January 11, 2024 • 35 mins
Massage therapy in BC is changing with the recent announcement of a new practice standard for RMTs, evidence-based practice. With the College of Massage Therapists of British Columbia (CMTBC) charting a bold new direction, I discuss how the adoption of this new standard come January 2024 could transform the professional landscape for therapists. With an enhanced focus on patient-centered care and focusing on the use of relevant research evidence, this should allow for a staunch rejection of pseudoscientific approaches that have lingered in the field for far too long. Join me, as we explore the commitment to integrating research, patient perspectives, and therapists' expertise, reshaping the definition of what practice competence could look like in our industry.
With the EBP new standards, this signals a departure from the old guard, mandating a clinical practice underpinned by robust research and continuous professional development. I share insights on the essential role of up-to-date research in shaping treatment plans that truly benefit the patient, not the bottom line. This episode highlights the surge of accountability as therapists are now expected to perpetually sharpen their knowledge and skills with a deep dive into evidence-based educational resources.
In a candid reflection, I recount my journey as an educator and the lessons I have learned from moving beyond outdated practice narratives. As we wrap up, I extend a warm invitation to all listeners to join the conversation on evidence-based practice, with a commitment to nurturing a community where professionals can confidently implement these progressive approaches. .
Head on over to my website. This includes a list of all my upcoming courses, webinars, self-directed learning opportunities as well as some helpful learning resources.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:12):
Hello and welcome to another episode of Purvist
Versus.
My name is Eric Purvis.
I'm a massage therapist coursecreator, continuing education
instructor, curriculum advisorand general advocate for all
things evidence based in themassage, manual and movement
therapy professions.
This episode is going tofeature a discussion on the
CMTVC's new standard of practice, on evidence based practice,
(00:34):
and we're looking to see whatthat means for us as a
profession in not just ourclinical environment but also in
our new quality assurancerequirements.
So I hope you enjoy thisepisode and if you do like it,
please share it on all yoursocial media platforms or you
can check us out on YouTube byjust searching Purvist Versus.
Alright, so this episode I'mreally excited about, actually,
(00:57):
because it's just going to be meagain just a solo episode.
In the future we will have somemore episodes with some guests.
I have a bunch of thoserecorded for you and I'm looking
forward to those, and I have abunch more planned for 2024.
But for this one today, Iwanted to talk a little bit
about something that just cameout in BC, and this is, I think,
(01:17):
such a great thing that they'redoing, and I really hope that
other associations and otherregulatory colleges will see the
work that the CMTVC is doingand hopefully they can start to
make similar decisions andsimilar progressions to advance
our profession, to kind of bringus out of the old school 1980s
(01:40):
science and bring us into whatcurrent evidence and best
practices are suggesting.
So just some background Forthose people that aren't
familiar with this.
The CMTVC recently came out witha new standard of practice and
this one is calledevidence-based practice, and
that's the new standard.
So for those of you that aren'tfamiliar with what does the
(02:01):
standard of practice mean?
Well, from the website, justreading word for word on the
CMTVC's website, it sayspractice standards define the
minimum level of expectedperformance for registered
massage therapists and thereforedefine what constitutes safe,
ethical and competent deliveryof care by RMTs.
And when I read this it'sactually funny, because one
(02:23):
thing I do notice is that itused to say effective delivery,
and I don't know when theychanged that, but it used to be
safe, ethical and effective.
Now it just says competent.
I don't know if there's somelegal rationale for that, but I
thought that's something worthmentioning.
It says here also, to expand onthat, that RMTs are responsible
for exercising theirprofessional development to
apply the standards to thesituations that they face in
(02:45):
practice, and this newevidence-based practice standard
of practice will go into effectJanuary 15, 2024.
So I'm assuming that as of thatday, january 15, there's going
to be some requirements for RMTsto abide by what this practice
suggests, and I'm going to gointo a little more details about
(03:07):
what this might look like forour continuing education, as
well as for how we practice andthe way that we practice and
interact with our patients orclients, depending on where you
look and BC patients is what theterm does.
So I'm just going to just giveme a minute here, as I'm just
going to bear with me for aminute here, as I'm just going
to read what this says.
(03:28):
So it says the definitionEvidence-based practice is an
approach to professionalpractice that integrates
information from four areas tosupport an RMT in providing safe
, ethical and competent care topatients.
An RMT incorporates anevidence-based practice approach
during all aspects of massagetherapy care, including, but not
(03:50):
limited to, assessment,treatment, patient education and
home care, by integrating thefollowing Research evidence
specific to the condition beingtreated or approached to
treatment.
This context, including RMT'sscope of practice, is defined by
the massage therapist'sregulation patient perspective,
(04:10):
so including the patient'svalues, experiences, preferences
, expectations and concerns andthe RMT's own knowledge, skills
and experience, which includesinformation obtained by an RMT
in practice through theassessment of outcomes in the
practice setting.
And it goes on to say that anevidence-based practice requires
RMTs to critically assess allinformation, focusing on facts
(04:34):
and observations rather thanbeliefs, opinions and traditions
.
In massage therapy.
Evidence-based practice alsorequires that RMTs are
responsive to new knowledgethroughout their career.
Once an RMT is collected andassessed information from all
sources, they are then taskedwith integrating the information
to inform their clinicaldecision making.
(04:56):
When integrating information,rmts must consider the impact
that the application of theinformation will have on an
individual patient.
Now that's a lot of words, but Iwant to just break that down a
little bit just to kind of makesome sense and highlight where I
think this is really reallygood.
And the one thing I want to saythat's really really good with
this is that previously, for thelast few years, the CMTBC was
(05:20):
using a evidence-informedpractice.
That was the term that theywere using, rather than
evidence-based.
I think that thisevidence-informed practice
definition, which is kind of ait's not a well-recognized term
in the kind of healthcare world,but it was developed or is
first used in Ontario, the CMTObrought in an evidence-informed,
(05:42):
and it was kind of like what wewould call like evidence-based
light or kind of like awatered-down evidence approach,
because what it did is it seemedthat the evidence-informed the
way it was worded kind of feltlike it could allow some
pseudosciences to make its wayinto the evidence or into the
(06:05):
clinic, which is something thatwe don't want, also to
evidence-informed.
When you look at the researchand you look at how many papers
are written out there that useevidence-based versus
evidence-informed, and youactually dissect the difference
between the two, it is actuallynot as subtle as some people
might think.
The evidence-based has beenused for a long time.
(06:25):
It's a little more rigid interms of its definitions,
whereas evidence-informed israther vague.
What I would do want to say,though, is that I think it takes
a lot of courage and a lot ofwillpower to stand up and say no
, we're going to useevidence-based.
Thank you for the CMTBC fortaking a stand and going with a
(06:48):
term and a definition that isconsistent within the healthcare
world.
I think that's fantastic when welook at this, the way they're
describing evidence-based andthis is something I just want
listeners to be mindful of, ifyou're not sure aware of this
already is that evidence-basedpractice doesn't mean you're
(07:09):
just Reciping the research.
It's not about just looking atevidence and following a script.
It's not.
That's a very commonmisunderstanding or
misinterpretation ofevidence-based practice.
We're using the evidence Tohelp inform our clinical
decision-making, but we're usingthe evidence as a way to
(07:32):
provide.
You know what's.
What's it mean when someonecomes like what's the best
practices for someone with lowback pain?
What's the best practice forsomebody with rotator cuff
surgical repair?
What's the best practices for,like, an acute strain or sprain?
These kind of things like theevidence is going to give you
what the data suggests isprobably the least wrong answer.
(07:54):
But what we also have tounderstand about evidence-based
practice is that there's the.
Your clinical expertise ishighly valuable.
Now, your clinical expertise itdoesn't explain mechanisms, it
doesn't tell you why people gotbetter with your intervention,
but it gives you an idea that,like when I've seen this before
and I've done this thing withpeople, they tend to get better.
(08:16):
So your clinical expertise ispart of the evidence based
practice framework and also, too, we got a.
We have to put the patientfirst right.
So the the patient perspective,including the patient's values,
experiences, preferences,expectations and concerns are
also part of evidence-basedpractice and I would say that's
(08:37):
probably the biggest part of itthe patient.
It's patient-centered care,person-centered care.
What does the person want, need, expect?
We use their goals, theirexpectations, and then we use
our clinical experience,combined with the research on
their presentation, to try tocome up with a clinical decision
(08:59):
to provide a treatment planthat works best for them.
So that's a very brief outlineof what evidence-based practice
is, something we probably a lotof us do already, but we might
not always Be sure about theevidence-based the evidence part
, the research evidence part andthat's what I like about what
(09:20):
they've done here is they talkabout relevant research evidence
specific to the presentation,and this is the part I think
that that I like the most is itsays that an evidence-based
practice Requires RMT tocritically assess all
information focusing on factsand observations rather than
beliefs, opinions and traditions, and massage therapy.
(09:43):
This is huge, because most of usthat pay attention to this
things, this information, or payattention to what's going on in
our industry, realize that thevast majority of the curriculum
that's being taught out there,the vast majority of Continuing
education courses that out there, are based on beliefs, opinions
(10:04):
and traditions Rather than whatthe evidence suggests.
And this, I think, is a problem, because what's happening is
we're just kind of passing onknowledge From generation to
generation without really muchchange If I talked to somebody
that went to massage school 20or 30, 40 years ago versus what
a lot of the grads are learningnow, obviously some schools are
(10:24):
doing better job than others.
The information is kind ofstill the same.
It's still very much a lot ofmyths, a lot of beliefs, a lot
of assumptions that are made,but there's no evidence to
support it.
If you look at some of thecommon ones which I can counter,
all the time on my courses Ialways do this kind of skeptical
hour.
I ask people, give people anopportunity to ask me questions
(10:45):
about what are some things thatyou you're not so sure about.
Things that come up all thetime are things like increasing
circulation, about the dangersof massaging the lower limb of
pregnant ladies, the, the risksof massaging people with cancer.
There's all kinds of thingsthat people have about the
different modalities and howthey work and the stories behind
(11:06):
them, and these are things thatare based on beliefs,
traditions, the way thingsalways have been, rather than
based on science and thesethings are still being taught
and perpetuated in the school.
So this is, I think, a verystrongly worded statement where
it's now a standard of practice,where the RMT has to focus on
facts and observations ratherthan beliefs, opinions and
(11:27):
traditions.
This is huge.
Now if this is going to gettranslated into the curriculums,
that is a wait-and-see thing,but I'm optimistic that this is
a first step in the rightdirection.
Now, that is the definition.
Now I'm going to give youthere's kind of four
requirements that the CMTBC haslaid out.
The first one is it says an RMTincorporates a patient-centered
(11:48):
and evidence-based practiceapproach to massage therapy
practice when providing massagetherapy services, by integrating
the following Now, first thingI want to say is I'm so happy
that they used patient-centered.
I don't know if this is I'dhave to take a look and see what
the other regulated healthcareprofessions are saying and doing
but the fact that it sayspatient-centered to me is
(12:10):
amazing.
I love that so much.
Big bias to mine, but I thinkit's great that they have that
in there.
So that's one.
And one A says research evidencespecific to the condition being
treated or approached totreatment.
So you're looking for researchon the condition.
I mentioned that before.
Is this a low back or surgicalor sprain strain?
Is it somebody that's got a Lor statin locer or some
(12:31):
hypermobility?
Is it somebody that's got sometype of pelvic pain condition?
What is it?
Is it rotator cuff?
Is it whiplash?
Whatever it might be?
So it's specific, which I thinkis fantastic.
It says the person.
The RMT also incorporatesincludes practice context, the
patient values and they usetheir own clinical knowledge and
(12:52):
skills.
So that's the requirement.
That's requirement one.
Requirement two says an RMTincorporates an evidence-based
practice approach to supportclinical decision making when
determining an appropriatetreatment plan for an individual
patient.
This is nothing treatmentplanning.
What is optimum treatmentplanning?
This is something I too, Idon't think is well taught and
(13:14):
well understood in ourprofession as much as it should
be.
Is a treatment plan?
Somebody is coming in everyweek forever, probably in some
cases maybe, depending on theperson.
But that if your treatment planis just to maximize how many
times people come in and see youfor treatment, I would say
that's probably not a goodtreatment plan that's working in
(13:34):
the person's best interest allthe time.
Obviously, some people maybehave some chronic conditions and
they benefit from ongoingmassage.
We're not talking about that.
We're talking about people thatjust kind of being sold.
You've got to keep coming inbecause I'm going to prevent you
from injury.
I'm going to.
You know, if you don't keepcoming in, things are going to
build up and you're going to getinjured and you're going to
(13:55):
fall apart and you're going tobreak that type of approach.
And I see that all the time inclinic.
People tell me these thingsthat they've been told by other
healthcare providers.
That is not evidence-based andthat's not appropriate treatment
planning.
Now number three it says an RMTtakes reasonable steps to remain
up to date on research evidenceto support an evidence-based
(14:17):
practice.
It is now a requirement forRMTs to remain up to date on
research evidence.
Now, for those of you that arefamiliar with the competency
documents, it actually does sayin the competency documents that
massage therapists have to beevidence-based.
But it really had no teethbefore.
It says that in the competencydocuments, but you can still
practice and not know any of theevidence and there's been no
(14:43):
recourse for it.
So now and this is a standardit's up to massage therapists to
be mindful of the research.
Now, this doesn't mean you haveto read 10,000 research papers.
This doesn't mean you need tostart subscribing to
professional journals.
This just means that you shouldstart small by paying attention
to some research, some clinicalpractice guidelines or some
(15:05):
systematic reviews,meta-analyses for specific
populations, fibromyalgia,geriatrics, osteoarthritis, neck
pain, shoulder pain,generalized chronic pain,
systemic inflammatory diseases.
You can go online right now andGoogle any of those things in
Google Scholar and you will findevidence that you can read to
(15:28):
give you some less wrong ideasof what you should and shouldn't
do with those populations.
So it's not as scary as itshould be, or as it could be, I
should say, for some people.
And this is number four, thistalks about an RMT engages in
learning activities that A areinformed by research evidence.
This is huge.
(15:49):
A lot of people out there claimthat their things are informed
by research evidence, but justbecause something might have
some anatomical connection tosome body part doesn't mean that
treating that helps with theperson's pain or doesn't mean
(16:09):
that the stories that are taughtby these structural
interventions and thesestructural approaches are
evidence-based.
So it's going to be up to RMTsand RMT educators and continuing
education providers to be moreaware of what your research that
you're using actually means andwhat it's actually saying.
(16:29):
And for B it says present anRMT engages in learning
activities that presentinformation with an RMT scope of
practice.
So that's the same.
We have to stay within ourscope.
And for C it says an RMT engagesin learning activities that are
taught by an instructor orpresenter who holds appropriate
(16:50):
knowledge and expertise toinstruct RMTs in the context of
a regulated health profession.
Now, there's probably a lot ofthis is kind of gray and there's
probably a lot of reasons forthat because they can't be too
prescriptive.
But what I think is great aboutthis is that it's easy to go
(17:11):
out there and teach a course Any.
If you're an RMT and you havesome experience, you can teach
the course.
But what I read but when I lookat this is what I think is I
think, well, you know it'sthere's more emphasis on
instructors now to increasetheir knowledge and to increase
their awareness of evidence,because you now have a
(17:32):
requirement to teach RMTsevidence-based stuff, so you
have to hold appropriateknowledge, and that appropriate
knowledge can't be from atextbook written in the 90s.
This can't be stuff that waspublished 30 years ago.
It can't be from your coursenotes.
This has to be up-to-date stuffand I think this is really,
really, really important, andthis is something that in other
(17:54):
healthcare professions we do seea certain standard that
instructors or presenters need,and because our profession
unfortunately doesn't have anacademic pursuit as part of
something that is available tomost of us.
This does, though, say hey, youknow what?
(18:15):
If you're going to be teachingRMTs, you've got to pull up your
socks, you've got to startlearning more, and you can't
just pass off knowledge becauseyou've learned this in another
course.
I think that is fantastic, andI'm really excited to see what
the next steps are with this.
Like, how is the CMTBC going toenforce this?
(18:37):
Or to they're probably notgoing to enforce it, but how are
they going to make theserequirements have some strength
and, like I said before, havesome teeth?
Now, when this first came out,I, admittedly I probably
received about a dozen emails orDMs through Instagram or
Facebook.
People asking me questionsabout are kind of freaking out
(18:58):
about it.
I think this is a good thing.
I think that we are still, asof today, waiting to hear what
the new quality assuranceprogram looks like, but I am
cautiously optimistic that thisnew standard of practice
evidence-based practice will bevery, very important with their
new quality assurancerequirements for RMTs and BC,
(19:21):
meaning that you are going tonow have to justify and defend
the content that you're using tosatisfy your learning
requirements with something thatis certified or maybe not
certified but is evidence-basedin some way, or not it can be.
It has to say look, this iswhat you've learned.
(19:41):
That doesn't really sound.
It might be consideredsomething that's close to scope
of practice, but it might notsound like there's any evidence
to support that.
So maybe you should.
That's not going to be required.
Maybe you should pursue someother learning opportunities.
I have mixed feelings about thechange of the way that our
(20:03):
continuing education program wasprovided in BC.
I think the old way of justhaving mandatory credits, you
know it was probably not thatgreat because people would just
sign up for things, get theirpiece of paper, submit it and
then maybe they did, theyparticipated in the course or
not.
Maybe they learned something,maybe they didn't.
It was a financial and timeconstraint on a lot of people
(20:26):
that probably didn't always workas well as it was intended.
With the new program and like Isaid, we're still waiting to
hear what that's going to looklike it should hopefully be a
little more flexible, so maybeit will be, courses will be part
of it, but it will hopefully bemore options for people to take
conferences or to engage inother things that move away from
(20:46):
just a specific two-dayworkshop that's worth 14 or 16
credits, as has been thestandard, and that still is the
standard for many healthcareprofessions and massage therapy
associations across the country.
So I'm, like I said, I'm goingto be cautiously optimistic
about what that means forcontinuing education.
Now, probably what matters morethan that is what does this mean
(21:08):
clinically?
So, clinically, what's it mean?
If you have to follow thisevidence-based practice,
standard of practice?
Now my hope is is that you willno longer be allowed to say
stupid things to people that arenot evidence-based.
You could.
We can no longer make claimsfor things based on
pseudoscience, you know, and wecan no longer follow very
(21:34):
outdated structural,patho-anatomical, tissue-based
rationale for everything thatwas taught previously.
Hopefully this means clinicallythat we can still do the same
cool things, the same amazingthings with our hands and get
people moving and rehab andstuff we can.
It's not going to change, Idon't think, a lot of how we
(21:54):
practice in terms of what we do,what our practice looks like
with our hands, but hopefullyit'll change a lot about the
stories and the narratives andthe things that people hear, and
this is something that you know.
When I first started teachingConEd back in 2016, I believe it
was was I did a course and it'sstill my most, probably my most
(22:15):
popular course on chronic painmanagement and that course what
we did is we, you know, spent alot of time and I still do this
in my other courses too.
We spend a lot of timediscussing kind of myths and and
and unhelpful ideas and thepower of the words and the
beliefs that we give to ourpatients, and I don't think that
(22:41):
people realize the potentialnegative outcomes that can
happen when we startcommunicating in ways that don't
really have evidence behindthem.
So a common one is postureright.
The evidence for perfectposture is not strong.
There's no good evidence thatsays you need to have optimum
(23:02):
posture in order to be out ofpain, right?
There's lots of people in veryperfect, straight, completely
upright posture strong core,strong muscles, flexible that
still have pain.
And there's people that haveterrible posture, that slump all
the time and don't have pain.
So the idea of posture as beingcausative or strongly related
to pain is not.
(23:22):
There's very little to noevidence to support that.
Actually, I would say there'sprobably no evidence to support
it.
I think when we look at some ofthe postural evidence stuff, it
actually tells us the opposite.
It says actually, you know what?
People with slumpy postureshave just as much or no pain as
people with very uprightpostures.
I remember reading a thing anumber of years ago about tech
(23:44):
snack and it actually found thatpeople that had more slump and
head forward posture actuallyhad less neck pain than those
people that were super rigid andhad ideal postures.
Don't quote me, don't ask mefor the exact reference for that
.
I could be full of BS, but I'mpretty sure there's something
that was out there that I readthat was similar to that.
(24:06):
Now I'm hoping that what thismeans is that we will now have a
responsibility to be mindful ofthe things that we're saying
and doing.
So maybe there's no evidence tosay that people need to
strengthen their core or thatpeople don't need to get their
shoulders in line with theirears and sit up straight all day
, because the evidence for thosethings are weak.
But maybe we can change, we canflip the script on that and say
(24:30):
, hey, I used to be reallyconcerned about correcting every
raised posture, but maybe now Ican give people some different
options, some different ideas ofhow to sit and stand and move,
rather than having these rigidguidelines of.
This is how I always practice,based on tradition, beliefs and
ideas.
So I think, clinically, this isgonna put more responsibility
(24:53):
on us as a massage therapist tobe mindful of what it is that
we're doing, not so much withour hands, I'm gonna say, but
more about the stories and ideasand beliefs behind what we do.
I'm hoping to see a big changeon this in the coming years as
people start to question theirown biases and beliefs before.
For me, I'm somebody thatquestions my stuff all the time
(25:17):
and if I look back at the way Iused to teach, the way I used to
think, I would say that I Imade a lot of mistakes.
I think a lot of us do but weneed to be mindful of those
mistakes and learn from them andtry and move forward and be
more comfortable with what thescience says.
I also hope to see with thistoo, that when we're looking
(25:38):
clinically is I'm hoping to seepeople stop putting non-evidence
based stuff on their clinicwebsites Things about, like
massage therapy come and see meto correct your postural
imbalances, come see me toincrease your circulation or, to
(25:59):
you know, disengage.
Or, to you know, break down allyour scar tissue and all these
kind of things.
Unless there is evidence outthere to say those things, we
now have an obligation that wecan't and those examples I just
gave you.
There's not evidence to supportthose.
Yet those things are commonlyused on people's websites for
(26:20):
marketing purposes and that'sprobably a topic for actually
another podcast I'd be curiousabout to see do patients,
clients, do they actually lookon your website to see what
techniques you do?
Do they go to your website andlook to see all the things that
you can fix?
I'm not so sure that they do.
(26:44):
In my years as a clinician andthe clinic that I used to be an
owner of, we were very adamantthat we didn't focus on language
, about techniques, or languageon things that we fixed.
But our language is more aboutwhat populations do we serve?
What populations do we haveinterest in?
Are we interested in athletes?
(27:05):
Chronic pain that was my areaof interest, still is an area of
interest of mine, and I find itfascinating to try and
understand chronic pain.
Do we have interest inneurological disorders or do we
have interest in regional thingslike necks and shoulders and
TMJ, focusing more on regionalareas of interest, more on
(27:26):
populations that we like totreat, rather than techniques
and the things that we fix?
I would love it if ourprofession would move towards
that direction, because I wouldsay that is a more
evidence-based approach.
Now it's easy for me to sithere and just talk to whoever is
(27:47):
going to listen about.
You know, these are all theproblems and stuff, but I think
there's room for solutions heretoo.
What I have been advocating forfor years, I feel like it's
finally there might be someinfluence from a stakeholder
probably the most powerfulstakeholder in BC, in the CMTBC
here to advocate for change, forchange to happen.
(28:10):
Now it's still going to be therole of our professional
associations, as well as thenumerous massage schools here in
BC, but as well, if you'relistening to this, in one of the
other 15 countries of peoplethat have downloaded this
podcast over this last year.
There's still room forimprovements there as well.
(28:32):
Now, for me, my way, I havetried to advocate and to change
and to influence in what I seeare positive ways, and our
profession is through the use ofeducation, and my goal from the
very beginning was to try toinfluence the masses by trying
(28:53):
and teaching courses andproviding workshops and
providing communities andenvironments for massage
therapists to learn, for massagetherapists to collaborate and
communicate and to hopefully tryand create a critical mass of
people that are starting to askthose hard questions of the
schools and the stakeholders inthe college, and maybe there's
been enough murmurs that arestarting to reach the people,
(29:19):
the powers that be, the peoplethat make the decision.
So this is great.
Now, the one thing that I havefound other than my courses, I
think the one thing I foundpersonally and professionally to
be the most valuable to massagetherapists has been my manual
and movement therapist community, so the MMTC for short.
(29:39):
I created this back in 2021 andthis was a way for me basically
just to bring a bunch ofthought leaders, educators,
clinicians and researchers alltogether to learn together.
So really, what I found wasthat I was going to conferences.
(29:59):
I've been to lots of conferences, some good, some not good.
Really good ones, san Diego,pain summit, not good ones, I'll
just leave those out, but I'vebeen to some really good ones
and San Diego was the one I gotthe most from, particularly in
the early days when I was reallystarting to get exposed to a
lot of this information, andwhat I found was that expensive
(30:21):
conferences are expensive.
You've got to pay a lot ofmoney to go there because
they're not cheap.
To host hotels, travel you'reeating out every night.
They got to be pricey and itwas not something that everybody
could access.
Maybe you live in a ruralcommunity or you're a one income
household, or whatever might be.
It became hard, it's not easy,for people to access this
(30:44):
information.
Those are things I heard allthe time as I was teaching in my
early days was well, where didyou find this information?
How do you find?
How do you get these papers?
Who do you learn from?
And it kind of planted a seedin my head that I should one day
maybe create a community whereI can.
It's gonna be like a one stophub where people can come and
(31:04):
learn from the individuals thatI feel have a lot of value, and
so when I created the MMTC backin 2023, it was the idea of
bringing like leaders andthought leaders in the
profession to you so you couldaccess it virtually on a private
(31:25):
course page without having toleave the comfort of your home,
and that was kind of the mainidea behind it.
And what I do every year forthis is I do a big push for it
in January.
So by the time you're listeningto this, if you listen to this
in January or January 31st iswhen I close the doors.
But what you get in thecommunity is in the last three
(31:47):
years is I've accumulated over65 hours of content from over 30
different presenters, and ofthese presenters there's a
million different topics.
I've got some world leadingresearchers Tasha Stanton's in
there, melanie Knowles in there,melissa Farmer was in there,
(32:09):
and these are kind of some ofthe academics I've had in this
year, in 2024.
I have a couple other academicsand then one of them being
Peter Stillwell, who some of youmight know, and I have one
other researcher from AustraliaI'm just keep my fingers crossed
, just waiting to getconfirmation that he will be
presenting and then also, on topof that, I have a lot of
clinicians and people that havea lot of clinical and practical
(32:31):
experience and providinginformation on tons of different
topics, everything fromhypermobility spectrum disorders
to working with people in grief, to palliative care, to cancer
care, to working with peoplewith pelvic and low back pain,
shoulder pain.
(32:53):
We've done stuff on movement andexercise and how to do dosing
for those.
There's a million differenttopics that are on here.
We even have people on BringComing and Telling their patient
stories.
So these are actual patientadvocates.
So people that live with healthconcerns have come in and
presented on their story, ontheir journey and some of the
(33:14):
research that they've done.
So there's a little bit ofeverything for everybody here.
I love this community.
It has been fantastic to meetand learn from so many different
fantastic people, as well as tosee the community grow steadily
over the year.
So if this is something thatyou are interested in, this is
kind of my big push to gettingpeople access to good quality,
(33:35):
evidence-based content is insidethe manual movement therapist
community.
So if you're interested in yourlistening to this podcast, you
can send me a message hello atericperviscom.
You can message me on Instagramor Facebook at ericpervisrmt,
or you can just go to my website, ericperviscom, and click on
(33:58):
courses online courses and youcan see the link there to
register.
What I'm doing this year, whichI haven't done in previous years
, is I'm actually givingeverybody the option of testing
it out for free.
I know the economy and life isexpensive these days, so I
wanted to give people an optionto check it out before you have
to pay.
(34:18):
So if you, once you log in, youcan use the coupon code
MMTCfree and check it out forfree.
See if this is something youwanna do.
But I'm happy to answer anyquestions, so please don't
hesitate to reach out to me.
I did wanna say also a big thankyou to those people that
listened to my last episode andreached out to me.
(34:39):
Thank you very much for that.
It was good to know who waslistening and that you enjoyed
the podcast.
So thank you to everybody thatdid that.
So that's it for this episode.
If you are listening and you dohave questions about
evidence-based practice, whatthat means and what this might
mean for you as a clinician,again please reach out to me.
(35:02):
I'm happy to answer yourquestions and try and turn you
in the right direction so youcan help to advance your career
and learn more about bestpractices for whatever it is
that might interest you.
So thanks to everybody forbeing here today.
I appreciate your time anduntil next time, take care.
Hello and welcome to another episode of Purvist
Versus.
My name is Eric Purvis.
I'm a massage therapist coursecreator, continuing education
instructor, curriculum advisorand general advocate for all
things evidence based in themassage, manual and movement
therapy professions.
This episode is going tofeature a discussion on the
CMTVC's new standard of practice, on evidence based practice,
(00:34):
and we're looking to see whatthat means for us as a
profession in not just ourclinical environment but also in
our new quality assurancerequirements.
So I hope you enjoy thisepisode and if you do like it,
please share it on all yoursocial media platforms or you
can check us out on YouTube byjust searching Purvist Versus.
Alright, so this episode I'mreally excited about, actually,
(00:57):
because it's just going to be meagain just a solo episode.
In the future we will have somemore episodes with some guests.
I have a bunch of thoserecorded for you and I'm looking
forward to those, and I have abunch more planned for 2024.
But for this one today, Iwanted to talk a little bit
about something that just cameout in BC, and this is, I think,
(01:17):
such a great thing that they'redoing, and I really hope that
other associations and otherregulatory colleges will see the
work that the CMTVC is doingand hopefully they can start to
make similar decisions andsimilar progressions to advance
our profession, to kind of bringus out of the old school 1980s
(01:40):
science and bring us into whatcurrent evidence and best
practices are suggesting.
So just some background Forthose people that aren't
familiar with this.
The CMTVC recently came out witha new standard of practice and
this one is calledevidence-based practice, and
that's the new standard.
So for those of you that aren'tfamiliar with what does the
(02:01):
standard of practice mean?
Well, from the website, justreading word for word on the
CMTVC's website, it sayspractice standards define the
minimum level of expectedperformance for registered
massage therapists and thereforedefine what constitutes safe,
ethical and competent deliveryof care by RMTs.
And when I read this it'sactually funny, because one
(02:23):
thing I do notice is that itused to say effective delivery,
and I don't know when theychanged that, but it used to be
safe, ethical and effective.
Now it just says competent.
I don't know if there's somelegal rationale for that, but I
thought that's something worthmentioning.
It says here also, to expand onthat, that RMTs are responsible
for exercising theirprofessional development to
apply the standards to thesituations that they face in
(02:45):
practice, and this newevidence-based practice standard
of practice will go into effectJanuary 15, 2024.
So I'm assuming that as of thatday, january 15, there's going
to be some requirements for RMTsto abide by what this practice
suggests, and I'm going to gointo a little more details about
(03:07):
what this might look like forour continuing education, as
well as for how we practice andthe way that we practice and
interact with our patients orclients, depending on where you
look and BC patients is what theterm does.
So I'm just going to just giveme a minute here, as I'm just
going to bear with me for aminute here, as I'm just going
to read what this says.
(03:28):
So it says the definitionEvidence-based practice is an
approach to professionalpractice that integrates
information from four areas tosupport an RMT in providing safe
, ethical and competent care topatients.
An RMT incorporates anevidence-based practice approach
during all aspects of massagetherapy care, including, but not
(03:50):
limited to, assessment,treatment, patient education and
home care, by integrating thefollowing Research evidence
specific to the condition beingtreated or approached to
treatment.
This context, including RMT'sscope of practice, is defined by
the massage therapist'sregulation patient perspective,
(04:10):
so including the patient'svalues, experiences, preferences
, expectations and concerns andthe RMT's own knowledge, skills
and experience, which includesinformation obtained by an RMT
in practice through theassessment of outcomes in the
practice setting.
And it goes on to say that anevidence-based practice requires
RMTs to critically assess allinformation, focusing on facts
(04:34):
and observations rather thanbeliefs, opinions and traditions
.
In massage therapy.
Evidence-based practice alsorequires that RMTs are
responsive to new knowledgethroughout their career.
Once an RMT is collected andassessed information from all
sources, they are then taskedwith integrating the information
to inform their clinicaldecision making.
(04:56):
When integrating information,rmts must consider the impact
that the application of theinformation will have on an
individual patient.
Now that's a lot of words, but Iwant to just break that down a
little bit just to kind of makesome sense and highlight where I
think this is really reallygood.
And the one thing I want to saythat's really really good with
this is that previously, for thelast few years, the CMTBC was
(05:20):
using a evidence-informedpractice.
That was the term that theywere using, rather than
evidence-based.
I think that thisevidence-informed practice
definition, which is kind of ait's not a well-recognized term
in the kind of healthcare world,but it was developed or is
first used in Ontario, the CMTObrought in an evidence-informed,
(05:42):
and it was kind of like what wewould call like evidence-based
light or kind of like awatered-down evidence approach,
because what it did is it seemedthat the evidence-informed the
way it was worded kind of feltlike it could allow some
pseudosciences to make its wayinto the evidence or into the
(06:05):
clinic, which is something thatwe don't want, also to
evidence-informed.
When you look at the researchand you look at how many papers
are written out there that useevidence-based versus
evidence-informed, and youactually dissect the difference
between the two, it is actuallynot as subtle as some people
might think.
The evidence-based has beenused for a long time.
(06:25):
It's a little more rigid interms of its definitions,
whereas evidence-informed israther vague.
What I would do want to say,though, is that I think it takes
a lot of courage and a lot ofwillpower to stand up and say no
, we're going to useevidence-based.
Thank you for the CMTBC fortaking a stand and going with a
(06:48):
term and a definition that isconsistent within the healthcare
world.
I think that's fantastic when welook at this, the way they're
describing evidence-based andthis is something I just want
listeners to be mindful of, ifyou're not sure aware of this
already is that evidence-basedpractice doesn't mean you're
(07:09):
just Reciping the research.
It's not about just looking atevidence and following a script.
It's not.
That's a very commonmisunderstanding or
misinterpretation ofevidence-based practice.
We're using the evidence Tohelp inform our clinical
decision-making, but we're usingthe evidence as a way to
(07:32):
provide.
You know what's.
What's it mean when someonecomes like what's the best
practices for someone with lowback pain?
What's the best practice forsomebody with rotator cuff
surgical repair?
What's the best practices for,like, an acute strain or sprain?
These kind of things like theevidence is going to give you
what the data suggests isprobably the least wrong answer.
(07:54):
But what we also have tounderstand about evidence-based
practice is that there's the.
Your clinical expertise ishighly valuable.
Now, your clinical expertise itdoesn't explain mechanisms, it
doesn't tell you why people gotbetter with your intervention,
but it gives you an idea that,like when I've seen this before
and I've done this thing withpeople, they tend to get better.
(08:16):
So your clinical expertise ispart of the evidence based
practice framework and also, too, we got a.
We have to put the patientfirst right.
So the the patient perspective,including the patient's values,
experiences, preferences,expectations and concerns are
also part of evidence-basedpractice and I would say that's
(08:37):
probably the biggest part of itthe patient.
It's patient-centered care,person-centered care.
What does the person want, need, expect?
We use their goals, theirexpectations, and then we use
our clinical experience,combined with the research on
their presentation, to try tocome up with a clinical decision
(08:59):
to provide a treatment planthat works best for them.
So that's a very brief outlineof what evidence-based practice
is, something we probably a lotof us do already, but we might
not always Be sure about theevidence-based the evidence part
, the research evidence part andthat's what I like about what
(09:20):
they've done here is they talkabout relevant research evidence
specific to the presentation,and this is the part I think
that that I like the most is itsays that an evidence-based
practice Requires RMT tocritically assess all
information focusing on factsand observations rather than
beliefs, opinions and traditions, and massage therapy.
(09:43):
This is huge, because most of usthat pay attention to this
things, this information, or payattention to what's going on in
our industry, realize that thevast majority of the curriculum
that's being taught out there,the vast majority of Continuing
education courses that out there, are based on beliefs, opinions
(10:04):
and traditions Rather than whatthe evidence suggests.
And this, I think, is a problem, because what's happening is
we're just kind of passing onknowledge From generation to
generation without really muchchange If I talked to somebody
that went to massage school 20or 30, 40 years ago versus what
a lot of the grads are learningnow, obviously some schools are
(10:24):
doing better job than others.
The information is kind ofstill the same.
It's still very much a lot ofmyths, a lot of beliefs, a lot
of assumptions that are made,but there's no evidence to
support it.
If you look at some of thecommon ones which I can counter,
all the time on my courses Ialways do this kind of skeptical
hour.
I ask people, give people anopportunity to ask me questions
(10:45):
about what are some things thatyou you're not so sure about.
Things that come up all thetime are things like increasing
circulation, about the dangersof massaging the lower limb of
pregnant ladies, the, the risksof massaging people with cancer.
There's all kinds of thingsthat people have about the
different modalities and howthey work and the stories behind
(11:06):
them, and these are things thatare based on beliefs,
traditions, the way thingsalways have been, rather than
based on science and thesethings are still being taught
and perpetuated in the school.
So this is, I think, a verystrongly worded statement where
it's now a standard of practice,where the RMT has to focus on
facts and observations ratherthan beliefs, opinions and
(11:27):
traditions.
This is huge.
Now if this is going to gettranslated into the curriculums,
that is a wait-and-see thing,but I'm optimistic that this is
a first step in the rightdirection.
Now, that is the definition.
Now I'm going to give youthere's kind of four
requirements that the CMTBC haslaid out.
The first one is it says an RMTincorporates a patient-centered
(11:48):
and evidence-based practiceapproach to massage therapy
practice when providing massagetherapy services, by integrating
the following Now, first thingI want to say is I'm so happy
that they used patient-centered.
I don't know if this is I'dhave to take a look and see what
the other regulated healthcareprofessions are saying and doing
but the fact that it sayspatient-centered to me is
(12:10):
amazing.
I love that so much.
Big bias to mine, but I thinkit's great that they have that
in there.
So that's one.
And one A says research evidencespecific to the condition being
treated or approached totreatment.
So you're looking for researchon the condition.
I mentioned that before.
Is this a low back or surgicalor sprain strain?
Is it somebody that's got a Lor statin locer or some
(12:31):
hypermobility?
Is it somebody that's got sometype of pelvic pain condition?
What is it?
Is it rotator cuff?
Is it whiplash?
Whatever it might be?
So it's specific, which I thinkis fantastic.
It says the person.
The RMT also incorporatesincludes practice context, the
patient values and they usetheir own clinical knowledge and
(12:52):
skills.
So that's the requirement.
That's requirement one.
Requirement two says an RMTincorporates an evidence-based
practice approach to supportclinical decision making when
determining an appropriatetreatment plan for an individual
patient.
This is nothing treatmentplanning.
What is optimum treatmentplanning?
This is something I too, Idon't think is well taught and
(13:14):
well understood in ourprofession as much as it should
be.
Is a treatment plan?
Somebody is coming in everyweek forever, probably in some
cases maybe, depending on theperson.
But that if your treatment planis just to maximize how many
times people come in and see youfor treatment, I would say
that's probably not a goodtreatment plan that's working in
(13:34):
the person's best interest allthe time.
Obviously, some people maybehave some chronic conditions and
they benefit from ongoingmassage.
We're not talking about that.
We're talking about people thatjust kind of being sold.
You've got to keep coming inbecause I'm going to prevent you
from injury.
I'm going to.
You know, if you don't keepcoming in, things are going to
build up and you're going to getinjured and you're going to
(13:55):
fall apart and you're going tobreak that type of approach.
And I see that all the time inclinic.
People tell me these thingsthat they've been told by other
healthcare providers.
That is not evidence-based andthat's not appropriate treatment
planning.
Now number three it says an RMTtakes reasonable steps to remain
up to date on research evidenceto support an evidence-based
(14:17):
practice.
It is now a requirement forRMTs to remain up to date on
research evidence.
Now, for those of you that arefamiliar with the competency
documents, it actually does sayin the competency documents that
massage therapists have to beevidence-based.
But it really had no teethbefore.
It says that in the competencydocuments, but you can still
practice and not know any of theevidence and there's been no
(14:43):
recourse for it.
So now and this is a standardit's up to massage therapists to
be mindful of the research.
Now, this doesn't mean you haveto read 10,000 research papers.
This doesn't mean you need tostart subscribing to
professional journals.
This just means that you shouldstart small by paying attention
to some research, some clinicalpractice guidelines or some
(15:05):
systematic reviews,meta-analyses for specific
populations, fibromyalgia,geriatrics, osteoarthritis, neck
pain, shoulder pain,generalized chronic pain,
systemic inflammatory diseases.
You can go online right now andGoogle any of those things in
Google Scholar and you will findevidence that you can read to
(15:28):
give you some less wrong ideasof what you should and shouldn't
do with those populations.
So it's not as scary as itshould be, or as it could be, I
should say, for some people.
And this is number four, thistalks about an RMT engages in
learning activities that A areinformed by research evidence.
This is huge.
(15:49):
A lot of people out there claimthat their things are informed
by research evidence, but justbecause something might have
some anatomical connection tosome body part doesn't mean that
treating that helps with theperson's pain or doesn't mean
(16:09):
that the stories that are taughtby these structural
interventions and thesestructural approaches are
evidence-based.
So it's going to be up to RMTsand RMT educators and continuing
education providers to be moreaware of what your research that
you're using actually means andwhat it's actually saying.
(16:29):
And for B it says present anRMT engages in learning
activities that presentinformation with an RMT scope of
practice.
So that's the same.
We have to stay within ourscope.
And for C it says an RMT engagesin learning activities that are
taught by an instructor orpresenter who holds appropriate
(16:50):
knowledge and expertise toinstruct RMTs in the context of
a regulated health profession.
Now, there's probably a lot ofthis is kind of gray and there's
probably a lot of reasons forthat because they can't be too
prescriptive.
But what I think is great aboutthis is that it's easy to go
(17:11):
out there and teach a course Any.
If you're an RMT and you havesome experience, you can teach
the course.
But what I read but when I lookat this is what I think is I
think, well, you know it'sthere's more emphasis on
instructors now to increasetheir knowledge and to increase
their awareness of evidence,because you now have a
(17:32):
requirement to teach RMTsevidence-based stuff, so you
have to hold appropriateknowledge, and that appropriate
knowledge can't be from atextbook written in the 90s.
This can't be stuff that waspublished 30 years ago.
It can't be from your coursenotes.
This has to be up-to-date stuffand I think this is really,
really, really important, andthis is something that in other
(17:54):
healthcare professions we do seea certain standard that
instructors or presenters need,and because our profession
unfortunately doesn't have anacademic pursuit as part of
something that is available tomost of us.
This does, though, say hey, youknow what?
(18:15):
If you're going to be teachingRMTs, you've got to pull up your
socks, you've got to startlearning more, and you can't
just pass off knowledge becauseyou've learned this in another
course.
I think that is fantastic, andI'm really excited to see what
the next steps are with this.
Like, how is the CMTBC going toenforce this?
(18:37):
Or to they're probably notgoing to enforce it, but how are
they going to make theserequirements have some strength
and, like I said before, havesome teeth?
Now, when this first came out,I, admittedly I probably
received about a dozen emails orDMs through Instagram or
Facebook.
People asking me questionsabout are kind of freaking out
(18:58):
about it.
I think this is a good thing.
I think that we are still, asof today, waiting to hear what
the new quality assuranceprogram looks like, but I am
cautiously optimistic that thisnew standard of practice
evidence-based practice will bevery, very important with their
new quality assurancerequirements for RMTs and BC,
(19:21):
meaning that you are going tonow have to justify and defend
the content that you're using tosatisfy your learning
requirements with something thatis certified or maybe not
certified but is evidence-basedin some way, or not it can be.
It has to say look, this iswhat you've learned.
(19:41):
That doesn't really sound.
It might be consideredsomething that's close to scope
of practice, but it might notsound like there's any evidence
to support that.
So maybe you should.
That's not going to be required.
Maybe you should pursue someother learning opportunities.
I have mixed feelings about thechange of the way that our
(20:03):
continuing education program wasprovided in BC.
I think the old way of justhaving mandatory credits, you
know it was probably not thatgreat because people would just
sign up for things, get theirpiece of paper, submit it and
then maybe they did, theyparticipated in the course or
not.
Maybe they learned something,maybe they didn't.
It was a financial and timeconstraint on a lot of people
(20:26):
that probably didn't always workas well as it was intended.
With the new program and like Isaid, we're still waiting to
hear what that's going to looklike it should hopefully be a
little more flexible, so maybeit will be, courses will be part
of it, but it will hopefully bemore options for people to take
conferences or to engage inother things that move away from
(20:46):
just a specific two-dayworkshop that's worth 14 or 16
credits, as has been thestandard, and that still is the
standard for many healthcareprofessions and massage therapy
associations across the country.
So I'm, like I said, I'm goingto be cautiously optimistic
about what that means forcontinuing education.
Now, probably what matters morethan that is what does this mean
(21:08):
clinically?
So, clinically, what's it mean?
If you have to follow thisevidence-based practice,
standard of practice?
Now my hope is is that you willno longer be allowed to say
stupid things to people that arenot evidence-based.
You could.
We can no longer make claimsfor things based on
pseudoscience, you know, and wecan no longer follow very
(21:34):
outdated structural,patho-anatomical, tissue-based
rationale for everything thatwas taught previously.
Hopefully this means clinicallythat we can still do the same
cool things, the same amazingthings with our hands and get
people moving and rehab andstuff we can.
It's not going to change, Idon't think, a lot of how we
(21:54):
practice in terms of what we do,what our practice looks like
with our hands, but hopefullyit'll change a lot about the
stories and the narratives andthe things that people hear, and
this is something that you know.
When I first started teachingConEd back in 2016, I believe it
was was I did a course and it'sstill my most, probably my most
(22:15):
popular course on chronic painmanagement and that course what
we did is we, you know, spent alot of time and I still do this
in my other courses too.
We spend a lot of timediscussing kind of myths and and
and unhelpful ideas and thepower of the words and the
beliefs that we give to ourpatients, and I don't think that
(22:41):
people realize the potentialnegative outcomes that can
happen when we startcommunicating in ways that don't
really have evidence behindthem.
So a common one is postureright.
The evidence for perfectposture is not strong.
There's no good evidence thatsays you need to have optimum
(23:02):
posture in order to be out ofpain, right?
There's lots of people in veryperfect, straight, completely
upright posture strong core,strong muscles, flexible that
still have pain.
And there's people that haveterrible posture, that slump all
the time and don't have pain.
So the idea of posture as beingcausative or strongly related
to pain is not.
(23:22):
There's very little to noevidence to support that.
Actually, I would say there'sprobably no evidence to support
it.
I think when we look at some ofthe postural evidence stuff, it
actually tells us the opposite.
It says actually, you know what?
People with slumpy postureshave just as much or no pain as
people with very uprightpostures.
I remember reading a thing anumber of years ago about tech
(23:44):
snack and it actually found thatpeople that had more slump and
head forward posture actuallyhad less neck pain than those
people that were super rigid andhad ideal postures.
Don't quote me, don't ask mefor the exact reference for that
.
I could be full of BS, but I'mpretty sure there's something
that was out there that I readthat was similar to that.
(24:06):
Now I'm hoping that what thismeans is that we will now have a
responsibility to be mindful ofthe things that we're saying
and doing.
So maybe there's no evidence tosay that people need to
strengthen their core or thatpeople don't need to get their
shoulders in line with theirears and sit up straight all day
, because the evidence for thosethings are weak.
But maybe we can change, we canflip the script on that and say
(24:30):
, hey, I used to be reallyconcerned about correcting every
raised posture, but maybe now Ican give people some different
options, some different ideas ofhow to sit and stand and move,
rather than having these rigidguidelines of.
This is how I always practice,based on tradition, beliefs and
ideas.
So I think, clinically, this isgonna put more responsibility
(24:53):
on us as a massage therapist tobe mindful of what it is that
we're doing, not so much withour hands, I'm gonna say, but
more about the stories and ideasand beliefs behind what we do.
I'm hoping to see a big changeon this in the coming years as
people start to question theirown biases and beliefs before.
For me, I'm somebody thatquestions my stuff all the time
(25:17):
and if I look back at the way Iused to teach, the way I used to
think, I would say that I Imade a lot of mistakes.
I think a lot of us do but weneed to be mindful of those
mistakes and learn from them andtry and move forward and be
more comfortable with what thescience says.
I also hope to see with thistoo, that when we're looking
(25:38):
clinically is I'm hoping to seepeople stop putting non-evidence
based stuff on their clinicwebsites Things about, like
massage therapy come and see meto correct your postural
imbalances, come see me toincrease your circulation or, to
(25:59):
you know, disengage.
Or, to you know, break down allyour scar tissue and all these
kind of things.
Unless there is evidence outthere to say those things, we
now have an obligation that wecan't and those examples I just
gave you.
There's not evidence to supportthose.
Yet those things are commonlyused on people's websites for
(26:20):
marketing purposes and that'sprobably a topic for actually
another podcast I'd be curiousabout to see do patients,
clients, do they actually lookon your website to see what
techniques you do?
Do they go to your website andlook to see all the things that
you can fix?
I'm not so sure that they do.
(26:44):
In my years as a clinician andthe clinic that I used to be an
owner of, we were very adamantthat we didn't focus on language
, about techniques, or languageon things that we fixed.
But our language is more aboutwhat populations do we serve?
What populations do we haveinterest in?
Are we interested in athletes?
(27:05):
Chronic pain that was my areaof interest, still is an area of
interest of mine, and I find itfascinating to try and
understand chronic pain.
Do we have interest inneurological disorders or do we
have interest in regional thingslike necks and shoulders and
TMJ, focusing more on regionalareas of interest, more on
(27:26):
populations that we like totreat, rather than techniques
and the things that we fix?
I would love it if ourprofession would move towards
that direction, because I wouldsay that is a more
evidence-based approach.
Now it's easy for me to sithere and just talk to whoever is
(27:47):
going to listen about.
You know, these are all theproblems and stuff, but I think
there's room for solutions heretoo.
What I have been advocating forfor years, I feel like it's
finally there might be someinfluence from a stakeholder
probably the most powerfulstakeholder in BC, in the CMTBC
here to advocate for change, forchange to happen.
(28:10):
Now it's still going to be therole of our professional
associations, as well as thenumerous massage schools here in
BC, but as well, if you'relistening to this, in one of the
other 15 countries of peoplethat have downloaded this
podcast over this last year.
There's still room forimprovements there as well.
(28:32):
Now, for me, my way, I havetried to advocate and to change
and to influence in what I seeare positive ways, and our
profession is through the use ofeducation, and my goal from the
very beginning was to try toinfluence the masses by trying
(28:53):
and teaching courses andproviding workshops and
providing communities andenvironments for massage
therapists to learn, for massagetherapists to collaborate and
communicate and to hopefully tryand create a critical mass of
people that are starting to askthose hard questions of the
schools and the stakeholders inthe college, and maybe there's
been enough murmurs that arestarting to reach the people,
(29:19):
the powers that be, the peoplethat make the decision.
So this is great.
Now, the one thing that I havefound other than my courses, I
think the one thing I foundpersonally and professionally to
be the most valuable to massagetherapists has been my manual
and movement therapist community, so the MMTC for short.
(29:39):
I created this back in 2021 andthis was a way for me basically
just to bring a bunch ofthought leaders, educators,
clinicians and researchers alltogether to learn together.
So really, what I found wasthat I was going to conferences.
(29:59):
I've been to lots of conferences, some good, some not good.
Really good ones, san Diego,pain summit, not good ones, I'll
just leave those out, but I'vebeen to some really good ones
and San Diego was the one I gotthe most from, particularly in
the early days when I was reallystarting to get exposed to a
lot of this information, andwhat I found was that expensive
(30:21):
conferences are expensive.
You've got to pay a lot ofmoney to go there because
they're not cheap.
To host hotels, travel you'reeating out every night.
They got to be pricey and itwas not something that everybody
could access.
Maybe you live in a ruralcommunity or you're a one income
household, or whatever might be.
It became hard, it's not easy,for people to access this
(30:44):
information.
Those are things I heard allthe time as I was teaching in my
early days was well, where didyou find this information?
How do you find?
How do you get these papers?
Who do you learn from?
And it kind of planted a seedin my head that I should one day
maybe create a community whereI can.
It's gonna be like a one stophub where people can come and
(31:04):
learn from the individuals thatI feel have a lot of value, and
so when I created the MMTC backin 2023, it was the idea of
bringing like leaders andthought leaders in the
profession to you so you couldaccess it virtually on a private
(31:25):
course page without having toleave the comfort of your home,
and that was kind of the mainidea behind it.
And what I do every year forthis is I do a big push for it
in January.
So by the time you're listeningto this, if you listen to this
in January or January 31st iswhen I close the doors.
But what you get in thecommunity is in the last three
(31:47):
years is I've accumulated over65 hours of content from over 30
different presenters, and ofthese presenters there's a
million different topics.
I've got some world leadingresearchers Tasha Stanton's in
there, melanie Knowles in there,melissa Farmer was in there,
(32:09):
and these are kind of some ofthe academics I've had in this
year, in 2024.
I have a couple other academicsand then one of them being
Peter Stillwell, who some of youmight know, and I have one
other researcher from AustraliaI'm just keep my fingers crossed
, just waiting to getconfirmation that he will be
presenting and then also, on topof that, I have a lot of
clinicians and people that havea lot of clinical and practical
(32:31):
experience and providinginformation on tons of different
topics, everything fromhypermobility spectrum disorders
to working with people in grief, to palliative care, to cancer
care, to working with peoplewith pelvic and low back pain,
shoulder pain.
(32:53):
We've done stuff on movement andexercise and how to do dosing
for those.
There's a million differenttopics that are on here.
We even have people on BringComing and Telling their patient
stories.
So these are actual patientadvocates.
So people that live with healthconcerns have come in and
presented on their story, ontheir journey and some of the
(33:14):
research that they've done.
So there's a little bit ofeverything for everybody here.
I love this community.
It has been fantastic to meetand learn from so many different
fantastic people, as well as tosee the community grow steadily
over the year.
So if this is something thatyou are interested in, this is
kind of my big push to gettingpeople access to good quality,
(33:35):
evidence-based content is insidethe manual movement therapist
community.
So if you're interested in yourlistening to this podcast, you
can send me a message hello atericperviscom.
You can message me on Instagramor Facebook at ericpervisrmt,
or you can just go to my website, ericperviscom, and click on
(33:58):
courses online courses and youcan see the link there to
register.
What I'm doing this year, whichI haven't done in previous years
, is I'm actually givingeverybody the option of testing
it out for free.
I know the economy and life isexpensive these days, so I
wanted to give people an optionto check it out before you have
to pay.
(34:18):
So if you, once you log in, youcan use the coupon code
MMTCfree and check it out forfree.
See if this is something youwanna do.
But I'm happy to answer anyquestions, so please don't
hesitate to reach out to me.
I did wanna say also a big thankyou to those people that
listened to my last episode andreached out to me.
(34:39):
Thank you very much for that.
It was good to know who waslistening and that you enjoyed
the podcast.
So thank you to everybody thatdid that.
So that's it for this episode.
If you are listening and you dohave questions about
evidence-based practice, whatthat means and what this might
mean for you as a clinician,again please reach out to me.
(35:02):
I'm happy to answer yourquestions and try and turn you
in the right direction so youcan help to advance your career
and learn more about bestpractices for whatever it is
that might interest you.
So thanks to everybody forbeing here today.
I appreciate your time anduntil next time, take care.
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