Massage therapy is an important part of a health care regimen. There are significant benefits to be achieved through the use of massage therapy treatments including, but not limited to, reducing or eliminating pain, improving joint mobility and circulation, reducing the physical symptoms presented by depression and anxiety, chronic stress, reducing muscular tension and improving lymphedema. Patients may seek care from a massage therapist for a variety of acute and chronic conditions, and massage therapists can work with a wide variety of patients in the treatment of illness, injury rehabilitation and disability.
- Massage therapists shall maintain personal hygiene and professional appearance.
- Massage therapists shall differentiate between personal and professional beliefs and behaviours.
- Massage therapists shall utilize professional oral and written communication.
- Massage therapists shall apply conflict resolution strategies as appropriate.
- Massage therapists shall demonstrate a commitment to life-long learning.
- Massage therapists shall conduct themselves with honesty and engage, employing appropriate relations, with patients by acknowledging the inherent imbalance of power by virtue of therapist authority and patient vulnerability.
- Massage therapists shall maintain patient confidentiality and trust at all times as appropriate to the therapeutic and fiduciary responsibilities.
- Massage Therapists shall listen to and respect the patient’s values, opinions, and cultural beliefs.
- Massage therapists shall be alert to and report, as required, any unethical practice by any member of the regulated health professions.
- Massage therapists shall always act in patients’ best interests as defined by the patient’s wishes and consistent with the standards of practice of the profession.
- Massage therapists shall endeavor, through their practice of massage therapy, to improve the quality and scientific knowledge related to the practice of massage therapy.
- Massage therapists shall provide reasonable access and appropriate care while maintaining the effective distribution of resources for both patient and therapist.
Provision of Information and Consent
- Informed consent requires massage therapists to discuss with the patient information about the benefits, risks and potential side effects of massage therapy treatment.
- Massage therapists must communicate the findings of the assessment and treatment recommendations including proposed treatments or procedures to the patient that are based on their presenting complaint, health history and objective and subjective assessment to ensure the patient is informed of the treatment plan.
- All decisions regarding the initiation of a treatment program will be made jointly with the patient, or when necessary, with the patient’s advocate.
- A record of informed consent to treatment is obtained voluntarily from the patient, or the patient’s advocate indicating the patient’s consent to treatment and must not be based on fraudulent or misrepresented information.
- It is the patient’s right to refuse or terminate treatment at any time, regardless of prior consent. Written consent to disclose personal health information must be obtained prior to sharing any portion of the patient’s health record with a third party or other health care practitioner.
- If a request for a release of the patient's health record is made by the third party, the patient must be immediately informed of the request and explicit consent provided.
- All third party requests must be reasonable and relating to the specific reasons for treatment, and specifics relating to the frequency, duration, and clinical outcomes.
- Provincial legislation outlines compliance requirements for health care consent.
- A posted schedule of fees and services must be readily available for current and potential patients.
- Policies and procedures regarding payment and fees for missed or cancelled appointments must be readily available.
- Fees for a proposed course of treatment must be congruent with displayed fee schedule and must be reviewed in detail with patient prior to commencement of treatment.
- Individual financial consideration for deviation from the fee schedule may be applied at the discretion of the massage therapist and documented in the clinical notes indicating the reasoning and agreement.
- The patient is entitled to an official receipt for all payments made to the massage therapist. Each receipt will include the date of treatment, treatment provided, and fee received. The massage therapist’s name, registration or provider number and signature are required on all receipts along with all other requirements as outlined by the provincial regulatory college or association where appropriate.
- No one should enter the clinic if they show signs of communicable disease; they should be tested for COVID-19.
- Public health authorities recommend the use of masks in indoor settings for those who are not fully vaccinated.
- Physical distancing in waiting rooms and other high traffic areas is advised (it is likely that you do not know the vaccination status of everyone in the practice environment).
- Hand hygiene must be followed.
- RMTs must not provide in-person care if they are waiting for the results of a COVID-19 test.
- Ensure adequate ventilation. > More
- Universal hygiene precautions for infection control and public health must be followed at all times.
- The area to be used for the practice of massage therapy shall be clean and free of impediments to ensure adequate space for safe movement and comfort.
- Massage therapy equipment and supplies shall be properly maintained and disinfected.
- There shall be separate areas for the patient and massage therapist to prepare for and engage in the practice of massage therapy.
- Undressing, draping and re-dressing procedures must be explained to the patient and agreed upon. This includes:
- Reasoning for removal of clothing and respect for the patient’s right to decline the removal of certain or any clothing.
- Ensuring privacy while the patient disrobes or dresses, out of the view of the massage therapist and other people.
- Instructing the patient on safely getting on and off the table and advising of the use of sheets to cover themselves once they are in position for treatment.
- Providing non-transparent draping materials, and arranging and securing draping so that only the part of the patient’s body that is being assessed or treated is exposed.
- The patient is told the nature and purpose of the proposed assessment/reassessment and/or treatment including areas of the body involved
- The massage therapist shall engage in therapeutic communication with the patient to determine the level of comfort as it relates to pressure and depth of touch, as well as general patient comfort including positioning.
Patient Health Records
Patient health records must be dated, accurate, legible and comprehensive and must include the following:
- Personal information including patient name, address, phone number(s), date of birth, source of referral (if any), and name and address of primary care physician.
- Health history information including general health status, primary complaint or area of focus, location and nature of pain or discomfort, contributing factors, current medications use and purpose, allergies or hypersensitivity reactions, timing and nature of injuries, accidents or surgical procedures, limitations on daily life, history of massage therapy, current involvement in treatment with other health care practitioner(s).
- Assessment and reassessment findings based on history, observation, palpation, movement, neurology, referred sensation and special tests as relevant and including acute and chronic conditions or pain, range of motion, evidence of tenderness or tension, potential risks of treatment and consultation with or referral to another health care professional if clinical reasoning or contraindications to massage therapy exist or a more desirable outcome would be achieved through that referral.
- Treatment plan based on clinical findings containing patient goals, all proposed treatment methods and areas of focus, anticipated frequency and duration of treatments, and anticipated patient responses to treatment.
- Records of ongoing treatment based on relevant research and evidence, patient education, recommendations for home care as relevant, treatment outcomes, relevant changes in patient status and all other required elements as listed by the provincial regulatory colleges or provincial association where appropriate.
- Documentation relating to the provision of consent (see Provision of Information and Consent Standard above).
Additional provisions covering patient health records include:
- Must be compliant with the requirements for the protection, privacy and security of records as set out in the Personal Information Protection and Electronic Document Act, and the respective provincial health information privacy legislation and all other relevant legal requirements.
- Records must be confidential and safely and securely stored to protect against reasonably anticipated threats or hazards to the security, integrity, loss or unauthorized use, disclosure, modification or unauthorized access to health information.
- Records must be stored in Canada and, if in digital format, stored on servers based in Canada.
- Records must be maintained and accessible according to the appropriate provincial requirement. Massage therapists must retain personal possession of the records, or have access to those records, or make arrangements for a custodian to assume this responsibility.
- Records may only be released if the request to release records has a basis in law or the patient has expressly consented to such release including the full scope of the request.