Executive Order 20-12, issued Monday, March 23rd, explicitly closes “medical spas, facial spas, day spas, and non-medical massage therapy services” until further notice. This order, unfortunately, leaves a lot open to interpretation. What is medical massage? When is massage therapy “medically necessary”? When does that necessity rise to the level of “urgent” or “emergent” care during a time of pandemic? What kind of clinical environment and PPE is required to mitigate the risk of infection? How do you navigate informed consent when there is a risk of infection? Will your liability insurance cover you if one of your clients is exposed at your office? Until we have more clarification, it appears massage therapy may *legally* continue as long as you do not operate in a spa and can justify medical necessity. But frankly, we do not have answers for any of the above questions, and the lack of clarity should concern anyone who is considering continuing to practice massage at this time.

I reached out to Geraldine Randles, Senior Advisor and Instructor of the Oncology Program at the Knight Cancer Institute at OHSU for her advice. OHSU has closed all inpatient, outpatient, pain management, and wellness massage until further notice. Geri was adamant that there are no urgent conditions that massage can treat that justify the risks of infection or the use of scarce PPE. Massage therapy educator Ruth Werner came to a similar unequivocal conclusion in a statement she released last week: “Close your practice.” (Her full article is well-worth reading.)

AMTA Oregon has reached out directly to Governor Brown asking her to remove the “medical massage” exemption due to our concerns about issues raised above. I have also heard from OBMT that they have asked Governor Brown to clarity her order so that they may advise licensees.

UPDATE (March 27th, 2020): On March 26th, OBMT emailed all licensees a document, which among other topics, provided clarification regarding the Governor’s Orders related to “medical massage services”

The intent of that distinction was to separate spas and other massage facilities/practitioners from those who provide massage ordered by a doctor (such as in physical therapy). The “exemption” of medical massage under Executive Order 20-12 is limited to a massage that a physician or someone authorized to prescribe massage in the State of Oregon for medical purposes has recommended to occur for the health of the patient. At this time, LMTs employed by doctors or at medical clinics or facilities, should consult with their employers to determine if they have any questions regarding “medical massage services” and requirements to work, or not work, accordingly. — OBMT Letter, page 3-4.

The way that I am reading this is that until Governor Brown’s Executive Order is lifted, LMTs may ONLY practice massage if it has been recommended by someone with prescribing authority (MD, DO, DC, Nurse Practitioner, etc). The board also clarified that massage therapy is an “elective and a non-emergency procedure,” and so “LMTs have been prohibited from using gloves, masks, or other PPEs since the issuance of Executive Order 20-10.” If your employer is asking you to work without PPE, there is a legitimate concern about workplace safety, since massage therapy is incompatible with social distancing. If that is your situation, you may consider filing a complaint with OHSA and/or the appropriate regulatory board.

END OF UPDATE

I know that many of you have already chosen to close your practices, even before these directives, or your employers have closed your offices. I know this represents a massive disruption in terms of your financial security, and this is a scary and threatening situation to be in. AMTA member Amy Bennett wrote a lovely article describing her decision to close her practice temporarily, and I highly recommend reading that. It’s important to keep in perspective the incredible strain that our health care systems will suffer for the next weeks and months. Reducing the spread of Coronavirus (even if you do not have symptoms) is an important part of “flattening the curve” and making sure there are enough hospital beds and healthcare professionals to treat everyone who gets sick.

There is some help on the way. This morning, we are seeing news that Congress has reached a deal on a $2 trillion aid package that includes relief for small business owners and independent contractors. We do not yet have details on this, but we will continue to track developments and advise you. Likewise, the Oregon Legislature will convene a special legislative session to consider additional economic relief for Oregonians. Now is a good time to write to your state representatives and ask them to support direct economic relief for service-sector workers. You might especially ask them to provide additional support for Independent Contractors and “microbusinesses” who are not covered by unemployment. The AMTA National Government Relations team created this form that will automatically send messages to your Congresspeople.

I have assembled some resources and action items in this Google Doc, and will update this document with additional resources as we learn about them. If you have resources you think we should include, please email president@amtaor.org.

I don’t know what will happen next. I’ve heard some people say they are planning to return to normal within a few weeks, but I think there’s a good chance we will be in this for much longer. Whatever happens, we will find ways to support each other and see this through. As for me, I will be stepping down as President as soon as we can figure out how to hold an online annual meeting, but I will remain on the AMTA Oregon Government Relations team, so I won’t be going far! Serving this community has been an absolute joy, and I’m so grateful for all the growth and connection it has brought into my life. Thank you!

Mark Retzlaff

AMTA-OR Government Relations Report: