S1E3: Playing Well With Others

Cal and Cathy welcome Beth Rosenthal and Dale Healey to talk about collaboration and true integrative care. It's about connecting practitioners and sharing resources. It's about knowing each other as people so we can advocate for other professions and have them advocate for ours.

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Show Links

https://integrativehealth.org/

ACIH Hospital Based Massage Therapy (HBMT) Competencies for Optimal Practice in Integrated Environments

For more information about the development of these competencies:

Hospital Based Massage Therapy (HBMT) Competencies Discussion (September 2016) https://integrativehealth.org/hbmt_competencies

Hospital Based Massage Therapy (HBMT) (September 2016) https://integrativehealth.org/hbmt-ewg-cwg

Hospital Based Massage Therapy https://integrativehealth.org/s/poster_hbmt_050516_ICIMH.pdf

AIHM | Body, mind, spirit, community and planet: https://aihm.org/

About Our Guests:

Dale Healey is the dean of the College of Health and Wellness at Northwestern Health Sciences University. He received his BS in Human Anatomy and his DC degree from Parker College of Chiropractic, and his PhD in Organizational Leadership, Policy and Development from the University of Minnesota. He is a Commissioner for the Commission on Massage Therapy Accreditation. He serves as vice-chair of the Academic Collaborative for Integrative Health (ACIH). He co-chairs the ACIH Education Working Group and serves on the task force for development of competencies for hospital-based massage therapy competencies.

Beth Rosenthal holds MBA and PhD degrees from the University of Chicago’s Graduate School of Business, and a Masters degree in Public Health from the University of California, Berkeley. Rosenthal is author of Replenish: A life enhancing activity book and It’s That Easy: The High Vibe Guide to Attracting what You Really Want. As Academic Collaborative for Integrative Health (ACIH) Director at the Academy of Integrative Health & Medicine (AIHM), Rosenthal coordinates efforts of educators in the Integrative Health and Medicine fields to advance team-based integrative care. She lives in Chicago, San Diego, and Charlevoix (Michigan) throughout the year, and enjoys dancing wherever she is! http://www.bethannerosenthal.com/

About Interdisciplinary:

In this podcast, massage therapy educators, practitioners and positive deviants Cathy Ryan, RMT and Cal Cates, LMT will use research, science, experience and humor to explore the broad landscape of health care through a truly interdisciplinary lens. We will be joined by compassionate, self-aware humans who are actively participating or are interested in participating in interdisciplinary care to have honest, uncomfortable conversations about topics like access, racism, death, ageism, ableism, and equity that address the intersection of being a human being and providing quality care, so that we can expand our impact, confidently navigate new challenges, and together create lasting, sustainable changes in health care. You’ll always learn something. You’ll always laugh and you’ll come away better informed and with real things you can do in your own community and practice to create a more compassionate and collaborative system of care for all humans.

Transcript

Cal Cates 0:14

Welcome to this latest episode of Interdisciplinary. In this podcast, massage therapy educators, practitioners, and positive deviants Cathy Ryan RMT and me, Cal Cates LMT, will use research, science, experience, and humor to explore the broad landscape of healthcare through a truly interdisciplinary lens. We'll have honest, uncomfortable conversations about topics like access, racism, death, ageism, ableism, all the isms, and equity that address the intersection of being human and providing quality care. You'll always learn something, you'll always laugh, and you'll come away better informed, and with real things you can do in your own community and practice to create a more compassionate and collaborative system of care for all humans. So Cathy, are you ready for for this week's pun, to get us rolling in?

Cathy: Oh, I'm so ready, my friend. Let that one fly.

Cal: Alright, so today's pun is not exactly just a pun, it's kind of a life hack. I want to just let you know that you can't trust atoms. I mean, they make up everything. Hum, gee. So Cathy Ryan, how is it going in the Canada?

Cathy Ryan 1:31

Um, a collective sigh of relief? We're feeling more of a sense of hope, I think like, perhaps some Americans are as well. And yeah, so there's that, and then there is COVID. It is real, it's still happening. We're starting to see the numbers stabilize a bit here in BC. So for a while then, we saw the big surge, and now it's starting to level off again, and even come down a bit, but still wearing masks, washing hands, staying away from people other than ones right in my household. So that's how it's going here. How are you, my friend?

Cal Cates 2:16

Yeah, well, it's similar here. I mean, I did hear this morning on the news that some communities feel like they're starting to see the downturn, that they feel that they have maybe hit the spike, and that they're headed downward. But, you know, we also, I just saw a friend of mine who is in her mid 70s and she said that what she's hearing in her circles is that, because of this sort of mutant version of COVID that is not really different except that it's more contagious, it's being recommended that people wear two masks. And so that's a whole nother debate. But honestly, the thing that I I really just want to comment on is how I didn't even understand how harmful and traumatizing it was to have the truth of this continually denied until I saw those 400 luminaries on the National Mall that were put there to commemorate and to remember that 400,000 people have died from this virus or related complications of this virus and that we've really been being told for the last year that this isn't happening. And it was this really, it was a surprise relief like when I got my first vaccine shot, like I just sort of all these things in my body just relaxed, and I was like, right, like, it is true. I'm not crazy. You know, I've been believing it. I have friends who are frontline providers and I've been in hospitals working with people who are treating people with COVID, and I've known and believed it's real this whole time, but to have this very visible display of "No, America, this is for real." And not only is it for real, we're going to honor the people who've died, but we're going to do something about it. And we're going to do something massive and collective. And I just, yeah, now I'm feeling the trauma of the denial of it in a way that I wasn't before that happened. So I do, I hope that, that the plans that the administration is going to put into place really do make the vaccine widely accessible, and that we do see a different, a different world by the summer. You know, it still doesn't address the issues. We've mentioned many times that there are millions of people who are probably years away slash will never have access, because of the state of their country or because of their socioeconomic status, and that is some of the work that we will still need to do. And, you know, as excited as I am about the new administration, you get like 36 hours to relax. And then it's back to work. You know, like if we become complacent, we will lose the momentum that is, you know, this hope and this possibility. So I'm really excited to have our two guests join us today because they are definitely part of the solution and just bright lights in their own regard. So, without further ado, we'll welcome Beth Rosenthal and Dale Healey. And, Beth, why don't you start and tell us who you are and why do we want to hear from you?

Beth Rosenthal 5:18

Well, thank you so much. It's, we're, we're both really excited to be on this podcast with you, so thank you for the invite, and this opportunity to talk with you. I am the director of the Academic Collaborative for Integrative Health. And I think, I think I'll give my bio and then Dale, after you give your bio, we'll release our announcement news. How does that sound?

Dale Healey 5:44

Sounds good.

Beth Rosenthal 5:44

We'll build up a little suspense. Because.. Yeah, we have a little announcement that many of you may know of, but still, it's exciting for us. So to continue on my about me, I am the Director of the Collaborative. And my educational background is I have a Master's in Public Health from University of California, Berkeley, I have an MBA and PhD from the University of Chicago Graduate School of Business. I have a passion for wellness and wellbeing and making care, caring, having good health care be available and accessible to all. And by healthcare, I'm really including all the social determinants of health. That's language that I didn't have when I was first getting into this field, I just did it because I wanted to feel better and I wanted to help other people feel better from what I had been learning. I had health challenges as a child so that made this desire for wellness and wellbeing really at the forefront for me. And this is how I, this is one of the ways I'm expressing it. I'm also an author and I've written books about how to use self care tools in your daily life. One of them is "It's That Easy: The High Vibe Guide to What You Really Want" and "Replenish". I don't remember the whole title now but it's like a workbook for good living. So helps you, helps you use the tools. And by being in the integrative health and medicine field, I feel like I'm really helping move forward things I believe in to enhance people's wellbeing and planetary wellbeing. So that's just me, a short thing and we'll probably talk about more as we go along. But that's a start.

Cal Cates 7:33

Excellent, thank you.

Dale Healey 7:35

Thanks, Beth.

Cal Cates 7:36

Dale, you're on.

Dale Healey 7:36

Yeah, so thank you, first of all, for inviting us on. Really appreciate the opportunity to chat with you and to share our story and then a little bit about our, the organization that we're here representing. I am the Vice-Chair of the Academic Collaborative for Integrative Health. I'm, as a board member, and maybe we'll get into this a little bit further into the discussion, but I actually, I represent the Commission on Massage Therapy Accreditation on the Academic Collaborative for Integrative Health. I'm actually the Vice-Chair for the Commission on Massage Therapy Accreditation. So my day job is with Northwestern Health Sciences University in Bloomington, Minnesota, where I serve as the Dean of the College of Health and Wellness. College of Health and Wellness is, basically it's a collection of health-related programs that don't fit into the other two colleges. Our other two colleges are the College of Chiropractic and College of Acupuncture and Chinese Medicine, which is pretty self-explanatory, but College of Health and Wellness - massage therapy, medical assisting, medical lab tech, medical lab science, radiologic technology, radiation therapy and then our undergrad and post-baccalaureate pre-health programs. So I've been at Northwestern for a little over 18 years. I came to Northwestern to oversee what was then the School of Massage Therapy, which is kind of how I got my start in integrative health education. I started at a small massage therapy school, outside of Salt Lake City, Utah, overseeing a teaching and then overseeing their massage therapy program. So education is my.. my education is in chiropractic. I'm a chiropractor by training but very shortly after graduating from chiropractic school, I kind of stumbled into the education side of thing through massage therapy school, and then expanded that at Northwestern and I love it. I also have a PhD from the University of Minnesota in Organizational Leadership Policy and Development, with a focus in higher education. So, and I guess the only other thing I'll say as far as my back, my bio is I'm one of, and we'll maybe we'll talk more about this too, but I am one of the co-chairs for the Education Working Group within the Academic Collaborative for Integrative Health. Lots of, lots of acronyms and words in there, but we can, we can dive into what all that means. So, thrilled to be here and looking forward to the conversation.

Cal Cates 10:39

Oh, so many places to start. I mean, I, you know, the thing that, I remember meeting you, Beth, like it, maybe even a decade ago at one of the, when it was ACCAHC, and...

Beth Rosenthal 10:51

ACCAHC, that's right. The Academic Consortium for Collaborative and Alternative Health Care, I believe, ACCAHC.

Cal Cates 10:58

That sounds right, yeah.

Beth Rosenthal 10:59

Something like that.

Cal Cates 11:02

Maybe we met at the same event, I can't remember, but I feel like I've known you both for a long time and sort of we, our profession moving forward, if we're talking about the massage profession and really healthcare in general, I feel like we'll really rely on people, like what you just described each of you are and do. You know, we sort of joke that you're sort of like the Swiss Army Knife of providers and influencers, because you've got public health and education. And, you know, Dale, you've got chiropractic as well as massage and sort of the natural overlaps don't get seen when we're in our silos. And, you know, I always, whenever I look at your bio, Dale, I think like, does this guy ever go to the bathroom? You know, talk about that. But, but I wonder also, how much of you know, you have a lot of titles, but I bet there's a lot of overlap in the various things that you do. And so I have like big broad questions but I know you guys have an announcement. So we should maybe we should start with your announcement and go from there.

Dale Healey 12:03

Yeah, don't keep us in suspense.

Beth Rosenthal 12:05

Becuase we can finally talk about it. And super, super excited. And the announcement, which some of your audience may already know but if they don't follow us, they will not know, if this is the first they've heard of our organization, and that is we have merged with the Academy for Integrative Health and Medicine. So this is, this is news, right?

Cal Cates 12:26

That's awesome!

Beth Rosenthal 12:27

This process began in December of 2018 and we talked about it because it's been, we've been in very deep and detailed discussions of, do we want to do this? Why do we want to do this? How would it work? And going back and forth between our respective boards. We have, we had a joint task force composed of members of our board members of their board members of our staff, members of their staff doing the deep, deep deliberations. And going back and forth between our boards, How does this sound? What do you want? What you know, what sounds good? And we came with a memorandum of understanding with which both our board signed in December. We started making the announcement December 28 so this is really hot off the press, and operationalization began January 4. So we still, we still have to sign the legal papers. They're being drawn up now, we expect that to be complete by the end of the month. And a lot will remain the same, because a lot of our working group members and our members of our organizations are asking, well, what does this mean for us? So let me first start by saying it's business as usual, but better. Yeah, access to way more resources, a bigger team, wider visibility. And we can talk about why this is such a great merger for both of our organizations and how it really extends our reach and the synergies. But that is the most exciting news and, when we had originally scheduled this interview, I didn't know when our merger would, if and when it would occur, and when we could talk about it. So I was kind of wanting to schedule the time when I felt we might be able to and so this is hugely exciting for us, because we've been on many discussions where we weren't at liberty to talk about it, because it was still in development. And now we can talk about it. And it's happening, and we're really, really happy.

Cathy Ryan 14:28

We got the scoop, Cal.

Cal Cates 14:30

Yeah, boom.

Beth Rosenthal 14:32

Yeah.

Cal Cates 14:33

Well, and that leads me to ask and I, and I don't know how openly or if there's anything to talk about here, but we at Healwell, we get questions all the time, how do I start a nonprofit and I just tell people don't. You know like, there are enough and they're..

Beth Rosenthal 14:50

Good answer.

Cal Cates 14:51

What you want to do and and you know, if you're starting a nonprofit because you want to say you started it and you're the boss of it, like think about that. And so I'm curious, as I think of these two really formidable organizations, some, somebody had to give up power, some, some lots of somebodies, and lots of like visions about that. And I feel like the conversations we're having on this podcast and in our own organizations and in how do we right the world, people have to be willing to give up power to create useful things. And so how I mean, can you say anything about that dynamic in all of this?

Beth Rosenthal 15:29

Yeah, I think we both can, because Dale's on the board, so I'll just start as a member of the joint task, I'm a member of the joint task force as well. And Dale's a member of our board, so Dale can speak to his perspective on that. But I think you hit on one of the main tensions, and this is an organization that is built on passion. It's done a lot, it's, it filled a need that had not been filled and so can we merge into another organization and keep everything that's important to us and our decision making and that we will be, we will be intact, we will be a business unit within the Academy, our board will become a council. So we are doing our best to address that but of course, we are losing some, some decision making, where we will now have to make sure we're aligned with the Academy's broader vision. We will have three board members from the collaborative unit on the Academy board. So we're doing everything we can to anticipate and address that, but that is a very real issue and fear and challenge of how do we maintain everything we've worked so so hard to maintain? Dale, did you want to add anything?

Dale Healey 16:47

Sure

Beth Rosenthal 16:48

From your perspective on that?

Dale Healey 16:49

Sure. I think I mean, I guess I would start by saying, I mean, there's a huge amount of trust that has to go into something like this. I mean, we didn't just meet the folks from the Academy the other day, and, you know, go through our, you know, papers and say this might make sense. You know, these are individuals that we've developed relationships with over the years, we've attended their conferences, they've participated in our gatherings and such, and so we have that deep trust that is so essential in this In spite of that, you know, there have been, at the board level, you know, questions and discussions about well, what about our budget? You know, we want to have control of our budget, and what about our board, our board has to stay intact, and I could, you could sense kind of this, you know, this hesitancy because of the passion that these people have, that everyone has and the energy that we have around changing the world. It's, we're hesitant to give that up. But with that trust and understanding who these people are and what their mission is, I think we're coming to a point where we realize that the whole will absolutely be more effective, stronger than the sum of its parts. I mean, there's so many elements to this union, that will make the things that we've been trying to accomplish on our own so much easier. I mean, if it works, that's the idea, right? But you're right. I mean, there is this sort of human tendency, this natural tendency to say, ooh, we're giving up some power. And you know, where I've been excited about the conversation is when we're able to shift that com... shift that to, it's not about our power, it's not about my individual power. That's, I mean, that's silly. You know, in a way, when you think about the big picture, the, what matters is the mission. What are we trying to accomplish here? What's it going to take to accomplish this mission? And if we're, if we're so hung up on what we can control and what we're going to get credit for? You know, that's, that's a limiting thought, I guess. And so I feel like we're sort of turning that corner a little bit. But it has been interesting to participate in those conversations and hear those anxieties come to the forefront.

Beth Rosenthal 19:08

Dale, can I, can I jump in and talk about some of the ways we complement each other?

Dale Healey 19:13

Absolutely. Let's hear it.

Beth Rosenthal 19:14

Cal, is that alright if we? Okay. Because it stimulated my thinking, and this is kind of the the broader picture is why would we do this and what are we gaining? And in our organization, the Collaborative, as Dale was saying, we have, we have these working groups. We have education, which Dale is the co-chair, we have a research working group, we have a clinical working group, and these working groups, composed of fabulous volunteers, have developed all these, these papers and products over the years. And then we put them on our website and in these great integrative practice webinars, which we'll put a link to that too. There's a really, really exciting one coming up in February. And then dissemination. Well, we need, we could use a little help with that, and here steps in the Academy and they have great, you know, global reaches, so we can work with them for visibility and dissemination of our, what we've been building in our scholarly academic works that can really help, we hope, help people on the ground. And they also have chapters, regional chapters, so we can, we can really use those to further interprofessional education, interprofessional collaboration, which is what we are designed to do. And we also complement each other because the Collaborative is more of an organization of organizations.

Cal Cates 20:43

Hmm, yeah.

Beth Rosenthal 20:44

And the Academy has primarily clinicians. And so there's just so many ways, and then on a personal level, even though, you know, we're going so nicely on the broad. I will just say, another, another way this, this merger is so healthy for us, is all the administration, administrative tasks that can now be streamlined and taken off of my plate?

Cal Cates 20:44

Yeah

Beth Rosenthal 20:52

So I can tend to programmatic work and our working group projects, and the bigger picture of helping, you know, assisting, being involved with all the things we want to do with our mission, creating a really a system of well being. I have more bandwidth to do that now, instead of overlooking, you know, administrative things that now I can pass along.

Cal Cates 21:34

Absolutely. I mean, that that is huge. Because when you're, if you are the leader of an organization, you're not actually there to manage the administration. You're ostensively, you are a visionary person who can help to hold the mission and vision and lead. And if you're busy with bookkeeping, and you know, just all of the things that go into maintaining an organization, it's hard to focus and to have those ideas and how to move them forward. That's an important point to make.

Dale Healey 22:01

The other thing that occurs to me that, that I'm excited about for this merger is, you know, Beth already mentioned that the the Collaborative is an organization of organizations. The Academy is an organization of clinicians, practitioners. But the other big difference, I think, is that the Academy is... most of those clinicians and, maybe you know more about this than I do, Beth, the numbers and such, but I think most of them are medical doctors, nurses - they're not chiropractors, acupuncturists, and massage therapists, the balance of them anyway. And so I feel like in the, in the complementary and integrative health world, there are organizations on the, not really even sure how to say it, the western side or the allopathic side that are reaching toward, reaching toward us if we can say that I'm using air quotes there with "us" as the integrative health world. And, and then we have organizations like the Collaborative that are made up of massage therapists, acupuncturist, chiropractors, those folks are usually thought of as the integrative health practitioners, and we're reaching out to them, you know, we have something to offer. And there's a few examples of that I can think about there, but but this merger feels like that line between these integrative health practitioners that are reaching one way and the allopathic practitioners who are reaching the other way, it feels like that line is we're not reaching for each other as much anymore. We're closer, that line is blurred, and we're able to share resources and ideas and that just feels like a huge win to me.

Beth Rosenthal 23:44

Yeah, and I will, I will add to that, that they have, the Academy has really done their work. They have a level playing field so well, they, I don't know the statistics, they may have more MDS and DOs than you know than other. They have other integrative professionals in leadership positions like Tabatha Parker ND who is a naturopathic doctor, and they do have our fields represented in, definitely in their membership and in their leadership. And, and still so, our meeting of the lions, as you say, Dale, they've done their work.

Dale Healey 24:21

Yes.

Beth Rosenthal 24:21

So we're not going into any hostile territory. They've already made it a level playing field and welcoming us to, to compliment even more.

Dale Healey 24:32

Absolutely, yeah.

Beth Rosenthal 24:33

Yeah, yeah.

Dale Healey 24:34

Yeah, I don't I certainly don't mean to take anything away from them about the work they've done and such. But that's just, that's how I think they started and they've been, you know, migrating.

Beth Rosenthal 24:42

Yeah.

Dale Healey 24:43

And trying to reach out and get people from our fields in leadership positions and such, and they've had huge success, but I think this is just going to be a huge leap forward in that evolution. I guess, so. Exciting.

Beth Rosenthal 25:01

Here, here's a quote I have from from Tabatha Parker, that the Academy was historically an association of holistic medical doctors and, while the Academy became interprofessional in 2014, merging with the Collaborative, that's us, will formally bring in the licensed integrative health professions and it signals that professional silos are truly coming down. And of course, we're bringing with us also our traditional world medicine and emerging professions and I think, maybe I should take a moment and just explain what the Collaborative is? Do you think that would be useful, Cal?

Cal Cates 25:37

Definitely.

Beth Rosenthal 25:38

Yeah. All right. The Collaborative was founded in 2004, and we represent 20, approximately 20, national integrative health and medicine organizations. We're very much an academic organization, with the councils of colleges, the certifying and testing organizations, the accreditation agencies for the, there's five licensed integrative health and medicine professionals, that means they have a federally recognized accrediting agency, and those are Acupuncture and East Asian Medicine, Chiropractic, Direct Entry Midwifery, Massage Therapy, and Naturopathic Medicine. And then, as I mentioned, we also have organizations representing traditional world medicines and emerging professions and those are, these are professions that are engaged in self regulation, or working towards future licensure. We have individual colleges in those professions that I mentioned, who can be members, and many individuals and organizations who are associate members meaning they support us, and they just want to be part of part of it.

Cal Cates 26:50

Yeah. Well, and I feel like one of the things that you hit on, both in your description of sort of the history of ACIH and also in what will be happening with this merger is that I feel like, I mean, I'm constitutionally cranky about many of these things, and so my, one of my frustrations has always been that integrative has been this sort of, it's been this limiting description of modalities under an umbrella of like, non-mainstream, and it's really a philosophy of care. And so we've had, as you described, you have these, you know, holistic and naturopathic, you have physicians over here who sort of believe in this stuff, whatever it might be, and then you have these people over here who practice this stuff. But there's, there hasn't been this idea that like integrative actually means that we are collaborating actively in the care of individuals, and that multiple people from different disciplines will be providing what is useful from their discipline for this person and that we're sharing our ideas about how to bring this person to the best state of wholeness. And that hasn't happened. And I feel like, we just had our strategic planning retreat at Healwell and we did a pretty big pivot during COVID toward we've always wanted to do and really focus on interdisciplinary education and collaboration. But COVID really gave us a chance because, for six months, we weren't able to touch patients because there wasn't enough PPE. So my board was kind of like, well, wait, so we're not doing massage anymore? And we're like, no, no, no, we're, we're cultivating relationships across this sort of discipline aisle, because the best advocates for other disciplines will always be other disciplines. You know, you can only toot your own horn so loudly. But if you have other practitioners, who are already recognized as essential to care, saying, gosh, you know, if we brought in an acupuncturist, if we brought in a massage therapist, that would really change what it looks like for this person. And that's really how we move forward, I feel like, so it's not a, it's not mission creep at all, it's actually kind of a more efficient way to get there.

Dale Healey 28:58

Absolutely.

Cathy Ryan 28:59

I don't want to miss the opportunity to really highlight one of the things that Dale said about look, I'm not really giving up any power here. Really, the whole point of this is the cause, what we are fighting for, what we are working for. And from my perspective, that is an essence what disciplinary ought to be, that it's not this profession works better or that profession works better, or you should listen to us because you haven't or whatever the case may be. It's about everyone collectively coming to the table and figuring out what it, what best serves the patient. You know, so from my perspective, someone who practices from my very patient-centered perspective, for me, this is exciting because this is what this is speaking to. We have these patients, they need such and such. How can we best achieve their goals or meet their needs?

Dale Healey 29:53

And the language is so important.

Beth Rosenthal 29:55

That's what are many of our..yes, languaging.

Dale Healey 30:00

The point that Cal made about the languaging of it, that this term integrative, and we're struggling with integrative now, it wasn't that long ago, we were struggling with alternative, right? Alternative was the thing for so long. We're alternative, we're alternative to, you know, what other folks are doing and, and such and, and that became that served a purpose at the time. You know, it's sort of that, that's what the situation called for, I think, was that term at the time, but we've evolved past that. And now alternative sounds terrible, right? We don't use alternative anymore. We're not alternative. We're integrative. We want to work with you. But, you know, I've struggled with, you know, every time I say integrative that, when I refer to us as the integrative health professions, it feels awkward to me. Inside my head, I'm like, ehh, we're not the integrative health professions, integrative is the model. We're working together for an integrative model. But then I do struggle with what to call us, know what I mean? What what, what is this other half of this health of the, of the healthcare world? I don't know, that we've we've come up with with the best term. And I think, eventually, there won't be a need for a term because...

Cathy Ryan 31:12

Excellent care.

Dale Healey 31:14

Say it again?

Cathy Ryan 31:17

Excellent care.

Dale Healey 31:19

Sure. That works. But there's excellent care on, on, throughout health care, right? I mean, there's excellent care in the, in the, in the ER, and in the, in the surgical suite and whatnot. So, you know, I think that, hopefully, the day will come that we don't have to call it, call it something else, because it's just healthcare. We're all just working together in this integrative model, we got a massage therapist over here, we got a surgeon over here, we got a dentist over there, we're all bringing our best selves to the table and practicing at the top of our scope. And, and that's that.

Beth Rosenthal 31:52

That's what Adi Haramati used to say too, someday we'll just call it good health care or something like that. So, well noted.

Dale Healey 32:05

I'm in good company if Adi said that.

Beth Rosenthal 32:07

Dale, should I do a bit now?

Dale Healey 32:08

Yep, please.

Beth Rosenthal 32:13

What I, this whole idea of interprofessional education and interprofessional collaboration is so big and so big with us, that's front and center for us. And I'm reminded of something that John Weeks used to say, who was our founding, not our founding, but he was our executive director for a long time.

Cal Cates 32:35

Yeah.

Beth Rosenthal 32:35

And he would say, we practice interprofessional education internally so we can foster it externally. We still are very much like that. We have a balance of professions on our board, on our Executive Committee, in each of our working groups, we've, by policy, we have a balance and certain number of slots for each. We work to fill them all on our projects. So we were very deliberate about that. And the working group projects are designed to have outputs that foster this interprofessional education and/or interprofessional collaboration to reach exactly what we're talking about today. How do all health professions educate their students so that they can understand and respect and work with people in other disciplines, as well as understand and respect patients, being patient centered care, and the languaging... I wrote a paper a quite a while ago, about the integrated, integrative, you know, all these. What, how the way people define it emphasizes what they're going to do. And the idea - let's see, integrative, integrated -oh, we used to see our disciplines referred to as modalities quite often, and maybe that still happens, but I don't see it so much. And that loses the whole context and deep, rich traditions and the wholeness of the paradigm. So I'm, I was glad to hear that mentioned earlier, too. We strive to make sure that we are talking about our disciplines and our professions and, and the collaborative work with the Consortium early on and their definition of integrative or interprofessional, I can't recall what it is now. But they did include practitioners in their definition as a result of comments from us. And so we really like the definition. It might be for integrative medicine, I don't recall.

Cal Cates 34:38

Yeah. Well, and I'm curious as you're talking, I mean, I think about all the work we're doing around social justice and unconscious bias and, and things in a broader sense, and we think about sort of Black/White relations and you know, Asian/Black relations, whatever, but I think we have the same unconscious biases interdisciplinarily. And, you know, massage therapists think these things about doctors, and doctors think these things about acupuncturists and, and I'm curious as we talk about interdisciplinary education and really that kind of collaboration and what we do within the professions to help people understand, right. So you have the the Desk Deference that, gosh, that's probably, what is the first edition is that is eight or 10 years old, that sort of describes them. But again, it's sort of, it tells you this is what a doctor looks like, right? This is what a doctor thinks, this is how a doctor was trained. But how do we get a doctor and a massage therapist sitting at a table saying, oh, yeah, I love Dr. Pepper, too. And, you know, this thing annoys me about the way healthcare happens. And, you know, I have a tiny dog and like, how do we make each other people so that our disciplines and our incorrect assumptions about them don't get in the way as we're trying to collaborate? And I wonder if that's, if that's on the radar at all about how to make this a more effective partnership?

Beth Rosenthal 36:00

Well, I was looking in the CDR of the Desk Reference because, at one point, we had this great table in there from John Weeks about prejudices and what we say and what they say. It was so funny, and so true. If you know, like chemotherapy, what we say about it, poison, with what they might say about it, you know, miracle drug.

Cal Cates 36:23

Right.

Beth Rosenthal 36:23

But, but on both sides, and so that, that's still, that's part of our job to to break down silos and the whole interprofessional education, and it's not easy work. No.

Cal Cates 36:35

Definitely.

Dale Healey 36:36

Yeah, it's, you know, we've talked earlier about the importance of relationships as the two, the two groups coming together and trust and such. And, I mean, it's, it's a lot of, it's a lot of work and it's sort of... You know, it's what you're talking about, Cal, can't really be delivered with a paper or, you know, a manual.

Cal Cates 36:57

Right.

Dale Healey 36:58

You know, one thing we do at Northwestern that we've done for many years is the second year medical students from the University of Minnesota come on campus. At least up until this last year, they came on campus, we did do it virtually this year, but they come on campus to learn about acupuncture and Chinese medicine and they, we set up these tables in the gym, they go from table to table, and they get a needle put in their arm and they, you know experience moxibustion and tuina, and all of those things from acupuncture students. And then we go back into the the auditorium after they've experienced these things and we have a panel. And there's a medical doctor up there and one of our senior acupuncture faculty, and they talk in very, very honest terms. And that's, this is one of the points I want to make is the importance of honesty around this. And we talk about the limitations of acupuncture, we talk about, you know, how we think it can help this and there's evidence for that, but there's not evidence for this, and, and we answer the medical students' questions, and it's very, you know, we're not hitting them over the head with, you know, acupuncture works, you must work with acupuncturists because of this paper, and that paper. It doesn't work, doesn't work, puts up barriers. But if we're able to have an honest conversation and be honest with ourselves, about the limitations of our own professions and be willing to be vulnerable, a little bit vulnerable with that, I think barriers will come down and we'll be able to see each other as, you know, competent practitioners and in our own individual professions and see those opportunities to invite the massage therapist into the hospital, the acupuncturist into the hospital, refer to a surgeon, you know. Those types of, those types of relationships can be built but it takes, it takes, you know, being willing to give up some of that power, as we said earlier, to trust, to be open to it. So and both ways, right?

Cal Cates 39:00

Yeah, definitely. So, you know, I think one of the, one of the challenges I know from our perspective in massage therapy is that I feel constantly like I'm not sure where to put the horse or the cart because I don't want a wholesale welcoming of 360,000 massage therapists into healthcare, because a lot of us are not prepared to make that integrative contribution. And so I, out of, you know, this horn, I'm yelling, gosh, you know, massage therapy could be so valuable in chronic pain management and chronic disease management and so many, we could be saving millions of healthcare dollars. But at the same time, then, I just spend two minutes in like a Facebook massage therapist group and I go, oh, except don't invite these people. From an education standpoint, it's hard to know, how far upstream do we go? How do we, then I imagine this is, there are some conversations and other disciplines that there are massage therapists who will never want to be in those environments? And how do we help them understand that by creating an avenue for that, nobody loses. And that you don't have to come to that party? Just don't stand in front of the door.

Dale Healey 40:19

Yeah. The, you know, my, we won't have, I don't think we'll have time to get into this in a lot of depth but I think you know this, Cal, and certainly you do, Beth, that we, you know, one of my areas of focus that I love is hospital-based massage therapy. And one of the projects, actually, that's come out of the Academic Collaborative is a set of competencies for hospital-based massage therapies, and they can be found on the, on the website, we can give you that that link, you know. Some of some of your listeners may know MK Brennan, the past president of the AMTA, Carolyn Tague, and then Beth also has worked on that project. So I'll say that, I'll put in that plug, but I'll also say, you know, massage therapy, the thing I've said for many years is the blessing and curse of massage therapy it is, that it is so fantastic in so many different environments. You know, I tell potential students, I say what other profession, what other health care profession can you practice, literally, on the beach or in the hospital and everything in between? I mean, it is, it is such a versatile, and people, you know, it tends to be unfortunate, the curse of that is sometimes it tends to be minimized or dismissed because it's everywhere, it's so ubiquitous and in the, in the market. But the twist on that is that the reason it's so popular and the reason it's practiced everywhere is because it works. It has such a tremendous possibility to impact the health and wellness of everyone, right? However, and to your point, Cal, circling back around to this, um, you know, it's the massage therapist that's practicing on the beach may or may not be qualified, based on their background and education, to practice in the hospital. They might be, you know, maybe they've taken some advanced training. And, you know, massage on the beach can be just as beneficial, I guess, in general terms as massage in the hospital. But there is a skill set, there is a specialty to being in the hospital, there's a whole slew of skills and competencies that you need to be effective and to be able to practice responsibly in that environment. So, and I'm sure that applies in some, to some level to the other professions, but I think massage, at least my experience is that that's it, I don't think any of the others have that range, and it's, it's tricky. It creates this identity crisis in massage therapy that shows up so many different ways - accreditation, licensing, levels of training, and you're very familiar with all the debates around each of those topics, Cal, for sure.

Cathy Ryan 43:11

Cal will know this about me, that I'm doing my best not to scream during this conversation. Because Cal knows this is one of the drums that I beat very loud here in Canada. I mean, we have a number of provinces where we do have national standards for education and training. I served on the task force to create the competencies for our entry to practice education and training here in Canada. But one of my issues, you know, one of the things that I've been banging on the door of regulators and associations and anybody who will listen, is that we do not have a pathway for advancement, a standardized pathway for advancements, like in many professions where they can do their Masters, do their PhD, or specialize in a particular area. We cannot specialize, you know, it's not written into our bylaws, there's no, and there's no, there's no standardized pathway for that. So, you know, Dale, the, what you're creating for the hospital-based competencies, I would love to see that happen in a way so exactly that. If someone wants to come in at entry level education and training, and just stick with that and do massage therapy on the beach or... Here in Canada, it's two years of training, it certainly is a lot of anatomy and physiology, all the foundational sciences to do, you know, what I would describe as maybe more clinical work. You're not offending any of my colleagues who work in a spa-type of setting. But give that as a foundation. And then for those who want to go in a different direction or specialize in an area, create advanced education and training competencies. So if we want to work more in the world of oncology, that we have those additional skills and that additional training that will support us so that we can practice in the safe and effective manner within those types of complex pain, complex trauma. You know, I can name a number of specialized populations that would be well served by massage therapists having an avenue for that.

Dale Healey 45:13

100% agree. Yeah, here here. So it's, yeah.

Cathy Ryan 45:18

Can you create that for us, Dale?

Dale Healey 45:20

Sure.

Cal Cates 45:20

Yeah.

Dale Healey 45:20

I'll have to write that up.

Cal Cates 45:22

Dale, um, no, today,

Dale Healey 45:25

I'll work on it this weekend.

Cal Cates 45:26

I, we, excellent. We want to, we have really shifted in the last couple years at Healwell to advocating for massage therapists. Because so much of the research that exists, whether you know, it be out with the public or with healthcare staff, or it's other providers providing a massage-y kind of intervention and, and doing strokes. And I mean, we know that the primary thing we're interacting with, when we're doing massage, is the nervous system. So it's not that these people lack sort of the anatomical knowledge or the, you know, the physiology, but there's a, there is, as we've just alluded to, a set of skills that go with this practitioner, that make your experience of that intervention different. And, you know, I think, we've seen in Australia, they have established some national standards, in Canada... I mean, the US is kind of too big, and I don't know that we'll ever have like sort of a national standard but, something that would allow us to show that sort of advanced level of practice that says, like, these kinds of providers can work with these conditions, or... You know, I think your point about setting is so important, because there are people doing really important clinical work at Massage Envy, and there are people probably doing important clinical work on the beach, you know, where your hands tell you what's under them. It's really useful right here. So I think it's important that we separate those pieces, that it's not about where you practice, it's about what skills and self awareness and things come to bear in you providing whatever the care is you provide.

Dale Healey 45:50

And, you know, I might add, just, you know, just to bring this back to the the broader integrative health world, I think that's going to be a point of tension, as we move forward with these relationships with the, with the Academy and, and the broader healthcare world is scope of practice. I mean, that, you know, the, the acupuncturist and the chiropractors, that's another, that's another example of where this shows up, you know. How, you know, the chiropractors and medical doctors can do a couple hundred hours, depending on your state, of acupuncture training and the patient oftentimes doesn't know the difference. I'm getting needles put in me, you know, and there's acupuncturist that had well over 3000 hours, so they're like, ah, you know, there might be a little bit of a difference there. And so that's, that'll be interesting, too. That will be an interesting piece of this evolution to navigate, I think, for all professions.

Cal Cates 47:55

Absolutely. Well.

Beth Rosenthal 47:56

An important, important thing that we can contribute, because when ACCAHC first began, there was a task force - hotspots, cooling points, something like that, for just these issues, because we are all educators. And the hope was that being an educator, would trump any turf issues you might have to come in and discuss with other educators of different professions. And so yeah, Dale, I appreciate you saying that, because it highlights that that could be an incredible opportunity for us as well to address this tension in in a way that's aligned with all of our values.

Cal Cates 48:35

Yeah, and I think we can bring a lot to bear from the diversity, equity and inclusion world that, you know, just as we have people of color being tokenized right now, as we know, the optics are good to bring people of color onto your boards or your whatever, massage therapists, acupuncturists also get brought on like, see, we have this person. This person has no say in how care is provided, and we sort of like tell them what to do. But look, they're on our team. And you know, I think we really need to take some of the pages from those books and understand what inclusion really means. And that brings us right back around to that who has to give up or at least is perceiving that they're being asked to give up power and how do we gracefully navigate those conversations because that, that, that will be one of the biggest sticking points, I think, of really moving forward as a whole.

Dale Healey 49:22

Very, very good point. Yeah, agreed.

Cathy Ryan 49:27

There's a Janet Travell, the mother of trigger points. There was a great quote that I saw of hers many, many, many years ago, and it has stuck with me and she said what? Who is right doesn't matter, what is right is what matters.

Beth Rosenthal 49:45

Yeah.

Cathy Ryan 49:46

You know, and I think that's a really important thing when we get into these collaborative spaces is to really focus on what, what is needed here. What is the correct way forward, not who comes up with the idea or who is going to be the person leading the charge, whatever the case may be. Let's stay focused on what is the issue and what needs to be done to manage that or fix that or create a better way forward or whatever the case may be.

Dale Healey 50:14

100%, I like that. Yeah, a lot of the work that the task force, the task forces that we participate on, you know, the goal is to eliminate the need for the task force, you know. You accomplish what is right, and therefore, you don't need that power anymore. So that's, I like that, I like that perspective. You know, it's not about my individual power, it's about what I'm trying to, what we're trying to accomplish.

Cal Cates 50:51

Yeah, look what I did - I put myself out of a job.

Dale Healey 50:53

Yeah.

Beth Rosenthal 50:55

Yeah. That's awesome.

Cathy Ryan 50:57

As a massage therapist. I try to do that all the time.

Cal Cates 51:00

Yeah, right. Exactly.

Cathy Ryan 51:02

That means I've done a good job. Exactly.

Cal Cates 51:05

Well, I think we could probably talk to both for hours more, but we, we want people not, you know, driving for hours just to keep listening? Or maybe we do, I don't know. What, what do you want to leave us with? If each of you is willing to take a minute or so to just kind of say, like, this is this is what's important about what we're doing, or this is how people can get involved? What should we know?

Dale Healey 51:28

Ah, I might just, I might just say, the, you know, what I've learned in this journey is just that the, I don't want to use the word power because we've been kind of knocking that, but the ability of an individual to make a difference, you know. I mean, involvement in organizations like the Collaborative or the Academy or, you know, local organizations, you know, the ability of one voice to make a difference and to move this, whether it's diversity, equity, and inclusion in the more traditional sense that we talked about it or the integrative health model that we're trying to move forward, everyone that's listening today has the ability to kind of move that and move the needle on that initiative. And I guess I would encourage folks not to minimize their ability to make a, make a difference. And there's, I feel tremendous hope, I guess, for many reasons today, but particularly around this topic, I'll say.

Beth Rosenthal 52:27

And I'll build on that. Integrative Health Day is coming up January 23. And at the Academy, we're talking about how people can participate in that. And so I would say, on that way of thinking, choose one thing today or right now, that is integrative care to you. Like what is one self-care thing that you know, would help you, that does help you and give yourself five minutes, right now or today, to do that one thing, and you have moved integrative health forward. Because it's cliched because it's true, that it all begins with us, in our relationships, and how we take care of ourselves impacts how we take care of others and our impact in the world. And we at the Collaborative and the Academy, are quite focused on bringing our best selves to our work, collaborating well, and making an impact in the world, world's communities. And we, if exploring our websites - we'll give the websites for the Collaborative and the Academy and the link to the hospital-based massage therapy competencies - if any of that calls to you, then become a supporter, become a member. But at least do something nice for yourself. That's how I'll end.

Cal Cates 54:00

That really does matter. Well, thank you both for being here. I am still Cal Cates, one of the hosts of Interdisciplinary, the healthcare podcast from Healwell, and thank you to Cathy Ryan, my co host.

Cathy Ryan 54:16

And I'm still Cathy Ryan here in British Columbia, major Healwell fan person.

Cal Cates 54:22

Beth and Dale, we'll see you out on the, I don't know, out on the playground, let's call it.

Dale Healey 54:28

Love it. Thank you so much.

Beth Rosenthal 54:29

Thank you so much. We have enjoyed this so much and it's great seeing both of you.

Dale Healey 54:34

Thank you.

Rebecca Sturgeon 54:44

Interdisciplinary is produced by Healwell. Our theme music is by Harry Pickens. You can send us feedback at info@healwell.org, that's info@healwell.org. New episodes will be posted weekly via Apple Podcasts, Spotify, and our Facebook page. Thank you.

Transcribed by https://otter.ai