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Nancy Ann Cotter MD

Clinical Assistant Professor

Dept PMR, Rutgers NJ Medical School

Clinical Director, Whole Health

VANJ Medical Center

BRINGING MASSAGE TO MAINSTREAM MEDICINE

Bringing Massage to Mainstream Medicine

• What are the needs of organizations, institutions, and individuals as pertains to massage therapists?

• Organization: Why, safety, economics

• Institution: Why, for who, how much, safety, economics, risk

• Individual: Who do I want to work with? How do I communicate my message? What are the logistics of getting scheduled and getting paid?

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LMT

Facility

Organization

Massage as part of an organization

• Healthcare organization: Is this part of our mission and vision?

• Mission: What we do/ how we do it/ our values

• Vision: Where we see our future self

• Mission Example: • Personalized, proactive , person centered care

• Personalized care for those who prefer holistic approach

• Mission to decrease opioid medication

• Vision example: • We will be a leader in combining leading edge technology with holistic care

• We will be a leader in partnering with our community and provide culturally relevant care

• Return on investment: what will the returns be? • Higher satisfaction scores- patient and family

• Decreased medication usage

• Goodwill and good press

• Risk and risk avoidance

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Where we put our health care dollarsvs

What actually contributes to health

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Social Determinants of Health: Developing Healthy People 2020. CDC Health Disparities and Inequalities Report- US, 2011. MMWR Jan 14, 2011, Vol 60.

Where we put our health care dollarsvs

What actually contributes to health

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Social Determinants of Health: Developing Healthy People 2020. CDC Health Disparities and Inequalities Report- US, 2011. MMWR Jan 14, 2011, Vol 60.

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Massage in an institution: Patient satisfaction!

• Attracts patients: edge over the competition• Example: new parents package on Mother -Baby Unit

• Patient safety: addresses pain and anxiety nonpharmacologically• non-pharmacologic pain management for rehab in substance use disorder;

• specialty massage for patients with specific diagnoses

• Comfort/ compassion: support for the most vulnerable• Human touch in hospice, pediatrics; may be supported by donors

• Calming: caring for anxious family members• massage for family members of ICU patients

• Economics: fewer medications, fewer adverse effects, leads to decreased length of stay

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Massage in an institution: What are the barriers?• Patient acceptance:

• Will we alienate an age group?

• Will we be culturally challenging to any group?

• Patient safety:• Who will provide training and oversight ?

• In high risk populations, will we have our precautions in place?

• Economics: Who is going to pay for it? • Most hospitals accept all insurance; compensation profiles vary

• Cannot discriminate between those who are covered and those who are not

• Satisfying demand

• Managing access

• Managing expectations

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How does the LMT get the attention of a hospital?

• Individual: Who do I want to work with?

• Specific age group: pediatrics, elderly, new mothers, teens

• Specific diagnosis group: Oncology, Cardiology, HIV etc

• If you don’t have experience , or don’t know what your “fit” is: volunteer!

• What is my role on the team?

• How do I communicate my message?

• Special training and experience

• SOAP notes ; documenting pre – and – post

• Understanding the pressures of the decision makers

• Respecting the many vantage points of decision makers ( ie need for “evidence base” )

• What are the logistics of getting scheduled and getting paid?

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LMT

Facility

Organization