The Future of the Profession (with Sandy Fritz)

Summary: Whitney has a conversation with Sandy Fritz on her vision of the current and future state of the profession. Topics discussed include the current economy’s impact on the massage profession, innovative changes with the ICMT, the migration of massage employment to a “job,” and more.

 

Whitney Lowe:

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Whitney Lowe:

So welcome everyone to Thinking Practitioner. Til is off this week, and I have the delightful pleasure of hanging out with my good friend and colleague of several decades, Sandy Fritz. We always get into fascinating discussions on education, practice, and all kinds of other topics, where we’re all going. Today I wanted to focus a little bit on the future of the profession. So Sandy, welcome to The Thinking Practitioner.

Sandy Fritz:

Oh Whitney, I’m thrilled to be here. I’ve been watching or listening to the podcast since you started it.

Whitney Lowe:

All right. We’re way too far into this to not have had you as a guest yet, so was glad to get to do that today. You are a household name in our profession for so many people, but for those very few who don’t know who you are, give us a little bit of introduction, if you will, to who you are and what you’re up to these days.

Sandy Fritz:

I have been a massage therapist since the dark ages almost, late 1970s. And-

Whitney Lowe:

You started the massage profession in fact, didn’t you?

Sandy Fritz:

Almost. I have practiced in multiple settings with multiple clients through those years, 45 years. I had a massage therapy school since the mid-1980s, 36 years. And I’ve written entry level and advanced level textbooks for Mosby, now under the imprint of Elsevier, for 25-plus years. I am actually in a revision process, and I also am now editing Dr. Leon Chaitow revisions and have a bunch of editorial queries to deal with that.

Whitney Lowe:

Yeah, right. That’s a monumental task. I mean, he was such a incredibly prolific writer, and he’s done so much, certainly for our field and for people in many other fields too. I know you had a wonderful working relationship with him for many years. I’m sure that’s been a great enriching process for you and also a big mantle to take on to continue that going.

Sandy Fritz:

But legacy is important. He’s like I am in that we didn’t necessarily develop a brand or shtick or something like that. He was the great integrator That doesn’t always develop a strong legacy line. I was really fortunate, as with other teachers that I’ve had over the years, to have spent so many years with him and doing what he told me to do.

Whitney Lowe:

Yeah. I remember back in massage school, this is probably 1987 or so, and I saw a copy of what a lot of people refer to as the blue book, the original one, the Soft-Tissue Manipulation. I was just astounded and blown away by the things that he was introducing with the concepts of what manual therapy could do and what we could potentially be doing and this whole idea of using this as a real therapeutic tool because nobody that I had seen, at least, had written anything like that up until that time. So that was certainly an inspiration for many of us.

Sandy Fritz:

One of the things you had mentioned we might talk about is trends. You look back on that book because that was my first introduction to him as well. I was so desperate for that level of understanding within the massage community in my early practice days that I immediately got a hold of him and told him that I would follow him wherever he went, which I basically did. If you look back on that, the concepts in that book, not much has changed. The research has polished it some, but the foundation remains solid.

Whitney Lowe:

Yeah, yeah, absolutely. It is always interesting when you look back about lines crossing and things like this. I think maybe you and I had talked about this one time before, about that time that you were saying that and communicating with him and saying that you had follow him anywhere, I had asked the continuing education director at our school, I said, “I know this is just an absolutely crazy thing to think about, but would you contact this guy that’s over in Europe that wrote this book and see if he’ll come over here and teach for us?” I think he probably looped through both of our geographic areas, me in Atlanta and where you are in Michigan at that time when he came over here. I don’t know if that was his first trip over here, but it was one of the early ones where he came over to do some teaching.

Sandy Fritz:

I can’t remember all of it, but I know that I would assist him. I had gone to Atlanta a couple of times. I don’t remember just how that goes. But I do remember meeting. You were so young.

Whitney Lowe:

We were all so young, weren’t we?

Sandy Fritz:

I remember us sitting and talking and chatting, so I’ve always appreciated your journey. We haven’t always agreed, but you know what, that doesn’t matter.

Whitney Lowe:

Well, that’s great, I think. That’s always great because we can have these kinds of debates and you open my eyes to things and hopefully maybe it’s a two-way street of us really opening thought processes on different things. I love having academic debates with people because it makes me grow, so I’ve always appreciated that.

Whitney Lowe:

But I want to talk about a couple other things here this morning. First of all, you were recently involved with the International Consortium on Manual Therapies. A lot of people don’t know what that was or is. They recently had an event, virtual conference. Tell us a little bit about the organization, its intent, and that event, how did that go?

Sandy Fritz:

So about three and a half, almost four years ago now, I was actually contacted about this group that was forming to try to support communication amongst interdisciplinary occupations that were using manual therapy. They wanted to make sure that massage therapy was represented. The truth is that I am pushing 70 now, and I am making very calculated choices on where I put my energy these days. I really did not want to take on another thing. But I looked at that and I looked at that and I compared it with what was I feel important in the massage therapy community and what was going on, and I thought, “I think that if I put my energy into this collaboration that it will make a difference.”

Sandy Fritz:

As a textbook author at entry level and beyond, I struggle with language, terminology, what to call things. I end up having to have a list of multiple terms because it’s not my job to decide what’s the right language, so I have to represent that and it is so confusing. For months, we as a collaborative group internationally, osteopathic physicians here in the United States, osteopaths in Europe and Canada, physical therapists, structural integration, massage therapy, chiropractic, we explained to each other what we do and what we call what we do. The focus was for this particular discussion on the biomechanical aspects, acknowledging there’s a psychosocial. But we were trying to find some commonality there, and it was so great.

Sandy Fritz:

Yes, we did have a virtual conference, and it was extremely rich. I had blasted Facebook and all the others with the importance of this and the idea of interdisciplinary collaboration, all this kind of stuff. I was disappointed, Whitney, that the massage therapy community that had talked about this idea of interdisciplinary, interdisciplinary, and all this kind of stuff, the professional organizations, all of them were mute. I think that when we look back, because looking back is always part of looking forward, there was a real opportunity missed.

Sandy Fritz:

Now, as far as the future goes and all that, we did develop a mind map that is unique, that is in development for a white paper and research. In that three-year process something very interesting happened in that the National Centers for Complimentary and Integrated Health were following a similar direction with their research strategy and their strategic plan. Helene Langevin and Dr. Partap and others were actually speakers at the International Consortium Conference. It was realized that there was two people doing the same thing. That affected the decisions made about how the consortium is going to go forward.

Sandy Fritz:

One of our main members, Bill Reed, was actually awarded one of the big research grants in what the NCCIH is calling force-based manipulations or force-based methods and how that all comes together. Right now, I wouldn’t say we’re in stasis, but there’s no sense in duplicating activities. That was a big aha when both groups realized how much we were working on the same things. And much of the work that we did that has to do with commonalities and terminology is going be influencing what the NCCIH is doing in their new strategic plan.

Whitney Lowe:

This is an interesting process, and I’ve seen this happen in multiple organizations. I saw the same thing happen years ago when I was working with ACCAHC, which was the… Oh gosh, now I forget. Academic Consortium for Complimentary Integrative Health was the acronym then, and they’ve changed it since that time. But the idea was to try to get what were at that time being called all the alternative and complimentary health practitioners communicating with the traditional medical environment. We had a couple of conferences and get-togethers, so to speak, where we started talking about where were our commonalities, where were our differences.

Whitney Lowe:

This seems like a similar process whenever you have these professions that do live so much in these silos without communicating with each other, it’s just hard to break those barriers down. You go to a conference or you go to an event and you get all excited because you talk to people and you see like, “Oh we really, really need to do these things to reach out.” But then it becomes difficult of the implementation process of how do we really put this into practice on a day-to-day basis to make these kinds of things happen. They will never happen if we don’t make some efforts to reach out and do this. So I applaud you in all the people because I know you were not only attending this event, but you were very involved with the planning and development of everything. I applaud your efforts in making headway in that direction.

Whitney Lowe:

I think many of us who’ve been around the block quite a number of years now realize that a lot of what we’re doing is laying stepping stones to the future. We may not see the finished line of a lot of places, but we will stand on the shoulders of giants, those before us, and lay stepping stones for the future somewhat.

Sandy Fritz:

And that’s the way I felt. There’s a lack of engagement in general. I don’t know if that is what is making the massage therapy world stagnant right now or there’s multiple factors going on. I knew it was going to be a slug. Everything I have done related to the massage therapy evolution is it takes forever. I also knew that it was going to probably rattle some chains, which whenever you try to move forward that people get concerned about losing their status or their identity. This was a big topic not just for massage, but all of the disciplines involved with this is, “Who am I if what we do is essentially the same? How do we embrace our professional identity and where do we go with that?” The intent of that whole process was non-political.

Sandy Fritz:

That was also something that made me go, “This is an opportunity for change here.” The stuff we did is housed on the website, it’s not gone, and it’ll be really interesting to see what happens next, especially with some pretty exciting stuff happening at NCCIH.

Whitney Lowe:

Yeah. Do you happen to off the top of your head the website so we can direct people to that? We’ll certainly put that in the show notes as well.

Sandy Fritz:

Let’s see, [email protected]

Whitney Lowe:

Okay, icmtconference.org. I’ll double check that link and make sure that’s correct and I’ll put that in the show notes for people to have a look at as well.

Whitney Lowe:

I want to go back for a second as something that you mentioned or said that having this sort of feeling that the massage therapy profession or the world was in some degree of stagnation right now. Can you elaborate on that? What’s your perception or feeling about that?

Sandy Fritz:

I’ve thought and thought about this. In fact, I think I even reached out to you and said, “I don’t get it. I don’t get where we are right now.”

Whitney Lowe:

I feel like one of those old people that’s trying to understand the new gadgets that their children or kids are playing with, like, “I don’t understand this. I don’t get it.”

Sandy Fritz:

I’m in process for the next revision cycle for Fundamental Therapeutic Massage and Essential Science for Therapeutic Massage, and I’m going, “What do we do? What can I do? What can the publisher do?” The school enrollments are still dropping. Schools are going out of business. That’s still occurring. The pandemic had maybe a little to do with it, but not as much as some people would like to think. This change was happening way before the pandemic hit. The professional organizations won’t work together. They say they have a leadership conference but there’s no transparency involved in it.

Sandy Fritz:

I volunteered for all of them. I’m active behind the scenes much more than people would think. I just can’t find cohesiveness, so it feels like a bunch of rubber duckies in a pond floating around. I don’t have an answer. I don’t know what it is. I troll Facebook looking for… I look at all the different groups of massage therapists to try to see where their energy is, where their intention is, where their passion is. I’m a little lost when I come to this, but I don’t see us moving forward with a unified vision. There are practice changes in the massage world. I really wasn’t much of a hippie, but I grew up in the ’60s, right?

Whitney Lowe:

Mm-hmm.

Sandy Fritz:

It was all about being on the edge and doing this and doing that and the other thing. Massage therapy as it has evolved and moved from that fringe, that edge, and is now not considered alternative, it’s really mainstream, has become less of a vocation and more of a job. I don’t know if that is a focus on it. The opportunities are broad spectrum. The spy industry is morphing quickly to wellness and preventative care. That means they are very nimble and they are really embracing that one end of healthcare. And then you’ve got the medical community at the other end of healthcare in this spectrum here. They’re also trying to figure it out. Yesterday, I listened to a webinar related to the opiate crisis and what could be done in non-pharmacological approaches and what needs to happen, and massage was talked about. The VA, Veterans Administration’s whole person care is very innovative and has really set a template for massage in the medical world, if that’s what people want to do.

Sandy Fritz:

There’s opportunities. We’re so fortunate. We can work autonomously. We can collaborate. We can integrate. But I spoke at the Michigan Chiropractic Association Conference, I do that for them, my son and I, and I had multiple chiropractors come up to me and say, “What’s going on with massage therapists? I can’t find them to hire. And then if I do hire them, they say I’m not paying them enough. And it’s this and it’s that, and I can only build this much, and they don’t get it. I am so over the drama. I’m going to stop having massage offered.” And yet at this webinar that I listened to yesterday, it appeared that massage therapy would need to be still within an integrated delivery plan. They talked a lot about chiropractic more so than a physical therapy. And so, Whitney, I don’t know. In some instances it breaks my heart a little bit, to tell you the truth.

Whitney Lowe:

Well, yeah. I was going to ask, you’ve owned a school and I’ve been teaching in a number of schools for years, and we’ve both been involved in the school environment for a long time. There’s a lot of talk about what we used to call at our school the equation that was given by the admissions department about 50 to $60 an hour. And then the perspective student starts running through their head, “Times 40 hours a week. Oh, this is great.” That starts before they even start school this mindset of, “I’m worth this much and I need to be getting this much.” Do you think that established mindset plays a role in maybe not appropriately understanding the whole economics of the work environment of what it really costs for an employer to run something?

Whitney Lowe:

I see this not only in this situation, but also many of my friends and colleagues who run clinics and have multiple practitioners working for them. They say the practitioners that work for them feel like, “Oh, well, you’re just raking in the money and scraping it off the top of what we’re all doing here,” without any kind of understanding of the overhead and the expenses involved in running that aspect of it. I mean, do you think that there’s this underlying… I’ll say ignorance, a lack of knowledge of what really goes on financially and economically for the underbelly of our profession that makes some of these practitioners not have that kind of, I don’t know, work ethic is the right statement?

Sandy Fritz:

It’s very confusing, and I absolutely feel what you’re saying. Not only do we own a massage therapy school and have forever, but six years ago, my family, my daughter and son and I, decided to open a franchise setting. We had the facility and we had all of that. In my mind I’m going, “I know that this is going to be the major employment track. I know that. People like it or not, I know it. If I’m going to be a mentor and a leader in the field, I need to know it from the inside.” So I supported this. People have no clue, they have no clue about the massage therapy community. I do hold schools accountable. It’s old think. It’s very old think. I am very supportive of massage therapy at entry level being vocationally trained. That allows for a progression in career development. And entry level focus is excellent in that wellness setting, which is the biggest place for growth.

Whitney Lowe:

Let me pause you for a second and have you elaborate, explain a little bit what you mean by vocational training for those listeners who may not be understanding some of those distinctions.

Sandy Fritz:

Non-economic degree.

Whitney Lowe:

Okay. You’re talking about not a degree program?

Sandy Fritz:

Right. Not an associate’s degree, not a bachelor’s degree. Although I worked for many, many years for there to be a pathway to those degrees through Beulah Heights University and other avenues. I think there needs to be a pathway. I think there needs to be a pathway of growth. I see board certification as a pathway. But the biggest growth is in the wellness sector, Whitney. And they’re morphing out to take on this chronic pain management. The diploma program, the skill-based program where most medical technicians are, if you want to look at it that way, how they are trained, not your nurses, but your medical assistants and that sort of thing, they’re trained in a vocational setting.

Sandy Fritz:

If you just look at the broader scope of what’s going on in education in general, the vocational focus on education of skill development and moving into skill development is really being supported. There’s not the idea of having a degree. I know massage therapists think, “Oh, we would be more respected by the medical community if we were degreed.” That’s not true.

Whitney Lowe:

Let me play devil’s advocate and ask that question here because I hear that all the time, is that we can’t be taken seriously by other healthcare professions because we don’t have an academic degree program. So what’s your take on that?

Sandy Fritz:

I can use my experience with this international consortium. They were all degreed except massage therapy instructional integration. I asked them this question, “Would you have more respect for massage therapists if they had academic degrees?” And to a one they said, “No. What we want is people that can work with us.”

Whitney Lowe:

We’re hearing this trend not only in our field, but we’re hearing this trend. I listen a lot to podcasts, read blogs, read books about the world of higher education in general. We hear this over and over again that employers are not so sold on the degree as they used to be in years past. They’re sold on skills, aptitudes, and abilities that they want the students to possess. So what you’re saying is that’s really what more people are interested in, not necessarily the credentialed degree program that we might have.

Sandy Fritz:

No.

Whitney Lowe:

Because there’s a lot of argument from a lot of other massage educators saying, “We need to up our standards and have a bit more rigorous training, a more comprehensive training and a degree programs, et cetera.” So you’re saying that you don’t think that’s-

Sandy Fritz:

Not at entry level. Not at entry level. I do think that there needs to be a pathway. That pathway exists. It exists through board certification and then the CNIH University, but there’s another college, will take that board certification credential as academic training towards an academic degree. It’s probably one of the best advantages of board certification. But people don’t understand board certification.

Whitney Lowe:

Really?

Sandy Fritz:

Board certification is our play. They talk about tier two, tier two. It’s already there. But there’s still that old guard out there with the… “Doesn’t do any good. It doesn’t make you make any more money. It doesn’t do this.” I have to go back to missteps by the professional organization and, yes, it’s Monday morning quarterback and all of that, but they missed it and they can’t… you know-

Whitney Lowe:

Yeah, absolutely. I have made public mea culpas for years for my time leading and working on the board with the national certification board of feeling like the mission was not being followed and that the organization got co-opted into all kinds of stuff, co-opted into being the entry level credential for the profession for years when it never should have been in that game to begin with. I think those kinds of things are really hard to back out of and reposition yourself as something different when there’s that legacy thing left along there. But-

Sandy Fritz:

That legacy is being perpetuated by the old guard that’s still teaching. Bless our hearts, all right, we instill in the new people coming in, I’m not talking about young in terms of age, but the next generation of massage therapist, we instill this in them. They don’t know. We could change the narrative now, but-

Whitney Lowe:

But that takes a collective mindset shift, I think, also simultaneously, which is just so very, very difficult. You and I have sat and talked about this at length before, but there are just so very few of us who are interested in and recognize issues around credentialing and how they influence the future development of the profession. It’s hard to get people interested in this as something that needs a great deal of attention and could guide the profession along certain directions. But I’m very troubled by some of the key trends that I see happening in education, in particular the exorbitant rise of the cost of college for getting these degrees and this whole idea that we need to steer the massage profession in the direction of getting degrees-

Sandy Fritz:

No.

Whitney Lowe:

… when the degree program often means you don’t really learn more about massage, you just have to take classes in geography and English 101 and algebra or whatever to get your degree. That doesn’t make you necessarily a better massage practitioner. I personally am very much in agreement with you that this vocational track is where we need to focus, and then it needs to have a supported second level for… I don’t want to say second level, but different track for those that want to work in, let’s say, more medically-oriented environments or those places that require significantly more training in skill base.

Sandy Fritz:

Well, and the VA job description model and progression for advancement mentions board certification, and it also talks about complimentary degrees like in healthcare administration or something that goes along with that. But we’re so stuck. I own a brick-and-mortar school for goodness sake. The days of the brick-and-mortar school, they need to be modified. Online education, now, that’s where I see a real positive that came out of the pandemic, was an absolute push to look at technology as part of an educational delivery.

Sandy Fritz:

The other thing is that apprenticeship training, earning while you’re learning, there are actually federal programs. Arkansas is a state that is following a federal, I don’t know if I want to use the word mandate, but a really strong push by the federal government to look at apprenticeship-based training as a similar track or in combination with vocational school training. Again, boy, the massage therapy community, including the Federation of State Massage Boards, really stuck their feet into it. Although, in their new policies they are mentioning the idea of if you have completed an apprenticeship program, but you can’t shut stuff like that down. We do. We try to anyway.

Whitney Lowe:

I want to ask another thing and just to hear your take on this, when we talk about this idea of different tracks of education, I feel like the vocational training model that we have established has been doing a pretty good job of training massage therapists for most of the jobs, so to speak, that are out there nowadays and working in franchise operations, entry level clinic positions, and all that kind of stuff. There is the flip side of this, which is that we have one massage school training, but we also have a lot of practitioners who may be interested, for example, in working in more complex environments with, let’s say, in conjunction with other health professionals or places where they really do need training that goes above and beyond what happens at most massage schools. We have a really good delivery system for that vocational training with… And you’ll probably be up on the numbers more than me. Where are we now in number of schools in the United States? Like in the 900s or something?

Sandy Fritz:

I hesitate to be definitive on that. But the additional training as you move into more complex environments and more fragile clients, it isn’t about massage.

Whitney Lowe:

Right.

Sandy Fritz:

It’s about the environment and the hierarchy and safety. That could be delivered electronically with an apprenticeship program.

Whitney Lowe:

And that is exactly what drove me into looking into online education starting back in the early 2000s because I saw that picture and that model, which is that we had a situation where there were people that really thirsted for, wanted, and needed some of that track of training and they were being geographically discriminated against, or in many instance financially also, because the only way to get that training was with the continued education workshops from the people who had come through the cities and teach some of these more advanced training programs and things like that. It seemed like there were a lot of people not able to access that kind of training.

Whitney Lowe:

I was looking at this and thinking a lot of the same things that you are. We’re not necessarily needing to learn new things to do with our hands as much as we need to learn a lot more about the why and the win. Not know so much about what you’re doing, but why you do it and when you do it and how does it differ in these different kinds of environments. Those are all skills that could be done very effectively, I thought, in the online environment.

Sandy Fritz:

Absolutely. The other thing is that in these medical type environments with these fragile and complex clients, they’re fragile. Your massage approach is primarily comfort care. To swing it back to economics, it will take a lot of massage therapists to interface with that, and the budget is going to be an issue. People say, “Well, I’m going to make a lot of money because I work at a long-term care facility.” No. In fact, you’re going to make more money either in a wellness sector employment situation or if you’ve got a sustainable self-employed. I’ve always been self-employed massage therapist. People were just not happy when the pay scale came out for the VA. The VA job description is, as a medical technician, where they have a lot of support staff with massage therapy, and I think it’s in E5… anyway, it started out at about 15, $16 an hour. So we’re swinging back around to this whole economic thing. Where did we get to the point where we thought that our skillset was worth $150 or $200 an hour? Where did we get-

Whitney Lowe:

It’s the equation that the admissions department advertise in so many schools just to try to bring students in the door, and it really sets the ball rolling.

Sandy Fritz:

I would not pay me $100 an hour to do a massage. A lot of that is also coming from business coaches and the, “I need to be paid what I’m worth.” Well, I don’t know. A personal caregiver that takes care of somebody who is unable to provide their own basic care is probably frontline in compassion, and they’ll never be paid what they’re worth. I understand the economic pressures. I absolutely get that. We’re in an inflationary process and trying to keep up, but I see people saying, “Well, I rebranded, and I’m going to raise my fees again.” I’m thinking, “Holy cow.”

Whitney Lowe:

“I went and took a workshop with so-and-so, so now I’m going to start charging more because I took this two-day workshop on something new.”

Sandy Fritz:

Yeah, it’s crazy. Massage is a maintenance restorative system. It’s not 12 sessions. It’s best as, “I’m going to take care of you forever,” thing. And who can afford $700 a month to get a massage every week or every other week. At our franchise location, we’re more rural where I’m located in Michigan, and a membership model oftentimes supports affordability in a business, and taking advantage of the membership model there, it’s $60 for an hour session with a little bit of a discount for multiple sessions during a month. It’s an enticement for people to get regular care. Membership does stabilize a business because you have at least some idea of what a baseline income is going to look like.

Sandy Fritz:

People will say, like you said before, “I’m making all this money. It’s making all this money.” I’m in regular communication with franchise owners, and they haven’t taken a paycheck. That’s not just with franchise. People who buy franchises are good business people. They know how to run a business. If they can’t provide a product or a service at a price that is going to support public utilization, they’re not going to do it. And so, I see a potential contraction of employment positions, which is sad.

Whitney Lowe:

I had said that we wanted to talk about the future of our profession, so tell me a little bit about that in terms of, when you look at your crystal ball and you look at the future, the relatively immediate future and farther down the road too, what do you see happening with some of these trends? I mean, most of us I think in this field were completely caught off guard by the franchise system when it came around. We weren’t seeing that as a model, and all of a sudden, “Wow, this really changed a lot of things.” But do you see any of those big seismic shifts coming down the pike for us, or what do you see coming up ahead for us in the next decade or two?

Sandy Fritz:

Well, I’ve already mentioned that the international spa industry, the complex, whatever you want to call it. They are very nimble and they’re very savvy. A subset of that is the massage therapy franchise structure. The staffing is a real issue with massage therapists and-

Whitney Lowe:

Staffing, you mean getting them and keeping them?

Sandy Fritz:

Yes. There’s a lot of things, but it’s very frustrating to have massage therapists as employees. I am a massage therapist, and I employ massage therapists, and I only employ who I graduate, and I get frustrated. Because there’s so much done in terms of the career for a massage therapist by the employer that is not understood. We’ve talked about this before. This wellness sector is only going to grow, and it’s going to reach out and really start to look at chronic pain and chronic conditions and longevity and quality of life. It’s really going to be the platform.

Whitney Lowe:

Yeah. I mean it now seems to also follow the demographics of what is happening with the aging boomer population being a big lump of the current demographics of people who can’t afford massage and want to utilize it for those purposes. That seems like that’s going to be a likely growth space.

Sandy Fritz:

Well, and this was reinforced with this webinar I watched yesterday. This is a foundation of the strategy at NCCIH, which is whole person care. It’s about the whole person, is integrated, multimodal, multidisciplinary, integrated treatment plan concepts working together. Affordability and access was the big topic on that. How is that going to happen and where is that going to go?

Sandy Fritz:

They weren’t talking about that necessarily in medical settings. They were talking about that as part of public health. Healthcare is a big umbrella, and then you’ve got areas underneath it. Massage therapy is a healthcare profession. It doesn’t mean it’s a medical necessarily. You know, the lone medical, but it certainly has a place in an integrated team within the medical setting. The acute care medical setting is in trouble. We know that. This very innovative wellness center concept is going to really take over. Now, where are they going to get their people, where they going to get their staffing, and not just with massage therapy but things like meditation and nutrition and therapeutic skincare and all that kind of stuff? They’ll open their own schools.

Whitney Lowe:

So that could be a very significant trend. We’ve seen some touching on that to begin with, like if you want to train them people in those kinds of things for your organizations.

Sandy Fritz:

Yeah.

Whitney Lowe:

Get your own.

Sandy Fritz:

They’ll just get tired of it and they’ll train their own staff. In that process they’ll reset the economics. Now I, again, qualifying this with, I realize that we’re in an economic crisis somehow, at the same time, massage therapists are actually paid more than similarly trained other healthcare professionals. And not underpaid. Massage therapists tend to not want to work full time.

Whitney Lowe:

I mean, that does bring in another issue. I know you’ve worked on this issue with ergonomics things and stuff like that over the years. I certainly can agree in terms of the timeframe of what massage therapists are getting paid on a per hourly basis. But the other thing is the reality of doing massage full time for people takes a significant toll on their physicality, on their physical health to do that. Seems like that becomes another big obstacle to have to hurdle and jump is, how do you do enough massage to make a living? If you were to say, “Okay, our pay rate is within reason if we were working a 40-hour week getting paid that amount of money. But since I can only do this many massages a week before my body gives out, how do you do that?”

Sandy Fritz:

People can throw apples or rotten tomatoes at me if they want. You’re not doing it right if you can’t work full time. The Massage Therapy Foundation, they have rolled out phase one of an ergonomics analysis. I’m sure you sat in a room with me at one time, Whitney, when I stood up and said, “We have to have a for real ergonomics-

Whitney Lowe:

That one time? The one time?

Sandy Fritz:

I’ve been saying this forever.

Whitney Lowe:

Thank you for holding that candle. I absolutely agree with you, we definitely need to do that.

Sandy Fritz:

There are ways to perform massage. I’m going to tell you the thing that really down spiraled the ability to perform in a three quarter to full time practice was the whole idea of deep tissue. That really messed it up. We’re starting maybe to come out of that. I have trained people to work full time for 37 years. And full time on a 40-hour work week, a 35 to 40-hour work week… I just looked at it the other day, it’s 37 hours, is what it is. It’s not 37 hours of massage. It’s more like 25 to 30 hours. You can’t probably do massage the way most were taught. You can’t use your thumbs. You can’t do this deep tissue stuff. And you got to quit working hard and twisting and turning.

Sandy Fritz:

The ergonomics, phase one did highlight some issues that I think could make a difference. Hopefully that will help. But the way I see people work, no wonder, no wonder they can’t work full time. A massage therapist’s job is no harder than a construction worker and probably less. A waitress or a waiter, a food server works just as hard as we do if we’re looking at it physically. There’s something there. If the Massage Therapy Foundation actually moves through phase two, that’s where they’re going to look at what they call a duty schedule, what can massage therapists do ergonomically? What can they do? But discussions I’ve had with ergonomists and other experts in biomechanics, that 25 to 30 hours of this type of work should not cause injury.

Whitney Lowe:

I mean this is opening up a whole nother can of worms and something that I have talked about too, which is that this proliferation of schools that we had from the late ’90s up until the roughly just about 2010 time period where we ballooned up to something like 1600 schools in this country at least anyway, made a situation where we just did not have qualified faculty to staff all those schools. A lot of inappropriate methods, concepts, ideas, and things got promulgated for many years through those situations. A lot of that was poor biomechanical training for how to do massage. And that’s, I think, led a lot of people to have these perpetual problems. That’s a hard thing to undo.

Sandy Fritz:

Yeah., and it’s a real mess. It is. But a lot of massage therapists, I just looked at a bunch of stuff, they want to work three-quarter time. All right. Well, okay, because then now that’s a big thing in the world right now is work like bounce and this and that. “I want to control my schedule. I want to be this way. I want to be that way.” That’s about 20 hours. But you can’t expect full-time pay for three-quarter time. Work, right?

Whitney Lowe:

Yeah. That’s not how it works.

Sandy Fritz:

I feel bad, I feel really sad for the people who are wanting to do massage and then they hurt themselves because they haven’t learned some really basic principles like stand up. Don’t plunge. Use larger tools. Don’t reach. Don’t do long reachy strokes. For goodness sakes, we got to do something with this maddening deep tissue thing. The pressure, the idea of pressure, that’s embedded in the consumer now, and we did that to ourselves.

Whitney Lowe:

I mean, this is, again, many, many other cans of worms, the whole fascinating thing around lineage education models in our field that came from and so into this school and they were trained with, you know, Ida Rolf’s techniques, and that’s where this deep tissue process came from and all those kinds of things. So yeah, it is interesting to see that fan out, but it is a challenge I think that we all will have to grapple with for making people who can have a career of longevity for the future.

Sandy Fritz:

It sounds like sometimes when I do these types of interviews or podcasts that I’m real down on the profession. I’m not. Massage therapy is getting more recognition and more utilization if there were practitioners able to provide and environments that are career-sustaining if people understood how to be part of them than ever, than ever before. If we lose this opportunity again, the big employers who are looking at staffing, or even the little employers like… Franchises are all little single-owner businesses. They’re not great big chains. People don’t understand what that is. They’ll find other ways. They’ll bring in a float tank. I mean, there’s robotics now that are coming out, and they always show up on time. Now, they do break down, but they don’t whine and gossip and complain in the break room.

Whitney Lowe:

Okay, so we’re going to have to start talking about the therapeutic alliance in artificial intelligence now. I think that’s going to be another big podcast.

Sandy Fritz:

It’s huge. I see huge breakthroughs in the next five years. I’m excited for it. I’m not concerned that it’s going to take a human’s place, but augmented, very interesting thing to watch. We got to take a really solid look at apprenticeship type of education, blended education, online development for complex environments. We’ve got to really nail down the ergonomics, and we need to reeducate and re-inform about the economics.

Whitney Lowe:

Mm-hmm. Yeah.

Sandy Fritz:

It was really quite profound, wasn’t it?

Whitney Lowe:

Indeed. That’s a great place, I think, for us to wrap here on that profound thought. If it was just up to us, we would be going on for another couple hours here going through this. But Sandy, tell us, if folks wanted to reach out and connect with you, what’s the best place for them to connect with you?

Sandy Fritz:

Well, the school is Health Enrichment Center School of Therapeutic Massage in Lapeer, Michigan. We’ve got a website and a YouTube channel that’s got all sorts of cool stuff on it.

Whitney Lowe:

All right.

Sandy Fritz:

I’m active on Facebook. I know that’s being antiquated or whatever, but I’m very active on Facebook. I use it as a platform, and I respond best I can to messages and stuff. Now, if I don’t know who you are and I don’t know what it is, you got to be careful because you’re going to get yourself hacked or something like that. If you reach out to me through Messenger or something like that, then you got to be clear with who you are. You can’t just say, “Hey, Sandy, how are you?” I fell into that one?

Whitney Lowe:

All right. Good thing to know. I can probably get away with that, though, right? You’ll say, “Hey, I’m doing okay. How are you doing?”

Sandy Fritz:

Yeah, if I saw you, yes, I would.

Whitney Lowe:

All right. Well, Sandy, it’s been an absolute delight having you here, and I love having our conversation, so thank you again so much for doing that and for joining us here on The Thinking Practitioner today.

Sandy Fritz:

Well, you do a great job. I like this podcast. Like I say, I’ve been a fan from the beginning and hopefully we can do this again.

Whitney Lowe:

We will definitely do it again. Yes, we will do it again. Please keep in mind, The Thinking Practitioner is supported by ABMP, the Associated Bodywork & Massage Professionals. ABMP membership gives professional practitioners like you a package, including individual liability insurance, free continuing education, and quick reference apps, online scheduling, and payments with PocketSuite, and much more. ABMP CE courses, podcast, and the Massage and Bodywork Magazine always feature expert voices and new perspectives in the profession, including my partner, Til Luchau, and from me as well. The Thinking Practitioner listeners can save on joining ABMP at abmp.com/thinking.

Whitney Lowe:

We would like to say a thank you to all of our listeners. Thanks for hanging out with us here today. Hope you enjoyed our discussion and can stop by again sometime. If you would like to stop by our sites for show notes, handouts, transcripts, and any extras there, you can find that on my site at academyofclinicalmassage.com and then also over on Til’s site at advanced-trainings.com. If you got any questions or things you’d like to hear from us or hear us talk about, please do email us at [email protected] or look for us on social media. You can find us under our names there over at Til Luchau, also mine under Whitney Lowe on social media as well.

Whitney Lowe:

You can rate us on Apple Podcasts as it does help other people find the show. And you can hear us on Spotify, Stitcher, or Google Podcast or wherever else you happen to listen. And please do share the word and tell a friend. Thanks so much again for listening. We’ll see you the next time.

 

 

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