The Hospital Environment

When Dale Healey graduated from chiropractic school, he faced a dilemma common to many new graduates: He didn’t know exactly what he wanted to do with his degree. So, Healey took a job teaching while he thought about the direction he’d like to take his career, only to find out that teaching was the career direction he’d been looking for. “I learned I liked teaching a great deal,” he explained. Now, as dean of the school of massage therapy at Northwestern Health Sciences University in Bloomington, Minnesota, Healey is in a position to help massage therapists who want to pursue hospital-based massage therapy.

Nuts and Bolts

Healey doesn’t believe the definition of hospital-based massage therapy needs to be complicated. Simply put: Hospital-based massage therapy is massage therapy that is based in a hospital setting. “Or, to put it another way,” he joked, “hospital-based massage therapy is massage therapy that happens in a hospital.

There is a clear and distinct difference between massage therapy that happens in a hospital setting and the massage therapy done in spas or a sole practitioner’s office—but it’s about environment, not skill-set. “Hospital-based massage therapy is not a technique or modality,” Healey suggested. “Hospital-based massage therapy is defined only by its location.”

Why? According to Healey, massage therapy is now being used in the hospital setting for many of the same reasons the general population seeks out massage: stress reduction, anxiety, and general relief from pain and depressive symptoms. “The hospital is a highly clinical environment, but there's not a huge clinical focus required of massage therapists,” Healey explained. “The hospital is full of people who will diagnose, so massage therapists don’t have the pressure to participate in the clinical decision-making tree.”

This clinical environment distinguishes hospital-based massage therapy from other practices in key areas, Healey explained. For example,in a hospital environment, you’ll be seeing patients (not clients), some of whom are going to be critically ill or dying.Additionally, Healey said, contraindications are common in these patients, which most often isn’t true in other massage therapy practices.

There’s also the difference in physical space that needs to be mentioned. The typical practice setting—where dim, controllable lights,a private room with a massage table and somewhat predictable scheduling are expected—goes out the window with hospital-based massage. In a hospital, massage therapists often have to adjust to the schedule of several people, mainly the patient and physician. Interruptions are common, as well, and massage therapy is performed with the patient in bed in their room, where lighting and noise isn’t often easily controlled.

The Right Stuff

Healey wasn’t shy about the fact that hospital-based massage isn’t going to be for everyone. “This is a hectic environment,” he told attendees.“Patients are in the hospital because they’re sick. It takes a real strong resilience to manage that day in and day out.” In fact, he’s up front with students considering attending the program at Northwestern Health Sciences University, encouraging them to be honest with themselves. “I basically ask them if they’ll be able to walk into a room and not burst into tears,” he explained. “Can they go home at night and not carry the events of the day with them?”

Massage therapists working in a hospital setting also need strong interpersonal skills. “You’re going to have to work with a lot of different people,” Healey said, “so you’re going to need negotiation skills.” Think seriously about how you’ll perform in a hospital, and assess both your personal preparedness, as well as if there is need for hospital-based massage therapy in the community where you practice.

Ask yourself some questions, and answer them honestly: Does a hospital-based massage therapy practice fit with my personal and professional goals? Am I qualified to practice in a hospital environment? Will I be able to handle the emotional challenges of a hospital-based position? How do I feel about working with patients who are very sick and perhaps dying? Is my personality suited to working with doctors, nurses and other hospital employees?

When assessing where you might practice hospital-based massage, asking yourself these questions is helpful: Is there a local hospital need that I could help satisfy? Does the compensation and schedule meet my needs? Will I be the only massage therapist on staff or joining a well-established team? Will I need to struggle to create a program or be coming into a massage-friendly environment?

Opportunity Knocks—Again

Since the mid-1800s, massage therapy was part of the nursing curriculum. In the early 1900s, too, hospital-based massage therapy was common and respected.

But then nursing shortages happened, government regulators began demanding more documentation, insurance carriers introduced new billing methods and medical technology and drug companies started overshadowing the benefits of hands-on methods of care.

Today, however, Healey sees the pendulum swinging back once again. In part because health care costs are rising at a rate that’s no longer sustainable. But also, an overwhelming number of hospitals are adding complementary and alternative medicine options because patients are asking for these services. “Patient demand is driving an increase,” Healey explained. “Patients are asking for these options.”

In hospitals, pain management is the No. 1 reason massage therapy is used, and Healey believes this idea has large potential. “This is huge,” he said. “Massage therapy has an opportunity to have an impact here.”

Foot in the Door

That demand for hospital-based massage is increasing is a good thing, but this increase also has implications for the massage therapy profession. According to a study conducted by the American Hospital Association, evidence-based research is the second highest-ranking criteria hospitals use when selecting complementary and alternative therapies. “That evidence-based research is so high on the list of criteria should indicate an importance for us to pay attention,” Healey explained.

Being well-versed in recent research findings regarding the efficacy of massage therapy, however, won’t be helpful if you can’t get in to talk with the hospital staff making decisions regarding complementary and alternative therapies. Here, your ability to build personal relationships with key personnel is absolutely essential. “The importance of building personal relationships cannot be underestimated,” Healey said. “You need to find the individuals that you can make connections with to get your foot in the door.”

Ok. But how do you do that?

A good first step is to understand who in the hospital environment commonly supports complementary and alternative therapies. Currently, according to research by the American Hospital Association, hospital administration tops the list of hospital personnel that supports initiating complementary and alternative therapy programs. “Sometimes, hospital administration is looked at as a barrier,” Healey noted, “but these people are leading the way and some of the biggest supporters of CAM.”

When you know who you should talk to, take the time to understand where you might fit. Healey warned against what he called “sending a gift basket,” and instead encouraged attendees to find authentic and genuine ways to communicate with hospital personnel. “Find out what they need,” Healey suggested. “Find out what the hospital’s mission is and what their interests are.” In other words, do your homework, and have an idea of how you and your skills fit the hospital’s goals and mission before reaching out to hospital personnel.

Hospital-based massage therapy offers a great deal of opportunity. First, however, massage therapists need to assess if this environment fits their professional goals.

BOOM!

It’s no secret that the baby boomers are aging—and there are a lot of them. This demographic is perhaps the first, too, that takes significant interest in remaining healthy and active. Combine these two factors and the impact this generation is going to have on the health care system cannot be underestimated.

This demographic isn’t interested in aging gracefully, but instead wants to remain active and involved. For many baby boomers, retirement is a time to reinvent themselves, not settle down. But with this zest for life comes an increase in chronic diseases and a greater need for health care services. And, as with almost everything else this generation has done, they have different expectations than the generations that have come before them.

They expect to be offered services that focus on maintaining wellness, not simply restoring health or relieving symptoms—presenting a good amount of opportunity for complementary and alternative programs. “I believe baby boomers are going to have a huge impact on the health care system,” Healey predicted. “They’re going to create a big demand for complementary and alternative medicine programs in a hospital environment.”

According to research done by the American Hospital Association, baby boomers utilize complementary and alternative therapies in fairly large numbers, with 70 percent of boomers reporting they’ve used some form of complementary and alternative option.