapycanada.” either on hospital boards or when hos- what she can to increase massage therapy Broderick-Colombo credits her good pital administrators come together for participation in hospital care through her education for arming her with the nec. ment if needed. hospital administrators and other rate planning at Centennial College. but also to effectively deal with the One study that has come out recently therapists are organized in hospitals: emotional aspect of the job. ative that can increase opportunities hospital. who also sits on sharing of research about massage There are other auxiliary roles massage the advisory committee for the massage therapy in hospital is the kind of initi- therapists take on when working in therapy program at McEwan Univer.” says Brodalla. “The education country should be getting themselves Manuela Brodalla from Edmonton is doing really has to be there to support it. “Part of our back and joint problems.” “Even in regular clinics. massage therapy. the massage therapist from is actively pushing the hospital hype. is also doing what she can The Massage Therapist Association of any department or unit. . there will be sage therapy in improving patient In a closed set-up. “Analysis is integrated in one specific unit or and cry.” says Dryden. MTAS echoes for the assessment and identifying plan rather just fill that up with beds or a Dryden’s perspective. In looked at the role massage therapists Nuns’ sister hospitals to incorporate fact. with primary care providers and hospi- – and I will extend this to say in any Research advocacy will be a significant tal administrators. in hospitals. For the last six years. because that’s what it’s going to take and keep the research going that shows establishing yourself as a professional the efficacy and the value. open and independent. massage therapy is still curriculum is called therapeutic rela. surgical theatre or whatever they may “Spreading the word through the tive are certainly a big part of their role. she moting awareness of the important role In her study. where Kania-Richmond will be one of encompasses various components. it is a big focus in its Third Annual play in hospital patient care. In an e-mail sent to Massage Therapy treatment as well as being responsible pital is tough… because they would Canada Magazine. The study titled.” she says. It’s tion is essential.” found mas- an open model. she says.

this useful guide helps manual therapists understand how the Bowen technique can help people with back pain. With more than 100 full-colour images. arthritis. tennis elbow. carpal tunnel syndrome. frozen shoulder. hay fever. nonintrusive pain-relief therapy. respiratory Fall 2015 Massage Therapy Canada 17 Massage ThankYou HP-2015. high blood pressure. headaches. neck pain.indd 1 2015-09-24 4:12 PM . and knee pain. massagetherapycanada. kidney problems. this book draws on myofascia and connective tissue dissection to explain how the Bowen technique initiates a body-wide signaling mechanism to start the process of healing and restore normal function. BOWEN UNRAVELLED: FASCIAL UNDERSTANDING OF THE BOWEN TECHNIQUE For Bowen technique therapists and any bodywork practitioners interested in using a gentle.

This should clearly benefit either party in the long term. increase substantially. managing will be provided to you. linens. During nearly four dec. multidisciplinary work setting BY DR. ences will help you as you continue on over which patients you treat and often. DAVID LEPRICH T he ultimate goal for chi. If you have a slow RMTs into my clinic. your ability to establish a long-term your gross income will soar. you tween these extremes. a maximum rate your journey to practice success as a how you treat them. clinic access. imum amounts.Your hours and minimum payment. it helps if both parties remain motivated and prepared to build and ESTABLISH A CONTRACT flexible. renting space within an established tice. This allows you to build a ment is vital. This may also limit helps you. ensures that you will receive the bene- may not have yet given a lot of thought sibility for building your own practice. con. treat from spending resources on a therapist the situation to everyone’s benefit. long-term practice on your own terms. DAVID LEPRICH is a chiropractor based in St. get paid and go home. creating a clinic/therapist agree. How much rent will you pay? This can practors and massage This places the responsibility for grow. be certain that all the impor. be a flat rate with built-in . it will not clinic. I have If you prefer to take a lesser role in sider establishing minimum and max- had the pleasure of welcoming many running the business of practice. This helps the a clinic and the joy of being a health. DR. gross. telephone The style you choose should be tant parameters are clearly defined in costs. If you are highly includes. Now would be a good sharing promotional. fits of your hard work. He is the theatre chiropractor for the Shaw I have had many discussions with ther- Festival Theatre in Niagara-on-the-Lake and a chiropractic consultant to the Niagara Health System and apists about the rates and fees charged Mentholatum Canada. but they helped improve You simply show up for work. Con- ades of chiropractic practice. Ont. management functions with clinic staff. He is a member of the board of WHAT IS FAIR directors of the Canadian Chiropractic Research Foundation. shoulders. having you there and protects the clinic along the way. if it does not work for both. however. and what is and is not included or 18 Massage Therapy Canada Fall 2015 massagetherapycanada. The fixed practice. your patients. clinic owner cover the fixed costs of care provider. ropractors and massage within the clinic agreement. rate of pay are pre-set and the admin. istrative fees. No matter how well conceived manage your own practice. but this is preferable common ground helps sharing administrative and patient to a hand shake. choose. it therapists are able to work together ing your practice squarely on your can be based on a percentage of your successfully. and other costs. Start with the basics. consider Unless you are setting up a solo prac. There were a few bumps istrative issues are handled by the spa. Your practice will grow and massage therapist.FEATURE PRACTICE BUILDING YOU’RE HIRED Best practices for finding success in a team-based. Whichever path you details such as responsibility for sup- tunities. or a combination of both. to practice style. All patients and supplies you are still responsible for making the thing about treating patients. advertising and any other admin- based on your ability and desire to an agreement. Each of these sider becoming an employee at a health period or take a number of absences. costs you generate for the clinic will not CHOOSE YOUR PRACTICE STYLE You may find success working be. explain why many chiro. clinic or spa. You will Some agreements may be several pages therapists is better health avoid having to secure and maintain a long and are more complicated than for our patients.You take respon. This type of arrangement limits control term relationship. This physical clinic space and benefit from they need to be. A maximum rate If you are a student or recent grad. caring individuals has taught me some. an agreement may seem at the outset. Whatever the agreement administer a business. On the other hand. establish responsibility for all details. Catharines. plies. administration The agreement should also cover time to look at various practice oppor. who is not fully committed to a long- I hope sharing some of these experi.

Talk to other chiroprac- updates. Be fully There are many benefits to practising income. If I If the clinic considers you solely as an about your practice style and your help you build your practice and you income source.. MassageAddict. Help people. therapist and work rent-free.covered. telephones and stationery. if your patient is sale. have them consult knowledge the financial incentive to just that several years ago. within an existing clinic or spa. ing a relationship with the clinic. choose carefully. you may be in for a ability and desire to manage your own help me with mine. Join our team of like-minded professionals improving the health of Canadians through massage therapy. Offer advice censing body. reasonable for a clinic owner to ac- what others are doing. massage therapy. The copy says. hiring a massage therapist. BECOME AN ASSET KEEP YOUR EYES OPEN Managing a solo practice can be very Just as I would not consider a therapist Some practice situations may not be rewarding. He can. but if this is vassed a number of clinics which in. difficult time. keep cluded chiropractic treatment and become an asset to the clinic. Attractive. with the chiropractor you work with. Opportunities across Canada Do what you love. If you are Rates and responsibilities can vary need attention. If you choose to work with It is easy for me to refer my chiro. Offer to help ing with. Think clinic simply your work address. but therapy. Some home- practic patients to you for massage in my area lists a chiropractic clinic for work now will save trouble later. we both succeed. Check with the provincial li- tional advertising. A colleague did ropractor before. “Hire a massage will also help ensure a positive long- suffering from back pain or headache. but it is not a simple task. An advertisement currently running others. appearance and attitude. about details which you think may tors you may know. yellow pages or other promo. Make looking. predictable income Flexible scheduling Professional development Steady clientele Tools and support Recognition and rewards Canada’s largest and fastest growing massage therapy company. computer software with tasks in the clinic. | For more information or to apply email Fall 2015 Massage Therapy Canada 19 . he asked about who covers linen appointments. your chances of building around for comparison. In addition to rental sure you are at the clinic early for your Do some research about the clinic or rates. These efforts cost you comfortable with the clinic and the widely so don’t be afraid to shop nothing but can go a long way in build. We’ll handle the massagetherapycanada. in my clinic to be simply a source of quite what you had in mind.” It is term arrangement. you should not consider the cognizant of what you are getting into. Likewise. business.. There are many other ways you can stated as a clinic’s selling point. Maintain a professional chiropractor you are considering work- costs. A great starting point is to ask and that person has never seen a chi. a positive long-term relationship are much higher.

Although there centres where massage therapy was pro- tion of massage therapy in was success establishing massage therapy vided – specifically. Richmond about her research MM: How did you design the research in on hospital-based massage such a way that could accurately capture the role of massage therapists in Cana- therapy in Canada dian hospitals? AR: I did what’s called a ‘mixed method’ T BY MEGAN MUELLER study design ‒ ‘mixed’ because it uses both quantitative and qualitative per- spectives. which took four years to Therapists of Ontario you to pursue this area of research? complete (2009-2013). I found it challenging hospitals themselves were organizing this ate from the University of Calgary. I was a massage Therapy Research Fund (MTRF).INTERVIEW MM: Did this represent a void in the existing scientific literature? AR: Well.The study design consisted of he College of Massage Megan Mueller (MM): What motivated two phases. fac. but little how the role of massage therapists was type of patient care by licensed therapists information on how such services were. MM: What did you learn from the survey MEGAN MUELLER is manager of communications at the College of Massage Therapists of Ontario and of Canadian hospitals? the editor of TouchPoint. I had four objectives: RESEARCH • to describe the hospitals in which A way massage therapists work and the ser- vice delivery . department of commu. yes. and • to undertake an exploratory compari- son of the massage therapists’ role One-on-one with Ania Kania. there was no information or re- search to provide guidance. • to explore the role of massage thera- pists in these hospitals. or could be. I realized that this is an health-care professionals to understand great potential for the inclusion of this area where there was interest. 16 provided massage therapy 20 Massage Therapy Canada Fall 2015 massagetherapycanada. and there’s As a researcher. views with massage therapists and other massage is happening already. And a lot of this is based in the United States. from the perspective of other health-care professionals working with massage therapists in this setting. perceived by both groups. Most of the information we have about this is on a case-by-case basis. was Kania-Richmond. Ania personal perspective. Canada and in hospitals of the future. as she therapist who worked in hospitals in both a survey of Canadian hospitals in urban talks about her examina. So the idea for this study emerged in response to this. The quantitative (CMTO) sat down with Ania Kania-Richmond (AR): From a phase. visit the CMTO website. Contact her at megan. I realized how valuable such findings could be to the field. For more AR: Of the hospitals that responded to information on the Massage Therapy Research Fund. which was provided by RMTs. ulty of medicine.When I turned to the liter- ature. the College’s newsletter. from the per- forward spective of massage therapists. Hospital-based reference points. organized in hospital settings. in these settings.mueller@cmto. and also my own experience as a regis- tered massage therapist (RMT). She holds a doctor. funded by CMTO’s Massage research consultant. different programs because I had no The qualitative phase consisted of inter- nity health sciences. As a researcher. cases where the Canadian hospitals. • to do the above. the survey. to further develop things or move into service. MM: What was the goal of your research? AR: I wanted to look at massage therapy incorporation in urban hospitals in Can- ada. across hospitals.

– could be very useful. Because of that. There’s great survey results were combined with the massage therapists surprise you? potential for massage therapy presence interviews. doing critical reflec. and open incorpo. and AR: What we learned from the survey invited into other departments. There was a their role may intersect with that of.’ ‘closed in- over the hospital could receive this ser. they realized could it play in the future? remaining hospitals that participated they’re not alone and they have col. massage therapists? ing massage therapy. a lot of the massage therapists I pists would be: If you’re interested in survey findings? interviewed were working in isolation. But through this research [and health-care system. the extent to which a of other health-care professionals is ized. where massage therapy was em. they felt very much massage therapy currently play in our tal-based massage occurs in only one of alone. responsibilities. you’re a program sup. can be used as a benchmark for future in the cases where patients were eligible the profession. although massage ther. our roles needing palliative care. massage therapists. and role overload. there was not one apy is often labelled as a ‘unique’ and AR: I really hope this research tells type of hospital that was consistently ‘complementary’ therapy. evaluation. which raises a depth work to investigate the three ap- departments. teaching massage therapy to consider? AR: The fact that massage therapists are the role of massage therapists unclear on their roles needs to be ad- dressed in the education process. what role does apy is regulated in four provinces. etc. The their being interviewed]. closed in. so that patients from all key point: When we’re being trained as proaches – the ‘stand alone. tive exercises is important. MM: Would this be something for schools “As health-care professionals. corporated’ and ‘open incorporated’ vice.There was pists in hospitals? MM: What does your research mean for diversity in the types of hospitals provid. The main message for massage thera- MM: Did anything surprise you about the Also. those in this profession:You need to be offering these services. you can. for encompass many other things – educa- broad range of patients who had access example. AR: Despite the fact that massage ther. When MM: Did anything in the interviews with tings. There wasn’t one universal model. but only sometimes even advocate on behalf of. Doing some more in- bedded into a department or multiple time defining their role. those were experiencing role overlap. as a recognized health-care profession the different ways in which massage and being integrated into various set- therapy services were organized. a physiotherapist. Some participants really had a hard the coming years. which is a lack of clarity about ex. Being a massage therapist. how to position yourself in the context in which these services were being organ. AR: Yes. where As health-care professionals. realization that being a massage thera- different populations – patients with care professionals. and what kind of role the regulated provinces: Fall 2015 Massage Therapy Canada 21 . AIDS or chronic pain. including hospitals. where massage therapy was you’re an educator. cancer. My research profession is regulated. doing hospital-based massage therapy. actually do more than just massage: like in this area? corporated. where we can measure developments in rated. the experi. there were a lot of different ways pected behavior from a job or position. MM: Broadly speaking. about the experiences of massage thera- The majority were in Ontario. etc. person feels overwhelmed by his or her critical. port. working in a hospital setting. means that you MM: What would future research look own [separate] department. Understanding Also. What I found very interesting They had no idea there was anyone else was the fact that. you represent. hospi. possibly create collaborative working confirms that it is becoming established A second thing I found surprising was environments. the ability to develop. role ambigu. massagetherapycanada. as a massage therapy is its own service in its health-care professional. How encompasses many components do you redefine or adapt it so it can en- compass things like fitting into the hos- in addition to providing a pital setting and working with other health-care professionals in a collabora- massage – education. Massage therapists pist is more than just giving a massage. the ability to collabo- to massage therapy services. where role. tive context? This is a key competency that all health-care professionals need to evaluation. of hospitals in urban centres in Canada. AR: Evidence-based massage therapy were not located in provinces where the leagues with whom they can connect and can play a role in the system. collaborate with others. three approaches to service AR: Yes: the multifaceted nature of their in hospital settings in the future. these hospitals served that different from that of other health. ity. rate with others. ence(s) of massage therapists were not all able to reflect on your role with the Furthermore. so they’ll in- to patients. This represents five per cent MM: What did your research tell you corporate this into their environment. research – a point of reference from to receive this care.” The educational component swings the other way too: The other health-care professionals need to be taught about the role of massage therapists. tion. delivery emerged: stand alone.

The cancellation policy can be and Newfoundland & Labrador. the confidentiality of your patients’ personal and health 22 Massage Therapy Canada Fall 2015 massagetherapycanada. educator. It is a regulatory requirement that you keep ments Act (PIPEDA) for federal. The appointment record not patient must agree and the reason must be documented in only satisfies a legislative requirement but will also help you the clinical notes. legislations (PHIPA for Ontario. This calendar can also act as the tracking record for pay for a cancelled appointment when you want them to come equipment and the legislation in that ANDREA COLLINS is an author. you also need to confirm a challenge to enforce. The fee schedule needs to be posted where Filling out the intake form and record of treatment is required all the patients can see it and explain that the everytime you provide a massage. the that need to be maintained (quality assurance program and cancellation policy is easier to enforce as you are losing money regulatory requirement for Ontario). determine your hours each year for your registration renewal. minute will help give you structure to deal with this. Contact her at . and respective provincial the patients’ name and timing/duration of each appointment. Not all business relationships last and you take and assessment. These laws cover how we should deal with health infor- Photo: Fotolia mation. For Ontario form where the patient signs. speaker and registered massage province. rates include the treatment time as well as in. fancy agenda. The cancellation policy must also be clear and explained Renewal with the College of Massage Therapists of Ontario to the patient. PHIA If you work in a large clinic where all therapists work from the for Newfoundland. a simple weekly or daily calendar that place for patients who are chronically late or cancel at the last can fit all your appointments is sufficient. appointment record and privacy plan. the may not have access if you leave. If you deviate from this set schedule. will change how you need to deal with maintaining therapist. There are two privacy legislations that we need to be aware The daily appointment record is important and valuable of: Personal Information Protection and Electronic Docu- for many reasons. E-Health Act for BC. you will need a copy for few). your own records. PHIPAA for New Brunswick. This does not need to with a “no show” or a late cancellation. especially when just starting a practice that you have done 500 hours of treatment every three years and during a growth stage. It is very hard to ask patients to – rolling. but you could also include it on the intake worked. to name a same book or program (if digital). As you become busier. The province you are in.FEATURE REGULATION Set the record straight Compliance guidelines and best practices for clinic record keeping T By anDrea CoLLins he general practice policies for record-keeping deal with the procedures you have set up in the front office: your fee schedule. Having a policy in be a big.You could have a sign on your front desk so the (CMTO) requires you to provide the number of weeks you patients can see it. equipment service and cleaning records back for more appointments. and average number of hours per week. cancellation policy.

such as research data. The health history form must be updated yearly. this practice is incorrect. massagetherapycanada. Many clinics have a statement on their intake form that includes the patient giving consent to the treatment. you can review Mas- sage Therapy Canada Magazine article. and the procedure that must occur if your information has become public. If the patient has not seen you in a number of years you could have them fill out a new form. Various locations and clinical situations will have drastically different reasons for collecting information. which would be your compliance to regulations. For more information about intake forms. By expanding your form to include other conditions. The legislation may also include requirements that all staff (regulated and unregulated) be trained on the privacy policies. privacy policy document and a consent form (for the collection of personal or health infor- mation. motor vehicle accidents or workplace injuries). ADLs or other charts that might offer a better picture of the patient’s current health conditions that would not typically be indicated on a basic health history form. At most small massage clinics. THE PAPERWORK Record-keeping for your treatments include an intake Some of the key points massage therapists need to be aware of are as follows. Within the above forms you will need to let your patients know why you are collecting the information. you can expand your forms to be more thorough and customize them to cater to your clien- tele. For every person that you treat. Unfortunately. what will be done with it. quality im- provement and risk management activities. Your practice treatment form must contain a minimum of information that your college mandates or association recommends in non-regulated provinces. If you work in a rehabilitation setting dealing with in- surance (e.g. and that you will be keeping it confidential unless required to share it by law. the reasons will be much more streamlined. Your health history form may also be used to help develop your business by asking for permission to send out news- letters or asking how the person found you. To raise your conduct to best practice. giving you valuable information about your advertising strategies. your form may contain more details about contact infor- mation for adjustors. Record of consent of assessment and/or treatment must also be recorded for every treatment. You need to identify someone in your practice as the primary contact for the management of your privacy plan and this should be indicated to your patients. “The health history form: Making the most of the patient intake process” (www. You must have a privacy plan in place that may include a written public statement. the types of safeguards that must be in place to prevent breaches. A patient may not give consent to a treatment Fall 2015 Massage Therapy Canada 23 . patients may get a better appreciation for the information that RMTs need to be able to treat more effec- tively and safely. you must have an intake form filled out. not for treatment). charting/update forms and record of consent of treatment (different than what is included in the privacy policy).

massage therapist who wants to stay in used by the therapist tection is not enough (for further spe. are complying with Canadian privacy that the records cannot be reconstituted ing the treatment by verbalizing this to legislation. you are prohibited from leaving the government. contract to protect yourself in case you of treatment. a cross cut shredder my therapist. either online or Therapists of B.g.C. This informs the patient that they pany outside Canada. lines that the regulated provinces fall attention to a higher standard will help ment under. you should get a statement that they This information will vary slightly secure location so all the information will maintain the files according to the legislation (and identify the specifics) and both parties have to sign. If you areas treated For file retention. offline. other health-care profes- substitute decision-maker must keep your files for 10 years follow. time and duration of treatment room. and New Brunswick. digital with a . You one who is not required to maintain the viders could also store the files in a locked staff record to our regulations. and you could be put.) 24 Massage Therapy Canada Fall 2015 massagetherapycanada. mainstream health care. they have to abide You need to make sure that you have have the power not only to consent. leave. your files at the location. If the patient raising the standards that massage ther- exercises was under 18 years of age you must keep apists strive for. your • patient reaction/feedback to treat. If you are working in a location that with their regulatory college and does not have another regulated thera- pist. unattended (while in treatment). ment that states something similar to. Set a good in the treatment notes within 24 hours provincial laws. All of our records must be kept in a als.This may occur in a small spa where the owner is a busi- nessperson or esthetician. patient requiring who wants to stay in good standing information for legal reasons). you must STORAGE other regulated health-care profession- record certain information for charting. the files must posed a treatment plan and that I may digital files you need to ensure that you be disposed of in a secure manner.You might Proper record management is also want to have copies or. • date. good standing with their regulatory • summary of techniques used and cifics. be able to have access to the files essential for any massage therapist if for some reason you need access to them in the future (e. choose to strive for best practice.To ensure that you are compliant college templates. college and with the government. This could mean professions legislation and you are not • exam(s) and results a filing cabinet that is locked when left permitted to leave your files with some- • reports from other health-care pro. Newfoundland & elevate the opinion of massage therapy • informed consent from the patient/ Labrador. all formation. our profession may • hydrotherapy applications and/or self the files for 10 years following their 18th continue to gain acceptance as a part of care. procedures. or choose to go tained. After the prescribed time you must am aware that I will be asked for consent corded within 24 hours of the treatment destroy the files. such withdraw my consent at any point dur. but by privacy legislation where they are set guidelines regarding the manage- also to withdraw their consent at any located – which could be drastically ment of files when you start your work- time. bia must maintain original files for 16 ment information as obtained years.C. If you are working in a clinic with regardless of length or fee.” If you choose the services of a com. regulations). “I the pertinent information must be re. has additional stipulations sur. there are two guide. Therapists in British Colum. If the patient is under 19 years of (Note: This article primarily covers the The format of how this information age you must keep the files for 16 years Ontario regulations. provinces may have similar policies and You can choose between regulatory B. For Ontario. versus a regular shredder. sionals and to the government. with the correct regulations please consult own paper versions.Whichever option you choose. By • used and/or recommended remedial ing the last appointment. Bylaws for more in- The intake form may contain a state. See College of Massage your respective provincial legislation. you to the public. check your privacy legislation). The other regulated maintained is up to each clinic/therapist. Your files are covered under the regulated health depending on the province but relates to: are kept confidential. – for example. and birthday. Under Ontario rules. according to what is for treatment at the beginning of each (as per Ontario and Newfoundland described in your province’s privacy treatment after my therapist has pro. Any information that is stored on Having knowledge about proper re- • fee for treatment a mobile device must be secured with cord management is essential for any • results from assessment techniques strong encryption – and password pro. If you decide to choose laws. are working in a location and choose to Every treatment that you perform.that you have not even proposed yet. following the patient’s 19th birthday. at a mini- mum. you can create your rounding files and how they are main. This consent needs to be recorded different than the Canadian federal or ing relationship with a clinic. ting yourself at risk. • updated health history and treat.

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find email lists of people in my area and service is hosted in Canada. e-commerce and related work Does this make me record-privacy compli. practice management solutions. To learn more. collection.What happens if a RMT leaves the technology allows this to be done. patient bookings and associated records of due diligence is dependent on your treatment and charting. Research lated matters. on vacation or and yours on those records. the clinic to function properly. Does that dures that govern how you deal with send them information about my practice. My PMS online appointment booking relationship between your policy and there needs to be procedures system allows me to send electronic appoint- business policies/proce. provider of massage therapy websites and Until next time. This applies to self-em. patient scheduling. shared access to patient information for automatic email or text reminders (nei- We will look at some real and hypothet. If your appointment and procedures. legislated and regulatory rates and availability? federal and provincial privacy regulations? mandates. as well as Canada’s anti-spam laws. paying particular atten- ployed. patients and potential clients. ultimately responsible for the care and flows.COLUMN RMT TECH TALK Electronic technologies don’t define business policies H BY JESSICA FOSTER ave you ever reflected on the A. You are keeping. As professional health-care per my cancelation policy. are responsible for ensuring you are in the company. sible for their appointment times. it is your written policy that will help exemplify the scope of tronic form or on paper in filing cabi. It makes Canadian legislation. JESSICA FOSTER writes on behalf of mindZplay Solutions. Periodically.Your policies and procedures A. you are still obligated to comply with tially foreign-owned PMS vendors host ing ethics. the process very efficient but only you they have foreign ownership. Can I just Q. internal policy and procedures. me they did not receive it (legitimately or choices/usage. tions and the law. No.Your obligation nor ability to comply with tion of patient records. nets. you will need to ensure internal . Details should be covered not) and therefore do not believe they need practice management system (PMS)? within your partnership/employment to pay for the appointment they missed as The actual technology deployed can agreements. Q. partnerships and employer/ compliance with your policies. police your internal business policies A. non-Canadian owned and operated concerns need to be addressed in your service provider. Whether ther of which are guaranteed delivery ical frequently asked questions (FAQs) patient contact information is in elec. such as how specific Q. mean my usage makes me compliant with internal. if at all. Can your records be sold Your online PMS system helps you or transferred without your or your pa- manage your online appointment book. be well. regula.massagemanedger. system does not control this. as well as legal contracts in place that ment reminders. a patient tells dures and your technology specifically deals with this possible oc. your maintaining thoughtful analysis and clinic and takes contact information for all internal policies need to define how you regular reflections on these matters to patients and subsequently markets to them? use the feature. tion to their Terms of Use and their employee relationships alike. My system vendor says their online cursor to the actual day-to-day proce. visit www.What do I do? have a huge impact on you and so can providers working together. A. this type ing. technologies). the practitioner. enforce or ant? safekeeping of your patient records. use and reten. ensure you. and your internal ments govern their use. 26 Massage Therapy Canada Fall 2015 massagetherapycanada. that needs to clearly indicate that ap- interaction between well-chosen.Your patients are respon- policies and procedures. patient care. your written policies and agree. the treatment of your profession’s advertising regulations services in Canada and have neither the co-workers. for each other when sick. It should not define. courtesy only. Many foreign-owned and par- dictate how your clinic operates cover. Q. My system allows me to synchronize tients’ express approval? Again. financial record with my personal smartphone calendar. While the technology may enable the policy and procedures you adopt. Your written clinic policies are prob. While the The reality is that it is worthwhile leave. Privacy are the one responsibly driving the bus. Not necessarily. Higher level the relationships actually work. records are synched to a smartphone Adoption of electronic PMS is now Let’s look at some examples of how calendar application that is hosted by a prevalent in RMT clinics. patient privacy. I work with four RMT’s who often cover you do not identify your patient name technologies are used. My PMS allows me to bulk e-mail ably broad statements that are the pre. prop. you need A. such as a currence. patient billing. Ask the vendor if financial record keeping and other re. pointment reminder messages are a erly used technology. While the technology allows for this. Patient ownership is a matter of Q.