Medical Massage vs. Wellness Massage
The way I understand and practice them, medical massage and wellness massage are two entirely different services.
Medical massage is medical care delivered to a patient under the direction of a prescribing health care provider and typically paid for by a third party.
Wellness massage is a consumer service delivered to a client who pays for the service themselves.
The table below is my attempt to clarify and elaborate on the differences between these practices (another table illustrates how clinical massage and relaxation massage fit in). This is an early draft of a work in progress. If you have comments, criticisms, or suggestions please leave a comment below.
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Medical Massage |
Wellness Massage |
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commercial context |
health care system |
personal service industry |
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customer relationship |
patient |
client |
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dominant paradigm |
scientific, problem-solving |
intuitive, nurturing |
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reason for treatment |
medical necessity |
client request |
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focus |
functional outcomes |
client satisfaction |
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termination of care |
maximum medical improvement (usually) |
when client’s needs are met or change |
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primary massage treatment techniques |
clinical massage techniques like myofascial treatments, deep tissue massage, cross-fiber friction, neuromuscular “trigger point” technique, and muscle energy technique |
relaxation massage techniques like Swedish, deep tissue, circulatory massage, and craniosacral |
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pricing |
rates set by UCR and RVU |
rates set by the consumer marketplace |
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billing services |
yes (discount for payment at time of service) |
no (all payments due at time of service) |
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payment |
can take 30-90 days or longer |
due at time of service |
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tipping |
never/rarely |
often |
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therapist accountable to |
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Medical Massage |
Wellness Massage |
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time spent on documentation, coordination, and communication |
5-20 minutes or more per session |
1-5 minutes or less per session |
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training |
basic 500-hour massage certification course plus advanced training in
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basic 500-hour massage certification course |
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experience |
need clinical and professional experience and/or an internship |
can start practicing right after graduating from massage school |
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receiver’s emotional state/level of proactiveness |
didn’t ask to be injured, may be depressed, anxious, or otherwise distressed by both the injury/accident and/or ensuing work, life, and health complications |
proactively seeking care, typically healthy and active |
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physical demands on practitioner |
can be heavy – orthodpedic assessments, muscle energy techniques, myofascial treatments, cross-fiber frictioning, and other injury-treatment techniques can be hard on your body |
may be lighter – Swedish and some other techniques are less demanding, but deep tissue massage can be hard on your body |
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emotional demands on practitioner |
can be heavy – patients can be disengaged, distraught, or otherwise unengaged or difficult to engage |
typically light and/or manageable |
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client education |
may be OK (therapist should ask the prescribing referrer about this), but shouldn’t contradict what the rest of the medical team is saying |
OK within scope of practice (“drink plenty of water,” “do that stretch I showed you,” “put an ice pack on it,” etc.) |
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marketing model |
business-to-business networking with referring providers, health care networks, etc.; many legal and ethical considerations regarding referral relationships, etc. |
consumer marketing (much like a tax preparer, hair dresser, real estate agent, etc.); gift certificates, referral discounts, and other consumer marketing practices are OK |
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Medical Massage |
Wellness Massage |
Clinical Massage vs. Relaxation Massage
Two other terms often arise in the process of distinguishing between medical massage and wellness massage. I primarily use clinical massage techniques, and approach my work with a clinical intention, in my medical massage practice, but I also take a clinical approach with some of my wellness clients. Similarly, I primarily use relaxation massage techniques in my wellness practice, but sometimes doctors prescribe massage for its relaxation benefits, so I sometimes use it in my medical practice. Here’s a graphical look at this idea:
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This page created 8/3/03; last updated 2/4/10.
{ 7 comments… read them below or add one }
Hi, this is good.
Does a licensed massage therapist, who is also nationally certified in neuromuscular therapy, and certified in manual lymphatic drainage and complete decongestive therapy have to also have a “medical massage” certificate to be able to deliver “medical massage” and have the services paid by a third party (i.e. insurance company)?
Thought I’d ask you as I don’t know for sure.
Thanks for you time Larry. I live in Florida
As far as I know, there is no additional requirement beyond your state license (and possibly your credentialing with managed-care networks) to deliver medical massage and bill insurance companies. If I learn differently, I’ll post the info to the website.
Best,
Larry
hi, larry, i liked this info.. very good stuff.. I am a new therapist and
i would like to one day start my own business.. I first want to
get my feet wet and work for a doctor or phyiscal therapist..I’d like to know
a liitle more about billing insurance.. I live in Texas.. DO u know
if it’s approved here ? THanks..
Wow, I hope your readers do their research. Yes I practice wellness massage & have all but one or two training skills you mention. Many colleges offer over 750 hrs. Of training not including volunteer work throught out the duration of our education. As for massage treatments we are trained in all or most of what you have list: I think 1-5 per sesion is a type o, right?, no harm done. It is good to question the difference liken the difference b/w misuse and therapist. Therapist receive academics in medical ed. Thank you for bringing up the conversation it was a good chat. CA Massage Therapist
Hello Larry,
Thank you for this great information. I have been providing massage therapy to hospice patients for the past 5 years and it was especially helpful to see in print the emotion challenges of medical type massage. For quite a few Pts, massage was elected by someone else and it takes time to engage them. Or they are so distressed by their prognosis and or failed treatment regime that they are not even connected to their bodies.
I am in the process of starting my own business because the hospice organization cannot pay me a sustainable income. It kills me. They are so rich and use massage to get the leading marketing edge…. What I do appreciate about them is that each person entering hospice has the option for massage. Since medicare etc. does not reimburse for massage I don’t know how to get paid except to provide care only to those who can afford it.
One idea is to become a non profit and grant writing. Any ideas or suggestions anyone has would be appreciated.
Thank you,
Pat
I am very surprise to get this information on this links from my teacher. She always sharing information that she known and think that will work/useful for her students. After reading the comparation between medical massage and wellness massage … it’s very useful for me! I am still in massage school learning about massage and may use this information in the future for talking to client and be able to explaining to them the different between these two massage. As I know that wellness massage usually do not get paid by health insureance and must be paid full price at the time of customer service . Sessions for the full body treatment within half hour or 60 minutes….and they might get the result after massage. Result is: relaxation, decrease tight muscle, pain, soothing tired muscles, improve circulation, and promotes an overall sense of happiness. Medical Massage is focuses on the areas have problems and treat the cause of pain. Medical massage take your personal insurance and required prescription from a doctor and only the area is determined by your doctor in treatment sessions. And the length of the session is determined by the number of treated area (until you get well)
Again, thank you for sharing this information so we can exchange ideas with each other by comparing these two kind of massage!
Hey Larry,
I am a Medical Massage therapist. I have over 1750 hours in my AA degree and 4 years internship. The biggest difference between Medical Massage and Wellness Massage is that we treat pathologies. There are specific treatments for Thoracic Outlet syndrome, Carpel Tunnel Syndrome, Frozen shoulder, scoliosis, etc. I offer treatments rather than 60 or 90 min massage and it does take time to “fix” the problem. I go by percentages and have my clients/patients come in once a week until the issue is resolved then come in once a month for maintenance if it’s needed. I am also trained in Orthopedic testing, along with all the rest you mentioned. Travell and Simons Myofascial Pain and Dysfunction vol 1 and 2 are good books to become familiar with if you are interested in learning more. A “cliff notes” version would be The Trigger point manual by Clair Davies. It is very hard on the hands and the body to this type of work, so if you decide to pursue it, make sure you have someone who can treat you who does similar work. The Medical Massage Office is a great tool to help with paperwork and filing insurance. Personally, I’ve moved away from a clinical setting and now work in a Wellness Spa (though I don’t do any spa therapies), my clients come with issues from their doctors and pay me directly. I now come under the heading of Holistic Healthcare Practitioner. I hope this was helpful.