Should Ontario's RMTs be treating clients during Provincial Lockdown?

This is a question that many Registered Massage Therapists are asking, and being asked. 

So, let's break the direction down.

The Province of Ontario is diligently trying to protect the healthcare system by controlloing the spread of the virus. As such they have implemented a plethera of  "stop the spread" protocols for individuals and businesses. During our most recent lockdown (December 26th, 2020) the loudest message is "STAY HOME!" The caveat to this message is.... "unless you need or provide essential services".

The Government has made the blanket statement that all Regulated Professions (including RMTs) may remain open provided they align their practice and protocol with the provincial, municipal and regulatory body directives. 

In Ontario, RMTs take their orders from CMTO which has provided a few written directives to RMTs. In Ontario, the celebrated decision seems to be to keep treating because Massage Therapy is a regulated profession. Unfortunately, what the majority of Massage Therapists and Massage Franchise owners are doing is turning a blind eye to the rest of the directive, which states:

1. The benefit of massage must outweigh the risk of harm to the client and the therapist;

2. RMTs must continually review the Municipal Risk Assessment chart, for their area, and decide which column pertains to their community - then follow the recommended actions. Currently this chart indicates that Ontario (iincluding the Durham Region) is at high risk for transmission. The corresponding "action" column for Healthcare Professionals clearly states that in-person treatments should be differed at this time.;

3. RMTs have received instruction from CMTO to prioritize clients, minimize treatments and follow MOH guidelines for screening, distancing, PPE and disifecting; and

4. RMTs should only be treating clients whose health condition would worsen to the point of hospitalization or death if the massage treatment was deferred.

So, what is an RMT in Ontario suppose to do?

Like everyone, they need to have an income to support themselves and their families; they are regulated so they are allowed to treat; Government financial assistance is not enough; and most small massage therapy businesses do not qualify for the financial programs. So, they don their PPE, screen, document, scrub and hope that their clinic does not accidentally transmit covid-19 to any of their clients -  or to them.

What happens to the RMT and/or clinics that transmits the virus because they decided to treat during the provinicial lockdown?

If history serves, we should expect that any clinical "outbreaks" would be investigated by MOH, the provincial government and by the CMTO; financial penalties could be incurred for any "found" breach to protocol;  and licenses could be suspended or revoked based on neglect to properly assess risk, protect clients and follow directives. 

Does the risk of treating in a high risk region during a pandemic out way the benefits of massage?

This question haunts me.

Shorlty after the news of the second lockdown, a colleague joyously announced to a client that she will remain open because she is regulated. My heart sunk. How many people are clinging to the term "regulated" and neglecting our other professional obligations - namely to keep our clients from harm?

Assessing risk is a very important component of treatment. We learn to evaluate conditions, modify treatments and to provide knowledgeable care - even if that means deferring massage. Our education did not provide for action response to a pandemic, so we must use our best judgement to navigate the pandemic. This means we have to put the well-being of others before our own personal needs.

Client need vs want

There is scientific proof  that massage therapy promotes the healthy function of all body systems. It soothes aching muscles, anxiety, depression and stress; it helps to improve mobility, stability and mood. Under normal evironmental conditions, massage is not a stand-alone practice used to treat serious, emergency or life-threatening conditions, it is a complimentary modality in these situations. Further to community risk assessment, we must consider the potential outcomes for each client: "will treatment prevent my client from being hospitalized and/or from dying?" - the answer is  most-likely "no".

Ethically and morally, I can not justify providing massage therapy to my clients when the risk of exposing my clients to a potentially lethal virus is at a high. My heart goes out to those RMTs and small businesses that must take this risk. I do not judge you or condem you for remaining open. I do have a lot of respect for each person and business that has elected to stay open at this time and I wish you all well. 

- Bridget van Eenennaam RMT, Owner

Siochana Massage Therapy & Spa Inc.