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Achieving Success in Integrated Care Settings

Integrated Care & Today's Student

While educators and practitioners debate the definition and practicalities of integrative health care, integrated practices continue to emerge at a vigorous rate. Hospitals, chiropractic clinics and wellness centers are combining therapies and clinicians in ways unimaginable even a decade ago. Massage therapy schools are struggling to keep pace with the needs of this new market by ensuring therapists have the competencies needed to thrive in these integrated employment settings. 

However, the focus of many massage therapy schools continues to be on the traditional one-hour massage session, on a massage table in a quiet room with dim lighting and relaxing music. Unfortunately integrated practices rarely offer these elements and many therapists are ill-prepared to make the necessary adjustments. 

Adapting to an Integrated Care Setting

The contextual elements of the integrated practice setting matter a great deal. For example, discussing treatment plans with a physician or psychologist requires communication skills beyond what might be expected in a solo or spa practice. In addition, massaging a patient on a hospital bed or chiropractic table requires significant adaptation of body mechanics in order to avoid injury to both the patient and practitioner.

Sometimes, too much emphasis is placed on the technique itself as the differentiating element of practice environments. Mastering the environmental nuances of an integrated practice is what generally leads to overall success in the setting. The skills needed to thrive as a practitioner in a hospital are very different than those needed to thrive on a cruise ship. One environment is not superior to the other; they are simply different and significant. Below, are five competencies for therapists looking to enter and thrive in integrated practice settings:

Five Competencies

1.  Communication skills 
Integrative practice environments by their nature involve interaction with different practitioners. The therapist will need to be able to communicate effectively, clearly and confidently with medical doctors, nurses, chiropractors, acupuncturists and physical therapists.

2. Respect for other disciplines
A therapist must have at least a rudimentary knowledge of and respect for the scope, philosophy and clinical theories behind the clinical approaches of their colleagues. A therapist who only knows massage and is not able to communicate respectfully about other practices will not likely experience success in that environment.

3. Physical environment adaptations
The therapist will need to have a practical knowledge of the physical environment and be trained in how to adapt their skills and body mechanics for that environment. For example, a therapist practicing in a hospital will likely be working with patients in hospital beds, not on a massage table. The therapist may need to work around intravenous tubes and heart rate monitoring equipment. All of these physical differences require training so the therapist will not harm either themselves or the patient.

4. Knowledge of contextual and cultural considerations
The therapist must be prepared for other contextual and cultural considerations specific to the environment. For example, a therapist practicing in a chiropractic office may be expected to provide focused work on a specific area for a short period of time while the patient is on a chiropractic table. In a hospital environment, the massage may need to be interrupted by other unscheduled clinical interventions.

5. Emotional fortitude
Integrative practice environments, particularly acute care settings often deal with patients who are very ill, perhaps in a lot of pain and maybe even dying. There is a certain amount of emotional fortitude needed by the therapist to work effectively with these patients on a daily basis.

About Dale Healey

Dale Healey has been in massage therapy education for 12 years and is the Dean of the School of Massage Therapy at Northwestern Health Sciences University (NWHSU). His curriculum development projects are most relevant to the development of the HBMT and Cancer and Massage Therapy courses.  He co-authored the paper “Steps toward Massage Therapy Guidelines: A First Report to the Profession”. Dale is currently working toward his Ph.D, in Higher Education.

NWHSU offers continuing education coursework focused on success in integrated clinical environments including hospitals and cancer treatment centers. These courses include clinical rotations and hands-on training in Twin Cities area hospitals. Please visit our website or contact our Continuing Education Department to learn more about our five-day training sessions.  www.nwhealth.edu or 1-800-888-4777 ext. 390

Show your students how to discover if the health care work environment is a good fit for them with AMTA's Massage Therapist Career Path Assessment.

Visit AMTA's Career Guidance section for detailed information on health care-related settings, including the AMTA Career Success Series: "Working in a Health Care Environment."



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