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How Massage Therapists and Doctors Can Work Together

Friday, February 07, 2025, 02:58 PM

When doctors and massage therapists work together, they create a partnership that benefits their patients' overall health and healing.

In this blog, we asked Dr. Mary Chisholm how holistic health practitioners can create an effective partnership with medical practitioners.

Meet Dr. Mary Chisholm, MD

Dr. Mary ChisholmDr. Mary (as she prefers to be called) is a seasoned medical professional with 24 years of experience in family practice (FP) and anesthesia. As an FP anesthetist, she combines patient-centred care at Synergy Medical Clinic in Sherwood Park, AB, with the precision of anesthesia services at Sturgeon Community Hospital in St. Albert, AB.

Besides her medical expertise, Dr. Mary enjoys incorporating massage therapy, yoga, aromatherapy, and meditation (using a Bible verse) into her health care routine.

She believes that "there is so much more to health care than medications or surgeries!"

How can doctors and massage therapists collaborate effectively in creating patient treatment plans?

I support the NHPC's Standards of Practice (PDF), which requires patients to fill out a medical history form (PDF) prior to starting therapy so that you are aware of any potential contraindications to therapy.

If they are unsure, they could ask their health professional to print off a medical summary from their electronic medical record (EMR) for the patient to take to their therapist.   

You should keep accurate and contemporaneous (current) records of treatment and any concerns you may have in case they are needed later in therapy.  

The best thing I can suggest if you have a concern about a particular patient is that you contact the patient's health care professional directly. This can be in the form of a letter or a phone call if the situation is more serious or urgent.

However, please be sure to get consent from the patient before contacting anyone on their behalf. 

If you contact us directly, we can ask questions, document your concerns, and potentially make a plan together if appropriate.

What advice do you have for massage therapists working with vulnerable populations, such as the elderly or those with disabilities?

Be gentle with the elderly!  Many of them have kyphosis, osteoporosis, or joint limitations.

They can't lie flat or have issues that may make it hard to position them for massage, so be creative and gentle with your positioning (like using pillows under the patient's knees when they are lying flat). 

Some elderly patients grew up with a different understanding about touch and may not be as comfortable with it as younger people, so do be sure to give them advance notice of the area you will treat and how you will treat it. 

It may take them a while to process information, so be patient.  Many seniors do not get a lot of social interaction, so let them talk. This may be their big outing for the week!

For patients with physical challenges, you really have to consider accessibility: to your room, onto the bed, etc. You may need a stool to help some patients get up onto the massage table.

Some people may come in with attachments (i.e. urinary catheters, oxygen tubing and tanks, insulin pumps, etc.), which you will have to be careful with during positioning and when moving the patient.

Some patients may not be able to move themselves, and you may need to recruit their caregiver for help. It's also important to remember that with people who have chronic disabilities, some things can be improved through therapy, but some cannot. You will have to mentally allow for that in your treatment. 

People with mental challenges may take time to understand what you tell them and may not like to be surprised, so make sure you tell them what you will be doing to them before you do it. Some may need time to process what you say, so, again, be patient. 

As with any client, receive their informed consent/permission before starting treatment, and check in regularly.

What signs or symptoms should massage therapists look for that indicate they must refer clients back to their doctors?

I might suggest that you refer the patient to their health care professional if they: 

  • have continued or worsening pain/stiffness/disability despite what you feel is adequate therapy
  • exhibit excessive bruising post-therapy
  • respond differently than you would expect to therapy

Dizziness after a massage could be normal for some (if they are dehydrated), but if you aren't comfortable with that explanation, referring them back to their health care professional would be appropriate.

If the dizziness is due to head positioning/movement, they might benefit from being referred back to their health professional to discuss possible causes, such as benign positional vertigo.

When doctors and massage therapists work together, they create a partnership that benefits their patients' overall health and healing. In this blog, we asked Dr. Mary Chisholm how holistic health practitioners can create an effective partnership with medical practitioners. Meet Dr. Mary Chisholm, MD Dr. Mary (as she prefers to be called) is a seasoned medical professional with 24 years of experience in family practice (FP) and anesthesia. As an FP anesthetist, she combines patient-centred care at Synergy Medical Clinic in Sherwood Park, AB, with the precision of anesthesia services at Sturgeon Community Hospital in St. Albert, AB. Besides her medical expertise, Dr. Mary enjoys incorporating massage therapy, yoga, aromatherapy, and meditation (using a Bible verse) into her health care routine. She believes that "there is so much more to health care than medications or surgeries!" How can doctors and massage therapists collaborate effectively in creating patient treatment plans? I support the NHPC's Standard of Practice which requires patients to fill out a medical history form prior to starting therapy so that you are aware of any potential contraindications to therapy. If they are unsure, they could ask their health professional to print off a medical summary from their electronic medical record (EMR) for the patient to take to their therapist. You should keep accurate and contemporaneous (current) records of treatment and any concerns you may have in case they are needed later in therapy. The best thing I can suggest if you have a concern about a particular patient is that you contact the patient's health care professional directly. This can be in the form of a letter or a phone call if the situation is more serious or urgent. However, please be sure to get consent from the patient before contacting anyone on their behalf. If you contact us directly, we can ask questions, document your concerns, and potentially make a plan together if appropriate. What advice do you have for massage therapists working with vulnerable populations, such as the elderly or those with disabilities? Be gentle with the elderly! Many of them have kyphosis, osteoporosis, or joint limitations. They can't lie flat or have issues that may make it hard to position them for massage, so be creative and gentle with your positioning (like using pillows under the patient's knees when they are lying flat). Some elderly patients grew up with a different understanding about touch and may not be as comfortable with it as younger people, so do be sure to give them advance notice of the area you will treat and how you will treat it. It may take them a while to process information, so be patient. Many seniors do not get a lot of social interaction, so let them talk. This may be their big outing for the week! For patients with physical challenges, you really have to consider accessibility: to your room, onto the bed, etc. You may need a stool to help some patients get up onto the massage table. Some people may come in with attachments (i.e. urinary catheters, oxygen tubing and tanks, insulin pumps, etc.), which you will have to be careful with during positioning and when moving the patient. Some patients may not be able to move themselves, and you may need to recruit their caregiver for help. It's also important to remember that with people who have chronic disabilities, some things can be improved through therapy, but some cannot. You will have to mentally allow for that in your treatment. People with mental challenges may take time to understand what you tell them and may not like to be surprised, so make sure you tell them what you will be doing to them before you do it. Some may need time to process what you say, so, again, be patient. As with any client, receive their informed consent/permission before starting treatment, and check in regularly. What signs or symptoms should massage therapists look for that indicate they must refer clients back to their doctors? I might suggest that you refer the patient to their health care professional if they: • have continued or worsening pain/stiffness/disability despite what you feel is adequate therapy • exhibit excessive bruising post-therapy • respond differently than you would expect to therapy Dizziness after a massage could be normal for some (if they are dehydrated), but if you aren't comfortable with that explanation, referring them back to their health care professional would be appropriate. If the dizziness is due to head positioning/movement, they might benefit from being referred back to their health professional to discuss possible causes, such as benign positional vertigo.

What is the most effective way for massage therapists to present their findings or concerns about a client's condition to a doctor?

Please mail or fax a letter to them. That way, the concern can be part of the patient's medical record, and then the health care professional will have your contact information in case they would like to contact you to discuss the issue further. If the concern is urgent, consider calling them directly.

What's the best way for massage therapists to assess whether their treatment contributes to a client's overall medical goals?

As specified in NHPC's Standards of Practice, practitioners should discuss the goals of treatment with the patient prior to their first treatment with you. Then, you can periodically discuss whether you are reaching these goals together.

If not, you can reassess and potentially alter your approach to treatment or suggest the patient follow up with their health care professional.

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