All For One

By Michelle Vallet, August 1, 2019

Little more than 100 years ago, the face of American medicine was completely different. Most of the research that was being done to advance the profession was occurring in Europe, partly because very few American physicians had the drive or the know-how to conduct good research, but mostly because faculty salaries in American medical schools were paid by student fees, so programs had few, if any, standards for entrance or completion. In many schools, students graduated with medical degrees without ever seeing a patient or the inside of a laboratory.

The foresight of a handful of medical professionals and the good fortune of Johns Hopkins leaving a $3.5 million trust fund to found a university and hospital, helped redirect the future of medicine and focus attention on what would make the most difference: creating educational standards that would ensure all physicians would have some common knowledge and skill set. A seemingly simple goal helped revolutionize American medicine, and allowed the profession and its practitioners to advance not only their understanding, but also their reputation.

Trying to think of a profession that hasn’t—at some point—aimed for consistency in education and what its practitioners know and understand is difficult, if not impossible. From civil engineering to information technology, most other professions reach the point where formally documenting what its practitioners know is a natural evolution.

Making this leap, as the massage therapy profession has done with the newly released Massage Therapy Body of Knowledge (MTBOK), is becoming a hallmark of maturity in a profession, according to Chip Hines, project manager for the MTBOK. “In the case of massage therapy, the MTBOK helps define the core competencies of the profession, which is valuable because of the tremendous diversity of practice found in our profession.”

Nuts and Bolts of a Body of Knowledge

In part, a body of knowledge builds credibility within a profession because it helps alleviate confusion for other professionals, as well as consumers. “There is a wealth of information about what massage therapy is, and in practice massage therapy is rich and diverse,” Hines says. “That’s part of what makes our profession so exciting and responsive to the many needs of our clients. But it’s also what leads to some confusion about what specifically a practitioner knows and what they are able to do.”

The MTBOK aims to bring some consistency to key areas of massage therapy so that consumers and practitioners in allied professions have a basic understanding of how massage therapists are educated and what they can do within the profession. “A body of knowledge helps bring about a universal consistency in what professionals are taught and are able to do in their work,” explains Hines. “It helps the profession focus on a core knowledge as a basis for the profession, and supports growth in consistent directions.”

In other words, similar to scope of practice, a body of knowledge gives a profession a strong foundation they can collectively build upon while, at the same time, giving consumers and other professionals a concrete idea of what can be expected of a profession’s practitioners.

And the confidence and understanding that often result from setting these expectations in the minds of people who aren’t massage therapists can be huge in terms of building and maintaining the profession’s reputation. When consumers and allied professionals fully understand what makes a massage therapist a massage therapist, the gap between “OK, I’ll give massage a try” and “I know massage therapy will help” shrinks. “The MTBOK will help strengthen the acceptance of massage therapy as a mainstream health care profession,” Hines says. “It will help massage therapists ensure that their peers have a consistent understanding of the knowledge necessary to practice massage therapy effectively.”

What About Me?

Gaining credibility and building a solid reputation are good things, but what does a body of knowledge mean to a massage therapist specifically? Simply put, for massage therapists, the MTBOK represents a collective knowledge of what you do within the massage therapy profession.

Hines understands the initial curiosity that might come from outlining educational standards and core competencies, as the MTBOK does. “One obstacle that will be overcome in the early years is the fear that an MTBOK will result in changes to what massage therapists can do,” he says, “or what they have to do to be able to continue to practice.”

Keep in mind, however, that the goal of a body of knowledge isn’t to radically change a profession or its practitioners, but rather to flesh out and fi m up what in many cases practitioners already know and believe about their profession.

That’s not to say that educational standards absolutely won’t change the profession on some levels. But any changes that might occur will most certainly be to the benefit of the profession and its practitioners. “The MTBOK will help ensure that those practicing as massage therapists meet standards of excellence,” Hines explains. “It will help massage therapists identify gaps in their knowledge that can be aided by continuing education, and will help continuing education providers develop courses that are specifically targeted at the knowledge, skills and abilities of the profession.”

Understanding where gaps in knowledge exist can also help drive research initiatives, giving the massage therapy profession another concrete way to define what it does. “The MTBOK provides a single place for research results to enter into the profession,” Hines says.

Even with some growing pains, however, the beauty of the MTBOK is that the profession and its practitioners are—and have always been—in control of its development. The MTBOK was created by and for the profession. Even better, it’s a living document massage therapists will continue to develop. “The profession needs to understand that they continue to be the ones who determine what is in the MTBOK,” explains Hines.

Into the Future

Nobody has a crystal ball, so knowing exactly how the MTBOK will infl uence the massage therapy profession in the future can’t be known at this moment. That there’s enormous potential for growth and advancement, however, cannot be questioned. “I think that the MTBOK will help make massage therapy a commonplace activity referred by practitioners from all of health care,” Hines suggests. “The consistency that comes from all massage therapy domains [practice, accreditation, research, certification, education and licensure] being informed by and informing the MTBOK will help make the massage therapy profession run smoothly.”

And most massage therapists have imagined that world, the world where respect and credibility are assumed instead of wondered about or cautiously extended. Not at all to suggest the real benefits of massage therapy aren’t well-known, but steering this momentum to solid, consistent ground gives the massage therapy profession an advantage when looking to develop relationships with allied professions. “Since part of massage therapy is becoming more aligned with mainstream health care, the establishment of the MTBOK strengthens these ties and helps to demonstrate credibility within the clinical and health care community.”

Today, it’s hard to imagine a physician graduating from medical school without seeing a patient, as the expectation from consumers seeking medical attention is, and has been, that their doctor has been adequately trained.

Sure, patients ask for second opinions and don’t blindly accept everything a doctor tells them, but many defer to a doctor’s judgment, specifically seeking out medical advice because they trust their physician’s opinion.

But that wasn’t true in the not-so-distant past.

And when you think about it, 100 years is a blip in the life span of a profession, and in that time, medicine recognized a need, built a foundation based on educational standards and competency, and continues to realize growth in ways that most probably weren’t even imagined by the medical professionals who first put out the call to action.

You, the stakeholders, the massage therapists and educators who have a real share of the future of this profession have a similar opportunity in developing the MTBOK. “The MTBOK will not only keep massage therapy from stagnating but will also help with the growth of the profession,” Hines believes.

Come Together

The Massage Therapy Body of Knowledge (MTBOK) is a prime example of the good that can be done when people and organizations work toward a common goal. “The current MTBOK was produced in two distinct phases,” Hines explains, “and the impact of the diversity of organizations cannot be overemphasized.”

During the initial stages, several organizations from not only massage therapy but also other allied professions were invited by AMTA to participate, an approach that fostered the understanding that the process would be open to differing perspectives instead of focusing on the views of only one organization. In the best interest of the profession, the participating organizations (Stewards) agreed their role in this project should be one of stewardship.This means they would not control the project, but due to the importance of the work and its impact on the profession, they would establish its outcomes and be accountable for its success.

Five organizations ended being active participants, all key representatives of massage therapy. “This first phase determined the stewards of the MTBOK, and resulted in a comprehensive, well-thought-out approach as to how the MTBOK should be developed to ensure it represented the profession’s view of what should be in the body of knowledge,” Hines says. “Having this mix of organizations helped ensure balance and independence in the development of MTBOK content. Checks and balances were built into the way the MTBOK would be accomplished.”

Phase two, where actual MTBOK content was developed, was accomplished by a group of volunteers selected by the MTBOK steward organizations. “In this way, the process was developed by a diverse group of participating organizations working together,” Hines explains. “But the content was developed independently of them.