ABMP (the largest professional organization of massage therapists and bodyworkers in the USA) has just published the results of their regular survey of massage education programs, and it reveals some very interesting trends. Whitney discusses these and their implications with Les Sweeney, the CEO of the Professional Assist Corporation and President of the ABMP (Associated Bodywork and Massage Professionals). Topics include:

  • How employment trends are changing in the field
  • How are schools doing in preparing students for the diversity in our field
  • What may be coming down the road for professional training in the future
  • ...much more
Scroll down for the full video and transcript!


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Full Transcript (click me!)

The Thinking Practitioner Podcast:
Episode 103: Where the Profession Is Now (with Les Sweeney) 

Whitney Lowe:

Welcome to The Thinking Practitioner Podcast.

Til Luchau:

A podcast where we dig into the fascinating issues, conditions, and quandaries in the massage and manual therapy world today.

Whitney Lowe:

I'm Whitney Lowe.

Til Luchau:

I'm Til Luchau. Welcome to The Thinking Practitioner.

Whitney Lowe:

Welcome to The Thinking Practitioner. This is Whitney Lowe and welcome to The Thinking Practitioner Podcast, where we are supported by ABMP, the Associated Bodywork and Massage Professionals. ABMP membership gives professional practitioners like you a package including individual liability insurance, free continuing education, and quick reference apps, online scheduling, and payments with PocketSuite, and much more. ABMP's CE courses, podcast, and Massage and Bodywork Magazine always feature expert voices and new perspectives in the profession, including those from both Til and myself.

Thinking Practitioner listeners can save on joining ABMP at abbmp.com/thinking. Speaking of ABMP, I am absolutely delighted to have Les Sweeney with us here today as my guest. Les, welcome to The Thinking Practitioner Podcast.

Les Sweeney:

Thank you very much, Whitney. I'm delighted to be here. Really appreciate it.

Whitney Lowe:

For those of you that don't know Les, let me make sure I got this correct. Your title, Les, is the CEO of the Professional Assist Corporation, but probably best known as the president of ABMP, the Associated Bodywork and Massage Professionals. Is that correct on your title there, Les?

Les Sweeney:

That is correct. That's what I purport to be and that's what the business card was printed with, so that's what I'm stick with.

Whitney Lowe:

That's what you answered to, so great. Well, I wanted to take some time today to talk about in one of the most recent issues of Massage and Bodywork Magazine that ABMP puts out. They had an overview of a survey that you all have been doing for a number of years now about educational programs in the massage and bodywork professions. Can you tell me a little bit about the history of this survey and evaluation that you opened in? How long has that been going on?

Les Sweeney:

Yeah, actually, I'll tell you a funny anecdote about that, that will demonstrate my length of time with the organization. We have a new person working in our marketing team who does some of the analytics and we were working on this project. They brought me in as grandpa to overlook the old stuff or make sure it's following the same routine as usual. She said, "This is really interesting stuff." I said, "Oh, I'm glad you think so." She's like, "How long have you been doing this?" I said, "Since before you were born." She started laughing and I said, "No, seriously, since before you were born. We did our first school census in 1998."

Whitney Lowe:

Is that right? I didn't realize it had been that long, huh?

Les Sweeney:

We do it every other year. We do it in the beginning of the following year. So, we did it in 1998 enrollment totals. We've done it every two years since then. So, yeah, this latest one was the one that we wrapped up in first quarter of this year contacting all the programs and asking them basically, how many graduates did you have in 2022? Yeah, so if memory serves, 24 years, I think that means it's the 12th or 13th iteration of this that we've been doing.

Whitney Lowe:

Yeah. So, essentially, in this survey too, you're looking at the number of massage programs that are out there and then the number of graduates per program and some other things about breaking down those programs are the trade schools, proprietary schools, and that thing. Is that correct?

Les Sweeney:

Yeah. One of the things that we did a pretty long time ago now, but one of the things I wanted to do is categorize in our database. We keep a database of all training programs because somebody graduates from a program and joins and we have to verify their training, make sure that they went to an approved school and that they have their licensure, et cetera for eligibility, for membership. So, they can qualify for liability insurance as well. So, a long time ago when I was just a wee lad and I was leading the charge in terms of working with schools, I wanted to have a better handle on what types of programs there were. So, these are better or worse my categories that I basically identified, which were proprietary schools, which is a term I used for what I would call mom and pops that historically were single campus programs.

As you well know back in the day especially were started mostly by practitioners. So, many of those schools from long ago all started the same way, which was somebody didn't sit out and say, "I'm starting a massage school." It's like they said, "I had clients who were interested. I started talking. I started doing small programs, or I did some little bit of teaching and then one day I looked up and I was a school. I had to get approved by the state and do all this other stuff."

So there are a lot of those programs that are still around. But one of the trends we've definitely seen over the last two decades plus was the advent of what I characterize as career institutions, which I would define as schools that offered massage therapy programs in addition to many times, dozens of other types of programs. So, it could be cosmetology, but it could also be HVAC or it could be all sorts of things. They were typically for-profit schools. As you well remember, it was probably 15 years ago where it really hit its peak. There were a lot of programs, because in the grand scheme of things of launching education programs, massage therapy I think generally was relatively low cost, because you weren't having to put in a big factory machine or something like that.

You bought tables and you either licensed or hired a curriculum. You found a therapist who might be interested or had something who could do this. So, you could roll out a massage program in a relatively short period of time. So, that segment really mushroomed late 2000s, early 2010s or so. I'll circle back to that in a second. Those were at one point, the two largest categories. Then there were colleges and those were programs that were offered through the community college system in a lot of states. Some states are more prominent than others. North Carolina had a pretty robust program of a lot of community colleges offered massage therapy programs.

There are ones that I call corporate schools, and this was along the lines of what used to be Utah College of Massage Therapy that became Corteva, where they were a different animal because they were for the most part just massage, but they were multi-campus, multi-state national networks. Maybe not as broad. NHI and California, for example, hasn't really gone nationally, but they're a similar operation style as well. There's probably one other one that I'm not thinking of, but those are the primary areas where there were programs. For a long time, proprietary schools, the mom-and-pops were the largest. It started to shift around the end of 2000s, 2010. There were about 400+ career institutions and there were 500+ massage programs.

This is back when there were as many as 1,600 programs in the country. We keep track of this, because as I said, to process a membership and also because we want to have a relationship with schools. So, we stayed pretty on task with this. But every two years when we do this census, it serves a couple different masters. One is it helps educate the field about this is where the trend line is as it relates to education. It was also a means by which we can clean up our system and make sure that if we hadn't had regular contact with somebody in a while, are they still there? Are they still operating? Are they graduating students, et cetera? But what we've seen in the last 10 years is that career institution sector has really atrophied. It's down.

I forget what we put in the magazine, 150 or something like that from a peak of over 400. That was surprising to me, because back then, I remember speaking at our school forum one year and the title was, "Will the Wolf Survive?" It was like, "Hey, is the individual single campus mom-and-pop school going to make it?" What I didn't realize at the time looking forward was they were going to make it because that was their life's work. Just as easy as some of these career institutions rolled out a massage program, they rolled it right back up when it didn't pass muster. It's funny because I remember one time I was visiting a school, it was a career institution. They had a bunch of different types of programs.

I was meeting with a campus person and I was just trying to explain to them who we were, what we did, et cetera. I was asking questions, trying to learn more about their program, and they said, "We don't have a massage program director." I was like, "Oh, really?" She said, "Yeah, we only have 95 students, so it's not like we need somebody on site keeping track of that." I thought to myself at the time, I was thinking there are about 800 schools that would give their IT to have 95 students. If you had 95 massage students graduate last year, you're probably in the top 10% of all programs. I mean, it's changed a lot. There were times where you and I know we have friends in this field who ran schools that graduated 400 students a year or whatever.

Now maybe it's a school that graduates 150 or something like that, but it's just changed. I think that's an interesting idea or thing to chew on and say, "Why has it changed so much?" I used to think that. Why are things going down? What's going on? People don't like massage. Is it the viability of the career, et cetera? I think there's probably some challenges related to the nature of the career. I like to tell people, massage therapist has not figured out how to speed up an hour. That is still the currency by which they all operate. No matter how great you are, you might be the Whitney Lowe of massage therapist, you might be a fantastic massage therapist, you might be fresh out of school, but your job is still defined in many cases by time.

That's a challenge for people because that creates an upper bound as it relates to your capacity to earn and your capacity to do the work. I think that's a natural governor on the field, but I also think when I look back at the change in that timeframe was I explained it like a lot of programs just rolled out and then rolled back up because it wasn't as lucrative as whoever was deciding to do it thought it was. I think that's why.

So, when I look at the number of graduates and you think there were 70,000 graduates in massage programs in 2006 or whatever the number was, I think there was some handwringing about that. Why can't we be like that? It's like, "We'll never be like that because we probably shouldn't have been like that in the first place." That's the issue. I think there's a natural level that we're probably settling into versus looking at it as a failure of some sort that we don't meet those go-go days before the big shift. I think that's part of the reality of it.

Whitney Lowe:

I've often wondered this. There seems to be a correlation or parallel between the timeframe in which there was a crackdown from the government on a lot of these for-profit institutions because of the loan repayment processes and the difficulty of students getting out from under these and getting viable jobs. I mean, do you think that played a role in the collapse of a number of these programs?

Les Sweeney:

I think it probably did and the interesting thing is that's not over. That's still happening and less so massage, but certainly in cosmetology, there is a concerted effort to push back against the gainful employment rules. But that's been happening for a better part of almost 10 years. I think the Obama administration first triggered that in 2013, 2014. I think there's certainly an aspect to that, but I think it's a little bit like if you're a short cutter, you probably got negatively affected, but there was a little bit of a sweep that hit some schools that I think probably it shouldn't have. It just made life difficult for them. I think it changed enrollment patterns for sure.

But I think the other aspect, one of the things that our mutual friend, Anne Williams, who used to be our director of education. She and I would talk about too is one of the things that the massage profession, the massage education profession didn't do a good job of was anticipating the interest and desire for remote learning. It's amazing how many schools got religioned when COVID hit because they didn't have a choice, just like a lot of businesses. But we were just behind the curve compared to a lot of other locations that might be at some of these training institutions even 10 years ago where we have been very... Pat in the sand is too strong of a statement, but we have been very resistant to rethinking the educational model in massage.

As you well know, the path of professional development in massage has been dictated by the regulatory forces. That's rather than maybe the education field leading it. It's been the other way around. I think that's been part of the challenge as well. So, some provincial thinking about training is probably also challenged. Some of that has probably contributed to that decline of enrollment as well. Look at it now and say we're turning back. It's really hard to do analysis and gain perspective when looking backward through 2021, 2020. It's like opaque. It's like the frosted glass. You can't really make things out as well because COVID was such a monkey wrench for not just massage education or massage, but just for all of us.

Whitney Lowe:

By all means, it really does become an asterisk in the statistical books because there's a lot of things that just have to be taken in context like that. So, yeah, I want to get back to a couple other things. You and I probably laughed about this a couple times. At the time, we were at some of the ABMP school forum meetings. I spoke at a couple of those meetings trying to bang the drum about the importance of digital education and those kinds of things early on. It was interesting to see the frequent backlash and non-participation from folks because there seems to be an anti-technology trend in our field.

I thought this is something that's going to come around to be a problem later on because it's not going away. It's going to come and it's going to be a much bigger part of our lives. I would like to bump everybody in the direction of thinking about the future, but that's not always the way it is.

Les Sweeney:

It's the official I told you so.

Whitney Lowe:


Les Sweeney:

He was right. People should have listened to him. He was right.

Whitney Lowe:

That's right. They'll put that on my gravestone or something. But the other thing I wanted to go back to and this is again something that I believe you and I probably had some conversations about over the years that has troubled me extensively about this huge bubble that we saw in the growth of programs in the early 2010s and everything and late 2000s. This is something that Anne and I talked about. Anne Williams and I talked about a lot also at the school forums, the troubling trend that we saw of a lack of appropriately trained teachers to staff all of these programs that were promulgating everywhere and booming and everything like that. To me, what that's produced is a big bubble of practitioners in the field who didn't really get very good training.

I really saw this happen a lot as a continuing education instructor over the years of people coming into our programs and being very surprised at what they just really didn't know and what they hadn't grasped from their entry level education. I'm curious to hear your thoughts on, do you think that that trend now that the number of programs are going down and maybe we might have put some more emphasis on education, especially the stuff that you all have been doing at ABMP with the Cornerstones project and the school forums and all the other things that you've been putting together for educators. Might we be able to see a reversal of that where people are getting better training now because there's not so many programs out there?

Les Sweeney:

I think it has to have had an impact in terms of just take even the specifics of our field aside, just the macro effects of that rapid of a growth puts a strain on the infrastructure period no matter what. I went to massage school 2004 to 2006 in a very small program. I was probably one of those people that the instructors I had were well intended and very nice people. They were practitioners. They weren't instructors. I always equated to what training I got as almost like folklore. It's passed down from the elders. This is how I was taught it, and I'm going to teach you this. So, it becomes a little bit of a game of educational telephone too. So, it's like there is a degradation that happens no matter how hard you try.

For us oldsters, if you recorded an album on a cassette, then you copied the cassette and then you copied the cassette another time, it definitely didn't sound the same as the album. That's I think a little bit of what happened. I remember in our own experience just being out interacting with schools and meeting a gal who graduated from the program like eight months earlier and she was now the teacher. So, yeah, I think that it happened. I think there's a change to a certain degree in that I think... We've tried to do that. We try to put our money where our mouth is to say, "Well, part of our focus needs to be..." Bob Benson, our chairman, you know well and I've worked with for the last 27 years, he came to me and said, "I think there's opportunities for us here."

I said, "100%." We also looked at it just from a theory of the sense that "What do we all want? We want a great experience for the consumer." So if you just take a step back from that and you say, "Well, that means we need to have a really qualified professional. How do we get a qualified professional?" Well, hopefully, they went to a good program and that we've taught them. We've challenged and it's been a rigorous curriculum, et cetera. So, if there are any weak links in that chain, we're not going to get the end result we're looking for. I think there's been more focus on that and we looked at it. Yeah, I appreciate the comments about Cornerstones. It took us a while and it was important.

This started 15 years ago with instructors on the front lines and Anne putting together curriculum and teaching and providing content for instructors to help them be better in the classroom. Our instructor 101 series and then we moved on to Cornerstones. Yeah, it's a 25-hour program. It's not something you breeze through. It's meaningful and hopefully it's helping, because we also know that one of the... It's not a downside, it's just a realities of the popularity of massage expanding is that the variety of clients you see is expanded and the conditions. Also, you throw that on the backdrop of the macro environment of the typical American in their current state of health and fitness and et cetera.

My wife and I just consume the Blue Zones on Netflix, so I've needed to get off this call and go eat some beans and squash and corn for the rest of my life. But you realize you're going to see a lot of different types of people with different types of conditions and different types of pharmacological challenges or interactions and things like that. So, I think it's just gotten a little more complicated because I think in partially it might be my own experience just oversimplifying things, but I used to think about the typical client was somebody who's fit and they're running a 5K and doing all this stuff. That's not necessarily the case and probably hasn't been the case overall.

Lots of different types of people in all walks of life really appreciate the value of massage and thank goodness for that because it is something that hopefully more and more people are exposed to and want to be part of, but that just puts more pressure on us to say, "Yeah, we got to make sure these people who are actually provisioning the work know what they're doing." As you well know, there's a lot of different aspects of that. Credible thinking, tableside manner, and customer service and basic human decency and manners and consideration, and then throw on top of that all the important elements of running a business that you have to do well. There is a lot. There's a lot that goes into it.

Whitney Lowe:

For sure. For those people who may not be familiar, let me just also make a quick note here. The Cornerstones project is a group of courses put together by the ABMP specifically aimed at massage educators to help teach them about teaching. I'm a passionate evangelist about education, and this is something that I think has really been missing a lot in our profession for a long time is to train some of these practitioners who come into it. Most of them who are teaching in these schools come into it from the standpoint of being a practitioner, not from being an educator and not having any background in education. So, that really does help to have some skills and awareness around those things that make you a good teacher to be able to relate things to everybody.

Les Sweeney:

Well, and I distinctly remember saying at one forum when you were speaking, I said, "Whitney could read the phone book and make it interesting." For those of you, younger listeners, phone books, these giant pieces of paper where you found what someone's phone number was, but it was Google and hard copy basically. Yeah, that is such a critical skill. As you know, it's probably more art than science and it's also something that you get better at through experience and reps. My youngest son's girlfriend is a brand new middle school science teacher. She's 23 and has an adult job and then just walked into a classroom with 13-year-olds a few weeks ago and just was expected to be an expert on day one.

It's been Interesting getting the reports over the last four weeks from I'm about to die to, "Okay, I can do this and I'm feeling a little better." But that happens whether it's middle school or massage school or anytime you have to get up and purport to know what you're talking about to present to a group of people. So, yeah, I think I've been very fortunate enough to interact with a lot of the best teachers in this profession, but I don't think there's a teacher out there that is done or knows everything or has had every experience. It's like we're all learning because the student is changing, so therefore we have to adapt. The student's different today than the student was 25 years ago.

One of the things I talk about is when I first started to go out to massage schools and I would get the opportunity to speak to graduating class or classes, and I would say, "How many of you plan to go start your own business?" 80, 90% would raise their hands. Now if you do that, I think it's the opposite, because in 1998 or whatever when I was doing that, there wasn't a Massage Envy or an Elements or a Hand in Stone or a Massage Heights or my Salon Suites or Woodhouse or any of these places that are hiring and are hiring tomorrow. I tell people, I'm like, "If you're a massage therapist and you're licensed and legal, you can work tomorrow." There isn't a place that would say, "Nope, no, I don't need you."

Everybody needs somebody. That's a very different environment than it was when I first started talking to students who were basically in their late 20s or early 30s and they already had a bit of a career. Now they've decided they're going to go do their own thing, but they're going to keep their other job and ease their way into it and all that stuff. It's just a different environment. Also, during that time, I've gotten a lot older, so I've had to adjust my thinking as well because it's like, "Yeah. Oh wait, they don't seem a lot younger. They are a lot younger."

Whitney Lowe:

So I want to touch on that for a second because I think this is a huge trend shift. I would agree with you that there's been a big shift more towards the employment model versus the solo practitioner model. I'm curious to hear your input on this in terms of the way in which practitioners may or maybe the clients in the public who are receiving our care might be receiving things differently or does this have any impact at all on the way in which services are delivered that people are thinking of themselves now more as employees doing a job versus in the older days when it's all about you got to be successful because this is your business? There's a bit more ownership in that model, I think, sometimes.

Les Sweeney:

Oh yeah, I think 100%. I think it's impossible. That's not impugning the character of the people who are employees, but I just think that's like that in any profession. The other part that I think happens is that I think there's not all. Certainly, I think I get massage as often as I can, and I get them at franchise locations and independent practitioners and people who are hobbyists and people do it for a full time. Because partially I feel like I never wanted to be in a position when somebody said, "You're the president of ABMP. When was your last massage?" I go, "Ah, I can't remember." I'm supposed to be the number one proselytizer for this stuff. So, it's a tough job, but somebody's got to lay on that table. So, that's what I do.

Whitney Lowe:

Well, also, I want to interject here and say kudos to you from early on, from many years back, because if I remember correctly, you had this position with ABMP and after that went to massage school to really learn about this field. That is correct, right?

Les Sweeney:

Yeah. Yeah. I actually started ABMP in 1994. When Bob came on in 1996, we basically set up a school relations program and I was the lead person on that. In 2003, I came back from... I was visiting a school and I went in to see him and I said, "I think I'm going to go to massage school." He said, "What are you talking about?" I said, "I'm going to be in charge of this organization. I think it's important for me to understand who our members are and what they've been through." I said, "I think it'd be valuable." I remember when I was talking to our controller at the time and she said, "Is this a calling or a project?" I said, "It's probably somewhere in the middle basically." Yeah.

So, I mean, I had been here for 10 years before I went to school, and it was incredibly illuminating for me. Even though I've never really been a practitioner, I had four clients for a while. All their last names were Sweeney. They were terrible tippers. They would tell you that he was not a very consistent massage therapist either. So, I was still at my table. But yeah, it's rare that I would do something. I'm still licensed in Colorado and I did my clinic work and all this stuff, but I just never hung out the proverbial shingle.

Whitney Lowe:

Well, I'm curious to know, with that experience, what were the things that shook you the most, surprised you the most, or what were the most significant takeaways from that experience that you saw about getting inside the field from somebody who has been managing it?

Les Sweeney:

It was funny, because as I said a little bit in school, I went to a very small school. I had a friend of mine, the late Dennis Simpson, who was the owner of the Colorado School of Healing Arts, which I would still maintain as one of the best programs in the country and it's been for 25 years. I told him I was not going to his school. I explained to him, because in Evergreen where we are, there was a small school and I was like, "Look, I can draw a line between the office and my house and I can go through that school. I'm doing this because it's important, but I'm doing it because I'm going through the process. I'm not looking to go to the best school possible. I was looking to go to a school so I could get the experience."

So my school was very small, it was quaint, it worked well for me. It was just really helpful to meet people. I met the typical students. One of my friends was this gal who was 19 and wasn't sure what she was going to do with her life. At that point, I was 37 or something like that or whatever. I was pretty well established what I was going to do with my life. At that point, we had three kids, so I was an adult at least on paper. It was just a really interesting experience to meet the people who were there, because as we hear the story and we tell the story over and over again, everybody ends up at a massage school on a journey. They're there for different reasons. They had experience in their life that had helped them or they're just in transition.

They're not sure what they want to do and they don't fit into what mom and dad wanted me to do for school, or I've been working and I'm 30 and I really like this and I'm sick of working at a bank or whatever the answer is. So, it was just a great exposure to interact with people in a way that I didn't always get to do in the office. I still don't. I mean, I talk to members almost every day in some capacity, but I'm not in their office. I'm not practicing with them. So, it was helpful to go through that experience in that regard. Even then the interesting thing, it gave me great insights when I would talk to a group of students, because I would be like, "I understand what you've gone through."

I would always usually draw on a whiteboard and I would make a little chart where I'm like, "You come into school and you're nervous because you don't know any of these people and you have a general idea about massage." But one thing you probably know is, "Oh, my God. I'm probably going to have to take my clothes off." So that seems weird because I had never had to do that in school and now I have to do it. Then you get comfortable with these people and you get this great bond with your classmates because you're working on them and you're interacting and you're sharing stuff and then you're comfortable. Okay, we're going to practice and then we switch and I do this, whatever. You do all that. Then clinic starts and the terrorist starts all over again.

I'm like, "I'm going to have to deal with this with people who are strangers from the public." I remember my first couple of clinic sessions thinking like, "Oh, my God, now I have to work on this strange person or whatever." Where we are at Evergreen, it's a pretty well off area, but we would have a steady stream of people because I used to say, you get 80% of the massage for 50% of the price. Back then I think the student clinic was like 25 or 30 bucks. So, we'd all these people pull up in their Mercedes to come get their half price massage because they're like, "Yeah, I can come twice a week or once a week because you're good enough and I am paying for frequency, not as much quality or whatever." But you go through that exercise and then I'm like, "Okay, I got this."

Then clinic starts to build, you meet the same people or you feel confident, and then I didn't get to the last step, which was and then you got to go do it again with strangers that you don't know and you have to get them to pay you money and you don't have this sign out front that is drawing people in that you're all on your own. That always resonated with me. Then especially because I've been involved in regulatory legislative issues since I've started here too, that always gave me an acute insight to say, "I'm really concerned about there was definitely a diplomaism push."

I'm not by definition of libertarian by any stretch of the imagination, but I was always very keenly focused on saying, "We need some level of regulation, but not enormous amount of regulation, because getting out of massage school and starting your career was such a function of momentum." Way back when it took forever to get your license, it took forever to take the test and all this stuff. I was like, "These people have just spent at that time, probably 3,000 to 5,000 bucks to go to school, and now they're just withering because they can't practice yet. They're in this zone." So it just sharpened my focus to say, "We got to do whatever we can to make these hurdles shorter for these people so they can get out there and start practicing and earning a living."

Some of that's changed and we probably deserve a little credit for some of that. But yeah, I think those barriers aren't quite as big in the same way as they were at one point. So, that's a lot what I took from it. Yeah, as I said when we started, an hour is still an hour and body mechanics is really important. There were a couple of days in clinic where I did four massages in five hours. I'm sure if someone was listening here, they'd be like, "Huh, I call that Tuesday or whatever." But it was a lot and I just had a much greater appreciation. The other thing I learned about myself, and it's been reinforced over the years, is I'm extroverted and our little clinic was small to the point where there'd be time where I'd be maybe the only person working and then the clinic director would come in on and off.

But I was just always struck by the fact that somebody would pull up, walk in and they were getting half undressed as I was saying hi, and trying to do an intake form, getting on the table. Then they'd get out and they'd stagger out and leave and then the next person would do the exact same thing. So, I would feel like I was almost in timeout. I was like, "I make my living talking to people."

Whitney Lowe:

It's hard to be in a massage room.

Les Sweeney:

For an hour and nobody to talk to. After I did it for four straight hours, I'd be like, "Man, it's like I was just sent to my room and wasn't allowed to talk to anybody or something." So that was just a great insight for my own life. I was like, "I never thought about that, but this feels stifling in a way because I did the work and I was okay at it, but it wasn't like my creative canvas." I think a lot of therapists, that's their happiest place, and for me, I was like, "I'm doing this, but it feels like I've been muzzled and that's not who I am." So that was an interesting just self-reflection that I've learned from it as well.

Whitney Lowe:

Yeah. I want to shift gears a little bit and ask you another thing that's along those lines. ABMP has done a whole lot over the years to really get a lot of your members and just all massage public in general access to a lot of the educators and people who are doing really innovative things in our profession through your webinars, the articles, and the magazines and all these things. You've done a lot of stuff to get outreach so you can connect people with those kinds of things.

But back to what we were talking about with education and making it accessible for a lot of the practitioners, I really am in agreement with you that there's an importance of getting people into work soon after their training programs to be able to do the types of things that they were doing, but we also have this really challenging split personality thing in our profession of the two tracks, one of the personal care wellness oriented massage and that of people who are doing more that might look more like operating as a healthcare professional. I've always advocated that I think our initial training in massage school does a really good job of preparing people for that first track, but not for that second track and from both a legislative regulatory arena and also running a professional organization.

I'm curious to hear your thoughts on what's going to happen in the future or what trends might be happening to try to better prepare some of those practitioners who are wanting to work within those models. But educationally, honestly, I think we're ill prepared to do that without some more specific types of training. There's been all these debates about, "Well, should massage become a degree program or should it require an advanced credential or should it do some of these kinds of things?" Those are all obstacles that block people from being able to practice certain types of things, but it also becomes a big public relations nightmare to try to make a distinction, "Who's got what type of training and how does the public know what to pick?" I'm just curious to hear your thoughts on that.

Les Sweeney:

Yeah, it's interesting, and this probably is the world according to Les, not necessarily the official ABMP policy position. You've written on this and we've had some of that in the magazine as well, but I came to a conclusion at one point and I've talked to our friend Anne about it a little bit. My thinking has evolved over time, but one of the things that's disappeared in the last 20 years is the apprenticeship model. I think that's been whether covertly or overtly, I think the mushrooming of the number of programs basically squash that.

I think regulators also crave consistency. One of the things we talk about in our system and just running our business, our database, counting our skin care and hair associations, sister associations, we have 120,000 members and we have 400,000 contact records for people who've been members over time or whatever. The phrase that can sometimes be the bane of our existence is edge cases. Edge cases are the tail that wags the dog, right? 98% of your data behaves in a certain way and the last 2%. We have about 5% of our members belong to more than one of our associations. We have to go through so many machinations to accommodate those people. 95%, they're easy. They all line up in the right direction.

I think there's an aspect of that related to education. There's two things I think about. One is the macroeconomic issue, which is at this point, I don't have hard data in front of me, but I think my assumption still hasn't decayed just yet, which is that the high percentage of professionals in our field operate in cash and carry. They're getting paid with disposable income from their clients that in one respect, our competitor is every other thing. You could spend your money. It's not the other massage therapist. It's eating in a restaurant or going to a movie or your phone bill or all these other things that people have discretionary spending on.

So, in most of those people, as we talked about before, the complexity of clients is probably increased, but most of those people have a certain expectation going to massage and stress reduction or relaxation, which I would still argue are probably the two most important health benefits related to massage therapy that are most in need of addressing in this country, which are reducing people's stress certainly. So, there's a large chunk of people that the current training probably meets most of expectations for, but then there's a segment of people that need and want advanced care and treatment. There's a segment of professionals who want to have that as well. It's absolutely not a 50/50 split.

I think it's a very small percentage of people of massage therapists that need one or pursue advanced training. But the challenge is we've had this regulatory regime that has also been the Billy club to fight off human trafficking and prostitution. Unfortunately, for our field, a lot of times the regulatory efforts have been viewed through that prism. So, we have this block of educational training that's required and then we leave it at that and then it's like you're on your own. The point I would make is that... We haven't done ourselves in the field, a great service in this process as well, because in 2006, January 2006, I graduated from my little program and eight weeks later I was nationally certified. I remember one of my staff coming in and go, "Hey, I have a question for you about this."

It was a technique oriented question and they're like, "Well, you're nationally certified, so I figured you can answer this question." I said, "At the time," I think there were 249 rough estimate, like 249,000 massage therapists in the United States. I'm like, "I am the 249,000 most qualified therapist to ask this question of," because it's like asking a 16-year-old to drive in NASCAR. I'm like, "No, no, no. What the state has decided is that person is barely capable of doing this, okay?" That's what regulation is. Regulation is saying, this person meets the minimum standards to make sure that they're not a menace to society, and after that, you're on your own.

So, I've never been a fan of saying, "Regulatorily, we should have a branch that's a super user, you have the super user license or whatever thing like that." I actually think that we should be letting people practice sooner, but then we should have a hybrid apprenticeship program and then a branching off where you can go do more. But I think one of the things we haven't done and the National Certification Board hasn't done has established what that advanced credential might look like because they're board certified. It's a black box and it's a little bit like a lifetime achievement award. One time we were talking about something. I said to Anne, I said, "We need to have certification in low back pain or we need to have certification in blah, blah, blah."

Rather than somebody's name technique, the Sweeney technique, I need certification in treating someone with a condition. Because conditions are what people have. They want treatments that apply to conditions. They don't need to know whether Sweeney Method helps that or harms it. They need to know what is the solution for this. It's not like we prescribe an antibiotic and we say, "Oh, it's okay. You're going to have erythromycin." We're operating under an assumption that the doctor knows what erythromycin is, and it's the right answer here. So, I feel like we've created a barrier. It's expensive to go to massage school. You've come out. We're in some ways better than we've ever been because there is an employment opportunity in front of somebody right away.

But we're also asking somebody now to go to school anywhere on average probably 600 to 750 hours of time and spend somewhere between $8,000 and $12,000 and decide whether they like it or not. There's a little bit of in America, we have an economy where you just roll the dice and you hope it works out. But it's like from a consumer protection standpoint, I would love somebody to have 300 hours and be able to work under a controlled environment for three months or whatever the time is, nine months.

If you don't go back and get the rest of your training, then you're out of luck, but at least you've had a little bit of try it before you buy it. I don't know if I have the right answer there, but I feel like there's an aspect of that that lets people engage, move into this, and then the next step you'd build upon that would be to say, "Okay, you made it through phase one and you like it and you finished your phase two. Now, you're a full-fledged regular person, regular therapist. Now if you want to go to the next level, you, you're going to have to get an approval through a body that recognizes that's done the work that says these are the areas you have concern or these are the hospital-based network says you have to meet these expectations." Then those are the ones you should work to meet. I think it's hard.

It's a little bit like we expanded the house without the benefit of an architect, and then we walked out in the front yard and they're like, "Whoa." We just put that bathroom out in the backyard. That probably should have been closer to where the plumbing is.

Whitney Lowe:

Looks a little bit like an MC Escher house after a certain point.

Les Sweeney:

Exactly. It's citing all my important resources. It's like the episode of the Simpsons where they build the Homer and Homer makes the car. It's just this monstrosity that has no continuity. It makes any sense. I always think that's one of the ones that I think about.

Whitney Lowe:

Yeah. Oh, we look back. Oh, that was interesting. We got there. Well, lastly, I want to ask you to put on your Nostradamus predict the future hat for a moment. In the context of what you all have seen over the course of the last several decades with this survey and analysis of education programs and the trends that you've seen happening in the profession, are there any significant things that you see on the horizon of directions that we would maybe want to pay attention to or any significant changes that you see happening in the way things are going in the field based on these trends that you all have analyzed?

Les Sweeney:

There's two things I think about. One is if you watch the news, listen to podcasts, all this stuff, I don't think AI is coming to replace massage therapy. That's the good news. I don't think we've figured out a way to do that. I do wonder if there's a role for it in education.

Whitney Lowe:

For sure.

Les Sweeney:

I think there will be.

Whitney Lowe:

As the education technology guy, I'm going to say yes.

Les Sweeney:

Yeah, I think there should be and I think there will be. I think that what we'll see, the big picture, part of the reason we're talking is what's the trend line look like for schools and enrollments? I think it's going to keep coming back a little bit, but if it's at 23,000 or whatever the number was, I don't think it's ever going to get to 40,000 unless something materially changes in terms of what the... Even if there are and there certainly are in employer environments right now, especially in the franchises. So, there's better part of 1,500, 2,000 employers of massage just in the big four franchises. They're not all made the same. They're franchises. Some of the franchise owners I've had members tell me are the greatest thing since sliced bread. Some of them think they're terrible bosses.

Here's a little secret. I've been managing people for 30 years. Some people think I'm a pretty good boss. I'm sure there are a handful of other people that don't think so. That's data. There's the distribution here, but even those who work for the most enlightened and progressive, thoughtful bosses, the massage is still hard work. So, there is still a constraint or a limit to what people can realistically do and therefore earn and therefore it manages. The good news is we get people who love this work. People aren't in it just for a quick buck. They're in it because they love it, and that's what makes it special. I do think we'll see more. I think I've been surprised at the level of demand, but consumer demand is good. I think it's indicative of the income inequality as a society as a whole.

I think people can afford it. Who can afford it do it. We haven't figured out a way to get it to more people who can't afford it. So, I don't know if I see something changing other than I think we'll continue to hopefully give people the opportunity to have access to it and help those who are doing the work continue to do the work. Because one of the things that I worry about is that we interact with our members on a daily basis and we reach out to members whose membership has expired. One of the things I've noticed is that I'm calling more people who are older than me. I'm getting older. I'm 56. I want to make sure that we have the next generation of therapists who fall in love with this and do all the good work.

So many in the generation that's come up from the last 30 years have done so much good work in the field. I want to make sure we have the next generation of those, whether they're the thought leaders or the practitioners or both. We need to continue to make sure that it's never going to be easy. Massage therapy is never going to be easy. You can get better at it. You can be more efficient. You can hone your body mechanics, but I got a massage recently. I was in California, met this wonderful lady, she was in her early 60s, and she's like, "I love doing it, but she's like, "Basically, I'm running out of hands here." So there's no getting around the fact that unless we eliminate people from the equation, which I think would be the worst case scenario, it's always going to be a challenge.

It's always going to be really hard to find the right people who do want to do the work. It's like teachers, whether it's elementary school or middle school or whatever, those people are doing the Lord's work. It's never going to be easy to find teachers. It's never going to be easy to find qualified massage therapists who care because this is the road less traveled, this is the harder work, but that's what makes it special and that's what makes those people special. So, my job, turn it back to our view is how do I grease the skids for those people? How do I make it a little bit easier for them to be a massage therapist and like what they do? Well, that's what we do. That's our job. I always explain to our staff, I'm like, "I have 80,000 bosses and we're here to make their life easier."

Whitney Lowe:

Right. Yeah. Well, one thing I just want to say is that your dedication to that vision of doing things for the members is something that shows through with the organization. I just want to say it's noticed by all of us out there. Thank you again for all the work that you've done over the years with ABMP for the profession of trying to make sure that people get the best experience, both the clients consuming it and the practitioners who are out here doing the work. So, we certainly appreciate that.

Les Sweeney:

Well, I appreciate the nice thoughts and likewise back at you for all you've done for this field in working with us. Whether you would admit it or not, I know you would because that's not who you are, but you're on the Mount Rushmore. I hope you know that. I've got a good deal. It's not South Dakota, it's North Dakota, but I got this nice area that I'm working on. I've got some staff with chisels and we're out there working. I haven't revealed the other ones yet, but you're definitely up there.

Whitney Lowe:

Okay. All right. Well, thank you, Les, again so much. Les Sweeney, President of ABMP. Les, thanks so much for joining us here on The Thinking Practitioner today.

Les Sweeney:

Loved it. Thanks so much, Whitney.

Whitney Lowe:

Great, and thank you all for joining us here on The Thinking Practitioner, where Books of Discovery has been a part of massage therapy education for over 20 years. Thousands of schools around the world teach with their textbooks, eTextbooks and digital resources, books of Discovery, likes to say learning adventures start here. They see that same spirit here on The Thinking Practitioner Podcast and are proud to support our work knowing we share the mission to bring the massage and bodywork community enlivening content that advances our profession. You can check out their collection of e-textbooks and digital learning resources for pathology, kinesiology, anatomy, physiology at booksofdiscovery.com, where thinking practitioner listeners can save 15% by entering the word "thinking" at checkout.

So, thank you all so much for stopping by and listening with us today. You can stop by our sites for the video, show notes, transcripts, and any extras. You can find that over on my site at academyofclinicalmassage.com and then over on till site at advancedtrainings.com. If you have questions, comments, or anything you'd like to hear us, talk about please, just drop us a short email info at thethinkingpractitioner.com. Or you can look for us on social media under our names. You can rate us on Apple Podcasts as it does help other people find the show. We certainly do appreciate that. You can hear us on Spotify, Stitcher, Google Podcast, Podbean, or wherever else you happen to listen. So, please do share the word and tell a friend. Once again, thanks so much for listening and we'll see you the next time.



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