This paper examined various factors in the development and enhancement of the profession of MT. Stakeholders of MT in British Columbia, Canada, identify research as a particularly important contributor. All stakeholders agree that more research would enhance the profession. Regulators specifically wanted more research on safety although no evidence currently exists to prove MT has serious adverse side effects. This emphasis on safety is understandable given that regulators’ main task is to protect the public. Other stakeholders, including RMTs themselves, are more interested in MT research that examines the efficacy of MT treatments.
Many MTRB participants were not satisfied with current curricula offered in MT colleges regarding research skills. Given the limited research training currently offered in MT colleges, many graduates of MT colleges are unable or unwilling to pursue MT research as a career option over or in combination with clinical practice. This is further exacerbated by the fact that limited funding opportunities for MT research exist across the country and since many RMTs graduate from college with large debts, engaging in clinical practice which is more profitable is often the priority. MT organizations, including colleges and the MTRB, are keen on collaborating with each other to increase the amount of MT research conducted.
Educators clearly stated that they saw research as an important way of advancing the profession but identified four main barriers: 1) faculty do not have the skills to teach research, 2) students are not keen to pursue research as a significant part of their studies, 3) there is very little room in a tight curriculum to incorporate research, 4) the MTRB board examination drives the current curriculum and research is not an important component of the board exam. Time, finances and motivation are additional barriers.
All stakeholders agreed that MT would move forward were their practitioners’ education validated by the conferral of baccalaureate status. Chiropractors and physiotherapists, professions with similar scopes of practice as RMTs, currently earn not only an undergraduate degree but postgraduate degrees which appear to have served them well. Currently MT colleges offer a 3,000 hour program which is more time than a standard university-level bachelor’s degree. If RMT colleges earn degree granting status, adding research to the curriculum will be a condition of this transition. There are two avenues to move toward this goal. The first would be to receive training entirely through a publicly funded university. Currently in British Columbia, trainees in MT at a private college can transfer three years of college credits to a public university towards a degree. However, no degree programs for MT exist and, therefore, individuals interested in pursuing a degree must study at private colleges beforehand. If students attend a public educational institution they are eligible for more loans and scholarships so they could potentially graduate with less debt. The second option would be for privately funded colleges to grant degrees themselves.
In addition to baccalaureate status, research has greatly impacted the advancement of nursing and other “hands-on” therapies such as physiotherapy and chiropractic. The combination of baccalaureate degree status and increased research into the efficacy of nursing, physiotherapy and chiropractic has increased the recognition of these professions as valuable components of healthcare by both their peers and various governments. A similar push is required, and is indeed occurring, in the profession of MT. However, obtaining undergraduate degree status for RMTs’ education has in itself been difficult, as indicated by some MT colleges actively engaged in the process.
MT is not understood by other healthcare professionals and there is an “identity crisis” within the profession. On the one hand, private funders interested primarily in profits, are willing to engage in the commercialization of MT. For example, connecting MT to aesthetic and cosmetic services and other beauty or fashion-oriented businesses is one way of increasing profits in this field. Indeed, one of the MT colleges we interviewed engages in such practices. Another “identity crisis” exists between MT as a medical or as a wellness profession. Insurance companies are keen to fund only medical MT and many RMTs are proponents of MT as a treatment-oriented medical practice. Others believe that MT ought to cover the complete spectrum of healthcare, incorporating wellness, disease prevention and rehabilitation. Agreement on the scope of MT practice has not been reached within or outside the profession. Further adding to this divide is the lack of unity between stakeholders of MT in the province. Acrimony and animosity between stakeholders characterize many relationships in BC’s MT community. These divisions in the MT community have created a lack of leadership and common direction within the profession. The skeptical positions of other healthcare providers, moreover, and governments towards MT create significant barriers to the advancement of this profession.
Besides the internal and external forces that prevent the advancement of this profession is the serious concern, on the part of insurers, that abusive claims occur. Insurers repeatedly noted that illegitimate charges were being made by RMTs.
In this paper we examined various issues related to the advancement of MT. MT is primarily a private healthcare service provided by practitioners who are largely outside the provincial healthcare system and it is misunderstood by other healthcare professionals. Despite these difficulties, British Columbians are increasingly accessing the services of RMTs and, therefore, the demand for RMTs has increased. Future research in this area should examine economic forces at play in the medical marketplace of BC. A study examining the financial and economic environment within which RMTs practice would be helpful to shed light on the larger context. When the profession is able to deal with the internal and external challenges we discuss here it will be able to move forward and be recognized as a significant player in healthcare in the province.