Massage therapists who work in hospitals in Pennsylvania, Ohio and Illinois sat down recently with the Massage Therapy Foundation (MTF) president to discuss their professional roles on the medical team, pay structures for this type of work, massage as a component of pain care, and how COVID-19 has changed the delivery of hospital-based massage therapy.

Massage therapists who work in hospitals in Pennsylvania, Ohio and Illinois sat down recently with the Massage Therapy Foundation (MTF) president to discuss their professional roles on the medical team, pay structures for this type of work, massage as a component of pain care, and how COVID-19 has changed the delivery of hospital-based massage therapy.

Robin Anderson, MEd, LMT, BCTMB, CEAS, is president of the MTF. She has been a practicing massage therapist for 15 years and directs Mpower Education, focusing on e-learning solutions for the massage industry.

Robin Miccio, LMT, CPMT, CEIM, has been a massage therapist for 11 years and works in an administrative role at Children’s Hospital of Philadelphia as its Integrative Health Program manager.

Corrie Frey, LMT, CIMI, CPMT, is a massage therapist at Nationwide Children’s Hospital, having worked there for 21 years total, 16 years as a massage therapist. Her focus for the last 10 years has been oncology massage.

Cynthia Spake, LMT, works at Blessing Hospital in Quincy, Illinois. She has been a massage therapist for more than 30 years and has worked at the hospital for the past three years.

The presentation was attended by a reporter from MASSAGE Magazine.

What is Medical Massage?

The group discussed the use of the term medical massage—and how some therapists talk about being certified in this type of massage. “But is it really a type of massage?” Anderson asked. “I really feel like this is something that is more environment-based or environment-driven.”

Robin Anderson
Robin Anderson

Frey said there is a strong on-the-job training component to medical massage, while Spake said that such trainings as hospice care and compassion-touch therapy transfer well to the hospital setting.

“It’s really applicable in a clinical setting where you’re going into a patient room and you have to very quickly think about where that patient is at that day in that moment, because the next day, when you go see that patient, it can be a completely different scenario,” Spake explained. “And so, being able to gather that information based on how the patient looks, or is the patient sleeping? How close do you have to get to the patient in order to make a connection?”

Those are some of the things that you learn when you take continuing education courses, Spake said. “It’s not really about technique as much as it is about what’s going on right in front of you at the time with this patient,” she added. “Of course, I read notes before I go in so that I have an idea of what I’m stepping into.”

According to Miccio, a massage therapist in private practice might have a treatment plan and provide massage based on a medical professional’s diagnosis; however, what makes that type of approach medical massage is the ability to bill for those services.

How Massage is Used in Hospitals

Departments that refer to massage therapy at Nationwide Children’s Hospital include the rehab unit, oncology, pulmonary, the ICUs, cardiology, and the burn and trauma units, said Frey.

“We do have a presence on pretty much every unit in the hospital … we pretty much cover the entire hospital,” she said.

Spake said the use of massage at Blessing Hospital is similar to what Frey described. “However, in our hospital, they have a large department that is strictly for behavioral health. And that’s a lockdown area, and we do not go into that area, but that’s the only area of the hospital that we do not get referrals from,” she said. “We’re very fortunate to have leeway, an opportunity on every floor in every department.”

She added that massage therapists at Blessing Hospital often work on patients who have addiction problems. “We get utilized a lot, especially for people that have very difficult pain, and also people who want more pain medication than they’re being given.”

Pre-surgery anxiety is another situation in which massage assists, said Spake. “Coming in and giving them, you know, a brief massage, neck, shoulders, hands, then that starts to calm them. Cueing them is just great … they just start to breathe a little deeper—and getting them calmed down so that they have a little better state of mind going into their surgery.”

Most of the massage services at Children’s Hospital of Philadelphia in 2021 were in oncology and gastroenterology, which is where the massage program was piloted, said Miccio, although massage therapists there also work on patients for pain, anxiety and other symptomatic events, she added.

Robin Miccio
Robin Miccio

Hospital-Massage Qualifications

Anderson asked the panelists what qualifications a massage therapist would need to be hired at each hospital.

The preference at Nationwide Children’s Hospital is that a therapist has two to three years of experience, and then additional training outside of traditional massage school, so having learned additional modalities, or earning certifications in infant or pediatric massage, and taking some classes in oncology, myofascial, lymphatic drainage or craniosacral, said Frey.

“The really cool thing with our team is we all had different trainings, and so we are able to collaborate and provide any of those services to our patients,” she added.

At Blessing Hospital, state licensing is the cornerstone of an application, said Spake. Once hired, the new massage therapist on staff is encouraged to complete clinical continuing training.

When massage candidates come to Children’s Hospital of Philadelphia, they are required to hold a state license and certification in pediatric massage therapy and have at least three years of massage experience, said Miccio.

“And then we’re also looking for those intangible, so-excellent oral and written communication skills,” she added. “We’re looking for people who can really think on their feet, deal with emergency situations, be able to build rapport quickly.

“We ask questions during the interview process to kind of get a feel for this,” she added. “We’re specifically asking candidates how they would feel working in an acute care setting environment—so, seeing bodily fluids, working around tubing, seeing sick children. I mean, you have to be OK with that.”

Pay and Benefits for Hospital Massage Therapists

Corrie Frey
Corrie Frey

What do pay structures, including benefits, look like for a massage therapist working in a hospital setting?

At Nationwide Children’s Hospital, said Frey, the majority of the team of 15 massage therapists is salaried. “We do have some contingent staff that are hourly,” she said, “but the great thing is we are offered benefits from the hospital.” Flexibility in scheduling is another perk, Frey added.

At Blessing Hospital, where a massage program began in 2018, all massage therapists are paid an hourly wage based on their experience combined with the recommendation from the U.S. Department of labor, and bonuses and benefits are paid as well, said Spake

At Children’s Hospital of Philadelphia, said Miccio, there are 1.75 full-time massage employees, paid hourly and eligible for benefits.

Results from the Joint Commission’s Mandate

Anderson asked the panelists if massage utilization had changed where they each work after a clarified standard made in 2017 by The Joint Commission—which accredits and certifies more than 22,000 health care organizations and programs in the U.S.—that hospitals must provide non-pharmacological pain management services that include such integrative therapies as acupuncture, relaxation techniques, massage therapy, chiropractic, cognitive behavioral therapy and physical therapy.

[Download a free report, “The Joint Commission’s Pain Standards: Origins and Evolution,” here.]

Not much has changed at Nationwide Children’s Hospital in this regard, said Frey, because the pain team there was already recommending massage therapy as part of the pain-treatment plan.

However, the clarified standard from the Joint Commission is what motivated management at Blessing Hospital to initiate a massage program, said Spake.

Medical providers at Children’s Hospital of Philadelphia are more open to integrative health therapies as an option for pain management since the mandate was issued, said Miccio.

“And then along these lines, our hospital uses a clinical pathways program,” Miccio said. “This really just supports standardization and quality in health care. Clinical pathways are almost like a care map that outlines evidence-based steps to care for a particular clinical problem, procedure, episode. We use this program, and so we’re beginning to get our services integrated into top clinical pathways, particularly in the pain management pathways.”

Massage + COVID-19 Patients

Cynthia Spake
Cynthia Spake

The final topic the panelists discussed is how, if at all, the COVID-19 pandemic has changed hospital-based programs. Both personal protective equipment (PPE) usage and telehealth came up as changes to hospital-based massage.

At Blessing Hospital, Spake said, massage therapists did not always wear masks before the pandemic but always do now. Her hospital isn’t offering massage to COVID-19 patients at this time.

Frey said at Nationwide Children’s Hospital, therapists are practicing as normal using PPE, and “we’re actually at the point where we’re even treating COVID-19 patients,” she added. Pre-pandemic, the massage therapists saw about 600 consults a month of new patients, she added, and although that number dropped during the pandemic, “now we’re getting back up there to those pre-pandemic numbers.”

Massage therapists at her hospital are also doing some telehealth visits, educating patient families on caregiver-child massage techniques during the initial period.

The Response to Hospital-Based Massage

How, Anderson asked, do massage therapists demonstrate the value of massage therapy in the hospital setting?

“One thing that really sticks out in my mind is during the pandemic, we were still considered essential, and still working through the pandemic,” said Frey. “I think we are very valued by the hospital because we have just had continued support all the way through. And they are supporting us in expanding, they support us when we need new staff—so I definitely feel that we are valued throughout the hospital.”

Spake replied, “How do you bottle what you see in front of you in the response of massage therapy, as we get a great response in front of us? That’s hard to quantify and to also show—but when other caregivers are in the room, and they see our work, sometimes they’re amazed. And sometimes they’re like, “Wow, I need to do this more.” And so, they see for themselves.”

About the MTF

The Massage Therapy Foundation is a 501(c)3 providing support to the massage therapy profession. Since 1990, MTF has provided over $1 million in research grants studying the science behind therapeutic massage.

[Watch the MTF’s panel discussion of Hospital Based Massage Therapy, which includes information about documentation and notes, collaborative patient care, how medical professionals refer to massage in the hospital setting, and how the panelists first got into hospital-based massage, here.]

About the Author

Karen Menehan is MASSAGE Magazine’s editor in chief, print and digital. Her recent articles include “As Clients Return, Massage Therapists Vanquish Touch Deprivation” and “A Move to Transcend State Boundaries: Updates on the Interstate Compact for Massage Therapists.”