08: Key Challenges Facing Our Field, Part 2

Episode Transcript

Summary: Til and Whitney talk about the key challenges and opportunities facing manual therapy, bodywork, and massage therapy. (Part 2 of 2) 

In this episode, 

• Increasing the accuracy of our explanations, 
• Polarization, divisiveness, and infighting within the profession, 
• Consolidation and up-scaling of the bodywork “industry,” 
• and more. 

Whitney Lowe:

Welcome to the Thinking Practitioner. Hello, everyone and welcome to The Thinking Practitioner. I’m Whitney Lowe, and joined today by my co-host, Til Luchau, and we’re going to hear first off from our sponsor for today’s message from Books of Discovery.

From Andrew Biel

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Til Luchau:

All right, thanks, Whitney. Thanks, as always to Books of Discovery, and our other sponsors. We are doing part two today of our discussion of Challenges Facing Our Field. We did part one in episode four, and we had our own particular favorites, our greatest hits in terms of the challenges, and the opportunities those open up, and Whitney, we left off with you, I think you were going to explore one of your challenges you perceived.

Whitney Lowe:

Yeah, and also, just again, a reminder, as we were talking about this, I found it fascinating that we did kind of talk about this in terms of challenges and opportunities, both, because I think we can sometimes slip into this place of just complaining about things, and saying, “These are all our big problems, and things facing us.” But, I liked that we framed that in terms of the opportunities that find themselves within there as well. Anyway, today, one of the items that I want to bring up was the issue of increasing the accuracy of our explanations of what we’re doing, and sort of getting into discussing why it matters that we explain things the way that we, or explain what we’re doing with both our clients, maybe with other colleagues, and other health professionals that we’re working with in conjunction with them.

Whitney Lowe:

This to me is a challenge, because there are so many myths out there about our field, in terms of what happens. We were taught lots of stuff. I know many of you probably were taught lots of things in your early initial training that may have changed a little bit, or the perspective has changed a little bit based on current research that’s come up, and now we’re saying like, “Oh, we used to think this, but now we sort of have a better understanding that something different is happening.” This is a challenge because if you do not keep up with some of the current information, and the research that is out there, you might be using descriptors, or sort of narratives about what you’re doing that might not be consistent with our current understanding of things.

Whitney Lowe:

And so, I do believe it is important for us to be accurate, as accurate as possible about what we’re doing, and there are number of different reasons for that. Number one is, the better we understand what we’re doing, the better we can sort of shape it, and adopt it into various different challenges to those kind of situations, like if something you’re doing doesn’t work a particular way, and you understand why it should be working, or what it’s doing, you can adopt it and change it in a way that might help it work differently, but it’s also very important, I think, for us to be able to have a good sound physiological understanding of why the treatments do what they do, or what various different approaches do what they do.

Whitney Lowe:

We’ll try to put this in the show notes as well, Todd Hargrove wrote a wonderful little blog post about why it matters in explaining the things that we do, why we do what we do? I would encourage people to take a good read of that, because there’s some really good stuff on there, so what are your thoughts about that Til in terms of the difficulties or challenges that we face in explaining what we’re doing?

Til Luchau:

Well, let me make sure I understand what you’re saying, because you’re saying some important things. You’re saying accuracy matters for its own sake, just so that we have a sense of how what we’re doing helps, but then, you’re saying it also opens up possibilities for us to apply our work in more flexible ways? I’m I right?

Whitney Lowe:

Yeah, absolutely. Yeah, absolutely.

Til Luchau:

I’ve got to say, well, let me help you unpack a little more before I try to respond, because it’s a complex issue. Are there costs of not being accurate? Did you see?

Whitney Lowe:

Well, I think, in some instances it could lead us down a road of misinformation. Here’s just one possible example of possible misinformation that we might transmit to clients who then transmit that to other health professionals who then form a perception of, “Oh yeah, people who do soft tissue manual therapy, massage therapists, body workers…” Whoever, “They don’t know what they’re talking about, because this is not current information.”

Til Luchau:

So, if we’re citing mechanisms that don’t have currency, or don’t have acceptance across the scientific consensus, maybe that doesn’t reflect well on us you’re saying?

Whitney Lowe:

Yeah, and I would say, there’s other instances where this is not going to happen to us a great deal, because the majority of the work that we do is pretty safe with people, but there could be instances where an enhanced understanding of some physiological responses to certain types of work that we’ve done might encourage us not to do that so much anymore. Just as an example, four years, back in the early days of training, I was taught working on the iliopsoas muscle deep in the abdominal region with some pretty significant pressure pressing down on that to treat the iliopsoas to work on it, and number of years later after exploring, and talking to, especially a number of people who are doing cadaver dissections, and reporting very high frequency of the presence of abdominal aneurysms, aortic aneurysms in the abdomen, saying that you’ve really got some potential to do some significantly harmful things in that area if you were to put pressure near the iliopsoas, on the external iliac artery, which is a branch right off of the aorta there.

Whitney Lowe:

And, that could cause a backflow of pressure that might be very dangerous for an existing aneurysm, so that narrative of what we do, and explaining what we’re doing would change based on our better understanding of physiology.

Til Luchau:

Or, in this case pathology. Some of the risk factors involved.

Whitney Lowe:

Yeah.

Til Luchau:

You could say. Well, Iliopsoas is a hot topic. It’s amongst the topics I’ve caught the most flak for in the different articles I publish. It’s like waving a red flag, and a lot of people will come out of the woodwork to express an opinion on iliopsoas. I think, we should have that for an episode, I’m thinking.

Whitney Lowe:

I imagine we should.

Til Luchau:

Yeah, but the larger topic you’re talking about is accuracy in general. I’m just going to try to take devil’s advocate for a minute, and I think the concerns, or objections to what you’re saying might be something like, well, who has the monopoly on accuracy? Who is it to say that your idea was accurate is the way that we should all be talking?

Whitney Lowe:

That’s a very good question, and I think this calls into question, is there some central authority that says that? I certainly don’t think there is, and we’d like to think there’s some degree of consensus of ideas on certain things, but we also have to recognize at a certain point that when some findings challenge an existing narrative, or an existing understanding, it’s kind of up to that individual to say, “Hey, this is the evidence supporting my reason for saying there’s maybe a change of perspective about what we’re doing.” Or, “Here’s why there isn’t a lack of supporting evidence for.” For example, the sort of myth around massage being able to enhance lactic acid removal for years that perpetuated until enough of an understanding through physiological studies came out, and said, “That doesn’t really happen.” Yeah.

Til Luchau:

Yeah, so here’s the other possible objection. You mentioned currency, and what about the fact that our ideas are always changing? And, what was current 10 years ago is now considered obsolete, and maybe even wrong?

Whitney Lowe:

Yeah, I mean, that’s a big factor, and here’s another interesting one that troubles me about this idea of our drive behind evidence-based practice, or evidence-informed practice emphasizing following things that are published in research. There’s all kinds of problems with how accurate stuff is that is published in research studies down that’s coming evident, because of some of the publication biases of some of the different journals, the way in which a lot of the articles get accepted into these journals. For example, there’s an incredible bias against articles that report negative results, so you’re much more likely to get something published if you have positive results on a certain treatment procedure, or the thing that you’re talking about, and that produces a certain bias about whether, or not stuff that contradicts something that exists is going to even get published to begin with, and so-

Til Luchau:

Publication biased, but help me get clear on which way you’re arguing it. Are you saying that we should be more attuned to scientifically consensual ideas, or that’s a problem?

Whitney Lowe:

I think both of those things are true.

Til Luchau:

Okay, go ahead.

Whitney Lowe:

I think it’s beneficial for us to really try to stay as current as possible, but also, not lose our critical and analytical thinking as we analyze new things that come out and say, “Is this really worthy of us changing a perspective about things?” Because it is tempting to sometimes just jump on the bandwagon, say, “Oh, this is new or different.” Or, “This is all wrong.” Or, “Something’s different because I saw it.” I hate to say it, but the people who say, “Because I saw it on the internet.” Or, “Because, it came out in a journal.” Or whatever, that doesn’t necessarily mean the whole world has changed, the whole paradigm has shifted those things. We need to see, is there an accumulation of a body of knowledge that really supports those ideas?

Til Luchau:

And, you see that as a challenge facing a field, one of the big ones on your list?

Whitney Lowe:

Yeah, it does, and it sort of taps into some other things, and we’ll get into some of these a little bit later, but it’s particularly challenging and difficult in our field, I think because we don’t come up through sort of an academic discipline of looking at research literature a lot in our field. Our whole educational system is not really shaped around that, and that’s, of course, a whole nother can of worms that we’ll get into in a little bit, but yeah. I think that certainly is true.

Til Luchau:

Was there more you want to say about that? Because, I do want to respond, but I’m going to respond with a concern of my own that starts a whole new topic, which is-

Whitney Lowe:

Well, yeah, let’s do. I think we can kind of spin off on where we go with that, so yeah, tell me what comes up for you

Til Luchau:

Well, that brings me to one of mine, which is the divisiveness, or polarization, or splits within our profession where there’s-

Whitney Lowe:

Yes, that’s a big one.

Til Luchau:

Yeah. Where there’s a lot of diversity, but there’s also a lot of polarization meaning would people just think, people don’t think like them are just wrong.

Whitney Lowe:

Yeah.

Til Luchau:

It’s a tricky realm, because I am somebody with strong opinions, and I got pretty clear values, and yet, somehow, collectively, not just in this field, I see it in our field, but of course, as a society, we’ve lost the ability to agree to disagree. We’ve gotten worse, at least at having our differences of opinion, and one of my concerns, or one of the challenges I see facing our field is that there are a lot of differences of opinion around for example, what you just spoke about, the idea that accuracy is defined by science, and currency is defined by science is desirable. That’s even a debate right there, so that point of view, which I actually am sympathetic to, I’m a science geek guy, is polarizing in certain conversations.

Til Luchau:

You go to social media fora, or places where any other point of view is polarizing, but that point of view itself can be polarizing in the right conversations too. There’s objections to a science oriented perspective, that are probably worth considering, worth keeping in mind, in my opinion, and yet what we’re losing is the ability to have conversations or have understandings that go beyond our own perspectives. That’s my fear.

Whitney Lowe:

Yeah, I think, that is so pervasive, and it is a significant challenge and problem for us because I think a lot of this, it’s I don’t know that we really want to blame it on social culture, and in our current society certainly.

Til Luchau:

Talking about like social media certainly exaggerates, so you can get more clicks if you’re stronger and more extreme in your opinion, so that…

Whitney Lowe:

Yeah, and it’s interesting to watch discussions in social media arenas like Facebook groups, or something quickly devolved from academic debate into personal attacks on people, and you wonder like, how much of that would happen if these people were in the room together talking about this versus hiding behind an electronic screen where they can shout and yell at everybody? But-

Til Luchau:

I that in the ’90s, the first forums I was a part of, we were discussing this, like we can see now that we’re interacting differently than we do in real life, and that’s become a well established phenomena. Yeah, fora go bad over time. They get more and more divisive, they get more and more polarized, they get more and more acrimonious, and people quit. They don’t want to do that. People get more enraged, they do want to do that, and that’s just some sort of devolution that can happen, and that’s a

Whitney Lowe:

Yeah, if we look at that through that lens of opportunities, how do we take this big challenge of communication, and try to do something with it that helps us enhance communication for the future? What do you think about that?

Til Luchau:

Yeah. I think it really is the skills we need now. It’s the skills of being able to understand different points of view, being curious enough about, and to really take the time to understand them, even articulate them, and then, my own personal goal is to even be sympathetic to them, even if I don’t agree with them, or they won’t resonate. To at least be able to put myself in their shoes enough to understand them, and that probably is becoming old fashioned, unfortunately, and yet, that’s the opportunity there for me. It helps me examine my own narratives, it helps me question, and shake them up, and a lot of things in our field are changing along the line to where you said, and it keeps me flexible. Keeps me learning and growing, so some of the opportunities there.

Whitney Lowe:

I saw a really good example of that, as matter of fact, I think it was just today I was reading this, and I’ll ask you maybe to just comment on it from your own personal experience. This was an article or a piece that you had written that just got published in the Terra Rosa e-magazine, from Australia, on your thoughts and perceptions from the Fascia Research Congress, and the San Diego Pain Summit are two kind of-

Til Luchau:

He put those together by the way.

Whitney Lowe:

Who did?

Til Luchau:

yeah, those are two different articles. He converges them-

Whitney Lowe:

Oh, is that right?

Til Luchau:

Yeah, he converges them, so this is interesting contrast and comparison. Do you mind if I 

Whitney Lowe:

Excellent.

Til Luchau:

Yeah.

Whitney Lowe:

That’s excellent. I thought it was a very good demonstration of looking at both of these different perspectives, because these two events are to me representative of some of these kind of different camps that exist in opposition to each other. Sometimes often in perspectives that are sort of thrown around out there on social media discussions, and I thought you did a really good job of talking about how do we see ourselves in these different arenas? What was that like for you, and being at those two events of doing that?

Til Luchau:

Well, oh boy, that’s a big question. Thanks for the compliment, first of all, but it’s challenging. It’s challenging, because once, but loyalty is my background, my lineage, my friends, my community are in the fascia world pretty strongly. That’s been taught at Rolf Institute for 20 years, etc, and yet, my interests, my curiosity, the possibilities, I think are aligning toward the neurology of what happens, the psychology, the social aspects of what we do, the contextual effects of what we do, which are less physical, and more about the process of being alive. There I was in the research congress, it was about fascia, which was actually as I wrote in that article super exciting. I was so surprised, and blown away by the amount of liveliness in that field, because fascia has been kicked around for a long time in various ways.

Til Luchau:

I mean, it was many about integrity, things like this. They’ve been concepts for a long time and when somebody who’s been in the field for a long time, years and things, okay, so that’s great, that’s cool, there’s more of that, and yet, there’s lots of so you could say refutations to a refuting of our old ways of seeing things going on too. I was really pleased to be in Berlin, and be excited with all of the new dimensions that are coming out, the catchphrase was, “It’s about the liquids. It isn’t about the fibers. It’s about the flow. It’s not about the fibers.” That kind of thing.

Whitney Lowe:

I like this, about the liquids not about the fiber.

Til Luchau:

Yeah, so really understanding the fluid dynamics of fascia, and how it dissipates in our immune systems, and tissue repair, and the connection with lymphatics, connection with other sorts of intracellular processes.

Whitney Lowe:

Yeah, and that’s a great example there too of how that that shift in perspective amongst that community really is an example of trying to increase the accuracy of those explanations, because there’s been a pretty significant degree of refutation of the tissue-based models of changing soft tissue structure through manual therapy.

Til Luchau:

Yeah, well, let’s say this way that we don’t have a consensus anymore, whether they’re thoroughly refuted and dead, who knows? It’s certainly in some people’s mind. You can go to places in social media where that’s clearly the case. There are spheres or bubbles where that model is been debunked, and debased, and gone. There are other places you go which, very much alive, and evolving, and clear. That’s part of the challenges in our field that we’ve compartmentalized ourselves, conceptually, and academically into these different domains, where there is evolution happening, and each of them, but there’s probably less crosstalk like than they would like, so it was fun to go to both of those events within a few months of each other, and really get the sense of what’s going on in each field.

Til Luchau:

My interest is in really how does this expand my realm of possibilities as a practitioner? I look for the applications, which really do transcend either point of view. Neither one was particularly polarized I got to say that, The polarization seems to happen, like you said on social media, or in particular individual’s opinions, but there’s a lot of people that are they doing fascia research that involves a lot of neurology, for example, and a lot of understanding of experience as its own thing, and there’s a lot of interest in the pain world about say, the neuro immune system, and is… say fluid dynamics, and the fact that it’s a physical structure as well as a psychosocial process.

Whitney Lowe:

These are all interesting perspectives, I think, of different ways to address keeping current. Do you have any particular suggestions, or ideas, or opportunities for people to… how best to keep current with stuff, so that we can challenge these idea?

Til Luchau:

Well, I’m going to ask you that too, because we didn’t get your opportunities around staying accurate, but maybe that’s where some of them lay. How best to stay current. I mean, for me, it’s diving into the stuff I’m interested in. I guess, taking it down to a practical level, even if it’s just a little bit of listening to a podcast, here we are, or a little bit of reading online, or a little bit of talking to people, having discussions, talking shop with people, trading ideas. The amount of that, you work into your diet, so your professional diet will keep you well nourished in this sense, keep you diverse, and for me is actively looking for things outside of my spheres, outside of my bubble, to understand how other points of view are seeing it, and how they’re talking.

Whitney Lowe:

That to me is one of the true beauties of despite all the headaches and craziness that social media has brought into our lives, to me it has been one of the most wonderful opportunities also that we can have conversations with practitioners on the other side of the world in very close to real time discussions, debates about research studies, or blog articles, or books, and things that are out there that make you start thinking about stuff, and it was so much easier to stay in your own silo, and bubble many years ago before that kind of communication was not available there, so this is one of the opportunities that comes out of that challenge, I think, is the fact that there is so much opportunity to look at things from a different perspective based on the input from other people that you would never have had the opportunity to communicate with, or get to know previously before we had that kind of open communication.

Til Luchau:

There you go, that’s a great opportunity, and then, there’s also an opportunity, I think, to go beyond the middle. The middle has disappeared in our politics, maybe the middle is disappearing in a lot of ways, and it isn’t about just having both sidesm, is something I heard criticized the other day. The idea of you’re trying to take both sides and stay in the middle, and not take a position. Understanding where things fits, amongst other points of view actually helps me get clearer and stronger, and where I want to practice, and what I value, so there’s an opportunity there as well, yeah.

Whitney Lowe:

Yeah. Great, do you think it’s time-

Til Luchau:

Is that good for that ?

Whitney Lowe:

I think that’s definitely good there, yes. I think, we should probably take a break here real quickly, and hear from our halftime sponsor, who is our sponsor today for this show?

Til Luchau:

Half time sponsor, Handspring Publishing, and the story there is that when I wrote my books, my advanced professional techniques books, I had two offers; one from a really big international media conglomerate, and another from a little tiny company in Scotland, it’s made up of four people, and that’s Handspring Publishing, and I chose them basically, because my gut said they’d be a whole lot more fun to work with, and they helped me make the books I wanted to share their catalog over the years has really emerged as one of the leading collections of professional level books. They write them especially for body workers, they say and for movement teachers, and for all professionals who want to use movement, or touch to help patients achieve wellness.

Whitney Lowe:

Yes, by all means, they certainly have done a great job of putting together a great catalog for the Movement Manual Therapy Professions, and their author list reads like a who’s who for many of the leading thinkers in our field, so if you’d like to head on over to their website at handspringpublishing.com and that’s where you can browse this outstanding catalog of great offerings from them, and once you find those wonderful treats that you’ve got to have, hey, it’s getting close to the holiday season, or probably by the time this episode comes out, it’s going to be past the holiday season, so how about maybe beginning of the year treats for yourself. Go-

Til Luchau:

Your birthday?

Whitney Lowe:

Yeah, right, so use the code TTP at checkout for a discount from them.

Til Luchau:

Handspringpublishing.com TTP check it out.

Whitney Lowe:

Yeah, great. Good. We kind of looked at a couple of those key things there. What else comes up that we need to look at with the big challenges and opportunity?

Til Luchau:

Oh, I got a few more. You want me to go, or you want to go?

Whitney Lowe:

Yeah, go ahead, and I don’t think I talked a good bit about getting all that well, whatever. Just, yeah, go ahead and tell me what your next one is on the list.

Til Luchau:

I want to talk about the discouragement I hear in our field, and I try to think it through for myself, I think maybe there’s a distinction that’s important between our field’s training aspect, and our field’s press practice aspect. Certainly, in the training aspect, the people that have really organized their work, and the professions around training people, overall, I could say, there’s a lot of discouragement partly because, yeah, you know what I mean?

Whitney Lowe:

Tell me about that. Tell me what kind of discouragement you see? Can you give me some examples of what you’re-

Til Luchau:

I was shocked a couple times in the last year to hear a couple of my colleagues in the training industry, because they say, “This is done, we’re done.” The numbers are going down, new people coming in it’s going down, it’s plateaued. It’s not happening. Certainly the number of schools has dropped enormously in the last decade, and then, the overall number of practitioners is still growing gradually, but it’s leveled off, and this curve, and the number of people entering the field has gone down. I think the training industry is super discouraged. Many aspect of people I talked to was super discouraged. Do you agree?

Whitney Lowe:

I would say so. I have heard those similar types of things that everybody… Many of the individuals that I speak to speak of much greater challenges here, both at the entry level for training, which is lots of schools having to close because of low enrollments, and that sense of like, there’s something really unfortunate happening here. There are some other really not so good fallout of that as well, which is, for example, Lippincott Williams and Wilkins dropped their entire line of massage therapy textbooks, and so, again, they saw this industry, or profession as a area where they did not want to keep putting their money.

Whitney Lowe:

Now, honestly, lots of the big publishers are struggling with what publishing is going to be looking like now in the next couple decades, and many of them are moving away from their former emphasis on textbooks, but that is a sort of a symptomatic indicator I think of a lot of other things going on, but what you said in terms of the discouragement, yeah. I hear that a lot from the educators, and other people who are having a hard time continuing to do the kinds of things that they were doing. A lot of people don’t realize, for example, how expensive it is to offer CE programs on the road, teaching and traveling, they see this as a big goldmine moneymaker for people that are doing stuff without recognizing that there’s a whole lot of expenses that go into the other end of that, and for a lot of people it’s a lot of stress, and a lot of effort to pack up your stuff, and get on the road, and go do all this kind of stuff, so it’s not so fun if you’re just barely breaking

Til Luchau:

Well, of course, you’re preaching to the choir on that one, but it’s poor us as teachers who have to travel around and teach this stuff, what a great thing to complain about? But no, it’s a big deal, and like here in Boulder, the closure of the Boulder School of Massage Therapy or Boulder College Massage Therapy, hundreds or maybe thousands, probably thousands of graduates over the years who have emerged in the field as leaders, and people in the profession, and to see their alma mater closing down, because it couldn’t get enough students is one of the factors was a big shock.

Whitney Lowe:

Yeah, and how do you think that, I mean, because I have heard similar types of things from individual practitioners also feeling some degrees of discouragement, this kind of taps back into some issues that we talked about in episode four around income levels and financial pressures from franchise associations, and things like that, so I wonder, does that impact the quality of care that individuals are getting from people who feel more stressed about being able to keep going and keep themselves moving ahead in this field?

Til Luchau:

Good question. Of course, it does. If I’m seeing more clients, and it’s good for me, if I’m getting appreciated, either financially or emotionally less than is good for me, then it’s going to affect the quality of what I can do.

Whitney Lowe:

Yeah, that also ties into one of the other things that I was seeing here is another challenge as we’re talking about this with especially with some of the educators that are teaching a lot of, let’s say, coursework in the continued education realm, because it is interesting in our fields in particular how there is sort of this entry level training, and then, everybody goes to continue education courses for advanced training, or specialization later on down the road, and with fewer of those courses may be being offered, or fewer opportunities for people to do that kind of stuff, is that going to affect and shape the training, and the skills that people are coming away with in the future that might be again available to clients that are out there? It seems like to me like that’s also shaping a good bit of what’s happening here in the future?

Til Luchau:

Well, I mean, I’m an interested party, it certainly drives my business, the business of training and credentialing people in our own certification program, and there’s quite a bit of interest in there. There’s probably a record year for us, because even though there’s a lot of discouragement out there, there’s a lot of people that want to go further with it, and maybe the bottom half, or I don’t know what proportion, the bottom part the market is getting even more difficult to get into it, it’s getting more difficult to get established. The wages are lower than they were 10, 15 years ago, and yet the top end of the market is for at least in a lot of places thriving. It’s really going forward, and furthering their education through this hunger for knowledge, and this tradition, long tradition of continuing education.

Whitney Lowe:

Yeah. To me that sort of speaks at when we get back to the opportunities of individuals looking at this particular realm is that if you can keep yourself from getting swept away in some perceptions, discouragement about where the field currently is or where it’s possibly going, there’s a tremendous amount of opportunity to make not only a tremendous impact, but also a very successful financial model for yourself within this arena. There’s no question it’s possible. It’s still possible, and available to a lot of people to do that if they want to. I mean, if they can find the right setting-

Til Luchau:

Or, you can say, yeah, if you can make it through the first five years of your practice, or whatever that number is the future looks bright. Every class I teach, which is a couple times a month, at least, I’m meeting people that are just having to deal with too much work, and so, it’s out there, and this is all across the country, all across the world, actually. It’s out there, it’s finding the way to make it work for you, and your situation.

Whitney Lowe:

I think that kind of gets back to, again, something else that we were talking about in the previous episode two, about individuals coming out of many of these training programs now without as much perception about an entrepreneurial model for what they’re doing, and looking for employment opportunities, and this is sort of a blanket generalization, but I would say that the majority of people who find themselves to be most financially successful in these fields are the ones that are able to find a pathway for themselves into that entrepreneurial world of either being their own solo practitioner, or working for somebody else in a situation that works really well there, or owning a clinic with other therapists there, or being part of a group practice of some kind-

Til Luchau:

That’s interesting.

Whitney Lowe:

But, some form of entrepreneurial environment that seems to be more successful for.

Til Luchau:

Do you think that’s a make or break? Do I need to be an entrepreneur to be “Successful?”

Whitney Lowe:

Absolutely not, because I know there’s a lot of people who work in a franchise environment and are extremely successful, and love what they do in that particular model for say, so it’s not something I think is by any means a requirement, but I would say that it is a trend of more people finding their own, because it’s not just about the financial end of it either. I think, for a lot of people it’s about the sense of personal control over their business, their practice, their life, or whatever. That sense of autonomy that people really love to have from an independent work situation.

Til Luchau:

Well, I know in allied professions, or parallel professions such as physical therapy, there’s a big trend toward wanting a self paid practice where you’re essentially working for yourself, and working for clients who can pay their own bills, because that does provide a lot of freedom, and gratification, and better rewards, so there’s that similar kind of drive, or desire incentive in our world to do body work or massage, and yet, I just heard what we were saying polarizing it into either franchising or entrepreneuring, and there’s a lot of places that I see people working that aren’t franchises, and on your own there’s people that have jobs they love, and allows them to thrive, and focus on what they want to do, which is their work without having to worry about running their own business, and having their own website, or whatever else that involves.

Whitney Lowe:

Yeah, absolutely, and that’s a good point. Yeah, we certainly wouldn’t want to indicate that there was just those two ends of the spectrum, because there’s all sorts of gray area in between there of the percentages of those different types of the work environments, but I think, each one of them poses a unique set of both challenges, and opportunities for the people who are there.

Til Luchau:

Or, people like, I want to give her a shout out Diane who’s doing… What does she call her forum? Massage Mentor?

Whitney Lowe:

The Massage Mentor.

Til Luchau:

She’s really got a model. She’s saying, “Let’s help those of you want to be entrepreneurial do it, go for it, run a business and hire some people, and make that work on that level too.” She’s not trying to start a whole chain of franchises, she’s saying, “Let’s help you really be the organizer for some talent in your area to make this work for everyone.”

Whitney Lowe:

Good. Well, we probably have time for just maybe a couple more quick ones in here. You’ve got anything else? Big challenges and opportunities in

Til Luchau:

My turn already? Okay. Did we get into your credentialing one enough? You mentioned that.

Whitney Lowe:

We didn’t. I was going to kind of maybe say we’ll wrap up with one of those, so I can jump off on that, or we can do it after you do it, whichever you like there.

Til Luchau:

No, I looked down my list. I had discouragement, I had the consolidation and up scaling. That’s a concern I hear a lot.

Whitney Lowe:

Tell me what that’s about?

Til Luchau:

Yeah, we’ve heard some of that. The people who have concerns about the emergence of franchising as a model, or the emergence of big schools coming in and buying up smaller massage schools as a model. When we did our poll in social media about people’s concerns to get some topics to talk about here, that emerged as a pretty frequent one, and it’s complex, because there’s good and bad, let’s put it that way. It’s difficult to, I mean, one, it drives down prices when you get the economies of scale that involves driving down prices for the consumers, which means there’s less to pay practitioners, and there’s also middleman involved to take a cut, so that’s the bad side. The upside is that it makes it more available. There’s more people, arguably, who have access to it, and can get involved in it, as well. It becomes more and more woven into the fabric of our culture, and it becomes more accessible to more people.

Til Luchau:

It’s the same concerns, though that happened with globalization. It means there’s movement of people, there’s movement of resources, and movement of interest, and that means moving away from some areas, it gets more difficult, and then there’s movement, and we’re having people come into this country, and I know just traveling in Europe, there’s a lot of cross border travel in the body work community for people to go to where people pay more, and there’s a lot of concern amongst people in the country when they see people coming into their country to take jobs, and are willing to take less, so that’s a topic in itself, and that’s in our field. It’s not something that we tend to talk about a whole lot. They certainly emerged in those polls that we did.

Whitney Lowe:

Yeah, I think, it’s just like any system you see any system as it grows and evolves growing into increasing levels of complexity, and it’s kind of hard to move away from that sometimes, so that’s going to be a natural part of its evolution it seems.

Til Luchau:

And yes, and the double edged sword of opportunity opening up, and yet the potential for exploitation, because the real shadow side of that is really the human trafficking where it’s to bleed over into sex work or there’s not a clear line. Let’s say, that’s not the only reason that can be exploitive either, that while many therapists working abroad seize an opportunity, we know there’s lots of situations where people feel indentured, or trapped into those situations too.

Whitney Lowe:

Yeah. God, I certainly would not have predicted 10, 15 years ago that we would have seen those kinds of things so pervasive for us having to deal with those in our field now, but it’s become a crazy world for sure. Well, yeah. One other thing I was going to chime in on here too on our challenges and opportunities is around credentialing issues as you alluded to earlier. I brought this up as one that I think it’s an uncomfortable subject for a lot of people to talk about, because it really taps into some of what you were speaking of earlier of some of the divisiveness, and polarization that exists, but one of our big issues that we have just in our cultures in general is that we usually like to have some degree of certainty, or a way to ascertain that people have a certain level of skill or capabilities when they’re doing something that’s related to, let’s say, addressing somebody’s health concerns.

Whitney Lowe:

For example, we have licensure laws in most states, because we’ve determined that manual therapy has the potential for harm and there’s a reason for licensing individuals for protecting public safety, so that’s the initial level of licensure for protecting public safety, but that’s generally where it ends, and the big challenge, I think, that we have around a lot of the credentialing issues is, it’s still very difficult to know, let’s say some healthcare organization, or large scale group, or organization and wants to try to employ massage therapists with specialized skills for, let’s say, working in a sport’s environment, or working in a rehabilitation clinic of some kind, or working with cancer patients. There is no way to know who has specialized training in those areas, because we don’t have any standardized credentials to indicate that people have accomplished certain competencies, or capabilities in those different areas.

Whitney Lowe:

There’s been some effort to kind of move in that direction with some of the credentialing organizations. The National Certification Board has been doing that to some degree, but again, until there is widespread adoption of these guidelines, or perspectives, or credentialing programs, there’s still a great degree of ambiguity out there of what does a person’s training mean? And how do you tell the difference between the individual who’s fresh out of school, and the individual with 15 to 20 years of experience? Because, there really is no other way to identify that?

Til Luchau:

Yes. Well, I know that’s an area where you’ve worked hard, and moved some solutions forward, and are still looking for ways to further that.

Whitney Lowe:

Yeah, I mean, it’s been one of the things that we’ve been working on for decades, and it seems like it’s just a never ending thing, because we see a lot of the same arguments, and discussions, and things come up over and over again, but the same problems seem to remain there, and so, at the same time, they are our challenges. I think, there’s a great opportunity there for us to see some kinds of creative credentialing happening in the future. I’m very excited about a lot of the things that are happening in the world of like the movement towards micro credentials, which is the idea in many traditional academic programs. Just as an example, you see this a lot in like software world, or something like that, where a degree, an academic college degree might indicate a broad base range of skills, but it doesn’t really indicate that that person is skilled in Photoshop, or that they are skilled in operating a particular accounting program, or something like that.

Whitney Lowe:

And, these smaller programs, which do micro credentials might say, “Hey, this person has done this highly specialized training program, and they have accomplished this set group of competencies, or skills, and abilities, and that’s how they have earned this particular mini or micro credential.” These kinds of things to me seem like a way out. They seem like to me the opportunity that comes out of this to be able to have some recognition of more specialized micro credentials if they highlight, and indicate what are the real core competencies that they’re supposedly representing. I hope that we might see more of this kind of stuff develop in the future along those kinds of lines with some degrees of standardization of those micro credentials as well.

Til Luchau:

Yeah, I think that fits with the move toward the way people want to learn, and use their time for sure, too, and like I said, I know you’ve worked hard on this, and I think that we’ve all benefited from the work you, and other people have been doing in this field, and so, even though, that in my trainings, and the people that come to my trainings are finding success on their own, I think it is something that we owe our gratitude for to help think about the field as a whole, and the ways that it can be supported across the board, for sure.

Whitney Lowe:

Yeah. I would certainly agree there. Well, this will probably kind of at least for the little bit here wrap up some of our look at, or inquiry into some of the big challenges and opportunities that are facing us, and for our listeners please feel free to chime in to give us some more input that you see other things that might be challenges, and opportunities. We may of course revisit this topic again in future episodes as well. We’ll take that, and see where it goes from here, but I would like to say a special thanks to our sponsors for sponsoring our show here today, and encourage everyone else to stop by our site. For show notes see credit updates, and any extras over there. You can find us at thethinkingpractitioner.com and you can also find transcripts of our episodes, and other information on our sites. Til where can people find you in other 

Til Luchau:

Yeah, please come out on our blog from advanced-trainings.com. How about yours Whitney?

Whitney Lowe:

They’ll also be over on our site at the academyofclinicalmassage.com.

Til Luchau:

Yeah, those words questions keep them coming, inputs, thoughts. I bet there’s going to be some social media discussion on these topics, I do look forward to that, but you can always email us at [email protected], and like we said, anywhere on social media you’ll find us.

Whitney Lowe:

That sounds great, and if you would, please take a moment to rate us on Apple Podcast, or wherever else you listen to your podcast. That does help people learn about the show. Tell a friend that’s there, and look forward to having some other great discussions with.

Til Luchau:

Yeah, we’re going to dive into some nuts and bolts. I know we have some technical topics, we have some body mind topics lined up, some interviews. Look forward to all those.

Whitney Lowe:

That sounds great. Well until next we’ll see what else comes boiling up at the pot, and we’ll see you again in two weeks.

Til Luchau:

Thanks, Whitney. See you later.

Whitney Lowe:

Okay. Take care.