January 25, 2020
Commissioner Monica Bharel, MD
Massachusetts Department of Public Health
250 Washington Street
Boston, Massachusetts 02108
Dear Commissioner Bharel:
On behalf of the approximately 3,000 members of the Massachusetts chapter of the American Massage Therapy Association (“AMTA-MA”), I am writing to seek clarity on the inclusion of massage therapists as health care providers under Commonwealth’s vaccination plan. In particular, while the Massachusetts Department of Public Health’s initial standard was straightforward, the subsequent inclusion of some professions and not others under non-COVID-19 facing health care provider has caused confusion.
As you know, Massachusetts massage therapists are licensed practitioners who provide therapeutic massage services to enhance the health and healing of the body’s soft tissues. Currently, there are over 12,000 licensed massage therapists and over 1,000 licensed massage therapy establishments in the Commonwealth. One of the fastest growing health care professions, massage therapy is increasingly viewed as part of integrative health care.
In particular, evidence continues to build, showing massage therapy as effective treatment of many common health complaints, including, but not limited to, anxiety and depression, post-operative recovery, headache, neck and shoulder pain, low back pain, athletic injury and post-exercise recovery. A study looking at the role of massage therapy in pain management found that “massage therapy may be beneficial, with minimal safety concerns, for treating various pain and function-related outcomes in pain populations.” A study looking specifically at massage therapy and the treatment of shoulder pain found “[t]he effect size estimate showed that massage therapy had a significant effect on reducing shoulder pain for short-term efficacy.” In short, while not a panacea massage therapy continues to demonstrate its value within health care.
With the aforementioned in mind, the DPH’s initial delineation of COVI-D-19 facing and non-COVID-19 facing health care providers was straightforward. Unfortunately, the subsequent addition of specifically named health care professionals created confusion by the act of omission. While massage therapy services are certainly not emergency medical care, these services are a part of many Massachusetts residents’ health care regimen. Whether used to assist in the management of anxiety, chronic pain, addiction or any other number of ailments, massage therapy has a role in today’s integrated health care world – just like physical therapists, occupational therapists, chiropractors and others – one that needs to remain available to residents of the Commonwealth.
The massage therapy profession, which has been focused on hygiene and public health, well before our statewide licensure in 2006, continues to work to protect practitioners and clients alike. Through a close adherence to the Commonwealth’s guidelines for “close contact personal services”, guidance issued by the United States Occupational Safety and Health Administration, guidance provided by the Centers for Disease Control and Prevention as well as standard best management practices that pre-date the COVID-19 pandemic, the massage therapy profession has remained focused on prevention and the safe provision of services. As a result, the DPH’s specific reference to massage therapists as non-COVID-19 facing health care providers will clarify the current standard, ensuring that patients can continue to receive these services.
We look forward to the opportunity of working with your agency to ensure that the massage therapy profession continues to meet the needs of practitioners and clients while balancing the overarching concerns for public health in light of COVID-19. I appreciate your consideration of this important matter. If you have any questions or concerns, please do not hesitate to let me know.
AMTA-MA Chapter President
Secretary Marylou Sudders, MSW
Executive Office of Health and Human Services
1 “Evidenced-Informed Massage Therapy: The Research Supporting Massage Therapy as an Integral Component in the ACA’s Essential Health Benefits”, Brooks, Hamm et. al, (2012)(https://www.massagemag.com/wordpress/wp-content/uploads/media.wix.com_ugd_866ad1_dcf69b1d9437e85c5d68ab1304fdee1b.pdf).
2 “The Impact of Massage Therapy on Function in Pain Populations—A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population”, Pain Medicine, Vol. 17, Issue 7 (July 2016)(https://academic.oup.com/painmedicine/article/17/7/1353/2223191).
3 “Effectiveness of Massage Therapy for Shoulder Pain: A Systematic review and Meta-Analysis.” Journal of Physical Therapy Science, 29(5): 936–940, (May 2017)(https://pubmed.ncbi.nlm.nih.gov/28603376/).